CAB Member Profile: Mr. John Jones

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, Mr. John Jones, a member of the Trinity Gardens community and a member of the CAB, shared a little about his experiences with the CAB.

Tell us a little bit about yourself and your background.

I was born in Chatom, AL, but moved to Mobile in 1947. I first moved to Trinity Gardens in 1949. After high school, I spent four years in the Air Force. Living in South Dakota, I attended the School of Mines in Rapid City. After leaving the Air Force, I returned to Trinity Gardens, graduated from Bishop State.  I spent the next 28 years working for the railroad. I’m now retired and have time to do more in the community.

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

My pastor, Rev. Ulmer Marshall at Trinity Lutheran Church, was involved with the group. He had to step back from the commitment and asked me if I would attend in his place. I came to check it out. I wanted to see if it was something that I could really contribute to. I thought it was worthwhile so became a part of the group.

Why did you decide to become part of the CAB?

I wanted to share my life experience with the community and with the CAB. If I could contribute to something that would help someone improve their health, I wanted to do that.

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

I would say the surveys that were taken. Particularly, I was instrumental in going to places and talking with business owners about the project about allowing the team to conduct surveys on their property. They were so congenial and open to helping. I was surprised. They will still ask how things are going and how they can help.

I have learned some things from the areas I’ve been in and the people I’ve talked with. I didn’t realize how many people don’t have insurance and don’t see a doctor until an emergency happens. I guess I saw it but didn’t see it.

What community needs are you most concerned about?

I’m mostly concerned about the lack of medical assistance available in my community. This includes a lack of education on illness, how do avoid different illnesses, and how to manage their disease if they to get sick. The lack of [health] education means people don’t take health seriously.

Over my life, I’ve watched people with diabetes who only had a torso when they were buried. Their limbs had been amputated. Also, people don’t know that they can lead a good life with Diabetes. Many think it is a death sentence. I’m seeing younger and younger people who say they have High Blood Pressure. Being retired, I now have the time to pay more attention to my surroundings.

In a project like this, we can see the problems and how people fall through the cracks. This work allows us to create a catch basin.

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

Hopefully, improve the areas where the data has been collected. I like to think this project will address the issues. I have been asked how long are you going to collect data, when are you going to do something. If I didn’t believe in it, I wouldn’t be sitting here.

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

No, I had no research experience before participating in this project.

What have you learned about research through this process?

I’ve learned that people are embarrassed to be honest about their health. I’ve learned that we can’t put people on the defensive when we talk to them about these issues and ask questions. I guess I’ve learned humility. I’ve never been known to have much patience. Now, I can look beyond a “fault” and understand how to help.

I’ve learned that some people can’t help themselves because they don’t know how. This has taught me to reach out and help them on their own terms.

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?

Yes, I would but I would be cautious. You have to be careful of people who want to make a big name for themselves and are not really focused on helping the community.

HDRG Recap: “From Charity to Justice: Optimizing the Impact of Service Learning and Community Service”

The final Health Disparities Research Group (HDRG) meeting for the 2016-2017 academic year was held Friday, May 19th. Dr. Erik Goldschmidt, the Director of the Foley Community Service Center at Spring Hill College (Foley Center) was the presenter. Dr. Goldschmidt described the integral role community service plays in the mission of Spring Hill College and the ways in which the Foley Center advances community service efforts by supporting the volunteer work of nearly 50% of the student body each year.

The Foley Center administers service learning courses for many of the departments at Springhill. Service learning classes must provide students with opportunities for authentic interaction with community groups and the individuals they serve. Springhill strives to ensure that these authentic interactions result in student experiences that are characterized by substantial and sustained onsite service to local non-profit, direct-service organizations. This interaction focuses on building relationships which then become the vehicle for student development of self-knowledge, awareness of others, and systems thinking.

