>> THANK YOU FOR JOINING US
FOR OUR SEPTEMBER EDUCATION
TITLED COMMUNITY ENGAGED
RESEARCH FOR CARDIOVASCULAR. A
LINK TO THE VIDEO CAST AND
SLIDES FROM THE SESSIONS TODAY
WILL BE POSTED ON THE WEBSITE
APPROXIMATELY ONE TO TWO WEEKS
AFTER THE SESSION. IN THE
PRESENTATION ARCHIVE OF THE
OHSRP EDUCATION AND TRAINING
WEBPAGE. OUR SPEAKERER IS
COVERING OBESITY AND
CARDIOVASCULAR RISK DEPARTMENT.
A JOINT DEPARTMENT IN THE
INTRAMURAL RESEARCH AND
CARDIOVASCULAR BRANCH AND
MINORITY BRANCH OF HEALTH
DISPARITIES AND USES RESEARCH,
EPIDEMIOLOGIC METHODS AND
APPROACHES TO UNDERSTAND SOCIAL
FACTORS THAT PROMOTE OBESITY AND
LIMIT CARDIOVASCULAR HEALTH. IN
2021 DR. POWELL-WYLIE'S WORK WAS
RECOGNIZED WITH THE RESEARCH
PRIZE AND PART OF THE SOCIETY
FOR CLINICAL INVESTIGATION. AT
NIH THE DOCTOR HAS MENTORED
MANY, SEVERAL WHO ARE
TENURE-TRACT NIH-FUNDED FACULTY.
SHE SERVES AS EDITOR FOR JOURNAL
AS AMERICAN HEART ASSOCIATION,
CONSULTING EDITOR FOR HEALTH
PSYCHOLOGY AND EDITORIAL BOARD
FOR JOURNAL CIRCULATION. SHE
RECEIVED THE NHLBI DIRECTOR'S
AWARD TO CREATE THE HOPE CENTER,
A COMMUNITY-ENGAGED RESEARCH HUB
IN WASHINGTON D.C.'S WARD 5 TO
INCREASE ACCESSIBILITY AND
PROMOTE DIVERSITY IN THE
BIOMEDICAL WORKFORCE AND
GRADUATED CUM LAUDE FROM
UNIVERSITY OF MICHIGAN AND
COMPLETED EPIDEMIOLOGY STUDIES
IN NORTH CAROLINA, GRADUATED
FROM DUKE SCHOOL OF MEDICINE,
MEMBER OF THE ALPHA OMEGA
MEDICAL HONOR SOCIETY. PRIOR TO
JOINING DR. POWELL-WYLIE
COMPLETED INTERNAL RESIDENCY AT
BRIGHAM WOMEN'S HOSPITAL AND
CARDIOLOGY FELLOWSHIP AT
UNIVERSITY OF TEXAS SOUTHWEST
MEDICAL CENTER. THROUGHOUT
TODAY'S SESSION WE ENCOURAGE
VIEWERS TO SUBMIT QUESTIONS BY
CLICKING ON THE BOX BELOW THE
VIDEO TITLED LIVE FEEDBACK LINK,
THEN WE WILL HAVE A Q&A SESSION
AFTER THE PRESENTATION. SO THANK
YOU FOR JOINING US. WHY DON'T
YOU GET STARTED.
>> THANK YOU SO MUCH. CAN YOU
SEE MY SLIDES?
>> LOOK FINE.
>> THANK YOU FOR THE
OPPORTUNITY TO BE HERE. I'M
HAPPY TO BE HERE. AS MENTIONED I
WILL BE TALKING ABOUT HOW WE ARE
USING COMMUNITY ENGAGED RESEARCH
TO ADDRESS CARDIOMETABOLIC
HEALTH DISPARITIES .
THE WORK IS FIRST TO THE DEFINE
COMMUNITY-ENGAGED RESEARCH OR
COMMUNITY-BASED PARTICIPATORY
RESEARCH. I WILL DESCRIBE THE
ROLE FOR COMMUNITY ENGAGED
RESEARCH IN ADDRESSING
CARDIOMETABOLIC DISPARITIES,
PARTICULARLY THOSE IMPACTED BY
SOCIAL DETERMINANTS OF HEALTH.
THEN I WILL TALK ABOUT HOW WE
UTILIZE COMMUNITY ENGAGED
RESEARCH TO ADDRESS CLINICAL
TRIAL DID VERIESTY. AS WE KNOW,
THE PREVALENCE OF OBESITY HAS
INCREASED OVER THE LAST TWO
GENERATION, HAD CLEAR
CARDIOMETABOLIC IMPACT ON THE
U.S. POPULATION. THE SPEED WITH
WHICH OBESITY HAS INCREASED OVER
THE LAST SEVERAL DECADES
HIGHLIGHTS THE ENVIRONMENTAL
FACTORS INTERACTING WITH BIOLOGY
AND SUGGESTS A NEED FOR NEW
PARADIGMS IN HOW WE DEVELOP
INTERVENTIONS TO STEM THESE
TRENDS. WE ALSO KNOW THAT
OBESITY IN CONJUNCTION WITH
DIABETES AS WELL AS SOCIAL
DETERMINANTS OF HEALTH ARE
IMPACTING CARDIOVASCULAR
MORTALITY IN THE U.S. INSTANCE
DATA FROM THE CDC SHOWS US THERE
HAVE BEEN DECLINES AND SLOWING
OF CARDIOVASCULAR MORTALITY IN
THE U.S. FOR INSTANCE, WE KNOW
THAT SEVERAL RACIAL AND ETHNIC
GROUPS, NON-HISPANIC BLACKS, FOR
INSTANCE, HAVE THE HIGHEST
CARDIOVASCULAR MORTALITY WITH
INCREASING AMONGST NATIVE
AMERICAN AND ALASKA NATIVE WITH
STAGNANT AMONG WHITE WOMEN IN
THE U.S. WE ALSO KNOW COUNTIES
WITH THE HIGHEST RATES OF NOT
ONLY OBESITY AND DIABETES BUT
WITH THE LOWEST LEVELS OF
EDUCATION IN THE UNITED STATES
ARE THOSE THE HIGHEST RISK FOR
PREMATURE CARDIOVASCULAR
MORTALITY SO HIGHLIGHTS AGAIN
THE ENVIRONMENT, THE SOCIAL
FACTORS INTERACT WITH THE RISK
FACTORS LIKE BE OBESITY AND
DIABETES. WE CAN THINK OF THESE
AS SEVERAL EPIDEMICS AND
PANDEMICS WORKING SIN
SYNERGISTICALL BUT THESE
FACTORIES CAN BE THOUGHT OF AS A
SYNDYMIC WHERE THEY ARE NOT ONLY
INFLUENCED EACH OTHER BUT BY
SOCIAL DETERMINANTS OF HEALTH
THAT LEAD TO A NEED FOR
SOLUTIONS ACROSS DIFFERENT
SECTORS THIS THINK ABOUT HOW WE
CAN PROMOTE HEALTH EQUITY ACROSS
DIVERSE POPULATIONS. THESE
DISEASE STATES, AND HOW CAN WE
ADDRESS THESE BIOLOGICAL
PATHWAYS. SO AS WE PUT FORWARD
WITH THE AMERICAN HEART
ASSOCIATION WE HIGHLIGHTED THE
CONNECTION NOT ONLY BETWEEN
BIOLOGY BUT ALSO PSYCHOSOCIAL,
ENVIRONMENTAL AND SOCIOECONOMIC
FACTORS WERE SOCIAL DETERMINANTS
OF HEALTH THAT CONTRIBUTED TO
WORSENING OUTCOMES RELATED TO
OBESITY. AS WE THINK OF
INTERVENTIONS WE NEED TO ACCOUNT
FOR THESE COMPLEXITIES THAT
INFLUENCE THE RATES OF OBESITY.
