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Kunze M, Wei Q, Bacon-Yates A, Pompan E, Lockwood H, Witthuhn N. Promoting Reciprocal Relationships with Flexibility, Coaching, and Teaching (PRRFCT Match): A Virtual Parent-Mediated Intervention Package for Young Children with Developmental Disabilities. J Autism Dev Disord 2024:10.1007/s10803-024-06386-3. [PMID: 38744741 DOI: 10.1007/s10803-024-06386-3] [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: 04/28/2024] [Indexed: 05/16/2024]
Abstract
This study aimed to evaluate Promoting Reciprocal Relationships with Flexibility, Coaching, and Teaching (PRRFCT Match), a parent-mediated naturalistic developmental behavioral intervention package. An expansion from an earlier pilot study (see Kunze et al., 2021), PRRFCT Match incorporates virtual coaching between a novice coach and parent to implement evidence-based, applied behavior analytic (ABA) techniques during play to increase engagement and decrease unengaged behavior exhibited by their young child with developmental delays (26-50 months old). Ten parent-child dyads were matched with a coach in this concurrent multiple baseline design across participants. Simulating the clinical training level of a novice early interventionist, nine graduate student clinicians received training as coaches on PRRFCT Match implementation and weekly supervision by a research team member. All aspects of training and intervention were delivered virtually. A visual analysis of the data combined with Tau-U revealed a strong basic effect between clinician coaching and parent strategy use. For child participants, a visual analysis and Tau-U results suggest that most increased engagement and decreased their unengaged behavior during the intervention. High variability, overlap, and high engagement at baseline are discussed. This study shows promise for the PRRFCT Match intervention package. The ABA technologies mediated by parents during play increased child engagement and decreased unengagement for most participants.
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Affiliation(s)
- Megan Kunze
- Center on Brain Injury Research & Training, Department of Psychology, University of Oregon, Eugene, OR, USA.
| | - Qi Wei
- Department of Special Education, University of Wisconsin-Whitewater, Whitewater, WI, USA
| | - Alexis Bacon-Yates
- Department of Special Education, University of Texas at Austin, Austin, TX, USA
| | - Emily Pompan
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene, OR, USA
| | - Hannah Lockwood
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene, OR, USA
| | - Nicole Witthuhn
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene, OR, USA
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2
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Epperson MW, Guz S, Sarantakos SP. Fostering Community-Engaged Research on Criminal Legal Innovations with Logic Models. SOCIAL WORK 2023; 68:307-319. [PMID: 37500600 DOI: 10.1093/sw/swad032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/24/2022] [Accepted: 11/18/2022] [Indexed: 07/29/2023]
Abstract
There is a persistent disconnect between research and practice, both in the social work profession as well as in the criminal legal system. Community-engaged research has been suggested as an approach to bridge this divide, but specific tools are needed to integrate research and practice efforts. This article presents three distinct logic model development processes that occurred in collaborative research and practice efforts in the context of criminal legal programming, including prosecutor-led diversion programs, a high-intensity drug court, and a multiagency justice and mental health collaborative. Logic model development incorporated multiple forms of program information using collaborative reflexivity, an approach focused on understanding the relationship between knowledge and power in the research process. For each program, the authors describe the context and process of logic model development, and how the logic models were used by both practitioners and researchers. The authors discuss how collaborative logic model development can facilitate community-engaged research, strengthen the research-practice connection, and advance applied social work scholarship.
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Affiliation(s)
- Matthew W Epperson
- PhD, MSW, is associate professor, Crown Family School of Social Work, Policy, and Practice, University of Chicago, 969 E 60th Street, Chicago, IL 60637, USA
| | - Samantha Guz
- LCSW, is a doctoral candidate, Crown Family School of Social Work, Policy, and Practice, University of Chicago, Chicago, IL, USA
| | - Sophia P Sarantakos
- PhD, LCSW, is assistant professor, Graduate School of Social Work, University of Denver, Denver, CO, USA
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3
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Penner F, Wall KM, Guan KW, Huang HJ, Richardson L, Dunbar AS, Groh AM, Rutherford HJV. Racial disparities in EEG research and their implications for our understanding of the maternal brain. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2023; 23:1-16. [PMID: 36414837 PMCID: PMC9684773 DOI: 10.3758/s13415-022-01040-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/26/2022] [Indexed: 11/24/2022]
Abstract
Racial disparities in maternal health are alarming and persistent. Use of electroencephalography (EEG) and event-related potentials (ERPs) to understand the maternal brain can improve our knowledge of maternal health by providing insight into mechanisms underlying maternal well-being, including implications for child development. However, systematic racial bias exists in EEG methodology-particularly for Black individuals-and in psychological and health research broadly. This paper discusses these biases in the context of EEG/ERP research on the maternal brain. First, we assess the racial/ethnic diversity of existing ERP studies of maternal neural responding to infant/child emotional expressions, using papers from a recent meta-analysis, finding that the majority of mothers represented in this research are of White/European ancestry and that the racially and ethnically diverse samples that are present are limited in terms of geography. Therefore, our current knowledge base in this area may be biased and not generalizable across racially diverse mothers. We outline factors underlying this problem, beginning with the racial bias in EEG equipment that systematically excludes individuals of African descent, and also considering factors specific to research with mothers. Finally, we highlight recent innovations to EEG hardware to better accommodate diverse hairstyles and textures, and other important steps to increase racial and ethnic representativeness in EEG/ERP research with mothers. We urge EEG/ERP researchers who study the maternal brain-including our own research group-to take action to increase racial diversity so that this research area can confidently inform understanding of maternal health and contribute to minimizing maternal health disparities.
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Affiliation(s)
| | - Kathryn M Wall
- Yale Child Study Center, Yale University, New Haven, CT, USA
| | - Kathleen W Guan
- Yale Child Study Center, Yale University, New Haven, CT, USA
| | - Helen J Huang
- Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL, USA
| | - Lietsel Richardson
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL, USA
| | - Angel S Dunbar
- Department of African American Studies, University of Maryland, College Park, MD, USA
| | - Ashley M Groh
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
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4
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Poku OB, Eschliman EL, Wang RY, Rampa S, Mehta H, Entaile P, Li T, Jackson VW, Ho-Foster A, Blank MB, Yang LH. Toward Meaningful Cultural Adaptation Across Implementation Stages: Lessons Learned From a Culturally Based HIV Stigma Intervention in Gaborone, Botswana. GLOBAL HEALTH, SCIENCE AND PRACTICE 2022; 10:e2200232. [PMID: 36951288 PMCID: PMC9771462 DOI: 10.9745/ghsp-d-22-00232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 11/02/2022] [Indexed: 11/23/2022]
Abstract
A culturally based stigma intervention for pregnant women living with HIV in Gaborone, Botswana highlights the importance of conceptualizing and formalizing cultural adaptation across all stages of implementation.
