Institutionalizing Community-engaged Translational Science in an Academic Institution: A Community Stakeholder-Driven Process.

BACKGROUND: Although studies have described the power imbalance in academic-community partnerships, little has been published describing how community-based participatory research-informed practitioners can change academic institutions to promote more effective community-engaged research. OBJECTIVES: This paper describes a university-funded community-based participatory project in which academic researchers and their community partners worked together to articulate, develop and advocate for institutionalizing best practices for equitable partnerships throughout the university. METHODS: Findings derive from a collaborative ethnographic process evaluation. RESULTS: The study describes the integral steps proposed to promote equitable community-university research collaboration, the process by which these principles and best practice recommendations were developed, and the institutional change outcomes of this process. CONCLUSIONS: When universities make even small investments toward promoting and nurturing community-engaged research, the quality of the science can be enhanced to advance health equity and community-university relationships can improve, particularly if based on trust, mutual respect, and openness to accomplish a shared vision.

Exclusionary School Discipline and School Achievement for Middle and High School Students, by Race and Ethnicity.

Importance: There are racial and ethnic inequities in exclusionary school discipline (ESD) (ie, a disciplinary action that removes students from their classroom or school environment, eg, referrals, suspensions, and/or expulsions) practices in the US. Exclusionary school discipline has been associated with negative education, health, and criminal justice outcomes. Objectives: To investigate whether experiencing an ESD event was associated with decreased grade point average (GPA) and whether minoritized students (eg, Black or Latine [description used in database]) are disproportionately affected compared with White students. Design, Setting, and Participants: In a cohort study using retrospective administrative longitudinal data of children in the 6th to 10th grades (August 18, 2014, to May 26, 2017) in a large, single urban school district in California, linear mixed models were applied to compare the timing of the first exclusionary event and the average change in GPA and evaluate the relative variation among minoritized students experiencing an exclusionary event. Data analysis was conducted from August 18, 2018, to August 21, 2023. Exposure: Year at which students experienced first ESD events over the study period. Main Outcomes and Measures: The primary outcome of interest was change in average grade point average (GPA); students' GPA averaged across courses was averaged across each year. Results: Of the 16 849 students (8756 [52.0%] male), 21.4% experienced at least 1 ESD event. The mean (SD) age was 14.3 (1.6) years, and 7.5% identified as Black, 25.6% Latine, and 10.0% White. Black and Latine students experienced exclusionary events at nearly 10 and 3 times more than White students (mean [SD]: Black, 6.69 [12.80] events; Latine, 2.01 [6.18] events; White, 0.71 [4.46] events; P < .001). When controlling for gender, maternal educational level, race and ethnicity, and school year, having experienced an ESD event in the first year was associated with an average decrease in GPA by 0.88 (95% CI, -0.91 to -0.84) points compared with no ESD events; experiencing ESD events also had significant differences in the second (-0.63 [95% CI, -0.67 to -0.59]) and third (-0.52 [95% CI, -0.57 to -0.47]) years. Black and Latine race and ethnicity was associated with the greatest decrease in GPA compared with White students (Black, -0.56 [95% CI, -0.61 to -0.51]; Latine, -0.51 [95% CI, -0.54 to -0.47]; P < .001). Conclusion and Relevance: This study observed racial and ethnic inequities in ESD prevalence and its association with educational attainment. The findings suggest that it may be beneficial for pediatricians and other health care professionals to screen for exclusion, as experiencing ESD events may affect health across the life course. In addition, it may be useful to categorize ESD events as an adverse childhood experience and abolish the practice from schools as a disciplinary measure.

COVID-19 Vaccination Perceptions Among Young Adults of Color in the San Francisco Bay Area.

Background: COVID-19 vaccination rates among U.S. young adults, particularly in communities of color, remain lower than other age groups. We conducted a qualitative, community-based participatory study to explore beliefs and attitudes about COVID-19 vaccines among young adults in Black/African American, Latinx, and Asian American or Pacific Islander (AAPI) communities in the San Francisco Bay Area. Methods: We conducted six focus groups between June and August 2021. Participants were recruited by partnering with community-based organizations in the San Francisco Bay Area. Focus groups included Black/African American (N=13), Latinx (N=20), and AAPI (N=12) participants between 18 and 30 years of age. Emerging themes were identified using a modified Grounded Theory approach. Results: Prominent themes among all three racial-ethnic groups included mistrust in medical and government institutions, strong conviction about self-agency in health decision-making, and exposure to a thicket of contradictory information and misinformation in social media. Social benefit and a sense of familial and societal responsibility were often mentioned as reasons to get vaccinated. Young adult mistrust had a generational flavor fueled by anger about increasing inequity, the profit-orientation of pharmaceutical companies and health institutions, society's failure to rectify injustice, and pessimism about life prospects. Conclusion: Factors influencing vaccine readiness among Black/African American, Latinx, and AAPI young adults have a distinct generational and life-course texture. Outreach efforts should appeal to young adults' interest in family and social responsibility and the social benefits of vaccination, while being cognizant of the friction mandates pose for young adults' sense of self-agency. Efforts will be most effective coming from trusted messengers with a proven commitment to communities of color and health equity.

COVID-19 vaccination readiness among multiple racial and ethnic groups in the San Francisco Bay Area: A qualitative analysis.

BACKGROUND: COVID-19 vaccination rates are lower among historically marginalized populations, including Black/African American and Latinx populations, threatening to contribute to already high COVID-19 morbidity and mortality disparities for these groups. We conducted a community-based participatory research study using qualitative methods to explore knowledge and beliefs about COVID-19 vaccination among Black/African American, Latinx, and Chinese American residents of the San Francisco Bay Area and assess their views on vaccination outreach and delivery strategies. METHODS AND FINDINGS: Data were collected from January 14, 2021, to February 24, 2021, with adult residents (N = 109 [Female: N = 76; 70%]) in San Francisco. Focus groups (N = 10) and in-depth interviews (N = 25) were conducted among Black/African Americans (N = 35), Latinx (N = 40), and Chinese Americans (n = 34) in English, Spanish, Cantonese, or Mandarin. Themes were identified using grounded field theory, and included misinformation, mistrust of government and health institutions, and linguistic and other barriers to vaccine access. All three racial/ethnic groups had experiences with vaccine misinformation and information overload. Many African American and Latinx participants cited structural and interpersonal racism, and anti-immigrant discrimination, as factors reducing their trust in government and public health disseminated information and their willingness to be vaccinated. Participants expressed trust in community-based organizations, including faith-based organizations and community-run clinics. Participants often experienced barriers to vaccine access, such as transportation to drive-in sites, with Latinx and Chinese American groups also frequently citing language barriers. CONCLUSIONS: Vaccine outreach strategies must acknowledge how longstanding systemic, institutional, and structural racism contributes to mistrust in government and health institutions and engage with and support trusted messengers from the community to eliminate cultural, linguistic, and other barriers to vaccine access.