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Community-based participatory research (CBPR) approaches in vaccination promotion: a scoping review

International Journal for Equity in Health volume 23, Article number: 227 (2024) Cite this article

Abstract

Background

Community-based participatory research (CBPR) is a collaborative research approach that engages academic researchers and community stakeholders as equal partners in all research steps to address community concerns and achieve health equity. The CBPR approach has been widely used in vaccination promotion programmes. However, the elements and steps of CBPR-based programmes varied among studies. The purpose of this scoping review was to synthesize the elements and steps, and establish an implementation framework to guide the utilisation of CBPR approaches in vaccination promotion.

Methods

This scoping review was performed in accordance with Arksey and O’Malley’s five-stage framework. A systematic search was conducted on a set of electronic databases and grey literature sources. The retrieved articles were screened according to the criteria of CBPR and vaccination promotion, and data were extracted and recorded on a calibrated and predefined form in terms of study characteristics and CBPR components. Two authors worked independently to complete literature search, study selection, and data extraction. A narrative summary was used in categorising characteristics, and the contents of the included studies were summarised through qualitative analysis.

Results

A total of 8557 publications were initially screened, and 23 articles were finally included. According to the CBPR conceptual model, the elements in each CBPR component specifically for vaccination promotion included (1) the establishment of community–academic partnership (CAP)s, (2) community capacity building by partner training vaccination knowledge, research literacy, and service abilities and skills, (3) development and implementation of community-based intervention and (4) Outcome evaluation. A CAP was established between academic researchers or institutes and eight types of partners, including community service organisation–related non-government organisations (NGOs), health service institution–related NGOs, religious organisations, government agencies, educational institutions, media agencies, business agencies, and community representatives. The maintenance of CAP was achieved with four key strategies, namely, strengthening communication, forming management groups, sharing resources and information, and providing incentives. Twelve studies provided comprehensive insights into the strategies employed for intervention development, utilising either quantitative surveys, qualitative methods or a combination of both approaches. The contents of interventions included health service supports, health education activities, social marketing campaigns, community mobilisation, interactive discussions, vaccination reminders and incentives. As for outcome evaluation, vaccination rate and the effectiveness of interventions were assessed. A considerable increase was observed in 95.7% of the included studies (22/23), and the highest increase (92.9%) was attained after the intervention. An implementation framework was generated to summarise the elements and steps of CBPR approaches for vaccination promotion.

Conclusions

This review summarised current evidence and generated an implementation framework to elucidate the elements and steps in the development and application of CBPR approaches in vaccination promotion. CBPR approaches are recommended for future vaccination promotion programmes, involving community stakeholders and research professionals, to ensure equitable access to vaccinations across diverse populations.

Background

The mass distribution of vaccines is one of the greatest public health achievements in history and has reduced morbidity, disability and mortality due to various infectious diseases worldwide [1]. The routine childhood immunisation schedule of the 2009 birth cohort in the United States has prevented approximately 42,000 early deaths and 20 million diseases, saving $13.5 billion in direct cost and $68.8 billion in total cost [2]. The Global Vaccine Action Plan 2011–2020 (GVAP) set forth various vaccination targets, such as poliomyelitis, measles, diphtheria, tetanus, and pertussis, and has proposed a coherent global framework for immunisation [3]. Building upon the GVAP and unmet vaccination targets, the Immunization Agenda 2030 (IA 2030) called for equitable access to routine vaccines, aiming to ensure that all people benefit from recommended immunisations throughout the life course [4]. However, the immunisation coverage of many vaccines has not reach the expected level. For example, a systematic analysis examined the coverage of routine childhood vaccination in 204 countries from 1980 to 2019 and demonstrated that global vaccine coverage broadly plateaued over the past decade, with only 11 countries reaching the 90% coverage target for all vaccines in 2019 [5]. Moreover, a pooled analysis quantified the worldwide cumulative coverage of human papillomavirus (HPV) vaccination, indicating that the full course of HPV vaccine in low-income or lower-middle-income countries had a total population coverage of 1.4%, which was far below the threshold of 70% HPV vaccination coverage in developed countries [6]. With the end of the GVAP era and the start of the IA 2030 plan, the COVID-19 pandemic presented further challenges to routine immunisation throughout the world in 2020. Academic wisdom and practical experience converges to reach GVAP targets and IA 2030 ambitions, and participatory research emerges as the most accepted and recognised response [7].

Participatory research serves as an umbrella term that covers a variety of interrelated research methods, such as community–academic partnership (CAP), participatory action research, community-engaged research and community-based participatory research (CBPR) [8, 9]. CBPR originated from public health research in the 1990s and has become the gold standard for participatory research. CBPR not only recognises the inherent complexity of health disparities and the importance of incorporating diverse perspectives, but it also utilises tools and methodologies from various disciplines to comprehensively understand and analyse the multifaceted forces that contribute to these disparities [10]. This methodology fosters dialogue and joint decision-making among various stakeholders within the community, aiming to ensure equitable allocation of resources, service provision, and health policy development. Previous studies indicated that utilizing CBPR as a collaborative process helped individuals understand the significant system-level changes necessary to address disparities and inequities, and it has been established within health inequity research [11, 12]. It differs from other participatory research methods and is a collaborative approach that equalises power relationship between academic researchers and community stakeholders, which is an orientation to research that involve community in several phages of research process, such as issue identification, data collection, outcome evaluation, and result dissemination [13]. The role of each partner is defined at the start of a research project [14]. CBPR is characterised by the highest level of community participation on the continuum developed by the National Center for Research Resources at the National Institutes of Health, progressing from outreach to involvement and empowerment [15]. Notably, CBPR is a community-driven research paradigm that fits well with community needs to improve health and reduce disparity [16]. A conceptual CBPR model based on extensive literature reviews, CBPR practitioner surveys, and CBPR expert consultations was developed with four major domains: context, partnership dynamics, research, intervention and outcome [17]. This conceptual model has been utilised in CBPR programmes, but its application within the realm of vaccination promotion requires further enhancement.

CBPR takes predominance in global immunisation strategies, showing potential capacity to boost vaccination equity. One proposed strategy to mitigate disparity associated with vaccines is to prioritize vaccination coverage. Previous studies have achieved preliminary progress in addressing substantial disparities in vaccine-preventable diseases by increasing vaccination rates in different populations. For instance, a study reported that immigrants/migrants such as refugees, asylum seekers, and individuals without legal documentation expressed increased motivation to receive COVID-19 vaccine after a CBPR-based intervention [18]. A preliminary study showed that CBPR intervention increased HPV vaccination rate to 92.9% in 323 Peruvian female adolescents [19]. Another large-scale study in Pakistan demonstrated that CBPR intervention achieved a good vaccination rate (74%) for two typhoid fever vaccines administered to 21,059 children aged 2–16 years [20]. However, owing to the lack of unified theoretical guidance of CBPR approach in vaccination promotion, substantial discrepancy in practical application has emerged among various CBPR programmes. A uniform framework is required to standardise the application of CBPR approaches in boosting vaccination. Therefore, this scoping review was performed to summarise the elements and steps of CBPR approaches and to formulate an implementation framework that can guide the utilisation of CBPR approaches in vaccination promotion.

Methods

This scoping review was performed in accordance with the five-stage methodological framework for scoping reviews defined by Arksey and O’Malley (2005) [21] and refined by Levac et al. (2010) [22]. This five-stage methodological framework included specifying research question, identifying relevant studies, selecting eligible studies, charting data and collating, summarising and reporting results [23, 24]. This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping reviews (Supplementary Material Table S1).

Step 1. Specifying research question

Two research questions were addressed in this scoping review: how the CBPR approach was used in community-based vaccination promotion programmes, that is, what were the key elements of CBPR in the vaccination promotion programmes, such as types of community partners, participation phases, and strategies for establishing and maintaining a CAP; community partners training components; development and implementation of the programmes; and outcome evaluation. Another question was how were these elements organised together to effectively increase the vaccine uptake for community residents.

Step 2. Identifying relevant studies

A systematic literature search was conducted to identify peer-reviewed publications and grey literature. Firstly, an initial search was conducted in PubMed to find articles related to the topic, and the keywords CBPR and vaccination were identified in the title, abstract and index of papers. Then, using the identified search terms, consisting of Medical Subject Headings terms and keywords on concepts of CBPR and vaccination, the formal search was conducted in the indexed databases including PubMed, Embase, Web of Science, and Cochrane Library. The search strategy was modified based on the specification of each database (Supplementary Material Table S2).

