Principle 6:

Focus on the local relevance of public health problems with an ecological approach to health

An ecological approach accepts that health and well-being are affected by interpersonal dynamics, societal structures, biology, behaviour and the environment (17, 18). This principle stresses the importance of considering health issues and the local context in which they occur in a holistic manner, with data that is relevant, timely, and inclusive. It emphasises an approach to health that extends beyond the individual, to the immediate and larger contexts in which families live, work, and play (1, 17). In CBPR partnerships, the multiple determinants of health, such as social, economic, and physical environmental factors are examined through an interdisciplinary lens, and their interactions stressed (1).

Capacities (competencies and conditions)

        Critical understanding of current local public health issues and theories on the determinants of health

        Appreciation for multiple methods and analytical traditions in population and health services policy research

        Ability to link immediate local issues to broader concerns, such as  environmental justice or improved housing

       Understanding of broader social, environmental, and economic issues and ‘education for political literacy and informed citizenship’ (19)

  •         Community leaders can link immediate problems with deeper aspirations (20)

            Awareness about root causes consistent with the emancipatory ideal of CBPR

            Enriched understandings of the needs, priorities, and health concerns of communities

            Enhanced relevance, usefulness, and use of the research data

            Improved quality and validity of research

            Development of practical, feasible, innovative and sustainable solutions that address some of the causes of health inequities 

             Research products that are tailored to meet the needs of implementers and communities (10)

  •         Awareness raising about the root causes underlying health issues using problem tree (page 41) analysis and other tools

            Present opportunities for community partners to educate academic partners on community needs and preferences

            Use mapping exercises with community members to provide powerful visual data to help address a wide range of health disparities – see community research blog

            Use creative research methods to identify and highlight public health problems in relation to wider context.


    o   Photovoice or participatory photography

    o   Participatory video  

            Engage with public health agencies to help citizen groups gather and analyse information, negotiate public bureaucracies, interpret previous studies and advocate for enforcement of existing laws and policies

            Create fora to bring formal and informal community leaders together to consider health issues within the socioecological setting

            Offer skills workshops and technical assistance on understanding health issues

            Support community events that build a sense of identity; create safe spaces for community members to discuss and analyse health issues

            Conduct reflexivity sessions to ensure that the partnership analyses and reflects on successes and limitations of their actions within the wider socioecological context
  •         Number of workshops exploring public health issues within the wider context

            Enhanced knowledge and understanding about community dynamics and conditions that affect health

            Knowledge sharing about theories on the determinants of health

            Exploring  health and wellbeing issues across different global contexts and their links to ecological perspectives that could be learned from

            Agreement on the health or related issues that community partners wish to address, and if needed, reframing the problem to ensure maximum relevance and the outcome(s) with which they are concerned

            Refined research questions based on increased community awareness of public health issues

            Research/action proposals designed and developed in full partnership to ensure cultural relevance, and benefits for the broader community

            Evidence of transdisciplinary approaches to health and wellbeing issues

  •         Audio visual outputs such as blogs, vlogs and podcasts

            List of disciplines engaged in the research

            Co-analysis workshops/processes documentation

            Minutes from meetings between research partners and local organisations to jointly explore problems and solutions

            Documentation of sessions exploring local health issues, roots causes and wider social determinants of health

            Reflexivity sessions – Audio/written documents 

*Please note that some statements are adaptations or direct quotes from the papers listed in the reference section