Research article
Building Community-Based Participatory Research Partnerships with a Somali Refugee Community

https://doi.org/10.1016/j.amepre.2009.09.036Get rights and content

Background

The U.S. has become home to growing numbers of immigrants and refugees from countries where the traditional practice of female genital cutting (FGC) is prevalent. These women under-utilize reproductive health care, and challenge healthcare providers in providing culturally appropriate care.

Purpose

This study examined Somali immigrant women's experiences with the U.S. healthcare system, exploring how attitudes, perceptions, and cultural values, such as FGC, influence their use of reproductive health care.

Methods

A mixed-method community-based participatory research (CBPR) collaboration with a Somali refugee community was conducted from 2005 to 2008 incorporating surveys, semi-structured focus groups, and individual interviews. Providers caring for this community were also interviewed to gain their perspectives and experiences.

Results

The process of establishing a partnership with a Somali community is described wherein the challenges, successes, and lessons learned in the process of conducting CBPR are examined. Challenges obtaining informed consent, language barriers, and reliance on FGC self-report were surmounted through mobilization of community social networks, trust-building, and the use of a video-elicitation device. The community partnership collaborated around shared goals of voicing unique healthcare concerns of the community to inform the development of interventional programs to improve culturally-competent care.

Conclusions

Community-based participatory research using mixed-methods is critical to facilitating trust-building and engaging community members as active participants in every phase of the research process, enabling the rigorous and ethical conduct of research with refugee communities.

Section snippets

History of Somali Refugee Resettlement in the U.S

The number of African-born immigrants to the U.S. increased 142% (from 363,000 to 881,300) between 1990 and 2000.1 After the onset of civil war in 1991, thousands of Somali refugees have resettled in the U.S., making them the single largest African refugee group to enter this nation.1, 2 Based on 2008 estimates by Columbus and Franklin County, Ohio, officials, there are 35,000–80,000 Somali immigrants and refugees residing in central Ohio,3 making it the nation's second largest Somali

Community Dialogue

The Midwest Network on Female Genital Cutting (MWNFGC) was formed in 2005 as a collaboration of health professionals, representatives from community-based organizations, refugee resettlement agencies, and immigration law experts across the Midwest, working together to identify the growing needs of immigrant and refugee populations of girls and women affected by or at risk for FGC in Minneapolis, Columbus, and Chicago. The MWNFGC fosters ongoing dialogue across communities and institutions aimed

Partnership Development and Community Mobilization

The presented results delineate the process involved in establishing a community partnership with the Somali community using CBPR methods. From November 2005 to May 2007, a series of meetings was held with the RIWHI Community Advisory Board (CAB) both in Columbus and in Ann Arbor, Michigan, to determine the specific aims of a collaborative partnership. Over this 18-month period, the research design was constructed, reviewed, revamped in an iterative fashion, and ultimately agreed on by all

Discussion

This is the largest study to date in the literature of African-born immigrants in the U.S., which incorporates a community-based, mixed-methods approach to examine socio-cultural determinants of health-seeking behavior and healthcare utilization. Our objective was to establish a dialogue with a Somali community, and to share the experiences and strategies used in the development and implementation of a CBPR effort to assess the unique healthcare needs of Somali women. A crucial aspect of this

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