scholarly journals 2438 Community-based research networks: Providing infrastructure for clinical and translational research in the State of Michigan

2018 ◽  
Vol 2 (S1) ◽  
pp. 65-66
Author(s):  
Meghan Spiroff ◽  
Patricia Piechowski ◽  
Karen D. Calhoun ◽  
Susan Goold ◽  
Ayse Buyuktur ◽  
...  

OBJECTIVES/SPECIFIC AIMS: As the sole Clinical and Translational Science Award (CTSA) site in Michigan, the Michigan Institute for Clinical & Health Research (MICHR) at the University of Michigan (UM) is working to develop community networks that drive clinical and translational research on community-identified health priorities. METHODS/STUDY POPULATION: These CBRNs will be modeled from successful work that has been accomplished in Jackson, MI where stakeholders from the local healthcare community, County Health Department, Health Improvement Organization, and grassroots community members created a Community of Solution to address the unmet behavioral health and social needs of community members. The CBRN’s will focus on identifying community health priorities by receiving input from community members in underserved communities using deliberative software called Choosing All Together (CHAT). RESULTS/ANTICIPATED RESULTS: In the fall of 2017, 3 focus groups were held in Northern Michigan to identify community health priorities. The top 5 community health priorities include; (1) mental wellness, (2) long-term illness, (3) alcohol and drugs, (4) air, water, and land, and (5) affording care. Additional focus groups are scheduled for the winter in 2 additional geographic areas. DISCUSSION/SIGNIFICANCE OF IMPACT: Future work for the creation of CBRNs includes building leadership groups comprised of clinicians, community leaders, public health leaders, health system leaders and researchers to inform the leadership groups of community-identified health priorities. In addition, the team is working to identify a platform to connect academic investigators across UM and community partners on shared research priorities in real time. In order to measure and map relationships within the networks, we are planning to utilize Social Network Analysis as an evaluation tool.

2011 ◽  
Vol 22 (4A) ◽  
pp. 165-173 ◽  
Author(s):  
Alexander Quarshie ◽  
Adam Davis ◽  
Gregory Strayhorn ◽  
Carolyn Weaver ◽  
Cigdem Delano ◽  
...  

2017 ◽  
Vol 3 (1_suppl) ◽  
pp. 67S-72S ◽  
Author(s):  
Peter M. Ginter ◽  
Lauren Wallace ◽  
Andrew C. Rucks

Public health departments provide many services critical to maintaining healthy populations, including communicable disease control, immunizations, primary care, and emergency preparedness. The Public Health Accreditation Board (PHAB) has established an accreditation process for public health departments that measures departmental performance against nationally recognized, evidence-based standards. The goal is to recognize departmental strengths and weaknesses, strengthen partnerships, and promote the prioritization of organizational goals to improve community health. Achieving accreditation from the PHAB requires health departments to develop Community Health Assessment (CHA), Community Health Improvement Plan (CHIP), and Strategic Plan processes. The intent of the CHA is to determine contributing factors for poor health outcomes and assess available resources. Building on the CHA, the CHIP establishes health priorities and improvement strategies, including measurable health outcomes and recommended policy changes. Finally, Strategic Plan defines the health department’s strategic priorities, goals, and implementation plans. A number of methodologies are available to develop these plans, but many prove to be complicated and confusing, leading to suboptimal performance. The Alabama-Mississippi Public Health Training Center assisted the Alabama Department of Public Health with the creation of their plans by developing the Focused Strategic Thinking Approach, which supplied simple and effective processes to develop useful and successful plans. These processes provide useful guides for other public health departments developing their prerequisites as they pursue PHAB accreditation.


2018 ◽  
Vol 2 (S1) ◽  
pp. 75-75 ◽  
Author(s):  
Laurie L. Novak ◽  
Sheba George ◽  
Kenneth Wallston ◽  
Yolanda Vaughn ◽  
Tiffany Israel ◽  
...  

