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

Background: In areas of new-immigrant population growth, medical and social infrastructure may be lagging behind the needs of those who do not identify with the majority culture or language. Subsequently, information regarding this population's health status and access to care is limited. Montana's Hispanic population is one such group. Despite its low total population, the state has experienced unprecedented growth in the number of Spanish-speaking individuals and families over the last decade.

Objectives: We utilized a community based participatory research framework to emphasize equal partnership between lay community members and researchers to ensure adherence to community priorities and strengthen trust between the two parties allowing for future collaboration. Based on community request, we designed four health screening events to provide needed health prevention services to the Hispanic community.

Methods: Through collaboration with a Community Advisory Board, we created four health screening events to provide basic primary care services, including height and weight, blood pressure, diabetes, and mental health screenings. We partnered with a team of dental hygienists to provide oral preventive health. We conducted a cost-effectiveness analysis, comparing our approach to traditional health services. Study variables were analyzed using analysis of variance to examine differences in health outcomes between health screening events.

Results: We screened 140 persons and found that 85.7% lacked health insurance and 80.7% lacked a usual source of care. We also found overweight and obesity in 47.1% and 27.1%, respectively, and hypertension in 63.6%. Services provided by the health screening events were up to $239 less expensive than comparable services provided at local health centers.

Conclusions: Working directly with the community, we designed and implemented health prevention events which served to meet a growing need and to identify and address health concerns among the Hispanic immigrant community.

Background: While correctional systems often function separately from academic and community-based organizations, there is opportunity for mutually beneficial collaborative partnerships to strengthen services and relationships. Community-academic partnerships (CAPs) are a well-established model in implementation science and in scientific literature. Applying best practices for CAPs to a partnership that includes community, academic, and correctional partners could contribute to a stronger partnership with more capacity to improve population health of people who experience incarceration.

Objectives: To describe our work to identify CAP best practices, and to discuss considerations and approaches for applying these best practices in an emerging community- academic-corrections partnership.

Methods: From the scientific literature, we identified best practices for CAPs across nine domains: bringing the community into the project; building new relationships while addressing the past; establishing mutually beneficial vision, goals, and purpose; roles and expectations of partners; communication; administration; leadership; project implementation and evaluation; and building community capacity and awareness. In this paper we describe considerations from the perspective of the academic partner regarding these nine best practice domains in the development of a community-academic-corrections partnership.

Conclusions: While established CAP best practices have relevance, there are specific considerations for partnerships with correctional authorities that require attention. Informed by best practices, planning and preparation for partnership can help mitigate challenges, support effectiveness, and strengthen relationships.

Background: Discontinuity between health care delivery systems and community-based organizations is a significant barrier to improving population health.

Objective: To describe the facilitators and barriers experienced by a health system-community partnership 15 months after implementation.

Methods: Coalition members who led committees within the coalition or had active, sustained participation in coalition activities were invited to participate. Qualitative interviews used a semi-structured interview guide that elicited information on coalition functioning. A content analysis used inductive and deductive codes which were reviewed using a consensus process. Final themes centered on factors that facilitated or impeded the coalition's success in supporting community needs during the COVID-19 pandemic.

Lessons learned: Coalition stakeholder perspectives identified several critical factors: defined governance, a culture of trust that accelerates learning, reliable resources, and a health-care anchor organization committed to shared investment.

Conclusions: Lessons from this endeavor contribute to a deeper understanding of successful practices for health system-community partnerships.

Background: Efforts to promote COVID-19 vaccination uncovered the effects of longstanding structural racism and perpetuated the erosion of community trust in science and public health institutions. Rebuilding trust is a priority to overcome barriers to vaccine uptake. Bridging Research, Accurate Information and Dialogue (BRAID) is a model that combines several evidence-based approaches to nurture trusting relationships with community experts, leading to the dissemination of accurate, timely, and acceptable COVID-19 vaccine messages.

Objective: To describe an innovative community-engaged participatory research model with the potential to build trust and spread accurate health information through social networks.

Methods: BRAID provided safe spaces for a series of facilitated conversation circles involving trusted community experts and invited clinicians and scientists. Community experts were encouraged to share their experiences, raise concerns, and ask pandemic-related questions in an informal setting. Community experts were empowered to codesign and coproduce accurate health messages acceptable to their communities. To gain insight into the process of building trust, dialogues involving 22 community experts were transcribed and coded, and post survey data from 21 participants were analyzed.

Conclusions: BRAID is a manualized community engagement model that aims to build the trust needed to improve COVID-19 vaccine uptake in historically marginalized communities. Through BRAID, participants developed increased trust in health systems and research. By empowering community experts to share information through their established social networks, BRAID has the potential to amplify the reach and impact of communications regarding health topics that are controversial and divisive, such as COVID-19 vaccination.

Background: Due to the COVID-19 pandemic, health professional training programs made substantial changes to shift previously in-person student training opportunities to remote settings.

Objectives: We present lessons learned from changes made to one community-engaged internship program, Bridging the Gaps (BTG)-Pittsburgh, that should prove helpful in future times of crisis.

