Community-Engaged Research: Common Themes and Needs Identified by Investigators and Research Teams at an Emerging Academic Learning Health System.

Community-engaged research (CEnR) has emerged within public health and medicine as an approach to research designed to increase health equity, reduce health disparities, and improve community and population health. We sought to understand how CEnR has been conducted and to identify needs to support CEnR within an emerging academic learning health system (aLHS). We conducted individual semi-structured interviews with investigators experienced in CEnR at an emerging aLHS in the southeastern United States. Eighteen investigators (16 faculty and 2 research associates) were identified, provided consent, and completed interviews. Half of participants were women; 61% were full professors of varied academic backgrounds and departments. Interviews were audio-recorded, transcribed, coded, and analyzed using constant comparison, an approach to grounded theory. Twenty themes emerged that were categorized into six domains: Conceptualization and Purpose, Value and Investment, Community-Academic Partnerships, Sustainability, Facilitators, and Challenges. Results also identified eight emerging needs necessary to enhance CEnR within aLHSs. The results provide insights into how CEnR approaches can be harnessed within aLHSs to build and nurture community-academic partnerships, inform research and institutional priorities, and improve community and population health. Findings can be used to guide the incorporation of CEnR within aLHSs.

Building bridges between a community and an academic medical center via community tours.

Academic medical centers (AMCs) face challenges in conducting research among traditionally marginalized communities due to long-standing community mistrust. Evidence suggests that some AMC faculty and staff lack an understanding of the history of distrust and social determinants of health (SDH) affecting their communities. Wake Forest Clinical and Translational Science Institute Program in Community Engagement (PCE) aims to build bridges between communities and Wake Forest Baptist Health by equipping faculty, clinicians, administrators, and staff (FCAS) with a better understanding of SDH. The PCE collaborated with community partners to develop and implement community tours to improve cross-community AMC understanding and communication, enhance knowledge of SDH, and build awareness of community needs, priorities, and assets. Nine day-long tours have been conducted with 92 FCAS. Tours included routes through under-resourced neighborhoods and visits to community assets. Participant evaluations assessed program quality; 89% reported enhanced understanding of access-to-care barriers and how SDH affect health; 86% acknowledged the experience would improve future interactions with participants and patients; and 96% agreed they would recommend the tour to colleagues. This work supports the use of community tours as a strategy to improve cross-community AMC communication, build trust, and raise awareness of community needs, priorities, and assets.

Violence as a health disparity: Adolescents' perceptions of violence depicted through photovoice.

Violence is a public health issue that disproportionately affects adolescents from historically marginalized communities. In response to growing concerns of local violence, our community-academic partnership explored adolescents' perspectives about violence, including perceptions of its causes, consequences, and potential solutions. Ten adolescents participated in a 12-week photovoice project. They received training in basic research methodologies, documented representations of violence through digital photography and creative writing, engaged in empowerment-based photo-discussions, and presented their work to influential advocates in a community forum. Adolescents and staff conducted a thematic analysis of photographs and narratives from which 10 themes emerged across 3 domains: a culture of violence and oppression, structural violence, and mental and physical health. Adolescents presented their work to community stakeholders in a public forum to foster additional discussions regarding violence in the community. This photovoice project yielded rich qualitative insight into adolescents' experiences with and perceptions of violence.