Community Engagement and Research Symposium Copyright (c) 2013 University of Massachusetts Medical School All rights reserved. http://escholarship.umassmed.edu/chr_symposium Recent documents in Community Engagement and Research Symposium en-us Mon, 01 Apr 2013 11:56:20 PDT 3600 Welcome http://escholarship.umassmed.edu/chr_symposium/2012/program/9 http://escholarship.umassmed.edu/chr_symposium/2012/program/9 Fri, 30 Nov 2012 10:00:00 PST Audio recording (15 min.) of Welcome by Ira S. Ockene, MD and Katherine Luzuriaga, MD.

]]> Ira S. Ockene et al. Panel Discussion: "Making It Happen" http://escholarship.umassmed.edu/chr_symposium/2012/program/8 http://escholarship.umassmed.edu/chr_symposium/2012/program/8 Fri, 30 Nov 2012 11:15:00 PST Audio recording (70 min.) of panel discussion about Community Partnered Research, moderated by Elmer Freeman, MSW, PhD(c). Panelists:

- Carol Bova, PhD, RN, ANP, UMass Worcester Graduate School of Nursing
- Elena Carbone, DrPH, RD, UMass Amherst
- Laura Hayman, PhD, RN, FAAN, UMass Boston
- Chioma Nnaji, MPH, MEd, Multicultural AIDS Coalition and UMass Medical School
- Milagros C. Rosal, PhD, UMass Medical School

]]> Elmer R. Freeman Poster Session http://escholarship.umassmed.edu/chr_symposium/2012/program/7 http://escholarship.umassmed.edu/chr_symposium/2012/program/7 Fri, 30 Nov 2012 08:30:00 PST View abstracts and full text of selected posters

]]> Posters from community agencies and researchers Breakout Session: "Paths to Obtaining Funding for Community Engaged Research: One Successful Example" http://escholarship.umassmed.edu/chr_symposium/2012/program/6 http://escholarship.umassmed.edu/chr_symposium/2012/program/6 Fri, 30 Nov 2012 13:30:00 PST The purpose of this talk is (1) To describe important elements of a successful preliminary studies section, and (2) To share a recent example of leveraging a small pilot study and in-kind on the fly activities to inform a successful NIH grant application.

]]> Stephenie C. Lemon Breakout Session: "Paths to Obtaining Funding for Community Engaged Research" http://escholarship.umassmed.edu/chr_symposium/2012/program/5 http://escholarship.umassmed.edu/chr_symposium/2012/program/5 Fri, 30 Nov 2012 13:30:00 PST Discusses the UMass CCTS Community Engagement & Research Section Pilot/Feasibility Grants Program and other potential sources of funding for community engaged research.

]]> Laura L. Hayman et al. Breakout Session: "Increasing Study Recruitment and Retention: Working with Communities to Use Social Media" http://escholarship.umassmed.edu/chr_symposium/2012/program/4 http://escholarship.umassmed.edu/chr_symposium/2012/program/4 Fri, 30 Nov 2012 13:30:00 PST Overview: Social media and research: What are the options? -- Ethical considerations -- Gateway to Community-Based Participatory Research. Conclusion: Social media has the potential to improve the methods and scope of community research. A number of technical and ethical issues remain unresolved.

]]> Leland K. Ackerson et al. Breakout Session: "Dissemination: Challenges and Successes in Working with Communities" http://escholarship.umassmed.edu/chr_symposium/2012/program/3 http://escholarship.umassmed.edu/chr_symposium/2012/program/3 Fri, 30 Nov 2012 13:30:00 PST Overview of the research dissemination goals and strategy of UMass Medical School's Center for Mental Health Services Research (CMHSR), including: (1) Determine the needs of the community/ agency; (2) Form partnerships with members of the community/agencies; (3) Designate Resources (Fiscal/Personnel); (4) Share research findings with various groups (e.g. consumers, providers, and other stakeholders); (5) Self Evaluate/Continuous Quality Improvement (CQI).

