Sustaining Community-University Partnerships: Lessons learned from a participatory research project with elderly Chinese

XinQi Dong
E-Shien Chang
Melissa Simon
Esther Wong


The strength of community-engaged research has been well documented in public health literature. It is recognised as a useful approach for eliminating health disparities by linking research and practice. While the framework of community-engaged research encompasses a broad range of research collaborations, community-based participatory research (CBPR) places most emphasis on involving the community as a full, equitable partner throughout the collaboration. Despite growing interest in and demand for community-university partnerships, less attention is given to the issue of partnership sustainability. The purpose of this article is to present the challenges faced in sustaining a community-university partnership when conducting a CBPR project with an elderly Chinese population in Chicago’s Chinatown. Lessons and strategies learned from the cultural and linguistic complexities of the Chinese community are also detailed. In addition, based on a well-accepted sustainability conceptual framework, we reflect on the initial stage, mid-term actions and long-term goals of developing partnership sustainability. Working with the Chinese community required trust and respect for its unique cultural values and diversity. The cultural, social and environmental contexts within which the partnership operated served as critical forces for long-term sustainability: a culturally sensitive approach is instrumental in sustaining community-university partnership. Also discussed are the significant implications for evidence-based, impact-driven partnerships to develop culturally appropriate strategies to meet the needs of diverse populations.

Community-based participatory research, community health partnerships, health promotion, Chinese Americans, ageing

Full Text:



Alexander, J, Weiner, B, Metzger, M, Shortell, S, Bazzoli, G, Hasnain-Wynia, R, Sofaer, S & Conrad, D 2003, 'Sustainability of collaborative capacity in community health partnerships', Medical Care Research and Review, vol. 60, no. 4, suppl., pp. 130â60s.

Baker, T & Wang, C 2006, 'Photovoice: Use of a participatory action research method to explore the chronic pain experience in older adults', Qualitative Health Research, vol. 16, no. 10, pp. 1405â13.

Barnes, J & Bennett, C 2002, The Asian population: 2000, United States Census 2000.

Bennett, C & Martin, B 1995, The nation's Asian and Pacific Islander population, Bureau of Census.

Blair, T & Minkler, M 2009, 'Participatory action research with older adults: Key principles in practice', The Gerontologist, vol. 49, no. 5, pp. 651â62.

Bryant, E 2002, Sustaining comprehensive community initiatives: Key elements for success, The Finance Project, Washington, DC.

Butterfoss, F, Goodman, R & Wandersman, A 1996, 'Community coalitions for prevention and health promotion: Factors predicting satisfaction, participation, and planning', Health Education Quarterly, vol. 23, no. 1, pp. 65â79.

Calamaro, C 2008, 'Culture competence in research: Research design and subject recruitment', Journal of Pediatric Health Care, vol. 22, no. 5, pp. 329â32.

Carrasquillo, O & Chadiha, L 2007, 'Development of community-based partnerships in minority aging research', Ethnicity and Disease, vol. 17, no. 1, suppl., pp. 3â5s.

Casado, B & Leung, P 2001, 'Migratory grief and depression among elderly Chinese American immigrants', Journal of Gerontological Social Work, vol. 36, nos 1â2, pp. 5â26.

CDC/ATSDR Committee on Community Engagement 1997, Principles of community engagement, Center for Disease Control and Prevention, Public Health Practice Program Office, Atlanta, GA.

Chan, A & Tan, S 2004, Filial piety in Chinese thought and history, Routledge, London.

Chang, E, Simon, M & Dong, X 2010a, 'Integrating cultural humility into health care professional education and training', Advances in Health Sciences Education, in press.

Chang, E, Simon, M, Wong, E, Skarupski, K, Wong, B & Dong, X 2010b, 'You show filial piety to your children: The changing meanings of filial piety among Chinese elderly immigrants', The Gerontologist, vol. 50, suppl. 1, p. 427s.

Chang, E, Simon, M, Wong, E, Wong, B & Dong, X 2010c, 'Depression and loneliness among Chinese older adults: Findings from a Chinese community needs assessment', The Gerontologist, vol. 50, suppl. 1, p. 3s.