Google and Google Scholar were searched for grey literature. The reference lists of the retrieved publications were manually searched for additional relevant literature. The systematic and grey literature search incorporated publication dates from database inception to January 2024. The species filter was limited to ‘Humans’, and no other restrictions were imposed on language, population, and study design.

Step 3. Selecting eligible studies

Eligible studies for this scoping review were original publications using CBPR approaches for vaccination promotion. The PICOS strategy, consisting of population, interventions, comparisons, outcomes and study design, was used in searching the literature.

Population (P): The study population covered all age groups which spanned from children to adults. Intervention (I): The eligible intervention was the CBPR approach. The operational definition of CBPR in the study selection process involved the active engagement of community stakeholders as the partners of researchers [25]. Community and academic partners collaborated at a minimum of two phases of the research process, including subject recruitment, intervention development, intervention delivery, data collection, results interpretation, and dissemination. For example, community partners had influence in the selection of research topics, research decision-making, data collection or research results interpretation and dissemination [23, 24]. Comparison (C): Eligible comparison included blank control, active control or any other interventions without community participation in the control group intervention. No predefined limitations were imposed on the pre-post design. Outcome (O): The primary outcome was the vaccination rate for any recommended vaccine for children, adolescents and adults. Study design (S): The original study with an experimental design in terms of randomised controlled trials (RCT), cluster RCT, non-RCT and pre-post design was eligible. Qualitative studies, case reports, conference presentations, study protocols, editorials, commentaries, perspectives, letters, and abstracts were excluded.

Two authors independently assessed the studies for inclusion and exclusion through a sequential process involving title, abstract, and full-text screening. Any disagreements were discussed until a consensus was reached.

Step 4. Charting data

Initially, a standardised data-charting form was created, and then a pilot test was performed by two reviewers, who assessed the three included papers to ensure consistency. After necessary adjustments, the standardised form was used for data extraction. Two authors extracted data, including the types of partners and their participation phases, contents of community partner training and community-based interventions involved in each study. In case of discrepancies between the reviewers, a third reviewer was consulted, who was responsible for the entire review process.

Step 5. Collating, summarising and reporting results

A narrative summary of the characteristics of these studies was made, and the contents of the literature were summarised through qualitative analysis. A widely used conceptual model of CBPR was used in the formulation of a CBPR-based implementation framework for vaccination promotion, which contained four domains: context, partnership dynamics, research, and intervention and outcome [17]. As the studies included in our scoping review did not provide sufficient information about the context of vaccination promotion programmes, this scoping review only focused on the other three domains to summarise the application of CBPR approaches. The key results were reported in four aspects: establishing CAP, building community capacity, developing and implementing community-based interventions and evaluating outcomes. An adaptive CBPR-based implementation framework for vaccination promotion was generated according to the three domains in the CBPR conceptual model and four elements in CBPR programmes.

Results

Selection of studies

Figure 1 presents the flowchart of the study selection process. The literature search identified 8557 records, and 8535 of the articles were excluded because of irrelevant article contents, ineligible study design, animal experiments and non-CBPR approaches. A total of 22 studies met the outlined criteria. One additional study was identified by manually searching the reference lists. In total, 23 articles were identified.

Fig. 1
figure 1

Flowchart diagram of study selection

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Characteristics of the included studies

Table S3 in the supplementary material shows the key characteristics of the included studies. Most of the studies were conducted in America (n = 14), followed by Nigeria (n = 3), Pakistan (n = 2), Peru (n = 2), India (n = 1), and Kenya (n = 1). Only nine studies explicitly reported the type of community involved (9/23, 39.1%), with three studies including both rural and urban communities, three focusing exclusively on rural communities, and three concentrating solely on urban communities. These studies were performed in various designs, over half (n = 12) adopted uncontrolled pre-post design [19, 26,27,28,29,30,31,32,33,34,35,36], six used cluster-RCT (n = 6) [20, 37,38,39,40,41] and five employed non-RCTs (n = 5) [42,43,44,45,46]. These included studies focused on multiple vaccines, 10 targeted routine childhood vaccines [20, 28, 29, 33, 34, 36, 37, 39, 40, 46], 8 targeted HPV vaccines [19, 26, 30, 31, 41, 43,44,45], 4 targeted hepatitis B vaccines [27, 32, 38, 42] and 1 targeted a COVID-19 vaccine [35].

CBPR component: establishment of CAPs

CAP establishment is the necessary and first step in CBPR projects, in which academic researchers and community stakeholders collaborate in an equal and cooperative partnership to share expertise [47]. Five studies used existing CAP networks [29, 31, 33, 38, 42], whereas 18 studies formulated new CAP networks [19, 20, 26,27,28, 30, 32, 34,35,36,37, 39,40,41, 43,44,45,46]. Only five studies detailed how to build CAP networks through meetings [19, 27], conversations [27], advocacy visits [19, 20, 27, 28], proactive invitations [19, 27, 28, 44], partnerships with institutes that have CAP networks [43] and support from the upper organisations of potential partners [27]. Advocacy visits and proactive invitations were the most common approaches. One study used five strategies to build a CAP network [27].

Types of community partners and their participation in different research phases

Table 1 displays the types of community partners. The included studies covered eight types of community partners, and health service institution-related non-government organisation (NGO) was the most common type (n = 21), followed by community service organisation-related NGO (n = 12), government agency (n = 9), and religious organisation (n = 5). Media agency was the least frequently encountered type of community partner (n = 1), followed by business agency (n = 2) and educational institution (n = 3). These studies involved different numbers of community partners, 69.6% of the studies (16/23) involved two types [19, 20, 29, 32, 36, 41, 44, 45] or three types of community partners [28, 30, 35, 38, 40, 42, 43, 46], and four studies involved four types of community partners [31, 33, 37, 39]. One study included six types of community partners [27], whereas another study included five types [34], and one study solely focused on one type of community partner [26].

Table 1 Types of community partners and their participation in different phases in each study
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Table 1 demonstrates the involvement of community partners in six distinct research phases, including subject recruitment, intervention development, intervention delivery, data collection, results interpretation, and findings dissemination. The phases of participation for community partners varied, and most community partners engaged in intervention delivery (n = 22), intervention development (n = 15), subject recruitment (n = 14), and data collection (n = 13). Few community partners engaged in finding dissemination (n = 5) and result interpretation (n = 2). The number of research phases involving community varied across the included studies, indicating different degrees of engagement among community partners. Only one study involved community partners in all six research phases [42], another engaged them in five phases [33], four studies covered four phases [29, 31, 35, 46], fewer than half (43.5%, n = 10) included community partners in three distinct phases [19, 27, 28, 32, 34, 36, 38, 40, 43, 45], and nearly one-third involved them in only two phases [20, 26, 30, 37, 39, 41, 44]. Details of the specific engagement phases of community in each study can be found in Table 1.

Maintenance of the CAP

Figure 2 presents the overall structure of CAPs and the strategies used for maintaining CAPs. These studies used four strategies to maintain CAPs by strengthening communication, forming management groups, sharing resources or information, and providing incentives. More than two-thirds of these studies (69.6%, 16/23) maintained the established CAPs by strengthening communication through meetings, dialogues, interviews, and community events between academic researchers and community partners during research processes [20, 27,28,29, 31, 33,34,35, 37,38,39,40,41,42, 44, 46]. More than a third of studies (39.1%, 9/23) maintained the established CAPs by forming management groups, such as steering committees, advisory boards, and subcommittees [27, 31, 33, 34, 38, 40, 42, 44, 46]. Nearly half of these studies (47.8%, 11/23) maintained the established CAPs by sharing resources or information between academic researchers and community partners [19, 27, 28, 31, 33, 34, 38,39,40, 42, 46]. Only one study maintained the established CAPs by providing incentives in the form of reimbursement of transportation costs to community partners [34].