]]> Carl E. Fulwiler et al. Breakout Session: "Integrating Community Engaged Research into the Patient-Centered Medical Home" http://escholarship.umassmed.edu/chr_symposium/2012/program/2 http://escholarship.umassmed.edu/chr_symposium/2012/program/2 Fri, 30 Nov 2012 13:30:00 PST Presents data from a survey of patients at four health centers in the Worcester, Mass., area on the topic of the Patient-Centered Medical Home (PCMH) model of patient care.

Implications for research: The PCMH model includes a variety of interventions that have been demonstrated to be successful in some fashion. However, whether they will be effective when implemented together, whether they will be effective for the populations in question, and whether they are cost-effective uses of provider and patient time (as well as healthcare dollars) remains to be answered.

]]> Toni McGuire et al. Keynote Address: "Research with Communities to Improve Health and Reduce Health Disparities" http://escholarship.umassmed.edu/chr_symposium/2012/program/1 http://escholarship.umassmed.edu/chr_symposium/2012/program/1 Fri, 30 Nov 2012 10:15:00 PST The mission of the Center for Community Health Education Research and Service (CCHERS) is to promote the development of “academic community health centers” that integrate service, education and research to influence and change health professions education, improve health care delivery, and promote health systems change, to eliminate racial and ethnic disparities in health. Freeman discusses the challenges of Community Partnered Research and lessons learned.

]]> Elmer R. Freeman Innovations in Primary Care: Implementing Clinical Care Management in Primary Care Practices http://escholarship.umassmed.edu/chr_symposium/2012/posters/6 http://escholarship.umassmed.edu/chr_symposium/2012/posters/6 Fri, 30 Nov 2012 08:30:00 PST The Massachusetts Patient Centered Medical Home Initiative (MA PCMHI) is a statewide, multi-payer demonstration that seeks to transform 46 primary care practices into PCMHs. Clinical care management of high-risk patients is a key element of the PCMH and a new service for most primary care practices. Training for practices in the MA PCMHI includes the clinical care manager (CCM) role, identification/tracking of highest-risk patients, care plan development/implementation, care coordination, and communications. Content is delivered through learning collaborative sessions, monthly webinars and practice-based transformation facilitation. Assessment of progress towards implementation is made through practice-based data on clinical care management measures and self-assessment of transformation. At year one of implementation, averages for measures such as percentage of patients who received timely follow-up after hospitalizations and ED visits range 37%-63% with 35-40 of 46 practices reporting. The challenges that have hampered implementation include lack of: (1) EMR/registry functionality, (2) hospital to practice notification systems, (3) clarity of the CCM role and workflow, (4) risk stratification criteria for high-risk patients, and (5) adequate resources to support this service. An important lesson learned is that engaged leadership is critical to successful clinical care management implementation. Next steps include refinement of the practice-based self-assessment that is used as a monitoring and QI tool, and a pilot to study the coordination of payer-based and practice-based clinical care management.

]]> Sai Cherala et al. Healthy Homes Asthma Survey http://escholarship.umassmed.edu/chr_symposium/2012/posters/5 http://escholarship.umassmed.edu/chr_symposium/2012/posters/5 Fri, 30 Nov 2012 08:30:00 PST Asthma is a serious health concern among older adults in Massachusetts, the age group with the highest number of deaths due to asthma. The objective of this research is to investigate the prevalence of asthma and respiratory illness as well as the presence of environmental respiratory irritants in public senior housing. A total of 57 survey participants were recruited from social events for senior citizens sponsored by the Lowell Housing Authority. A paper survey was used to collect data regarding respiratory health and the presence of respiratory irritants in the homes. The study found that a large portion of the study participants has one or more respiratory ailments, and the majority of the participants have respiratory irritants present in their homes. Seniors living in public housing may benefit from residential respiratory health interventions.

