In the United States, we spend $81 billion taxpayer dollars annually on the costs of incarceration according to the Bureau of Justice Statistics, but including other costs may increase that estimate to $181 billion. Data from Worcester suggest that the cost of incarcerating individuals in the Piedmont neighborhood of Worcester eclipse the entire annual budget of the Division of Public Health in Worcester. With a hard line on petty crime, lack of substance use disorder treatment in jail and prison, concentrated policing and racial profiling in low income communities of color and poor reentry support services, mass incarceration is destined to continue. The opioid crisis in Massachusetts has affirmed that individuals with a history of incarceration and opioid use disorder are at greatest risk for nonfatal and fatal overdose. Furthermore, homelessness and serious mental illness increase that risk dramatically. In turn, the Governor and Secretary of Health and Human Services in concert with the Massachusetts Medicaid Program, the Department of Public Health and the Trial courts have undertaken a multi-pronged strategy to mitigate those risks. This panel will present three interventions to improve those outcomes. Three panelists will describe and present findings on three studies completed and in process to reduce the health risks for justice-involved persons in Massachusetts. Dr. Ferguson will describe an implementation science study of four correctional systems which embarked on medication assisted therapies for opioid use disorder which has helped to inform current mixed methods research to study a pilot of medication assisted treatment in seven Massachusetts jails; Dr. Pivovarova will describe her study of health status for individuals participating in Drug Court, a diversionary program that mandates substance use disorder treatment in the community for individuals arrested for drug related offenses; and Ms. Dupuis will describe the MassHealth funded Behavioral Health Justice Involved project to provide returning citizens with navigators to assist them in linking to community-based treatment and to address social determinants of health such as housing and employment. During the presentations, attendees will be asked to formulate questions or reflections for discussion. These will be collected and prioritized by the moderator of the session for further discussion.

The Medication Assisted Treatment (MAT) and Re-entry Initiative was one of several projects funded in 2018 by the Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Services Administration (SAMHSA) to expand capacity to deliver medications to treat opioid use disorder (MOUD). Nationwide, the Franklin County Sheriff’s Office (FCSO) was the only criminal justice institution to be awarded a grant. The project created a new criminal justice-engaged evaluation and research collaborative in Western Massachusetts that now involves the University of Massachusetts Amherst (UMass), the Hampshire County House of Corrections, and several community-based providers of health and social services. Building on this foundation, the collaborative is now a key component of several NIH-funded research projects. Presenters will provide an overview of the SAMHSA-funded project, report on findings, and present lessons learned from the first year of implementation. This session will also provide guidance on how to launch, sustain, and grow criminal justice-engaged evaluation and research collaboratives.

Biographies of all the speakers for the Community Engagement and Research Symposium Webinar Series 2020 from the UMass Center for Clinical and Translational Science.

Background: Optimum management after an Acute Coronary Syndrome (ACS) requires considerable patient engagement/activation. Religious practices permeate people's lives and may influence engagement in their healthcare. Little is known about the relationship between religiosity and patient activation in hospital survivors of an ACS. Methods: We recruited patients hospitalized for an ACS at six medical centers in Central Massachusetts and Georgia (2011-2013). Participants self-reported three measures of religiosity - strength and comfort from religion, making petition prayers, and awareness of intercessory prayers for health. Patient activation was assessed using the 6-item Patient Activation Measure (PAM-6). We categorized participants as either having low (levels 1 and 2) or high (levels 3 and 4) activation in examining the association between religiosity and patient activation while adjusting for sociodemographic, psychosocial, and clinical variables. Results: Patients (n=2,067) were on average, 61 years old, 34% were women, and 81% were non-Hispanic White. Approximately 85% reported deriving strength and comfort from religion, two-thirds prayed for their health, and 89% received intercessions for their health. Overall, 57.5% had low activation. Reports of a great deal (aOR: 2.02; 95% CI: 1.44-2.84), and little/some (aOR: 1.45; 95% CI: 1.07-1.98) strength and comfort from religion were associated with high activation respectively, as was the receipt of intercessions (aOR: 1.48; 95% CI: 1.07-2.05). Praying for one's health was associated with low activation (aOR: 0.78; 95% CI: 0.61-0.99). Conclusion and Clinical Practice Implications: Patient activation was associated with religiosity, suggesting that healthcare providers may use this knowledge to enhance patient engagement in their care.