Fig. 2
figure 2

The CAP of CBPR approach for vaccination promotion. CAP was established between academic researchers/institutes and community partners. The eight types of community partners were community leaders/representatives and collaborative organizations, including community service organisation–related NGOs, health service institution–related NGOs, religious organisation, government agency, business agencies, education institutions, and media agencies. Four kinds of strategies could be used to maintain CAPs, which included strengthening communication, forming management groups, sharing resources or information, and providing incentives

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CBPR component: community capacity building by community partner training

Community capacity encompasses research literacy and vaccination service–related ability. Research literacy refers to community partners’ understanding of research stages and ability to collaborate with researchers effectively throughout the whole research process. Vaccination service–related ability includes knowledge of vaccines and immunisation, effective communication skills and self-efficacy in engaging with a target population. The community capacity building can be achieved by training community partners, and creating opportunities for academic researchers and community partners to express opinions, exchange ideas and share resources. The followings were the contents of training and delivery method, including the individuals responsible for training tasks, training sites, duration and frequency of the partner training sessions, and diverse training methods.

Contents of community partner training

Most of the included studies (82.6%, 19/23) conducted training for community partners [19, 20, 26,27,28,29, 32, 33, 35, 37,38,39,40,41,42,43,44,45,46], over half of the studies (56.5%, 13/23) provided detailed training contents [19, 20, 27,28,29, 32, 38,39,40,41,42, 44, 45], three studies demonstrated prepared training materials based on previous research experience or surveys [26, 35] and tools [40] and only one study used training materials verified by experienced community health officers [40].

Table 2 summarises the contents of the training materials for community partners. The contents contained four aspects: relevant knowledge of vaccination [19, 20, 26,27,28,29, 32, 35, 39,40,41, 44], and research project introduction [19, 20, 28, 29, 32, 38, 40, 42, 44] were the two most common aspects, followed by research literacy and skills [19, 20, 26, 29, 39, 40, 42] and service capacities and skills [29, 35, 39,40,41, 44].

Table 2 The contents of community partner training for community capacity building
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Delivery of community partner training

Nine studies specified individuals responsible for training tasks. Out of the studies, six relied solely on academic researchers to complete the training [19, 28, 40,41,42, 44], two relied exclusively on community partners [20, 39], and one study involved a collaborative effort between academic researchers and community partners (church leaders) to complete the training programmes [38]. These studies covered different stakeholders as trainees, and healthcare providers were the most commonly involved trainees [20, 26, 27, 32, 37, 40, 41, 44, 46], followed by community representatives [19, 20, 28, 33, 37, 39, 43, 46], religious staff [38, 40, 42], community-based organisation staff [29, 37], community traditional and religious leaders [40] and hired community coordinators [38].

These studies used different venues as training sites for partners, and local communities (such as health centre and town council hall) were the generally involved location [40, 44]. The duration of partner training varied from one hour to three days [19, 26, 40, 41, 44, 46], and the frequency of training sessions ranged from one to over 40 within a span of two years [19, 26, 35, 37, 40, 41, 44, 46]. One study performed partner training with various methods, including group discussions, brainstorming, role plays, case studies, and learning aids [40].

CBPR component: development and implementation of community-based intervention

CBPR enabled collaborative and equitable partnerships between academic researchers and community partners throughout research phases [48]. Researchers recognized existing power differentials and addressed them by fostering trust and mutual respect, empowering the community, and tailoring their approaches to meet the community’s specific needs. Communities were engaged in decision-making processes ranging from identifying health issues to disseminating research findings. This efforts were aimed at optimally facilitating communication and decision-making, thereby promoting a more equitable distribution of power.

Development of community-based intervention

Twelve studies detailed strategies used to develop community-based interventions. Among these studies, six studies relied on baseline qualitative evaluation to inform the development of interventions [30, 34, 38, 42, 44, 46], four developed interventions based on community needs identified through baseline quantitative surveys [31,32,33, 35] and two utilised a combination of quantitative surveys and qualitative methods [38, 42]. The qualitative methods included interviews with religious or traditional leaders [38, 42, 46] and health professionals [44], focus groups with community representatives or leaders [30], and dialogues with community representatives or policymakers [34, 46]. The formulated interventions were updated and revised by community stakeholders [33, 34, 38, 42, 44] or validated for the refinement of the contents and structures of the interventions [30, 34].

Contents of community-based intervention

Table 3 shows the contents of the community-based interventions. The studies contained seven strategies, and health service support was the most frequently used strategy (n = 19), followed by follow-ups and home visits (n = 15), health education activities (n = 12), social marketing campaigns and community mobilisations (n = 9), interactive discussions (n = 9), vaccination reminders (n = 7), and financial or material incentives (n = 5).

Table 3 Contents of community-based intervention for vaccination promotion
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Table 4 illustrates the strategies utilised in each study for community-based interventions. Approximately half of the studies (47.8%, 11/23) implemented at least four types of strategies [20, 27,28,29, 31, 33, 35, 38, 42,43,44], six studies adopted three types [19, 34, 36, 39, 41, 46] and another six studies employed two types of strategies [26, 30, 32, 37, 40, 45].

Table 4 Contents of community-based interventions and the effects on vaccination rates
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Implementation of community-based intervention

The included studies adopted various approaches to deliver interventions, and four studies integrated interventions into existing projects within community organisations [27, 29, 32, 36]. In most studies (73.9%, 17/23), interventions were delivered by researchers and partners [19, 27,28,29, 31, 33,34,35,36,37,38, 40,41,42,43, 45, 46], five studies solely relied on community partners [20, 26, 32, 39, 44], and one study conducted interventions by academic researchers alone [30]. Most interventions used a face-to-face delivery modality with various methods, such as group discussion and one-to-one interaction [19, 26,27,28,29, 31,32,33, 37,38,39,40, 42,43,44,45,46]. Some interventions were conducted through telephones [27, 36, 41, 43], text messages [30, 35, 45], and mail [27, 31, 41]. In some cases, interventions were tailored to participants’ preferences, allowing for the customisation of factors, such as the frequency and contents of text messages [30], individual or group settings, time, and location [33].

CBPR component: outcome evaluation of community-based intervention

Figure 3 visually demonstrates the increased vaccination rates observed in the intervention group in each study. The average increased vaccination rates for four types of vaccines were as follows: 75.6% for COVID-19 (n = 1), 41.2% for HBV (n = 4), 37.5% for HPV (n = 8), and 25.9% for childhood vaccines (n = 12). Most studies (n = 22) confirmed the positive effects of community-based interventions on increasing vaccination rates, and the highest observed vaccination rate for HPV reached 92.9% [19]. However, two studies did not find promising results. One study indicated that the community-based intervention did not lead to considerably different vaccination rates within the intervention group (51.8%) compared with the control group (54.7%) [40]. The other study showed similar results regarding improvements in the vaccine uptake of three-dose HPV (12.4% vs. 18.0%) [44]. Nearly half of these studies (n = 11) exhibited moderate increase in vaccine rate, which indicated at least 30% increase in vaccine rate after intervention [19, 20, 26,27,28,29,30, 33, 38, 42, 45]. A small number of studies (n = 3) exhibited small increase in vaccine rate, which exhibited less than 10% increase in vaccine rate after intervention [37, 39, 41].

Fig. 3
figure 3

The increased vaccine rates after intervention in each study

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Nine studies highlighted the potential of CBPR-based interventions in mitigating immunisation disparities through improving vaccination rates or expanding coverage within the vaccinated population [28,29,30,31, 33, 35, 38, 42, 46]. Three of them explicitly stated the objective of reducing health disparities associated with vaccination among high-risk underserved populations [29, 31, 42]. One study further pointed out the methodology for measuring the reduction of disparity by comparing immunization coverage rates with previous National Immunization Survey [29].

Formulation of a CBPR-based implementation framework for vaccination promotion

Based on the three domains of the CBPR conceptual model, four components of CBPR approach and evidence summarised above, an implementation framework was developed (Fig. 4), which refines the elements and steps of a CBPR approach for vaccination promotion. The details of the partnership dynamics of CAP is displayed in Fig. 2. Four strategies were implemented to reinforce the established CAP, which involved strengthening communication, forming management groups, sharing resources or information, and providing incentives.

