Community Engagement Institute Livestream with Interactive Presentations & Dialogue

The USA Center for Healthy Communities in partnership with the USA Office of Research Development & Learning will host a livestream of the 4th Annual Community Engagement Institute “Community Health from Engagement and Environmental Renewal (CHEER) for Civil Inclusion & Empowerment.” The event will take place in the Faculty Club of the University of South Alabama on October 6, 2017, from 8:00 am to 2:00 pm. The keynote presentations will be broadcast from Birmingham with onsite presentations and discussions related to the inclusion of community members in research.

Keynote speakers: Crook 100

Errol D. Crook, M.D., Physician & Director of the Center for Healthy Communities,  USA College of Medicine

 

McKoy_100
Diane Bell McKoy,  President and CEO of Associated Black Charities-Maryland

 

A continental breakfast and lunch will be provided.

Space is limited so register today.

Download the event flier.

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New Publication: Consolidating the Academic End of a Community-Based Participatory Research Venture to Address Health Disparities

A recent article published in the Journal of Higher Education Outreach and Engagement explores the development of the Health Disparities Research Group (HDRG) at the University of South Alabama.  Written by a team led by Dr. Martha Arrieta, the article discusses

  • the formation process of the HDRG
  • Activities leading to the promotion of group identity and permanence
  • Activities to Foster Health Disparities Research Capacity
  • Activities Leading to Engagement in Participatory Research
  • Activities Leading to the Dissemination of CBPR Principles and Practice
  • Keys to Success in the Consolidation of HDRG
  • Challenges Encountered and Responses Devised

Read the full article.

2017 CHA Led Projects: Reaching the Community to Improve Health

This June, five Community Health Advocates(CHAs), submitted applications to the Center for Healthy Communities to implement short term, limited scope community projects addressing nutrition, health literacy, family health, and mental health. These projects are:

Nutrition through Gardening: CHA Lead, Sheena Billingsley
Starting in July, Sheena and her partners planned four health and nutrition awareness events at community gardens in the area. These events focused on educating community members on healthy eating and healthy living. Each consisted of

  • Hands on gardening activities
  • Healthy cooking demonstrations
  • Sustainable gardening techniques
  • Conversations with volunteer health professionals

As an incentive for participation, participants received personal growing space in the community garden located in their zip code.

Community Garden at Ridge Manor: CHA Lead, Frewin Osteen
The goal of this project is to increase and enhance home-based and community centered gardening though the construction of a Hoop House to demonstrate the feasibility of a new gardening method suited to small, protected areas.

Smart Grocery Shopping Workshop: CHA Lead, Barbara Hodnett
Through this workshop which was held in June, Ms. Hodnett offered an educational program designed to help participants develop shopping skills to save money while buying healthy foods. The workshop topics included:

  • Learning the typical layout of a grocery store
  • Arranging your pantry and food storage areas to maximize healthy choices
  • Reading labels to determine whether a product is a sound nutritional choice
  • Creating a healthy weekly meal plan

Workshop participants also participated in a walking field trip to practice applying the information they had learned.

Hearts to HEAL (Health Education and Literacy): CHA Lead, Porsche Blount
This five-day summer enrichment program aims to improve the health knowledge and literacy, reduce associated stigmas, improve self-self esteem, and help to create a positive self-image among adolescent girls aged 12 to 18. The topics addressed in the program are

  • Health literacy
  • Nutrition
  • Family Health
  • Mental Health

A pre/post test design will be used to measure the knowledge gained by participants in the program. Also, the final day of the enrichment experience will be an opportunity for the girls to give presentations about what they have learned.

Black Mental Health Matters: CHA Lead,  Zionne Williams
Through this two part project, Zionne and her partners hope to “break the stigma associated with mental health in minority communities and to bring much-needed awareness to the issues associated with mental health.” Part one of the project consists of a family-friendly community event to raise awareness of the importance of recognizing when someone may need help and how to connect those in need with the correct resource. The event included fun kid’s activities, food and entertainment, and presentations from mental health professionals.