IF WE WANT TO THINK ABOUT SOCIAL
DETERMINANTS OF HEALTH, WE THINK
OF FRAMEWORKS HOW THESE
INFLUENCE THESE. THESE ARE
STRUCTURAL, SOCIOECONOMIC,
SOCIAL CULTURAL FACTORS THAT
INFLUENCE HEALTH BUT ALSO
FACTORS THAT ARE MORE
INTERMEDIARY INCLUDING SOCIAL
AND COMMUNITY CONTEXT.
PARTICULARLY THOSE FACTORS
AROUND SOCIAL NEEDS THAT
INFLUENCE MARGINALIZED
POPULATIONS. THESE FACTORS THAT
HAVE CONSEQUENCES. AS I TALKED
ABOUT ON BIOLOGICAL PATHWAYS
THAT INFLUENCE CARDIOVASCULAR
DISEASE OUTCOMES. SO THE WORK
WE'VE DONE IN MY GROUP, IN
PARTICULAR, HAS FOCUSED ON
NEIGHBORHOOD FACTORS IN
PARTICULAR THAT WORK IN
CONJUNCTION WITH SOCIAL AND
COMMUNITY FACTORS THAT INFLUENCE
STRESS AND HAVE, AGAIN,
BIOLOGICAL EFFECTS AND LEAD TO
CARDIOVASCULAR OUTCOMES. SO
ENGAGED RESEARCH SERVES AS A WAY
TO WORK WITH COMMUNITIES MOST
IMPACTED BY ADVERSE SOCIAL
CONDITIONS BUT ACCOUNT FOR THESE
DISEASE STATES THAT WORK
TOGETHER, WORK SYNERGISTICALLY
AND CAN BE CONSIDERED A
SYNDEMIC. LET'S FIRST START BY
DEFINING COMMUNITIES THAT WE
WORK WITH. WE CAN DEFINE A
COMMUNITY BASED ON MANY
DIFFERENT ASPECTS. WE CAN THINK
OF COMMUNITIES BASED ON
GEOGRAPHY, BASED ON RACE OR
ETHNICITY, BASED ON GENDER,
SEXUAL ORIENTATION, DISABILITY
OR A SPECIFIC HEALTH CONDITION
OR EVEN A COMBINATION OF ANY OF
THESE FACTORS. COMMUNITY ARE
TYPICALLY GROUPS WITH A COMMON
INTEREST OR A CAUSE BUT THEY MAY
BE CONNECTED BY CARE THEY ARE
OBTAINING BY A SPECIFIC HEALTH
CARE ORGANIZATION OR BASED ON
PUBLIC HEALTH CAUSE THAT IS
COMMON AMONG THEM. COMMUNITIES
CAN BE BROUGHT TOGETHER BY
STATE, LOCAL OR TRIBAL LEADERS
AS WELL AS POLICYMAKERS. WE CAN
ALSO THINK OF HOW COMMUNITY
ENGAGEMENT IS IMPORTANT FOR
OVERCOMING THE MISTRUST THAT
EXISTS WITH THE HEALTH CARE
SYSTEM. THIS MISTRUST EXISTS DUE
TO HISTORICAL EVENTS BUT ALSO
DUE TO MISTREATMENT OR BIAS THAT
MAY BE EXPERIENCED BY
INDIVIDUALS IN THE HEALTH CARE
SYSTEM, EVEN THOSE WHO ARE
EXPERIENCING THOSE TYPES OF
EVENTS, EVEN TODAY. MORE
RECENTLY. NOT NECESSARILY JUST
HISTORICAL EVENTS. THIS IS DUE
TO THESE FACTORS AND THESE
EVENTS LEAD TO MISTRUST AND LEAD
TO FACTORS THAT ARE INFLUENCING
SOCIETY WITHIN WHICH THEY LIVE.
COMMUNITY ENGAGEMENT ALLOWS FOR
INPUT FOR THOSE WHO ARE MOST
IMPACTED BY HEALTH DISPARITIES
BUT ALSO THOSE WHO ARE MOST
IMPACTED BY BIAS AND
MISTREATMENT AND HAVE MISTRUST
OF THE HEALTH CARE SYSTEM.
AGAIN, COMMUNITY ENGAGEMENT
ACCOUNTS FOR FACTORS ACROSS THE
CONTINUUM OF -- FROM INDIVIDUAL
TO SOCIETY FOR FACTORS THAT
INFLUENCE THEIR ENGAGEMENT WITH
THE HEALTH CARE SYSTEM. WE CAN
THINK OF COMMUNITY ENGAGED
RESEARCH AS A CONTINUUM. FROM
BEING A SITUATION THERE IS NO
LEVEL OF ENGAGEMENT BETWEEN THE
RESEARCHER AND THE COMMUNITY
WHERE THE RESEARCHER DESIGNS THE
STUDY, DESIGNS THE QUESTIONS AND
GOES TO THE COMMUNITY WHERE THEY
PROVIDE INPUT JUST AROUND THAT
SPECIFIC QUESTION. AT THE OTHER
END O F THE SPECTRUM WE CAN
THINK OF COMMUNITY ENGAGEMENT AS
BEING FULLY ENGAGED WHERE THE
COMMUNITY DEFINES THE QUESTIONS,
DESIGNS THE STUDY AND RECRUITS
THE PARTICIPANTS FOR THAT STUDY
AND WORKS AS A COLLABORATOR
THROUGH THE ENTIRE PROCESS.
WITHIN THIS FULLY ENGAGED
PROCESS, RESEARCHERS SERVE AS
COLLABORATORS TO HELP AND
FACILITATE THE WORK DONE WITHIN
THE COMMUNITIES. WITHIN THESE
EXTREMES OF COMMUNITY ENGAGEMENT
THERE ARE VARIOUS WAYS IN WHICH
BOTH THE COMMUNITY AND
RESEARCHERS CAN WORK TOGETHER IN
DESIGNING RESEARCH PROGRAMS.
THERE ARE DIFFERENCES WHEN WE
THINK WHAT IS COMMUNITY ENGAGED
RESEARCH VERSUS PATIENT-ENGAGED
RESEARCH. FOR INSTANCE IN
BUILDING TRUST WITH STAKEHOLDERS
COMMUNITY ENGAGEMENT TYPICALLY
BUILDS ON RELATIONSHIPS BETWEEN
ACADEMIC PARTNERS AND COMMUNITY
MEMBERS OR ORGANIZATIONS WHERE
PATIENTS WORK TOGETHER AND
ENGAGE AS OPPOSED TO PATIENT
ENGAGEMENT, TYPICALLY BUILT ON
RELATIONSHIPS ESTABLISHED WITHIN
THE CARE SETTINGS. COMMUNITY N
GAUGEMENT IS TYPICALLY BUILT ON
A COMMON INTEREST AROUND ISSUE
THAT AFFECTS AN ENTIRE COMMUNITY
WHILE THE SOURCE OF COMMON
INTEREST AND PATIENT ENGAGEMENT
IS TYPICALLY A FAMILY OR A
PERSONAL HEALTH ISSUE OR AN
EXPERIENCE RELATED TO MEDICAL
CARE. COMMUNITY ENGAGEMENT
TYPICALLY INVOLVES MORE OF A
DIVERSE SET OF STAKEHOLDERS,
INCLUDING LOCAL GOVERNMENT
OFFICIALS, SCHOOL OFFICIALS OR
FAITH-BASED ORGANIZATIONS AS
EXAMPLES BUT PATIENT ENGAGEMENT
TYPICALLY INVOLVES TRADITIONALLY
MORE CLINICIANS AND PATIENTS AT
THE TABLE. STUDIES HAVE EXAMINED
HOW COMMUNITY ENGAGEMENT CAN
ACTUALLY INFLUENCE
REPRESENTATION OF POPULATIONS
FOR UNDERREPRESENTED AND -- IN
BIOMEDICAL RESEARCH. FOR
INSTANCE RESEARCH AT BETH ISRAEL
IN BOSTON EXAMINED
CARDIOVASCULAR DISEASE
INTERVENTIONS UP UNTIL 2019 TO
LOOK AT RECRUITMENT OF
NON-HISPANIC BLACK ADULTS IN THE
CARDIOVASCULAR STUDIES AND FOUND
ONLY 21% SPECIFIED THE TYPES
RECRUITMENT STRATEGIES FOR
REACHING UNDERREPRESENTED AND
USED COMMUNITY BASED STRATEGIES.