]]> John Corbacio et al. Mobile Pantry of Lowell Survey http://escholarship.umassmed.edu/chr_symposium/2012/posters/4 http://escholarship.umassmed.edu/chr_symposium/2012/posters/4 Fri, 30 Nov 2012 08:30:00 PST The Mobile Pantry (MP) program of the Merrimack Valley Food Bank in Lowell, Massachusetts provides supplementary food to ensure that their clients have a sufficient amount of appropriate foods for a nutritious diet. The purpose of this project was to assess the effectiveness of MP services and explore opportunities for providing more healthful foods. The project was a descriptive cross-sectional study surveying MP clients, who are homebound, low-income elderly and/or disabled individuals residing in Greater Lowell. The survey took place between October 10 and November 16, 2011. Participation was anonymous and voluntary. The primary client from each of 77 households out of 309 responded to the questionnaire. Most of the respondents were white, female, and over age 65. Most respondents agreed strongly that with MP’s aid they ate more fruits, vegetables, and healthy foods; ate a balanced diet; were more physically and socially active; and generally felt healthier. Most respondents also stated that they would skip more meals and spend less on other necessities if they did not have help from MP. The program may be essential for the health, nutritional well-being, and food security of the low-income elderly and/or disabled in the Greater Lowell community. The results of this study may be utilized to improve MP services and food variety.

]]> Krista Bobola et al. A Parent Focus Group to Inform Improving Access to Adolescent Reproductive Health Services and the Prevention of Teen Pregnancy: A Community Participation Study http://escholarship.umassmed.edu/chr_symposium/2012/posters/3 http://escholarship.umassmed.edu/chr_symposium/2012/posters/3 Fri, 30 Nov 2012 08:30:00 PST Background: In 2009, Lowell’s teen birth rate was 53 per 1,000 teens age 15-19 more than double the Massachusetts 2009 rate of 19.6. Teen births occur disproportionately to the most vulnerable teens, with racial and ethnic disparities being common.

Methods: A focus group qualitative methodology was used to capture the subjective experiences of parents of pre-teen and teen parents to explore adolescent utilization of reproductive health services and the issue of teen pregnancy. Focus group interviews (FGI) enabled the researchers to gather rich and detailed information. A diverse group of 10 women who met the selection criteria agreed to participate.

Results: Parents thought teen pregnancies occurred for a variety of reasons with peer pressure, lack of sex education and family discussion of sexuality, pressure from mate and cultural influences being the most common. When exploring barriers to accessing sexual health services, lack of transportation, teen invincibility, denial that they could get pregnant, misconceptions and faulty information were identified as contributing to teen pregnancies. Suggested solutions were: enhance parental communication with teens using techniques such as ―car talk‖ and ―backyard sharing‖; include preteen and teen sexual health discussions in pediatric visits; involve other community groups working with youth; normalize the discussion of sexual health and encourage absence.

Conclusions: The focus groups results will guide the building of teen programs that focus on specific characteristics of risk and resilience, the adolescent-parent relationships and youth development to build a community based intervention to prevent teen pregnancy and improve teen sexual health.

]]> Dorothy Brewin et al. Stressing the Hormone: Biological and Psychosocial Factors associated with Chronic Stress http://escholarship.umassmed.edu/chr_symposium/2012/posters/2 http://escholarship.umassmed.edu/chr_symposium/2012/posters/2 Fri, 30 Nov 2012 08:30:00 PST Chronic stress has been associated with a constellation of deleterious psychological and physical health outcomes. We collected cortisol from hair (CORT) to assess chronic stress retrospectively for 3 months’ time (3cms). Over two studies from the UMass Boston campus and the local community, we recruited in t1: 134 adults (ages 18-67; M = 29.49, SD = 12.48) and t2: 145 adults (ages18-30, M = 22.56, SD = 3.54) to participate on two studies assessing objective biological stress (via hair cortisol), subjective perceived stress (via self-reports), psychosocial factors, and health indicators. In follow-up Study 2, we also included indices of perceived discrimination, cardiovascular parameters, and affective vigilance.

