National Advisory Research Resources Council Meeting

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National Advisory Research Resources Council
Meeting
Engaging Underserved Communities as Partners
Sergio Aguilar-Gaxiola, MD, PhD Professor of
Clinical Internal Medicine Director, Center for
Reducing Health Disparities Director, Community
Engagement UCD CTSC UC Davis School of
Medicine Bethesda, MD May 14, 2008
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Important Goals when Working with Underserved
Communities

• Include underserved communities in research
• Increase of URM researchers
• Increase the diversity of the workforce
• Address health disparities vigorously
• Disseminate research results widely

Source IOM Report Examining the Health
Disparities Research Plan of the National
Institutes of Health Unfinished Business, 2006
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Learning How to Reduce Disparities

• We need direct input from underserved
  communities.
• Not an easy task. Underserved communities may be
  
• Unaware of potential benefits.
• Not ready to participate in research/policy
  processes.
• Suspicious and distrustful of health services.

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• Go in search of people. Begin with what they
  know. Build on what they have
• Chinese proverb

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Community Engagement at UC Davis

• California Department of Mental Health Prevention
  and Early Intervention Needs Assessment for
  Californias Underserved Communities
• to reach out and engage communities that have
  been underserved by public health/mental health
  services and solicit their input on communities
  needs, concerns, strengths, and resources.

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Outreach Methods

• Identify specific underserved communities
• Interview key informants to focus on specific
  needs within communities
• Work with cultural brokers or community health
  representatives to develop outreach strategies
• Conduct focus groups with community members about
  health needs, community assets, etc.
• Provide feedback to communities about the impact
  of the information collected on policy and
  services.

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Participants

• 30 focus groups were conducted primarily in
  community-based locations in 10 counties across
  California
• specific ethnic groups African American, Native
  American, Native Hawaiian, and Pacific Islander,
  Asian (including Hmong, Cambodian, and Chinese),
  and Latino (Mexican and Central and South
  American)
• other underserved groups (LGBTQ, foster youth,
  young adults with juvenile justice history, and
  older adults) from rural and urban locations
• community-based providers that serve these
  communities.

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Key Findings

• mental health problems in underserved
  communities
• problems accessing mental health care and quality
  of services received
• social determinants of health such as poverty and
  discrimination
• social exclusion of underserved communities based
  on current and historical experiences with
  government agencies

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Community Assets

• Individual and community resiliency
• Traditional and spiritual healers
• Religious leaders
• Informal and formal support networks (family and
  friendships, reconnection to native cultures,
  role models and mentors)
• Community-based organizations
• Social service/Health programs

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Project Outcomes

• Reports
• Building Partnerships Key Considerations when
  Engaging Underserved Communities Under the MHSA
• Engaging the Underserved Personal Accounts of
  Communities on Mental Health Needs and Prevention
  and Early Intervention
• Dissemination of findings
• Ongoing partnerships with community agencies and
  underserved groups

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Building Partnerships Key Considerations When
Engaging Underserved Communities Under the MHSA

• Purpose of the Report
• Introduce guiding principles of community
  engagement with underserved communities
• Outline some guiding questions to assist counties
  in their community outreach and stakeholder
  processes
• Suggest specific strategies that California
  Counties Mental Health Departments might employ
  to nurture sustained partnerships with
  communities.

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Recommended Strategies

• Identifying underserved communities within your
  county
• Establishing bi-directional relationships
• Finding community representatives
• Facilitating meetings and exchanging information
• Engaging community representatives and maximizing
  the opportunity for developing trust in
  communication
• Using the information once it is collected
• Making sure the voices are heard and integrated
  into programmatic plans
• Building ongoing partnerships

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Examples of other Community Engaged Research at
UC Davis

• National Demonstration of Early Detection,
  Intervention and Prevention in Psychosis in
  Adolescents and Young Adults (Carter, PI)
• Reducing Disparities in Depression Care for
  Ethnically Diverse Older Men (Hinton, PI)
• Community Partnerships with Pediatricians for
  Healthy Children (Pan, PI)
• Transforming Education and Community Health
  (TEACH) Program (Henderson, PI)
• Community Lactation Assistance Project (Chantry,
  PI)
• National Faith-Based and National Community
  Cardiovascular Disease Prevention Programs for
  High-Risk Women (Villablanca, PI)
• Epidemiology of Dementia in an Urban Community
  (DeCarli, PI)

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Community-Based Research
Opportunities for Inclusion
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Source Taylor, NCRR, 2007