ONLY 5% DESCRIBED USING -- AND
WORKING WITH COMMUNITY MEMBERS
IN A SPECIFICALLY ENGAGING
COMMUNITY MEMBERS AS PART OF
THEIR STUDY DESIGN. THEY ALSO
SHOWED THOSE THAT DEFINE THE
RECRUITMENT TARGETS FOR
UNDERREPRESENTED POPULATIONS AT
HAS /* HAD A HIGHER NUMBER OF
BLACK RECRUITMENT IN STUDIES BUT
SHOWS HOW MUCH ROOM AT LEAST
WITHIN CARDIOVASCULAR SPACE TO
USE COMMUNITY ENGAGEMENT
RECRUITMENT TECHNIQUES. WHEN WE
THINK OF TERM AND DEFINITION FOR
COMMUNITY BASED PARTICIPATORY
RESEARCH THAT IS USED TO
ACKNOWLEDGE AND EMPHASIZE
PARTICIPATION, INFLUENCE AND
CONTROL OF MORE NON-ACADEMIC
RESEARCHERS AS PART OF THE
PARTNERSHIP IN DOING RESEARCH TO
UNDERSTAND AND TO DESIGN STUDIES
THROUGHOUT THE RESEARCH PROCESS.
THIS APPROACH IS DESIGNED TO
EQUITABLY INVOLVE COMMUNITY
MEMBERS, COMMUNITY ORGANIZATIONS
AND ACADEMIC RESEARCHERS IN ALL
ASPECTS OF THE RESEARCH PROCESS.
COMMUNITY BASED PARTICIPATORY
RESEARCH OR C B P R ENABLES ALL
TO CONTRIBUTE AND BE INVOLVED IN
THE RESEARCH PROCESS AND
RECOGNIZES THE COMMUNITY AS A
SOCIAL AND CULTURAL ENTITY WITH
ACTIVE ENGAGEMENT AND THE
IMPORTANCE OF THE INFLUENCE OF
COMMUNITY MEMBERS IN ALL ASPECTS
OF THE RESEARCH PROCESS. CBPR
PLAYS A PARTICULARLY IMPORTANT
ROLE IN THINKING HOW DO WE
DESIGN INTERVENTIONS THAT
PROMOTE HEALTH EQUITY.
PARTICULARLY AS WE THINK ABOUT
ADDRESSING THE SYDEMIC OF
OBESITY, DIABETES AND
CARDIOVASCULAR, CBPR CAN PLAY A
KEY ROLE AND IS IMPORTANT IN
COMMUNITIES IMPACTED BY
DISPARITIES AND ALLOWS CLINICAL
RESEARCH STUDIES TO BE TAYLORED
TO THE SPECIFIC NEEDS AND ASSETS
WITHIN THE COMMUNITY. CBPR WORKS
BY DEVELOPING KEY PARTNERSHIPS
WITH TRUSTED COMMUNITY MEMBERS
AND WORKING WITH COMMUNITY
LEADER WHO'S CAN HELP TO
IDENTIFY THE ASSETS THAT EXIST
WITHIN THE COMMUNITY TO IMPROVE
HEALTH OUTCOMES AND PROMOTE
HEALTH EQUITY. THESE ARE ASSETS
THAT EXIST IN ALL COMMUNITIES
AND SERVE AS RESILIENCE FACTORS
THAT CAN BE MOBILIZED TO TARGET
HEALTH ISSUES WITHIN THE
COMMUNITY. THESE MAY BE THINGS
THAT ARE HEALTH-RELATED OR MORE
STRUCTURAL ISSUES THAT ARE SEEN
WITHIN THE COMMUNITY AS
CONTRIBUTING TO HEALTH
DISPARITIES. THERE ARE KEY
PRINCIPLES TO THINK ABOUT AS
PART OF THE COMMUNITY ENGAGEMENT
PROCESS. THESE KEY PRINCIPLES
ARE INVOLVED IN GUIDING THE
DEVELOPMENT OF THE CBPR
PARTNERSHIP. FIRST CBPR REQUIRES
BEING CLEAR ABOUT THE PURPOSE
AND GOALS OF THE EFFORT TO BUILD
THE PARTNERSHIP FROM THE VERY
BEGINNING OF THE PROCESS.
ANOTHER KEY PRINCIPLE IS THAT
CBPR BUILDS ON STRENGTHS AND
RESOURCES WITHIN THE COMMUNITY.
IT REQUIRES A RESEARCHER TO BE
KNOWLEDGEABLE ABOUT THE SPECIFIC
HISTORY OF THE COMMUNITY BUT THE
ASSETS THAT EXIST WITHIN THE
COMMUNITY. FOR INSTANCE IT IS
CRITICAL, WORK THATS ALREADY
EXIST. AND THE MEDIATING
STRUCT
STRUCTURES, FAITH-BASED AND
COMMUNITY-BASED ORGANIZATIONS
THAT HELP COMMUNITY MEMBERS WORK
TOGETHER TO IM PIMPROVE THEIR
HEALTH. CBPR PROMOTES COLLECTIVE
AND COLLABORATIVE PARTNERSHIPS
NEEDED TO BUILD TRUST. THIS
STARTS BY WORKING WITH COMMUNITY
MEMBERS TO IDENTIFY THE ISSUES
AND CONCERNS THAT NEED TO BE
ADDRESSED. IT MEANS THAT
RESEARCHERS WHO ARE INVOLVED IN
CBPR RECOGNIZE INEQUALITIES THAT
EXIST BETWEEN THEMSELVES AND THE
COMMUNITY MEMBERS THEY WORK
WITH. THEY PAY EXPLICIT
ATTENTION EXPERTISE OF COMMUNITY
MEMBERS. IN ADDITION IT IS
IMPORTANT TO THINK ABOUT
CREATING AN EMPOWERING PROCESS
BY SHARING INFORMATION, SHARING
THE DECISION MAKING PROCESS.
AGAIN, CENTERING THE COMMUNITY
AS DECISIONS ARE BEING MADE
THROUGHOUT THE RESEARCH PROCESS.
AND INVOLVING AND LEARNING WITH
EACH OTHER THROUGHOUT THE
PARTNERSHIP. ANOTHER KEY
PRINCIPLE IS THOSE INVOLVED IN
CBPR RECOGNIZE THAT SELF
DETERMINATION IS A RIGHT AMONG
ALL THOSE WORKING WITHIN THE
COMMUNITY AND COMMUNITY MEMBERS
MAY NOT BE WILLING OR ABLE TO
WORK IN PARTNERSHIP AND
THROUGHOUT THE PROCESS OF
RESEARCH. CBPR IS MEANT TO
FACILITATE CO -LEARNING AND
CAPACITY BUILDING TO CREATE
CHANGE AND IMPROVE HEALTH. SO
RESEARCHERS NEED TO LEARN FROM
THE LOCAL KNOWLEDGE FROM
COMMUNITY MEMBERS ABOUT THE
CULTURE AND SOCIAL CONTEXT FOR
THAT COMMUNITY. ALSO AGAIN LEARN
THE COMMUNITY'S SKILL SET THAT
CAN BE A PART OF THE RESEARCH
PROCESS. IN ADDITION COMMUNITY
MEMBERS LEARN SKILLS IN
CONDUCTING CLINICAL RESEARCH AS
THEY WORK WITH ACADEMIA -- THOSE
FROM ACADEMIA BUT ALSO LEARN THE
PROCESS OF RESEARCH INCLUDING
WRITING GRANT PROPOSALS OR
IDENTIFYING FUNDING
OPPORTUNITIES FOR FUTURE WORK.
