Competencies Needed for Community-Engaged Dissemination and Implementation Research

An article recently published in Translational Behavioral Medicine proposes a conceptual framework for assessing a researcher’s readiness to engage in dissemination and implementation research with community stakeholders. The authors, all affiliated with the North Carolina Clinical and Translational Sciences Institute, started with a table that included community engagement principles as defined by NIH, potential domains areas for competencies, and potential competencies. Through a process of development, evaluation, and refinement, the researchers developed a list of 40 competencies for community-engaged dissemination and implementation (CEDI) research that fit within 9 domains.  These domains were:

  • Perceived value of CE in D&I research: The researcher’s attitude toward the potential for enhancing D&I research processes and outcomes through community engagement
  • Introspection and openness: The researcher’s willingness and/or ability to examine their own preconceptions and to be receptive of others’ beliefs and opinions
  • Knowledge of community characteristics: The researcher’s willingness and/or ability to learn about the community’s characteristics and prior experiences
  • Appreciation for stakeholder’s experience with and attitudes toward research: The researcher’s willingness and/or ability to assess how the community’s research attitudes and experiences may affect the partnership
  • Preparing the partnership for collaborative decision-making: The researcher’s willingness and/or ability to organize the partnership in a way that facilitate dialogues, collective decision-making, and coordinated action
  • Collaborative planning for the research design and goals: The researcher’s willingness and/or ability to adapt to the attitudes and needs of community stakeholders when defining the research process
  • Communication effectiveness: The researchers’ willingness and/or ability to clearly present ideas, listen to community partners, and work through issues
  • Equitable distribution of resources and credit: The researcher’s willingness and/or ability to share resources for conducting the research and credit for outcomes of the research
  • Sustaining the partnership: The researcher’s willingness and/or ability to invest in a long-term relationship with community stakeholders

The individual competencies associated with each of these domains provide specific actions and/or attitudes to help assess readiness to undertake CEDI research. The authors describe this framework as a “first step toward development of a readiness assessment for researchers interested in conducting CEDI.”

The article is available from Translational Behavioral Medicine.

Introducing the Language Access Portal

From the article by Kelli Carrington on NIMHD Insights:

Many of us know what it’s like to feel overwhelmed during a doctor’s visit by information about health conditions, medicines, and behavior recommendations. For patients who don’t speak or understand English fluently, the situation can be more than overwhelming—it can be dangerous. Patients with limited English proficiency (LEP) are nearly three times more likely to have an adverse medical outcome.1

Language is one of the most significant barriers to health literacy, the ability to understand the basic health information needed to make good health decisions. Patients who lack health literacy are often unable to read or understand written health information or to speak with their healthcare providers about their symptoms or concerns. These patients are less likely to follow important health recommendations or be able to give informed consent.2

According to the U.S. Census Bureau, more than 1 in 5 U.S. residents don’t speak English at home. Of that group, about 4 in 10, or 25 million people, have limited English proficiency.3 Many people with limited proficiency also live in households where no one speaks English well, meaning there isn’t a translator readily available to accompany them to doctor’s visits.

The National Institute on Minority Health and Health Disparities (NIMHD) is committed to addressing these language barriers and to improving the health literacy and lives of everyone living in America. We’re excited to announce a new tool, the Language Access Portal, as a resource for the NIMHD research community, public and community health professionals, healthcare providers, and others who work with health disparity populations with LEP. The portal improves access to cross-cultural and linguistically appropriate health information produced by the National Institutes of Health (NIH), NIMHD, and other federal agencies.

The Language Access Portal pulls together health resources from across NIH in selected languages, particularly those languages spoken by populations experiencing significant health disparities. As we launch, the portal includes information in Spanish, Hindi, Tagalog, Korean, and Vietnamese. The portal currently has language resources for the following areas where health disparities have been identified:

Read the full article.

Useful Resource: Compendium of Publicly Available Datasets and other Data-Related Resources

From the Announcement from the Office of Minority Health:

The Office of Minority Health (OMH) at the U.S. Department of Health and Human Services (HHS) announced the release of a new resource to aid researchers, public health practitioners and policymakers with data on health and health care disparities and social determinants of health. The Compendium of Publicly Available Datasets and Other Data-Related Resources (Compendium) is a free resource that compiles in one place descriptions of and links to 132 public datasets and resources that include information about health conditions and other factors that impact the health of minority populations.