Methods: BTG-Pittsburgh places inter-disciplinary graduate pairs of students in community-based organizations that serve marginalized populations, to work directly with program participants and develop tangible products aimed to build organizational capacity. Students get additional training on poverty awareness, health literacy, community violence, food justice, trauma-informed self-care, cultural and academic humility, oral health and advocacy. Upon pandemic onset, given increased community need and community partner feedback, BTG-Pittsburgh pivoted quickly, shifting to remote engagement and making critical adjustments to ensure responsiveness to student and community partner needs. Adjustments included: 1) adopting a trauma-informed approach, 2) developing remote mentoring guidance, and 3) doubling site visits to ensure that students and site mentors felt sufficiently supported.

Conclusions: Several program and partnership attributes contributed to our overall program success, including a model of reciprocal benefits, providing supports, flexibility, and long-standing relationships. The university's quick adoption of remote technology and each participating school's commitment to supporting the program model, further enabled effective student-organization-program collaboration. These lessons can inform community-partnered experiential learning programs that may need to incorporate remote components moving forward.

Background: Behavioral models play a key role in identifying pathways to better health and provide a foundation for health promotion interventions. However, behavioral models based in epidemiological research may be limited in relevance and utility in practice.

Objectives: We describe a participatory approach within a community-based participatory research partnership for integrating epidemiological and community perspectives into the application of the sociocultural resilience model (SRM). The SRM posits that cultural processes have a symbiotic relationship with health-promoting social processes, which contribute to the health advantages among Mexicanorigin and other Latinx populations.

Methods: Community action board members engaged with academic partners to interpret and apply the SRM to a community-clinical linkages intervention implemented in the context of three U.S.-Mexico border communities. In a two-day workshop, partners engaged in a series of iterative discussions to reach common definitions and measures for SRM constructs.

Results: Partners described daily cultural processes as the food they eat, how they communicate, and a collectivist approach to getting things done. For intervention activities, the partners opted for intergenerational storytelling, sharing of food, and artistic forms of expression. Partners included measures of cultural nuances such as border identity and the complexities that often arise from navigating bicultural norms.

Conclusions: Collaborative approaches within community-based participatory research partnerships can facilitate the adaptation and measurement of conceptual health behavior models in community practice.

Background: African Americans are disproportionately affected by cardiovascular disease and hypertension. To address this, we partnered with local church leaders in developing a virtual reality (VR) hypertension reduction program.

Objectives: A community-based participatory research approach was adopted to develop a hypertension education program using VR, incorporating feedback from the African American church congregation members.

Methods: Using a qualitative approach, a modified Delphi exercise, and member checking, the research team collaborated with congregation members who provided feedback and assisted in the development of the intervention.

Lessons learned: Incorporating feedback from church members significantly impacted the educational platform. Encouraged by the reverend, church members were engaged and participated in the 12-week program designed to reduce blood pressure. Novel approaches like VR may need more time to pilot to achieve desired results, particularly with vulnerable populations.

Conclusions: This participatory research platform highlights the importance of incorporating external stakeholders throughout the research process in order to develop a meaningful health intervention using new technology that is tailored to the church members.

Background: The Flint water crisis (FWC) was a public health tragedy caused by crumbling infrastructure, subverted democracy, and indifference toward a predominantly poor and Black community that resulted in lead-in-water exposure, Legionnaires' disease, and emotional and health-related trauma. Through the cooperation of community partners, the Flint Registry (FR) was conceived to track long-term health and improve public health via service connections.

Objectives: This study sought to share the FR's community-partnered, multi-tiered engagement strategy and determine the efficacy of this strategy to engage the community and reach Flint residents.

Methods: Community engagement and impact were measured by collecting and describing feedback from the community engagement strategies and by comparing the demographics of the enrollees recruited through community-engaged recruitment (CER) and non-CER methods. Enroll-ees indicated how they heard about the FR; CER involved direct interaction with a community member.

Results: Community engagement strategies incorporated approximately 1,200 people and 7 funded organizations, impacting 22 key areas of FR design and implementation. More than 50% of enrollees heard about the FR through CER methods. They were, on average, more likely to be younger, female, Black/African American, and living outside of Flint during the FWC.

Conclusions: Community engagement elevated voices of those impacted by the FWC. CER methods were as effective as non-CER methods. Although there were no differences in screened measures of social vulnerability, there were in age, gender, and race. CER methods may increase participation and build trust in populations which historically are hesitant to participate in public health efforts.

Background: Families of youth involved in the juvenile justice system (YJJ) are integral to YJJ well-being, so it is important to consider the direct input of YJJ families as well as YJJ themselves in justice system reform efforts aiming to improve YJJ health outcomes.

Objective: Our university research team partnered with one Midwest county's juvenile court, as well as YJJ family members, to form an advisory council to the juvenile court. We report lessons learned through a case study of this council.

Methods: Researchers reviewed and analyzed council records, meeting minutes, and interviews of varied stakeholders, including system representatives, leaders of similar advisory councils, and individuals with lived experience of the juvenile justice system.

Lessons learned: Council sustainability required addressing participation barriers, valuing authentic experiences, seeking out system-based champions, and identifying concrete opportunities for members to be heard.

Conclusions: Investments in community health partnerships with YJJ families could improve system efforts to meet YJJ needs.