FINALLY CBPR RECOGNIZES THE NEED
TO BALANCE RESEARCH AND ACTION
FOR THE MUTUAL BENEFIT OF A
DIVERSE SET OF STAKEHOLDERS.
THESE PARTNERSHIPS NEED TO AGREE
THAT ALL RESEARCH EFFORTS MAY
NOT INVOLVE IN INTERVENTION
COMPONENT BUT THEY ARE WORKING
TO TRANSLATE THESE RESEARCH
FINDING TO INTERVENTION
STRATEGIES THAT CAN ADDRESS THE
NEEDS AND CONCERNS OF COMMUNITY
MEMBERS. ADDITIONALLY CBPR
FOCUSES AGAIN ON IDENTIFYING AND
MOBILIZING COMMUNITY ASSETS.
CBPR IS ABOUT DISSEMINATING
FINDING TO ALL PARTNERS AND
INVOLVING THEM THROUGHOUT THE
DISSEMINATION PROCESS. IT
REQUIRES, AGAIN, CONTROL NOT
BEING WITHIN ONE PARTICULAR
GROUP BUT ALLOWING THE CONTROL
OF ACTIONS RELATED TO PARTS OF A
STUDY TO BE WITHIN -- LED BY
COMMUNITY MEMBERS AND BEING
FLEXIBLE ABOUT THE CHANGING
NEEDS AMONGST COMMUNITY MEMBERS.
IT CAN BE LONG AND COMMITMENT ON
THE PART OF BOTH PARTNERSHIPS.
BUT GENERALLY TO FOLLOW THESE
LONG-TERM AND EXTEND BEYOND A
SINGLE PROJECT OR A SINGLE
FUNDING PERIOD. SO ULTIMATELY
THE CORE VALUES WITHIN COMMUNITY
BASED PARTICIPATORY RESEARCH ARE
INCORPORATING AND FOSTERING
TRUST, BUILDING RESPECT BETWEEN
RESEARCHERS AND COMMUNITY
MEMBERS AND COMMUNITY LEADERS,
FOCUSSING ON SELF-DETERMINATION,
MUTUAL INTERESTS, RECIPROCITY AS
WELL AS COLLECTIVE BENEFIT AND,
IN PARTICULAR, A LONG-TERM
COMMITMENT TO IMPROVING THE
HEALTH OF COMMUNITY. IT IS
IMPORTANT TO REMEMBER THAT CBPR
IS AN APPROACH TO RESEARCH,
WHICH CHANGES THE ROLE FOR A
RESEARCHER AND THE POPULATION
PARTICIPATING IN THE ERESEARCH
AND DESIGNED TOWARD BRINGING
EQUITY BETWEEN THE TWO GROUPS.
IT IS NOT MEANT TO BE A SPECIFIC
METHOD OR SET OF METHODS. IT CAN
INVOLVE MANY DIFFERENT TYPES OF
METHODS INCLUDING QUALITATIVE
AND QUANTITATIVE METHODS AND CAN
HAVE DIFFERENT RESEARCH DESIGNS
DEPENDING ON WHAT IS BEST TO
BUILD A PARTICULAR PROJECT. FOR
INSTANCE, IT CAN INVOLVE
RANDOMIZED TRIALS, OBSERVATIONAL
STUDIES OR EVEN STUDIES OF
THERAPEUTICS OR TREATMENT OF
DISEASE .
THE GOAL IS WORK ACROSS
DIFFERENT GROUPS WITHIN THE
COMMUNITY, WITHIN THE ACADEMIC
INSTITUTION TO WORK AT CHANGING
THE HEALTH AND TO IMPROVE THE
SYSTEMS THAT ARE DESIGNED TO
PROMOTE AND DEVELOP RESEARCH
PROJECTS TO INFLUENCE HEALTH
WITHIN THE COMMUNITY. SO IF WE
THINK CBPR ACROSS THE STEPS AND
COMPONENTS INFORMING THE
PARTNERSHIPS THAT ARE NEEDED, WE
CAN THINK OF THE FIRST PART OF
THE PROCESS AS BEING WORK TO
IDENTIFY POTENTIAL PARTNERS AND
COMMUNITIES WHO CAN BE INVOLVED
IN THE PARTNERSHIP. ASSESSING
THE STRENGTHS OF THAT -- THE
STRENGTHS OF THOSE PARTNERS WHO
ARE COMING TO THE TABLE.
ESTABLISHING THE NORMS AROUND
HOW THESE GROUP ALSO WORK
TOGETHER AND CREATING
INFRASTRUCTURE FOR CARRYING OUT
THE RESEARCH PROCESS. IN TERMS
OF DESIGNING AND CONDUCTING THE
RESEARCH PROJECT, IT IS
IMPORTANT TO THINK ABOUT WHAT
ARE THE MAJOR PROBLEMS THAT ARE
IMPACTING THE COMMUNITY THAT THE
PARTNERSHIP MIGHT ADDRESS. THEN
IT INVOLVES FEEDING THAT
INFORMATION BACK TO THE
COMMUNITY AS THE RESEARCH
PROGRAM IS BEING DEVELOPED BUT
MAKING SURE THE COMMUNITY IS IN
TUNE WITH WHAT IS BEING
DEVELOPED. THERE IS BUY-IN FOR
WHAT MAY BE PROPOSED AS A
POTENTIAL INTERVENTION OR
POTENTIAL STUDY BY THE PARTNERS
AT THE TABLE. IN TERMS OF
IMPLEMENTING THE INTERVENTION OR
STUDY THAT INVOLVES WORKING
TOGETHER THROUGH EACH PART OF
CONDUCTING THE PROJECT. THEN
TAKING THOSE FINDING BACK O THE
COMMUNITY FOR DISSEMINATION. AND
RETOOLING AND RE-TAYLORING THE
STUDY BASED ON FEEDBACK FROM THE
COMMUNITY AND TRANSLATING THOSE
RESEARCH FINDING FOR THE DESIGN
OF FUTURE STUDIES OR
INTERVENTIONS. OF COURSE THIS
PROCESS CAN BE DESCRIBED IN THE
IDEAL BUT THERE ARE MANY
CHALLENGES THAT CAN EXIST IN
BUILDING THESE ACADEMIC AND
COMMUNITY RELATIONSHIPS. THERE
ARE QUESTIONS ABOUT
PARTICIPATION AND COMMUNITY
CONSENT. IF THERE ARE SEGMENTS
PARTICULARLY OF A COMMUNITY THAT
ARE PARTICIPATING IN THE STUDY
WHILE OTHER GROUPS ARE NOT.
THERE MAY BE BUY-IN FROM ONE
SEGMENT VERSUS OTHER SEGMENTS.
