Now showing items 1-20 of 167

    • Strategies for Reducing Adverse Outcomes for Criminal Justice-Involved Populations

      Pivovarova, Ekaterina; Ferguson, Warren J.; Dupuis, Meaghan; Nickl, Dyana (2020-11-16)
      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.
    • Developing a Strategic Plan for Community Based Research in Springfield

      Pirraglia, Paul A.; Balder, Andrew; Torres, Cristina Huebner; Lindenauer, Peter K.; Robinson, Frank; Szegda, Kathleen L. (2020-10-29)
      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.
    • A criminal justice-engaged research collaborative: Findings and lessons learned from Western Massachusetts

      Evans, Elizabeth; Hayes, Ed (2020-10-14)
      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.
    • Presentation Descriptions: Community Engagement and Research Symposium Webinar Series 2020

      Community Engagement and Research Symposium (2020-09-22)
      Descriptions of all the presentations scheduled for the Community Engagement and Research Symposium Webinar Series 2020 from the UMass Center for Clinical and Translational Science.
    • Speaker Biographies: Community Engagement and Research Symposium Webinar Series 2020

      Community Engagement and Research Symposium (2020-09-22)
      Biographies of all the speakers for the Community Engagement and Research Symposium Webinar Series 2020 from the UMass Center for Clinical and Translational Science.
    • The Opioid-related Syndemic in Rural Northern New England: Findings from the DISCERNNE Study

      Friedmann, Peter D. (2020-09-22)
      This presentation will discuss the risk and resource environment surrounding the syndemic of opioid use disorder, HCV and overdose in rural communities in the northern New England, and opportunities to prevent Scott County-like HIV outbreaks. These findings are from the Drug Injector Surveillance and Care Enhancement in Rural Northern New England (DISCERNNE) study.
    • Engaging Emergency Department Patients in the Creation of a Shared Decision-­Making Tool Regarding CT Scanning in Kidney Stones: Challenges to Traditional Stakeholder Engagement

      Schoenfeld, Elizabeth M.; Houghton, Connor J.; Patel, Pooja P.; Merwin, Leonora; Mazor, Kathleen M.; Hess, Erik; Scales, Charles; Breslin, Maggie; Lindenauer, Peter K. (2019-03-22)
      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.
    • Addressing Bias in LGBTQIA+ Undergraduate Medical Education: An Innovative and Community Based Approach to Curriculum Reform

      Austin, John-Marc; Foscolos, Anthony; Bennet, Nancy; Allison, Jeroan J.; Trobaugh, Jules; Austin, John-Marc; Foscolos, Anthony; Bennet, Nancy; Allison, Jeroan J.; Trobaugh, Jules (2019-03-22)
      Background: Individuals who are LGBTQIA+ or gender nonconforming have specific health needs and face health disparities that are exacerbated by a lack of training and cultural sensitivity among health professionals. This study was initiated by a second year University of Massachusetts School of Medicine student in response to the lack of LGBTQIA+ health content in the first year Doctoring & Clinical Skills (DCS1) course. The DCS1 session on collecting a sexual history was selected as the primary focus for revision. Community-Based Participatory Research, because of its emphasis on joining with a community of interest as full and equal partners in all phases of the research process, served as an ideal model for the novel application to curriculum development to address this gap in training in undergraduate medical education. Methods: A sample of 13 LGBTQIA+ community members from Worcester were recruited to form a curriculum advisory committee. The committee convened for two focus-group style meetings where they reviewed the curriculum and had the opportunity to provide their feedback, which was used to rewrite the session. Additionally, the community members had the opportunity to participate in a storytelling video where they discussed their experiences in healthcare as LGBTQIA+ patients. A pre-test post-test design was used to survey the UMMS SOM students in order to evaluate the new version of the DCS1 session. Results: The percentage of M1 students reporting they had the necessary skills to treat LGBTQIA+ patients increased from pre-session to post-session (26.2% (n=130), 63.2% (n=76), p = < 0.001). Compared to current M2 students who completed the course last year (n=65), more MS1 students (n=76) rated the overall quality of the DCS1 session as excellent or good (23.1%, 77.6%, p= < 0.0001. Conclusion: CBPR serves as an efficacious model for the creation of curriculum inclusive of LGBTQIA+ health.
    • Community Engaged Research Academy at the University of Massachusetts Dartmouth: Reflections, Visions, and Plans