Results: t1: CORT levels were positively associated with Total perceived stress and one health indicator: systolic blood pressure. An SES by Race interaction predicted both higher CORT and perceived stress, although higher SES did not always confer the expected benefit of higher SES: minorities in high SES had the greatest CORT, systolic blood pressure, and lowest self-rated health.

Results: t2: Perceived stress measures and new measures of discrimination were negatively associated with well-being and health. Higher racial/ethnic pride was associated with better health, but also increased daily discrimination and waist-to-hip ratio. The SES by Race interaction was again associated with Total perceived stress and minorities in higher SES reported greatest Total stress. Minorities also showed the greatest vigilance. Specifically, African-Americans had the longest latencies for social devaluation words during a modified Stroop, the greatest city stress, and the greatest pride/identity for heritage group.

]]> Kymberlee M. O'Brien et al. Lessons Learned in Conducting School Health Research in Massachusetts: A Massachusetts School Nurse Research Network (MASNRN) Project http://escholarship.umassmed.edu/chr_symposium/2012/posters/1 http://escholarship.umassmed.edu/chr_symposium/2012/posters/1 Fri, 30 Nov 2012 08:30:00 PST The Institute of Medicine (2007) and the Robert Wood Johnson Foundation (RWJF) (2010) recognized that the school environment plays a role in shaping children’s health and health behaviors, and school health services are positioned to model these approaches. The majority of school health services are school nurse (SN) managed (RWJF, 2012; Schainker, 2005), but a research gap exists linking school health services with improved student outcomes (Hootman, 2002; Lear, 2007). In Massachusetts, the student health research question ideally has roots in the expertise of the SN. The researcher conducting a school-based student health study interacts with SNs and administrators in school districts that vary by the type and number of health staff , as well as district location and size. These variables confound the research design in terms of structure and process. IRB issues and permission for research conduction in the school district are particularly vexing. Consent of parents and assent of children are required, and SNs participating in the research must complete human subjects training. Massachusetts School Nurse Research Network (MASNRN) was founded in 2004 by a group of SN experts to conduct school based research. The 100 members of MASNRN have conducted studies across the state and within school districts on asthma, availability of epinephrine for anaphylaxis, bullying, immunizations, training modules and mental health. Particular lessons learned from the unique experience of conducting research in schools are presented.

]]> Mary Jane O’Brien et al. Using Concept Mapping to Quickly Move a Group from Ideas to Action to Results http://escholarship.umassmed.edu/chr_symposium/2011/posters/9 http://escholarship.umassmed.edu/chr_symposium/2011/posters/9 Fri, 04 Nov 2011 08:30:00 PDT Concept Mapping Defined

The ability to collect ideas and opinions on a topic from any number of independent stakeholders and quickly integrate the ideas into a series of easy-to-read graphics.

Why Concept Mapping?

  • Blends the best of qualitative and quantitative methods
  • Seeks and organizes variation in stakeholder knowledge, opinion
  • Gives flexible design and participation options
  • Creates a framework that is multi-purpose, taking you from planning to implementation through evaluation

Concept Mapping Process

  • Planning for concept mapping
  • Generate ideas
  • Structure the ideas
  • Analyze the "maps"
  • Interpret the "maps"
  • Put the "maps" into action

This poster shows how concept mapping was used in the planning "The Local Public Health Collaborative Skin Cancer Prevention Project", a program to reduce skin cancer rates in the North Shore / Cape Ann area, and to strengthen the capacity of local public health to be able to work more collaboratively.

]]> James Ryan Eat Walk Sleep Discuss: Building a Multi-Dimensional Participatory Relationship http://escholarship.umassmed.edu/chr_symposium/2011/posters/8 http://escholarship.umassmed.edu/chr_symposium/2011/posters/8 Fri, 04 Nov 2011 08:30:00 PDT A multi-faceted relationship has developed between UMass Worcester and the Worcester Refugee Assistance Project (WRAP). The relationship has its roots in student engagement, and has grown to include faculty, students and community members in a range of community-based participatory activities, which can be shaped in response to needs as they are identified and defined. This poster describes the different ways student engagement and community partnerships worked together in a research project.