SO HOW DO YOU DEAL WITH THOSE --
IDENTIFYING HOW DO YOU DEAL WITH
THOSE ISSUES AND HOW DO YOU
BUILD PARTNERSHIPS THAT CAN WORK
ACROSS AND ADDRESS ISSUES THAT
MAY LIMIT WHO IS ACTUALLY
PARTICIPATING IN A PARTICULAR
STUDY. THERE ARE ISSUES RELATED
TO POWER DIFFERENTIALS AND
PRIVILEGE, DEPENDING WHO IS
SAYING THE RESEARCH QUESTION AND
WHO HAS KNOWLEDGE WITHIN THE
PARTNERSHIP. AND ADDRESSING
THOSE THROUGHOUT THE PROCESS IS
IMPORTANT. ONE MUST ALSO
RECOGNIZE AGAIN THE HISTORICAL
RESEARCH ABUSE THAT LIMITS TRUST
BUT ALSO RACISM, STEREOTYPING
AND BIAS THAT LEAD TO HOW THOSE
CAN INFLUENCE WHAT IS BEING
IMPLEMENTED AS PART OF AN
INTERVENTION AND WHAT IS -- WHAT
WORKS WITHIN A PARTNERSHIP. THEN
THROUGHOUT THE PARTNERSHIP IT IS
IMPORTANT TO BE WILLING TO TALK
ABOUT THESE NEGATIVE HISTORICAL
EVENTS AND PRESENT-DAY EVENTS
THAT LIMIT AND SO MISTRUST
WITHIN -- THOSE WITHIN COMMUNITY
ACADEMIC PARTNERSHIPS AND HAVE
PRODUCTIVE DIALOGUES TO TALK
ABOUT HOW THOSE EVENTS MAY BE
INFLUENCING WHAT IS HAPPENING
FOR OUR COMMUNITY MEMBERS. IT IS
ALSO IMPORTANT TO CONSIDER
DIFFERENCES AND REQUIREMENTS FOR
PUBLISHING AND REQUIREMENTS IN
ACADEMIA THAT ARE DIFFERENT FROM
REQUIREMENTS FOR COMMUNITY
ORGANIZATIONS. WITHIN CBPR THERE
ARE RESEARCH GOALS THAT MAY NEED
TO BE EXPLICITLY OUTLINED AND
ALIGNED FROM THE BEGINNING FOR
COMMUNITY MEMBERS AND THE
ACADEMIC PARTNERS. BUT
ULTIMATELY IT IS IMPORTANT THAT
MEMBERS THROUGHOUT THE RESEARCH
TEAM ENGAGE IN CULTURAL
HUMILITY, LISTENING AND
DECISION-MAKING SO THEY CAN WORK
TOGETHER TO IDENTIFY WHERE ARE
THE COMMON GOALS THAT THEY CAN
WORK TOWARDS IN IMPLEMENTING A
PARTICULAR PROJECT BUT ALSO IN
DISSEMINATING INFORMATION AND
POTENTIALLY INFLUENCING POLICY
BASED ON FINDING FROM THE STUDY.
IT IS IMPORTANT, OF COURSE, TO
REMEMBER THE BENEFITS OF CBPR
GIVEN THAT IT ENHANCES RESEARCH
QUESTIONS FOR COMMUNITIES.
PARTICULARLY THOSE AT HIGHEST
RISK FOR DISEASE AND ENHANCES
THE RELIABILITY AND VALIDITY OF
TOOLS BEING USED WITHIN THE
COMMUNITY INTERVENTION OR
COMMUNITY STUDY. IT ALSO
IMPROVES RESPONSE RATES FOR
STUDIES THAT ARE MEANT TO
RECRUIT INDIVIDUALS FROM DIVERSE
AND UNDERREPRESENTED POPULATIONS
IN CLINICAL RESEARCH. IT SERVES
AS A WAY TO STRENGTHEN
INTERVENTIONS AND STUDIES
TAILORED ON CULTURAL BELIEFS BUT
ALSO THE CONTEXT IN WHICH
COMMUNITIES LIVE. SO MY GROUP
STARTED TO PUT FORTH A FRAMEWORK
AND THINK ABOUT THE METHODS
BEHIND COMMUNITY ENGAGEMENT FOR
WORK WE HAVE BEEN DOING IN THE
WASHINGTON D.C. AREA TO WORK
WITH COMMUNITIES MOST IMPACTED
BY CARDIOVASCULAR DISEASE IN THE
WASHINGTON D.C. AREA. WE
DEVELOPED A MODEL CALLED THE
CARE MODEL, WHICH IS MEANT TO
WORK AT COMMUNICATION, AT
BUILDING AWARENESS,
RELATIONSHIPS AND EMPOWERING
POPULATIONS. REALLY AGAIN TO
BUILD THE TRUST THAT IS NEEDED
FOR IMPLEMENTING COMMUNITY
ENGAGED STUDIES. SO IT STARTS
WITH COMMUNICATING WITH
ORGANIZATIONS THAT ARE TRUSTING
OF THE WORK WE ARE DOING AND THE
POTENTIAL FOR PARTNERSHIPS
AROUND A PARTICULAR RESEARCH
PROGRAM AND HEALTH PROVIDING
OUTREACH TO PROMOTE HEALTH FOR
COMMUNITY MEMBERS SO THAT WE ARE
PRESENT AND KNOWN WITHIN THE
COMMUNITY. SO WE ARE PROVIDING
EDUCATION ON A CONSISTENT BASIS.
IT MEANS MAINTAINING
RELATIONSHIPS EVEN WHEN PROJECTS
ARE NOT HAPPENING SO THAT IF
THERE ARE REOSOURCES WE CAN SHAE
AROUND HEALTH TOPICS OR LEADING
PROGRAMS RELATED TO HEALTH THAT
WE CAN PROVIDE THOSE TYPES OF
RESOURCES. NOT ONLY EMPOWER BUT
WORK COLLABORATIVELY ON HEALTH
RELATED PROJECTS AS WELL AS TO
OBTAIN INDEPENDENT FUNDING SO
THAT THEY CAN BUILD SUSTAINABLE
PROGRAMS AS WELL. TO GIVE YOU A
SENSE HOW WE HAVE WORKED WITH
COMMUNITY ENGAGED RESEARCH IN
THE WASHINGTON D.C. AREA, I WANT
TO HIGHLIGHT HOW WE HAVE
COMBINED COMMUNITY ENGAGED
RESEARCH WITH WHAT HAS
TRADITIONALLY BEEN SILOED AREAS,
INCLUDING AREAS RELATED TO
DIGITAL HEALTH TECHNOLOGIES, GEO
SPATIAL TOOLS INCLUDING OMIX AND
BIOINFORMATICS. WE HAVE WORKED
WIT
TOGETHER TO BUILD A FRAMEWORK TO
WORK WITH PARTNERS IN THE
WASHINGTON D.C. AREA. BECAUSE
CBPR AND COMMUNITY ENGAGED
RESEARCH REQUIRES ONE TO THINK
OF THE SYSTEMS THAT INFLUENCE --
AND THE CONTEXT IN WHICH PEOPLE
LIVE, WE HAVE SOUGHT TO EMBRACE
THOSE SYSTEMS AND THINK FROM A
SYSTEMS STANDPOINT, HOW CAN WE
THINK ABOUT COMPLEXITY OF
INEQUITY, BETTER UNDERSTAND
THOSE COMPLEXITIES BUT ALSO HOW
CAN WE INCORPORATE THOSE
COMPLEXITIES INTO THE
INTERVENTIONS THAT WE DO. WE
HAVE LOOKED AT HOW DO WE BRING
TRANSLATIONAL WORK, HOW DO WE
BRING THAT INTO
COMMUNITY-ENGAGED RESEARCH AND
HOW DO WE UTILIZE THOSE TOOLS AS
POTENTIAL BIO MARKERS FOR
TARGETS AND IDENTIFYING TARGETS
FOR IMPROVING CARDIOMETABOLIC
HEALTH. AS I SAID WE WORK
SPECIFICALLY RIGHT NOW IN THE
WASHINGTON D.C. AREA, BUT OUR
MODEL IN WORKING AND BRINGING
MORE TOOLS AROUND, DIGITAL, OMIX
AND BIO INFORMATICS TO
COMMUNITY-ENGAGED RESEARCH, THAT
IS A MODEL WE CAN USE IN OTHER
URBAN AREAS. IT IS ALLOWING US
TO THINK ABOUT HOW CAN WE BUILD
OUT SOME OF THESE PROGRAMS FOR
POPULATIONS NOT JUST IN THE D.C.
