I'M FERNANDO BRUNO FROM HEALTH SCIENCES AT THE CENTER FOR RESEARCH AND I AM AT NHLBI/NIH AND I'M A CO-CHAIR AND IT GIVES ME THE PLEASURE TO WELCOME YOU TO OUR EVENT. THANK YOU FOR BEING HERE TODAY. WE HAVE 1,006 REGISTRANTS PLUS THOSE JOINING US VIA THE LIVE BROADCAST. I WOULD ALSO LIKE TO THANK OUR 24 PANELISTS, SIX MODERATORS AND SIX SPEAKERS ENGAGING IN THE CONVERSATION ON INVESTING IN THE SCIENCE OF COMMUNITY ENGAGED HEALTH DISPARITIES RESEARCH AND THANK THE PLANNING COMMITTEE THAT HAVE BEEN WORKING TIRELESSLY OVER THE PAST YEAR TO MAKE THIS WORKSHOP POSSIBLE. Dr. MALIA ILIAS AND Dr. MARY MATH RA BECKER ROPER AS WELL ASR LEADERSHIP DOCTORS DAVID CLARK AND OUR DIRECTOR GEORGE MENSA AND THE LOGISTICAL TEAM LED BY RASHAWN JONES WITH TATIANNA KING AND ALTHOUGH TODAY MAY MARK THE END OF THE PLANNING AND THE FRUITION OF THIS WORKSHOP, I PERCEIVED THIS ONLY AS THE BEGINNING AND I HOPE THAT ALL OF US ENGAGE IN ALL THESE CONVERSATIONS LIGHT A FLAME THAT WILL PROPEL YOUR INTEREST IN THIS FIELD. SOME HOUSEKEEPING NOTES, FOR THOSE WHO ARE REGISTERED, YOU HAVE THE CHANCE TO POSE QUESTIONS AND IF YOU KNOW SOMEONE WHO DIDN'T HAVE A CHANCE TO REGISTER, PLEASE TELL THEM THEY CAN STILL JOIN US THROUGH THE LIVE BROW CAFFEINE THOUGH THEY'RE NOT GOING TO BE ABLE TO ASK QUESTIONS THEY CAN AT LEAST WATCH ALL THE DISCUSSIONS WE'LL HAVE. OUR WEBSITE CONTAINS TODAY'S AGENDA OUTLINING OUR WELCOME ADDRESS, KEYNOTE PEAKERS AND ALL THE MOTIONPEAKERSINFORMATION YOR BREAKS. WE HAVE PHOTOS AND BIOS OF OUR PARTICIPANTS AND PANELISTS AND SPEAKERS WHICH THEN WE WILL ALLOW US TO KEEP OUR INTRODUCTIONS SHORT. SO, WITH THAT BEING SAID, I THANK YOU AGAIN FOR BEING HERE AND IT'S A PLEASURE TO SEE THIS FINALLY HAPPENING AFTER SO MANY MONTHS OF PLANNING AND IT WILL BE TWO AMAZING DAYS. WITHOUT FURTHER ADIEU, I'LL PASS THE WARD TO INTEREST ELISEO PEREZ-STABLE ON MINORITY HEALTH IN HEALTH DISPARITIES AND HERE AT THE NATIONAL INSTITUTE OF HEALTH INSTITUTE WHOWILL THE WILL DELIVER OUR WELCOME ADDRESS. >>GOOD MORNING, EVERYONE. I WANT TO MAKE SURE YOU HAVE MY RIDSLIDES AND YOU WILL ADVANCE M OR SHOULD I SHARE THE SCREEN? >>WE SHOULD BE ABLE TO SHARE YOUR SLIDES. WE HAVE A MASTER DECK READY TO GO. CAN YOU PLEASE, CONFIRM. >>YOU SAW THEM EARLIER SO I WAS EXPECTING THAT. >>YES, WE HAVE YOUR SLIDES. >>OK, GREAT. SO, PUT THOSE UP, PLEASE. SO FIRST OF ALL, WELCOME, EVERYONE, WHO IS HERE. I CAN SEE FOLKS WHO HAVE JOINED US. I WORK VERY CLOSELY WITH A NHLBI ON A VARIETY OF PROGRAMS RELATED TO OUR COMMUNITIES AND THIS IS A TIMELY AND FROM A SCIENTIFIC