Fig. 4
figure 4

A CBPR-based implementation framework for vaccination promotion. A CBPR-based implementation framework for vaccination promotion was generated with four steps. (1) Establishment of CAP. CAP was established between academic researchers or institutes and community partners, and different kinds of strategies were used to maintain CAP. (2) Community capacity building by training community partners, including vaccination relevant knowledge, research project introduction, research literacy and skills as well as service capacities and skills. (3) Development and implementation of community-based intervention. Community-based intervention was developed with 7 intervention strategies, which involved health service supports, follow-ups/home visits, health education activities, social marketing campaigns, community mobilisation, interactive discussions, vaccination reminders and financial or material incentives. Community-based intervention was implemented through 4 delivery strategies, which involved face-to-face, telephone, text message, and mailing. (4) Outcome evaluation mainly focused on vaccine rate in these studies. Future studies could incorporate broader vaccination outcomes, such as vaccine hesitancy, long-term outcomes, and well-being

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Discussion

CBPR has emerged in the last century as an action-oriented research paradigm to develop and implement community-based interventions, which can redress power imbalance, facilitate mutual benefits, and promote knowledge translations for all stakeholders [47, 49, 50]. Community participation ensures the credibility of a research project and enhances its usefulness by aligning it with what the community perceives as important social and health goals. This approach is characterised by equitable collaboration between academic researchers and community stakeholders in the whole research process and focuses on translating research findings into practical application within the community and is widely used for community health equity and improvement [51, 52]. Despite the potential of CBPR-based efforts to address immunisation gaps, their consistent replication and widespread success have yet to be demonstrated, as prevailed by the persistent disparities in immunisation uptake. This may be related to the discrepant and inconclusive core elements and practical steps of CBPR in the field of vaccination promotion [50]. Therefore, this scoping review was performed to summarise the components of CBPR approaches from the aspects of CAP establishment, community capacity building, intervention development and implementation, and outcome evaluation and to generate a framework to guide the utilisation of CBPR approaches in the process of vaccination promotion.

Establishment of CAPs

As the critical component of CBPR, a CAP is characterised by equitable control, relevance to the community of interest, specific aims, and the active involvement of community members and academic researchers [53]. The establishment of CAP converged to deliver interventions and facilitate the translation of information into practice [54], varied in organisational structures and power allocation [55]. Except the five studies with pre-existing CAP networks, the studies prioritised the establishment of CAPs as the initial step in their CBPR programmes. The findings indicated that academic researchers were found to be the most common initiators in the establishment of CAPs, consistent with the findings of previous studies [53, 56]. The role of academic researchers as primary initiators can be attributed to the community partners’ limited awareness of health-related questions and their mistrust of academic research [57]. The establishment of a CAP is time-consuming and resource intensive, whereas trust is foundational to the sustainability of a CAP [58]. Further efforts are warranted to build trust in the establishment of a partnership. The included studies utilised the same methods for establishing CAPs as those used in previous studies. These methods involved meetings, conversations, advocacy visits and active invitations [59, 60]. The meetings, conversations and advocacy visits could help identify key issues and community needs to ensure buy-in from essential stakeholders and constituencies [19, 27]. Moreover, inviting active support from higher-level organisations greatly facilitated the establishment of the CAPs [61]. Thus, identifying influential groups or prominent individuals who can increase the likelihood of collaboration with targeted partners is promising method for future research on CAPs.

CAP enabled a collaborative partnership among diverse stakeholders, which followed the principles of equal participation in CBPR approach and recognised the strengths of stakeholders in community [62]. However, previous studies rarely reported characteristics, such as membership numbers or duration of CAP [53]. By contrast, the findings of this scoping review have provided additional insights into these aspects. The collaborative partnership consisted of a diverse group of members, which included community service organisation–related NGOs, health service institution–related NGO, religious organisation, government agency, business agency, education institution, and media agency. The types of partners and the research phases of participation varied with the unique context of each community and fluctuated across the phases of the research project. This variation in the composition of the CAP networks highlights the importance of tailoring an approach for network construction based on the specific needs and context of a community being served [63].

The types of community partners and their participation in various research phases were similar to those of previous literature [56, 64]. Community partners were more frequently involved in intervention development and delivery, participant recruitment, and data collection, while researchers were involved in traditional research activities. This division of tasks likely reflected a logical distribution of roles based on respective areas of expertise [55]. In other words, the background features of community partners influenced their involvement throughout the research process. Community partners with community knowledge and expertise actively contributed to the intervention development and implementation. However, their limited academic literacy and research leadership skills restricted their participation in data collection and results interpretation. Future studies can undertake multiple initiatives to train community partners with regard to research literacy. These initiatives may facilitate community partners to be engaged equitably throughout the research process.

Four strategies can be implemented to reinforce the partnership dynamics in the established CAP, which involved strengthening communication, forming management groups, sharing resources or information, and providing incentives. A successful CBPR partnership could be strengthened by the effective communication through regular group meetings [42]. Previous study also demonstrated that meetings, dialogues, interviews, and community events were common strategies and can effectively facilitate the maintenance of CAPs [56]. Other studies inversely validated the importance of communication in CAP, which demonstrated that inadequate communication was a common impediment to CAP establishment [65, 66]. Forming management groups, such as steering committee that included both community and research representatives, could enhance coordination, clarify roles and responsibilities, and facilitate consensus building in the planning stage or the intervention process [33, 46]. Financial incentives were the least frequently utilised strategy (n = 5) among the included studies. The lack of financial incentives was a common hindering factor to the construction of CAP, as verified in a systematic review [53]. Therefore, future studies need to clarify communication channels and ensure financial incentives to mobilise stakeholders joining CAPs.

Community capacity building by community partner training

CBPR relies on iterative processes to generate and build knowledge and is an ongoing co-learning effort, in which researchers and community partners work collaboratively to build capacity to address health issues [67]. Community partner training is a major avenue of community capacity building, providing necessary knowledge and skills for effectively implementing and sustaining CBPR projects. Community partners equipped with community expertise and academic skills are equitably and deeply engaged in the research process, which promotes collaboration between researchers and community partners and bridges the connection between research and community practice [68]. Among the included studies, only three studies developed the training materials based on previous investigations. For instance, one study developed training contents based on a prior survey of community members’ vaccine attitudes and preferences [35]. One study designed the training by the research team, validated the contents with experienced community health officers, and conducted a pilot testing to ensure the effectiveness of the training [40]. The limited number of studies developing training based on evidence deviated from the iterative development or the theoretical model–based design approach employed in previous studies for creating the contents of training programmes [69, 70]. The integration of validated scientific evidence into training contents likely enhanced their acceptability and applicability, thereby resulting in effective capacity building efforts. The present review examined the value of community participation in refining training materials and designing training courses, which facilitated the development of training programmes to meet the aspirations of trainees and the needs of local communities [71, 72]. Health knowledge and research literacy were identified as the two most prevalent topics in community partner training. This finding was consistent with a study showing that relevant health and research knowledge were the two main topics in community health worker training [73].

The included studies exhibited wide variations in training delivery in terms of trainers, duration, frequencies, and methods. Among nine studies that specified individuals responsible for training tasks, academic researchers were the most common type (66.7%, 6/9). The exclusion of community partners in training challenged the acceptability and effectiveness of training by ignoring stakeholders’ preferences and community needs. A qualitative study among community stakeholders revealed the importance of adopting a collaborative approach to incorporate community stakeholders and researchers to align training competencies [74]. The included studies conducted training with varied durations and frequencies. Only one study conducted refresher training four months since the start of the intervention [44]. The importance and impact of training diminished over time [75, 76]. All these studies underscored the importance of conducting multiple training sessions at an appropriate frequency. Regarding the training method, limited information was disclosed in the included studies (n = 1). Previous studies adopted diverse methods in the training of community partners through didactic presentation, group discussion, and role plays, which may help effectively disseminate and implement curricula to health care workers [77].

Development and implementation of community-based intervention

Many included studies utilised specific methods to develop community-based interventions based on community needs and previous evidence. Quantitative surveys and qualitative methods were employed to evaluate stakeholder claims and community needs and clarify partners’ views and preferences on community health questions. Previous studies highlighted the importance of community needs and practice evidence in intervention development [78, 79], which could ensure the cultural adaptability and community relevance of interventions and increase the acceptability and feasibility of interventions. This review suggested that most studies engaged community partners in intervention implementation, and some interventions were tailored to the preferences of participants. Such efforts can enhance the receptivity of interventions because community partners were familiar with the communities. In addition, this allowed community partners to deliver interventions to participants in the most suitable and acceptable manner and increase their effectiveness.