The second part of the project is the development of a mental health awareness campaign through an online platform to promote health literacy, create an open dialogue with the community, and encourage potentially affected individuals to seek and complete treatment. To accomplish the goal, individuals will be invited to share their personal stories through visual, written and audio documentation that will be shared online.

These CHA led projects provide an important mechanism for the Center for Healthy Communities to support the CHAs in applying the knowledge they gain through CHC supported trainings to target health issues that are of greatest concern to them.  Through these projects they provide information in culturally relevant formats to improve the health of their neighbors.

Learn more about the CHA program.

Meet the Community Advisory Board of the Sentinel Surveillance Project

The Sentinel Surveillance to Monitor Progress toward Health Equity project of the CHC’s Center for Excellence aims “to develop and implement a surveillance system to capture the information necessary to monitor progress towards health equity for health disparate populations.” Members of the Community Advisory Board (CAB) are community leaders who work in the research focus areas target by the project. Since the inception of the project in 2011, CAB members have provided the research team with important insight for choosing data collection sites and guidance in interpreting and understanding the collected data. The CAB members include:

Click on the links above to read more about the experiences of each of the CAB members in working with a multi-year research project.

CAB Member Profile: Porsche Blount

Porsche profile
Porsche Blount

The Sentinel Surveillance to Monitor Progress toward Health Equity project aims to develop and implement a surveillance system to capture the information necessary to monitor progress towards health equity for health disparate populations. One key element of this project is the engagement of community members through a Community Advisory Board (CAB). Recently, Ms. Porsche Blount, a native Mobilian and community health activist and advocate, shared a little about her reasons for participating in the CAB and the importance of continued investment in research.

Tell us a little bit about yourself and your background.

I’m a graduate of Dillard University where I majored in biology and chemistry. I originally intended to attend medical school but shifted professionally to community health education.  I have two beautiful daughters that fuel the synthesis of my passions for health education and working with the youth. My hope is that we can prevent health issues by working with the youth; in other words, stopping problems before they start.

How did you become involved with the Community Advisory Board for the Sentinel Surveillance Project?

Years ago, I became a Community Health Advocate as a part of the community engagement core of the Center for Healthy Communities. A woman named Brittany Duncan, the health education specialist at the time, knew my professional background and suggested that my knowledge might be helpful as a member of the CAB.

Why did you decide to become part of the CAB?

I had experience in both community work and research. From this, I knew there wasn’t really any middle ground between the two. Research isn’t knowledgeable about the community and vice-versa. Participating in the CAB seemed like an opportunity to bridge the two areas.

Give us a few highlights of your time as a CAB member. Is there any one memory that stands out?

For me, the opportunities presented by being a part of the CAB have been the most meaningful. Through the connections made from working with Dr. Arrieta, Dr. Crook and the Center for Healthy Communities I had the opportunity to become a part of the Regional Community Engagement Consortium within the UAB Center for Clinical and Translational Science.

What community needs are you most concerned about?

First, I think about the way we define community needs. In my opinion, the community needs resources to address socioeconomic barriers. The socioeconomic impacts on health are far more wide-ranging than we’ve ever considered. The community needs life resources to impact the things that affect their health.

How do you see the sentinel surveillance project addressing these issues in the community?

I see two contributions from the Sentinel Surveillance Project. First, the way we carried out the project was an opportunity for relationship building between research and the community. I saw this in the way the project was established and the way we let community members know that research is vital to getting help and resources. In the long-term, I believe, the project has opened that door to encourage underserved communities to voice their needs.

Secondly, the data is an opportunity to look at what we know and understand from the literature and look at it from a focused community level. Once we can disseminate to local agencies it will effect change locally. It’s a local answer to a nationwide solution.

Have you ever been involved in research before, if so how is this similar or different?

I have been involved in research projects but this is really different. This is my first experience with community-based participatory research (CBPR). It can be defined as CBPR since the community was actually, actively involved. Also, being on the CAB was the first time for me to serve in that capacity rather than being the researcher.

What have you learned about research through this process?

I’ve learned a lot. The process also confirmed something that I already knew: there is no one size fits all approach to improving health outcomes. This is the biggest lesson.