AND I WANTED TO BRIEFLY, RADIO THIS INTRODUCE YOU INFORM NIMMB AND GOT I SEE IT WE CAN HAVE THE SLIDES, THANK YOU. I'LL START WITH THE POPULATIONS WITH HEALTH DISPARITIES AND NIMHD/NIH PERCEIVES THEM. THE FIRST THREE BULLETS ON THIS SLIDE ALL RACIAL AND ETHNIC MINORITY POPULATIONS, ALL POOR PEOPLE REGARDLESS OF THEIR RACE OR ETHNICITY AND UNDERSERVED RULE RESIDENTS WHERE DESIGNATED AS POPULATION WITH HEALTH DISPARITIES BY OUR ORIGINAL LEGISLATION IN THE YEAR 2000 SO WE ADHERE TO THESE BY STATUTORY MANDATES AND SEXUAL MINORITY WHY DECLARED A POPULATION WITH HEALTH DISPARITIES IN 2016 AFTER A TWO-YEAR PROCESS WHICH I INHERIT IT WHEN I ARRIVED IT IN SEPTEMBER OF 2015. KEEP IN MIND THIS STATUE THAT THE LEGISLATION DOES AUTHORIZATION ME AS DIRECTOR OF NIMHD AS THE ONLY PERSON WHO DESIGNATE A POPULATION HAVING HEALTH DISPARITIES IN COLLABORATION WITH THE DIRECTOR OF THE AGENCY AND CLEARLY NEEDED TO GO APPROVAL PROCESS AND NIH IN THE DEPARTMENT LEVEL. NOTE THAT ALL OF THESE FOUR GROUPS ARE DEFINED NOT BY CAN CONDITION OR CHRONIC DISEASE BY IDENTITY, FACTORS, WHERE THEY LIVE OR SOCIAL CLASS. WE CONSIDER THERE'S AN INHERENT SOCIAL DISADVANTAGE H THAT RESUS FROM BEING SUBJECT TO DISCRIMINATION OR RACISM IN ALL THESE GROUPS, AND THEN ALSO, BEING UNDERSERVED IN HEALTHCARE. SO, WE SEE A DIFFERENCE IN AN OUTCOME THAT IS WORSE IN ONE OF THESE POPULATIONS COMPARED TO A REFERENCE GROUP AS DEFINING HEALTH DISPARITIES. NEXT SLIDE, PLEASE. I ALSO START FROM THE FUNDAMENTAL POINT THAT RAI RACED ETHNICITY IS SOCIOECONOMIC STATUS FROM FORMAL YEARS OF EDUCATION OR ININ MOST SIMPLY, ARE FUNDAMENTAL IN DETERMINING HEALTH AND BECAUSE THEY'RE SO OPPORTUNITY MENTAL, THEY SHOULD FUNDAMENTAL THEY SHOULD BE MEASURED ACROSS ALL STUDIES THAT INVOLVE HUMAN PARTICIPANTS. AND THESE ARE EXAMPLES OF ISSUES THAT HAPPEN THAT WE DON'T FULLY UNDERSTAND. RACE, ETHNICITY AND SOCIOECONOMIC STATUS, FOR EXAMPLE, PREDICT LIFE EXPECTANCY IN A ROBUST WAY, THAT ARE NOT EXPLAINED. THERE'S NOT ONE CAUSE OR ANOTHER BUT WE NEED TO UNDERSTAND WHY THIS IS THE COMMON DISEASE AND THIS EFFECTS AFRICAN AMERICAN AND PUERTO RICAN INDIVIDUALS BOTH IN TERMS OF INCIDENTS AND SEVERITY AND AGAIN, NOT FULLY UNDERSTOOD. MOST CHRONIC DISEASES ARE MORE COMMON IN PEOPLE WHO ARE POOR AND YET IT IS NOT DUE TO BAD BEHAVIOR OR POOR BEHAVIOR. THERE ARE A LOT OF STRUCTURAL FACTORS THAT PLAY IN. WITHIN THE DIAGNOSIS OF TYPE-2 DIABETES, WE SEE A WIDE VARIETY OF OUTCOMES FORECAST, ALL RACIAL AND ETHNIC POPULATIONS WITH DIABETES OF LESS HEART DISEASE BY ABOUT 30% BUT TWICE AS MUCH