OBJECTIVES/SPECIFIC AIMS: Community stakeholder engagement along the translational spectrum of biomedical research has been identified as a potentially crucial factor for encouraging participation among underrepresented groups, improving research relevance, and adoption of evidence into practice. Although we have developed various methods to improve communication between researchers and community stakeholders, we have not focused much attention on the manner by which community stakeholders choose to communicate with researchers in scientific feedback settings. In our PCORI funded study using Community Engagement Studios to elicit feedback on research from community stakeholders, we found that feedback from participants was frequently provided in the form of stories. This presentation aims to describe these narratives, examine their function in the feedback process and consider how a focus on these narratives enhances our understanding of community engagement for clinical and translational research. METHODS/STUDY POPULATION: The present study comes from a larger randomized, controlled methodological study. We randomized 20 investigators seeking input on their research to either a Community Engagement Studio (a panel of community members or patients) or a Translational Studio (a panel of researchers). Any faculty member or research trainee at Vanderbilt University or Meharry Medical College was eligible to participate. Each Studio panel was convened to provide project-specific input. The 153 stakeholders who participated in CE Studios were patients, caregivers, or patient advocates identified by health status, health condition, or demographic variables based on the project-based needs of the 20 researchers randomized in this project. Stakeholders include individuals with diabetes, heart failure, Parkinson’s disease, sickle cell disease, and ICU survivors. All stakeholders had experience as a partner or consultant on a research project or through serving on a research advisory board or committee. All Studios were recorded and transcribed, and experienced qualitative researchers analyzed the data. For this paper, we focus on the narrative feedback in the form of stories elicited in the CE Studios. Using qualitative methods, we coded the transcripts from the 20 CE Studios to identify stories and their functions in the feedback. Stories were defined as narratives with (a) at least one actor (b) action that unfolds over time, and (c) a realization, destination, or conflict resolution (i.e., a point of the story). For example, “I refilled my mother’s pillbox on Sunday and on Friday I found the pillbox still completely full” would be a story, however, “my mother doesn’t take her meds correctly” would not. We coded the stories for how they facilitated communication in the Studio using an open-coding style, that is we did not apply a specific theoretical framework of interaction or communication. It was possible for any given story to have more than one code applied to it; that is they were not classified in a mutually exclusive way. RESULTS/ANTICIPATED RESULTS: We found 5 major functions of stories in the Studios. Basic sender-receiver functions were noted, including responding to queries and seeking mutual understanding. The other functions served to move or add to the conversation, including adding expansion and depth, characterizing abstract concepts, and providing context, with the latter being the most frequent function of stories. Speakers provided context in a wide variety of dimensions, ranging from the context of the body to spatial and institutional contexts. These stories served to help others understand the speakers’ lived experiences. DISCUSSION/SIGNIFICANCE OF IMPACT: We often engage community members in research for their expertise with regards to their lived experiences as patients or community members, and for their experiences of healthcare and social determinants of health in particular community contexts. Yet we may expect them to share their expertise in a manner that is consistent with a scientific, explanatory framing and language. However, we know there is a difference in the way that professional researchers discuss research Versus how community members discuss research. In our PCORI study, we found that our Community Studio participants relied on storytelling as an important means to communicate their lived experiences. Their stories were often key to communicating the complex contexts of their experiences. We focus on examining these narrative practices and their functions in how community members engaged with and provided advice to researchers. This understanding may help us in: (1) Characterizing the contexts, processes, and meanings associated with community stakeholder experiences that are otherwise difficult to access. (2) Identifying community priorities relevant to research that are embedded in community narratives to better align research priorities with community needs and to improve patient outcomes. (3) Collecting insights for improving the design of community engagement activities in research. (4) Harnessing more fully the potential of community engagement in research.


Author(s):  
Jacquelyn Fede ◽  
Stephen Kogut ◽  
Anthony Hayward ◽  
John F. Stevenson ◽  
Amy Nunn ◽  
...  

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
David Musoke ◽  
Charles Ssemugabo ◽  
Rawlance Ndejjo ◽  
Edwinah Atusingwize ◽  
Trasias Mukama ◽  
...  

Abstract Objective The objective of the project was to strengthen the community health worker (CHW) programme in Ssisa sub-county, Wakiso district, Uganda by providing a coherent, structured and standardized training, supervision and motivation package so as to enhance their performance. Results The project trained all 301 CHWs who received non-financial incentives of t-shirts, gumboots and umbrellas, and 75 of them received solar equipment to support lighting their houses and charging phones. Twenty-four of the CHWs who had coordination roles received additional training. Three motorcycles were also provided to enhance transportation of CHW coordinators during their work including supervision. By end of the project, the CHWs had conducted 40,213 household visits, carried out health education sessions with 127,011 community members, and treated 19,387 children under 5 years of age. From the project evaluation, which used both quantitative and qualitative methods, 98% of the CHWs reported having improved competence in performance of their roles. In addition, the CHWs were highly motivated to do their work. The motorcycles were instrumental in supporting the work of CHW coordinators including monthly collection of reports and distribution of medicines. The project demonstrated that by improving training, supervision and motivation, performance of CHW programmes can be enhanced.