]]> Heather-Lyn Haley et al. Mapping Patient Distributions Informs Community-Oriented Primary Care in Four Community Health Centers in Central Massachusetts http://escholarship.umassmed.edu/chr_symposium/2011/posters/7 http://escholarship.umassmed.edu/chr_symposium/2011/posters/7 Fri, 04 Nov 2011 08:30:00 PDT Background

Based on the philosophy that family medicine training should occur in community-based practices and hospitals, the Worcester Family Medicine Residency (WFMR) training program was structured to combine learning opportunities in an academic medical center with outpatient care training in three unique community-based practices: the Barre Family Health Center, a rural site thirty miles west of Worcester, the Family Health Center of Worcester, a federally funded community health center serving a poor and culturally diverse urban population, and the Hahnemann Family Health Center, a hospital-owned health center serving a socioeconomically diverse population in the northeast part of Worcester.

The WFMR received an AAMC “Regional Medicine-Public Health Education Centers-Graduate Medical Education (RMPHEC-GME)” grant to further integrate public health training into the clinical training experience. As part of the effort, collaboration was begun between the department of Family Medicine and Community Health at UMASS Medical School, the academic home of the WFMR, and geographers at Clark University, a local resource providing expertise in mapping of data using Geographic Information Systems (GIS).

Mapping Patient Distribution

A series of thematic maps were generated from actual practice data on the patients being served by each residency site and also by Fitchburg Community Health Center. Faculty champions from each site attended two training sessions to learn more about the capabilities of mapping. They were then asked to lead faculty at their site in discussion to define five maps they would like to see made from their own patient data. Most sites chose a map showing the distribution of the entire patient population, some requested a map of their pediatric patients, and then the rest were designed to depict the spread of certain chronic diseases, including asthma, hypertension, coronary disease, and diabetes. Maps were generated using geocoding and point density tools in ArcGIS Desktop software. The main goal of this mapping activity was to educate physicians in training about where their patients live and facilitate discussion about environmental factors that impact health. These maps can also be used by practitioners to communicate important information to their patients about available community resources such as gyms, parks, health clinics, and supermarkets (as shown on some maps).

Making Maps Available Online

One element of the grant initiative was to build an online resource to aid faculty in teaching about population health concepts. This portal, the Community Health Toolkit (http://www.umassmed.edu/fmch/toolkit.aspx), provides three types of information to aid clinicians in both their teaching and their practice. The “Data on Communities” section was developed as part of the UMMS/Clark University collaboration. In total, 24 thematic maps were generated by the GIS team at Clark University and uploaded to the “Data on Communities” web section of the Community Health Toolkit. Other sections of the Community Health Toolkit include “Learning about Populations” which provides links to a variety of local, regional and national health indicators, and a “Community Resources” section which provides links to community resources for patients. The Toolkit is presented to learners along the continuum of medical education, including second year students in the Population Health Clerkship, first year residents in the Family Medicine and Community Health rotation, then used as a resource by residents as they complete presentations and research projects.

]]> Yelena Ogneva-Himmelberger et al. Understanding Sleep Patterns in the Brazilian Community in Lowell, MA: Perspectives from Community Health Workers and Healthcare Consumers http://escholarship.umassmed.edu/chr_symposium/2011/posters/6 http://escholarship.umassmed.edu/chr_symposium/2011/posters/6 Fri, 04 Nov 2011 08:30:00 PDT Introduction

The purpose of this study was to collect pilot data on the sleep and medical/psychiatric health of immigrants from the Brazilian community in Lowell, Massachusetts. Studies on Brazilian immigrants are rare in the United States.

The first objective was to seek information related to sleep, sleep dysregulation and medical/psychiatric health from consumers of healthcare services within the Brazilian immigrant community in Lowell. The second objective was to solicit information from Brazilian community lay health workers (Promotoras) regarding their impressions of factors related to sleep dysregulation with members of the Brazilian immigrant community in Lowell. Both groups participated in focus groups. In addition, the immigrant healthcare consumers completed a Health Questionnaire, the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale.