Outcome evaluation of community-based intervention

The findings of this scoping review indicated the success of CBPR in vaccination promotion, whereby most included studies supported the effectiveness of community-based intervention on vaccine rate. The outcome evaluation of CBPR programmes in the included studies primarily focused on vaccination rates. Future studies could explore broader vaccination outcomes, including vaccine hesitancy, vaccine confidence, and long-term outcomes, such as well-being and disease incidence. By examining these broad outcomes, a more comprehensive understanding of the impacts of CBPR programmes on vaccination and public health can be gained.

Improving the vaccination rate among vulnerable groups could contribute to addressing disparities in vaccine-associated diseases. The involvement of the community in the planning and implementation processes, fully integrated within routine organisational programs, facilitates the equitable distribution of resources and promotes the sustainability of disparities elimination efforts. Therefore, it is advisable for public health officials to undertake and implement CBPR-based interventions to enhance health equity among populations affected by disparities.

Limitations

The review had limitations. Despite the inclusion of studies conducted in diverse countries for a long period, evidence yielded in this review may not apply to diverse demographic groups in various communities. Comparing the effects of vaccination promotion across different types of vaccinations and various research phases involving communities is challenging due to limitations like different study designs, data heterogeneity, significant variability in vaccine types, and diverse targeted populations, all of which further complicate the interpretation of the results. In addition, given that the focus was directed to the elements and steps of CBPR approaches to vaccination promotion, other problems, such as promoters and barriers in the development and implementation of CBPR programmes were not extensively emphasised.

Conclusion

This scoping review firstly summarised the core elements and practical steps of CBPR and generated an implementation framework, specifically in the context of vaccination promotion. The results highlighted the success and potential of utilising CBPR for improving vaccination rates and indicated that researchers and community practitioners to further expand theoretical orientations and methodological toolkit associated with CBPR. The CBPR-based implementation framework, including CAP establishment, community capacity building, intervention development and implementation, and outcome evaluation, can serve as a framework for future vaccination promotion programmes involving community stakeholders and research professionals to facilitate equitable vaccination access for diverse populations.

Data availability

All data generated or analysed during this study are included in the supplementary information files of this article.

Abbreviations

CAP:

Community Academic Partnership

CBPR:

Community-based Participatory Research

NGOs:

Non Government Organisations

PICOS:

Population, Intervention, Comparison, Outcome, Study design

RCT:

Randomised Controlled Trial

References

  1. Ehreth J. The value of vaccination: a global perspective. Vaccine. 2003;21(27–30):4105–17. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/s0264-410x(03)00377-3.

    Article  PubMed  Google Scholar 

  2. Zhou F, Shefer A, Wenger J, Messonnier M, Wang LY, Lopez A, Moore M, Murphy TV, Cortese M, Rodewald L. Economic evaluation of the routine childhood immunization program in the United States, 2009. Pediatrics. 2014;133(4):577–85. https://doiorg.publicaciones.saludcastillayleon.es/10.1542/peds.2013-0698.

    Article  PubMed  Google Scholar 

  3. MacDonald N, Mohsni E, Al-Mazrou Y, Kim AJ, Arora N, Elden S, Madrid MY, Martin R, Mahmoud MA, Rees H, et al. Global vaccine action plan lessons learned I: recommendations for the next decade. Vaccine. 2020;38(33):5364–71. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/j.vaccine.2020.05.003.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Wallace AS, Ryman TK, Privor-Dumm L, Morgan C, Fields R, Garcia C, Sodha SV, Lindstrand A, Nic LL. Leaving no one behind: defining and implementing an integrated life course approach to vaccination across the next decade as part of the immunization agenda 2030. Vaccine. 2022. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/j.vaccine.2022.11.039.

    Article  PubMed  PubMed Central  Google Scholar 

  5. GBD2020R1VCC. Measuring routine childhood vaccination coverage in 204 countries and territories, 1980–2019: a systematic analysis for the global burden of Disease Study 2020, release 1. Lancet. 2021;398(10299):503–21. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/S0140-6736(21)00984-3.

  6. Bruni L, Diaz M, Barrionuevo-Rosas L, Herrero R, Bray F, Bosch FX, de Sanjose S, Castellsague X. Global estimates of human papillomavirus vaccination coverage by region and income level: a pooled analysis. Lancet Glob Health. 2016;4(7):e453–63. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/S2214-109X(16)30099-7.

    Article  PubMed  Google Scholar 

  7. Niccolai LM, Hansen CE. Practice- and community-based interventions to increase human Papillomavirus Vaccine Coverage: a systematic review. Jama Pediatr. 2015;169(7):686–92. https://doiorg.publicaciones.saludcastillayleon.es/10.1001/jamapediatrics.2015.0310.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Xie YJ, Liao X, Lin M, et al. Community Engagement in Vaccination Promotion: systematic review and Meta-analysis. JMIR Public Health Surveill. 2024;10:e49695. https://doiorg.publicaciones.saludcastillayleon.es/10.2196/49695.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Wallerstein N. Engage for equity: advancing the fields of Community-based participatory research and community-engaged research in Community psychology and the Social Sciences. Am J Commun Psychol. 2021;67(3–4):251–5. https://doiorg.publicaciones.saludcastillayleon.es/10.1002/ajcp.12530.

    Article  Google Scholar 

  10. Townsend CK, Dillard A, Hosoda KK, Maskarinec GG, Maunakea AK, Yoshimura SR, Hughes C, Palakiko DM, Kehauoha BP, Kaholokula JK. Community-based Participatory Research Integrates Behavioral and Biological Research to Achieve Health Equity for native hawaiians. Int J Env Res Pub He. 2015;13(1):ijerph13010004. https://doiorg.publicaciones.saludcastillayleon.es/10.3390/ijerph13010004.

    Article  Google Scholar 

  11. Glaser KM, Dauphin C, Johnson D, Harris N, Crabtree-Ide CR, Bouchard EG. Advancing community-academic partnerships to achieve breast health equity: applying the community-based participatory model to build capacity for sustained impact. Cancer-Am Cancer Soc. 2023;129(S19):3162–70. https://doiorg.publicaciones.saludcastillayleon.es/10.1002/cncr.34976.

    Article  Google Scholar 

  12. Duran B, Oetzel J, Magarati M, Parker M, Zhou C, Roubideaux Y, Muhammad M, Pearson C, Belone L, Kastelic SH, et al. Toward Health Equity: A National Study of Promising practices in Community-based Participatory Research. Prog Comm Hlth Partn. 2019;13(4):337–52. https://doiorg.publicaciones.saludcastillayleon.es/10.1353/cpr.2019.0067.

    Article  Google Scholar 

  13. Rodriguez EP, Verney SP. The underutilization of community-based Participatory Research in psychology: a systematic review. Am J Commun Psychol. 2021;67(3–4):312–26. https://doiorg.publicaciones.saludcastillayleon.es/10.1002/ajcp.12469.

    Article  Google Scholar 

  14. Chen E, Leos C, Kowitt SD, Moracco KE. Enhancing community-based participatory research through human-centered design strategies. Health Promot Pract. 2020;21(1):37–48. https://doiorg.publicaciones.saludcastillayleon.es/10.1177/1524839919850557.

    Article  PubMed  Google Scholar 

  15. Key KD, Furr-Holden D, Lewis EY, Cunningham R, Zimmerman MA, Johnson-Lawrence V, Selig S. The Continuum of Community Engagement in Research: a Roadmap for understanding and assessing Progress. Prog Comm Hlth Partn. 2019;13(4):427–34. https://doiorg.publicaciones.saludcastillayleon.es/10.1353/cpr.2019.0064.

    Article  Google Scholar 

  16. Wallerstein N, Muhammad M, Sanchez-Youngman S, Rodriguez EP, Avila M, Baker EA, Barnett S, Belone L, Golub M, Lucero J, et al. Power Dynamics in Community-based Participatory Research: a multiple-case study analysis of partnering contexts, histories, and practices. Health Educ Behav. 2019;46(1suppl):S19–32. https://doiorg.publicaciones.saludcastillayleon.es/10.1177/1090198119852998.

