Community Engagement and Research Symposia

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

Introduction

The University of Massachusetts Medical School (UMMS) Center for Mental Health Services Research (CMHSR) conducts research to enhance services, improve the quality of life, and promote recovery for people with behavioral health conditions. The Center was founded in 1993 as a Massachusetts Department of Mental Health Research Center of Excellence.

Center faculty receive funding from a variety of federal, state and foundation sources. The Center’s focus on community-based research and engagement with providers, consumers and families also carries the message of hope for the many adults, children, adolescents and families living with mental illness.

The Mental Health Agency Research Network (MHARN) expands on the dissemination and research functions of CMHSR to reach providers serving DMH clients across the Commonwealth of Massachusetts. The goals of the MHARN include Dissemination, Engagement and Collaboration as a way to facilitate the translation of research findings into practice and bring together providers with researchers to engage in new research on services provided in the community.

Four Research Subject Areas:

• Child, Youth & Family Mental Health
• Law, Ethics & Mental Health
• Multicultural Research
• Rehabilitation, Recovery & Wellness

The Dissemination Series

Products for a diverse audience including clinicians/providers, mental health service users and their families, and researchers.

Psychiatry Issue Briefs

• Issue briefs focus on translating research findings into concise, user-friendly information that is accessible to all

Research You Can Use

• A one-page summary of research findings and recommendations specifically developed for busy providers

Research in the Works

• Summarizes current and ongoing research projects

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.

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.

Abstract:

The mission of the Department of Nutrition, UMass Amherst, is to provide excellence and innovation in teaching, research, and outreach by applying a scientific foundation that addresses the nutritional needs of individuals and diverse populations. We conduct laboratory and applied community-based research that spans a wide range of issues. Housed within the Department of Nutrition, the UMass Extension Nutrition Education Program (NEP) collaborates with more than 100 agencies and provides nutrition education in over 46 communities in Massachusetts. This poster presents 1) the range of work undertaken by faculty, students, and NEP; and 2) highlight faculty research areas as well as emerging priorities for clinical and community-based nutrition research. We are interested in establishing collaborations for improved nutrition and health outcomes with researchers and community organizations across the Commonwealth.

Introduction:

Nutrition research is important to establish dietary requirements, investigate the metabolic basis for therapies, and translate research to dietary behaviors and policies to improve health and prevent disease. The UMass Department of Nutrition research ranges from cellular and metabolic investigations to community-based and policy approaches. With over $2.5 million in annual grant expenditures, the Department ranks among the top of the university departments in expenditures per faculty.

Nutrition faculty utilize laboratory facilities on the UMass campus, along with collaborative community research in Springfield, Holyoke, Lowell, and other communities in Massachusetts, nationally and internationally. In addition, the UMass Extension Nutrition Education Program provides nutrition education to thousands of limited income families annually through eight community-based sites throughout the state.

Background

Untreated perinatal depression is common and has deleterious effects on mother, fetus/child and family

• Despite effective evidence-based treatment for perinatal depression, most women do not get treatment

• Obstetricians have not traditionally identified and/or responded to the mental health needs of perinatal women

• Caring and committed providers are frustrated and confused5 and mothers do not feel seen, heard or understood by their providers

• Implementing supports for perinatal women within the traditional medical model poses many challenges to mental health and obstetric providers

MotherWoman is a community-based grassroots organization dedicated to preventing and treating perinatal depression through an innovative organizational change approach, the Community-Based Perinatal Support Model (CPSM). This model includes:

1. Peer-led support groups for perinatal women
2. Organizational change interventions that include structured screening and referral, health care provider trainings and networks, and resource and referral guides

Methods

Participants

Four focus groups with MotherWoman clients, 3 months – 3 years postpartum who self-identified as having experienced perinatal depression or emotional crisis

Data collection

• Focus group probes targeted perceptions of the best practices to engage perinatal women in depression treatment and potential strategies for change
• Investigators met after each group to record observations and review verbatim notes
• Participants received gift cards for their participation

Data analysis

• Transcripts were reviewed, segmented, and coded by investigators using an iterative, constant-comparative process to identify emerging themes and recurrent patterns
• Inter-rater reliability of more than 90% was achieved by two investigators comparing randomly selected coded pages from focus group notes

Discussion

• Despite barriers, numerous facilitators to treatment were identified

• Supporting women’s mental health during the perinatal time period should ideally be done in both the medical setting and community

• Supporting the mental health of perinatal women is a fundamental challenge with multiple opportunities for intervention and education

• Strategies to address perinatal depression include:

1. Offer training to OB/Gyn and mental health providers in the detection and screening of perinatal depression
2. Prepare women for the postpartum period through psychoeducation and peer-support
3. Create flexible treatment options that go beyond medication management and emphasize transition to motherhood

Results will

• Contribute to understanding the barriers and facilitators perinatal women experience when trying to access depression treatment

• Provide preliminary guidelines for the development of strategies to engage perinatal women in depression treatment

• Inform the development of interventions that aim to integrate the treatment of perinatal depression into medical settings

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.

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.