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Rabin BA, Cain KL, Ayers LO, Lomeli A, Escoto A, Burola ML, Aguilar M, Calvillo ST, Reyes B, Salgin L, Tukey R, Laurent LC, Stadnick NA. Adaptation of the brainwriting premortem technique to inform the co-creation of COVID-19 testing strategies in underserved communities in South San Diego. BMC Health Serv Res 2024; 24:12. [PMID: 38172787 PMCID: PMC10765849 DOI: 10.1186/s12913-023-10341-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 11/17/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION Meaningful engagement of partners in co-creating and refining health-related programs can increase the initial uptake, sustained implementation, broad reach, and effectiveness of these programs. This is especially important for underserved communities where resources are limited and need to be prioritized. Brainwriting premortem is a novel qualitative approach to partner engagement that combines the strengths of individual idea generation with the concept of premortem exercise that addresses failure points prior to the implementation of new programs. METHODS An adapted form of brainwriting premortem was used to inform iterative refinements to a COVID-19 testing program at a Federally Qualified Health Center (FQHC) in San Diego. Patients and providers from the FQHC participated in interviews at two time points (early- and mid-implementation of the program). Interview data were transcribed, translated, and analyzed using a rapid qualitative approach. Key themes and sub-themes were identified and used to inform refinements to the program. RESULTS A total of 11 patients (7 Spanish- and 4 English-speaking) and 8 providers participated in the brainwriting premortem interviews. Key themes related to possible reasons for COVID-19 testing program failure: advertising/sharing information; access to testing; handling of test results; staff and patient safety; patient beliefs and views regarding the SARS-CoV-2 virus; and COVID-19 testing options offered. Proposed solutions were offered for the key failures except for patient beliefs and views regarding the SARS-CoV-2 virus. Additional solutions offered were related to education, physical operations, and recruitment strategies. Real-time changes to the program flow and components were made in response to 7 suggestions from patients and 11 from providers. Changes related to the process of returning results were the most common, and included sending results via email with distinct workflows based on the test result. CONCLUSION The implementation of the adapted brainwriting premortem technique allowed us to incorporate the perspective of key partners in the delivery and iterative refinement of the COVID-19 testing program. This was an effective tool in the context of an FQHC and can be a promising and approach to incorporate iterative input from patients and providers to ensure successful program implementation. Future studies, particularly those requiring rapid response to public health emergencies, should consider the use of this technique.
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Affiliation(s)
- Borsika A Rabin
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA.
- UC San Diego Altman Clinical and Translational Research Institute Dissemination and Implementation Science Center, University of California San Diego, La Jolla, CA, USA.
| | - Kelli L Cain
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Lawrence O Ayers
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA
| | - Angel Lomeli
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA
| | - Arleth Escoto
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA
| | - Maria Linda Burola
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA
| | - Melanie Aguilar
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA
| | - Stephenie Tinoco Calvillo
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA
| | - Breanna Reyes
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA
| | | | - Robert Tukey
- Superfund Research Center, University of California San Diego, La Jolla, CA, USA
- Department of Pharmacology, University of California San Diego, La Jolla, CA, USA
| | - Louise C Laurent
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA
| | - Nicole A Stadnick
- UC San Diego Altman Clinical and Translational Research Institute Dissemination and Implementation Science Center, University of California San Diego, La Jolla, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Child and Adolescent Services Research Center, San Diego, CA, USA
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Persad-Clem R, Ventura LM, Lyons T, Keinath C, Graves KD, Schneider ML, Shelton RC, Rosas LG. Community Engagement in Behavioral Medicine: A Scoping Review. Int J Behav Med 2023:10.1007/s12529-023-10242-6. [PMID: 38057655 DOI: 10.1007/s12529-023-10242-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Behavioral medicine has made key contributions toward improving health outcomes. Engaging community partners in research is critical to addressing persistent health inequities. The aim of this scoping review was to explore how researchers engaged community partners within the field of behavioral medicine research from 2005 to 2023. METHOD Publication databases and gray literature were searched for research that engaged community partners to address questions relevant to behavioral medicine. Articles were screened by title and abstract, and then by full text. Articles meeting the inclusion criteria were coded using the framework provided by the Engagement Navigator to identify engagement approaches, methods, and tools and when they were used during the research. RESULTS Of 1486 articles initially identified, 58 met the inclusion criteria. Most articles used well-known approaches (e.g., community-based participatory research; 67%), methods (e.g., advisory committees; 59%), and tools (e.g., interviews; 41%), and engaged with healthcare service providers (62%) and/or patients (53%). Community partners were most often included in research planning and design (79%), and less often in dissemination (45%). CONCLUSION Community engagement has considerable potential to address health inequities. Our assessment of the approaches, methods, and tools used by behavioral medicine researchers to engage with a diverse range of community partners points toward promising strategies for enhancing the impact of community engagement. Researchers should incorporate explicit descriptions of community engagement strategies in publications, an outcome that could be facilitated by clear publishing guidelines, structured reporting tools, and clear messaging from funders about the value of community engagement in behavioral medicine research.