The study was supported by a seed grant from the University of Massachusetts Lowell School of Health & Environment with additional funding from the Office of the Provost.

Methods

We conducted three focus groups with Brazilian healthcare consumers with the participation of 25 Brazilian immigrants, and one with 8 Brazilian lay health workers or Promotoras. Promotoras are specially trained members of the Brazilian community who serve as liaisons between their community and health, human, and social service organizations in Lowell, such as the Lowell Community Health Center and the Massachusetts Alliance of Portuguese Speakers (MAPS). They work formally and informally with individuals, families, and local organizations to bring health-related information to their communities.

Twenty two of the focus groups participants were females, while 10 were males. The focus groups lasted 1.5 hours and were conducted in the Lowell office of MAPS in the spring and summer of 2010. The topics addressed in the focus groups included: quality and duration of sleep; problems associated with sleep; sleepiness during the day; safety concerns related to sleepiness; relationship between work schedule and sleep; use of medications to assist sleep; amount of daily use of stimulants to combat sleepiness; knowledge and perceptions of the relationship between sleep and diseases such as diabetes and psychiatric disorders; and suggestions for informing the community about sleep-related issues.

All focus group sessions were conducted in Portuguese by bilingual facilitators and audio recorded. The recordings were transcribed in Portuguese and translated into English by the same bilingual transcriber. Transcripts were analyzed for themes related to sleep dysregulation amongst Brazilian immigrants in Lowell.

Conclusions

Most participants in the focus groups agreed that sleep deprivation is a common problem in the Brazilian community. According to several participants, many Brazilians sleep 4 or 5 hours a day, noting long work hours, irregular work schedules, high levels of stress and financial pressures. Common daily work schedules are in excess of 17 hours a day.

While it seems that the regular use of drugs to induce sleep does not seem to be common, high consumption of caffeinated beverages, such as Red Bull and coffee are common to combat excessive daytime sleepiness. Drowsy driving or falling asleep at the wheel were commonly reported. Impaired work performance due to sleep deprivation was widespread. Many participants reported that they or their spouses had poor sleep quality. They viewed sleep apnea, obesity, irritability, and excessive snoring to be associated with poor sleep quality. A few participants also reported depression, anxiety, and other psychiatric disorders as the reasons for their insomnia. Combined, these factors point to significant sleep-related morbidity.

The experience of participants with health care providers suggests that most providers, especially physicians, do not ask Brazilian patients about sleep-related issues during regular visits, unless the patients themselves voice complaints such as insomnia.

]]> Geoffry Phillips McEnany et al. Brigham and Women’s Hospital HIV Vaccine Trials Unit: Using Research to Engage Communities in HIV Prevention http://escholarship.umassmed.edu/chr_symposium/2011/posters/5 http://escholarship.umassmed.edu/chr_symposium/2011/posters/5 Fri, 04 Nov 2011 08:30:00 PDT Background:

A unit of physicians, nurses and research staff perform clinical trials research in order to find a safe and effective HIV vaccine. The goals of the HIV Vaccine Trials Unit are:

  • Increase the visibility of HIV vaccine research studies withing the Boston community as an (1) educational resource, (2) community advocate, and (3) clinical research site.
  • Promote academic and humanitarian mission through (1) leading and contributing to discussions about HIV, and (2) making connections within the scientific, student and activist communities.

Methodology:

Held transgender women focus group to explore barriers and facilitators to participation in clinical trials and research. Used feedback from the groups to establish "My 'T' Matters" campaign, a series of ads to recruit participants specifically from the transgender community.

Results:

Series of activities targeted towards engaging the community, including:

  • Plan and attend events that focus on raising awareness about HIV/AIDS in general community and events that target specific community
  • Where there are gaps in programming, create HIV vaccine awareness / recruitment campaigns
  • Collaborate with group leaders
  • Support organizations that address HIV related issues
  • Online canvassing through use of social media

]]> Teress Votto et al.