2018 ◽  
Vol 2 (S1) ◽  
pp. 75-76
Author(s):  
Grisel Robles-Schrader ◽  
Ashley Sipocz ◽  
Evelyn Cordero ◽  
Gina Curry

OBJECTIVES/SPECIFIC AIMS: The goals of this project are to: (1) Help research teams better understand, anticipate, and adapt research to address the needs of diverse communities. (2) Help clinicians and researchers develop patient-centered communication skills needed for more frequent and meaningful engagement of research participants. (3) Identify additional service support needs of clinical research teams not currently offered by other centers (e.g., translation services by certified translators, access to bilingual/bicultural research staff) so they can effectively recruit diverse communities. METHODS/STUDY POPULATION: Mixed methods evaluation approaches centered on obtaining community and academic input aimed at revising the tool to enhance its feasibility and relevance. Round one of focus groups were conducted (4), 2 with a diverse group of community stakeholders, 2 with a diverse group of academic stakeholders. Focus group feedback guided HLCR Assessment Tool revisions. This round of focus groups, served as an opportunity for community and academic stakeholders to discuss shared and divergent priorities related to the development and utilization of the tool. Feedback from these sessions guided a second set of revisions to the tool. Brief surveys were administered at each time point to gather participant demographic data. For the first round of focus groups with community stakeholders, 2 diverse groups totaling 19 people participated (11 female, 7 male, 1 no answer; 6 Asian/Pacific Islander, 6 Black/African American, 4 Latino/Hispanic, and 3 White/Caucasian). Participants served a variety of populations including seniors, youth, underserved, Muslim Americans, Bangladeshi, Arab, South Asian, refugees, community health centers, service organizations, 1st generation students, Latinos, multi-ethnic groups, limited English speaking, people with lupus, un/underinsured, people with HIV, Korean Americans, African Americans, and the disability community. Data pending on the first round of focus groups with academic stakeholders. All participants of the first round of focus groups will be invited to return to a second round of focus groups (2), this time only 2 groups will be held, and these will combine community and academic participants in each focus group. RESULTS/ANTICIPATED RESULTS: Along with formatting and grammatical revisions, recurring recommendations focused on considerations/clarifications in 3 main areas: compensation for all stakeholders, developing a common language and clarifying terms, and aligning the research process with the community. Considerations around compensation was mentioned in discussions related to multiple tool domains. In particular, community stakeholders recommended inclusion and consideration of compensation not just for research participants but also community partners, sites, community representatives, and other academic partners. It was also very important to make sure the form of compensation for both community partners and participants aligns with what was being asked of them. Community stakeholders sited a few examples where they were involved in studies where the time and requirements for participation were not commensurate with the compensation they received or the study budget did not include compensation for community partner effort. Along with edits to questions in the HLCR Assessment Tool, community stakeholders also recommended education for budget/finance personnel on fair compensation for research participants and community partners. In both focus groups, there was also confusion around specific terms and an identified need to develop a common language and clarify terms among all those involved in the research process. More specifically, terms such as community, culture, community of focus, community partners, accessible, and convenient were identified as needing further definition or clarification. Through the focus groups, we learned the valuable lesson that it cannot be assumed broad terms or even seemingly specific ones will be interpreted the same by everyone or have the same meaning in different contexts. Therefore, it needs to be very clear what these terms mean and who or what they represent. Finally, the community stakeholders emphasized throughout both focus groups the importance of making sure that the HLCR Assessment Tool unpack and explicitly emphasize how the research process can align and should align with community needs, communication structures, influencers, and assets. Some factors community stakeholders suggested be considered were: (1) Where the researcher is in the research process; (2) How community members prefer to communicate with each other; (3) Stigma/biases (e.g., class) that may be pervasive in a particular community; (4) Identification of key community influencers/gatekeepers; (5) Learning about a community’s assets along with their needs. DISCUSSION/SIGNIFICANCE OF IMPACT: Currently, there is dearth of resources focused on increasing diverse engagement in clinical and translational research, and consequently, research teams have little or no knowledge or support for how or when to engage community partners in clinical or translational research. The goal of this project is to help fill that gap with a tool to guide clinical and translational research teams in assessing the health literacy and culturally responsive components of their research projects to improve recruitment of diverse populations. Feedback on the first iteration of the HLCR Assessment Tool helped us identify the priorities for community stakeholders and better understand their concerns and needs around engagement with academic partners in clinical and translational research. This understanding will help us enhance the relevance and usefulness of the HLCR Assessment Tool so that clinical and translational science researchers more effectively engage with community partners and help ensure the community’s needs are better aligned with. Therefore, developing and pilot testing this tool can offer a significant opportunity for clinical and translational sciences institutions to enable their researchers and their teams to teams better understand, anticipate, and adapt to the cultural and health literacy needs of diverse populations. More specifically, this tool can: (1) Help clinicians develop the patient-centered communication skills needed to facilitate more frequent and meaningful engagement of potential research participants during medical visits to truly make every healthcare encounter an opportunity for research. (2) Help clinical and translational sciences institutes identify additional service support clinical research teams will need access to in order to effectively recruit diverse communities, that are not currently not supported [e.g., translation services by certified translators, access to bilingual/bicultural research staff at all level (i.e., study coordinators, research assistants, etc.), etc.].


