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Humphries D, Marotta P, Hu Y, Wang V, Gross G, Rucker D, Jones J, Alam F, Brown T, Carter CR, Spiegelman D. St. Louis Enhancing Engagement and Retention in HIV/AIDS Care (STEER): a participatory intersectional needs assessment for intervention and implementation planning. RESEARCH SQUARE 2024:rs.3.rs-4225131. [PMID: 38746123 PMCID: PMC11092814 DOI: 10.21203/rs.3.rs-4225131/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Background Missouri is one of seven priority states identified by the Ending the HIV Epidemic Initiative, and St. Louis contains almost half of the people living with HIV (PLWH) in Missouri. As St. Louis has a marked history of structural racism and economic inequities, we utilized the Intersectionality Based Policy Analysis (IBPA) framework to guide a participatory needs assessment for planning and program development. Methods The planning team included researchers, the lead implementer from our community partner, and two community representatives, and had biweekly 60-90 minute meetings for 18 months. The planning team discussed and approved all research materials, reviewed and interpreted results, and made decisions about outreach, recruitment, conduct of the needs assessment and development of the planned intervention. The needs assessment integrated information from existing data, (1) interviews with (a) PLWH (n=12), (b) community leaders (n=5), (c) clinical leaders (n=4), and (d) community health workers (CHWs) (n=3) and (e) CHW supervisors (n=3) who participated in a Boston University-led demonstration project on CHWs in the context of HIV and (2) focus groups (2 FG, 12 participants) with front line health workers such as peer specialists, health coaches and outreach workers. A rapid qualitative analysis approach was used for all interviews and focus groups. Results The IBPA was used to guide team discussions of team values, definition and framing of the problem, questions and topics in the key informant interviews, and implementation strategies. Applying the IBPA framework contributed to a focus on intersectional drivers of inequities in HIV services. The effective management of HIV faces significant challenges from high provider turnover, insufficient integration of CHWs into care teams, and organizational limitations in tailoring treatment plans. Increasing use of CHWs for HIV treatment and prevention also faces challenges. People living with HIV (PLWH) encounter multiple barriers such as stigma, lack of social support, co-morbidities, medication side effects and difficulties in meeting basic needs. Conclusions Addressing intersectional drivers of health inequities may require multi-level, structural approaches. We see the IBPA as a valuable tool for participatory planning while integrating community engagement principles in program and implementation design for improving HIV outcomes.
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Affiliation(s)
| | - Phillip Marotta
- Washington University In St Louis: Washington University in St Louis
| | | | | | - Greg Gross
- Washington University In St Louis: Washington University in St Louis
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Hippalgaonkar N, Nguyen RHT, Cohn EB, Horowitz J, Waite AW, Mersha T, Sandoval C, Khan S, Salum K, Thomas P, Murphy AM, Brent B, Coleman L, Khosla P, Hoskins KF, Henderson V, Carnahan LR. Are We the Problem? A Call to Action for Addressing Institutional Challenges to Engaging Community Partners in Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:236. [PMID: 38397725 PMCID: PMC10888328 DOI: 10.3390/ijerph21020236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/10/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024]
Abstract
Community-engaged research (CEnR) is a potent tool for addressing health inequities and fostering equitable relationships among communities, researchers, and institutions. CEnR involves collaboration throughout the research process, demonstrating improvements in study recruitment and retention, intervention efficacy, program sustainability, capacity building among partners, and enhanced cultural relevance. Despite the increasing demand for CEnR, institutional policies, particularly human participation protection training (HPP), lag behind, creating institutional barriers to community partnerships. Here, we highlight challenges encountered in our ongoing study, Fostering Opportunities in Research through Messaging and Education (FOR ME), focused on promoting shared decision-making around clinical trial participation among Black women diagnosed with breast cancer. Grounded in CEnR methods, FOR ME has a partnership with a community-based organization (CBO) that addresses the needs of Black women with breast cancer. Our CBO partner attempted to obtain HPP training, which was administratively burdensome and time-consuming. As CEnR becomes more prevalent, academic and research institutions, along with researchers, are faced with a call to action to become more responsive to community partner needs. Accordingly, we present a guide to HPP training for community partners, addressing institutional barriers to community partner participation in research. This guide outlines multiple HPP training pathways for community partners, aiming to minimize institutional barriers and enhance their engagement in research with academic partners.