    Article  Google Scholar 

  17. Belone L, Lucero JE, Duran B, Tafoya G, Baker EA, Chan D, Chang C, Greene-Moton E, Kelley MA, Wallerstein N. Community-based participatory research conceptual model: Community Partner Consultation and Face Validity. Qual Health Res. 2016;26(1):117–35. https://doiorg.publicaciones.saludcastillayleon.es/10.1177/1049732314557084.

    Article  PubMed  Google Scholar 

  18. Lohr AM, Neumbo KC, Njeru JW, Molina L, Hasley R, Ahmed Y, Quirindongo-Cedeno O, Torres-Herbeck GA, Goodson ML, Osman A, et al. Addressing COVID-19 inequities using bidirectional crisis and emergency risk communication and vaccine clinic interventions: a descriptive study. BMC Public Health. 2023;23(1):1517. https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12889-023-16410-3.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Levinson KL, Abuelo C, Chyung E, Salmeron J, Belinson SE, Sologuren CV, Ortiz CS, Vallejos MJ, Belinson JL. The Peru cervical cancer prevention study (PERCAPS): community-based participatory research in Manchay, Peru. Int J Gynecol Cancer. 2013;23(1):141–7. https://doiorg.publicaciones.saludcastillayleon.es/10.1097/IGC.0b013e318275b007.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Khan MI, Ochiai RL, Hamza HB, Sahito SM, Habib MA, Soofi SB, Bhutto NS, Rasool S, Puri MK, Ali M, et al. Lessons and implications from a mass immunization campaign in squatter settlements of Karachi, Pakistan: an experience from a cluster-randomized double-blinded vaccine trial [NCT00125047]. Trials. 2006;7:17. https://doiorg.publicaciones.saludcastillayleon.es/10.1186/1745-6215-7-17.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Method. 2005;8(1):19–32. https://doiorg.publicaciones.saludcastillayleon.es/10.1080/1364557032000119616.

    Article  Google Scholar 

  22. Levac D, Colquhoun H, O’Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010;5:69. https://doiorg.publicaciones.saludcastillayleon.es/10.1186/1748-5908-5-69.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Munn Z, Peters M, Stern C, Tufanaru C, McArthur A, Aromataris E. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. Bmc Med Res Methodol. 2018;18(1):143. https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12874-018-0611-x.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Davis K, Drey N, Gould D. What are scoping studies? A review of the nursing literature. Int J Nurs Stud. 2009;46(10):1386–400. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/j.ijnurstu.2009.02.010.

    Article  PubMed  Google Scholar 

  25. Bogart LM, Uyeda K. Community-based participatory research: partnering with communities for effective and sustainable behavioral health interventions. Health Psychol. 2009;28(4):391–3. https://doiorg.publicaciones.saludcastillayleon.es/10.1037/a0016387.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Abuelo CE, Levinson KL, Salmeron J, Sologuren CV, Fernandez MJ, Belinson JL. The Peru Cervical Cancer Screening Study (PERCAPS): the design and implementation of a mother/daughter screen, treat, and vaccinate program in the Peruvian jungle. J Commun Health. 2014;39(3):409–15. https://doiorg.publicaciones.saludcastillayleon.es/10.1007/s10900-013-9786-6.

    Article  Google Scholar 

  27. Bailey MB, Shiau R, Zola J, Fernyak SE, Fang T, So SK, Chang ET. San Francisco hep B free: a grassroots community coalition to prevent hepatitis B and liver cancer. J Commun Health. 2011;36(4):538–51. https://doiorg.publicaciones.saludcastillayleon.es/10.1007/s10900-010-9339-1.

    Article  Google Scholar 

  28. Bawa S, Shuaib F, Saidu M, Ningi A, Abdullahi S, Abba B, Idowu A, Alkasim J, Hammanyero K, Warigon C, et al. Conduct of vaccination in hard-to-reach areas to address potential polio reservoir areas, 2014–2015. BMC Public Health. 2018;18(Suppl 4):1312. https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12889-018-6194-y.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Findley SE, Irigoyen M, Sanchez M, Guzman L, Mejia M, Sajous M, Levine DA, Chen S, Chimkin F. Community-based strategies to reduce childhood immunization disparities. Health Promot Pract. 2006;7(3 Suppl):S191–200. https://doiorg.publicaciones.saludcastillayleon.es/10.1177/1524839906288692.

    Article  Google Scholar 

  30. Lee HY, Koopmeiners JS, McHugh J, Raveis VH, Ahluwalia JS. mHealth Pilot Study: text messaging intervention to promote HPV vaccination. Am J Health Behav. 2016;40(1):67–76. https://doiorg.publicaciones.saludcastillayleon.es/10.5993/AJHB.40.1.8.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Lennon T, Gundacker C, Nugent M, Simpson P, Magallanes NK, West C, Willis E. Ancillary Benefit of increased HPV immunization Rates following a CBPR Approach to address immunization disparities in younger siblings. J Commun Health. 2019;44(3):544–51. https://doiorg.publicaciones.saludcastillayleon.es/10.1007/s10900-018-00610-9.

    Article  Google Scholar 

  32. Weir RC, Toyoji M, McKee M, Li V, Wang CC. Assessing the Impact of Electronic Health Record Interventions on Hepatitis B Screening and Vaccination. J Health Care Poor U. 2018;29(4):1587–605. https://doiorg.publicaciones.saludcastillayleon.es/10.1353/hpu.2018.0114.

    Article  Google Scholar 

  33. Willis E, Sabnis S, Hamilton C, Xiong F, Coleman K, Dellinger M, Watts M, Cox R, Harrell J, Smith D, et al. Improving immunization rates through community-based Participatory Research: Community Health Improvement for Milwaukee’s children program. Prog Comm Hlth Partn. 2016;10(1):19–30. https://doiorg.publicaciones.saludcastillayleon.es/10.1353/cpr.2016.0009.

    Article  Google Scholar 

  34. Akwataghibe NN, Ogunsola EA, Popoola OA, Agbo AI, Dieleman MA. Using participatory action research to improve immunization utilization in areas with pockets of unimmunized children in Nigeria. Health Res Policy Sy. 2021;19(Suppl 2):88. https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12961-021-00719-9.

    Article  Google Scholar 

  35. Marquez C, Kerkhoff AD, Naso J, Contreras MG, Castellanos DE, Rojas S, Peng J, Rubio L, Jones D, Jacobo J, et al. A multi-component, community-based strategy to facilitate COVID-19 vaccine uptake among latinx populations: from theory to practice. PLoS ONE. 2021;16(9):e257111. https://doiorg.publicaciones.saludcastillayleon.es/10.1371/journal.pone.0257111.

    Article  CAS  Google Scholar 

  36. Suryadevara M, Bonville CA, Ferraioli F, Domachowske JB. Community-centered education improves vaccination rates in children from low-income households. Pediatrics. 2013;132(2):319–25. https://doiorg.publicaciones.saludcastillayleon.es/10.1542/peds.2012-3927.

    Article  PubMed  Google Scholar 

  37. Habib MA, Soofi S, Cousens S, Anwar S, Haque NU, Ahmed I, Ali N, Tahir R, Bhutta ZA. Community engagement and integrated health and polio immunisation campaigns in conflict-affected areas of Pakistan: a cluster randomised controlled trial. Lancet Glob Health. 2017;5(6):e593–603. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/S2214-109X(17)30184-5.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Ma GX, Lee MM, Tan Y, Hanlon AL, Feng Z, Shireman TI, Rhee J, Wei Z, Wong F, Koh HS, et al. Efficacy of a community-based participatory and multilevel intervention to enhance hepatitis B virus screening and vaccination in underserved Korean americans. Cancer-Am Cancer Soc. 2018;124(5):973–82. https://doiorg.publicaciones.saludcastillayleon.es/10.1002/cncr.31134.

    Article  Google Scholar 

  39. More NS, Das S, Bapat U, Alcock G, Manjrekar S, Kamble V, Sawant R, Shende S, Daruwalla N, Pantvaidya S, et al. Community resource centres to improve the health of women and children in informal settlements in Mumbai: a cluster-randomised, controlled trial. Lancet Glob Health. 2017;5(3):e335–49. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/S2214-109X(16)30363-1.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Oyo-Ita A, Bosch-Capblanch X, Ross A, Oku A, Esu E, Ameh S, Oduwole O, Arikpo D, Meremikwu M. Effects of engaging communities in decision-making and action through traditional and religious leaders on vaccination coverage in Cross River State, Nigeria: a cluster-randomised control trial. PLoS ONE. 2021;16(4):e248236. https://doiorg.publicaciones.saludcastillayleon.es/10.1371/journal.pone.0248236.