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Affiliation(s)
- Ohemaa B Poku
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality, and Health, Columbia University and New York State Psychiatric Institute, New York, NY, USA.
| | - Evan L Eschliman
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rayna Y Wang
- New York Coalition for Asian American Mental Health, New York, NY, USA
| | - Shathani Rampa
- Department of Psychology, Queens College, City University of New York, Queens, NY, USA
| | - Haitisha Mehta
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA
| | | | - Tingyu Li
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA
| | - Valerie W Jackson
- Department of Anesthesiology, University of California San Francisco, San Francisco, CA, USA
| | - Ari Ho-Foster
- Research and Graduate Studies, Faculty of Medicine, University of Botswana, Gaborone, Botswana; Division of Infectious Disease, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael B Blank
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Lawrence H Yang
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Utilizing Community Partnerships to Devise a Framework for Cultural Adaptations to Evidence-Based Mental Health Practice in Diverse Communities. COGNITIVE AND BEHAVIORAL PRACTICE 2022. [DOI: 10.1016/j.cbpra.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Janevic MR, Mathur VA, Booker SQ, Morais C, Meints SM, Yeager KA, Meghani SH. Making Pain Research More Inclusive: Why and How. THE JOURNAL OF PAIN 2022; 23:707-728. [PMID: 34678471 PMCID: PMC9018873 DOI: 10.1016/j.jpain.2021.10.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/28/2021] [Accepted: 10/05/2021] [Indexed: 02/09/2023]
Abstract
Current knowledge about mechanisms and interventions for pain has largely been derived from samples that are healthier, wealthier, younger, and more likely to be White than the general population. Failure to conduct inclusive pain research not only restricts generalizability and application of findings, but also hampers the discovery of mechanisms and the development of measures and interventions that are valid across population subgroups. Most of all, inclusive practices are critical to ensure that underrepresented groups derive equitable benefit from pain research. Here, we provide guidance for the pain research community on how to adopt inclusive research practices. We define "inclusion" to encompass a range of identities and characteristics, including racialized group/ethnicity, disability status, gender identity, sexual orientation, and age. We first describe principles relevant to promoting inclusion in pain research, including attention to: 1) stakeholder engagement; 2) structural factors underlying inequities; 3) the limitations of "disparity" research; 4) intersectionality; and 5) universal design. Next, we provide checklists with practical strategies for making studies more inclusive at each stage of the research process. We conclude by calling for system-level changes to ensure that the future of pain research is socially just, scientifically productive, and responsive to the needs of all people. PERSPECTIVE: This paper offers guidance on promoting inclusion of underrepresented groups in pain research. We describe principles relevant to conducting more inclusive research; eg, attention to stakeholder engagement, structural factors, and universal design. We provide checklists with practical strategies for inclusion at each stage of the research process.
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Affiliation(s)
| | - Vani A. Mathur
- Department of Psychological & Brain Sciences, Texas A&M University
| | - Staja Q. Booker
- College of Nursing, Department of Biobehavioral Nursing Science University of Florida
| | - Calia Morais
- Department of Community Dentistry and Behavioral Science, University of Florida
| | - Samantha M. Meints
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School
| | | | - Salimah H. Meghani
- Department of Biobehavioral Health Sciences; New Courtland Center for Transitions and Health; Leonard Davis Institute of Health Economics, University of Pennsylvania
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Oyesanya TO, Loflin C, You H, Kandel M, Johnson K, Strauman T, Yang Q, Hawes J, Byom L, Gonzalez-Guarda R, Van Houtven C, Agarwal S, Bettger JP. Design, methods, and baseline characteristics of the Brain Injury Education, Training, and Therapy to Enhance Recovery (BETTER) feasibility study: a transitional care intervention for younger adult patients with traumatic brain injury and caregivers. Curr Med Res Opin 2022; 38:697-710. [PMID: 35174756 PMCID: PMC9131748 DOI: 10.1080/03007995.2022.2043657] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/28/2022] [Accepted: 02/14/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES We developed a patient- and family-centered traumatic brain injury (TBI) transitional care intervention, called BETTER (Brain Injury Education, Training, and Therapy to Enhance Recovery), to improve quality of life (via SF-36) of younger TBI patients of different racial groups discharged home from acute hospital care and caregivers. We describe our design, methods, and baseline characteristics for our feasibility study. METHODS We co-developed BETTER with input from key stakeholders (TBI patients and caregivers, healthcare providers, and interdisciplinary research team members). BETTER is guided by the Individual and Family Self-Management Theory, our team's prior research, as well as literature used to support, educate, and train patients and families recovering from TBI and other conditions. The intervention is delivered by trained clinical interventionists (transitional care managers), beginning 24-72 h pre-discharge to 16 weeks post-discharge. BETTER offers tailored transitional care support to patient/family dyads, including assessing needs; establishing goals; coordinating post-hospital care, services, and resources; and providing patient/family education and training on brain injury coping skills. The majority of the intervention is delivered remotely via phone and remote video conferencing platform (Clinicaltrials.gov: NCT04584554). RESULTS We enrolled 15 dyads (N = 31, 15 patients, 16 caregivers) in this single arm, single center feasibility study. Most patients were men (n = 11, 73.33%), had a mean age of 39.07 (SD: 15.15), and were Black (n = 9, 60%), White (n = 5, 33.3%), or American Indian (n = 1, 0.66%). Injury severities were mild (n = 6, 40%), moderate (n = 4, 26.6%) or severe (n = 5, 33.33%). Most patients were insured (n = 10; 66.7%), had a high school education (n = 6; 40%); and earned $30,000 or less per year (n = 11; 73.3%). Most caregivers were married (n = 9, 56.25%) women (n = 14, 87.5%) with a mean age of 43.38 (SD: 10.45) and were Black (n = 8, 50%), White (n = 7, 43.75%), or American Indian (n = 1, 0.62%). Most caregivers identified as the spouse (n = 7; 43.75%) or parent (n = 6; 37.5%) of the patient. CONCLUSIONS BETTER is among the first TBI transitional care intervention to address needs/preferences for younger TBI patients of different racial groups after discharge home from acute hospital care and families. Findings can be used to inform future work.