END-STAGE RENAL DISEASE COMPARED TO THEIR WHITE COUNTERPARTS. AND THIS IS ALSO NOT BEEN EXPLAINED. SO WHAT CAN SCIENCE DO TO REDUCE INEQUITIES. I'LL START WITH THESE FIVE POINTS. FIRST OF ALL, STANDARDIZED MEASUREMENT OF SOCIAL AND DEMOCRATIC FACTORS THAT AFFECT HEALTH. WE NEED TO USE COMMON MEASURES SO WE CAN HAVE POWER IN NUMBERS. SECOND, AND THIS IS THIS WORKSHOP'S THEME, WE NEED TO CULTIVATE COMMUNITY ENGAGEMENT AND BUILD TRUST FOR SUSTAINABLE RELATIONSHIPS. THIS IS NOT FOR SOCIAL JUSTICE PURPOSES ONLY, THIS OR FOR DISSEMINATING RESULTS AND THIS IS REALLY A RESEARCH PLATFORM AND INFRASTRUCTURE THAT IS JUST AS IMPORTANT ONE MIGHT BUILD FOR OTHER KINDS OF INVESTIGATIONS AND THEY NEED FACILITATE DISCOVERY SCIENCE WITH BIG DATA AND SOME OF THIS IS OBVIOUS THROUGH ELECTRONIC THROUGH HEALTH RECORDS AND LINKAGES IN POPULATION DATA. THERE'S A LOT OF DATA COLLECTED AND MOST SUPPORTED BY THE FEDERAL GOVERNMENT BUT NOT ALL AND ON A VARIETY OF TOPICS THAT WE NEED TO LEVERAGE IN ORDER TO FACILITATE DISCOVERY AND WE ALSO NEED TO IMPLEMENT WHAT WE KNOW. CONTROL BLOOD PRESSURE, FOR EXAMPLE, IN THE POPULATIONS THAT ARE MOST AFFECTED BY IT. AND THIS IS SOMETHING THAT SHOULD REALLY BE A PRIORITY. AND WE ALSO NEED TO BE AN ENGINE FOR PROMOTING DIVERSITY BECAUSE WE ARE BEYOND CRISIS AND NEXT SLIDE, PLEASE. BACK IN 2018 OR SO ON A PROJECT TO CREATE OR VET EXISTING MEASURES FOR SOCIAL DETERMINANTS OF HEALTH AND WE CAN SEE OUR CONCEPTION OF THIS INCLUDES BOTH INDIVIDUAL FACTS OR THE AND LISTED AT THE TOP OF THE SLIDE, DEMOGRAPHICS AS WELL AS OTHER FACTORS LISTED HERE AS WELL AS STRUCTURAL DETERMINANTS WHICH ARE USUALLY WHAT PEOPLE ROW FER TO WITH SOCIAL DETERMINANTS OF HEALTH SO IT'S JUST AROUND HOUSING, GREEN SPACE, TRANSPORTATION AND BROADBAND ACCESS, ET CETERA. I ENCOURAGE EVERYONE TO VISIT IT AND WE WILL ENCOURAGE MORE THAN ENCOURAGING OUR SCIENTIST TO USE THE MEASURES WE'VE VETTED IN ON THE PHOENIX COOL KIT. STAFF CREATED THIS FRAMEWORK INSPIRED BY THE SOCIALLY LOGICAL MODEL ON A FRAMEWORK WE DEVELOPED ON AGING TO CAPTURE WHAT THE RESEARCH FIELD OF MINORITY HEALTH AND MEANT DISPARITIES IS ABOUT AND YOU NOTE THE DOMAINS OF INFLUENCE VARYING FROM BIOLOGICAL TO THE HEALTH-CARE SYSTEM AND MORE RECENT IN THE LAST 20 OR 25 YEARS THAT THEY'VE EMERGED AS IMPORTANT AND THE INDIVIDUAL TO SOCIETAL AND THERE'S NO CAUSAL DIRECTION HERE, THERE'S NOT COMPREHENSIVE AND IT'S JUST MEANT TO BE A REFERENCE POINT TO HELP INDIVIDUALS RESEARCHERS IDENTIFY WHERE THEIR WORK IS AND I DO WANT TO EMPHASIZE THE HEALTH-CARE SYSTEM, COMMUNITY