Listening First: How Community-Based Participatory Research Drives Better Health Outcomes

Building equitable partnerships through empathy, respect, and shared decision-making

Have you ever wondered why some health programs look great on paper but fall flat once they reach the community? Or why certain neighborhoods—especially Black, Latino, and Indigenous communities—keep facing the same health struggles year after year, no matter how many health fairs pop up or pamphlets get passed around?

It’s not because people don’t care about their health.

It’s not because communities are “hard to reach.”

Most of the time, it’s because systems still aren’t listening and meaningfully engaging. Many underserved communities feel unheard or misunderstood by healthcare systems that were never designed with them in mind. Those feelings are real, and they come from real history. And the impact is serious. For example, Black women are still nearly three times more likely to die from pregnancy-related causes than white women (CDC, 2024). Latino and Indigenous families continue facing higher rates of diabetes and barriers to culturally respectful care.

This is where cultural competence and humility step into the room. 

This idea is at the heart of Public Health Impact Academy’s course on  The Human Connection: Cultural Competence and Humility in Public Health, which focuses on building trust, using Community-Based Participatory Research (CBPR), and creating shared decision-making processes.

What Contributes to Health Disparities?

Health disparities are caused by more than just individual choices. They are shaped by larger system failures, which contribute to the social determinants of health (non-medical factors that impact health decisions). These include access to healthcare, education, safe housing, and economic opportunities, for example.

Another major factor is mistrust. Many minority and underserved communities have historical reasons to mistrust the healthcare system. When people feel like their voices are ignored or their culture is not respected, it creates a gap between providers and patients. 

Bias—both conscious and unconscious—also plays a role. Healthcare providers may not always recognize how their assumptions affect the care they give. This can lead to misdiagnoses, poor communication, and lower-quality care.

Real-World Examples

Community-Based Participatory Research (CBPR)

One of the most effective ways to address these issues is through Community-Based Participatory Research (CBPR). Instead of researchers making decisions alone, CBPR involves community members as equal partners. This means community voices are included in every step—from identifying the problem to creating and evaluating solutions. This approach helps ensure that programs and research projects are not only culturally relevant but also practical and trusted.

These programs worked better because they were designed with input from the communities they served, making the information more relatable and easier to apply in everyday life.

Another example comes from research focused on Black women’s health. A 2025 peer-reviewed study titled From Insight to Action: Applying Community-Based Participatory Research to Improve Population Health Among Black Women, highlighted how CBPR approaches helped address chronic disease disparities by involving Black women in designing and implementing health programs that reflect their real-life experiences. The study found that when Black women were included as equal partners, participation rates increased, trust in the program improved, and health outcomes were more positive.

Women reported feeling more respected, heard, and motivated to make changes because the program reflected their actual needs—not just what professionals thought they needed.

CBPR has also been used to improve care in surgical and chronic disease settings, showing that when communities are included in decision-making, interventions are more effective and sustainable (Alder et al., 2022). In these cases, patients and community members helped shape how care was delivered, which led to higher patient satisfaction and more sustainable health improvements. When people feel like they are part of the process, they are more likely to trust the system and stay involved in their care.

What Can Be Done?

Improving health equity starts with changing how we approach people and communities.

For Public Health Professionals:

• Practice cultural humility: Be open to learning from the community instead of assuming you know everything

• Build Real Partnerships: Partner with communities at every stage of a project and ensure their ideas are included. 

• Build trust over time: Show consistency, honesty, and respect

• Encourage shared decision-making: Let communities help shape solutions

• Address bias: Reflect on personal beliefs and how they impact your work

  
  

For Community Members :

• Speak up about your needs: Your voice matters in your healthcare

• Find culturally respectful providers: Look for care that values your background

• Stay informed: Learn about health topics that affect your community

• Get involved locally: Join programs or discussions that focus on community health

  
  

These steps may seem small, but they can lead to big changes when done consistently. Health equity starts with connection. 

Whether you’re working in public health or just trying to take care of yourself and your family, building trust and understanding culture can make a real difference. And remember —listen, learn, and act. Because when communities are heard, healthier futures become possible for everyone.

The Public Health Impact Academy (PHIA) provides dynamic evidenced-based training designed to equip public health professionals with the knowledge, skills, and strategies needed to drive meaningful change and improve health outcomes in all communities.https://www.beaconpublichealth.com/phia.

Check out our educational resources on our website at www.beaconpublichealth.com to help educate and inspire positive behavior change. Let’s continue the conversation on social media. 

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About the author: Ariana Midgette, a recent graduate from Morgan State University with a degree in Health Education with a concentration in Health Administration. She is passionate about enhancing healthcare access and utilizing effective leadership to improve service delivery for diverse communities. With a solid foundation in healthcare systems and management practices, Ariana is poised to make a meaningful impact in the field.

References: 

• Adler, R. R., Smith, R. N., Fowler, K. J., Gates, J., Jefferson, N. M., Adler, J. T., & Patzer, R. E. (2022). Community Based Participatory Research (CBPR): An Underutilized Approach to Address Surgical Disparities. Annals of surgery, 275(3), 496–499. https://doi.org/10.1097/SLA.0000000000005329 

• Bourgeois, J. W. (2025, May 29). From Insight to Action: Applying Community-based participatory research to address health disparities impacting Black Women. Centers for Disease Control and Prevention. https://www.cdc.gov/Pcd/issues/2025/24_0400.htm 

• CDC. (2024, April). Working together to reduce Black Maternal Mortality. Centers for Disease Control and Prevention. https://www.cdc.gov/womens-health/features/maternal-mortality.html 

• McCuistian, C., Peteet, B., Burlew, K., & Jacquez, F. (2023). Sexual Health Interventions for Racial/Ethnic Minorities Using Community-Based Participatory Research: A Systematic Review. Health education & behavior : the official publication of the Society for Public Health Education, 50(1), 107–120. https://doi.org/10.1177/10901981211008378