    Article  CAS  Google Scholar 

  41. Paskett ED, Krok-Schoen JL, Pennell ML, Tatum CM, Reiter PL, Peng J, Bernardo BM, Weier RC, Richardson MS, Katz ML. Results of a multilevel intervention trial to increase human papillomavirus (HPV) vaccine uptake among adolescent girls. Cancer Epidem Biomar. 2016;25(4):593–602. https://doiorg.publicaciones.saludcastillayleon.es/10.1158/1055-9965.EPI-15-1243.

    Article  CAS  Google Scholar 

  42. Ma GX, Gao W, Tan Y, Chae WG, Rhee J. A community-based participatory approach to a hepatitis B intervention for Korean americans. Prog Comm Hlth Partn. 2012;6(1):7–16. https://doiorg.publicaciones.saludcastillayleon.es/10.1353/cpr.2012.0002.

    Article  Google Scholar 

  43. Parra-Medina D, Morales-Campos DY, Mojica C, Ramirez AG. Promotora Outreach, Education and Navigation Support for HPV vaccination to hispanic women with unvaccinated daughters. J Cancer Educ. 2015;30(2):353–9. https://doiorg.publicaciones.saludcastillayleon.es/10.1007/s13187-014-0680-4.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Sanderson M, Canedo JR, Khabele D, Fadden MK, Harris C, Beard K, Burress M, Pinkerton H, Jackson C, Mayo-Gamble T, et al. Pragmatic trial of an intervention to increase human papillomavirus vaccination in safety-net clinics. BMC Public Health. 2017;17(1):158. https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12889-017-4094-1.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Ma GX, Zhu L, Tan Y, Zhai S, Lin TR, Zambrano C, Siu P, Lai S, Wang MQ. A Multilevel intervention to increase HPV vaccination among Asian American adolescents. J Commun Health. 2022;47(1):9–16. https://doiorg.publicaciones.saludcastillayleon.es/10.1007/s10900-021-01013-z.

    Article  Google Scholar 

  46. Olayo R, Wafula C, Aseyo E, Loum C, Kaseje D. A quasi-experimental assessment of the effectiveness of the Community Health Strategy on health outcomes in Kenya. Bmc Health Serv Res. 2014;14(Suppl 1):S3. https://doiorg.publicaciones.saludcastillayleon.es/10.1186/1472-6963-14-S1-S3.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Wallerstein N, Duran B. Community-based participatory research contributions to intervention research: the intersection of science and practice to improve health equity. Am J Public Health. 2010;Suppl 1S40–6. https://doiorg.publicaciones.saludcastillayleon.es/10.2105/AJPH.2009.184036. 100 Suppl 1.

  48. Collins SE, Clifasefi SL, Stanton J, The LAB, Straits K, Gil-Kashiwabara E, Rodriguez EP, Nicasio AV, Andrasik MP, Hawes SM, et al. Community-based participatory research (CBPR): towards equitable involvement of community in psychology research. Am Psychol. 2018;73(7):884–98. https://doiorg.publicaciones.saludcastillayleon.es/10.1037/amp0000167.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Holkup PA, Tripp-Reimer T, Salois EM, Weinert C. Community-based participatory research: an approach to intervention research with a native American community. Adv Nurs Sci. 2004;27(3):162–75. https://doiorg.publicaciones.saludcastillayleon.es/10.1097/00012272-200407000-00002.

    Article  Google Scholar 

  50. Israel BA, Schulz AJ, Parker EA, Becker AB. Review of community-based research: assessing partnership approaches to improve public health. Annu Rev Publ Health. 1998;19:173–202. https://doiorg.publicaciones.saludcastillayleon.es/10.1146/annurev.publhealth.19.1.173.

    Article  CAS  Google Scholar 

  51. Schlechter CR, Del FG, Lam CY, Fernandez ME, Greene T, Yack M, Schulthies S, Nelson M, Bohner C, Pruhs A, et al. Application of community-engaged dissemination and implementation science to improve health equity. Prev Med Rep. 2021;24:101620. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/j.pmedr.2021.101620.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Balls-Berry JE, Acosta-Perez E. The Use of Community Engaged Research Principles to improve Health: community academic partnerships for Research. P R Health Sci J. 2017;36(2):84–5.

    PubMed  PubMed Central  Google Scholar 

  53. Drahota A, Meza RD, Brikho B, Naaf M, Estabillo JA, Gomez ED, Vejnoska SF, Dufek S, Stahmer AC, Aarons GA. Community-academic partnerships: a systematic review of the state of the literature and recommendations for Future Research. Milbank Q. 2016;94(1):163–214. https://doiorg.publicaciones.saludcastillayleon.es/10.1111/1468-0009.12184.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Pellecchia M, Mandell DS, Nuske HJ, Azad G, Benjamin WC, Maddox BB, Reisinger EM, Skriner LC, Adams DR, Stewart R, et al. Community-academic partnerships in implementation research. J Community Psychol. 2018;46(7):941–52. https://doiorg.publicaciones.saludcastillayleon.es/10.1002/jcop.21981.

    Article  PubMed  Google Scholar 

  55. Hacker K, Tendulkar SA, Rideout C, Bhuiya N, Trinh-Shevrin C, Savage CP, Grullon M, Strelnick H, Leung C, DiGirolamo A. Community capacity building and sustainability: outcomes of community-based participatory research. Prog Comm Hlth Partn. 2012;6(3):349–60. https://doiorg.publicaciones.saludcastillayleon.es/10.1353/cpr.2012.0048.

    Article  Google Scholar 

  56. Brookman-Frazee L, Stahmer A, Stadnick N, Chlebowski C, Herschell A, Garland AF. Characterizing the use of research-community partnerships in studies of evidence-based interventions in children’s Community services. Adm Policy Ment Hlth. 2016;43(1):93–104. https://doiorg.publicaciones.saludcastillayleon.es/10.1007/s10488-014-0622-9.

    Article  Google Scholar 

  57. Larios SE, Wright S, Jernstrom A, Lebron D, Sorensen JL. Evidence-based practices, attitudes, and beliefs in substance abuse treatment programs serving American indians and Alaska Natives: a qualitative study. J Psychoact Drugs. 2011;43(4):355–9. https://doiorg.publicaciones.saludcastillayleon.es/10.1080/02791072.2011.629159.

    Article  Google Scholar 

  58. Jagosh J, Bush PL, Salsberg J, Macaulay AC, Greenhalgh T, Wong G, Cargo M, Green LW, Herbert CP, Pluye P. A realist evaluation of community-based participatory research: partnership synergy, trust building and related ripple effects. BMC Public Health. 2015;15:725. https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12889-015-1949-1.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Brookman-Frazee L, Stahmer AC, Lewis K, Feder JD, Reed S. Building a research-community collaborative to improve community care fro infants and toddlers at-risk for autism spectrum disorders. J Community Psychol. 2012;40(6):715–34. https://doiorg.publicaciones.saludcastillayleon.es/10.1002/jcop.21501.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Ruffolo MC, Price D, Smith A. Building a Community-Academic Partnership to Expand Workforce Development in Underserved, High-Need/High-Demand areas. Public Health Rep. 2023;138(1suppl):S9–15. https://doiorg.publicaciones.saludcastillayleon.es/10.1177/00333549221138852.

    Article  Google Scholar 

  61. Simmons VN, Klasko LB, Fleming K, Koskan AM, Jackson NT, Noel-Thomas S, Luque JS, Vadaparampil ST, Lee JH, Quinn GP, et al. Participatory evaluation of a community-academic partnership to inform capacity-building and sustainability. Eval Program Plann. 2015;52:19–26. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/j.evalprogplan.2015.03.005.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Brush BL, Mentz G, Jensen M, Jacobs B, Saylor KM, Rowe Z, Israel BA, Lachance L. Success in Long-Standing Community-based Participatory Research (CBPR) partnerships: a scoping literature review. Health Educ Behav. 2020;47(4):556–68. https://doiorg.publicaciones.saludcastillayleon.es/10.1177/1090198119882989.