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Affiliation(s)
| | - Callan Loflin
- Duke University School of Nursing
- Duke University School of Medicine
| | | | - Melissa Kandel
- Duke University Health System, Department of Physical and Occupational Therapy
| | - Karen Johnson
- Duke University Health System, Department of Physical and Occupational Therapy
| | | | | | | | - Lindsey Byom
- University of North Carolina at Chapel Hill, Department of Allied Health Sciences
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Knight SJ, Haibach JP, Hamilton AB, Whittle J, Ono SS, Butler J, Flower M, Ray CD, Pugh MJ, Zickmund SL. Veteran Engagement in Health Services Research: a Conceptual Model. J Gen Intern Med 2022; 37:94-98. [PMID: 35349018 PMCID: PMC8993964 DOI: 10.1007/s11606-021-07309-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 11/24/2021] [Indexed: 12/13/2022]
Abstract
With 20 million living veterans and millions more immediate family members, and approximately 9 million veterans enrolled in the nationally networked VA healthcare system, representing the interests and needs of veterans in this complex community is a substantial endeavor. Based on the importance of engaging Veterans in research, the VA Health Services Research and Development (HSR&D) Service convened a Working Group of VA researchers and Veterans to conduct a review of patient engagement models and develop recommendations for an approach to engage Veterans in health research that would incorporate their unique lived experiences and interests, and their perspectives on research priorities. The Working Group considered the specific context for Veteran engagement in research that includes other VA stakeholders from the operational and clinical leadership of the VA Health Administration (VHA). The resulting model identifies the range of potential stakeholders and three domains of relevant constructs-processes expected to facilitate Veteran engagement in research with other stakeholders, individual stakeholder and external factors, and outcomes. The expectation is that Veteran engagement will benefit research to policy and practice translation, including increasing the transparency of research and producing knowledge that is readily accepted and implemented in healthcare.
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Affiliation(s)
- Sara J Knight
- Informatics, Decision Enhancement, and Analytic Sciences (IDEAS) Center of Innovation, Research and Development Service, VA Salt Lake City Healthcare System, 500 Foothill Drive, Salt Lake City, UT, USA. .,Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.
| | - Jeffrey P Haibach
- Veteran Consulting and Research, Eastern Region, USA.,US Department of Veterans Affairs, Washington, DC, USA
| | - Alison B Hamilton
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Jeff Whittle
- Clement J Zablocki VA Medical Center, Medical College of Wisconsin, Center for Advancing Population Science, Milwaukee, WI, USA.,Department of Medicine, Clement J Zablocki VA Medical Center, Milwaukee, WI, USA
| | - Sarah S Ono
- Center to Improve Veteran Involvement in Care, VA Portland Healthcare System, Portland, OR, USA.,Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Jorie Butler
- Informatics, Decision Enhancement, and Analytic Sciences (IDEAS) Center of Innovation, Research and Development Service, VA Salt Lake City Healthcare System, 500 Foothill Drive, Salt Lake City, UT, USA.,Geriatric Research Education and Clinical Center, VA Salt Lake City Healthcare System, Salt Lake City, UT, USA
| | - Mark Flower
- Department of Medicine, Clement J Zablocki VA Medical Center, Milwaukee, WI, USA.,Veteran Peer Services, Mental Health America of Wisconsin, Milwaukee, WI, USA
| | | | - Mary Jo Pugh
- Informatics, Decision Enhancement, and Analytic Sciences (IDEAS) Center of Innovation, Research and Development Service, VA Salt Lake City Healthcare System, 500 Foothill Drive, Salt Lake City, UT, USA.,Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Susan L Zickmund
- Informatics, Decision Enhancement, and Analytic Sciences (IDEAS) Center of Innovation, Research and Development Service, VA Salt Lake City Healthcare System, 500 Foothill Drive, Salt Lake City, UT, USA.,Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
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9
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Maurer MA, Shiyanbola OO, Mott ML, Means J. Engaging Patient Advisory Boards of African American Community Members with Type 2 Diabetes in Implementing and Refining a Peer-Led Medication Adherence Intervention. PHARMACY 2022; 10:37. [PMID: 35314618 PMCID: PMC8938802 DOI: 10.3390/pharmacy10020037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/01/2022] [Accepted: 03/08/2022] [Indexed: 11/17/2022] Open
Abstract
African Americans are more likely than non-Hispanic whites to be diagnosed with and die from diabetes. A contributing factor to these health disparities is African Americans' poor diabetes medication adherence that is due in part to sociocultural barriers (e.g., medicine and illness misperceptions), which negatively affect diabetes management. In our prior work, we engaged with community stakeholders to develop and test a brief version of a culturally adapted intervention to address these barriers to medication adherence. The objective of this study was to elicit feedback to inform the refinement of the full 8-week intervention. We utilized a community-engaged study design to conduct a series of meetings with two cohorts of patient advisory boards of African Americans with type 2 diabetes who were adherent to their diabetes medicines (i.e., peer ambassadors). In total, 15 peer ambassadors were paired with 21 African American participants (i.e., peer buddies) to provide specific intervention support as peers and serve in an advisory role as a board member. Data were collected during nine board meetings with the patient stakeholders. A qualitative thematic analysis of the data was conducted to synthesize the findings. Feedback from the patient advisory board contributed to refining the intervention in the immediate-term, short-term, and long-term. The inclusion of African American community members living with type 2 diabetes on the advisory board contributed to further tailoring the intervention to the specific needs of African Americans with type 2 diabetes in the community.
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Affiliation(s)
- Martha A. Maurer
- Sonderegger Research Center for Improved Medication Outcomes, School of Pharmacy, University of Wisconsin-Madison School of Pharmacy, Madison, WI 53705, USA;
| | - Olayinka O. Shiyanbola
- Division of Social and Administrative Sciences, School of Pharmacy, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Mattigan L. Mott
- School of Nursing, University of Wisconsin-Madison, Madison, WI 53705, USA;
| | - Julia Means
- Ebenezer Ministry & Family Worship Center, Milwaukee, WI 53212, USA;
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10
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Rawl SM, Bailey S, Cork B, Fields M, Griffin T, Haunert L, Kline J, Krier C, Lagunes J, Lambert RL, Malloy C, Quick J, Shedd-Steele R, Strom S, Carter-Harris L. Partnering to Increase Colorectal Cancer Screening: Perspectives of Community Advisory Board Members. West J Nurs Res 2021; 43:930-938. [PMID: 33586632 PMCID: PMC8364565 DOI: 10.1177/0193945921993174] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Patient-Centered Outcomes Research Institute (PCORI) defines engagement in research as the meaningful involvement of patients, caregivers, clinicians, insurers, and others throughout the entire research process-from planning to conducting the study to disseminating study results. The purposes of this paper are to (a) describe methods used to engage community members across the various phases of a PCORI-funded comparative effectiveness trial to increase colorectal cancer screening; and (b) report results of qualitative and quantitative evaluations of community advisory board members' experiences on this project. Decisions to join and stay engaged with the study included feeling valued and appreciated, being compensated, the opportunity to contribute to research based on their skills and expertise, and being committed to colon cancer prevention efforts. Challenges identified by advisory board members included the significant time commitment, transportation, and meeting location. Lessons learned and guidance for researchers committed to patient and community engagement are described.