In addition, Dr. Goldschmidt discussed the Foley Center’s plans for future growth. A core principle driving the next phase of development is the goal of facilitating systemic engagement that advances beyond charitable work to justice oriented action. The College intends to support students as they work alongside partners to solve real-world problems. Ultimately the expectation is that there will be a “reciprocal learning process” that will improve the community while supporting students in their academic and spiritual journey.

The Foley Center is also exploring ways to bring community members on to the Spring Hill College campus for authentic interactions. One approach is “college exposure” days for students from area middle and high schools. More than a campus tour, the exposure day is designed for two way interaction between the 25 visiting students and approximately 70 faculty, staff and students involved with the group throughout the day. The day also provides for cooperative learning activities in the classes.

Another approach to bringing the community into the campus is a semester focus on one community partner. The partner organization’s leadership and staff can visit the campus, interact with students, and speak in various classes. The interaction includes asking, “what more could we be doing with you.”

Throughout his presentation, Dr. Goldschmidt stressed the potential for personal development of students of service learning, while reinforcing the need to authentically engage with partners with respect and humility.

 

CAB Member Profile: Leevones Fisher

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Mrs. Leevones Fisher speaking at the CHC Community-Engagement forum in January 2017.

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, Mrs. Leevones Fisher, a community activist and member of the CAB, 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 grew up in the Trinity Gardens community of Mobile, AL. My family of nine consisted of mom, dad, and six siblings. After attending school at Trinity Lutheran School and graduating from Trinity Gardens High School, I did undergraduate studies at Talladega College where I majored in chemistry with a minor in math. After receiving my degree, I moved to Atlanta, GA, to teach school for five years. I returned to Mobile when my mother fell ill with cancer. I started working in Alabama, married and had one son. I’ve been in Mobile ever since.

I stared the Bay Area Women Coalition (BAWC)  in 1997 in response to the many problems with crime in the neighborhood. My brother had been murdered. The children of friends had been murdered. Crime in our community was bad at that time with police and service workers afraid to come into the neighborhood. As a result of the organizations advocacy and focus on improved housing, the crime rate has gone down. We’ve constructed 50 new homes and build two affordable housing subdivisions – with one made up of apartments for seniors. We’ve also renovated or repaired over 400 houses and are currently working with community gardens to improve access to healthy food.

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

It all started when I attended a workshop at Bishop State Community College 10 years ago. Dr. Crook and Dr. Arrieta came to the workshop to talk about health. I talked to them about health and how the university needs to be more involved with the community. The relationships shouldn’t be a one-way thing.

Why did you decide to become part of the CAB?

One reason I joined the CAB is I wanted to give my opinion on the neighborhood and what is happening as a community member. Being a apart of the group provided an opportunity to see things improve and grow; and I wanted to monitor the growth of the impact the project would have on the community.

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

One thing that stands out is when I got the chance to go to the national conference and meet others from across the country and share during the poster session. It was an eye-opening experience to find out that so many people were interested in what we are doing.

What community needs are you most concerned about?

Health is a big concern, especially women’s health. Most of the women in our community are the heads of households and they are not in good health. When we don’t take care of ourselves, it means that we are not taking good care of our family.

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

Poor housing is a big issue. But, I’ve learned that health is also one of the main issues. Poor housing and poor health go together. If people are not healthy, they don’t care about the housing part. They are just trying to get well. Health helps housing and housing helps health. The two go together. Poor health means that you can’t keep up your house.

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

Yes has been involved in research before this project. I did a lot with with the College of Business, Dr. Semon Chang. He had us go door to door to do an assessment of the community, a housing assessment. With Dr. Ken Hudson, we tried to figure out why the housing and health issues were such a detriment in the neighborhood. Both surveys were done because we had gone out to find the information we needed to make a change on the housing issue. The impact was we learned that poor housing had an impact on health conditions. This led to trying to find out what could be done about health conditions.

What have you learned about research through this process?

It has to continue. When you start looking at one thing, you find something else that has to be addressed. We need to continue investing in research to address issues in the community with people. Housing work led to health research, and we learned that it is big and needs to be narrowed down to certain areas. There are so many issues with health, which is very different than housing. So we must continue researching to understand the issues and how they work together and how they can be addressed.