2020 ◽  
Author(s):  
Leticia R. Moczygemba ◽  
Whitney Thurman ◽  
Kyler Tormey ◽  
Anthony Hudzik ◽  
Lauren Welton-Arndt ◽  
...  

BACKGROUND People experiencing homelessness are at risk for gaps in care after an emergency department (ED) or hospital visit, which leads to increased utilization, poor health outcomes, and high health care costs. The majority of homeless individuals have a cell phone of some type, which makes mobile health interventions a feasible way to connect a person experiencing homelessness with providers. OBJECTIVE To investigate the accuracy, acceptability, and preliminary outcomes of a global positioning system-enabled mobile health (GPS-mHealth) intervention designed to alert community health paramedics when people experiencing homelessness were in the ED or hospital. METHODS This was a pre-post design with baseline and 4-month post-enrollment assessments. A person experiencing homelessness taking at least two medications for chronic conditions who scored at least 10 on the Patient Health Questionnaire-9 (PHQ-9) and had at least two ED or hospital visits in the prior 6 months was eligible. Participants were issued a study smartphone with a GPS app programmed to alert a community health paramedic when a participant entered an ED or hospital. For each alert, community health paramedics followed up via telephone to assess care coordination needs. Participants also received a daily e-mail to assess medication adherence. GPS alerts were compared to ED and hospital data from the local health information exchange (HIE) to assess accuracy. Paired t-tests compared scores on the PHQ-9, Medical Outcomes Study Social Support Survey, and ASK-12 adherence survey at baseline and exit. Semi-structured exit interviews examined perceptions and benefits of the intervention. RESULTS Thirty participants enrolled; the mean age was 44.1 years (SD 9.7). Most were male (67%; n = 20), White (57%; n = 17), and not working (63%; n = 19). The GPS app showed limited accuracy in ED or hospital visit alerts. Only 18.8% of the alerts aligned with HIE data (3/16), mainly due to patients not having the phone with them during the visit, phone being off, and gaps in GPS technology. There was a significant difference in depressive symptoms between baseline (M=16.9, SD=5.8) and exit (M=12.7, SD=8.2); t(19)=2.9, p=.009 and a significant difference in adherence barriers between baseline (M=2.4, SD=1.4) and exit (M=1.5, SD =1.5); t(17)=2.47, p = .025). Participants agreed that the app was easy to use (M=4.4/5 with 5 = strongly agree (SA)) and indicated the e-mail helped them remember to take their medications (M=4.6/5). Qualitative data indicated that unlimited phone access allowed participants to meet social needs and maintain reliable contact with case managers, healthcare providers, family, and friends. CONCLUSIONS mHealth interventions are feasible for and acceptable to people experiencing homelessness. Objective data from the HIE provided more accurate ED and hospital visit information, but unlimited access to reliable communication provided benefits to participants beyond the study purpose of improving care coordination. CLINICALTRIAL Not applicable


Author(s):  
LaKaija J. Johnson ◽  
Jolene Rohde ◽  
Mary E. Cramer ◽  
Lani Zimmerman ◽  
Carol R. Geary ◽  
...  

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