Has the experience changed the way you consider or approach research in other areas of your life?

It truly has because throughout the process analytical breakdown we’ve done on the collected data. I can’t help but implement the lessons in my day-to-day life. This is true both personally and professionally. It forces me to take into consideration where people are. We are studying peoples knowledge of diseases and we can’t make any assumptions. Again, both personally and professionally, it has made me more open and considerate.

Would you encourage others people in your life to participate in or be a part of leading/shaping research projects as a result of your involvement with Sentinel Surveillance?

I would.  Truthfully, one of my biggest takeaways for underserved communities is the element of distrust when it comes to research. As a member of that community, I understand where this comes from but there has to be a way to encourage people to understand that there is good research, beneficial research. So, for me, if more people could have this experience then it could help break down barriers.

Useful Resource: “Health Equity Change Makers” Toolkit

The Office of Minority Health’s web port “Health Equity Change Makers” using stories to highlight the impact of health disparities and ways in which individuals and groups can make changes. The portal includes a toolkit “designed to provide ideas and resources for activities that you can do — at home, at work, and in the community– to help end health disparities and accelerate health equity.” The toolkit topics cover:

Visit the Health Equity Change Makers web portal to see the full toolkit.

 

Useful Resource: Plain Language Writing

In June, the Community First at Carleton University in Canada sponsored the webinar “Easy to Read, Easy to Use: How to Write about Your Work in Words Everyone Will Understand.” Designed for a beginner audience, the webinar covered:

  • What is plain language writing?
  • Why is it important?
  • How do I write in plain language?
  • Where can I find additional resources?

The webinar video and materials are currently available online. Downloadable resources include:

Working with Communities to Improve Health

The following excerpt comes from an article that first appeared May 1, 2017, on the NIMHD website under NIMHD Community Health and Population Sciences Feature Articles


Improving health is not always a matter of prescribing the right medicine. Sometimes the environment needs to change. Many Americans live in neighborhoods that lack safe walking routes, grocery stores, and health facilities.

“Are there places for kids to play? Are there good farmers markets or grocery stores?” asks Irene Dankwa-Mullan, M.D., M.P.H., formerly of NIMHD and now deputy chief health officer of IBM Watson Health. Such features help people in a neighborhood live healthier lives. Along with NIMHD director Eliseo Pérez-Stable, Dr. Dankwa-Mullan wrote an editorial in the April 2016 issue of the American Journal of Public Health, “Addressing Health Disparities Is a Place-Based Issue.”

Efforts to address these problems in particular communities are called “place-based interventions.” Ideally, these interventions come from a collaboration among community members, businesses, and other stakeholders, working together with police, urban planners, and other groups to improve their neighborhood. Community members are involved to make sure the interventions are based on their values.

Examples of place-based interventions include an effort to bring a farmers market to a neighborhood without a grocery store or promoting public safety so that residents feel safe walking on the street. Walking is a simple way to improve health, but there can be many barriers to walking, a fact highlighted in the Surgeon General’s Call to Action on walking.

Place-based interventions have been used successfully in rural areas, disadvantaged urban neighborhoods, and Indian reservations. People who live in such places tend to have particular health problems, such as diabetes and heart disease, and working to change the place-based conditions may help address health disparities.

Communities are complicated, and figuring out the best way to improve the health of all residents in a particular place can be a daunting task. “Part of the issue is that we do not have a best practices model for place-based interventions,” Dr. Dankwa-Mullan says. The editorial in the American Journal of Public Health was part of a new series on best practices for place-based interventions. Through this series, public health professionals will be able to learn how to develop place-based interventions.

One key to success of place-based interventions is involving the community. This is similar to community-based participatory research, a way of doing research in which the community sets priorities, ensuring that communities that are asked to participate in research get answers to the questions that are most important to them.

Read the full article.

