There is a unique opportunity to improve the health of the residents of Springfield. In combination, the Baystate affiliated Community Health Centers (CHC’s) and Caring Health Center—a Federally Qualified Health Center (FQHC)—care for a large percentage of the total population of Springfield. Baystate’s and Caring’s CHC’s have partnered through the BeHealthy ACO to provide much of this care. Because a large and concentrated population with substantive challenges is served, focus could be downstream (i.e. healthcare oriented) or upstream (i.e. policy, social, political) or some combination thereof. Many faculty, staff, and trainees in these systems in general and in the CHC’s specifically are interested and have the content knowledge regarding social determinates of health and health care delivery but would benefit from a coordinated system and mentoring structure to make a more meaningful impact. Creating a community based infrastructure for alignment and coordination among key stakeholders (e.g healthcare delivery systems, academic institutions, community based organizations, government entities, and others) will help assure common goals, efforts, and sustainability are maximized. The purpose of this session is to brainstorm how to further leverage existing and potential partnerships towards research that emanates from needs of the community and addresses these needs in a systematic, rigorous, and sustainable manner. The ideas generated in this session will serve to guide the development of a strategic plan for community based research in Springfield. An open panel discussion of current state (stakeholders, resources, ongoing efforts) and early steps to begin developing a strategic plan will be followed by an open forum to brainstorm for next steps. The brainstorming topics include, but are not limited to: potential avenues of inquiry, model for engagement by CHC faculty and trainees, establishing and/or enhancing collaborations between local institutional stakeholders, assuring input and engagement of the community, and grant procurement strategies.

Background: Residents of Springfield, Massachusetts experience disproportionately poorer health compared to the rest of the state. Springfield's community of color population (39.5% Hispanic/Latino; 21.6% Black; 2% Asian) experiences high rates of poverty, unemployment, and low educational attainment leading to large health disparities. Objective: The overall objective of the PCORI-funded Project ACCCES is to develop capacity to conduct community engaged research (CEnR) in Springfield that is based on patient and community needs, can be more easily translated, and improves community health. This engagement framework will be applied to development of patient-centered comparative effectiveness research proposals. Methods: In the project's first phase, we conducted focus groups with patients, community organization leaders, and physicians to better understand the most pressing health needs of the community, past research experiences, and important considerations for building community-academic partnerships. We then convened a multi-stakeholder Advisory Board to inform all Project ACCCES activities. In the second phase, we developed and implemented two half-day workshops to give participants the knowledge and tools to conduct CEnR and to begin to build community-academic partnerships in the areas of perinatal/maternal-child health, mental health/substance use, chronic disease/nutrition, and respiratory health. The third phase is currently underway and is focused on convening research partnership action groups that will seek to address Springfield residents' health needs through culturally appropriate interventions. The final phases will entail dissemination of both the process used to develop new collaborations to conduct CEnR in an underserved community and the workshop template, and development of structures to foster sustainability of partnerships.

AIMS: Hispanic women are at increased risk of gestational diabetes mellitus (GDM) as compared to non-Hispanic white women. While smoking has been associated with increased risk of type 2 diabetes, studies of smoking and GDM are sparse and conflicting. Therefore, we evaluated the relationship between cigarette smoking and GDM in Hispanic women. METHODS: We conducted a pooled analysis of two Hispanic datasets based in Massachusetts: the UMass Medical Health Care dataset and the Proyecto Buena Salud dataset. A total of 3029 Hispanic prenatal care patients with singleton gestations were included. Cigarette smoking prior to and during pregnancy was collected via self-report. Diagnosis of GDM was abstracted from medical records and confirmed by study obstetricians. RESULTS: One-fifth of participants (20.4%) reported smoking prior to pregnancy, and 11.0% reported smoking in pregnancy. A total of 143 women (4.7%) were diagnosed with GDM. We did not observe an association between pre-pregnancy cigarette smoking and odds of GDM (multivariable OR=0.77, 95% CI 0.47, 1.25). In contrast, smoking during pregnancy was associated with a 54% reduction in odds of GDM (OR=0.46, 95% CI 0.22, 0.95). However, this association was no longer statistically significant after adjustment for age, parity, and study site (OR=0.47, 95% CI 0.23, 1.00). CONCLUSIONS: In this population of Hispanic pregnant women, we did not observe statistically significant associations between pre-pregnancy smoking and odds of GDM. A reduction in odds of GDM among those who smoked during pregnancy was no longer apparent after adjustment for important diabetes risk factors.