CBPR-COMR Hybrid Model to Combat a Proposed Polluting Facility in the Anderson Community

Abstract: Community-based participatory research (CBPR) has long been promoted as an approach to university-community collaboration that centers community expertise, supports mutual benefits among all partners, directly addresses community-identified needs, and promotes the redistribution of resources to communities. More recently, community-owned and -managed research (COMR) has been proposed as an approach that gives community partners even greater control and power over the processes and products of research. Using a CBPR-COMR hybrid approach, we describe how the Anderson Community Group (ACE) and researchers at UNC-Chapel Hill partnered to conduct a health and environmental quality assessment of the predominantly Black community, Anderson, in Caswell County, NC in response to the proposed siting of a polluting facility. We found that most Anderson residents live with multiple chronic health conditions and many expressed concerns about poor environmental quality that would potentially be exacerbated by a polluting facility. While our CBPR-COMR hybrid model has many benefits, we continue to grapple with the limitations of this approach, many related to university policies that should be reassessed to facilitate access to university resources and ensure that researchers are not discouraged from conducting community-driven research. Furthermore, we hope that our research findings and CBPR-COMR hybrid model can serve as an example for academic researchers to engage equitably with community partners to promote environmental justice and health equity.

Narrative: Public health research and practice has traditionally utilized a top-down approach that does not always prioritize community expertise and lived experience as a form of knowledge for understanding public health issues and informing the planning, implementation, and evaluation of public health solutions1. The American Public Health Association and other health organizations and agencies have recognized the limitations of this approach and advocate for community-engaged approaches to address public health inequities1,2,3. The benefits of community-engaged research are well documented in the literature and include shifting power, enhanced trust between researchers and community members, and increased validity and relevance of research2,3,4,5.

Given these benefits, our team strives to conduct community-driven research to address environmental injustices. In 2021, the UNC Environmental Justice Action Research Clinic at Gillings School of Global Public Health and the Anderson Community Group (ACE), a grass-roots organization, formed a partnership to understand the current status of health and environmental quality within the predominantly Black neighborhood of Anderson in Caswell County, NC. ACE collaborated with UNC to conduct a survey of residents, in hopes of informing ongoing processes by local and state agencies to permit an asphalt plant that would be located within 250 ft of the nearest resident. To conduct the health survey, this partnership was initially designed to employ community-based participatory research (CBPR) principles, which equitably includes researchers and community partners in each phase of research, builds on community assets, and promotes action on research findings4. CBPR has been found to enhance the relevance, scientific validity and quality, and use of research findings and increase trust between researchers and community partners4,5,6. However, CBPR partnerships are limited as they typically originate from university faculty, data is owned by universities, and research objectives and questions may be outlined before engaging with community partners7. Community-owned and -managed research (COMR) goes a step further by promoting direct credibility, ownership, and management of research by community partners7. COMR partnerships originate from the community, research questions and objectives are developed by the community and are based on community-identified needs, and data is owned and managed by the community8. Furthermore, COMR partnerships underscore that scientifically valid research can be led by communities8. Based on these criteria, the ACE/UNC partnership utilized a hybrid CBPR-COMR approach as 1) ACE led initial efforts against the asphalt plant and conducted outreach out to partner with UNC; 2) ACE identified the need for the survey and determined research objectives and goals; 3) survey research questions, methodologies, and dissemination strategies were largely determined by ACE; 4) ACE held decision-making power for sharing documents and materials related to this research; and 5) the research findings and many documents related to this research are housed and managed by UNC.

Throughout the study, ACE and the UNC team met weekly using a phone-based conference line, preferred by ACE as it did not require access to a stable internet connection. To conduct the survey, the team used an NCIPH template and incorporated ACE’s expertise and feedback to modify the template to protect residents’ privacy; ensure accessible and culturally sensitive language; and reduce survey burden. Once validated by ACE, the survey was input into Qualtrics and pilot tested. ACE identified 105 eligible households as those within a 1-mile radius of the proposed site and downwind from the facility to account for wind patterns in the area. The IRB reviewed methodologies to ensure ethical practices and we received exemption status.

To collect data, the research team initially utilized phone-based surveys to reduce the risk of COVID-19, but the team experienced low response rates due to mistrust of outside callers. In response, we conducted in-person surveys on tablets alongside ACE co-leader Rev. Shoffner and a community resident. This approach facilitated trust between community residents and outside researchers and a total of 48 surveys were collected over one month. The UNC team conducted data analyses and ACE leaders selected dissemination strategies (including a final report and flyer) and reviewed all products prior to dissemination.

Our survey found that over three-quarters of Anderson residents report at least one formally diagnosed chronic illness (77%) and almost half report three or more chronic illnesses (48%) and/or a disability that limits life activities (45%). Asthma, high blood pressure, diabetes, and lung disease are 1.7-4.4 times more prevalent compared to NC averages. Additionally, over 60% of residents reported concerns about environmental quality. These findings underscore how vulnerable the Anderson community is to the proposed asphalt plant and highlight the need to protect communities of color from environmental racism.

Since the completion of the survey, ACE and UNC have continued to partner using the CBPR-COMR approach to protect Anderson residents from pollutants. Collaborative actions include applying for grants, writing letters to public officials, engaging in media and other advocacy efforts, reviewing permits and other technical documents, and preparing documents to support appeals. Our CBPR-COMR hybrid approach effectively centers on community expertise to address pressing environmental injustices. We have found that this approach promotes actionable research that directly addresses community-identified needs, underscores the credibility of community-driven research, results in the creation authentic partnerships based on trust and co-learning; and redirects academic resources to grassroots organizations.

While this approach has many benefits, we continue to navigate various challenges in our partnership. These include 1) inequitable risk faced by community researchers versus academics; 2) university policies that prevent dispersing award money directly to community partners; 3) recent changes to IRB processes that hinder community-engaged research; 4) constraints to data distribution and sharing related to the public records act; 5) a lack of normalized accessibility standards; 6) the use health indicators upheld by government agencies that do not reflect the realities of structural racism and cumulative impacts. While we persist in our efforts to support environmental justice in the Anderson community, we hope that these research findings and our CBPR-COMR model can motivate academics to consider progressive research strategies that go beyond CBPR to uphold and center community-driven research methods to better address structural oppression, environmental injustice, and health inequities.

Keywords: community-driven; environmental justice; CBPR; community-owned and -managed research