 

Partnerships for Better Health Outcomes

In June, the Partnership for Healthy Outcomes: Bridging Community-Based Human Services and Healthcare issued the report “Working Together Toward Better Health Outcomes” detailing the findings from a national request for information that sought information about partnerships between healthcare organizations and community-based organizations (CBOs).  The data came from 200 respondents to the request for information with 67% of respondents from CBOs, 13% from healthcare organizations, and 9% from government agencies. The remaining respondents represented foundations, research institutions, consulting organizations, and for-profit CBOs. Responses came from all 50 states while California, New York, Colorado, Pennsylvania, and Minnesota were the most represented.

The following key findings come from the report’s executive summary.

  • There’s no one-size-fits-all formula: Respondents represented partnerships of many sizes, shapes, and contractual and funding arrangements; many were among healthcare providers and CBOs – but partners also included public health and other government agencies, private insurers, foundations, schools, supermarkets, and more.
  • Shared goals provide common ground: Most of the responding partnerships were initiated by CBOs and noted the value of developing shared goals to improve health outcomes and contain or reduce costs.
  • Most partnerships have some sort of formal agreement in place, though partner integration varied from communicating (sharing client information) to coordinating (aligning services toward better client outcomes) to collaborating (sharing staff, space, or resources) to integrating (becoming a collective entity with connected programs, planning, and funding).
  • Most commonly, partnerships provided services to impact immediate-term clinical needs, such as reducing hospital admissions or length of stay. This may be due, at least in part, to a funding environment with incentives for cost reduction. More than half of respondents reported that their partnerships include care coordination support to better organize services across multiple providers; fewer partnerships reported providing services that address underlying social determinants to improve health in the long-term. A majority (65%) of partnerships reported realizing cost savings.
  • Partnerships rely on an evolving variety of funding sources, including private foundations, healthcare systems, and government entities, and typically more than one. A number of partnerships were established through a one-time grant and have developed – or are developing – a long-term, sustaining funding model.
  • Nearly all organizations acknowledged expanding skills and capacities through partnership, particularly in network-building, improving programs, and generating new funding.
  • Advancing the field will require partners and funders to:1)Prioritize and invest time in relationship-building – the key ingredient to effectiveness; 2)Engage a wide range of stakeholders, including community members, early on and throughout the partnership; 3)Identify and fund the full cost of partnership to effectively support development and evolution; 4)Stay adaptable and nimble in an ever-shifting environment.

To learn more, download the full report.

The Messenger Also Matters: Value-Based Payment Can Support Outreach To Vulnerable Populations

 

The following excerpt comes from the July 10, 2017 article by Ruth C. Browne, Marilyn Fraser, Judith Killen, and Laura Tollen on the Health Affairs Blog.


With the proliferation of value-based payment initiatives and implementation of the Affordable Care Act’s (ACA’s) coverage expansions, states have had many opportunities in recent years to improve the health of vulnerable populations through health promotion, prevention, and care coordination. We believe value-based payment models can and must support accountable health care delivery systems in partnering with community-based “messengers” to engage vulnerable individuals in health education and promotion. We explore one such messenger program, ACCESS, a Brooklyn-based project of the Arthur Ashe Institute for Urban Health, which trains barbers and hairstylists to help formerly incarcerated men learn to recognize and act upon their own health risk factors. Value-based payment offers an opportunity to support programs such as this.

“Messengers,” as we define them here, are community health workers—those who serve “as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery.” Unfortunately, there are few dedicated funding streams available to support the messenger role. Fee-for-service payment arrangements do not reimburse these activities. Value-based payment, on the other hand, not only highlights the need to support messengers but also potentially provides funding to do so.

Value-based payment programs hold the health care delivery system accountable for meeting health goals for entire enrolled or attributed populations, which requires more than just providing better medical care. Shortfalls in medical care are responsible for only an estimated 10 percent of early mortality in the United States, while individual health-related behavior is responsible for 40 percent. Even the finest delivery system can only expect to see a modest improvement in the health of its community if it focuses only on the very thing it has been designed to do—providing medical care to sick people. Value-based payment requires delivery systems to redefine nothing less than their product, place, and providers. The product must be health; the place must be where people live and work; and the providers must include credible, community-based messengers.