Biographies of all the speakers at the 8th annual Community Engagement and Research Symposium, held Friday, March 22, 2019 at the University of Massachusetts Medical School, Worcester, MA.

Research suggests that there are many benefits of school gardens for students, teachers and community. Not only can they help children eat more fruits and vegetables and be more physically active, they can help to create learning opportunities and increase teacher satisfaction. In Worcester, Massachusetts, a city with high poverty and food insecurity rates, a broad community coalition formed to brainstorm novel implementation models to improve the use and sustainability of school gardens. The group decided to foster new collaborations among higher education, K-12 schools and community organizations. The innovative idea was that higher education could meet their need for real-world application of various curricula, such as education, business, urban agriculture, marketing, horticulture, sustainable development, and engineering, through the implementation of school gardens. The resulting conference called AGES (Academic Gardening to Enrich our Students) united school teachers, professors, administration and community partners. The sessions featured information on: 1) successful models of higher education-K12 school garden partnerships, 2) building school gardening into the curriculum (psychosocial skills, STEM, environmental sciences, project-based learning, nutrition, healthy lifestyles), 3) research evidence on the benefits of school gardens, 4) strategies for building community through gardening, and 5) garden planning and maintenance. US Representative Jim McGovern was the keynote speaker, highlighting the importance of this collaborative work.

The Worcester Healthy Baby Collaborative (WHBC) consists of a group of volunteers from organizations with an interest in reducing infant mortality in Worcester, including representatives from UMass Memorial, Family Health Center of Worcester, the Massachusetts Department of Public Health, and the March of Dimes. The organization originally began as the Worcester Infant Mortality Reduction Task Force in the mid-1990s in order to examine trends in Worcester's infant mortality rate (IMR). This work has continued, evolving in response to changes in both the needs and desires of the local community, and has come to encompass several intervention and reduction strategies over the past two decades. Ultimately, in pursuit of the goal of IM reduction, the WHBC's mission is to improve health outcomes for infants and their families by engaging and working collaboratively with the community to reduce health inequities, so that Worcester’s infant mortality rate is decreased. Our work thus seeks to make a wide variety of improvements in the “social determinants of health.” The WHBC collects and examines data around IM by conducting reviews of the medical charts surrounding an infant death, and tackles specific projects addressing these social determinants of health. Although overall IMR has decreased from 8-10 to about 5, ongoing disparities remain with Hispanic IMR higher than our overall IMR at a time when state and national trends do not show this higher Hispanic IMR. Presenters will describe their progress in the last decade in addressing the racial and ethnic disparities in Worcester using a community-engagement model. Presenters will review their work with the local Ghanaian community that led to the Nhyira Ba project, with lessons learned from that project informing 2016 work with the Latino community and from their work to develop Worcester's Baby Box initiative. Throughout this work, real time chart audits by volunteer physicians have enabled the group to remain ahead of the state's data about local IMR. This panel discussion will include the current preventive medicine faculty member who does the chart reviews discussing her work with local college students using in-depth Geographic Information Systems (GIS) to analyze data; the current family medicine faculty member who chairs the WHBC and the current nurse member who is recent past vice-chair to review the history and future goals; the current Commonwealth Medicine member who leads the Baby Box community project funded by the UMass Remillard Foundation, with multidisciplinary groups of medical and nursing students working in the community. Presenters will survey the audience before their presentation on their knowledge of WHBC work and survey the audience during Q&A for ways to further engage with the community. Objectives of this breakout session include: 1) Explain concepts of community-oriented approach to addressing infant mortality disparities, using Worcester as an example, 2) Summarize three projects that use these concepts currently in Worcester (chart audit and academic collaboration, Baby Box program, ongoing WHBC work).