Cristancho, S, Garces, D, Peters, K & Mueller, B 2008, 'Listening to rural Hispanic immigrants in the Midwest: A community-based participatory assessment of major barriers to health care access and use', Qualitative Health Research, vol. 18, no. 5, pp. 633â46.

Davies, S & Nolan, M 2003, 'Nurturing research partnerships with older people and their carers: Learning from experience', Quality in Ageing, vol. 4, no. 4, pp. 2â23.

Dong, X, Chang, E, Wong, E & Simon, M, 'Association of depressive symptomatology and elder mistreatment in a U.S. Chinese population: Findings from a community-based participatory research study', Journal of Aggression, Maltreatment and Trauma, in press.

Dong, X, Chang, E, Wong, E, Wong, B & Simon, M 2011a, 'How do U.S. Chinese older adults view elder mistreatment? Findings from a community-based participatory research study', Journal of Aging and Health, vol. 23, no. 2, pp. 289â312.

Dong, X, Chang, E, Wong, E, Wong, B, Skarupski, K & Simon, M 2011b, 'Assessing the health needs of Chinese older adults: Findings from a community-based participatory research study in Chicago's Chinatown', Journal of Aging Research, vol. 3, p. 1242â46.

Doyle, M & Timonen, V 2010, 'Lessons from a community-based participatory research project: Older people's and researchers' reflections', Research on Aging, vol. 32, no. 2, pp. 244â63.

Fisher, T, Burnet, D, Huang, E, Chin, M & Cagney, K 2007, 'Cultural leverage: Interventions using culture to narrow racial disparities in health care', Medical Care Research and Review, vol. 64, no. 5, suppl., pp. 243â83s.

Goldsworthy, T 2010, 'Our progressive spirit has been glad to convene: The presence, residence and jurisprudence of Chinese Americans in antebellum Chicago', Chinese American Museum of Chicago, viewed 1 October, 2010,

Gomez, B, Greenberg, M & Feinberg, M 2005, 'Sustainability of community coalitions: An evaluation of Communities that Care', Prevention Science, vol. 6, no. 3, pp. 199â202.

Green, L & Mercer, S 2001, 'Can public health researchers and agencies reconcile the push from funding bodies and the pull from communities?', American Journal of Public Health, vol. 91, no. 12, pp. 1926â29.

Guo, Z 2000, Ginseng and aspirin: Health care alternatives for aging Chinese in New York, Cornell University Press, Ithaca, NY.

Hart, A & Wolff, D 2006, 'Developing local communities of practice" through local community-university partnerships', Planning, Practice & Research, vol. 21, no. 1, pp. 121â38."

Huff, R & Kline, M 1999, Promoting health in multicultural populations: A handbook for practitioners, Sage, Thousand Oaks, CA.

Institute of Medicine 2008, Retooling for an aging America: Building the health care workforce, The National Academics Press, Washington, DC.

Israel, B 2000, 'Community-based participatory research: Principles, rationale and policy recommendations', Successful Models of Community-Based Participatory Research, Final Report, L O'Fallon, F Tyson & A Dearry (eds), NIEHS/National Institutes of Health, Washington DC, 29â31 March, pp. 16â22.

Israel, B, Coombe, C, Cheezum, R, Schulz, A, McGranaghan, R, Lichtenstein, R, Reyes, A, Clement, J & Burris, A 2010, 'Community-based participatory research: A capacity-building approach for policy advocacy aimed at eliminating health disparities', American Journal of Public Health, vol. 100, no. 11, pp. 2094â102.

Israel, B, Krieger, J, Vlahov, D, Ciske, S, Foley, M, Fortin, P, Guzman, J, Lichtenstein, R, McGranaghan, R, Palermo, A & Tang, G 2006, 'Challenges and facilitating factors in sustaining community-based participatory research partnerships: Lessons learned from the Detroit, New York City, and Seattle Urban Research Centers', Journal of Urban Health: Bulletin of the New York Academy of Medicine, vol. 83, no. 6, pp. 1022â40.