Credible messengers can bring to delivery systems important knowledge about social determinants of health that impact individuals’ ability to access and act upon health-related information. We focus here on one social determinant—incarceration. Individuals formerly incarcerated have become eligible for Medicaid in large numbers and, as such, participate in a variety of value-based payment initiatives. New York State, where the ACCESS program has been implemented, is moving aggressively toward value-based payment in Medicaid. In 2015, the state announced its intention to shift 80–90 percent of its Medicaid managed care provider payments from fee-for-service to value-based arrangements by 2020.

In the United States, nearly 700,000 state and federal prisoners are released annually, and more than 11 million cycle through local jails. Incarcerated individuals have poorer physical health status than the rest of the population, a high burden of mental health and substance abuse disorders, and, once they are released, are more likely than the general population to be uninsured. However, under the ACA, more than one-third of inmates released annually from state and federal prisons are estimated to be Medicaid-eligible. If this pattern holds true for those released from local jails as well, there are potentially millions of formerly incarcerated individuals newly eligible for Medicaid—and for the value-based payment initiatives that may come with it.

The burdens of incarceration are distributed unevenly. Sixty percent of New York State prisoners come from New York City, and two-thirds of the 28,000 people released each year return to the city. Some Brooklyn neighborhoods have especially high incidences of incarceration and concomitant prison spending, earning them the dubious honorific of “million-dollar blocks,” even though they are among the poorest neighborhoods in Brooklyn.

At the Arthur Ashe Institute for Urban Health (AAIUH), we found a striking overlap between Brooklyn’s million-dollar blocks and areas where we were already engaged in health-promotion activities. Founded in 1992, the AAIUH is an independent, nonprofit organization that collaborates with community members to incubate, test, and replicate neighborhood-based interventions to improve health conditions disproportionately affecting minorities. Arthur Ashe, a world-renowned African American tennis champion and social justice advocate, founded the AAIUH in partnership with the State University of New York Downstate Medical Center. Using community-based participatory research, the AAIUH navigates disparate worlds—the institutional universe of academic medicine and day-to-day life in multi-ethnic, multi-linguistic neighborhoods.

Among other projects, the AAIUH has a long history of training barbers and hairstylists to deliver health education related to breast cancer, cardiovascular disease, asthma, and diabetes in women, and HIV/AIDS and prostate cancer in men. When we began the ACCESS program in 2009, exploratory work revealed that more than 80 percent of barbers working in our ongoing projects had themselves spent at least one night in jail. This made them particularly credible messengers for our priority population of formerly incarcerated men and the supportive women in their lives. Guided by input from a community-based advisory board, we conducted focus groups of barbers, stylists, and customers to determine the best way to discuss incarceration and health, and which health issues would be most important to the community. Based on that input, the program emphasized cardiovascular disease, stress, and HIV/AIDS. We developed a health curriculum to increase awareness of these conditions, emphasizing prevention and the importance of “knowing your numbers”—that is, understanding health indicators such as blood pressure and cholesterol levels. The curriculum included a resource guide for community health and social services related to the priority conditions and services for the re-entry population.

We trained barbers and stylists to deliver the curriculum in six establishments in the Bedford-Stuyvesant and Crown Heights areas of Brooklyn, emphasizing that health messages must be delivered in a way that could be useful to any member of the community who might know someone who had been incarcerated, instead of focusing solely on the formerly incarcerated themselves. In addition to the health messages and the resource guide, ACCESS included an HIV-focused health education video played several times a day in participating salons and barbershops and 12 AAIUH-sponsored Health Resource Days held at these establishments.

The project evaluation consisted of pre- and post-intervention surveys of patrons. The pre-intervention survey assessed patrons’ familiarity with risk factors, prevention, and resources related to the priority conditions. For example, patrons were asked multiple-choice questions such as: “What are some of the warning signs of a heart attack? What is a normal blood pressure reading?” The post-intervention survey of the same individuals sought to determine whether they had been exposed to the intervention and whether their knowledge regarding any of the previously asked questions had changed. Survey respondents’ ability to identify ways to assess their cardiovascular disease risk increased from 44 percent to 62 percent, and understanding that condom use can decrease the spread of HIV increased from 77 percent to 88 percent.

Read the full article.