    Article  PubMed  Google Scholar 

  63. Luger TM, Hamilton AB, True G. Measuring community-engaged research contexts, processes, and outcomes: a mapping review. Milbank Q. 2020;98(2):493–553. https://doiorg.publicaciones.saludcastillayleon.es/10.1111/1468-0009.12458.

    Article  PubMed  PubMed Central  Google Scholar 

  64. De Las ND, Hacker K, DiGirolamo A, Hicks LS. A systematic review of community-based participatory research to enhance clinical trials in racial and ethnic minority groups. Health Serv Res. 2012;47(3 Pt 2):1363–86. https://doiorg.publicaciones.saludcastillayleon.es/10.1111/j.1475-6773.2012.01386.x.

    Article  Google Scholar 

  65. Stedman-Smith M, McGovern PM, Peden-McAlpine CJ, Kingery LR, Draeger KJ. Photovoice in the Red River Basin of the north: a systematic evaluation of a community-academic partnership. Health Promot Pract. 2012;13(5):599–607. https://doiorg.publicaciones.saludcastillayleon.es/10.1177/1524839910370737.

    Article  PubMed  Google Scholar 

  66. Zendell AL, Fortune AE, Mertz LK, Koelewyn N. University-community partnerships in gerontological social work: building consensus around student learning. J Gerontol Soc Work. 2007;50(1–2):155–72. https://doiorg.publicaciones.saludcastillayleon.es/10.1300/J083v50n01_11.

    Article  PubMed  Google Scholar 

  67. Frerichs L, Lich KH, Dave G, Corbie-Smith G. Integrating Systems Science and Community-Based Participatory Research to Achieve Health Equity. Am J Public Health. 2016;106(2):215–22. https://doiorg.publicaciones.saludcastillayleon.es/10.2105/AJPH.2015.302944.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Sanchez V, Sanchez-Youngman S, Dickson E, Burgess E, Haozous E, Trickett E, Baker E, Wallerstein N. CBPR implementation Framework for Community-Academic partnerships. Am J Commun Psychol. 2021;67(3–4):284–96. https://doiorg.publicaciones.saludcastillayleon.es/10.1002/ajcp.12506.

    Article  Google Scholar 

  69. Zhou Q, Stewart SM, Wan A, Leung CS, Lai AY, Lam TH, Chan SS. Development and evaluation of a Train-the-Trainer Workshop for Hong Kong Community Social Service Agency Staff. Front Public Health. 2017;5:15. https://doiorg.publicaciones.saludcastillayleon.es/10.3389/fpubh.2017.00015.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Rodriguez NM, Casanova F, Pages G, Claure L, Pedreira M, Touchton M, Knaul F. Community-based participatory design of a community health worker breast cancer training intervention for South Florida latinx farmworkers. PLoS ONE. 2020;15(10):e240827. https://doiorg.publicaciones.saludcastillayleon.es/10.1371/journal.pone.0240827.

    Article  CAS  Google Scholar 

  71. Lee S, Mak V. Train-the-trainer program on cardiovascular health for community pharmacists in Malaysia. Int J Clin Pharm-Net. 2017;39(6):1166–70. https://doiorg.publicaciones.saludcastillayleon.es/10.1007/s11096-017-0540-5.

    Article  Google Scholar 

  72. Iris C, Mandong L, Songsong W. Developing the Asian Pacific Islander Caregiver Train-the-Trainer Program in the United States. J Ethnic Cult Divers Social Work. 2020;6(29):490–507.

    Google Scholar 

  73. O’Brien MJ, Squires AP, Bixby RA, Larson SC. Role development of community health workers: an examination of selection and training processes in the intervention literature. Am J Prev Med. 2009;37(6 Suppl 1):S262–9. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/j.amepre.2009.08.011.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Tang YC, Haque S, Chassler D, Lobb R, Battaglia T, Sprague ML. It has to be designed in a way that really challenges people’s assumptions: preparing scholars to build equitable community research partnerships. J Clin Transl Sci. 2021;5(1):e182. https://doiorg.publicaciones.saludcastillayleon.es/10.1017/cts.2021.858.

    Article  Google Scholar 

  75. Lai AY, Stewart SM, Mui MW, Wan A, Yew C, Lam TH, Chan SS. An evaluation of a Train-the-Trainer Workshop for Social Service Workers to develop community-based family interventions. Front Public Health. 2017;5:141. https://doiorg.publicaciones.saludcastillayleon.es/10.3389/fpubh.2017.00141.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Aravind G, Graham ID, Cameron JI, Ploughman M, Salbach NM. Conditions and strategies influencing sustainability of a community-based exercise program incorporating a healthcare-community partnership for people with balance and mobility limitations in Canada: a collective case study of the together in Movement and Exercise (TIME) program. Front Rehabil Sci. 2023;4:1064266. https://doiorg.publicaciones.saludcastillayleon.es/10.3389/fresc.2023.1064266.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Pearce J, Mann MK, Jones C, van Buschbach S, Olff M, Bisson JI. The most effective way of delivering a train-the-trainers program: a systematic review. J Contin Educ Health. 2012;32(3):215–26. https://doiorg.publicaciones.saludcastillayleon.es/10.1002/chp.21148.

    Article  Google Scholar 

  78. Gandelman AA, Desantis LM, Rietmeijer CA. Assessing community needs and agency capacity-an integral part of implementing effective evidence-based interventions. Aids Educ Prev. 2006;18(4 Suppl A):32–43. https://doiorg.publicaciones.saludcastillayleon.es/10.1521/aeap.2006.18.supp.32.

    Article  PubMed  Google Scholar 

  79. Sprague ML, Rapkin BD, Young A, Freisthler B, Glasgow L, Hunt T, Salsberry PJ, Oga EA, Bennet-Fallin A, Plouck TJ, et al. Community engagement to implement evidence-based practices in the HEALing communities study. Drug Alcohol Depen. 2020;217:108326. https://doiorg.publicaciones.saludcastillayleon.es/10.1016/j.drugalcdep.2020.108326.

    Article  Google Scholar 

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Acknowledgements

The authors would like to acknowledge Meijuan Lin for her contributions in the literature search, article selection, and data extraction; and acknowledge Xiaoli Liao for her contribution in drafting the original background and discussion sections.

Funding

This program of research is funded by the Health and Medical Research Fund (HMRF) Commissioned Research on the Novel Coronavirus Disease (COVID-19) (Reference No: COVID1903006). The funding body has (and will continue to have) no role in the study design, data collection, analysis and interpretation, or in the decision to submit the paper for publication.

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Author notes

  1. Yan Zhang and Yao Jie Xie contributed equally to this work.

Authors and Affiliations

  1. School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China

    Yan Zhang, Yao Jie Xie, Lin Yang, Kin Cheung, Yan Li & Angela Yee Man Leung

  2. Cardiology Department, The Affiliated Hospital of Qingdao University, Qingdao, China

    Yan Zhang

  3. Research Centre for Chinese Medicine Innovation, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China

    Yao Jie Xie

  4. Musketeers Foundation Institute of Data Science, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China

    Qingpeng Zhang

  5. Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China

    Qingpeng Zhang

  6. Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China

    Chun Hao & Harry HX Wang

  7. Usher Institute, Deanery of Molecular, Genetic & Population Health Sciences, The University of Edinburgh, Edinburgh, UK

    Harry HX Wang

  8. Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China

    Qianling Zhou

  9. Research Institute for Smart Aging, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China

    Angela Yee Man Leung

  10. Research Centre of Textile for Future Fashion, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China

    Lin Yang

  11. WHO Collaborating Centre for Community Health Service, School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China

    Angela Yee Man Leung

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  1. Yan Zhang
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Contributions

YJX conceptualised and designed the study. YJX and YZ conducted the study selection processes and extracted, analysed and interpreted the data. YZ and YJX wrote the manuscript. YJX was the guarantor. LY, KC, QZ, YL, CH, HW, QZ, and AL all contributed to manuscript revision and approved the final version for submission.

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Correspondence to Yao Jie Xie.

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Zhang, Y., Xie, Y.J., Yang, L. et al. Community-based participatory research (CBPR) approaches in vaccination promotion: a scoping review. Int J Equity Health 23, 227 (2024). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12939-024-02278-1

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International Journal for Equity in Health

ISSN: 1475-9276

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