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

Yes… keep researching looking at every facet from infancy to old age. Pick an age and you can research and find out so many fascinating facts about that age. Whether it is finance or spiritual needs,  there is so much that can be researched. I used to think of research as trying to find a cure for cancer or something. But, it is multifaceted.

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. I would like for them to be a part of it not just because they are receiving something; but, because they want to see a different in their community. We need to research how this could happen. I think of President Kennedy saying, “Ask not what your country can do for you – ask what you can do for your country.” This always resonated in my mind because most people when asked to participate in research want something in return.

Any final thoughts on research.

We need to keep the ball rolling because I don’t think the need for research will ever end.

 

Next HDRG Meeting

The Health Disparities Research Group (HDRG) is a multidisciplinary assembly of faculty, students, staff, and community representatives with a vision “to become an integral facilitator in eliminating health disparities through partnerships with our community.” Held the 3rd Friday of each month throughout the academic year, the meetings provide an opportunity to share research and cultivate a positive atmosphere for community-engagement in addressing health disparities.

The next meeting is May 19 at 1:00 pm in Bio-medical Library Room 222-A.  Dr. Erik Goldschmidt,  Director of the Foley Community Service Center at Springhill College, will share about their work in his presentation “From Charity to Justice: Optimizing the Impact of Service-Learning & Community Service”.

Please join us for the final HDRG meeting of this academic year.

 

Call for Papers: Community-Academic Partnerships in Health Research in the Southeast

From the call issued by the Gulf States Health Policy Center and Progress in Community Health Partnerships:

Progress in Community Health Partnerships (PCHP) and the Gulf States Health Policy Center (GS-HPC) are collaborating to release this Call for Papers on the theme of “Community-Academic Partnerships in Health Research in the Southeast.”

This PCHP special issue aims to include articles on best practices in community-academic partnerships for improving health outcomes in the Southeast region of the United States, defined as Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Texas, Virginia, and West Virginia, as a regional particularly vulnerable to health disparities. To this effect, we are inviting papers and products (see Author Guidelines) presenting research that was conducted by partnerships of community members and academics. We place a priority on manuscripts co-authored by community members and academics and those that include the community perspective of the research process. The call is open to all areas of health policy and/or health research, focusing on the community-academic process and/or results.

Download the full call for papers.

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.

How Do Community-based Field Workers View the Impact of Their Research Participation on Their Lives

An  article recently published in BMC Public Health explored the way community-based field workers viewed the impact of research participation on their lives. Authored by Christabelle S. Moyo, Joseph Francis and Pascal O. Bessong, the article — Perceptions of community-based field workers on the effect of a longitudinal biomedical research project on their sustainable livelihoods — reports findings of a study conducted with 16 individuals who had worked as community-based field workers in the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project (MAL-ED) South Africa which was initiated in 2009. Recruited from the community, the field workers were trained to collect data on childhood illnesses, vaccination history, feeding habits; and to collect biospecimens such as tool and urine following standard protocols that governed eight field sites in the project’s network.

To understand the way the field workers viewed the impact of their work in the lives, the researchers undertook a qualitative research project in January and February 2016. The methodology consisted of one-on-one interviews and focus group discussions with 16 former field workers and five community members who were not directly involved in the project. Benefits reported by the MAL-ED community-based field workers included:

  • Knowledge about child growth and malnutrition
  • Acquisition of knowledge & various skills
  • Knowledge about conducting research and data collection
  • Received financial benefits
  • Acquired physical assets
  • Experience working with children
  • Personal development
  • Social capital benefits (greater social network)
  • Understanding of water and sanitation issues

The article can be accessed from BMC Public Health.

Decisive action by communities can reduce health disparities and improve lives

From the article by Risa Lavizzo-Mourey and Victor Dzau on STAT

Our choices for good health depend on our choices for everything else in life: a good education, safe and decent housing, a secure job that allows us to support our families.