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Affiliation(s)
- Susan M. Rawl
- Indiana University School of Nursing
- Indiana University Simon Comprehensive Cancer Center
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11
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Yano EM, Resnick A, Gluck M, Kwon H, Mistry KB. Accelerating learning healthcare system development through embedded research: Career trajectories, training needs, and strategies for managing and supporting embedded researchers. HEALTHCARE-THE JOURNAL OF DELIVERY SCIENCE AND INNOVATION 2021; 8 Suppl 1:100479. [PMID: 34175096 DOI: 10.1016/j.hjdsi.2020.100479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 07/04/2020] [Accepted: 09/18/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Health systems and organizations seeking to achieve learning healthcare system principles are increasingly relying on embedded research teams to optimize delivery of evidence-based, high-quality care that improves patient and staff experience alike. However, building organizational capacity to conduct and benefit from embedded research may be challenging in the absence of clearer guidance on career pathways and training, as well as strategies for managing and supporting this unique workforce. METHODS In February 2018, 115 attendees from multiple agencies, institutions and professional societies participated in a conference to accelerate development of learning healthcare systems through embedded research. Workgroups engaged in structured brainstorming discussions of key domains; 21 diverse members focused on strengthening the embedded research community through more explicit development and support of multilevel career trajectories. RESULTS Emphasis emerged on the need for training that goes beyond traditional curricula in rigorous scientific methods to include leadership, communication, and other organizational and business skills rarely offered in research training programs. These skills are required for effective engagement of multilevel stakeholders supporting evidence-based changes in routine care. Improving readiness of other stakeholders to effectively act on evidence was noted as equally crucial, as was creation of mid-career development opportunities for researchers and implementers. CONCLUSIONS Further development and support of the embedded research workforce will require explicit attention to novel training programs and support of researchers and the stakeholders in the systems they aim to improve. IMPLICATIONS Strategies for improving career entry and mastery of skills that foster effective multilevel stakeholder engagement hold promise for strengthening the embedded research community and their contributions to systematic improvements in health and health care.
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Affiliation(s)
- Elizabeth M Yano
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, 16111 Plummer Street, Sepulveda, CA 91343 USA; Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, 90095, USA; Department of Medicine, UCLA Geffen School of Medicine, Los Angeles, CA, 90095, USA.
| | - Adam Resnick
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, 16111 Plummer Street, Sepulveda, CA 91343 USA; Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, 90095, USA.
| | - Michael Gluck
- AcademyHealth, 1666 K Street NW, Suite 1100, Washington, DC, 20006, USA.
| | - Harry Kwon
- Agency for Healthcare Research and Quality, 5600 Fishers Lane, Rockville, MD, 20857, USA.
| | - Kamila B Mistry
- Agency for Healthcare Research and Quality, 5600 Fishers Lane, Rockville, MD, 20857, USA.
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12
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Anderson D, Gau JM, Beck L, Unruh D, Gioia G, McCart M, Davies SC, Slocumb J, Gomez D, Glang AE. Management of Return to School Following Brain Injury: An Evaluation Model. INTERNATIONAL JOURNAL OF EDUCATIONAL RESEARCH 2021; 108:10.1016/j.ijer.2021.101773. [PMID: 33927471 PMCID: PMC8076871 DOI: 10.1016/j.ijer.2021.101773] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Traumatic brain injury (TBI) affects children's ability to succeed at school. Few educators have the necessary training and knowledge needed to adequately monitor and treat students with a TBI, despite schools regularly serving as the long-term service provider. In this article, we describe a return to school model used in Oregon that implements best practices indicated by the extant literature, as well as our research protocol for evaluating this model. We discuss project aims and our planned procedures, including the measures used, our quasi-experimental design using matched controls, statistical power, and impact analyses. This project will provide the evidential base for implementation of a return to school model at scale.
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Affiliation(s)
| | - Jeff M. Gau
- University of Oregon, Eugene, 97403-5252, USA
| | - Laura Beck
- University of Oregon, Eugene, 97403-5252, USA
| | | | - Gerard Gioia
- Children’s National Health System, 111 Michigan
Avenue NW, Washington, DC, 20010
| | | | - Susan C Davies
- University of Dayton, University of Dayton, 300 College
Park Dayton, Ohio 45469, USA
| | | | - Doug Gomez
- University of Oregon, Eugene, 97403-5252, USA
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13
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Documet PI, Louth W, Smith-Tapia I, Jaime MC, Miller E, Taverno Ross SE. Pedagogic Tailoring of a Human Research Ethics Training for Community-Engaged Research With Latinos. Health Promot Pract 2020; 23:98-108. [PMID: 32892637 DOI: 10.1177/1524839920954122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Because of the increase in community-engaged research, several human research ethics trainings for laypeople have been developed. We aim to (1) describe the pedagogical tailoring of a research ethics training for laypeople for a research study where promotores-community health workers-delivered an intervention to increase health care access and promote healthy behaviors among Latinos and (2) present results of the application of the training after 4 months in the field. We tailored a previously developed training to Latino community members implementing a research study. Key modifications included (1) translation (2) use of pedagogical tools, such as cooperative learning, role-plays, and inclusion of cultural preferences. One novel addition was to use dialogues that the trainees enacted and then discussed. We evaluated the training with a posttraining survey with eight community liaisons and 13 promotores implementing the intervention, and a focus group with eight promotores, 4 months after working in the field. Trainees said they felt confident obtaining informed consent, felt the dialogues were realistic and helped them remember what they learned, and wanted more feedback from trainers on their performance. Promotores demonstrated the application of ethical principles beyond the training by discussing the possibility of advertising broadly in social media (justice), the risks and benefits of providing community resources to participants (beneficence), and the university's role in legitimizing their position as promotores (respect). We conclude that a pedagogically tailored ethics research training for laypeople can be successful and that dialogues to be enacted need to be explored further.
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Luger TM, Hamilton AB, True G. Measuring Community-Engaged Research Contexts, Processes, and Outcomes: A Mapping Review. Milbank Q 2020; 98:493-553. [PMID: 32428339 PMCID: PMC7296434 DOI: 10.1111/1468-0009.12458] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Policy Points Community‐engaged research (CEnR) engenders meaningful academic‐community partnerships to improve research quality and health outcomes. CEnR has increasingly been adopted by health care systems, funders, and communities looking for solutions to intractable problems. It has been difficult to systematically measure CEnR's impact, as most evaluations focus on project‐specific outcomes. Similarly, partners have struggled with identifying appropriate measures to assess outcomes of interest. To make a case for CEnR's value, we must demonstrate the impacts of CEnR over time. We compiled recent measures and developed an interactive data visualization to facilitate more consistent measurement of CEnR's theoretical domains.