ENGAGEMENT DOES NOT EXIST IN ISOLATION JUST LIKE HEALTHCARE. WE NODE TO CREATE LINK AGES WITHIN THOSE TWO. PEOPLE WITH CHRONIC DISEASE DEPEND ON AN EXCELLENT HEALTH-CARE SYSTEM TO MANAGE THEIR QUALITY AND QUANTITY OF LIFE AND EVEN THOUGH POPULATION WILL DO FINE WITH JUST PERIODIC AND OCCASIONAL HEALTH-CARE SYSTEM CONNECTIONS. WE HAVE WORK TO DO TO SHIFT MORE OF THE FUNDING TOWARDS THE RIGHT ON THIS FRAMEWORK. NEXT SLIDE. THE ALLIANCE AGAINST COVID-19 THAT NHLBI AND NIMHD STOOD UP IN 2020 YOU CAN SEE THE TEAMS WE FUNDED IN 2020 AND THEN IN 2021 Dr. GIBBONS AND I ARE FULLY COMMITTED TO MAINTAINING THIS AND THIS IS I THINK A POINT TO A INFRASTRUCTURE OF COMMUNITY ENGAGE TEAMS FOR PARTNERSHIPS FOR CONDUCTING RESEARCH AND IT MAY NOT HAVE BEEN THE PRIMARY EMPHASIS THAT PEOPLE HAVE NOTICED ABOUT CEAL IN THE FIRST TWO YEARS BUT THIS IS ULTIMATELY OUR GOAL. CEAL IS BUILT AND DEPENDS ON A TRUSTING RELATIONSHIP. WE ACKNOWLEDGED ALL THE SOCIAL DETERMINANTS AND WE CREATED THIS MACHINE TRA OF MOVE AT THE SPEED OF TRUST AND IT'S TRUST BETWEEN SCIENTISTS AND NIH AND IN THE COMMUNITY. AND WE'RE NOT GOING TO THE COMMUNITY TO SAY YOU HAVE TO TO THIS AND DO THAT NOR ARE THEY COMING TO US AND SAYING GIVE US MONEY TO DO WHAT WE WANT. IT REALLY IS A PARTNERSHIP. IT WILL DEPEND ON TRUSTING EACH OTHER. AND DEPEND ON, YOU WILL BE THERE FOR ME WHEN I NEED YOU IF WE HAVE BUILT THIS TRUSTING RELATIONSHIP IN VI VICE VERSA AD WE NEED TO FUND THAT AT SOME NIH SO THERE'S AN INFRASTRUCTURE THEXISTS. THAT'S THE GOAL THE GOAL. COMPASS IS A CRITICAL COMMON-FUND PROGRAM THAT IS GOING TO BE TRANSFORM TIVE PRIMARILY BECAUSE WE ARE GOING TO FUND AND I'M ONE THE CO-CHAIRS OF THIS AND 10 YEARS, $300 MILLION, THE COMPASS MOUNT-LED HEALTH EQUITY STRUCTURAL INTERVENTIONS AND THE FUNDING WILL GO TO COMMUNITY ORGANIZATION AND IT'S ON FRIDAY AND THOSE SELECTED WILL COME IN. THIS IS FROM OTHER TRANSFER AUTHORITIES SO IT'S NOT A REGULAR GRANT MECHANISM. WE WILL FUND A COORDINATING CENTER, THAT'S THE U-24 THROUGH A REGULAR GRANT MECHANISM DUE AT THE END OF JANUARY AND THERE WILL BE ACADEMIC RESEARCH HUBS WHICH WE WILL FUND AFTER THESE TWO PROCESSES ARE COMPLETED IN THE SECOND YEAR. SO, LET ME FINISH BY HIGHLIGHTING POINTS THAT NEED TO BE CONSIDERED IN PROMOTING HEALTH EQUITY IN HEALTHCARE. EXPANDING ACCESS AND NEED INSURANCE AND WE NEED ACA EXPERIMENT, A PLACE AND WE NEED A CLINICIAN. DON'T FORGET THAT. AND COMMUNITY ENGAGEMENT, IT'S ESSENTIAL PARTNER IN THAT REGARD. IMPLEMENT THE INTERVENTIONS WE KNOW TO WORK AND COORDINATION OF CARE, THIS IS A LOT OF