Low literacy influences individuals'attitudes toward health information and research, and is associated with poor health outcomes. Low literacy adults are disproportionately racial and ethnic minorities who also have the highest tuberculosis (TB) prevalence in this country. The overall long-term objective of this application is to strengthen the research collaboration of Rochester's scientific community and the Hawthorne literacy community for addressing sensitive health issues affecting diverse populations. This application focuses on the development of innovative ways for communication of culturally sensitive health information and implementation using community-based participatory research (CBPR) approach. We will build community health research capacity by orienting community members to research methods. We will use the model of adult informal education to understand socio cultural factors influencing TB evaluation, and develop culturally sensitive and linguistically appropriate learning approach to TB evaluation for the Hawthorne community. The application is designed to achieve the aims by basing it in the Hawthorne community, rather than in a scientific institution. Hawthorne community members will be engaged in the entire process and it is their cultural beliefs and concerns, expressed in focus groups and in-depth interviews that will form the basis of TB education and evaluation. A health team from the Hawthorne community will be recruited from focus group participants and assigned significant roles in the design, implementation, and evaluation phases of the project. The Rochester scientific community will bring its strengths in health promotion and care, research and analysis to the project. Together, the two communities will gain experience as a research team and have an experiential base to learn about CBPR. In Rochester, MN, a city of 100,000 people, there is a disconnect between the scientific community (Mayo Clinic, University of Minnesota Rochester, and Winona State University) and the low level literacy community (Hawthorne Education Center). Both literally and figuratively, these two communities do not speak the same language. Through an established CBPR partnership, these two disparate communities will jointly work and learn the process of health science research. As the two communities learn and work together, they will build an ongoing relationship based on respect, trust and a shared commitment to improving the health of the Hawthorne community. This application is of paramount importance in transforming community perceptions of the scientific process and research, and to public health. This project will promote the active engagement of affected members of the community to work with researchers to maximize the potential for change in knowledge, attitudes, and behavior as they pertain to the health needs of the community. It also addresses a vital public health interest by devising and implementing effective communication strategies for tuberculosis evaluation in some of the highest risk populations in this country.