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Affiliation(s)
- Reema Persad-Clem
- School of Graduate Education, Geisinger College of Health Sciences, Scranton, PA, 18509, USA
| | - Liane M Ventura
- Center for Applied Research and Evaluation in Women's Health, Department of Health Services Management and Policy, East Tennessee State University, Johnson City, TN, 37614-1700, USA
| | - Tierney Lyons
- School of Medicine Library, Geisinger Commonwealth School of Medicine, Scranton, PA, 18509, USA
| | - Christiana Keinath
- Charles C. Sherrod Library, East Tennessee State University, Johnson City, TN, 37614-1700, USA
| | - Kristi D Graves
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, 20007, USA
| | - Margaret L Schneider
- Department of Population Health and Disease Prevention, Program in Public Health, University of California, Irvine, Irvine, CA, 92697, USA
| | - Rachel C Shelton
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Lisa G Rosas
- Department of Epidemiology and Population Health, Department of Medicine, Office of Community Engagement, Stanford School of Medicine, Palo Alto, CA, 94304-1210, USA.
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Parker LL, Bonner CM, Sobol RW, Arrieta MI. Co-creation and engagement in a DNA integrity cohort study. J Clin Transl Sci 2023; 7:e122. [PMID: 37313377 PMCID: PMC10260344 DOI: 10.1017/cts.2023.556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/03/2023] [Accepted: 05/10/2023] [Indexed: 06/15/2023] Open
Abstract
Introduction The partnership between a research community engagement team (CE Team) and a community advisory board (CAB) formed the basis for bidirectional communication in developing resources for participant recruitment in a DNA integrity study. Engaging with a minoritized community, this partnership focused on respect, accessibility, and expanded engagement. Methods A ten-member CAB, working in two groups defined by meeting time convenience, provided insight and feedback to the CE Team in the creation of recruitment and consent materials, via an iterative design process in which one CAB group reviewed and enhanced materials, and the second group tested and refined them further. The continuous analysis of CE Team notes from CAB meetings captured information needed both for materials refinement and implementation of CAB-suggested activities. Results The partnership resulted in the co-creation of recruitment and consent materials that facilitated the enrollment of 191 individuals into the study. The CAB encouraged and assisted in expanded engagement inclusive of community leaders. This broader engagement provided information about the DNA integrity study to community decision-makers as well as responded to questions and concerns about the research. The bidirectional communication between the CAB and the CE Team encouraged the researchers to consider topics and research interests related to the current study but also responsive to community concerns. Conclusions The CAB helped the CE Team develop a better understanding of the language of partnership and respect. In this way, the partnership opened doors for expanded community engagement and effective communication with potential study participants.