PROMISE HEALTHCARE SETTINGS AND ALSO IN COMMUNITIES SO, THE NAVIGATORS PERSONS WITH TARGET CONDITIONS, THIS IS A COMMON THEME BETWEEN HEALTHCARE SETTINGS AND COMMUNITY ENGAGEMENT. PATIENT-CENTERED CARE. IF THE COMMUNITY CLINICS PRIMARY CARE SHOULD BE THE FUNDAMENTAL BASIS OF OUR HEALTH-CARE SYSTEM EVEN THOUGH IT HAS NOT BEEN THAT WAY AND THERE'S EVIDENCE IT SAVES LIVES AND COMPETENCE IN MANAGING DIFFERENT PROBLEMS IS IMPORTANT AND INCREASE FOSTER INCREAS AND I DON'T HAVE A COMPUTER OR WIFI AND OR I HAVE HARDER ACCESS TO WIFI I DEPEND ON MY PHONE AND THE ELECTRONIC HEALTH REGARD CAN DO A LOT TO THIRD AND A PERFORMANCE ON EQUITY, QUALITY MEASURE OF EQUITY, NOT JUST DID YOU SAVE MONEY AND GET THE BEST OUTCOMES? ALL ARE IMPORTANT BUT THE SAFETY NET NEEDS TO BE VALUED AND THIS IS ONE CONTEXT OF HOW TO DO IT AND FINALLY, WHAT COMMUNITY ENGAGEMENT NEEDS TO DO IS CREATE THIS FRAMEWORK, THIS INFRASTRUCTURE FOR EQUAL PARTNERSHIP BETWEEN SCIENTIST ORGANIZATIONS, SCIENTISTS NED TO BE SEEN INDEPENDENT OF YOUR RACE, ETHNICITY AND ALL THESE OTHER FACTORS ONE NEEDS TO GO AND TALK AND SOMETIMES PEOPLE ARE HESITANT TO DO THAT BUT WE NEED TO MIX IT UP JUST LIKE WE WANT COMMUNITY LEADERS AND ORGANIZATION MEMBERS TO IN VISIT US AND THESE BUILD THESE LONG-TERM SUSTAINABILITY RELATIONSHIPS. THE COMMUNE ENGAGEMENT IS BUILT ON THE FUNDAMENTAL PREMISE THAT HEALTH IS IMPORTANT, NOT JUST HEALTHCARE MANY OF WE CAN HAVE THE BEST HEALTH-CARE SYSTEM IN THE WORLD AND HAVE NOT A HEALTHY ENVIRONMENT AND ADVANCES WHERE WE END UP WITH JUST BEING TREAT AND TAKING CARE OF ALL THE EXTREME CASES, WE NEED BOTH, A GREAT HEATH CARE SYSTEM TO MANAGE ILL AND SICK PERSONS AS WELL AS PROMOTE HEALTH IN OUR COMMUNITY AND TO DO THAT WE NEED TO ENGAGE COMMUNITY RESOURCES AND TO ADDRESS THE ISSUES WE UNDERSTAND ARE IMPORTANT TO PROMOTING HEALTH AND ENHANCE THE ROLE OF COMMUNITY-BASED OUTREACH STAFF WHICH IS ONE OF THE MECHANISMS THAT WE WOULD PROPOSE. I THINK THIS IS THE LAST SLIDE. THANK YOU FOR YOUR ATTENTION AND I TURN IT BACK TO THE ORGANIZERS OF THE WORKSHOP, THANK YOU, VERY MUCH. >>THANK YOU, VERY MUCH. IT'S A WONDERFUL WAY TO GET US STARTED FOR THESE TWO DAYS OF WORKSHOPS AND NOW IT'S MY PLEASURE TO INVITE Dr. SYLVIA TRENT ADAMS FROM THE UNIVERSITY OF NORTH TEXAS HEALTH SCIENCE CENTER AT FORT WORTH AND SHE WILL FOCUS ON HEALTH DISPARITIES RESEARCH SO Dr. TRENT ADAMS, WELCOME. >>GOOD MORNING AND THANK YOU. I MUST SAY I'M SO PLEASED TO BE HERE WITH YOU TODAY AND TO SHARE SOME INFORMATION PROBABLY NOT NEW MOTION TO MOST OF US ON THIS MEETING BOWED I