Israel, B, Lichtenstein, R, Lantz, P, McGranaghan, R, Allen, A, Guzman, R, Softley, D & Maciak, R 2001, 'The Detroit Community-Academic Urban Research Center: Development, implementation, and evaluation', Journal of Public Health Management Practice, vol. 7, no. 5, pp. 1â19.

Israel, B, Schulz, A, Parker, E & Becker, A 1998, 'Review of community based research: Assessing partnership approaches to improve public health', Annual Review of Public Health, vol. 19, pp. 173â202.

Kleinman, A, Eisenberg, L & Good, B 1978, 'Culture, illness and care: Clinical lessons from anthropologic and cross-cultural research', Annals of Internal Medicine, vol. 88, pp. 251â56.

Kobetz, E, Menard, J, Diem, J, Barton, B, Blanco, J, Pierre, L, Auguste, P, Etienne, M & Brewster, C 2009, 'Community-based participatory research in little Haiti: Challenges and lessons learned', Progress in Community Health Partnerships: Research, Education, and Action, vol. 3, no. 2, pp. 133â37.

Kreuter, M, Lezin, N & Young, L 2000, 'Evaluating community-based collaborative mechnisms: Implications for practitioners', Health Promotion Practice, vol. 1, pp. 49â63.

Kreuter, M & McClure, S 2004, 'The role of culture in health communication', Annual Review of Public Health, vol. 24, pp. 439â55.

Lam, R, Pacala, J & Smith, S 1997, 'Factors related to depressive symptoms in an elderly Chinese American sample', Clinical Gerontologist, vol. 17, no. 4, pp. 57â70.

Lasker, R & Committee on Medicine and Public Health 1997, Medicine and public health: The power of collaboration, Health Administration Press, Chicago, IL.

Lasker, R & Weiss, E 2003, 'Broadening participation in community problem solving: A multidisciplinary model to support collaborative practice and research', Journal of Urban Health: Bulletin of the New York Academy of Medicine, vol. 80, no. 1, pp. 14â47.

Leung, M, Yen, I & Minkler, M 2004, 'Community-based participatory research: A promising approach for increasing epidemiology's relevance in the 21st century', International Journal of Epidemiology, vol. 33, pp. 499â506.

Li, P, Logan, S & Yee, L 1999, 'Barriers to meeting the mental health needs of the Chinese community', Journal of Public Health Medicine, vol. 21, no. 1, pp. 74â80.

Lindamer, L, Lebowitz, B, Hough, R, Garcia, P, Aguirre, A, Halpain, M, Depp, C & Jeste, D 2009, 'Establishing an implementation network: Lessons learned from community-based participatory research', Implementation Science, vol. 4, pp. 4â17.

Martinez, I, Carter-Pokras, O & Broan, P 2009, 'Addressing the challenges of Latino health research: Participatory approaches in an emergent urban community', Journal of the National Medical Association, vol. 101, no. 9, pp. 908â14.

Minkler, M 2000, 'Using participatory action research to build healthy communities', Public Health Reports, vol. 115, nos 2â3, pp. 191â97.

Minkler, M 2005, 'Community-based research partnerships: Challenges and opportunities', Journal of Urban Health, vol. 82, no. 2, suppl. pp. 3â12s.

Minkler, M & Wallerstein, N 2003, Community-based participatory research for health, Jossey Bass, San Francisco, CA.

Moreno-John, G, Gachie, A, Fleming, C, Napoles-Springer, A, Mutran, E & Manson, S 2004, 'Ethnic minority older adults participating in clinical research: Developing trust', Journal of Aging and Health, vol. 16, pp. 93â123.

Mui, A 1996, 'Depression among elderly Chinese immigrants: An exploratory study', Social Work, vol. 41, no. 6, pp. 633â45.

Norman, J 1988, Chinese, Cambridge University Press, Cambridge, UK.

Norris, K, Brusuelas, R, Jones, L, Miranda, J, Duru, O & Mangione, C 2007, 'Partnering with community-based organization: An academic institution's evolving perpective', Ethnicity and Disease, vol. 17, no. 1, suppl., pp. 27â32s.