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Affiliation(s)
- L. Lynette Parker
- Center for Healthy Communities, Frederick P. Whiddon College of Medicine, University of South Alabama, Mobile, AL, USA
| | - Chantel M. Bonner
- Center for Healthy Communities, Frederick P. Whiddon College of Medicine, University of South Alabama, Mobile, AL, USA
| | - Robert W. Sobol
- Mitchell Cancer Institute, University of South Alabama, Mobile, AL, USA
- Department of Pharmacology, College of Medicine, University of South Alabama, Mobile, AL, USA
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School & Legorreta Cancer Center, Brown University, Providence, RI, USA
| | - Martha I. Arrieta
- Center for Healthy Communities, Frederick P. Whiddon College of Medicine, University of South Alabama, Mobile, AL, USA
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Rabin BA, Cain KL, Salgin L, Watson PL, Oswald W, Kaiser BN, Ayers L, Yi C, Alegre A, Ni J, Reyes A, Yu KE, Broyles SL, Tukey R, Laurent LC, Stadnick NA. Using ethnographic approaches to document, evaluate, and facilitate virtual community-engaged implementation research. BMC Public Health 2023; 23:409. [PMID: 36855118 PMCID: PMC9974043 DOI: 10.1186/s12889-023-15299-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 02/20/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Community Advisory Boards (CABs) have been frequently used to engage diverse partners to inform research projects. Yet, evaluating the quality of engagement has not been routine. We describe a multi-method ethnographic approach documenting and assessing partner engagement in two "virtual" CABs, for which we conducted all meetings remotely. METHODS Two research projects for increasing equitable COVID-19 testing, vaccination, and clinical trial participation for underserved communities involved remote CAB meetings. Thirty-three partners representing 17 community groups participated in 15 sessions across the two CABs facilitated by a social change organization. We developed ethnographic documentation forms to assess multiple aspects of CAB member engagement (e.g., time spent speaking, modality used, types of interactions). Documenters were trained to observe CAB sub-groups via virtual sessions. Debriefing with the documentation team after CAB meetings supported quality assurance and process refinement. CAB members completed a brief validated survey after each meeting to assess the quality and frequency of engagement. Content and rapid thematic analysis were used to analyze documentation data. Quantitative data were summarized as frequencies and means. Qualitative and quantitative findings were triangulated. RESULTS A total of 4,540 interactions were identified across 15 meetings. The most frequent interaction was providing information (44%), followed by responding (37-38%). The quality and frequency of stakeholder engagement were rated favorably (average 4.7 of 5). Most CAB members (96%) reported good/excellent engagement. Specific comments included appreciation for the diversity of perspectives represented by the CAB members and suggestions for improved live interpretation. Debriefing sessions led to several methodological refinements for the documentation process and forms. CONCLUSION We highlight key strategies for documenting and assessing community engagement. Our methods allowed for rich ethnographic data collection that refined our work with community partners. We recommend ongoing trainings, including debriefing sessions and routinely reviewed assessment of data to strengthen meaningful community engagement.
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Affiliation(s)
- Borsika A Rabin
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, San Diego, CA, United States of America.
- UC San Diego Altman Clinical and Translational Research Institute Dissemination and Implementation Science Center, University of California San Diego, La Jolla, San Diego, CA, United States of America.
| | - Kelli L Cain
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, San Diego, CA, United States of America
| | - Linda Salgin
- San Ysidro Health, San Diego, CA, United States of America
- Joint Doctoral Program in Public Health, San Diego State University, University of California San Diego, San Diego, United States of America
| | - Paul L Watson
- The Global Action Research Center, San Diego, CA, United States of America
| | - William Oswald
- The Global Action Research Center, San Diego, CA, United States of America
| | - Bonnie N Kaiser
- UC San Diego Altman Clinical and Translational Research Institute Dissemination and Implementation Science Center, University of California San Diego, La Jolla, San Diego, CA, United States of America
- Department of Anthropology and Global Health Program, University of California San Diego, La Jolla, San Diego, CA, United States of America
| | - Lawrence Ayers
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, San Diego, CA, United States of America
| | - Crystal Yi
- Department of Urban Studies and Planning, University of California San Diego, La Jolla, San Diego, CA, United States of America
| | - Alexander Alegre
- Department of Urban Studies and Planning, University of California San Diego, La Jolla, San Diego, CA, United States of America
| | - Jessica Ni
- UC San Diego Altman Clinical and Translational Research Institute Dissemination and Implementation Science Center, University of California San Diego, La Jolla, San Diego, CA, United States of America
| | - Allyn Reyes
- Department of Urban Studies and Planning, University of California San Diego, La Jolla, San Diego, CA, United States of America
| | - Kasey E Yu
- UC San Diego Altman Clinical and Translational Research Institute Dissemination and Implementation Science Center, University of California San Diego, La Jolla, San Diego, CA, United States of America
| | - Shelia L Broyles
- Department of Pediatrics, University of California San Diego, La Jolla, San Diego, CA, United States of America
- UC San Diego Altman Clinical and Translational Research Institute Community Research Partnerships, University of California San Diego, La Jolla, San Diego, CA, United States of America
| | - Robert Tukey
- Laboratory of Environmental Toxicology, Department of Pharmacology, University of California San Diego, La Jolla, San Diego, CA, United States of America
| | - Louise C Laurent
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, San Diego, CA, United States of America
| | - Nicole A Stadnick
- UC San Diego Altman Clinical and Translational Research Institute Dissemination and Implementation Science Center, University of California San Diego, La Jolla, San Diego, CA, United States of America
- Department of Psychiatry, University of California San Diego, La Jolla, San Diego, CA, United States of America
- Child and Adolescent Services Research Center, San Diego, CA, United States of America
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