Context Community‐engaged research (CEnR) aims to engender meaningful academic‐community partnerships to increase research quality and impact, improve individual and community health, and build capacity for uptake of evidence‐based practices. Given the urgency to solve society's pressing public health problems and increasing competition for funding, it is important to demonstrate CEnR's value. Most evaluations focus on project‐specific outcomes, making it difficult to demonstrate CEnR's broader impact. Moreover, it is challenging for partnerships to identify assessments of interest beyond process measures. We conducted a mapping review to help partnerships find and select measures to evaluate CEnR projects and to characterize areas where further development of measures is needed. Methods We searched electronic bibliographic databases using relevant search terms from 2009 to 2018 and scanned CEnR projects to identify unpublished measures. Through review and reduction, we found 69 measures of CEnR's context, process, or outcomes that are potentially generalizable beyond a specific health condition or population. We abstracted data from descriptions of each measure to catalog purpose, aim (context, process, or outcome), and specific domains being measured. Findings We identified 28 measures of the conditions under which CEnR is conducted and factors to support effective academic‐community collaboration (context); 43 measures evaluating constructs such as group dynamics and trust (process); and 43 measures of impacts such as benefits and challenges of CEnR participation and system and capacity changes (outcomes). Conclusions We found substantial variation in how academic‐community partnerships conceptualize and define even similar domains. Achieving more consistency in how partnerships evaluate key constructs could reduce measurement confusion apparent in the literature. A hybrid approach whereby partnerships discuss common metrics and develop locally important measures can address CEnR's multiple goals. Our accessible data visualization serves as a convenient resource to support partnerships’ evaluation goals and may help to build the evidence base for CEnR through the use of common measures across studies.
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Affiliation(s)
- Tana M Luger
- VA Greater Los Angeles Healthcare System, Health Services Research and Development Center for the Study of Healthcare Innovation, Implementation and Policy
| | - Alison B Hamilton
- VA Greater Los Angeles Healthcare System, Health Services Research and Development Center for the Study of Healthcare Innovation, Implementation and Policy.,David Geffen School of Medicine, University of California, Los Angeles
| | - Gala True
- Southeast Louisiana Veterans Healthcare System, South Central Mental Illness Research, Education, and Clinical Center.,Louisiana State University School of Medicine, Section of Community and Population Medicine
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Martineau JT, Minyaoui A, Boivin A. Partnering with patients in healthcare research: a scoping review of ethical issues, challenges, and recommendations for practice. BMC Med Ethics 2020; 21:34. [PMID: 32393230 PMCID: PMC7216517 DOI: 10.1186/s12910-020-0460-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 02/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Partnering with patients in healthcare research now benefits from a strong rationale and is encouraged by funding agencies and research institutions. However, this new approach raises ethical issues for patients, researchers, research professionals and administrators. The main objective of this review is to map the literature related to the ethical issues associated with patient partnership in healthcare research, as well as the recommendations to address them. Our global aim is to help researchers, patients, research institutions and research ethics boards reflecting on and dealing with these issues. METHODS We conducted a scoping review of the ethical issues and recommendations associated with partnering with patients in healthcare research. After our search strategy, 31 peer reviewed articles published between 2007 and 2017 remained and were analyzed. RESULTS We have identified 58 first-order ethical issues and challenges associated with patient partnership in research, regrouped in 18 second-order ethical themes. Most of the issues are transversal to all phases and stages of the research process and a lot of them could also apply to patient-partnership in other spheres of health, such as governance, quality improvement, and education. We suggested that ethical issues and challenges of partnered research can be related to four ethical frameworks: 1) Research ethics; 2) Research integrity; 3) Organizational ethics, and 4) Relational ethics. CONCLUSIONS We have identified numerous ethical issues associated with the recent approach of patient-partnership in research. These issues are more diverse than the issues associated with a more traditional research approach. Indeed, the current discussion on how we address ethical issues in research is anchored in the assumption that patients, as research participants, must be protected from risk. However, doing research with, and not on, the patient involves changes in the way we reflect on the ethical issues associated with this approach to research. We propose to broaden the ethical discussion on partnered research to not only rely on a research ethics framework, but to also frame it within the areas of research integrity, organizational ethics and relational ethics.
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Affiliation(s)
- Joé T Martineau
- Department of Management, HEC Montreal, 3000 chemin de la Cote-Ste-Catherine, Montreal, QC, H3T2A7, Canada.
| | | | - Antoine Boivin
- Canada Research Chair in Patient and Public Partnership, CHUM Research Center (CRCHUM) and University of Montreal, Montreal, Canada
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Hamilton AB, Yano EM. The importance of symbolic and engaged participation in evidence-based quality improvement in a complex integrated healthcare system: response to "The science of stakeholder engagement in research". Transl Behav Med 2019; 7:492-494. [PMID: 28929322 DOI: 10.1007/s13142-017-0528-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
In this commentary, we respond to the commentary provided by Goodman and Sanders Thompson regarding our paper on multilevel stakeholder engagement in a VA implementation trial of evidence-based quality improvement (EBQI) in women's health primary care. We clarify our overall approach to engagement (comprised of both symbolic and engaged participation, according to the authors' classification rubric), highlighting that symbolic participation is of more import and value than the authors suggest, especially in the context of a hierarchical healthcare system. We contend that the issue of power-and how power matters in stakeholder engagement-needs to be considered in this context rather than in global "community" terms. In response to the authors' call for greater detail, we clarify our planning processes as well as our approach to veteran engagement. We concur with Goodman and Sanders Thompson that the science of stakeholder engagement necessitates a broader understanding of best practices as well as the impact of engagement on implementation outcomes.
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Affiliation(s)
- Alison B Hamilton
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Building 206, Los Angeles, CA, 90073, USA. .,Department of Psychiatry and Biobehavioral Sciences, UCLA Geffen School of Medicine, Los Angeles, CA, 90095, USA.
| | - Elizabeth M Yano
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Building 206, Los Angeles, CA, 90073, USA.,Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, 90095-1772, USA
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Immigrants as Research Partners: A Review of Immigrants in Community-Based Participatory Research (CBPR). J Immigr Minor Health 2018; 19:1457-1468. [PMID: 27491305 DOI: 10.1007/s10903-016-0474-3] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Community-based participatory research (CBPR) is uniquely suited to engage immigrants in all aspects of research, from research question development to data collection to interpretation and dissemination of results. An increasing number of research studies have utilized the methodology for exploring complex health issues for immigrants. In the current manuscript, we present a review of peer-reviewed articles in health-related research where CBPR was conducted in partnership with immigrants. We examined the role of immigrants in the CBPR process and how immigrant involvement improved/enhanced the research rigor. A total of 161 articles met the inclusion criteria. The results of this literature review enhance our understanding of how CBPR can be used in direct collaboration with immigrants and highlights the many potential benefits for both researchers and immigrant communities.