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Affiliation(s)
- Neha Hippalgaonkar
- Division of Hematology/Oncology, University of Illinois Chicago, Chicago, IL 60612, USA; (R.H.-T.N.); (K.F.H.)
| | - Ryan Huu-Tuan Nguyen
- Division of Hematology/Oncology, University of Illinois Chicago, Chicago, IL 60612, USA; (R.H.-T.N.); (K.F.H.)
- University of Illinois Cancer Center, Chicago, IL 60612, USA; (A.W.W.); (T.M.); (L.R.C.)
| | - Eliza Brumer Cohn
- Fred Hutchinson Cancer Center, Seattle, WA 98126, USA; (E.B.C.); (K.S.); (V.H.)
| | - Joseph Horowitz
- Department of Medicine and Pediatrics, University of Illinois College of Medicine, Chicago, IL 60612, USA;
| | - Ana Williams Waite
- University of Illinois Cancer Center, Chicago, IL 60612, USA; (A.W.W.); (T.M.); (L.R.C.)
| | - Tigist Mersha
- University of Illinois Cancer Center, Chicago, IL 60612, USA; (A.W.W.); (T.M.); (L.R.C.)
- School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA; (C.S.); (A.M.M.)
| | - Christen Sandoval
- School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA; (C.S.); (A.M.M.)
| | - Sarah Khan
- Sinai Chicago, Chicago, IL 60612, USA; (S.K.); (P.K.)
| | - Kauthar Salum
- Fred Hutchinson Cancer Center, Seattle, WA 98126, USA; (E.B.C.); (K.S.); (V.H.)
| | | | - Anne Marie Murphy
- School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA; (C.S.); (A.M.M.)
| | - Beulah Brent
- Sisters Working It Out, Chicago, IL 60612, USA; (B.B.); (L.C.)
| | - Lolita Coleman
- Sisters Working It Out, Chicago, IL 60612, USA; (B.B.); (L.C.)
| | | | - Kent F. Hoskins
- Division of Hematology/Oncology, University of Illinois Chicago, Chicago, IL 60612, USA; (R.H.-T.N.); (K.F.H.)
- University of Illinois Cancer Center, Chicago, IL 60612, USA; (A.W.W.); (T.M.); (L.R.C.)
| | - Vida Henderson
- Fred Hutchinson Cancer Center, Seattle, WA 98126, USA; (E.B.C.); (K.S.); (V.H.)
| | - Leslie R. Carnahan
- University of Illinois Cancer Center, Chicago, IL 60612, USA; (A.W.W.); (T.M.); (L.R.C.)
- School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA; (C.S.); (A.M.M.)
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Akintobi TH, Barrett R, Hoffman L, Scott S, Davis K, Jones T, Brown NDV, Fraire M, Fraire R, Garner J, Gruner A, Hill J, Meckel R, Obi C, Omunga P, Parham Q, Rice T, Samples O, Terrill T. The community engagement course and action network: strengthening community and academic research partnerships to advance health equity. Front Public Health 2023; 11:1114868. [PMID: 37404270 PMCID: PMC10317472 DOI: 10.3389/fpubh.2023.1114868] [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: 12/03/2022] [Accepted: 04/28/2023] [Indexed: 07/06/2023] Open
Abstract
Background Historically Black Colleges and Universities and Minority Serving Institutions are uniquely positioned to implement community-campus research partnerships based on a history of service, the pursuit of community trustworthiness and student demographics often similar to surrounding marginalized communities. The Morehouse School of Medicine Prevention Research Center collaborates with members of Historically Black Colleges and Universities, Minority Serving Institutes, and community organizations on the Community Engaged Course and Action Network. This network is the first of its kind and aims to strengthen members' ability to implement Community-Based Participatory Research (CBPR) principles and partnerships. Projects address public health priorities including mental health among communities of color, zoonotic disease prevention, and urban food deserts. Materials and methods To assess the effectiveness of the network, a Participatory Evaluation framework was implemented to conduct process evaluation which included review of partnership structures, operations, project implementation processes, and preliminary outcomes of the research collaborations. A focus group of Community Engagement Course and Action Network members (community and academic) was also conducted to identify benefits and challenges of the network with emphasis on key areas for improvement to further enhance the relationships between partners and to facilitate their subsequent community-campus research. Results Network improvements were tied to themes strengthening community-academic partnerships including sharing and fellowship, coalition building and collaboration, and greater connections and awareness of community needs through their current community-academic partnerships. The need to conduct ongoing evaluation during and after implementation, for determining the early adoption of CBPR approaches was also identified. Conclusion Evaluation of the network's processes, infrastructure, and operation provides early lessons learned to strengthen the network. Ongoing assessment is also essential for ensuring continuous quality improvement across partnerships such as determining CBPR fidelity, assessing partnership synergy, and dynamics, and for quality improvement of research protocol. The implications and potential for advancing implementation science through this and similar networks are great towards advancing leadership in modeling how foundations in community service can advance to CBPR partnership formation and ultimately, health equity approaches, that are local defined and assessed.