      Robinson, Robin A.; Hensel, Mary (2019-03-22)
      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.
    • Researcher Trauma in Dangerous Places: Navigating Peril in Physical and Psychological Milieux

      Robinson, Robin A.; Markowitz, Ariana (2019-03-22)
      Many community-engaged research studies in health and allied health conclude that challenges to individual and public health are mediated by trauma in any of its forms. Researchers who investigate such challenges - e.g., interpersonal violence, sexual abuses and assaults, addictions - may well acquire a traumagenic burden from their research partners, subjects and/or the community milieux in which they conduct their studies, resulting in acute trauma and/or vicarious traumatization (VT). This poster summarizes the content and interactions of a recent workshop on researcher trauma that explored psychodynamics of VT in a translational approach that shows: 1) implications for principal investigators and research staff; 2) education they need about researcher-respondent trauma transmission; and 3) supports that can help to mitigate researcher trauma. We present an interdisciplinary theoretical model to consider how burdens of VT can impact researchers' work, health, and personal lives. How do researchers perceive their work and provisions of care and healing? What are their experiences of the work, and the harm it may promulgate? While VT has been most thoroughly studied amongst psychotherapists who provide individual treatment, a few studies show that VT symptoms and chronicity appear to be quite similar amongst others who work in trauma-saturated environments. Indeed, this workshop advanced our understanding of this and other forms of secondary trauma, and signposted important lessons for the education and practice of researchers engaged, and immersed, in community-engaged health and allied health studies, broadly defined.
    • Infant Mortality: A Community Engagement Model

      Shields, Sara G.; Violette, Cathy; Hydery, Tasmina; Alker, Heather J. (2019-03-22)
      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).
    • Stakeholder Engagement through Participatory Action Research at iSPARC

      Costa, Amanda; Anderson, Melissa L.; Logan, Deirdre G.; Larkin, Celine (2019-03-22)
      The Implementation Science & Practice-based Advances Research Center (iSPARC) is a new DMH-funded collaborative effort between the former Systems and Psychosocial Advances Research Center, Quantitative Health Sciences and Boston University's Center for Psychiatric Rehabilitation. With 52 core and affiliate investigators, iSPARC features five interacting programs: Stakeholder Engagement, Public Mental Health and Implementation Research, Technical Assistance and Consultation, Workforce Development, and External Funding. The mission of the Stakeholder Engagement Program is to lead the mental health research community and beyond in working in partnership with individuals with lived mental health experience, their families, and the agencies that serve them. This program intersects with several of iSPARC's activities. It includes three active advisory groups with more than 20 members representing youth, individuals with lived mental health experience, and family members. These advisory groups adopt a participatory action research (PAR) approach and seek to engage community stakeholders at every stage of research, from development through enrollment and dissemination. Starting in 2018, the Stakeholder Program will seek to increase engagement and diversity through several additional initiatives. A new community provider advisory group is currently being developed and the Program is working to assess and assure diversity across all advisory groups. The Program will use a structured assessment tool and continuous quality improvement approach to measure and facilitate participatory action research across all iSPARC's projects. The Program will develop and disseminate products to assist other organizations in initiating and maintaining stakeholder engagement. The proposed poster will summarize these activities and include examples of products created.
    • Next Steps from a School Gardening Partnership Conference (AGES: Academic Gardening to Enrich our Students): Expanding the Impact of School Gardens Through Higher Education, K-12 School and Community Coalitions

      Assefa, Martha; Barnosky, Pat; Beaulieu, Michelle; Borg, Amy; Burns, Casey; Cawley, Marguerite; De Jordy, Jennifer; Harvey, Daina; Hopkins, Kelsey; Hunt, Sue; et al. (2019-03-22)
      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.
    • Poster Session: 2019 Community Engagement and Research Symposium

