Community-academic Partnership Research Articles

"I'm Fighting for My Life": Exploring Interactions Between Black Women with Breast Cancer and Healthcare Providers.

Black Americans face a multitude of problems in the healthcare system, including challenges during interactions with healthcare providers. The present study examined the quality of healthcare provider-Black patient interactions in a sample of Black American women with a breast cancer diagnosis. More specifically, the study examined potential contributors to Black Americans' current healthcare experiences and lack of trust by identifying their specific negative and positive encounters in the healthcare system. Three in-person Gatherings (i.e., culturally curated focus groups; N = 37) were conducted as part of a community-academic research partnership, Project SOAR (Speaking Our African American Realities). Four themes were identified through reflexive thematic analysis: Individual and Systemic Injustice Directed at Black Breast Cancer Survivors; Protecting Myself from an Untrustworthy Medical System; Stereotypes Interfered with My Care; and Good Care Should Include Compassion, Respect, Shared Decision Making, and Tailored Support. The present findings highlight the importance of addressing systemic and individual injustice toward Black Americans in healthcare settings generally, and Black women diagnosed with breast cancer specifically.

Building a Community-Academic Partnership to Expand Workforce Development in Underserved, High-Need/High-Demand Areas.

This case study highlights the partnership development between a large, urban, public, community-based behavioral health system and an academic program. Using principles of partnership building and facilitators that enhance partnership building, we describe the process of initiating, building, and sustaining the partnership. The Health Resources and Services Administration (HRSA) workforce development initiative was the primary catalyst for the partnership development. The public, community-based behavioral health system is located in an urban, medically underserved area and health care professional shortage area. The academic partner is a master in social work (MSW) program in Michigan. We assessed partnership development by using process and outcome measures that captured changes in the partnerships and in implementation of the HRSA workforce development grant. The goals of this partnership were to develop the infrastructure to support the training of MSW students, expand workforce skills in integrated behavioral health, and increase the number of MSW graduates who work with medically underserved populations. During 2018-2020, the partnership trained 70 field instructors, engaged 114 MSW students in HRSA field placements, and developed 35 community-based field sites (including 4 federally qualified health centers). The partnership provided training for field supervisors and for HRSA MSW students and developed new courses/trainings focusing on integrated behavioral health assessment/intervention practices, trauma-informed care, cultural awareness, and telebehavioral health practices. Of 57 HRSA MSW graduates who responded to a postgraduation survey, 38 (66.7%) were employed in medically underserved, high-need/high-demand urban areas. Partnership sustainability was helped by formal agreements, regular communication, and a collaborative decision-making approach.

A call to create evidence-based mental health promotion interventions for youth that are equitable across ethnic/racial subgroups: Advocates 4-ALL Youth.

Adolescents from historically racial and ethnic minoritized and low-income communities have higher rates of early-life and chronic difficulties with anxiety and depression compared to non-Hispanic White youth. With mental health distress exacerbated during and in the wake of the COVID-19 pandemic, there is a need for accessible, equitable evidence-based programs that promote psychological well-being, strengthen one's ability to adapt to adversity, and build self-efficacy prior to adolescence. An evidenced-based resiliency-focused health coaching intervention was adapted using a health equity implementation framework to meet the needs of a Title I elementary school in rural Alabama (AL) that serves over 80% Black and Hispanic students. To ensure that the program met local community needs while maintaining core program educational activities, all adaptations were documented utilizing a standard coding system. Leveraging an existing academic-community partnership with Auburn University and a local AL school district, a new program, Advocates 4-All Youth (ALLY), was created. Three major adaptations were required: (1) the use of local community volunteers (ALLYs) to deliver the program versus health coaches, (2) the modification of program materials to meet the challenge of varying levels of general and health-related literacy, and (3) the integration of the Empower Action Model to target protective factors in a culturally-tailored delivery to ensure key program outcomes are found equitable for all students. With continued increases in youth mental health distress, there is a need for the development of universal primary prevention interventions to promote mental well-being and to strengthen protective factors among youth from historically disadvantaged backgrounds. ALLY was created to meet these needs and may be an effective strategy if deemed efficacious in improving program outcomes.

Dissemination of Remote Patient Monitoring: An Academic-Community Primary Care Partnership in South Carolina.