AREA BUT OTHER PARTS O OF THE
COUNTRY. WE STARTED WORKING IN
2012 IN BUILDING A COLLABORATION
WITH HOWARD AND FAITH-BASED
LEADERS IN THE WASHINGTON D.C.
AREA. AND THESE ARE PARTNERS WE
IDENTIFIED THROUGH WORKING
THROUGH ORGANIZATIONS LIKE THE
AMERICAN HEART ASSOCIATION BUT
ALSO THROUGH PARTNERSHIPS
ESTABLISHED BY IDENTIFYING THOSE
WORKING IN THE COMMUNITY WHO
WERE ALSO WORKING AT NIH. OVER
TIME WE HAVE BEEN ABLE TO
INCORPORATE PARTICIPANTS FROM
OTHER NIH INSTITUTES INTO OUR
COLLABORATIVE WITHIN THE
WASHINGTON D.C. AREA TO WORK
TOGETHER WITH INVESTIGATORS IN
IDDK, NIANS AS WELL AS THE
CLINICAL CENTER TO BUILD OUT
PARTNERSHIPS THAT CAN BUILD
DIFFERENT PROJECTS WITHIN THE DC
COMMUNITY. WE HAVE BROUGHT IN
ACADEMIC PARTNERS FROM GW,
AMERICAN UNIVERSITY AND
INDIVIDUALS WORKING IN NONPROFIT
SPACE TO MAKE SURE THAT THEY ARE
REPRESENTED BUT ONE OF -- MOST
IMPORTANT REPRESENTATIVES ARE
COMMUNITY MEMBERS WHO LIVE IN
WASHINGTON D.C. MOST IMPACTED BY
CARDIOVASCULAR DISEASE. MOST ARE
PARTICIPANTS IN OUR PROGRAM AND
BRING EXPERTISE AROUND ASSETS IN
THE COMMUNITY THAT CAN BE --
IMPORTANT AS PART OF OUR STUDIES
SO ALLOWED US TO EMBED LIVED
EXPERIENCE OF COMMUNITY MEMBERS
INTO WORK WE ARE DOING AND
ALLOWS FOR COLLABORATION ACROSS
INSTITUTIONS IN THE D.C. AREA
AND BROAD ENS THE REACH OF THE
WORK WE ARE DOING SO TO GIVE YOU
A SENSE OF HOW THIS WORKS WITH
OUR ADVISORY BOARD OUR FIRST
WORK WAS TO LOOK AT
CARDIOVASCULAR HEALTH WITH THE
UNIVERSITY TO LOOK AT WHAT CAN
BE TARGETS IN THE WASHINGTON
D.C. AREA. THEN WE TOOK THAT
STUDY TO HELP US DESIGN A
DIGITAL HEALTH INTERVENTION FOR
POPULATIONS IN D.C.,
PARTICULARLY AFRICAN-AMERICAN
WOMEN WITH CARDIOMETABOLIC RISK.
THIS THEN EVOLVED INTO WORK IN
OTHER INSTITUTES WHERE WE
CREATED PROJECTS LIKE THE HOPE
NET PROJECT, RUN BY HOWARD
UNIVERSITY TO EXAMINE BARRIERS
TO CLINICAL TRIAL PARTICIPATION
IN AFRICAN-AMERICAN COMMUNITY.
IT ALSO LED TO PROJECT CALLED
D.C. COOK, A PROJECT RUN OUT OF
THE NIH CLINICAL CENTER AND IS A
" FOOD IS MEDICINE
INTERVENTION " AND WE'VE GOT
QUITE A BIT OF FEEDBACK FROM OUR
COMMUNITY MEMBERS ON HOW WE CAN
DEVELOP ADDITIONAL
INTERVENTIONS. THROUGH THIS
PROCESS IN THE STEP-IT-UP
PHYSICAL ACTIVITY INTERVENTION
BUT THE D.C. COOKS INTERVENTION:
IT IS DESIGNED AS A CLINICAL
TRIAL, AS A RANGE OF HEALTH
TOOLS FOR IMPROVING PHYSICAL
ACTIVITY AND TESTING WHETHER
TAYLORING INFORMATION AROUND
PHYSICAL ACTIVITY TO WHERE
PEOPLE LIVE CAN IMPROVE THEIR
LEVELS OF PHYSICAL ACTIVITY. IT
IS DESIGNED IN THEI TERATIVE WAY
OF PROVIDING INFORMATION AND
FEEDBACK ABOUT THE TOOLS WE WERE
USING AS PART OF THE
INTERVENTION BUT WHAT THE
INTERVENTION WOULD LOOK LIKE,
HOW IT WOULD START TO
DISSEMINATE FINDING AND WHAT WE
WOULD -- EVEN NOW WHAT WE WERE
THINKING ABOUT FOR FUTURE
INTERVENTIONS. AS I SAID, WORK
WITHIN THE COMMUNITY ALSO LED TO
WORK TO THINK ABOUT HOW CAN WE
IMPROVE CLINICAL TRIAL
PARTICIPATION WITHIN THE
AFRICAN-AMERICAN COMMUNITY AND
SPECIFICALLY HOW THE WE WORK
WITH THE COMMUNITY ADVISORY
BOARD THE START TO LOOK AT
BARRIERS TO CLINICAL TRIAL
PARTICIPATION IN THE
AFRICAN-AMERICAN COMMUNITY. THIS
WAS A PROJECT FUNDED BY
GENENTECH, HOWARD UNIVERSITY,
AGAIN THROUGH HOPE NET. THIS IS
LED BY HOWARD UNIVERSITY, RUN BY
THEIR IRB. IT IS RUN IN THREE
PHASES. THE FIRST IS DESIGNED TO
LOOK AT BARRIERS AMONG COMMUNITY
MEMBERS BUT ALSO AMONG
INVESTIGATORS TO BETTER
UNDERSTAND WHAT THEY SEE AS
BARRIERS TO CLINICAL TRIAL
PARTICIPATION. WE WORK WITH
INVESTIGATORS AT NIH BUT ALSO AT
HOWARD UNIVERSITY. WE GATHER
DATA ON -- THEY ARE PERCEIVED
THROUGH QUALITATIVE INTERVIEWS
BUT THROUGH QUANTITATIVE SURVEY
TOOLS. WE BROUGHT THE COMMUNITY
MEMBERS AND INVESTIGATORS INTO A
GROUP-BASED MODEL BUILDING
EXERCISE WHERE THEY ARE LOOKING
TO DEFINE THESE BARRIERS AND
FACILITATORS AND HOW THEY
ACTUALLY FIT TOGETHER AND
INFLUENCED CLINICAL TRIAL
PARTICIPATION. PHASE 2 IS WHERE
WE WILL BRING PARTICIPANTS
TOGETHER TO WORK WITH THE
COMMUNITY ADVISORY BOARD TO
REVISE THIS MODEL OF CLINICAL
TRIAL PARTICIPATION. OUR LAST
PHASE, THIRD PHASE WILL BE WHERE
WE ARE ACTUALLY USING MACHINE
LEARNING TOOLS TO SEE IF WE CAN
MODEL THESE -- THIS GROUP-BASED
MODEL AND ACTUALLY USE IT AS A
PREDICTIVE TOOL FOR FUTURE
STUDIES. SO CURRENTLY WE ARE IN
THE SECOND PHASE OF THIS
PROCESS, WHERE WE ARE STARTING
TO LOOK AT HOW WE CAN BRING OUR
COMMUNITY MEMBERS AND
INVESTIGATORS TOGETHER WITH THE
ADVISORY BOARD TO START TO BUILD
A MODEL -- GROUP-BASED MODEL
THAT IS REVISED BASED ON ALL OF
THEIR INPUT. SO OUR WORK ACROSS
THE ADVISORY BOARD WITH THE HOPE
NET PROJECT AS WELL AS THE
STEP-IT-UP PROJECT AND DC COOKS
HAS ALSO LED TO US THINKING
ABOUT HOW CAN WE WORK TOGETHER
AND MAKE RESEARCH AS ACCESSIBLE
AS POSSIBLE FOR THE COMMUNITY.