The Compendium provides a one-stop shop for researchers, public policymakers and staff, the general public and all who are interested in the intersection of health, health care, health disparities and social determinants of health – the conditions that impact the environment in which individuals live, learn, work and play.

The Compendium was created by the Federal Interagency Health Equity Team of the National Partnership for Action to End Health Disparities (NPA) to advance research, public policy and the public’s knowledge of issues related to health equity. The compendium fills a gap that researchers and practitioners frequently face in locating federal datasets in one place, with information that is vital to conduct research on various topics. It is a valuable, time-saving resource that reduces the significant amount of time and work of identifying and sorting through datasets for pertinent variables of study.

The datasets provided in the Compendium can serve a variety of purposes. Researchers who are interested in studying the specific health services that Americans frequently use and the cost of and payment methods for those health services may access the Medical Expenditure Panel Survey (MEPS) data source available from AHRQ found in the Compendium. Organizations interested in program and policy development for children and families served by Head Start and Early Head Start programs may access the Head Start Program Information Report from ACF.

The Compendium of Publicly Available Datasets and Other Data-Related Resources is available on the NPA website.

See the original announcement.

Useful Resources: Considering the Impact of Proposed Legislation on Populations of Color

In the the third report from its Race for Results Case Study Series, the Annie E. Casey Foundation describes the use of racial equity impact assessment tools to improve policy making. The report focuses on four areas:

  • Why it is critical to measure the impact of any proposed legislation or change in policy on communities of color.
  • How racial equity impact assessments can lead to smarter and more targeted public investments.
  • How racial equity impact assessments keep decision-making focused on data and facts, not assumptions and long-held subjective beliefs.
  • How advocating and using racial equity impact assessments can position leaders and elected officials as strong champions of equity.

Download the report to learn more.

Useful Resource: Public Health Translational Toolbox

Through the Public Health Services and Systems Research (PHSSR) Translational Toolbox, the National Coordinating Center for Public Health Services and Systems Research and Public Health Practice-Based Research Networks offers a variety of digital resources related to “quality improvement initiatives, assessing the quality of community health improvement planning processes, and estimating the cost of delivering specific public health services, among others.”

The available tools include:

Visit the PHSSR Translational Toolbox to see all the available resources.

Useful Resources: Science-Based Health & Wellness Resources for Your Community

The National Institutes of Health (NIH) provides a series of evidence-based resources to help individuals and groups work for improved health. Available resources include:

NIH News in Health  Provides practical health information based on NIH research. This monthly newsletter can help you eat healthier, move more, and learn the science behind medical topics like acupuncture, menopause, and heart disease. Can help you or someone you care about quit smoking. Use the step-by-step quit guide, talk to an expert, and find other tools to help you quit.

Rethinking Drinking Provides research-based information about how your drinking habits can affect your health. Learn to recognize the signs of alcohol problems and ways to cut back or quit drinking. Interactive tools can also help you calculate the calories and alcohol content of drinks.

NIDA for TeensLearn how drugs affect the body and hear from teens who’ve struggled with addiction. This interactive web site has quizzes, videos, games, and a blog that shows the science behind drug abuse.

Talking to Your DoctorLinks you to NIH resources that can help you make the most of your conversations with your doctor. Communication is key to good health care. Get tips for asking questions and talking openly about your symptoms and concerns.

Aim for a Healthy WeightCan help you learn how to reach and maintain a healthy weight by taking small steps to change your lifestyle. Find tips for eating well at home and on the road, and for becoming more physically active.

My Family Health Portrait : Developed by the U.S. Surgeon General and NIH, helps you build a drawing of your family tree and a chart of your family health history that you can print and share with your family members and doctor. This information will help your doctor provide better care for you.

See the full list of resources.

Useful Resource: Community Commons Archived Webinars

Community Commons provides a web-portal of tools and information for groups and individuals working to create healthy, equitable, sustainable communities. The archived webinars were conducted by the training team to help site users “get a sense of how data tools can be used in partnership with community context for case-making.”