HOPE THAT WE CAN START TO HAVE A CONVERSATION ABOUT THE PAST, PRESENT AND FUTURE OF COMMUNITY ENGAGE HEALTH DISPARITIES RESEARCH, WHY IT'S SO IMPORTANT TO US, AND TO THINK ABOUT THE INDIVIDUAL CHARRER ADVERTISE PICK AND COMMUNITY CHARRER ADVERTISE TICKS THAT ALLOW US TO LOOK INSIDE OF OUR OWN AREAS OF INFLUENCE, COMMUNITIES AND THE PATIENT POPULATIONS WE SERVE AND THE RESEARCH WE DEVELOP AND DRIVE AS PART OF OUR INDIVIDUAL AND COLLECT ADMISSIONS SO I WANT TO SAY THANK YOU TO NIH AND NHLBI AND ALSO FOR THE WORK THAT IS BEING DONE BY THE NATIONAL INSTITUTE OF MINORITY HEALTH AND HEALTH DISPARITIES. LET ME GO TO MY FIRST SLIDE. PLEASE. I JUST WANT TO DISCLOSE I HAVE NO FINANCIAL DISCLOSURES SO THE CONFLICT OF INTEREST IN THIS PRESENTATION. THE -I WILL EXPRESS TODAY DURING THIS PRESENTATION ARE OF THE PRESENTERS, MYSELF AND NOT THE UNIVERSITY OF NORTH TEXAS HEALTH SCIENCE CENTER. THERE ARE A FEW THINGS I WANT TO MAKE SURE WE COVERED TODAY AS PART OF THIS PRESENTATION. I WANT TO TALK ABOUT SOME OF THE HISTORICAL ASPECTS OF HEALTH DISPARITIES AND RESEARCH IN THE UNITED STATES AND I ALSO WANT TO LOOK AT SOME OF THE CHALLENGES THAT WE'VE EXPERIENCED IN THE RESEARCH ARENA AROUND COMMUNITY ENGAGE RESEARCH AND SOME OF THE PERSPECTIVES FROM THE COMMUNITY'S STANDPOINT AND HOW IT'S RELATED TO THE RESEARCH THAT WE DO IN THE SCIENTIFIC AND THE SCIENCE SOCIAL SCIENCES AND EDUCATION AND WORKFORCE DATA THAT IS SO CRITICAL TO US. AND I WAS DESCRIBING STRAT GOES TO IMPROVE HEALTH DISPARITIES RESEARCH AS YOU MOVE IN ORDER INTO OTHER AREAS OF RESEARCH AND NEXT SLIDE. I WANT TO LEAVE YOU WITH THIS QUOTE, WHY IS HEALTH DISPARITIES AND A LOT OF WHAT WE'VE SEEN OVER THE COURSE OF HISTORY IN THE UNITED STATES AND THIS QUOTE FROM MARTIN LUTHER KING SUMS IT UP, OF ALL THE FORMS OF INEQUALITY, INJUSTICE AND HEALTHCARE IS THE MOST SHOCKING AND INHUMANE END QUOTE. TODAY I WANT TO TALK ABOUT WHY HEALTH DISPARITIES ARE SO IMPORTANT AND WE'RE SEEING INCREASED DIVERSITY IN THE UNITED STATES BUT ALSO WE LIVE IN A GLOBAL COMMUNITY AND IF COVID-19 DID NOT TEACH US ANYTHING, IT DID TEACH US THAT WE ARE IN DEED A GLOBAL COMMUNITY AND WHAT HAPPENS AT HOME AND IMPACTS THOSE EVENTS ABROAD AND WHAT HAPPENS ABROAD IMPACT OUR LOCAL COMMUNITIES AND I HIGHWAY PATROL WE CAN ENGAGE SO ALL CAN BENEFIT FROM THE SCIENTIFIC ADVANCES THAT WE'RE EXPERIENCING IN THE SCIENTIFIC ARENA AND SPREAD THAT KNOWLEDGE INTO COMMUNITIES SO THEY CAN BEST INFORM US HOW WE CAN WORK WITH THEM AND MINORITIES WILL RECEIVE PREVENTATIVE HEALTHCARE SERVICES AND THIS IS IN COMPARISON