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Musesengwa R, Chimbari MJ, Mukaratirwa S. A Framework for Community and Stakeholder Engagement: Experiences From a Multicenter Study in Southern Africa. J Empir Res Hum Res Ethics 2018; 13:323-332. [PMID: 29701110 DOI: 10.1177/1556264618769002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Community and stakeholder engagement (CSE) are central to conducting multicenter health research. Multicenter studies are, however, considerably more complex because they involve a geographically diverse pool of participants and researchers, making uniform application of CSE strategies difficult. This article describes a framework to achieve CSE based on the experiences of a conducting a multicenter study in Southern Africa. The CSE framework is divided into three phases: before research commences, during, and after the study. This CSE framework offers a practical step-by-step guide on the operational aspects of CSE in a multicenter study. The framework shows the importance of consistent monitoring and evaluation during implantation of CSE.
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19
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Hamilton AB, Mittman BS, Campbell D, Hutchinson C, Liu H, Moss NJ, Wyatt GE. Understanding the impact of external context on community-based implementation of an evidence-based HIV risk reduction intervention. BMC Health Serv Res 2018; 18:11. [PMID: 29316922 PMCID: PMC5759288 DOI: 10.1186/s12913-017-2791-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 12/12/2017] [Indexed: 12/19/2022] Open
Affiliation(s)
- Alison B Hamilton
- UCLA Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Plaza, 38-240 NPI, Box 175919, Los Angeles, CA, 90024-1759, USA. .,VA Center for the Study of Healthcare Innovation, Implementation, & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Los Angeles, CA, 90073, USA.
| | - Brian S Mittman
- VA Center for the Study of Healthcare Innovation, Implementation, & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Los Angeles, CA, 90073, USA.,Kaiser Permanente Southern California, Department of Research and Evaluation, 100 S. Los Robles Avenue, Pasadena, CA, 91101-2453, USA
| | - Danielle Campbell
- UCLA Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Plaza, 38-240 NPI, Box 175919, Los Angeles, CA, 90024-1759, USA
| | - Craig Hutchinson
- UCLA Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Plaza, 38-240 NPI, Box 175919, Los Angeles, CA, 90024-1759, USA
| | - Honghu Liu
- UCLA Department of Medicine, 760 Westwood Plaza, Los Angeles, CA, 90024-1759, USA
| | - Nicholas J Moss
- HIV STD Section, Alameda County Public Health Department, 1000 Broadway, Suite 310, Oakland, CA, 94607, USA
| | - Gail E Wyatt
- UCLA Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Plaza, 38-240 NPI, Box 175919, Los Angeles, CA, 90024-1759, USA
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20
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Musesengwa R, Chimbari MJ. Experiences of community members and researchers on community engagement in an Ecohealth project in South Africa and Zimbabwe. BMC Med Ethics 2017; 18:76. [PMID: 29237440 PMCID: PMC5729516 DOI: 10.1186/s12910-017-0236-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 11/30/2017] [Indexed: 11/17/2022] Open
Abstract
Background Community engagement (CE) models have provided much needed guidance for researchers to conceptualise and design engagement strategies for research projects. Most of the published strategies, however, still show very limited contribution of the community to the engagement process. One way of achieving this is to document experiences of community members in the CE processes during project implementation. The aim of our study was to explore the experiences of two research naïve communities, regarding a CE strategy collaboratively developed by researchers and study communities in a multicountry study. Methods The study was carried out in two research naïve communities; Gwanda, Zimbabwe and uMkhanyakude, South Africa. The multicentre study was a community based participatory ecohealth multicentre study. A qualitative case study approach was used to explore the CE strategy. Data was collected through Focus Group Discussions, Key Informant Interviews and Direct Observations. Data presented in this paper was collected at three stages of the community engagement process; soon after community entry, soon after sensitisation and during study implementation. Data was analysed through thematic analysis. Results The communities generally had positive experiences of the CE process. They felt that the continuous solicitation of their advice and preferences enabled them to significantly contribute to shaping the engagement process. Communities also perceived the CE process as having been flexible, and that the researchers had presented an open forum for sharing responsibilities in all decision making processes of the engagement process. Conclusions This study has demonstrated that research naïve communities can significantly contribute to research processes if they are adequately engaged. The study also showed that if researchers put in maximum effort to demystify the research process, communities become empowered and participate as partners in research.
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Affiliation(s)
- Rosemary Musesengwa
- College of Health Sciences, University of KwaZulu Natal, 1st Floor George Campbell Building, King George V Ave, Durban, 4041, South Africa.
| | - Moses J Chimbari
- College of Health Sciences, University of KwaZulu Natal, 1st Floor George Campbell Building, King George V Ave, Durban, 4041, South Africa
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Shea CM, Young TL, Powell BJ, Rohweder C, Enga ZK, Scott JE, Carter-Edwards L, Corbie-Smith G. Researcher readiness for participating in community-engaged dissemination and implementation research: a conceptual framework of core competencies. Transl Behav Med 2017; 7:393-404. [PMID: 28341897 PMCID: PMC5645278 DOI: 10.1007/s13142-017-0486-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Participating in community-engaged dissemination and implementation (CEDI) research is challenging for a variety of reasons. Currently, there is not specific guidance or a tool available for researchers to assess their readiness to conduct CEDI research. We propose a conceptual framework that identifies detailed competencies for researchers participating in CEDI and maps these competencies to domains. The framework is a necessary step toward developing a CEDI research readiness survey that measures a researcher's attitudes, willingness, and self-reported ability for acquiring the knowledge and performing the behaviors necessary for effective community engagement. The conceptual framework for CEDI competencies was developed by a team of eight faculty and staff affiliated with a university's Clinical and Translational Science Award (CTSA). The authors developed CEDI competencies by identifying the attitudes, knowledge, and behaviors necessary for carrying out commonly accepted CE principles. After collectively developing an initial list of competencies, team members individually mapped each competency to a single domain that provided the best fit. Following the individual mapping, the group held two sessions in which the sorting preferences were shared and discrepancies were discussed until consensus was reached. During this discussion, modifications to wording of competencies and domains were made as needed. The team then engaged five community stakeholders to review and modify the competencies and domains. The CEDI framework consists of 40 competencies organized into nine domains: perceived value of CE in D&I research, introspection and openness, knowledge of community characteristics, appreciation for stakeholder's experience with and attitudes toward research, preparing the partnership for collaborative decision-making, collaborative planning for the research design and goals, communication effectiveness, equitable distribution of resources and credit, and sustaining the partnership. Delineation of CEDI competencies advances the broader CE principles and D&I research goals found in the literature and facilitates development of readiness assessments tied to specific training resources for researchers interested in conducting CEDI research.
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Affiliation(s)
- Christopher M Shea
- North Carolina Clinical and Translational Sciences Institute (NC TraCS), Chapel Hill, NC, USA.
