Background/Significance: To support the need of a critical access hospital in completing a community health needs assessment required by the Affordable Care Act. The CBCAR framework was chosen to guide the project because it promotes long-term commitments with on-going social action processes within communities, and served as the research process that used relationships to value the community narrative, validate community concerns, and engage people to better understand health patterns and their meanings. The CBCAR framework has been shaped by participatory action researchers and blends the unitary participatory paradigm and social-ecological perspective with the tenets of human rights and social justice.
Theoretical/Conceptual Framework: The CBCAR framework was originally published in 2012 and is a relatively new nursing approach that requires the collaboration to explore underlying assumptions, identify population strengths and describe barriers toward improving community health outcomes. The CBCAR framework was successfully implemented with public health and clinical nurses, community leaders, nurse researchers and nursing students to create a process where all voices were heard and understood.
Methods: The CBCAR methodology was utilized and each of the phases were described through specific examples from an unfolding case study. The six phases of the CBCAR framework are: 1) Partnership: Collaboration; 2) Dialogue: Research question and direction determined; 3) Pattern recognition: Data collection and analysis; 4) Dialogue on meaning of pattern: Representation of research findings; 5) Insight into action: Community dialogue about meaning of research findings-Action planning; 6) Reflecting on evolving pattern: Evaluating actions and considering new questions.
Results: The CBCAR framework methodology supported research methods that assisted the community access hospital to meet the federal mandate by conducting a community health needs assessment, examined health disparities and social justice issues within the community and enhanced the nursing students’ understanding of research. Nurse researchers summarized the findings of the community within a report that was made public on the critical access hospital’s website.
Conclusions: The CBCAR framework provided a safe environment where open, non-judgmental dialogue encouraged and strengthened community voices which had not always been heard by health care professionals. CBCAR created space where meaningful work by community members, nursing students and nurse researchers could collaborate to enhance the health and wellness of the rural community. CBCAR provided gratifying work for nursing students and nurse researchers which benefited community growth through dialogue, and promoted meaningful long-term relationships with those involved in the process.
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