Remote patient monitoring (RPM) for diabetes and hypertension may reduce barriers to patient care, leading to improved disease control and decreased morbidity and mortality. We describe the implementation of a community-academic partnership to improve diabetes and hypertension control for underserved populations using RPM. In 2014, our academic medical center (AMC) began working with community health centers (CHCs) to implement a centrally monitored RPM program for patients with diabetes. AMC nurses recruited, trained, and supported community partners through regular communication. Community sites were responsible for enrollment, follow-up visits, and all treatment adjustments. More than 1350 patients have been enrolled across 19 counties and 16 predominantly rural CHCs. The majority of patients reported low annual household income and African American or Hispanic background. It took about 6 to 9 months of planning at each CHC prior to first enrolled patient. More than 30% of patients utilizing the newer device continued to transmit glucose readings regularly at week 52 of enrollment. Hemoglobin A 1c data reporting was completed for more than 90% of patients at 6 and 12 months postenrollment. Partnering of our AMC with CHCs enabled dissemination of an effective, inexpensive tool that engaged underserved populations in rural South Carolina and improved chronic disease management. We supported implementation of clinically effective diabetes RPM programs at several CHCs, reaching a large number of historically underserved and underresourced rural CHC patients with diabetes. We summarize key steps to achieving a successful, collaborative RPM program through AMC-CHC partnerships.

A Novel Capacity-Strengthening Intervention for Frontline Harm Reduction Workers to Support Pre-exposure Prophylaxis Awareness-Building and Promotion Among People Who Use Drugs: Formative Research and Intervention Development.

HIV prevalence among people who use drugs (PWUD) in Baltimore, Maryland, is higher than among the general population. Pre-exposure prophylaxis (PrEP) is a widely available medication that prevents HIV transmission, yet its usefulness is low among PWUD in Baltimore City and the United States. Community-level interventions to promote PrEP uptake and adherence among PWUD are limited. We describe the development of a capacity-strengthening intervention designed for frontline harm reduction workers (FHRWs) to support PrEP awareness-building and promotion among PWUD. Our study was implemented in 2 phases in Baltimore City, Maryland. The formative phase focused on a qualitative exploration of the PrEP implementation environment, as well as facilitators and barriers to PrEP willingness and uptake, among cisgender women who use drugs. This work, as well as the existing literature, theory, and feedback from our community partners, informed the intervention development phase, which used an academic-community partnership model. The intervention involved a 1-time, 2-hour training with FHRWs aimed at increasing general PrEP knowledge and developing self-efficacy promoting PrEP in practice (eg, facilitating PrEP dialogues with clients, supporting client advancement along a model of PrEP readiness, and referring clients to PrEP services). In a separate paper, we describe the conduct and results of a mixed methods evaluation to assess changes in PrEP-related knowledge, attitudes, self-efficacy, and promotion practices among FHRWs participating in the training. The pilot was developed from October to December 2021 and implemented from December 2021 through April 2022. We leveraged existing relationships with community-based harm reduction organizations to recruit FHRWs into the intervention. A total of 39 FHRWs from 4 community-based organizations participated in the training across 4 sessions (1 in-person, 2 online synchronous, and 1 online asynchronous). FHRW training attendees represented a diverse range of work cadres, including peer workers, case managers, and organizational administrators. This intervention could prevent the HIV burden among PWUD by leveraging the relationships that FHRWs have with PWUD and by supporting advancement along the PrEP continuum. Given suboptimal PrEP uptake among PWUD and the limited number of interventions designed to address this gap, our intervention offers an innovative approach to a burgeoning public health problem. If effective, our intervention has the potential to be further developed and scaled up to increase PrEP awareness and uptake among PWUD worldwide.

Implementation of nursing services in community corrections: A community-academic partnership.

Persons who are incarcerated (PWAI) suffer from a disproportionately higher number of physical and mental health conditions. While most jails and prisons provide onsite healthcare, community correctional centers often do not and accessing community healthcare is challenging due to insurance issues, inadequate health literacy, mistrust, and long waits for appointments. A registered nurse-led wellness clinic provides a viable solution to addressing the healthcare needs of PWAI in a community correctional setting. Through a community-academic partnership between a college of nursing and two community correctional transitional centers for men, a registered nurse (RN) faculty member and nursing students provide onsite healthcare. Services include, but are not limited to, acute and chronic disease management, case management, healthcare navigation, and health education. In the first 2 years of operation, there have been 587 new resident health assessments, 882 RN visits, and 152 group education sessions. RN visits have been primarily for: connection to resources (42.6%), medication management (15.6%), and acute conditions (12%). A RN-led wellness clinic is an innovative way to address health needs for PWAI. While this model of care focuses on an academic RN faculty practice at community correctional centers it could be replicated across community settings.

Abstract 4241: Reducing your risk cancer-focused health events to meaningfully engage the medically underserved and diminish future cancer disparities

Abstract Lack of access to cancer prevention education, early screening, and timely treatment, particularly in low socioeconomic, underserved communities, are cited as substantial barriers to improving survivorship. Outreach educational efforts with on-site screenings offered in partnership with community groups are known to be valuable in encouraging community members’ uptake of healthy behaviors and adherence to screening recommendation. To create more engaging events, a community-academic partnership, We Engage 4 Health (WE4H), co-created 11 unique 4-panel comic-style stories designed to be read aloud together as attendees visit each event table. These colorful stories are shared on boards that stand on each table and are offered in both English and Spanish at this time. Many tables also have an accompanying hands-on activity. Together, they lead to meaningful “low stakes” discussions which support understanding of seemingly complex health information. Story topics include the cause of cancer (Cells Gone Wrong), cancer risk factors (Reducing Your Risk), the role of primary care in cancer screening (Primary Care for Prevention), the purpose of research (short Research Ready) and details about specific cancer types (Combatting Colon Cancer, Blocking Breast Cancer, Looking for Lung Cancer, Silencing Skin Cancer, Hindering HPV, and Professional Prostate Protection) and COVID-19 (Take Your Best Shot FAQs). A health passport is used to facilitate table visitation and survey collection at each table enables meaningful evaluation of the event as well as provides the community hosts and their partners baseline cancer data to inform future programing. In 2022, WE4H and the University of Cincinnati Cancer Center partnered with three different communities to co-host pilot events that served over 100 adult residents. Community, research interns and university students volunteered to work the tables at the event and received training prior. Post event surveys and discussions indicated that community partners appreciated the different take on a health fair event. Most volunteers indicated that they would enjoy volunteering again. Attendees indicated that they liked the graphic-style story format used and most preferred it to text and text with graphics approaches. Taken together, the data indicates that Reducing Your Risk events are useful in meaningfully engaging hard to reach, at risk attendees. Additional in-person and virtual events are being planned for 2023 as an approach to reach the medically underserved throughout our region. Citation Format: Melinda Butsch Kovacic, Susan Gertz, Lauren Bates, Susan Hershberger, We Engage 4 Health Community-Academic Partnership. Reducing your risk cancer-focused health events to meaningfully engage the medically underserved and diminish future cancer disparities. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4241.

Abstract 5525: Community cancer research advocates: Helping underrepresented minority groups become research ready

Abstract Even though certain racial/ethnic minority groups get cancer more often, are diagnosed at younger ages, and are at risk for earlier death, clinical trials fail to include adequate proportions of representatives from these groups. Encouraging equitable participation in research becomes an important tool in the fight against cancer disparities. Therefore, we co-created with community representatives a graphic-style story entitled “Research Ready” that is used by trained Community Research Advocates (including some survivors or family of survivors themselves) to hold brief discussions to help eligible hesitant participants to learn the 3 P’s: the purpose of cancer research, how they are kept safe while participating, and why people from diverse backgrounds are needed to participate. Importantly, advocates use a Research Review activity to discuss factors that influence their willingness to participate as well as identify questions they have for the research study’s staff. Focus group and survey-based evaluation data show these discussions to be useful in increasing hesitant patients’ willingness to consider participation in research and increase perception of safety. Advocates too appreciate the opportunity to serve. While this pilot is small, additional partnerships within the University of Cincinnati Cancer Center to expand the program will be developed. Future partnership with a community patient navigator program will also enable additional support and transportation to research appointments. Collectively, we anticipate that this program will ultimately support hesitant patients’ decision-making and improve cancer research participation particularly among racial/ethnic minorities. Citation Format: Sarah Been, Susan Gertz, Susan Hershberger, Melinda Butsch Kovacic, We Engage 4 Health Community-Academic Partnership. Community cancer research advocates: Helping underrepresented minority groups become research ready. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5525.

Abstract 5520: Research Ready graphic-style story to support future research participation among adolescents

Abstract Historically, marginalized adults are more likely to be mistrustful of health research worrying both about its invasiveness and their own safety. As a result, many decline to participate. Adolescents have a much lower perception of risk compared to adults and are also susceptible to peer pressure and socialized trust or mistrust from their parents and family members, which can influence risk perception. As encouraging equitable participation in research becomes an important tool in the fight against cancer disparities, We Engage 4 Health created a graphic-style story “Research Ready” to help community members learn the 3 P’s: the purpose of cancer research, how they are kept safe while participating, and why people from diverse backgrounds are needed to participate. An accompanying Research Review Activity was also included to further support participants’ decision-making regarding research participation. Two groups of diverse adolescents were asked to read the story aloud together in small groups and then discuss an active research study targeting adolescents using the review activity with a scientist to consider whether the first the teen story character (Vito) and ultimately themselves, should consider participation in the study and to identify what information was needed from study staff to better be able to make a decision based on their values and accurate information provided by study staff. Group 1 included 45 adolescents that were 68% African American and 10% European American. Group 2 included 73 high schoolers that were 78% Asian, 15% European American, and 5% African American. Post-discussion surveys indicated that only 9% and 3% in group 1 and group 2 respectively had previously participated in health research. However, after the story discussion, 83% and 89% indicated they thought it would be safe to participate in research and 76% and 89% indicated a willingness to participate in research in the future. Finally, 60% collectively enjoyed the story’s graphic-style format. These data suggest Research Ready to be potentially useful in promoting future research participation and may be especially useful in engaging ethnic/racial groups commonly underrepresented in cancer research. Citation Format: Lauren Bates, Susan Gertz, Susan Hershberger, Melinda Butsch Kovacic, We Engage 4 Health Community-Academic Partnership. Research Ready graphic-style story to support future research participation among adolescents. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5520.

242 Listening to and Learning from the Community: A Model for Community Engagement and Building Trust

OBJECTIVES/GOALS: We have developed a community engagement model that embraces several core values: bi-directional, co-equal, co-created, inclusive, culturally centered, and trust. Our promotoras de salud and community health workers (CHWs) facilitate listening sessions to understand the most pressing health needs and concerns as perceived by the community. METHODS/STUDY POPULATION: Our Southern California CTSI Community Engagement team includes promotoras de salud and community health workers who are trusted individuals within our targeted communities–Latino and Black populations in South and the Eastside of Los Angeles. Listening sessions identify the community’s perceived health needs and concerns, and our team in turn delivers a workshop series that addresses those concerns. Workshops are co-developed by community members, offered in English and Spanish, and delivered both virtually and in-person in community venues. Workshop topics have included mental health, depression, anxiety in children; child development and autism; COVID-19 testing, variants, and vaccines; monkeypox; and a primer on understanding clinical research. RESULTS/ANTICIPATED RESULTS: In 2022, we held 49 workshops that delivered evidence-based information including how to access needed resources. We had a total of 1212 participants, 60% of whom were returning, meaning they had attended at least one prior workshop. An evaluation of the workshop program demonstrated that our promotoras de salud and community health workers are trusted by the community and that workshops are meeting community needs. 677 surveys were completed by participants, 87.5% of whom were female. 85% of respondents stated that they will use the information they learned in their daily life, and 90% said they would attend another workshop. Feedback from the evaluation will inform future workshop format and topics. DISCUSSION/SIGNIFICANCE: Academic-community partnerships are key to advancing health equity, especially in diverse and under-resourced communities. This is one model of community engagement, which includes promotoras de salud and CHWs that was designed to build trust, empower individuals through education, and to address the health needs as defined by the community.

163 Building a Supportive Community-Engaged Research (CEnR) Infrastructure: Assessing and Addressing the Interests and Educational Needs of Researchers and Community Partners

OBJECTIVES/GOALS: Identify ways surveys capture the needs of researchers and community partners (CPs) to build a supportive community-engaged research (CEnR) infrastructure Identify strategies to match existing CEnR researchers and CPs who are interested in future CEnR projects Address educational needs of CPs and researchers for sustainable partnerships METHODS/STUDY POPULATION: The Penn State Community Health Equity & Engagement Research (CHEER) Initiative team developed and implemented surveys to capture the unique interests of Penn State researchers and community partners (CPs) in an effort to build a supportive community-engaged research (CEnR) infrastructure. CPs and researchers were identified from the Penn State Clinical and Translational Science CEnR Core, prior engagement in research studies, and through tracking systems of individuals interested in research. The researcher and CP surveys ascertained detailed information of existing CEnR projects and interests in future community-academic partnerships. These results guided six workshops including an Introduction to Community-Engaged Research, Community-Facing Grant Writing, and Research Ethics Training for CPs. RESULTS/ANTICIPATED RESULTS: A total of 99 PSU researchers and 119 community partners (CPs) throughout PA communities completed the baseline surveys. From the data collected, the CHEER Initiative cataloged over 100 CEnR projects, researcher interests, resources/support needed to jumpstart future CEnR projects, types of CPs, PA regions represented by CPs and researchers, and training resources needed to prepare CPs to engage in research efforts. Heat maps illuminating researcher/CP engagement were generated from survey results. While CEnR research projects spanned all 67 PA counties, several studies were in concentrated areas, and thus allow for opportunities to target CEnR outreach in less engaged areas. Data analysis from follow-up surveys will continue to serve as a foundation to best support existing and future CEnR projects. DISCUSSION/SIGNIFICANCE: The CHEER Initiative’s purpose is to reduce health disparities and increase wellness throughout underrepresented PA communities by promoting community-engaged research (CEnR). Surveys used to capture both CEnR interests of Penn State researchers and community partners built a successful and sustainable infrastructure for meeting this goal.

Using an academic-community partnership model to deliver evidence-based falls prevention programs in a metropolitan setting: A community case study.

Prevention is an effective approach for mitigating the negative health outcomes associated with falls in older adults. The Administration for Community Living (ACL) has sponsored the implementation of evidence-based falls prevention programs (EBFPPs) across the United States through cooperative agreement grants to decrease the health and economic burden of falls. Marymount University received two of these grants to deliver three EBFPPs into the northern Virginia region. This community case study describes the development of a collaboration between a university and community-based organizations to adopt and implement multiple evidence-based programming in an area where none previously existed. Through an academic-community partnership, EBFPPs were introduced to and implemented by senior-focused organizations. Target adopters were senior and community centers, multi-purpose senior services organizations, recreational organizations, and residential facilities serving older adults. The three EBFPPs were (1) Stay Active and Independent for Life (SAIL), (2) a Matter of Balance (MOB) and (3) Otago Exercise Program (OEP). Key interdependent project elements included: (1) fostering ongoing community organization collaboration, (2) introducing programs in the community, (3) growing and sustaining delivery sites, (4) preparing trained program leaders, and (5) building community demand for the programs. From August 2016-June 2022, 5,857 older adults participated in one of the three EBFPPs. SAIL classes were offered at 33 sites and MOB workshops at 31 with over 70% of them occurring at community or senior centers. OEP was offered at 4 sites. Factors that influenced the implementation of these programs included having: key advocates at host organizations, programs embedded into site workflows, sufficient capacity and workforce, engaged invested partners, and flexibility in working with a complex set of agencies and systems with different administrative structures. By connecting academic faculty with various community members from multiple sectors, new initiatives can be successfully implemented. Results from this ACL-funded project indicate that using an academic-community partnership model to build relationships and capacity for ongoing delivery of health promotion programming for older adults is feasible and effective in delivering EBFPPs. In addition, academic-community partnerships can develop a strong network of invested partners to foster continued support of fall prevention activities.

A vocational rehabilitation partnership to provide transition services to young adults with neurodevelopmental disabilities: The cognitive skills enhancement program.

There is an urgent need for services that support a successful transition to postsecondary education and employment for young adults with neurodevelopmental and cognitive disabilities (e.g. autism spectrum disorder, attention-deficit/hyperactivity disorder, traumatic brain injury). The purpose of this expository article is to describe the Cognitive Skills Enhancement Program (CSEP), a comprehensive clinical program designed for young adults with neurodevelopmental and cognitive disabilities transitioning to postsecondary education. CSEP was developed through a community-academic partnership between a university and a state vocational rehabilitation program. Young adult participants complete programming that addresses four primary clinical targets: (1) emotion regulation, (2) social skills, (3) work readiness, and (4) community participation with the overall goal to increase awareness and promote successful employment outcomes while they transition to post-secondary education. To date, CSEP has supported 18 years of sustained programming and clinical services to 621 young adults with neurodevelopmental and cognitive disabilities. This partnership model allows for flexible responses to participant needs, implementation barriers, and advances in evidence-based practices. CSEP meets the needs of diverse stakeholders (e.g. state vocational rehabilitation, postsecondary training facilities, participants, universities) while providing high-quality and sustainable programming. Future directions include examining the clinical efficacy of current CSEP programming.

Addressing health disparities of individuals experiencing homelessness in the U.S. with community institutional partnerships: An integrative review.

To examine existing community-institutional partnerships providing health care services to people experiencing homelessness by addressing social determinants of health (SDOH) at multiple socioecological levels. Integrative review. PubMed (Public/Publisher MEDLINE), CINAHL (The Cumulative Index of Nursing and Allied Health Literature database), and EMBASE (Excerpta Medica database) were searched to identify articles on health care services, partnerships, and transitional housing. Database search used the following keywords: Public-private sector partnerships, community-institutional relation, community-academic, academic community, community university, university community, housing, emergency shelter, homeless persons, shelter, and transitional housing. Articles published until November 2021 were eligible for inclusion. The Johns Hopkins Nursing Evidence-Based Practice Quality Guide was used to appraise the quality of articles included in the review by two researchers. Seventeen total articles were included in the review. The types of partnerships discussed in the articles included academic-community partnerships (n= 12) and hospital-community partnerships (n= 5). Health services were also provided by different kinds of health care providers, including nursing and medical students, nurses, physicians, social workers, psychiatrists, nutritionists, and pharmacists. Health care services spanning from preventative care services to acute and specialized care services and health education were also made possible through community-institutional partnerships. There is a need for more studies on partnerships that aim to improve the health of homeless populations by addressing social determinants of health at multiple socioecological levels of individuals who experience homelessness. Existing studies do not utilize elaborate evaluation methods to determine partnership efficacy. Findings from this review highlight gaps in the current understanding of partnerships that seek to increase access to care services for people who experience homelessness. The results of the systematic review were solely from the articles reviewed and do not include information from patients, service users, caregivers, or members of the public.

Using Our Strengths: Establishing a Community-Academic Partnership to Tackle Menstrual Health Concerns in Philadelphia.

Menstrual health is a secretive, stigmatized, and understudied topic in the United States. To begin addressing this stigma requires understanding menstrual communication patterns in the community; however, few studies have applied community-based participatory research to explore menstrual health stigma. To describe the team and lessons learned building a community-academic partnership aimed to explore menstrual health stigma and communication in Philadelphia, Pennsylvania.Partnership: A menstrual health non-profit and a social-reproductive epidemiologist forged a community-academic partnership using a unique program that encourages partnerships between researchers and community organizations. Three lessons are described: 1) take time to build trust, 2) be patient and respectful navigating challenges and unforeseen difficulties, and 3) ensure equitable distribution of project resources and benefits. Our partnership accomplished impactful work by acknowledging the unique resources, skills, and networks that each partner possessed.

Building Leadership Through Partnerships: Using Concept Mapping to Develop Community Capacity to Address Gender-Based Violence.

Building Leadership Through Partnerships:Using Concept Mapping to Develop Community Capacity to Address Gender-Based Violence Alisa J. Velonis, MPH, PhD, Erin Howes, MPH, Karla Altmayer, JD, Sheerine Alemzadeh, JD, Linda Forst, MD, MPH, and Jeni Hebert-Beirne, MPH, PhD What is The Purpose of This Study/Review? • Our study describes an academic–community partnership formed to help the leaders of a community-based organization (CBO) identify the critical elements for a leadership training program to address gender-based violence (GBV) in communities with high levels of precarious employment and little access to institutional supports. • The research partnership consisted of the leaders of the CBO, several academic researchers, and a team of "community animators," or community researcher trained in conducting research activities. • Concept mapping methods were used to generate and prioritize a list of resources and skills individuals from the targeted communities felt they would need to address GBV that happened at work and home. • While the findings directly influenced the content of the leadership program, the community partners found the process to be of equal benefit. What Is the Problem? • Despite the increased publicity surrounding workplace sexual harassment, women in temporary, low-wage jobs with few or no benefits are particularly vulnerable to experiencing GBV and its ramifications, both at home and at work. While some workplaces have initiated GBV response programs, the nature of precarious employment (e.g., few/no benefits, low wage, dangerous working conditions) and accompanying informal workplaces (e.g., private homes, warehouses, small businesses) preclude workers from having access to these programs, and likely discourage employees from seeing workplaces as a source of support. Thus, community-based and community-driven responses will be needed to provide support for women experiencing GBV in these populations. What Are the Findings? • The findings from the concept mapping activities suggested that participants believe that informal leaders from their communities who want to address issues of GBV would benefit from having skills and resources related to addressing workplace violence. ○ They suggested that a program that covered topics such as employee and survivor support and resources would be likely to draw participants to such a program. ○ Participants' focus on workplace violence may have been related to our initial emphasis on precariously employed individuals, but it is also likely that this is a less-sensitive form of GBV providing an entry point from which to initiate discussions about other forms of GBV, including violence initiated by partners and family members. [End Page e9] • The CBO leaders who co-led this research felt that the process of engaging members of the community (including the community animators) in prior to the launch of the programs was equally useful to the development of the program as the findings were. ○ They were able to build relationships and make connections they may not have made otherwise and allowed them to have a very successful program launch, with roughly one-third of program participants having been part of the concept mapping process, either as animators or as participants. Who Should Care Most? • The findings from our study are important for groups interested in developing community-driven approaches for addressing GBV. While the specific findings of our study may not be generalizable beyond low-wage communities and predominantly Latinx individuals, we believe that that the process of engaging communities was critical to our success. Our work highlights the platform that community driven research can provide in response to GBV. Recommendations for Action • Academic–community partnerships can be useful for soliciting input and buy-in from especially marginalized communities prior to launching programs in the area. [End Page e10] Alisa J. Velonis University of Illinois at Chicago, School of Public Health, Division of Community Health Sciences Erin Howes University of Illinois at Chicago, School of Public Health, Division of Community Health Sciences Karla Altmayer Healing to Action Sheerine Alemzadeh Healing to Action Linda Forst University of Illinois at Chicago, School of Public Health, Division of Environmental and Occupational Health Sciences Jeni Hebert-Beirne University of Illinois at Chicago, School of Public Health, Division of Community Health Sciences Copyright © 2023 Johns Hopkins University Press

Abstract P6-05-46: Project SOAR (Speaking Our African American Realities): A qualitative study of the Strong Black Woman schema in the breast cancer context

Abstract Background: Marked disparities exist for African American women, relative to non-Latina white women, in the five-year survival rate for breast cancer. Black women breast cancer survivors also demonstrate relative disadvantage in specific quality of life (QOL) domains, persisting through at least two years after diagnosis. Although Black women have higher QOL in the spiritual domain relative to white women, disparities include lower physical QOL, as well as more pronounced depressive symptoms, perceived stress, fear of dying, unmet supportive care needs, and financial distress, with younger Black women (< 50 years) particularly at risk. African American breast cancer survivors also report receiving too little information from their oncologists during diagnosis, treatment, and follow-up care. Sociodemographic and medical factors only partially explain the QOL disparities. The goal of Project SOAR (Speaking Our African American Realities), a community-academic partnership, is to interrogate the potential relevance of the Strong Black Woman (or Black Superwoman) schema in the breast cancer context. The schema involves historically grounded expectations to prioritize caregiving over self-care, suppress emotions, present an image of strength, decline support, and strive to achieve success without adequate resources. Method: Black women were recruited via relevant email listservs and flyers distributed at local breast cancer events to take part in a study “to understand the unique experiences of African American women and their views on the Strong Black Woman concept as it applies during their breast cancer experience.” Eligibility criteria were self-identification as being: 1) an African American woman (or a Black woman living in the United States); 2) diagnosed with breast cancer (any stage, any diagnosis duration); 3) at least 21 years old; and 4) able to communicate in English. Three Gatherings (i.e., culturally curated focus groups) were held as half-day experiences in intimate settings (e.g., private homes, a church) in three California cities (Sacramento, Oakland, Los Angeles). Gatherings provided an entirely Black women’s space to discuss the breast cancer experience and the relevance and consequences of the Strong Black Woman schema, break bread together, and engage in an inspiring activity. Reflexive thematic analysis was conducted on the Gatherings transcripts with a critical realist, contextualist approach. Results: All participants (N = 37; age range = 30-94 years; M = 59 years) had heard of the concept of the Strong Black Woman. Reflexive thematic analysis yielded six themes: 1) historical legacy of Strong Black Woman; 2) navigating intersecting Strong Black Woman identities; 3) everyday challenges encountered on the battlefield by Strong Black Women; 4) Strong Black Woman in action during the breast cancer journey; 5) the complexities of seeking and accepting support; and 6) the liberated Strong Black Woman. Participants linked both negative and positive consequences with the Strong Black Woman schema. Negative consequences included the oncologic team and others expecting them to be strong and not to need support, as well as expectations of themselves to suppress emotions and to continue caring for others to the neglect of caring for themselves. Positive consequences included engaging in self-advocacy in the oncologic context, having a sense of resilience, and redefining strength to include expressing emotions and accepting help from others. Conclusion: Qualitative analysis revealed the relevance of the Strong Black Woman schema in the breast cancer context, as well as its negative and positive consequences. Future research can assess whether oncologic professionals’ awareness of the schema is useful in ensuring they offer support and refer Black women diagnosed with breast cancer to culturally relevant supportive resources. Citation Format: Tammie Denyse, Kimberly J. Martin, Yrvane K. Pageot, Praise Owoyemi, Annette L. Stanton, Jacqueline H. Kim. Project SOAR (Speaking Our African American Realities): A qualitative study of the Strong Black Woman schema in the breast cancer context [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-46.

Prioritizing rural populations in state comprehensive cancer control plans: a qualitative assessment

PurposeThe Centers for Disease Control and Prevention’s National Comprehensive Cancer Control Program (NCCCP) requires that states develop comprehensive cancer control (CCC) plans and recommends that disparities related to rural residence are addressed in these plans. The objective of this study was to explore rural partner engagement and describe effective strategies for incorporating a rural focus in CCC plans.MethodsStates were selected for inclusion using stratified sampling based on state rurality and region. State cancer control leaders were interviewed about facilitators and barriers to engaging rural partners and strategies for prioritizing rural populations. Content analysis was conducted to identify themes across states.ResultsInterviews (n = 30) revealed themes in three domains related to rural inclusion in CCC plans. The first domain (barriers) included (1) designing CCC plans to be broad, (2) defining “rural populations,” and (3) geographic distance. The second domain (successful strategies) included (1) collaborating with rural healthcare systems, (2) recruiting rural constituents, (3) leveraging rural community–academic partnerships, and (4) working jointly with Native nations. The third domain (strategies for future plan development) included (1) building relationships with rural communities, (2) engaging rural constituents in planning, (3) developing a better understanding of rural needs, and (4) considering resources for addressing rural disparities.ConclusionSignificant relationship building with rural communities, resource provision, and successful strategies used by others may improve inclusion of rural needs in state comprehensive cancer control plans and ultimately help plan developers directly address rural cancer health disparities.

Sustaining Long-term Community-Academic Partnerships: Negotiating Power and Presence

Community based participatory research (CBPR) partnerships simultaneously increase knowledge and community well-being. Despite the growing number of long-term (as opposed to project-specific) CBPR partnerships, research has yet to sufficiently explore factors that contribute to their success and sustainability over time. This study investigated this question by exploring the perceived benefits, barriers, and facilitators of participation in one long-term CBPR partnership, with particular attention to the role of power. Fifteen members and non-members of a CBPR partnership were interviewed, and data were analyzed using qualitative content analysis. Interviewees discussed the value of involvement in the partnership, including strong relationships, honest discussion of power dynamics, mutual learning, and capacity building. Barriers and facilitators to involvement included access factors (ability to be involved) and participation factors (desire to be involved.) Attention to power dynamics was an important benefit for members, yet culturally-specific organizations faced unique barriers to participation. The findings of this study suggest that future long-term CBPR partnerships should prioritize addressing inequitable logistical barriers to participation, discussing power dynamics and power-sharing, and “centering the margins” by focusing on the needs and interests of culturally-specific organizations.

A training program to increase collaboration between interpreter and therapists in psychotherapy with resettled refugees.

Drawing from the framework of community-academic partnerships, we describe the development and implementation of a training module to increase collaboration between interpreters and therapists in interpreter-mediated psychotherapy with refugees. Beginning with community engagement with local agencies and leaders to identify barriers to accessing psychotherapy services in the resettled refugee populations, this project involved multiple layers of collaboration to include multiple perspectives. The program was funded by a local community foundation and was implemented in three phases. In the first phase we identified key community partners and stakeholders with first-hand knowledge of the needs of refugee populations. Phase two involved a two-day workshop for student therapists from different disciplines and interpreters working in the field. Phase three included a follow up to re-assess challenges in the field and refine our training. The need to build early collaboration between therapists and interpreters was highlighted throughout the development and implementation of the project. We discuss the project’s impact, challenges encountered, and implications of lessons learned in developing community-engaged partnerships for graduate programs as a way of promoting social justice in practitioner training.