Community-engaged Research Partnerships as Healing Spaces for Health Professionals and Researchers.

Drawing from collective experiences in our capacity building project: Health Equity Activation Research Team for Inclusion Health, we argue that while community-engaged partnerships tend to focus on understanding health inequities and developing solutions, they can be healing spaces for health professionals and researchers. Data were obtained from a 15-month participatory ethnography, including focus groups and interviews. Ethnographic notes and transcripts were coded and analyzed using both deductive and inductive coding. Practices of radical welcome, vulnerability, valuing the whole person, acknowledging how partnerships can cause harm, and centering lived experience expertise in knowledge creation processes were identified as key characteristics of healing spaces. Ultimately, health professionals and researchers work within the same social, political and economic contexts of populations with the worst health outcomes. Their own healing is critical for tackling larger systemic changes aimed at improving the well-being of communities harmed by legacies of exclusion.

The Radical Welcome Engagement Restoration Model and Assessment Tool for Community-Engaged Partnerships.

People experiencing addiction, houselessness, or who have a history of incarceration have worse health outcomes compared with the general population. This is due, in part, to practices and policies of historically White institutions that exclude the voices, perspectives, and contributions of communities of color in leadership, socio-economic development, and decision-making that matters for their wellbeing. Community-based participatory research (CBPR) approaches hold promise for addressing health inequities. However, full engagement of people harmed by systemic injustices in CBPR partnerships is challenging due to inequities in power and access to resources. We describe how an Allentown-based CBPR partnership-the Health Equity Activation Research Team of clinicians, researchers, and persons with histories of incarceration, addiction, and houselessness-uses the Radical Welcome Engagement Restoration Model (RWERM) to facilitate full engagement by all partners. Data were collected through participatory ethnography, focus groups, and individual interviews. Analyses were performed using deductive coding in a series of iterative meaning-making processes that involved all partners. Findings highlighted six defining phases of the radical welcome framework: (a) passionate invitation, (b) radical welcome, (c) authentic sense of belonging, (d) co-creation of roles, (e) prioritization of issues, and (f) individual and collective action. A guide to assessing progression across these phases, as well as a 32-item radical welcome instrument to help CBPR partners anticipate and overcome challenges to engagement are introduced and discussed.

COVID-19 and practice transformation: Building an office-based opioid treatment program in a family medicine residency practice.

INTRODUCTION: This brief report describes how a family medicine residency practice (FMRP) leveraged a resident-led quality improvement project and a grant-funded Addiction Integrated Care Team (AICT) to initiate an office-based opioid treatment (OBOT) program to provide medications for opioid use disorder during the COVID-19 pandemic. METHOD: In 2020, the practice experienced four disruptors that shifted motivation for practice development: (a) The COVID-19 pandemic demanded rapid change in primary care processes/staffing, including pivoting to telehealth/remote practice. (b) The practice's transition to a federally qualified community health center model meant a shift in organizational priorities that required offering OBOT services. (c) External grant resources became available through the AICT program to support practice core for OBOT, and 10 implementation strategies were utilized. (d) A resident champion implemented an OBOT quality improvement project. RESULTS: These efforts resulted in the practice offering the OBOT program and 18 patients receiving OBOT from January 2020 to February 2021, with 10 of 18 patients engaged for 12 months or longer. Further, the cumulative adoption and reach from January 2020 through September 2022 was 15 faculty and 14 residents becoming prescribers and 101 patients served within the OBOT program, respectively. DISCUSSION: FMRPs striving for significant practice transformation, such as implementing an OBOT program during a pandemic, may benefit from synergistic guidance and resources including established theory, strategies from the implementation science literature, and resident-led quality improvement efforts. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Survey of the Health of Urban Residents: a Community-Driven Assessment of Conditions Salient to the Health of Historically Excluded Populations in the USA.

BACKGROUND: Data from the Survey of the Health of Urban Residents (SHUR) identified connections between police brutality and medical mistrust, generating significant media, policy, and research attention. Amidst intersecting crises of COVID-19, racism, and police brutality, this report describes survey development and data collection procedures for the SHUR. BASIC PROCEDURES: We conducted focus groups with Black men, Latinxs, and immigrants in Allentown, Pennsylvania. Findings were used to develop and refine measures of conditions salient to the health of urban residents across the country. Quota sampling was employed; oversampling people of color and persons whose usual source of care was not a doctor's office. MAIN FINDINGS: Non-Hispanic Whites made up just under two thirds of the sample (63.65%, n = 2793). Black/African American respondents accounted for 14.2% of the sample (n = 623), while 11.62% (n = 510) were Latinx. Only 43.46% of respondents reported a doctor's office as their usual source of care. Novel measures of population-specific stressors include a range of negative encounters with the police, frequency of these encounters, and respondents' assessments of whether the encounters were necessary. SHUR assessed the likelihood of calling the police if there is a problem, worries about incarceration, and cause-specific stressors such as race-related impression management. PRINCIPAL CONCLUSIONS: SHUR (n = 4389) is a useful resource for researchers seeking to address the health implications of experiences not frequently measured by national health surveillance surveys. It includes respondents' zip codes, presenting the opportunity to connect these data with zip code-level health system, social and economic characteristics that shape health beyond individual factors.