What happens when those choices don’t exist? Ask Alpha Whitaker.

Whitaker, a single mom in Indianapolis who put herself through college, had to turn down a dream job because she didn’t have a safe way to get to work. Her bus route ended 10 blocks from the job, and she would have had to walk through a dangerous neighborhood — twice — every day.

In choosing safety, Whitaker gave up a job with full health benefits, a 401(k) plan to help her save for her daughter’s education, and a salary that would have allowed her family to move to a safer neighborhood. These things — financial security, health insurance, education, and neighborhood — influence health.

Fortunately, Indianapolis is one of many US communities working to create better choices for their residents in transportation, public safety, and employment. In doing so, they are creating better choices for health as well.

On the surface, the link might not be obvious. But as “Communities in Action: Pathways to Health Equity,” a new report from the National Academy of Medicine’s Culture of Health program shows, health equity and equal opportunity are inextricably linked. The report, commissioned by the Robert Wood Johnson Foundation, defines health equity as the state in which everyone has a chance to attain their full health potential.

Americans today live shorter, sicker lives than people in other developed countries. Across America, health varies by income, education, race and ethnicity, geography, sexual identity, and disability status. We pay a high price for these health disparities in lost lives, wasted potential, and squandered resources. They also affect national security: Some 26 million young adults are unqualified to serve in the United States military because of persistent health problems, poor education, or convictions for a felony. The report estimates that racial health disparities are projected to cost health insurers $337 billion between 2009 and 2018.

“Communities in Action” spotlights how communities are working together to create pathways to health equity. By addressing factors well beyond access to health insurance, cities like Indianapolis, Buffalo, Minneapolis, San Antonio, and Los Angeles are seeding the conditions needed to enjoy full, healthy lives.

Take the Indianapolis Congregation Action Network (IndyCAN), a multiracial, multifaith group that took on limited access to bus routes. That transportation issue created barriers to good jobs and opportunity. Working with a variety of stakeholders, including the residents most affected, IndyCAN helped pass a regional transit referendum to triple bus service in Indianapolis, fuel economic development, and increase access to jobs. Because all residents understood that improved bus service would benefit everyone in the community in a range of ways, the referendum passed last November — with the Indianapolis Chamber of Commerce as a leading champion.

This is just one example of what a community can do to promote health equity. “Communities in Action” explores many other efforts to curb violence, boost education, improve social connectedness, and expand access to healthy foods — all of which create the opportunity for healthier lives. Although their approaches differ, these community efforts consistently bring a shared vision for promoting health equity, building and harnessing community capacity, and involving many different sectors to enlist broad buy-in.

Read the full article.

Exploring Community-Engaged Research and Scholarship


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On January 13, 2017, the Center for Healthy Communities hosted its second forum on community-engaged scholarship, Strengthening the Community Engaged Research and Scholarship “Tool Box”. The one day event featured presentations, group engagement activities, and posters by researchers, students, and community members reflecting on the importance and value of community-engaged research.

In their morning session, Dr. Farrah Jaquez and Dr. Lisa Vaughn, both from the University of Cincinnati,  discussed “The process and power of community-engaged research: Moving from outreach to shared decision-making.” They described community-engagement a spectrum with community-based participatory research (CBPR) being the most complete expression of community engagement. At the same time, the speakers stressed the importance of being on the spectrum including:  

  • Collaborating with co-researchers (community members) about research questions and considering a topic/issue of importance to tem
  • Maintaining the collaborative spirit through each phase of a project
  • Working with an idea of making social change and helping improve health
  • Improving relevance and trusted connections in the community through working with a team
  • Including the needs and realities of all community partners when planning for logistics, etc.
  • Stressing the need to ensure community dissemination is done and incorporates opportunity and authentic feedback

In their afternoon session, Jaquez and Vaughn focused on developing tools for community engaged-scholarship.They started by exploring the way researchers often understand communities and the need to alter this understanding so to recognize the strengths that already exist in the community. With this context, the speakers took the group of approximately 100 attendees through an interactive exercise in which groups provided one to three word answers to a series of five questions. Jaquez and Vaughn then mapped the responses into categories such as resources, institutional commitment, individual skills,  sustainable goals and outcomes, relationships, and communication.