WE'VE GOTTEN A LOT OF FEEDBACK
DEVELOPING THE NHLBI HOPE
CENTER, WHICH STARTED AS A
CONCEPT IN 2018. IT IS DESIGNED
AS A COMMUNITY-BASED CLINICAL
RESEARCH HUB. SO THIS REALLY
SERVED AS A PARADIGM SHIFT FOR
CONDUCTING CLINICAL RESEARCH AT
NIH. IT IS DESIGNED AS AN
ACCESSIBLE LOCATION FOR CLINICAL
RESEARCH. IT IS EMBED WITHIN A
HOUSING DEVELOPMENT IN NORTHEAST
WASHINGTON D.C. AND IT IS MEANT
TO PROVIDE A SITE FOR N GAUGING
POPULATIONS WHO ARE HISTORICALLY
UNDERREPRESENTED IN CLINICAL
RESEARCH AND ALLOWS MY TEAM TO
SEE PROTOCOL PARTICIPANTS BUT WE
WORK WITH NIAMS TO SEE PATIENTS
THERE. THIS SITE OPENED IN
JANUARY TO 23. SO THE OTHER WORK
WE DO IS MAKING SURE IN OUR
EFFORTS IN COMMUNITY EVENTS AND
EFFORTS WITH THE HOPE CENTER BUT
ALSO IN WORKING IN PARTNERSHIP
WITH COMMUNITY ORGANIZATIONS, WE
ARE DISSEMINATING FINDING FROM
OUR STUDIES AND TRYING TO FIND
HOW WE ARE ENGAGING COMMUNITIES
IN TERMS OF PROVIDING HEALTH
INFORMATION BUT ALSO PROVIDING
THE FINDING BACK TO COMMUNITY
MEMBERS FROM STUDIES. WE
RECOGNIZE IF WE WANT THESE
PARTNERSHIPS TO BE SUSTAINABLE,
THAT WE NEED TO DON'T RECOGNIZE
RESILIENCE AND ASSETS OF
COMMUNITIES WE WORK WITH. THAT
WE NEED TO CONTINUE TO LOOK TO
COMMUNITIES FOR THE DAY
TAILORING AND INTERPRETATION OF
WHAT WE ARE FINDING, MAKE SURE
WE ARE BUILDING THESE
PARTNERSHIPS SO THAT THEY CAN
WORK AT DIFFERENT LEVELS TO
ADDRESS COMMUNITY NEEDS AND
UNDERSTAND HO WE CAN MAKE SURE
THAT THEY -- THAT THEY ARE
INCORPORATING AND IDENTIFYING
THOSE WHO CAN SERVE AS CHAMPIONS
FOR THE NEEDS OF THE COMMUNITY
AND HIGHLIGHTING THOSE
INDIVIDUALS SO THAT WHAT WE ARE
DOING ACTUALLY LEADS TO MORE
SUSTAINABLE INTERVENTIONS AND
PROGRAMS IN THE FUTURE. WE ALSO
NEED TO THINK ABOUT HOW DO WE
ADDRESS WHAT -- WHAT ARE SOME OF
THE WAYS IN WHICH WHAT WE ARE
LEARNING BE TRANSLATED TO HEALTH
CARE SYSTEMS OUTSIDE OF NIH.
EVEN WITHIN THE CLINICAL CENTER.
SO WE CAN THINK OF EXPANDING THE
RESOURCES THAT ARE UTILIZED
WITHIN CLINICAL TEAMS, MAKING
SURE THAT CLINICAL TEAMS HAVE
INDIVIDUALS SUCH AS HEALTH
NAVIGATORS OR COMMUNITY HEALTH
WORKER WHO'S CAN CONNECT
PATIENTS TO COMMUNITY ASSETS TO
ADDRESS SOCIAL NEEDS, THINK
ABOUT CREATING MORE -- REDUCING
BARRIERS TO CLINICAL AND SOCIAL
SERVICES FOR PATIENTS WITHIN
HEALTH CARE SYSTEMS AND THINKING
ABOUT HOW DO HEALTH CARE SYSTEMS
INVEST IN SOCIAL NEEDS
RESOURCES. FOR INSTANCE, AROUND
HOUSING OR FOOD THAT PATIENTS
MOST AFFECTED BY ADVERSE SOCIAL
DETERMINANTS, THOSE FACTORS ARE
THINGS THAT MOST AFFECT WHAT IS
HAPPENING FOR THEM. AND
ULTIMATELY AS WE THINK OF
OBESITY AS PART OF THIS
CONTINUUM ACROSS CARDIOVASCULAR
KIDNEY METABOLIC SYNDROME, THAT
FIRST STEP IN DEVELOPING
CARDIOVASCULAR KIDNEY METABOLIC
SYNDROME WE NEED THE THINK OF IT
AS A PROCESS WHERE WE ARE
SCREENING FOR SOCIAL
DETERMINANTS OF HEALTH AND
ADDRESSING SOCIAL NEEDS ACROSS
THAT PROCESS AND CROSS THE CARE
OF THOSE PATIENTS. SO ULTIMATELY
WHEN WE THINK OF COMMUNITY
ENGAGEMENT IT SERVES AS A WAY OF
BUILDING INTO INTERVENTIONS
METHODS FOR ADDRESSING -- NOT
ONLY UNDERSTANDING BUT
ACCOUNTING FOR AND WORKING WITH
COMMUNITIES TO ALLEVIATE THE
EFFECTS OF ADVERSE SOCIAL
DETERMINANTS BUT ACCOUNTING FOR
ASSETS THAT EXIST WITHIN
COMMUNITIES, WORKING TO BUILD
INTERVENTIONS THAT CAN BE
SUSTAINABLE, THAT ARE BUILT ON
TRUST BUT ULTIMATELY ARE
ACCESSIBLE TO AS BROAD A
POPULATION WITHIN THE COMMUNITY
AS POSSIBLE, TO IMPROVE
CARDIOVASCULAR OUTCOMES AND
IMPROVE THE OUTLOOK OF OBESITY.
THANK YOU FOR YOUR TIME AND I'M
HAPPY TO TAKE QUESTIONS.
>> THANK YOU VERY MUCH. WE
ARE DO HAVE TIME FOR SOME
QUESTIONS. IF YOU DO HAVE
QUESTIONS PLEASE GO AHEAD A. AN
WE WILL SEE WHAT WE HAVE. YOU
HAD MENTIONED CHALLENGES. IN
YOUR EXPERIENCE IN THE D.C.
SETTING WERE THERE PARTICULAR
BARRIERS THAT YOU EXPERIENCED.
THEN HOW DID YOU DEAL WITH
THOSE?
>> SURE. SO THERE HAVE BEEN
MANY CHALLENGES. I WOULD SAY
SOME OF THOSE INITIAL BARRIERS
WERE AROUND WORKING AND BEING A
REPRESENTATIVE OF THE FEDERAL
GOVERNMENT, WORKING IN CITY AND
PART OF THE COUNTRY THAT I'M NOT
ORIGINALLY FROM SO THEY ARE
BEING VERY LIMITED JUST BECAUSE
I'M NOT BEING FROM THE
WASHINGTON D.C. AREA BUT ALSO
NOT BEING TRUSTED BECAUSE I
WORKED FOR THE FEDERAL
GOVERNMENT. SO TRYING TO ADDRESS
THAT MEANT TRYING TO IDENTIFY
COMMUNITY MEMBERS THAT MAY WORK
WITHIN NIH OR THE FEDERAL
GOVERNMENT BUT WHO WERE ALREADY
ALREADY TRUSTED LEADERS WITHIN
THE COMMUNITY. MAY LEAD HEALTH
MINISTRIES AND FAITH-BASED
ORGANIZATIONS OR WORKING WITH
THE NONPROFIT, WORKING AND
VOLUNTEERING WITH A NONPROFIT
THAT COULD START TO BUILD SOME
OF THOSE PARTNERSHIPS. AND THAT
ALLOWED ME TO WORK THROUGH THOSE
INITIAL BRIDGES TO START TO
BUILD PARTNERSHIPS THAT BUILT ON
THEMSELVES.