      Community Engagement and Research Symposium (2019-03-22)
      Abstracts of posters presented at the 8th annual Community Engagement and Research Symposium, held Friday, March 22, 2019, at the University of Massachusetts Medical School, Worcester, MA. Some presenters have made the full text of their posters available; these posters can be viewed in the symposium's Poster Archive.
    • Communicative Competence for Researchers working with LGBTQ Communities

      Pagano-Therrien, Jesica; Chiriboga, German; Simpson, Shauna M.; Calista, Joanne L.; Marien, Kendra (2019-03-22)
      The ethical principles of respect and justice oblige the use of culturally sensitive approaches when engaging participants in research, however cultural competence training is lacking for researchers who work with LGBTQ populations. The purpose of this study was to explore how researchers can create a welcoming research environment for LGBTQ research participants in the context of historical distrust of medical research as a barrier to research participation among minority populations. Grounded by a framework of communicative competence, this study explored elements of preferred communication during recruitment and informed consent for research involving LGBTQ participants. Grammatical, sociolinguistic, strategic and discourse competence domains aided exploration of the preferences held by participants in LGBTQ sub-groups, as well as the perceived barriers to research. Thirty-six participants, who self-identified as part of the LGBTQ community and were recruited through our community partner, the Center for Health Impact, took part in either focus groups or individual interviews. Preliminary analysis reveals community engagement and building trust are key, particularly in an academic medical center where a patient's clinical experiences may impact their willingness to become a research participant. Participants offered insight into each competence domain, covering: terminology to promote inclusivity, body language to avoid, reducing stigma by being up front and feedback on crafting a more LGBTQ-friendly basic demography questionnaire. These findings will aid in the refinement of an LGBTQ-focused version of our Simulation-based Community-engaged Research Intervention for Informed Consent Protocol Testing and Training (SCRIIPTT) to build communicative competence among clinical researchers.
    • Religiosity and Patient Engagement in their Healthcare Among Hospital Survivors of an Acute Coronary Syndrome

      Abu, Hawa Ozien; McManus, David D.; Kiefe, Catarina I.; Goldberg, Robert J. (2019-03-22)
      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.
    • Keynote and Breakout Session Descriptions: 2019 Community Engagement and Research Symposium

      Community Engagement and Research Symposium (2019-03-22)
      Descriptions of Keynote and Breakout Sessions for the 8th annual Community Engagement and Research Symposium, held Friday, March 22, 2019, at the University of Massachusetts Medical School, Worcester, MA.
    • Speaker Biographies: 2019 Community Engagement and Research Symposium

      Community Engagement and Research Symposium (2019-03-22)
      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.
    • Healthy Bodegas: Bringing the Community Together to Eat Healthier

      Amweg, Laura N.; Hayman, Laura (2019-03-22)
      Background: Colorectal cancer (CRC) incidence rates have remained stable in the United States (U.S.) the past 30 years, however, there has been a significant increase in CRC incidence among the millennial generation. The association between the Western diet and CRC, and racial and gender disparities in CRC is well-established. Public health and community efforts are needed to address barriers to healthy nutrition in this population. One identified barrier is food access in lower-income communities, sometimes called "food deserts." Local stores, or "bodegas," have potential to increase access to healthy affordable foods and contribute to risk reduction for the development of chronic diseases such as CRC. Objectives: Assess the effectiveness of the Healthy Bodega Initiative (HBI), designed to increase availability and promotion of healthy foods; engage community participation by mobilizing community-based organizations and local store owners to participate in the initiative; and, facilitate positive dietary changes. Methods: Guided by the Conceptual Logic Model of community-based participatory research, this study will evaluate the intervention through in-store observations and pre- and post-intervention surveys of participating store owners, in addition to surveys with customers at a subset of stores. Major findings: This study is in planning phases; no findings are available. Conclusions and implications: Prospective longitudinal research with long-term follow-up should be conducted to explore the social determinants affecting low-income populations, changes that result after improved access to healthy foods, and long-term disease outcomes.
    • Agenda: 2019 Community Engagement and Research Symposium

      Community Engagement and Research Symposium (2019-03-22)
      Agenda for the 8th annual Community Engagement and Research Symposium, held Friday, March 22, 2019 at the University of Massachusetts Medical School, Worcester, MA.