The rise of community-based participatory research in the National Institute of Environmental Health Sciences: An historical policy analysis using the policy streams model

Chronic diseases and widening health disparities represent two major problems facing the modern public health field. Community-based participatory research (CBPR), which equitably involves lay persons and scientists in all phases of the research process, as opposed to the traditional scientist-driven research approach, may represent the best mechanism to identify and test solutions for these modern public health problems. However, the scientific community and funding entities have been slow to support it.;In 1995, the National Institute for Environmental Health Sciences (NIEHS) launched the first research initiative specifying the use of the CBPR approach. This study's purpose was to conduct an historical case study analysis of the development of the CBPR Initiative, using Kingdon's Policy Streams Model as an analysis framework. Kingdon's Model describes how and why a policy idea enters the policy adoption process when it does. No previous application of this Model to an internal organizational policy adoption process had been identified in the literature.;The study produced two significant results: First, the study produced an historical record of the factors and events which led NIEHS to develop the CBPR Initiative, a record which to date was lacking from the literature. Second, the study documented the effectiveness of Kingdon's model in explaining how the CBPR Initiative came about. Specifically, the policy stream indicated a re-emergence of interest in participatory research. In the problem stream, a series of focusing events and indicators brought national attention to environmental injustice, which elevated it to the level of a problem requiring government attention. In the political stream, there was an ideology change supportive of community participation and a leadership change. These problem stream and political stream changes opened a policy window of opportunity in the mid-1990s. Using the power and resources of his position, the NIEHS Director acted as a policy entrepreneur and seized that opportunity in 1995 to create the CBPR Initiative. This historical accounting indicates the existence of all the domains of Kingdon's Policy Streams Model and supports its effectiveness in explaining how a policy idea in an organization comes about.