Archived webinars include:

  • Growing Your Case: Good Data & Resources on Community Commons
  • Partnership Spotlight: Salud America! And Tools for Healthy Change
  • Using Maps to Support Storytelling
  • Exploring the intersection of Poverty and Education
  • Prioritizing Vulnerable Populations & Gathering Secondary Data
  • Planning for Grant Funding – CDC Funding Opportunities
  • Community Health Improvement Planning
  • A Nonprofit Resource for Case-Making

Visit the site to see the full list of available webinars.

Improving Population Health by Working with Communities: Action Guide 3.0

From the Report released by the National Quality Forum:

The United States ranks lower than many other developed nations on health outcomes, faces unsustainable healthcare costs, and continues to struggle with significant health disparities. To address these issues, the National Quality Strategy is driving action to foster healthier people and communities, better healthcare, and more affordable care. Improving population health by working together is an essential part of the solution. In collaboration with a multi-stakeholder Committee and 10 groups at the regional and community levels working on population health improvement across the country, the National Quality Forum developed the Action Guide with funding from the Department of Health and Human Services.

The Action Guide is a framework to help multi-sector groups work together to improve population health by addressing 10 interrelated elements for success and using the related resources as needed. Like a “how-to” manual, the Action Guide is organized by these 10 elements and contains definitions, recommendations, practical examples, and a range of resources to help communities achieve their shared goals and make lasting improvements in population health. It is intentionally brief and written in plain language to be as accessible as possible for all types of stakeholders at the local, state, regional, and national levels to take action.

The Action Guide’s 10 key elements are:

  • Collaborative Self-Assessment
  • Leadership Across the Region and Within Organizations Audience-Specific Strategic Communication
  • A Community Health Needs Assessment and Asset Mapping Process
  • An Organizational Planning and Priority-Setting Process
  • An Agreed-Upon, Prioritized Set of Health Improvement Activities
  • Selection and Use of Measures and Performance Targets
  • Joint Reporting on Progress Toward Achieving Intended Results
  • Indications of Scalability
  • A Plan for Sustainability

Download the full Action Guide.

IHI Releases Health Equity Guide for Health Care Organizations

From the article on Business Wire:

The Institute for Healthcare Improvement (IHI) aims to ignite new thinking and activity by the nation’s hospitals and health systems to address the ongoing, decades-long reality of disparities and inequities in health and health care. With the publication of a new white paper – Achieving Health Equity: A Guide for Health Care Organizations – IHI identifies numerous strategies health care systems can adopt to address equity in their communities, as well as in the access, treatments, and outcomes of health care. The white paper also describes how the time-tested tools of quality improvement can accelerate the elimination of inequities by race, ethnicity, gender, age, disability, and more.

IHI’s new white paper is grounded in the belief that one of the most significant ways to improve health and health care in the US is to focus on equity. Organizations can more effectively pursue the Triple Aim of better care, better health, and lower per capita costs if equity is central to these ambitions.

According to lead author, Ronald Wyatt, MD, MHA, Patient Safety Officer and Medical Director, Office of Quality and Patient Safety, The Joint Commission, for too long equity has been the “forgotten aim” in the quality improvement movement, even though it was identified as a key priority by the Institute of Medicine (IOM) in 2001. Dr. Wyatt states: “The data clearly show that inequities exist, and we believe that armed with the tools and guidance in this white paper, health care leaders have ways to elevate equity as a strategic priority in their organizations and to take immediate action to improve health equity at the point of care and in the community. Together, we can reduce unjust, costly, and persistent inequities in health and health care across our nation.”

Designed to be actionable with numerous starting points, the white paper includes a 5-part framework for health care organizations to improve health equity in the communities they serve, a list of key considerations when measuring health equity, a case study of Henry Ford Health System, and a self-assessment tool for health care organizations to evaluate their current state related to each component of the framework.

Derek Feeley, IHI CEO, remarks in the foreword to the white paper that no matter where a health care organization decides to put its energy, improving health equity requires a fundamentally new outlook on the work ahead. He states that the framework urges organizations to “work both within our walls, dismantling the institutional racism and implicit biases that hold us back; and beyond our walls, creating and nurturing new partnerships in our communities that can make an impact on all the social determinants of health.” Feeley adds, “Improving only what we’re doing now isn’t enough; real improvement will require broadening and deepening our connections to our patients, our staff, and our communities.”

Read the full article.

Access the white paper.