- Department of Health Policy and Management, UNC Gillings School of Global Public Health, UNC-Chapel Hill, CB#7411, Chapel Hill, NC, 27599-7411, USA.
| | - Tiffany L Young
- North Carolina Clinical and Translational Sciences Institute (NC TraCS), Chapel Hill, NC, USA
- UNC Center for Health Equity, Department of Social Medicine, UNC-Chapel Hill School of Medicine, Chapel Hill, NC, USA
- Department of Medicine, UNC-Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Byron J Powell
- North Carolina Clinical and Translational Sciences Institute (NC TraCS), Chapel Hill, NC, USA
- Department of Health Policy and Management, UNC Gillings School of Global Public Health, UNC-Chapel Hill, CB#7411, Chapel Hill, NC, 27599-7411, USA
| | - Catherine Rohweder
- North Carolina Clinical and Translational Sciences Institute (NC TraCS), Chapel Hill, NC, USA
- Department of Health Policy and Management, UNC Gillings School of Global Public Health, UNC-Chapel Hill, CB#7411, Chapel Hill, NC, 27599-7411, USA
| | - Zoe K Enga
- North Carolina Clinical and Translational Sciences Institute (NC TraCS), Chapel Hill, NC, USA
| | - Jennifer E Scott
- North Carolina Clinical and Translational Sciences Institute (NC TraCS), Chapel Hill, NC, USA
- Department of Health Policy and Management, UNC Gillings School of Global Public Health, UNC-Chapel Hill, CB#7411, Chapel Hill, NC, 27599-7411, USA
| | - Lori Carter-Edwards
- North Carolina Clinical and Translational Sciences Institute (NC TraCS), Chapel Hill, NC, USA
- Public Health Leadership Program, UNC Gillings School of Global Public Health, UNC-Chapel Hill, CB#7426, Chapel Hill, NC, 27599-7426, USA
| | - Giselle Corbie-Smith
- North Carolina Clinical and Translational Sciences Institute (NC TraCS), Chapel Hill, NC, USA
- UNC Center for Health Equity, Department of Social Medicine, UNC-Chapel Hill School of Medicine, Chapel Hill, NC, USA
- Department of Medicine, UNC-Chapel Hill School of Medicine, Chapel Hill, NC, USA
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Developing Research Collaborations in an Academic Clinical Setting: Challenges and Lessons Learned. Community Ment Health J 2017; 53:647-660. [PMID: 27900495 DOI: 10.1007/s10597-016-0073-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 11/24/2016] [Indexed: 10/20/2022]
Abstract
Research collaboration in "real world" practice settings may enhance the meaningfulness of the findings and reduce barriers to implementation of novel intervention strategies. This study describes an initiative to integrate research into a hospital-based outpatient psychiatric clinic within an academic medical center, focusing on collaborative processes across three research projects. We report on the varied outcomes of the projects and utilize data from two focus groups to identify the key elements that contributed to the challenges and successes. We identify barriers to practice-research collaborations that emerged even when the initial circumstances of the partnership were favorable. These barriers include the presence of varied agendas across clinicians and investigators, resource constraints, limited staff buy-in, and staff turnover. In highlighting the lessons learned in this collaborative process, we hope to facilitate successful partnerships in other clinical settings.
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Fryer CS, Passmore SR, Maietta RC, Petruzzelli J, Casper E, Brown NA, Butler J, Garza MA, Thomas SB, Quinn SC. The Symbolic Value and Limitations of Racial Concordance in Minority Research Engagement. QUALITATIVE HEALTH RESEARCH 2016; 26:830-41. [PMID: 25769299 PMCID: PMC4658313 DOI: 10.1177/1049732315575708] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The well-documented underrepresentation of racial and ethnic minorities in research demands action. The field of health disparities research, however, lacks scientific consensus about how best to respectfully recruit underrepresented minority populations in research. We explore the investigators' perspective regarding how their own racial and ethnic background influenced their ability to recruit minorities, including (a) the influence of racial concordance ("race-matching") in research recruitment, (b) attributes and shared values important in the development of trust with minority communities, and (c) the role self-reflection plays in the development of meaningful research relationships. In 2010, we conducted in-depth, semi-structured, telephone interviews with investigators (N= 31) experienced with minority populations. Through the analysis of this coherent narrative, we uncovered both the symbolic and surface-level assumptions regarding minority recruitment to expose a deep structural understanding of race, ethnicity, and social context that is critical for bridging the true social difference between researchers and participants.
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Affiliation(s)
| | | | | | | | - Erica Casper
- University of Maryland, College Park, Maryland, USA
| | - Natasha A Brown
- University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - James Butler
- University of Maryland, College Park, Maryland, USA
| | - Mary A Garza
- University of Maryland, College Park, Maryland, USA
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Trinidad SB, Ludman EJ, Hopkins S, James RD, Hoeft TJ, Kinegak A, Lupie H, Kinegak R, Boyer BB, Burke W. Community dissemination and genetic research: moving beyond results reporting. Am J Med Genet A 2015; 167:1542-50. [PMID: 25900516 DOI: 10.1002/ajmg.a.37028] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 02/08/2015] [Indexed: 12/31/2022]
Abstract
The community-based participatory research (CBPR) literature notes that researchers should share study results with communities. In the case of human genetic research, results may be scientifically interesting but lack clinical relevance. The goals of this study were to learn what kinds of information community members want to receive about genetic research and how such information should be conveyed. We conducted eight focus group discussions with Yup'ik Alaska Native people in southwest Alaska (N = 60) and 6 (N = 61) with members of a large health maintenance organization in Seattle, Washington. Participants wanted to receive genetic information they "could do something about" and wanted clinically actionable information to be shared with their healthcare providers; they also wanted researchers to share knowledge about other topics of importance to the community. Although Alaska Native participants were generally less familiar with western scientific terms and less interested in web-based information sources, the main findings were the same in Alaska and Seattle: participants wished for ongoing dialogue, including opportunities for informal, small-group conversations, and receiving information that had local relevance. Effective community dissemination is more than a matter of presenting study results in lay language. Community members should be involved in both defining culturally appropriate communication strategies and in determining which information should be shared. Reframing dissemination as a two-way dialogue, rather than a one-way broadcast, supports the twin aims of advancing scientific knowledge and achieving community benefit.
