Paula Winkler, M.Ed.

Elisabeth Martinez, M.S.

University of Texas Health Science Center at San Antonio South Central Area Health Education Center University of Texas School of Public Health

What is the NIH?

 N ational I nstitutes of H ealth (NIH)  Funds health research in the U.S.

 $28 billion per year  Provides infrastructure funds to academic health centers (such as UTHSCSA)  Sponsors the C linical T ranslational S cience A ward (CTSA) until this year: NCATS new agency!

Where are CTSA’s located?

CA OR WA AK NV AZ ID UT MT NM WY CO ND SD NE KS OK MN IA MO AR WI IL MS MI IN KY OH ME WV PA VA NY VT NH NJ CT RI MA DE MD NC TN SC AL GA TX LA FL

HI

Participating Institutions New members 2008 Members 2006 & 2007

How did the CTSA come about?

Perceptions:  Many scientific breakthroughs are not improving the health status of the community on a consistent basis.

 Physicians & communities are not benefiting from NIH funded research.

What is the purpose of CTSA?

Transfer of basic science to humans (T1) Transfer of clinical science to bedside/clinic (T2) Transfer of clinical knowledge to everyday practice (T3)

Who is on the receiving end of the transfer?

Communities Clinicians

UTHSCSA’s CTSA Components

T ranslational A dvisory B oards C ommunity H ealth A ssessment P ractice B ased R esearch N etworks Community Engagement Clinical Research Ethics Clinical Resources CTSA HOME Biostatistics Trial Design Regulatory Support

Advanced Degree-Granting Programs Biomedical Informatics

Research Driven By Authentic Demand

 A shared understanding and commitment to a vision for change that reflects the needs and perspective of community residents.

 A shared responsibility for the health of the community.

 Community stated evidenced-based problems.

How do we build the bridge?

Community AHEC UTHSCSA

South Central Texas AHEC

 Core functions:    Health Disparities Health Careers Health Promotion  Responsible for 12 county area  501 (C) (3) Not for Profit Organization  Bluff Creek Tower 4201 Medical Drive - Suite 360 San Antonio, TX 78229

AHEC Board Members

Leonard Bentch, M.D. (retired) Susan Bell, RN, BSN (retired) Robert Jonas, Ph.D.

Javier Garcia, DDS Michael Thompson

What is a “TAB”?

 T ranslational A dvisory B oard  A diverse group of local community members who will:  engage with academic researchers in a partnership to enhance public trust;  prioritize local research needs; and  provide feedback to researchers who interact with the community.

What do TABs do?

   Define and prioritize community health priorities based on local community needs assessments Learn about C ommunity B ased P articipatory R esearch (CBPR) principles and methods Provide review and recommendations to academic researchers about research proposals

What do TABs do?

 Co-develop:  Public Learning Forums for joint engagement and education of researchers and the community about CBPR processes  Partner with academic health researchers in:     planning, design, implementation, and evaluation  of community-based clinical and translational research

FRIO County TAB

Timeline

       September 2008 –First Meeting at Frio Regional Hospital February 2009 – CBPR Training at UTHSCSA Monthly Meetings April - September 2009 Leadership Change – September 2009 Recharge and Revitalize – December 2009 Community Forum – April 2010 Frio Heart Health Fair – February 2011

Health Fair Assessment Activities

    Three collaboratively-developed assessment activities: 1.

2.

3.

Health Priorities Wall Community Health Survey, and Exit Satisfaction Survey Sample - adult health fair attendees Conducted by UTSPH graduate students who were shadowed by PHS students All materials translated in Spanish and English

Community Health Survey

  44 questions focused on: (1) physical activity and health care barriers (2) utilization of recreational facilities in Pearsall, Dilley and Cotulla for physical activity n= 64 participants

Health Priorities Wall

 Health Priorities: diabetes, drug abuse, high blood pressure, depression, availability of fresh fruits and vegetables, teen pregnancy, oral health, asthma, and water quality   Tools:  4x6’ poster  Colored stickers n= 64 participants

• 

Exit Satisfaction Survey

11 questions focused : (1) how participants learned about the health fair; (2) what information was the most helpful; and (3) the likelihood of participants sharing the information learned. n = 65 participants

Summary of Findings

   Teen pregnancy, diabetes and drug abuse top health priorities All participants familiar with recreational facilities; however, the majority had not used them within the past month Time, distance, and cost are not barriers to exercise; however, too few places to exercise

Next Steps

1. Select a health priority: 2. Plan Strategic Planning Community Forum focused on selected health priority  Identify dissemination partners:  develop possible solutions to address issue 4. Create media packet with assessment and strategic planning results 5.

6.

Present results to “end users” Community Health Improvement Intervention A. co-led research project B. community health event



Diabetes

“Low Hanging Fruit!

Lessons Learned

 Community based research has its’ own language – “Deer in the headlights”  Community participants DO NOT want to be called STAKEHOLDERS! Too much pressure!

 Research agendas may not match – community & researcher! All at the table from the beginning!

 Timetable for community does not match researcher & vice versa

Lessons Learned

  Researchers need a paper! Community needs resources! Both have to win!

Community Based Research is not just an event!

 Translational Research is not “test tube” to “practice” to “bookshelf”! Did we move the dial?

  Leadership Change is inevitable in all communities!

Rural research is easier for the politics, harder for the researcher!