Sequencing of the human genome and decades of genetic association and linkage studies have dramatically improved our understanding of the etiology of many diseases. However, the multiple causes of complex diseases are still not well understood, in part because genetic and sociocultural risk factors are not typically investigated concurrently. Hypertension is a leading risk factor for cardiovascular disease and afflicts more African Americans than any other racially defined group in the US. Few genetic loci for hypertension have been replicated across populations, which may reflect population-specific differences in genetic variants and/or inattention to relevant sociocultural factors. Discrimination is a salient sociocultural risk factor for poor health and has been associated with hypertension. Here we use a biocultural approach to study blood pressure (BP) variation in African Americans living in Tallahassee, Florida by genotyping over 30,000 single nucleotide polymorphisms (SNPs) and capturing experiences of discrimination using novel measures of unfair treatment of self and others (n = 157). We perform a joint admixture and genetic association analysis for BP that prioritizes regions of the genome with African ancestry. We only report significant SNPs that were confirmed through our simulation analyses, which were performed to determine the false positive rate. We identify eight significant SNPs in five genes that were previously associated with cardiovascular diseases. When we include measures of unfair treatment and test for interactions between SNPs and unfair treatment, we identify a new class of genes involved in multiple phenotypes including psychosocial distress and mood disorders. Our results suggest that inclusion of culturally relevant stress measures, like unfair treatment in African Americans, may reveal new genes and biological pathways relevant to the etiology of hypertension, and may also improve our understanding of the complexity of gene-environment interactions that underlie complex diseases.

The Health Equity Alliance of Tallahassee (HEAT) Ethnographic Field School (EFS) uses a community-based participatory research (CBPR) framework to provide intensive, hands-on training in methods of collecting and analyzing qualitative and quantitative ethnographic data. In this article, we describe (1) how the field school addresses a disciplinary need for more rigorous training in research methods, (2) the value of grounding field training in a participatory framework, and (3) the structure and aims of the field school training program. Our efforts promote mutual learning in a collaborative environment and the integration of teaching, research, and action.

The Health Equity Alliance of Tallahassee (HEAT) is a diverse team of academic and community members interested in examining existing health disparities and in improving the health of those experiencing social or economic disadvantage. In 2010, HEAT designed a Heart Health study to examine the causes of high blood pressure and heart disease among African Americans living in Tallahassee, Florida. The study aimed to understand how the social environment, neighborhood conditions, social relationships, experience of stress, and the stress of racism impacts health. This paper discusses the community engagement plan used to involve Tallahassee residents in a dialogue and conversation about the HEAT Heart Health (HHH) Study. Using the example of HHH, we argue for a community engagement approach that involves community residents in all processes of a research study, including the reporting of findings.

Community-based participatory research (CBPR) is increasingly being used by academics to address urban health and inequity. While its foundational literature emphasizes CBPR’s role in eschewing the traditional balance of power between communities and institutions, some scholars and grassroots activists note that it has not consistently delivered community-led, action-oriented strategies. Here we examine gaps between theory and current practice of CBPR. First, we assess its fundamental practices through social movement theory. Second, we examine narratives from grassroots leaders who have utilized CBPR in their environmental justice efforts. Three key facilitating factors are often cited for authentic applications of CBPR: (1) grounding research within community-specific opportunities for change, (2) collaborating with a strong community partner, and (3) facilitating flexibility in research processes. Building on previous scholarship, we investigate the complexity of CBPR implementation that may dampen its potency as a social change strategy and highlight the need for nuanced and critical application of best practices to suit local contexts. This is accomplished by pairing the theoretical framework with the experiences of four community leaders who are members of the Moving Forward Network (MFN). Narratives from their experiences with partnering with academic institutions speak to how theoretical complexities with CBPR occur in practice.

Community-based Participatory Research (CBPR) provides a methodology that creates mutually beneficial and equitable partnerships between researchers and community people involved in positive change. Participatory Action Research (PAR) is rooted in trust, connectivity, and reciprocity to address issues and actions that remedy inequitable social, economic, and environmental problems arising from racism rooted in structural/political imbalances. In this paper, we discuss the Health Equity Alliance of Tallahassee (HEAT) and its affiliated six week Ethnographic Field School that trains graduate students in CBPR methodology by bringing faculty, local community activists and stakeholders, and students together for mutual learning in dynamic classroom, community, and social settings. The paper offers reflections on the experience by a student, HEAT activist, local and visiting faculty, and demonstrate how a model field school based on PAR offers an empirical approach to building capacity to address power inequities in local settings and beyond.

This community-based participatory research study explores perceptions about infant mortality among Black women in Leon and Gadsden counties of North Florida. It emphasizes engagement and leadership for community organizers and health profession students and partnership building across disciplines. Three focus groups were conducted with Black women (N=20) ages 19 to 68. Participants responded to questions about infant mortality definitions, community impacts, sociocultural causes, prevention strategies, health care access, and racial dynamics. Content analysis with open coding was used to identify key themes. Findings suggest that infant mortality in local Black communities stems from interconnected individual, family, community, health system, and societal factors. These include discrimination, socioeconomic challenges, female burden, stress, cultural taboos, health care access, psychosocial support, educational opportunities, and intergenerational communication. Participants describe community outreach,...