>> WERE THERE CONNECTIONS YOU
FOUND TO BE MOST FRUITFUL IN
TERMS OF ADVANCING YOUR EFFORT?
>> THE MOST FRUITFUL
INITIALLY WERE PARTNERSHIPS WITH
-- MORE NIH STAFF ACTUALLY THAT
WERE LEADERS WITHIN THEIR
FAITH-BASED ORGANIZATIONS,
WITHIN THEIR CHURCHES. THEY
WORKED AT NICH BUT THEY ALSO
KNEW WHAT WAS HAPPYING IN THE
COMMUNITY. THEY WERE TRUSTED
WITHIN THE COMMUNITY SO THEY
ALLOWED ME AND MY TEAM TO START
TO WORK WITH THEIR FAITH-BASED
ORGANIZA
ORGANIZATIONS, TO BUILD OUT SOME
INITIAL CONNECTIONS.
>> HOW DID YOU IDENTIFY THOSE
INDIVIDUALS, LIKE THE NIH STAFF
THAT WERE VERY INVOLVED IN THEIR
COMMUNITY?
>> IT STARTED REALLY BY WORD
OF MOUTH AND TALKING TO PEOPLE
WHO WERE -- WHO MIGHT ALREADY BE
WORKING IN SOME ASPECT OF
RESEARCH WITHIN D.C. BUT NOT
NECESSARILY WORKING IN COMMUNITY
ENGAGED RESEARCH. IT MAY HAVE
BEEN GOING TO COMMUNITY MEETINGS
AND SEEING WHO MIGHT BE THERE.
IT MAY HAVE BEEN PRESENTING WHAT
MY HOPE WAS AND GOALS IN TERMS
OF BUILDING COMMUNITY
PARTNERSHIPS AND PEOPLE FROM NIH
BEING PART OF THOSE
PRESENTATIONS, SO IT VARIED IN
TERMS OF HOW I WAS ABLE TO
IDENTIFY SOME OF THOSE INITIAL
PARTNERS.
>> HERE'S SOMEBODY WHO SAYS
THANKS FOR YOUR WORK IN THIS AND
CURRENTLY USE IT.
>> FOR NIHLBI THERE ARE TWO
STUDIES WE ARE RECRUITING THERE
AND ABLE TO SEE PATIENT THERE
IS. THEN NIANS HAS STUDIES. I
DON'T KNOW HOW MANY THEY ARE
SEEING, PATIENTS THERE FOR, BUT
THEY ALSO ARE SEEING PATIENTS.
>> ANOTHER COMMENT. THIS IS
EXCELLENT WORK ON ADDRESSING A
BROADER ISSUE RELATED TO THE
SOCIOECONOMIC IMPACT ON HOW THIS
RESEARCH IS VITAL TO IMPROVEMENT
OF HUMAN HEALTH, THANK YOU. YOU
MENTIONED A PROGRAM CALLED D.C.
COOKS. FOOD IS MEDICINE AND
CLINICAL CENTERS INVOLVED. CAN
YOU SAY A LITTLE MORE ABOUT
THAT?
>> SURE. SO THIS IS A COOKING
BEHAVIOR INTERVENTION THAT IS
LED BY DR. NICOLE FARMER. IN THE
CLINICAL CENTER. IT IS DESIGNED
TO IMPROVE COOKING BEHAVIOR FOR
THOSE WHO HAVE CARDIOVASCULAR
RISK SO PRIMARILY WORKS WITH
INDIVIDUALS IN WARDS 7 AND 8 IN
WASHINGTON D.C. SO THOSE ARE
AREAS MORE IN SOUTHEAST D.C.
MORE EAST OF THE AN COST YA
RIVER. AREAS THAT HAVE HIGH
RATES OF KARZ /* CARDIOVASCULAR
DISEASE BUT HIGHER SOCIOECONOMIC
LEVEL LEVELS SO WITH THAT
INTERVENTION THEY ARE LOOKING AT
TRAINING COOKING BEHAVIOR,
IMPROVING COOKING BEHAVIOR,
WORKING WITH A CHEF WHO IS BASED
IN D.C. TO TEACH PARTICIPANTS ON
COOKING BUT ALSO HOW THAT
CHANGES OTHER DIETARY BEHAVIORS
AROUND SHOPPING, FOOD SHOPPING,
AROUND DIETARY HABITS, AROUND
EVEN SOME OF THE OCCUPATIONAL
HEALTH RELATED FACTORS AROUND
DIETARY BEHAVIOR AND HOW THAT
ALSO RELATES TO MORE BIO BE
BIO BEHAVIOR MEASURES SUCH AS
IMMUNE AND MICRO BUY BIOME
MEASURES RELATED TO
CARDIOVASCULAR DISEASE AND
STRESS.
>> INTERESTING PROGRAM. THERE
IS A QUESTION. ARE YOU
INTERESTED IN EXPANDING CONCEPTS
LIKE HOPE CENTER TO OTHER
COMMUNITIES OR CITIES. BY
EXTENSION DO YOU KNOW IF THERE
ARE OTHERS AT NIH LOOKING AT
EXPAND ING THAT CONCEPT?
>> SO THE HOPE CENTER TOOK A
LONG TIME TO COME TO FRUITION SO
I THINK IT IS RIPE FOR EXPANSION
IN TERMS OF THINKING HOW IT
COULD GROW AS A MORE RESEARCH
NETWORK. I WOULD BE -- I
CERTAINLY WOULD BE INTERESTED IN
THINKING ABOUT HOW THAT COULD
HAPPEN. THERE ARE OPPORTUNITIES
IN THINKING ABOUT WHERE IT IS IN
TERMS OF ITS LOCATION. IT IS
BASED IN A HOUSING DEVELOPMENT
RUN BY ENTERPRISE DEVELOPMENT
ORGANIZATION THAT HAS HOUSING
DEVELOPMENTS THROUGHOUT THE
MID-ATLANTIC. SO IF THERE WERE
WAYS TO THINK ABOUT IT AS A
MODEL FOR BUILDING OUT THROUGH
OTHER ENTERPRISE FACILITIES I
THINK THAT WOULD BE -- THERE IS
DEFINITELY POTENTIAL THERE. I DO
THINK IT CAN SERVE AS A MODEL
FOR GROWING THE ACCESSIBILITY OF
CLINICAL RESEARCH THAT NIH DOES.
>> I DON'T SEE ANY OTHER
QUESTIONS AT THE MOMENT. WE
WOULD CERTAINLY LIKE TO THANK
YOU FOR JOINING US TODAY. FOR
THOSE OF YOU THAT WATCH US ON A
REGULAR BASIS, OUR NEXT
EDUCATION SERIES SESSION WILL BE
THURSDAY OCTOBER 17TH FROM 3:00
TO 4:00 AND AT THE NIH VIDEO
CAST. I WILL BE SENDING OUT
ADDITIONAL INFORMATION WITHIN
THE NEXT FEW WEEKS. THANK YOU,
DOCTOR. WE APPRECIATE YOU
JOINING US TODAY.
>> THANK YOU FOR THE
OPPORTUNITY. I APPRECIATE IT.
>> THANK YOU, BYE-BYE.
>> ALL RIGHT, BYE-BYE.