A Delphi study was implemented as part of a long-term Community-Based Participatory Research (CBPR) effort involving Brazilian church members and their local communities. The study purpose was to measure key informant perceptions about health needs in their community, the capacity of local churches to address those needs, and the efficacy and impact of a recent CBPR-based pilot study. The six key informants who participated had partnered with the research team in the pilot study and were experienced in the community of interest.
A two-round “policy Delphi” approach was used. In Round One, each participant responded to six core questions and related probes during an in-depth, moderately scheduled telephone interview. Example questions include What do you see are the major health needs in your local community?, How well equipped do you think the local church is to address important community health issues?, What were your impressions and experiences with [the recent pilot study]?
The responses were transcribed and independently reviewed by two researchers who used a selective coding technique to identify six emerging themes and subthemes. These themes and subthemes were included in a follow-up questionnaire (Round Two) in which the participants indicated whether they agreed with (yes), disagreed with (no), or were uncertain about (don't know) each subtheme statement. Written comments were also requested. Response frequencies were interpreted within the context of written comments (Round Two) and the original telephone interviews (Round One).
Strong consistencies emerged from this Delpi study regarding community health needs, the capacity of local churches to address them, and recommendations for future CBPR efforts. Identified community health issues included a mix of water- and insect-borne diseases (e.g., malaria, parasitic illnesses) and chronic conditions (e.g., cancer, high blood pressure) exacerbated by behavioral choices (drug and alcohol abuse, poor eating habits) and environmental conditions (e.g., unemployment, lack of adequate water and sanitation services.) Though most participants expressed certainty in the general capacity of churches to promote health in their local communities, perceptions differed about what constitutes true capacity (current readiness versus potential if training and support were provided.)
Perspectives about a recent CBPR community health assessment effort were generally positive. Most viewed the effort as useful in identifying health needs and generating community awareness. Recommendations for future research included the need to follow the assessment with in-depth surveys and interventions that targeted specific health issues. The responses validated the CBPR principal of using research only for community benefit.