Okubo, D & Weidman, K 2000, 'Engaging the community in core public health functions', National Civic Review, vol. 89, issue 4, pp. 309â26.

Paine-Andrews, A, Fisher, J, Campuzano, M, Fawcett, S & Berkeley-Patton, J 2000, 'Promoting sustainability of community health initiatives: An empirical case study', Health Promotion Practice, vol. 1, no. 3, pp. 248â58.

Parikh, N, Fahs, M, Shelley, D & Yerneni, R 2009, 'Health behaviors of older Chinese adults living in New York City', Journal of Community Health, vol. 34, no. 1, pp. 6â15.

Raskin, A, Chien, C & Lin, K 1992, 'Elderly Chinese-Americans compared on measures of psychic distress, somatic complaints and social competence', International Journal of Geriatric Psychiatry, vol. 7, issue 3, pp. 191â98.

Ren, X & Chang, K 1998, 'Evaluating health status of elderly Chinese in Boston', Journal of Clinical Epidemiology, vol. 51, no. 5, pp. 429â35.

Resnicow, K, Baranowki, T, Ahluwalia, J & Braithwaite, R 1999, 'Cultural sensitivity in public health: Defined and demystified', Ethnicity and Disease, vol. 9, no. 1, pp. 10â21.

Roussos, S & Fawcett, S 2000, 'A review of collaborative partnerships as a strategy for improving community health', Annual Review of Public Health, vol. 21, pp. 369â402.

Shah, A, Magee, M, Krishnan, S, Whitman, S & Liu, H 2007, 'Chicago Chinatown community health survey: A model for gathering local level data in Asian communities and beyond', paper presented at APHA 135th Annual Meeting and Expo, Washington, DC, 3â7 November.

Shediac-Rizkallah, M & Bone, L 1998, 'Planning for the sustainability of community-based health programs: Conceptual frameworks and future directions for research, practice and policy', Health Education Research, vol. 13, no. 1, pp. 87â108.

Shinagawa, L 2008, A portrait of Chinese Americans, Asian American Studies Program, University of Maryland, College Park, MD.

Simon, M, Magee, M, Shah, A, Guo, L, Cheung, W, Liu, H & Dong, X 2008, 'Building a Chinese community health survey in Chicago: The value of involving the community to more accurately portray health', International Journal of Health and Ageing Management, vol. 2, no. 1, pp. 42â55.

Suh, E, Kagan, S & Strumpf, N 2009, 'Cultural competence in qualitative interview methods with Asian immigrants', Journal of Transcultural Nursing, vol. 20, no. 2, pp. 194â201.

Tervalon, M 2003, 'Components of culture in health for medical students' education', Academic Medicine, vol. 78, no. 6, pp. 570â76.

Wallerstein, N 2006, 'Using community-based participatory research to address health disparities', Health Promotion Practice, vol. 7, no. 3, pp. 312â23.

Westfall, J, Mold, J & Fagnan, L 2007, 'Practice-based research: Blue highways" on the NIH roadmap', Journal of American Medical Association, vol. 297, no. 4, pp. 24â31."

Williams, A, Labonte, R, Randall, J & Muhajarine, N 2005, 'Establishing and sustaining community-university partnerships: A case study of quality of life research', Critical Public Health, vol. 15, no. 3, pp. 291â302.

Wolff, M & Maurana, C 2001, 'Building effective community-academic partnerships to improve health: A qualitative study of perspectives from communities', Academic Medicine, vol. 76, no. 2, pp. 166â72.

Wong, S 1998, 'Language diversity: Problem or resource?', in S McKay & S Wong (eds), A social and educational perspective on language minorities in the United States, Newbury House, New York.

Yancey, A, Ortega, A & Kumanyika, S 2005, 'Effective recruitment and retention of minority research participants', Annual Review of Public Health, vol. 27, pp. 1â28.

Yu, E 1982, 'Problems in Pacific/Asian American community research', in W Liu (ed.), Methodological problems in minority research, The Pacific/Asian Mental Health Research Center, pp. 93â118.



Share this article: