Community Engagement Principles Research Articles

Co-designing an Integrated Health and Social Care Hub With and for Families Experiencing Adversity.

Integrated care research often fails to adequately describe co-design methods. This article outlines the process, principles and tools to co-design an integrated health and social care Hub for families experiencing adversity. The Child and Family Hub was co-designed in four stages: (1) partnership building and stakeholder engagement, (2) formative research, (3) persona development and (4) co-design workshops and consultations. Local families, community members and intersectoral practitioners were engaged at each stage. The co-design workshops employed a human-centred design process and were evaluated using the Public and Patient Engagement Evaluation Tool (PEET). 121 family participants and 80 practitioners were engaged in the Hub's co-design. The PEET highlighted the co-design team's satisfaction achieved by community members working alongside practitioners to generate mutual learning. Resourcing was a key challenge. Human-centred design offered a systematic process and tools for integrating formative evidence with lived and professional experience in the Hub's co-design. Applying community engagement principles meant that a diverse range of stakeholders were engaged across all stages of the project which built trust in and local ownership of the Hub model. Co-design research with families experiencing adversity should attend to language, engagement methods, team composition and resourcing decisions.

Abstract PL03-05: Early Engagement Equals Early Detection

Abstract PL03-05: Early Engagement Equals Early Detection

231 Training Medical Interns and Graduate and Professional Students on Community Engaged Research: Lessons Learned from Implementing a Community Scholars Program

OBJECTIVES/GOALS: 1. Describe the development and implementation of a Community Scholars Program to train graduate and professional students on principles of community engagement and its application to their research. 2. Evaluate lessons learned and overall impact implementing a Community Scholars Program. METHODS/STUDY POPULATION: After identifying a need to train scholars on the principles of community engagement, the Community Engagement Research Core’s (CERC) Community Advisory Council (CAC) developed the Community Scholars Program (CSP) in 2014. The CSP was designed to educate scholars on community engaged research and how it can be applied to their research projects. The program is currently in its ninth cohort with 19 graduate and professional students having participated in the program to date. Prospective scholars identify a community partner and faculty mentor and apply to conduct a community engaged research project over the course of an academic year. The purpose of this project is to describe the development and implementation of a CSP and identify lessons learned throughout the process. RESULTS/ANTICIPATED RESULTS: Five lessons learned have been identified: five major lessons learned from implementing the CSP: (1) establish partnership agreements between the scholars and their community partners and faculty mentors, setting expectations to avoid conflict and increase mutual understanding; (2) expand and implement more creative outreach approaches to cultivate a more diverse pool of applicants; (3) increase networking between current and past scholars to share experiences and serve as a resource for each other; (4) provide formal CE training for scholars to develop a better understanding of the principles of CE and CE research; and (5) document progress of the program through formal feedback and evaluations. DISCUSSION/SIGNIFICANCE: The CSP was constructed to fill a gap in CE research training for graduate and professional scholars. Over the course of the program, the identified lessons learned have created program clarity and increased accountability for scholars, mentors, and community partners alike.

Community engagement in health services research on soil-transmitted helminthiasis in Asia Pacific region: Systematic review.

The research question was what studies are available that have assessed community engagement in the health services research on soil-transmitted helminths? We aimed to synthesise evidence on how communities were engaged in health services research on soil-transmitted helminths in low-and-middle-income countries of the Asia-Pacific Region. We focused on this region because soil-transmitted helminths are endemic, and their burden is significant in this region. This review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) checklist. Relevant studies were searched in health-related databases including PubMed, Ovid, and Google Scholar. We selected studies based on the selection criteria set for this review. We collected textual information about the type of health services research, the degree of community engagement, the research phases involved, and the barriers/enablers affecting community engagement in research since they are pertinent to our review question and objective. Ten studies from seven countries in the Asia Pacific region were identified for this review. Albeit with variation in the extent of their involvement, various forms of communities/groups within communities were included such as Aboriginal communities, local communities, school children and their parents, school teachers and headmasters of schools, heads of villages, religious leaders, and so on. Overall, community engagement in health services research focused on of soil-transmitted helminths was limited. Six studies (60%) had collaboration at 'developing methodology', mainly through an explanation of the objectives of the study or study process to be conducted. Seven studies (70%) revealed community participation in soil-transmitted helminths at the "data collection" stage. Only one study (10%) documented that a community leader was involved as a co-author, reflecting an involvement in 'report writing' and further 'dissemination'. Findings suggest that there were various forms of community engagement in various aspects of the health services research context. Overall, there was moderate level of participation, but there was insufficient information on the partnership between various stakeholders, which prevented in-depth analysis of the engagement. Future health services research on soil-transmitted helminth interventions needs to be carefully planned, well designed, grounded in principles of community engagement, and designed methodologically to allow in-depth participation by communities in all stages of the research.

A Framework for Justice-Centering Relationships: Implications for Impact in Place-Based Community Engagement

Community engagement in higher education has been promoted as critical to fulfilling higher education’s responsibility to the public good through teaching, learning, and knowledge generation. Reciprocity and mutual benefit are key principles of community engagement that connote a two-way exchange of knowledge and outcomes. However, it is not clear from existing literature whether community engagement impacts communities in positive ways. 
 The problem addressed through this study was how campus-community partnership stakeholders define impact. Using grounded theory, the ways community and campus partners defined, measured, and understood community impact in a diverse set of campus-community partnerships at two U.S. urban, Jesuit universities that employ place-based approach to community engagement were explored. Relationships as facilitators of impact and as impacts in and of themselves emerged as central themes. Themes from the data led to the development of the Justice-Centering Relationships Framework which includes two paradigms for understanding community impact in higher education community engagement – Plug-and-Play and Justice-Centering Relationships – that are bridged by a Reframing process. The Framework contributes to and informs the “how” of taking a place-based community engagement approach that leads to positive benefits for community impact, student learning and formation, and institutional change.

Promoting Authentic Academic—Community Engagement to Advance Health Equity

Meaningful community engagement is critical to achieving the lofty goal of health equity. Nonetheless, implementing the principles of community engagement is not easy. Attempting to implement best practices for collaborating on transdisciplinary teams and working with community partners can be challenging, particularly in locales that have a long history of strained university-community relationships. The purpose of this paper is to provide additional context and consideration for researchers, community partners, and institutions interested in conducting community-engaged research. Here, we provide guidance and highlight exemplary programs that offer effective approaches to enhance the strength of community partnerships. These partnerships not only hold promise but are also essential in the development of the local, multi-factor solutions required to address racial/ethnic inequities in health.

Embedding community-engaged research principles in implementation science: The implementation science center for cancer control equity.

Gaps in the implementation of effective interventions impact nearly all cancer prevention and control strategies in the US including Massachusetts. To close these implementation gaps, evidence-based interventions must be rapidly and equitably implemented in settings serving racially, ethnically, socioeconomically, and geographically diverse populations. This paper provides a brief overview of The Implementation Science Center for Cancer Control Equity (ISCCCE) and describes how we have operationalized our commitment to a robust community-engaged center that aims to close these gaps. We describe how ISCCCE is organized and how the principles of community-engaged research are embedded across the center. Principles of community engagement have been operationalized across all components of ISCCCE. We have intentionally integrated these principles throughout all structures and processes and have developed evaluation strategies to assess whether the quality of our partnerships reflects the principles. ISCCCE is a comprehensive community-engaged infrastructure for studying efficient, pragmatic, and equity-focused implementation and adaptation strategies for cancer prevention in historically and currently disadvantaged communities with built-in methods to evaluate the quality of community engagement. This engaged research center is designed to maximize the impact and relevance of implementation research on cancer control in community health centers.

The Community Research Liaison Model: Facilitating community-engaged research.

The Community Research Liaison Model (CRLM) is a novel model to facilitate community-engaged research (CEnR) and community-academic research partnerships focused on health priorities identified by the community. This model, informed by the Principles of Community Engagement, builds trust among rural communities and expands capacity for community and investigator-initiated research. We describe the CRLM development process and how it is operationalized today. We followed a multi-phase process to design and implement a community engagement model that could be replicated. The resulting CRLM moves community-academic research collaborations from objectives to outputs using a conceptual framework that specifies our guiding principles, objectives, and actions to facilitate the objectives (i.e., capacity, motivations, and partners), and outputs. The CRLM has been fully implemented across Oregon. Six Community Research Liaisons collectively support 18 predominantly rural Oregon counties. Since 2017, the liaison team has engaged with communities on nearly 300 community projects. The CRLM has been successful in facilitating CEnR and community-academic research partnerships. The model has always existed on a dynamic foundation and continues to be responsive to the lessons learned by the community and researchers. The model is expanding across Oregon as an equitable approach to addressing health disparities across the state.

CONDUCTING COMMUNITY-BASED RESEARCH AS AN INSIDER AND OUTSIDER IN YOUR OWN COMMUNITY

Abstract As an Alaska Native from the Bristol Bay region, this presentation will discuss being an insider and outsider in your own community and how it impacts research studies. Using case studies from my dissertation research, this presentation will discuss positionality and how to collect objective data, the lack of objectivity in getting, analyzing, and reporting data, and how research methods influenced my study. I will also discuss challenges and benefits of being an insider, including enhancing the validity of the research process, data collection, and analysis, understanding the group’s culture. The results include trusting relationships with communities, the Elders’ voices guiding the findings, an appreciation for the challenge of conducting research as an insider and outsider. This presentation will conclude with a discussion on how to obtain objective data and ensure the accuracy of findings through community-engagement principles and the benefits of working in your own community.

Technology-aided community engagement for exercise promotion: a mixed-methods systematic review

Abstract Background This review aims to provide an overview of evidence on feasibility and effectiveness in diverse populations of eHealth physical activity (PA) community engagement (CE) interventions. Increasing global PA levels would have a substantial positive impact on population health. Given their diffusion, eHealth technologies may address certain barriers to PA and reach wide audiences. The most recent Italian guidelines on PA highlight inequalities in health, which can be addressed using CE models. The potential scalability of successful eHealth CE interventions and the scarcity of previous reviews on the topic are reasons which convinced us to work on this paper. Methods This mixed-methods systematic review utilized the Joanna Briggs Institute methodologies. Primary quantitative outcome measures were minutes of PA per week. Qualitative outcome measures included self-efficacy and user engagement. Data were processed using a segregated convergent design. A narrative summary and a meta-aggregation were performed for synthesizing quantitative and qualitative data respectively. Only the interventions where CE principles were fulfilled were analyzed. Results Quantitative evidence supported effectiveness and feasibility of interventions to improve PA outcomes and related proxy indicators across studied populations. Qualitative findings suggest the utility of peer-support and that from other health care providers. Conclusions Implementing CE in future PA interventions will be critical for producing an effective digital application with the potential for considerable impact in the real world. If supported by central governments and the European Union, entities such as primary care hubs and local health units with their professionals and CE capabilities may play the key role in implementing evidence. Key messages • eHealth PA CE interventions work better when peer support takes place. • Health systems could pursue these prevention strategies for population health gains.

Community-based surveillance of infectious diseases: a systematic review of drivers of success

IntroductionCommunity-based surveillance may improve early detection and response to disease outbreaks by leveraging the capacity of community members to carry out surveillance activities within their communities. In 2021, the WHO...

Description of global innovative methods in developing the WHO Community Engagement Package

ObjectivesDevelopment of a Community Engagement Package composed of (1) database of community engagement (CE) experiences from different contexts, (2) CE learning package of lessons and tools presented as online modules,...

Preparation for COVID-19 vaccines rollout: Interventions to increase trust, acceptability, and uptake in West African countries.

IntroductionThe approval of COVID‐19 vaccines for use has come as a relief to West Africa and world. However, concerns raised about the vaccines in America and Europe have created anxiety among some citizens in Africa. These concerns are likely to affect the acceptance, and uptake of the COVID‐19 vaccines in West Africa.MethodsGuided by the principles of effective community engagement, this research reviewed typical case studies of past vaccination exercises to document concerns, challenges and lessons learnt. These were then used to propose pre‐immunisation interventions in West Africa to increase the COVID‐19 vaccines acceptance and uptake.ResultsConcerns about safety can undermine the rollout of the COVID‐19 vaccines. These concerns can be addressed through effective community engagement. Community leaderships could be engaged through courtesy calls, workshops and durbars to sensitise them on immunisation. Engaging the scientific community can help build trust and reduce concerns about vaccine safety. In vaccines rollout, managing misinformation is important and the media can play a critical role in addressing these in their reportage. In addition, social media is an effective monitoring tool for vaccine‐related misinformation.ConclusionThe analysis underscores the need for more community engagement before the importation and deployment of COVID‐19 vaccines in West Africa. Experiences from community responses to previous vaccination exercises for emerging and remerging infectious diseases should inform the current efforts and enhance the process to achieve high uptake and reduce vaccine hesitancy.

Health Advocacy Learning Activities for Medical Students in Clinical Clerkship Training: Why We Are Changing Our Model.

Purpose: Health advocacy is a key physician skill to address social determinants of health and promote health and health equity. 1 We noted a lack of medical school curricula that both address skills necessary to develop partnerships with advocacy stakeholders and students’ desires to self-determine advocacy topic areas. A novel learning project was therefore designed to address these goals. Outcomes were followed for 3 years. We aim to describe student and community health partner outcomes and key lessons learned through the delivery of this project. Approach: The health advocacy project (“HAP”) was incorporated as part of a required ambulatory clinical course at the University of Wisconsin School of Medicine and Public Health (UW-SMPH). The HAP allowed medical students to identify a topic and community partner and required students to arrange meetings with the partner to identify shared goals and a mutually agreed-upon project. Students dedicated approximately 8 hours of work over the 10- to 12-week course to this effort. Projects were focused on community partner goals. At the end of the course, students delivered their project, wrote a summary paper, and completed a self-evaluation on changes in attitudes and practice. Community partners submitted qualitative feedback. Outcomes: After 12 cycles of the course (January 2018 through December 2020), 408 students completed the HAP and 328 students completed a self-evaluation. Of these, 218 (~66%) rated increased likelihood of “Doing Health Advocacy Work in the Future,” and 267 (~81%) rated increased “Comfort Level with Health Advocacy Work.” More than 250 different organizations partnered with students (some hosted >1 student) and 222 organizations gave a definitive response to a survey question regarding the helpfulness of the HAP. Of these, 220 (99%) of these indicated the HAPs were helpful, while the other 2 (1%) responses indicated that there was not sufficient time to complete the project. Additionally, 211 organizations gave a definitive response to question regarding interest in “Partnering with a UW-SMPH student in the future related to Health Advocacy.” Of these, 187 (89%) responded that they were interested in future partnerships; and among the 24 community partners who answered no, the need to have a preexisting relationship with the organization and limited organizational capacity were among the most commonly noted reasons. Discussion: Overall, the HAP was well received by community partners and promoted self-reported student comfort with and interest in future advocacy efforts. Despite these positive outcomes, rare negative feedback from community health stakeholders offered critical insight and clear opportunities for program improvement. The short nature of the HAP likely served as a barrier to successful relationship building in some cases, and possibly contributed to increased pressure on our community partners for capacity due to the recurring cycle of the HAP and student outreach. This prompted curriculum leaders to move beyond the short-term positive impacts and reflect on the long-term institutional footprint of this curriculum within the community. Consequently, after 3 years, we opted to discontinue the current HAP curriculum at the end of 2020, with these lessons informing the next iteration of the health advocacy curriculum. The reimagined health advocacy curriculum will have additional learning activities to address advocacy-related communication, including standardized training before engaging with community partners. In addition, standardized assessment will occur through use of simulated encounters with advocacy stakeholders. Finally, new curriculum will ensure sufficient time and support to community partners when students engage community partners on advocacy efforts. Significance: The HAP demonstrated the feasibility of medical school curricula that promoted student independence and skills in community partnership development; and the majority of student and community partner feedback was favorable. Nonetheless, it was important to address the few exceptions and design a curriculum that adheres to principles of community engagement. 2

Recruitment planning for clinical trials with a vulnerable perinatal adolescent population using the Clinical Trials Transformative Initiative framework and principles of partner and community engagement

Recruitment planning is needed to establish a foundation for obesity prevention research with high risk, disadvantaged perinatal adolescent populations. In the context of developing clinical trial protocols, investigators partnered with Mississippi's Nutrition Program for Women, Infants and Children (WIC) and adopted the Clinical Trials Transformative Initiative (CTTI) framework for recruitment planning to identify and mitigate challenges to recruitment early in the clinical trial development process. The recruitment protocol consisted of 20 passive strategies grounded in principles of partner and community engagement and was flexible, accommodating, altruistic, community-focused, and minimally burdensome to partners and participants. The recruitment goal included 150 adolescent-coparticipant dyads and 145 dyads (96.7%) were successfully recruited. Investigators demonstrated the feasibility of recruiting a disadvantaged and vulnerable perinatal adolescent population that is underrepresented in health research, in one of the most persistently impoverished and poor health regions in the U.S. Four important aspects of recruitment planning using the CTTI framework are discussed including: (1) establishing partnerships with trusted community resources is a paramount investment; (2) dedicating time and resources to know and go to your community is invaluable; (3) fostering trust by offering convenient, continuous and clear communication; and (4) encouraging collaboration and participation through limiting partner and participant burden. Establishing organizational and community partnership requires a substantial amount of invaluable time and fosters recruitment success. Following the CTTI recommendations for recruitment planning led to a robust recruitment protocol that will be used in future intervention trials with an understudied perinatal adolescent population with high risk for poor maternal and fetal health outcomes.

25179 The Community Mentor for Scholars Program: Pilot Program Results

ABSTRACT IMPACT: Strengthening investigator and community engagement to improve human health OBJECTIVES/GOALS: Community Engagement is one of the 14 core competencies for CT research defined by the CTSA Education Core Competency Work Group. To meet this, the UMN CTSI created the Community Mentor for Scholars Program with goals to: 1) train Scholars to engage stakeholders; and 2) provide community with formal mentoring training and linkages to researchers at UMN. METHODS/STUDY POPULATION: The CM Program was implemented over 12 months and includes four components. One, Scholars were trained in stakeholder identification and working with a community mentor (CM) through two seminars presented by expert faculty and staff. Two, CMs were identified, recruited, and matched with Scholars through a collaborative effort of our CTSI Education and Community Engagement cores. Three, Scholars and CMs learned about the program from a 2-hour Kick-Off event. Four, CMs and Scholars each completed four online modules developed through an NCATS administrative supplement. Scholar-CM pairs met at least four times to plan and hold a bi-directional ‘Community Conversation’ with an audience of key stakeholders convened by the CM. The CM Program was evaluated through in-person interviews. RESULTS/ANTICIPATED RESULTS: In 2019-2020, CTSI initiated the pilot program with four KL2 Scholar - CM pairs. Two pairs did not complete the program due to time pressures, a parental leave, and the COVID-19 pandemic. Feedback from the two Scholar - CM pairs was positive, specifically:CMs reported the training modules were useful, resulting in better understanding of CTSI research programs and increased capacity to mentorScholars felt the interactions with CMs positively impacted their future researchMentors supported experiential learning, offered insight on community perspectives, and successfully facilitated community engagement principles. DISCUSSION/SIGNIFICANCE OF FINDINGS: The second cohort launched in late 2020 with inclusion of TL1 Scholars. They will be matched with CMs in spring 2021. After Cohort 2 completion, the program design and materials will be updated based on evaluation results from scholars and mentors and then will be piloted with select CTSAs before sharing across the CTSA consortium.

