Building Community-Based Participatory Research Partnerships with a Somali Refugee Community

Background: The U.S. has become home to growing numbers of immigrants and refugees from countries where the traditional practice of female genital cutting (FGC) is prevalent. These women under-utilize reproductive health care, and challenge healthcare providers in providing culturally appropriate care. Purpose: This study examined Somali immigrant women's experiences with the U.S. healthcare system, exploring how attitudes, perceptions, and cultural values, such as FGC, influence their use of reproductive health care. Methods: A mixed-method community-based participatory research (CBPR) collaboration with a Somali refugee community was conducted from 2005 to 2008 incorporating surveys, semi-structured focus groups, and individual interviews. Providers caring for this community were also interviewed to gain their perspectives and experiences. Results: The process of establishing a partnership with a Somali community is described wherein the challenges, successes, and lessons learned in the process of conducting CBPR are examined. Challenges obtaining informed consent, language barriers, and reliance on FGC self-report were surmounted through mobilization of community social networks, trust-building, and the use of a video-elicitation device. The community partnership collaborated around shared goals of voicing unique healthcare concerns of the community to inform the development of interventional programs to improve culturally-competent care. Conclusions: Community-based participatory research using mixed-methods is critical to facilitating trust-building and engaging community members as active participants in every phase of the research process, enabling the rigorous and ethical conduct of research with refugee communities.