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Affiliation(s)
- Tabia Henry Akintobi
- Morehouse School of Medicine Prevention Research Center, Atlanta, GA, United States
| | - R. Barrett
- Morehouse School of Medicine Prevention Research Center, Atlanta, GA, United States
| | - L. Hoffman
- Morehouse School of Medicine Prevention Research Center Community Coalition Board, Atlanta, GA, United States
| | - S. Scott
- Morehouse School of Medicine Prevention Research Center, Atlanta, GA, United States
| | - K. Davis
- Morehouse School of Medicine Prevention Research Center, Atlanta, GA, United States
| | - T. Jones
- Morehouse School of Medicine Prevention Research Center, Atlanta, GA, United States
| | - N. De Veauuse Brown
- Georgia State University, School of Public Health, Atlanta, GA, United States
| | - M. Fraire
- Coalition of Latino Leaders (CLILA), Dalton, GA, United States
| | - R. Fraire
- Coalition of Latino Leaders (CLILA), Dalton, GA, United States
| | - J. Garner
- Georgia State University, School of Public Health, Atlanta, GA, United States
| | - A. Gruner
- Coalition of Latino Leaders (CLILA), Dalton, GA, United States
| | - J. Hill
- Georgia State University, School of Public Health, Atlanta, GA, United States
| | - R. Meckel
- Georgia Department of Natural Resources, Atlanta, GA, United States
| | - C. Obi
- Fort Valley State University College of Agriculture, Family Sciences and Technology, Fort Valley, GA, United States
| | - P. Omunga
- Savannah State University, Political Science and Public Affairs, Savannah, GA, United States
| | - Q. Parham
- Savannah State University, Political Science and Public Affairs, Savannah, GA, United States
| | - T. Rice
- Dalton State College Allied Health and Social Work, Dalton, GA, United States
| | - O. Samples
- Fort Valley State University College of Agriculture, Family Sciences and Technology, Fort Valley, GA, United States
| | - T. Terrill
- Fort Valley State University College of Agriculture, Family Sciences and Technology, Fort Valley, GA, United States
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Govender K, Nyamaruze P, Cowden RG, Pillay Y, Bekker LG. Children and young women in eastern and southern Africa are key to meeting 2030 HIV targets: time to accelerate action. Lancet HIV 2023; 10:e343-e350. [PMID: 37149293 DOI: 10.1016/s2352-3018(23)00012-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/15/2023] [Accepted: 01/19/2023] [Indexed: 05/08/2023]
Abstract
New HIV infections and AIDS-related deaths among children and adolescent girls and young women (aged 15-24 years) in eastern and southern Africa continue to occur at unacceptably high rates. The COVID-19 pandemic has also severely undermined ongoing initiatives for HIV prevention and treatment, threatening to set the region back further in its efforts to end AIDS by 2030. Major impediments exist to attaining the UNAIDS 2025 targets among children, adolescent girls, young women, young mothers living with HIV, and young female sex workers residing in eastern and southern Africa. Each population has specific but overlapping needs with regard to diagnosis and linkage to and retention in care. Urgent action is needed to intensify and improve programmes for HIV prevention and treatment, including sexual and reproductive health services for adolescent girls and young women, HIV-positive young mothers, and young female sex workers.