How Ecosystem-Based Adaptation to Climate Change Can Help Coastal Communities through a Participatory Approach

Coastal rural communities worldwide face many challenges not only related to climate change but also extreme events, environmental degradation, population growth or aging, and conflict usage of the ecosystem. Historically, the economies of coastal communities have been based on the exploitation of natural resources, thus shaping its socioeconomic development. This has led to some limitations in the way these communities can now adapt to climate change. In Canada, coastal communities are increasingly dealing with climate change consequences. Sea level rise, coastal erosion, and increasing frequency in storm surges threaten the fragility of both natural and human systems. Various approaches have been used to try to reduce the vulnerability and improve adaptive capacity of communities. One approach, promoted by many organizations including the United Nations, is ecosystem-based adaptation. This approach is part of the series of nature-based solutions that help social–ecological systems become more resilient; by promoting biodiversity conservation and ecosystem services, this approach also relates to principles of community engagement and supports adaptive governance and social inclusion. This paper describes and analyzes these principles and considers strategies for ensuring community engagement. Combining ecosystem-based adaptation with a strong community engagement can enhance the long-term sustainability of the social-ecological system.

A Community-Engaged Approach to Environmental Health Research: Process and Lessons Learned

This study used a community-engaged approach to examine associations between environmental contaminants and health outcomes among residents of Yuma, Arizona. Our team conducted a process evaluation to assess scientific rigor and adherence to community engagement principles. Our evaluation focused on four dimensions of community-based participatory research: 1) context, 2) group dynamics, 3) intervention and research, and 4) outcomes. Interviews were conducted with key informants from community partner organizations. Thematic analysis was used to evaluate community partners' experiences with our collaborative process. Community partners reported collaborating to establish research goals, recruit participants, collect data, plan analyses, and formulate dissemination strategies. Training needs, roles, and expectations of community partners varied based on available resources, prior research experience, and perceived research challenges. Leveraging community-engaged principles for studies of environmental contamination can expedite recruitment efforts and stimulate action to improve health outcomes.

Learning From the Past and Working in the Present to Create an Antiracist Future for Academic Medicine.

Learning From the Past and Working in the Present to Create an Antiracist Future for Academic Medicine.

Opening doors to clinical trial participation among Hispanics: Lessons learned from the Spanish translation of ResearchMatch.

Clinical trial participation among US Hispanics remains low, despite a significant effort by research institutions nationwide. ResearchMatch, a national online platform, has matched 113,372 individuals interested in participating in research with studies conducted by 8778 researchers. To increase accessibility to Spanish speakers, we translated the ResearchMatch platform into Spanish by implementing tenets of health literacy and respecting linguistic and cultural diversity across the US Hispanic population. We describe this multiphase process, preliminary results, and lessons learned. Translation of the ResearchMatch site consisted of several activities including: (1) improving the English language site's reading level, removing jargon, and using plain language; (2) obtaining a professional Spanish translation of the site and incorporating iterative revisions by a panel of bilingual community members from diverse Hispanic backgrounds; (3) technical development and launch; and (4) initial promotion. The Spanish language version was launched in August 2018, after 11 months of development. Community input improved the initial translation, and early registration and use by researchers demonstrate the utility of Spanish ResearchMatch in engaging Hispanics. Over 12,500 volunteers in ResearchMatch self-identify as Hispanic (8.5%). From August 2018 to March 2020, 162 volunteers registered through the Spanish language version of ResearchMatch, and over 500 new and existing volunteers have registered a preference to receive messages about studies in Spanish. By applying the principles of health literacy and cultural competence, we developed a Spanish language translation of ResearchMatch. Our multiphase approach to translation included key principles of community engagement that should prove informative to other multilingual web-based platforms.