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Affiliation(s)
- Susan Brown Trinidad
- Department of Bioethics and Humanities, University of Washington, Seattle, Washington
| | | | - Scarlett Hopkins
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Alaska
| | - Rosalina D James
- Department of Bioethics and Humanities, University of Washington, Seattle, Washington
| | - Theresa J Hoeft
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Alaska
| | - Annie Kinegak
- Community Planning Group, Center for Alaska Native Health Research, University of Alaska Fairbanks, Alaska
| | - Henry Lupie
- Community Planning Group, Center for Alaska Native Health Research, University of Alaska Fairbanks, Alaska
| | - Ralph Kinegak
- Community Planning Group, Center for Alaska Native Health Research, University of Alaska Fairbanks, Alaska
| | - Bert B Boyer
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Alaska
| | - Wylie Burke
- Department of Bioethics and Humanities, University of Washington, Seattle, Washington
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deKleijn M, Lagro-Janssen AL, Canelo I, Yano EM. Creating a roadmap for delivering gender-sensitive comprehensive care for women Veterans: results of a national expert panel. Med Care 2015; 53:S156-64. [PMID: 25767971 PMCID: PMC4379113 DOI: 10.1097/mlr.0000000000000307] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Women Veterans are a significant minority of users of the VA healthcare system, limiting provider and staff experience meeting their needs in environments historically designed for men. The VA is nonetheless committed to ensuring that women Veterans have access to comprehensive care in environments sensitive to their needs. OBJECTIVES We sought to determine what aspects of care need to be tailored to the needs of women Veterans in order for the VA to deliver gender-sensitive comprehensive care. RESEARCH DESIGN Modified Delphi expert panel process. SUBJECTS Eleven clinicians and social scientists with expertise in women's health, primary care, and mental health. MEASURES Importance of tailoring over 100 discrete aspects of care derived from the Institute of Medicine's definition of comprehensive care and literature-based domains of sex-sensitive care on a 5-point scale. RESULTS Panelists rated over half of the aspects of care as very-to-extremely important (median score 4+) to tailor to the needs of women Veterans. The panel arrived at 14 priority recommendations that broadly encompassed the importance of (1) the design/delivery of services sensitive to trauma histories, (2) adapting to women's preferences and information needs, and (3) sex awareness and cultural transformation in every facet of VA operations. CONCLUSIONS We used expert panel methods to arrive at consensus on top priority recommendations for improving delivery of sex-sensitive comprehensive care in VA settings. Accomplishment of their breadth will require national, regional, and local strategic action and multilevel stakeholder engagement, and will support VA's national efforts at improving customer service for all Veterans.
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Affiliation(s)
- Miriam deKleijn
- Department of Primary and Community Care, Gender and Women's Health Unit, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Antoine L.M. Lagro-Janssen
- Department of Primary and Community Care, Gender and Women's Health Unit, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ismelda Canelo
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles, Sepulveda
| | - Elizabeth M. Yano
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles, Sepulveda
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA
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Hill NL, Penrod J, Milone-Nuzzo P. Merging person-centered care with translational research to improve the lives of older adults: creating community-based nursing research networks. J Gerontol Nurs 2015; 40:66-74. [PMID: 25275784 DOI: 10.3928/00989134-20140812-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 06/20/2014] [Indexed: 11/20/2022]
Abstract
Translational research is a leading trend in science with the aim of bridging the research-practice gap to significantly speed the implementation of effective interventions in clinical practice. Integrating the values and preferences of older adults and their families into this process is critical to the success of translational research. Engaging communities in meaningful research is an important part of advancing translational science in which older adults are partners in developing solutions to the health needs of individuals within communities. The current article describes one approach to developing an infrastructure (i.e., community-based nursing research network) to support patient-centered care within translational research. Nurses are uniquely poised and prepared to assume leadership roles in community-based research networks to support a true collaboration among stakeholders that prizes the voices of older adults and integrates them into practice efforts.
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Abstract
Obesity is a pervasive global public health concern of utmost priority. Effective and efficient interventions are urgently needed to reverse current trends, especially among children. The past decade has witnessed increasing adoption and implementation of community-engaged and -participatory interventions that employ a bottom-up approach to identifying and realizing sustainable solutions within communities. It is argued herein that community-based approaches are most effective when implemented via a systems perspective that integrates across societal sectors. This approach seizes upon the synergistic effects that result from simultaneously mobilizing community assets at multiple levels. This paper provides an overview of the evolution and theory behind community-engaged, community-participatory, and systems-level interventions, discusses recent findings in the field, offers reflections based on first-hand experience, outlines advances in relevant resources, and lays forth potential and promising directions for future research. It emphasizes the centrality and necessity of community-engaged systems-level interventions in halting and reversing the obesity epidemic.
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Affiliation(s)
- Christina Economos
- Friedman School of Nutrition, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA.
| | - Stacy Blondin
- Food Policy and Applied Nutrition, Friedman School of Nutrition, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA.
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Haldeman KM, Cadigan RJ, Davis A, Goldenberg A, Henderson GE, Lassiter D, Reavely E. Community engagement in US biobanking: multiplicity of meaning and method. Public Health Genomics 2014; 17:84-94. [PMID: 24556734 DOI: 10.1159/000357958] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 11/28/2013] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND/AIMS Efforts to improve individual and population health increasingly rely on large-scale collections of human biological specimens and associated data. Such collections or 'biobanks' are hailed as valuable resources for facilitating translational biomedical research. However, biobanks also raise important ethical considerations, such as whether, how and why biobanks might engage with those who contributed specimens. This paper examines perceptions and practices of community engagement (CE) among individuals who operate 6 diverse biobanks in the US. METHODS Twenty-four people from a diverse group of 6 biobanks were interviewed in-person or via telephone from March to July 2011. Interview transcripts were coded and analyzed for common themes. RESULTS Emergent themes include how biobank personnel understand 'community' and CE as it pertains to biobank operations, information regarding the diversity of practices of CE, and the reasons why biobanks conduct CE. CONCLUSION Despite recommendations from federal agencies to conduct CE, the interpretation of CE varies widely among biobank employees, ultimately affecting how CE is practiced and what goals are achieved.
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Affiliation(s)
- K M Haldeman
- Department of Social Medicine, University of North Carolina, Chapel Hill, N.C., USA
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Woods-Giscombé CL, Gaylord SA. The Cultural Relevance of Mindfulness Meditation as a Health Intervention for African Americans: Implications for Reducing Stress-Related Health Disparities. J Holist Nurs 2014; 32:147-60. [PMID: 24442592 DOI: 10.1177/0898010113519010] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
African Americans experience a disproportionate rate of stress-related health conditions compared to European Americans. Mindfulness meditation has been shown to be effective for managing stress and various stress-related health conditions. This study explored the cultural relevance of mindfulness meditation training for African Americans adults. Fifteen African American adults with past or current experience with mindfulness meditation training were interviewed. Participants felt that mindfulness meditation helped them with enhanced stress management, direct health improvement, and enhanced self-awareness and purposefulness. They felt that they would recommend it and that other African Americans would be open to the practice but suggested that its presentation may need to be adapted. They suggested emphasizing the health benefits, connecting it to familiar spiritual ideology and cultural practices, supplementing the reading material with African American writers, increasing communication (education, instructor availability, "buddy system," etc.), and including African Americans as instructors and participants. By implementing minor adaptations that enhance cultural relevance, mindfulness meditation can be a beneficial therapeutic intervention for this population.
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