The Community Engaged Research (CER) Academy at UMass Dartmouth began in 2015 to develop and support dynamic research efforts, in partnerships with community organizations, agencies, and public services, with the goal of seeking external funding to support substantial CER projects. Its primary aim is to engage research-active faculty who are working, specifically, with community partners in the UMass Dartmouth catchment area. Further, the CER Academy actively seeks to build a community of like-minded scholars in interactive, supportive, and didactic processes. The coordinator of the CER Initiative facilitates modules, with activities designed to mentor CER Academy scholars during and after their participation in the structured curriculum of the CER Academy. Beyond the interactive curriculum with a cohort of CER Scholars, ongoing mentorship continues for as long as CER Scholars want/need support to develop durable community partnerships. Plans going forward include 1) working with community-based professionals in UMass Dartmouth catchment area agencies and organizations to participate in the structured CER Academy with their respective CER Scholars; and 2) to incentivize and recruit, and then to educate and engage, undergraduate students to develop skills and experience in community engaged research in an academic CER Student-Scholar Partnership Program. This poster articulates the development, curriculum, work, and plans of the UMass Dartmouth Community Engaged Research Academy, to disseminate our experience and vision, and to invite collaborations with potential community partners and CER colleagues across the UMass System.

Background: Every year approximately 2 million patients are seen in US EDs for suspected renal colic, and the majority receive CT scans. The objective of our study was to develop a stakeholder-informed conversation aid to help clinicians use SDM regarding CT scanning in patients with suspected renal colic. Methods: Using a published decision aid development framework, and under the direction of a multi-disciplinary Steering Committee, we engaged a diverse set of stakeholders via qualitative methods. EM clinicians, urologists, radiologists, researchers, and emergency department patients participated in focus groups and semi-structured interviews. All groups were recorded, transcribed, and analyzed in an iterative process by a four-person coding team. Emergent themes were identified and used to develop a decision aid which was iteratively refined. Results: A total of 8 interviews and 7 focus groups were conducted with 36 stakeholders (including local ED patients) The following three themes emerged: 1. Patient participants reported a desire to be involved in this decision and wanted more information regarding risks and benefits of CT scans. 2. Clinicians were comfortable diagnosing kidney stones without a CT scan, however, some felt that clinical uncertainty was a barrier to SDM. 3. All stakeholders identified strategies to facilitate this conversation such as check-lists and visual aids. Conclusion: Using stakeholder input, we developed a communication tool to facilitate an SDM conversation around the use of CT in suspected renal colic. Further testing will assess whether this tool can safely improve patient engagement and decrease low yield CT usage.

The Tulumbe! Partnership was created with funds from the Pipeline to Proposal (P2P) awards established by the Patient-Centered Outcomes Research Institute (PCORI). The P2P awards were designed to develop partnerships; promote patient engagement; and build patient-led research proposals. Tulumbe! has spent the last two years working to engage the African immigrant community in addressing issues related to HIV, specifically focusing on identifying research topics and questions 3 that are important to community members. There are currently 10 core members representing health providers, African immigrants living with HIV, advocates, researchers and community leaders. Tulumbe! has utilized various approaches to engage African immigrants in research and advocacy, including (1) ensuring African immigrants are on the Tulumbe! core partnership support (2) inviting them to attend various HIV specific events (3) convene community forums (4) surveys and (5) listserv. As a result of our efforts, we received additional funding from the Getting to Zero Coalition to implement a photovoice project based on the communities’ priority to address HIV stigma. Tulumbe! will discuss how they have engaged community partners in different stages of the research projects. In this breakout session, Tulumbe! will discuss the challenges and successes of engaging African immigrants by focusing on the engagement opportunities implemented as part of the Tulumbe! Project, as well as highlight the challenges and successes in developing a diverse partnership. The 6-topics that compose the research agenda and a photovoice project will be presented.