Interrogating academic hegemony in community-based participatory research to address health inequities.

Community-based participatory research holds promise for addressing health inequities. It focuses on issues salient to specific populations, prioritizes community engagement and amplifies the voices of marginalized populations in policy formulation and designing interventions. Although communities are partners, academic hegemony limits their level of influence over the research initiative. Drawing from our own collaborative research experiences, we raise questions for community-engaged health services researchers to reflect upon as a means of interrogating academic hegemony in partnerships that seek to address health inequities. We describe what it means for researchers to acknowledge and relinquish the power they wield in the community-engaged health services research enterprise. We propose three guiding principles for advancing equity: authentic engagement, defining and living values, and embracing accountability.

Time banking and health: the role of a community currency organization in enhancing well-being.

Time banking is an international movement that seeks to transform traditional asymmetric social service models into social networks in which members both provide and receive services that are assigned equal value. Time banks have been shown to enhance social capital, and there is some evidence for improved health. This article, based on a survey of 160 members of a hospital-affiliated time bank, examines the likelihood and predictors of improvement in physical and mental health as a result of membership. Men, people with lower income, and those who were not working full-time reported highest levels of participation in exchanging services; attachment to the organization was greatest among women, older members, people with less education, and those with the highest participation levels. Multivariate analyses revealed that physical health improvement attributed to membership was significantly predicted by attachment to the organization and living alone; mental health gains were predicted by general health changes, average number of exchanges, and attachment to the organization. We conclude that a sense of belonging, a dimension of social capital, is key to improved well-being and that time banking may be particularly valuable in promoting health and belonging among older and lower-income individuals and those who live alone.

Understanding the role of the promotora in a Latino diabetes education program.

We explore the role of the promotora de salud (health promoter) who provided diabetes self-management education to Puerto Rican diabetics in her community. The education program was developed as a hospital and community-based organization partnership. Information from both Spanish-language focus groups with 35 class participants and an in-depth interview with the promotora indicated patients appreciated having the classes taught in Spanish by a Latina promotora from their community. Respondents reported satisfaction with the program, increased ability to self-manage diabetes, and strengthened connections with other Latino diabetics. Terms patients used for the promotora included comadre, hijita, and buena profesora. Some of these words denote almost kinship-level connections, suggesting that patients were forming strong connections with the promotora. Specific promotora roles were identified but varied among patients, promotora, and the literature. This hospital and community-based organization partnership promotora model appears to be effective for providing chronic disease self-management education in an urban community setting.

Community-based participatory research shows how a community initiative creates networks to improve well-being.

BACKGROUND: Evidence from more than 30 years of research suggests a profound relationship between social participation and human health and well-being. People who hold meaningful roles in supportive social contexts live longer, get sick less often, suffer less disability, and recover faster from life-threatening events. However, despite ample evidence of benefit, the complex phenomenon of social participation has proved difficult to untangle in creating policies or programs for optimizing health in diverse communities. For vulnerable populations, the answer to the question of what contexts invite meaningful participation and improve well-being remains unclear. PURPOSE: This study explores how diverse participants engage in a supportive network and proposes a theoretic model of community-building for health promotion. METHODS: Principles of community-based participatory research were used for qualitative study using in-depth interviews, with a purposeful sample of 28 members of a service exchange program in an urban community. RESULTS: Four primary themes that were related to participation in the service exchange program were identified: (1) motivation for participation; (2) service exchange, or reciprocity, as vital to the program, with distinct benefits in a heterogeneous group; (3) occurrence of personal and community growth; and (4) health promotion and improved well-being. A model of how participation in the service exchange leads to community-building is presented. CONCLUSIONS: The model suggests that opportunities for reciprocity are fundamental to healthy community development in heterogeneous groups. Further study of how reciprocity encourages diverse populations to work together to create a landscape of healing may provide a valuable framework for health promotion.