Dr. John C. Higginbotham from the University of Alabama rounded out the afternoon with his presentation “Photovoice, speed dating, and other things for working with communities.” Dr. Higginbotham used stories of projects in Alabama’s Black Belt to describe key elements of community-engaged research and the need for flexibility and creativity when working together. One example described a project in which researchers were to make presentations to community members about possible projects or partnerships. However, the in-person presentations were not best mechanism for the community members. So, to bridge the gap between researchers and community members, Dr. Higginbotham’s program allowed each researchers to make a three-minute video and then provided those videos online for community members to watch and decide who they wanted to work with. Throughout his presentation, Dr. Higginbotham stressed the need to incorporate community voices into decision-making both in the designing of research initiatives and the development of product arising out of those initiatives.

The program also spotlighted speakers from the USA community who shared their perspectives and experience with engaged research. Their presentations included:  

According to one participant, the forum provided “a great opportunity for all of us to come together and learn from each other’s experiences, develop new networks, and build connections.” Another said, “…I certainly left inspired to continue work in this area.”

Videos from Strengthening the Community Engaged Research and Scholarship “Tool Box” are available on the CHC website.

Addressing Mental Health in African Americans Through FAITH

From the article by Dr. Tiffany Haynes on the NIMHD Insights Blog:

Rural African Americans are disproportionately exposed to numerous stressors, such as poverty, racism, and discrimination,  that place them at risk for experiencing elevated levels of depressive symptoms. Elevated levels of depressive symptoms can lead to a host of negative outcomes, including poor management of chronic illnesses (e.g., hypertension, diabetes), poor social and occupational functioning, and development of clinical depression. Although effective treatments for decreasing depressive symptoms exist, structural barriers (e.g., lack of available services, transportation) and perceptual barriers (e.g., stigma, fear of misdiagnosis) impede the use of traditional mental health services within these communities, resulting in a significant unmet psychiatric need. Failure to develop culturally appropriate strategies to provide adequate, timely care to rural African Americans can result in a significant public health crisis.

African American churches have been identified as potential venues for providing depression education and treatment for rural African Americans. Within the African American rural community, churches represent a key portal through which as much as 85% of the community can be reached. Churches have been used to address physical health outcomes in those communities, but few have focused primarily on addressing mental health outcomes. Through the NIMHD-funded project entitled “Faith Academic Initiatives to Transform Health (FAITH) in the Delta,” our partnership, consisting of faith community leaders and University of Arkansas for Medical Science researchers, conducted formative work in the Arkansas Delta. Data suggested that community members consider elevated depressive symptoms to be a significant unmet need. Furthermore, community members suggested that attempts to improve depressive symptoms should do the following:

  1. Provide education about depressive symptoms. Recognizing when depressive symptoms become a clinical problem is the first step toward receiving adequate treatment. However, rural African Americans report difficulties in differentiating between normal sadness and clinically significant depressive symptoms. Providing education about depressive symptoms allows rural African Americans to make informed treatment decisions.
  2. Address the role that stress from social inequities plays in the development and maintenance of depressive symptoms. Rural African Americans correctly realize that prolonged exposure to stress caused by social inequities is a significant factor in the development and maintenance of depressive symptoms. Treatments that conceptualize depressive symptoms as normal reactions to stress are more culturally acceptable in rural African American communities.
  3. Find ways to increase social support for those experiencing depressive symptoms. Stigma is a significant concern in rural communities. Rural African Americans experiencing depressive symptoms tend to socially isolate themselves, which, in turn, can worsen depressive symptoms.
  4. Provide mental health interventions in community-based settings. Residents suggest that offering mental health services in community settings, such as churches, would allow residents to receive treatment in less stigmatizing places and improve access to mental health care.

Read the full article.