Progress in Community Health Partnerships-Research Education and Action最新文献

Background: Soil constitutes a major source of childhood lead exposure, disproportionately affecting communities of color. Mulching offers a low-cost interim control.

Objectives: A community-academic partnership was established for lead poisoning prevention, with a three-fold aim: (1) control soil lead hazards by applying mulch, (2) identify home lead hazards with screening kits, and (3) connect residents to resources to address lead hazards.

Methods: Student volunteers canvassed neighborhoods one month prior to the annual event. They requested consent for mulching, distributed lead screening kits, and screened residents for grant eligibility. Soil samples were collected from each home before mulching. According to principles of community-based participatory research, materials and plans were iterative, guided and adjusted by neighborhood association feedback, and detailed reports about home lead results were shared with each participating resident. Composite neighborhood data and survey results were shared with volunteers and community partners.

Results: The project was evaluated in the third (41 homes) and fourth (48 homes) years of implementation. Before mulching, the median soil lead level was over 400 ppm, and after mulching, it was less than 20 ppm. Lead screening kits identified widespread lead hazards in paint, soil, and dust, but not water. Challenges remain in (a) increasing child blood lead testing and (b) increasing submissions for city grant funding for lead abatement. Evaluation surveys indicate a sense of ownership in the project among community partners and high levels of engagement among students.

Conclusions: Community-academic partnerships are an effective tool for lead poisoning prevention, generating evidence for public health action.

Background: Colorectal cancer (CRC) incidence and mortality are disproportionately high among rural residents and Medicaid enrollees.

Objectives: To address disparities, we used a modified community engagement approach, Boot Camp Translation (BCT). Research partners, an advisory board, and the rural community informed messaging about CRC outreach and a mailed fecal immunochemical test program.

Methods: Eligible rural patients (English-speaking and ages 50-74) and clinic staff involved in patient outreach participated in a BCT conducted virtually over two months. We applied qualitative analysis to BCT transcripts and field notes.

Results: Key themes included: the importance of directly communicating about the seriousness of cancer, leveraging close clinic-patient relationships, and communicating the test safety, ease, and low cost.

Conclusions: Using a modified version of BCT delivered in a virtual format, we were able to successfully capture community input to adapt a CRC outreach program for use in rural settings. Program materials will be tested during a pragmatic trial to address rural CRC screening disparities.

Research funding has been criticized as biased against novel initiatives and lacking diversity, which leads to further disparities. Patient and stakeholder engagement could support research that goes beyond traditional paradigms and increases diversity. However, best practices to engage stakeholders in research, including funding decisions, continue to be developed. We report on the implementation of stakeholder input in two federally funded initiatives, one that seeks to advance research reducing disparities, and the other seeks to advance deprescribing research. Overall, the review process includes stakeholders as decision makers and supports their efforts through group discussion and other activities. Reconciling stakeholder input that may differ from scientific peer review is a challenge within the decision for funding. Lessons learned include balancing stakeholder and scientific assessments and including guidance on stakeholder engagement to grant awardees.

Background: Health care access for migrant farmworkers is limited given the nature of seasonal farm work, including migration patterns, capacity, and availability of local community health services. Consideration of these contextual elements when exploring a community-academic partnership to increase access to care for migrant farmworkers is essential.

Objective: Explore the partnerships and processes for integrating nursing faculty and students from a regional public university's school of nursing into a farmworker health outreach program's mobile clinic process.

Methods: A feasibility study was undertaken using Bowen et al.'s feasibility framework.

Results: Integrating faculty and students into the farmworker health outreach program's mobile clinic process was determined to be feasible.

Conclusions: Integrating faculty providers and students into a farmworker outreach program's mobile health process has several nuances requiring consideration before operationalizing the partnership, including nursing faculty practice (e.g., credentialing, malpractice insurance), student clinical placement processes, the farmworker outreach program's processes, and farmworker availability.

Background: Using community-engaged research may result in interventions that reduce infant oral health disparities in underserved populations.

Objective: Develop community partnerships to create a sustainable infant oral health program that meets specific community-identified needs and provides an interprofessional education experience.

Methods: Partnering with the Homewood Community Engagement Center, researchers engaged and surveyed key community partners to assess the need for an infant oral health invention.

Lessons learned: Community-identified organizing principles and barriers became the framework for, "Healthy Teeth, Healthy Me," a community-driven infant oral health program. Barriers, like access to care, were addressed with community-specific solutions like agreements with local dental clinical for referrals.

Conclusions: Community partnerships can be leveraged to develop oral health programs that fit specific community needs and provide resources to families at greatest risk for child dental caries. Community engagement can be used to modify the intervention to meet oral health needs of other vulnerable communities.

Background: Individuals with opioid use disorder and cooccurring mental health concerns experience heightened consequences and lower rates of treatment access. Engaging patients as research partners alongside health systems is critical for tailoring care for this population. Collaborative care is promising for the treatment of co-occurring disordersObjectives: We used a community-participatory partnered research1 approach to partner with patients, providers, and clinic administrators to adapt and implement a collaborative care intervention for co-occurring disorders in primary care.

Methods: We conducted qualitative interviews with patients to assess their feedback on the proposed collaborative care model before intervention implementation. A first round of interviews was conducted to obtain patient feedback on our adaptation ideas (n = 11). The team then incorporated these suggestions, beta-tested the intervention with participants (n = 9), and assessed participant feedback. Data were analyzed using rapid content analysis and then implemented by health systems.

Results: Patient feedback underscored the need for the care coordinator (CC) to be trained in patient engagement and stigma reduction and to provide assistance around socioeconomic barriers and relapse. Patients shared that it was helpful to have the CC address co-occurring disorders, emphasized the need for the CC to be flexible, and expressed that tele-health was acceptable. Patient feedback was integrated in subsequent CC training with health systems.

Conclusions: The present research demonstrates the feasibility and usefulness of incorporating patient perspectives into treatment design and implementation in health systems using community-participatory partnered research .