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Affiliation(s)
- Kaymarlin Govender
- Health Economics and HIV and AIDS Research Division, School of Accounting, Economics and Finance, University of KwaZulu-Natal, South Africa.
| | - Patrick Nyamaruze
- Health Economics and HIV and AIDS Research Division, School of Accounting, Economics and Finance, University of KwaZulu-Natal, South Africa
| | - Richard G Cowden
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Boston, MA, USA
| | - Yogan Pillay
- Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Linda-Gail Bekker
- The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
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Participatory Action Research for Adolescent Sexual and Reproductive Health: A Scoping Review. SEXES 2022. [DOI: 10.3390/sexes3010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Youth-friendly sexual and reproductive health (SRH) interventions are essential for the health of adolescents (10–19 years). Co-designing is a participatory approach to research, allowing for collaboration with academic and non-academic stakeholders in intervention development. Participatory action research (PAR) involves stakeholders throughout the planning, action, observation, and reflection stages of research. Current knowledge indicates that co-producing SRH interventions with adolescents increases a feeling of ownership, setting the scene for intervention adoption in implementation settings. Objectives: This scoping review aims to understand the extent of adolescents’ participation in PAR steps for co-designed SRH interventions, including the barriers and facilitators in co-designing of SRH intervention, as well as its effectiveness on adolescents’ SRH outcomes. Methods: Database searching of PubMed, Medline, Embase, CINAHL, Scopus, Web of Science, Google Scholar, and organisational websites was performed, identifying 439 studies. Results: Upon screening, 30 studies (published between 2006–2021) met the inclusion criteria. The synthesis identified that adolescents were involved in the planning and action stages of the interventions, but not in the observation and reflection stages. Although the review identified the barriers and facilitators for co-designing SRF interventions, none of the included studies reported on the effectiveness of co-designing SRH interventions with adolescents; therefore, meta-analysis was not performed. Conclusions: While no specific outcome of the interventions was reported, all papers agreed that adolescent co-designing in ASRH interventions should occur at all stages to increase understanding of local perceptions and develop a successful intervention.
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Pyra M, Motley D, Bouris A. Moving toward equity: fostering transdisciplinary research between the social and behavioral sciences and implementation science to end the HIV epidemic. Curr Opin HIV AIDS 2022; 17:89-99. [PMID: 35225249 DOI: 10.1097/coh.0000000000000726] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Since the beginning of the HIV epidemic, social and behavioral scientists have developed interventions to stem the spread of the virus. The dissemination of these interventions has traditionally been a lengthy process; however, implementation science (IS) offers a route toward hastening delivery of effective interventions. A transdisciplinary approach, wherein IS informs and is informed by social and behavioral sciences (SBS) as well as community participation, offers a strategy for more efficiently moving toward health equity and ending the HIV epidemic. RECENT FINDINGS There has been considerable growth in HIV research utilizing IS theories, methods and frameworks. Many of these studies have been multi or interdisciplinary in nature, demonstrating the ways that IS and SBS can strengthen one another. We also find areas for continued progress toward transdisciplinarity. SUMMARY We review literature from 2020 to 2021, exploring the ways IS and SBS have been used in tandem to develop, evaluate and disseminate HIV interventions. We highlight the interplay between disciplines and make a case for moving toward transdisciplinarity, which would yield new, integrated frameworks that can improve prevention and treatment efforts, moving us closer to achieving health equity.
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Affiliation(s)
- Maria Pyra
- Chicago Center for HIV Elimination, Biological Sciences Division, University of Chicago
- Howard Brown Health Center
| | - Darnell Motley
- Chicago Center for HIV Elimination, Biological Sciences Division, University of Chicago
| | - Alida Bouris
- Chicago Center for HIV Elimination, Biological Sciences Division, University of Chicago
- Crown Family School of Social Work, Policy and Practice, University of Chicago, Chicago, IL, USA
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Bammann K, Recke C, Albrecht BM, Stalling I, Doerwald F. Promoting Physical Activity Among Older Adults Using Community-Based Participatory Research With an Adapted PRECEDE-PROCEED Model Approach: The AEQUIPA/OUTDOOR ACTIVE Project. Am J Health Promot 2020; 35:409-420. [PMID: 33267636 PMCID: PMC8010898 DOI: 10.1177/0890117120974876] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE The PRECEDE-PROCEED model (PPM) is a community-based participatory research (CBPR) framework for health promotion, yet the direct application of the PPM into practice is unclear. This paper describes how the PPM was adapted for the development and application of a pilot intervention study to promote outdoor physical activity (PA) in older adults (OUTDOOR ACTIVE). We illustrate the steps and adaptations we applied to put the PPM into practice and present the developed interventions. DESIGN The PPM was adapted by incorporating a socio-ecological model. This ensured the design of any resultant intervention would explicitly address multi-level determinants of physical activity. The list of possible program components to select from for the design of an intervention was also extended. SETTING Bremen, Germany. PARTICIPANTS Participants in the intervention development were 924 noninstitutionalized older adults, aged 65-75 years (response: 25.2%), living in Bremen-Hemelingen, Germany. For implementation of the intervention and to ensure sustainability, several groups of stakeholders were involved throughout the process. METHODS A mixed method design was employed (e.g., focus groups, quantitative survey) to identify determinants. A round table and participatory workshops were held to involve the target group and community stakeholders in the design of an intervention using the adapted PPM model. RESULTS A conceptual model was developed illustrating the integration of a socio-ecological model into the PPM. The model received ecological validity, as it was affirmed by community stakeholders as an appropriate method for designing a community-level PA intervention. Target goals to address PA determinants were selected by target group members. An intervention to meet the goals was developed and implemented with target group input. CONCLUSION The adapted PPM is a promising starting point for developing multi-level interventions. Steps should be taken to ensure all social groups are participating in the process and all levels of determinants are addressed.
