Transcript Engaging Communities as Partners Sergio Aguilar-Gaxiola, MD, PhD

Engaging Communities as Partners
Sergio Aguilar-Gaxiola, MD, PhD
Professor of Clinical Internal Medicine
Director, Center for Reducing Health Disparities
Director, Community Engagement UCD CTSC
UC Davis School of Medicine
Academy Health Annual Research Meeting
Washington, DC
June 9, 2008
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Why Engage Communities?

Community engagement and collaboration is a cornerstone of
effective public health practice;

Successful community engagement builds skills and capacity within
the community, which are fundamental factors for optimal health.

Communities are essential in proactively looking for effective, longterm, and sustainable solutions for reducing health and healthcare
disparities;

Community involvement is crucial in the recruitment and retention of
diverse groups’ participation in health research;

The community is where the full impact of evidence-based
information will be realized; dissemination and implementation are
key.
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Principles of Community Engagement
Community engagement processes are about
personal and local relationships that should be:




Participatory
Cooperative
Conducive to learning from each other
Encourage community development and capacity
building
 Empowering
IDENTIFY also ASSETS, STRENGTHS, RESOURCES
within COMMUNITIES
Important Goals when Working with
Underserved Communities
 Include underserved communities in research
 Increase of URM researchers
 Increase the diversity of the workforce
 Address health disparities vigorously
 Disseminate research results widely
Source: IOM Report “Examining the Health Disparities Research Plan of the National Institutes
of Health: Unfinished Business”, 2006
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Learning How to Reduce Disparities
 We need direct input from underserved
communities.
 Not an easy task. Underserved communities
may be:
 Unaware of potential benefits.
 Not ready to participate in research/policy processes.
 Suspicious and distrustful of health services.
Community Engagement at UC Davis

California Department of Mental Health Prevention
and Early Intervention Needs Assessment for
California’s Underserved Communities
to reach out and engage communities that have been
underserved by public health/mental health services
and solicit their input on communities’ needs,
concerns, strengths, and resources.
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Outreach Methods
1.
Identify specific underserved communities;
2.
Interview key informants to focus on specific needs
within communities;
3.
Work with “cultural brokers” or community health
representatives to develop outreach strategies;
4.
Conduct focus groups with community members
about health needs, community assets, etc.;
5.
Provide feedback to communities about the impact
of the information collected on policy and services.
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Participants
30 focus groups were conducted primarily in communitybased locations in 10 counties across California
 specific ethnic groups: African American, Native
American, Native Hawaiian, and Pacific Islander, Asian
(including Hmong, Cambodian, and Chinese), and Latino
(Mexican and Central and South American);
 other underserved groups (LGBTQ, foster youth,
young adults with juvenile justice history, and older
adults) from rural and urban locations;
 community-based providers that serve these
communities.
Key Findings
 mental health problems in underserved communities;
 problems accessing mental health care and quality
of services received;
 social determinants of health such as poverty and
discrimination;
 social exclusion of underserved communities based
on current and historical experiences with government
agencies
Community Assets
 Individual and community resiliency
 Traditional and spiritual healers
 Religious leaders
 Informal and formal support networks (family and
friendships, reconnection to native cultures, role models
and mentors)
 Community-based organizations
 Social service/Health programs
Project Outcomes
 Reports:
 “Building Partnerships: Key Considerations when
Engaging Underserved Communities Under the MHSA”
 “Engaging the Underserved: Personal Accounts of
Communities on Mental Health Needs for Prevention and
Early Intervention Strategies”
 Dissemination and implementation of findings
 Ongoing partnerships with community agencies
and underserved groups
Recommended Strategies
1.
Identifying underserved communities within your
county
2.
Establishing bi-directional relationships

Finding community representatives
Facilitating meetings and exchanging information
3.
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Engaging community representatives and maximizing
the opportunity for developing trust in communication
Using the information once it is collected
4.
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Making sure the voices are heard and integrated into
programmatic plans

Building ongoing partnerships
2. Establishing Bi-directional
Relationships
 Clarity of purpose
 Understand that the relationship will be a two-way relationship
 Awareness of past interactions with community
 Recognize that part of the purpose is building up ongoing
relationships
 Be clear about how participants can influence the decisions that
may be made and what issues cannot be influenced
2. Establishing Bi-directional
Relationships (2)
 Understanding the partner community
 Be clear about who should be engaged
 Identify the community leaders and key community organizations
with whom to partner (who has trust, respect, and credibility
within the community?)
 Address the “culture”, as well as the cultural, language, racial,
and ethnic issues of the community
 Use awareness and sensitivity when working with tribal
communities. Recognize and honor tribal sovereignty issues
2. Establishing Bi-directional
Relationships (3)
 Approach communities with awareness of past
interactions with community and be prepared to address
mistrust and disbelief
 Be aware of how government agencies are perceived
 Validate concerns
 Be transparent about your purpose and reasons for being there
2. Establishing Bi-directional
Relationships (4)
 Identify opportunities for co-learning
 From the community to the county: the communities’ needs,
priorities, assets, existing resources
 Existing services, programs that can be enhanced or
supported within the community
 From the county to the community: Informing opportunities for
accessing funds and learn about procurement process and
participation in policy decisions
Acknowledgements
DMH/MHSOAC
UCD CRHD
CMHDA
Emily Nahat
Jennifer Clancy
Nichole Davis
Rachel Guerrero
Barbara Marquez
Sonia Mays
Sheri Whitt
Beverly Whitcomb
Lois Williams
Sergio Aguilar-Gaxiola
Joshua Breslau
Leticia Carrillo
Natalia Debb-Sossa
Katherine Elliott
Ron King
Cristina Magaña
Arnulfo Medina
Elizabeth Miller
Marbella Sala
Bill Sribney
Alfredo Aguirre
Bill Arroyo
Nancy Peña
Dan Souza
Stephanie Welch
Examples of other Community Engaged
Research at UC Davis

National Demonstration of Early Detection, Intervention and Prevention in
Psychosis in Adolescents and Young Adults (Carter, PI)

Reducing Disparities in Depression Care for Ethnically Diverse Older Men
(Hinton, PI)

Community Partnerships with Pediatricians for Healthy Children (Pan, PI)

Transforming Education and Community Health (TEACH) Program
(Henderson, PI)

Community Lactation Assistance Project (Chantry, PI)

National Faith-Based and National Community Cardiovascular Disease
Prevention Programs for High-Risk Women (Villablanca, PI)

Epidemiology of Dementia in an Urban Community (DeCarli, PI)
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