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Affiliation(s)
- Karin Bammann
- Institute for Public Health and Nursing Sciences (IPP), 9168University of Bremen, Bremen, Germany
| | - Carina Recke
- Institute for Public Health and Nursing Sciences (IPP), 9168University of Bremen, Bremen, Germany
| | - Birte Marie Albrecht
- Institute for Public Health and Nursing Sciences (IPP), 9168University of Bremen, Bremen, Germany
| | - Imke Stalling
- Institute for Public Health and Nursing Sciences (IPP), 9168University of Bremen, Bremen, Germany
| | - Friederike Doerwald
- Institute for Public Health and Nursing Sciences (IPP), 9168University of Bremen, Bremen, Germany
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Henry Akintobi T, Jacobs T, Sabbs D, Holden K, Braithwaite R, Johnson LN, Dawes D, Hoffman L. Community Engagement of African Americans in the Era of COVID-19: Considerations, Challenges, Implications, and Recommendations for Public Health. Prev Chronic Dis 2020; 17:E83. [PMID: 32790605 PMCID: PMC7458103 DOI: 10.5888/pcd17.200255] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
African Americans, compared with all other racial/ethnic groups, are more likely to contract coronavirus disease 2019 (COVID-19), be hospitalized for it, and die of the disease. Psychosocial, sociocultural, and environmental vulnerabilities, compounded by preexisting health conditions, exacerbate this health disparity. Interconnected historical, policy, clinical, and community factors explain and underpin community-based participatory research approaches to advance the art and science of community engagement among African Americans in the COVID-19 era. In this commentary, we detail the pandemic response strategies of the Morehouse School of Medicine Prevention Research Center. We discuss the implications of these complex factors and propose recommendations for addressing them that, adopted together, will result in community and data-informed mitigation strategies. These approaches will proactively prepare for the next pandemic and advance community leadership toward health equity.
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Affiliation(s)
- Tabia Henry Akintobi
- Prevention Research Center, Morehouse School of Medicine, Atlanta, Georgia.,Department of Community Health and Preventive Medicine. Morehouse School of Medicine, 720 Westview Dr, Atlanta, GA 30310.
| | - Theresa Jacobs
- Georgia Primary Care Association, Decatur, Georgia.,Georgia Clinical and Translational Science Alliance Community Steering Board, Atlanta, Georgia
| | - Darrell Sabbs
- Georgia Clinical and Translational Science Alliance Community Steering Board, Atlanta, Georgia.,Phoebe Putney Memorial Hospital, Albany, Georgia
| | - Kisha Holden
- Satcher Health Leadership Institute, Morehouse School of Medicine, Atlanta, Georgia
| | - Ronald Braithwaite
- Prevention Research Center, Morehouse School of Medicine, Atlanta, Georgia
| | - L Neicey Johnson
- Georgia Clinical and Translational Science Alliance Community Steering Board, Atlanta, Georgia.,Visions, Incorporated, Atlanta, Georgia
| | - Daniel Dawes
- Satcher Health Leadership Institute, Morehouse School of Medicine, Atlanta, Georgia
| | - LaShawn Hoffman
- Hoffman & Associates, Atlanta, Georgia.,Morehouse School of Medicine Prevention Research Center Community Coalition Board, Atlanta, Georgia
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