TO OUR WHITE COUNTERPARTS. MINORITIES GENERAL WAIT LONGER FOR HEALTHCARE SERVICES AND WHEN THEY EXPERIENCE HEALTHCARE THEY HAVE LOWER QUALITY OF CARE AND THIS IS NOT ONLY TRUE FOR ONE CONDITION. AT THE EXPERIENCE WORSE HEALTH OUTCOMES ACROSS MANY DIFFERENT DISEASE ENTITIES AND WE CAN CITE RESEARCH FROM THE CARDIOVASCULAR RESEARCH AND WE'VE SEEN IT IN LATE DIAGNOSIS OF CANCER AND ACROSS THE GLOBE WITH RESPECT TO HIV AND NEXT SLIDE. SO, WHY IS IT WE HAVE SUCH HUGE DISPARITIES IN OUR RURAL COMMUNITIES AND THOSE WHO ARE GEOGRAPHICALLY THIS DISPARATE. THERE'S A LOT OF MEDICAL MISTRUST. WITH COVID-19 THERE WAS A LOT OF MEDICAL MISTRUST WITHIN RACIAL AND ETHNIC COMMUNITIES. WE SEE PORTAL TEE AND THERE'S STRUCTURAL VARIES AND WE SEE HUGE DISPARITIES IN ACCESS BECAUSE OF SIMPLY THE ACCESS TO SERVICES OR RESEARCH ENTERPRISE DOESN'T ALWAYS CONSIDER RURAL COMMUNITIES AS A PART OF THE RESEARCH NETWORK THEY WILL REACH OUT TO INCLUDE THEM AS A PART OF RESEARCH STUDIES BECAUSE OF THE DIFFICULTIES RELATED TO GEOGRAPHIC BARRIERS AND THIS IS SOMETHING THAT IS REALLY IMPORTANT TO ME AS WE HAVE STARTED TO LOCK AT HEALTHCARE SYSTEMS ON IMPLICIT BIAS OF PROVIDERS AND THIS IS NOT TO INDIVIDUAL OUT ONE PARTICULAR PROVIDER POPULATION AND ACROSS THE HEALTHCARE DELIVERY SYSTEM FROM THE FRONT DESK ALL THE WAY THROUGH TO THOSE DELIVERING HEALTHCARE SERVICES OR CREATE OPPORTUNITIES FOR ACCESS AND THIS IS BEEN DOCUMENTED FOR CASE MANAGEMENT, WE'VE SEEN IT IN DIRECT CARE AND TREATMENT SERVICE AND WE'VE ALSO SEEN IT IN THE ADMINISTRATIVE BILLING OPERATIONS OF HEALTHCARE INSTITUTIONS WHERE THERE'S IMPLICIT BIAS THAT FROM A GROUP OF ORGANIZATIONS. THERE ARE SIGNIFICANT GAPS IN ACCESS QUALITY AND SAFETY AND THESE ARE THE FACTORS THAT HAVE INFLUENCED THE LACK OF ACCESS FOR DESPAIRED POPULATIONS. SO, THERE IS A DIFFERENCE BETWEEN HEALTH HEALTHCARE DISPARITIES AND I WON'T GO INTO A LOT OF DETAIL HERE AND WHAT WE SEE WITH HEALTHCARE, WE SEE HEALTH AND HEALTHCARE DISPARITIES AND THEY'RE DIFFERENT CONCEPTS AND THEY REFER TO A HIGHER BURDEN OF ILLNESS, AREA AND DISEASE AND ALSO MORTALITY AND IT'S EXPERIENCED BY ONE GROUP IN HEALTH INSURANCE COVERAGE AND IT'S THE HEALTHCARE ADVERTISE PARTY AND HEALTH AND HEALTHCARE DISPARITIES HAVE DIFFERENCES THAT CANNOT BE EXPLAINED BY VARIATIONS AND NEEDS SO THERE ARE MANY STUDIES THAT HAVE SHOWN THAT INDIVIDUALS, ESPECIALLY MINORITY POPULATIONS, THAT HAVE SAME INCOME LEVEL SAME EDUCATION LEVEL AND ARE INSURED AND HAVE DIFFERENT HEALTH COME EXPERIENCES WHEN THEY ACCESS THE SYSTEM. THOSE ARE SOME OF THE UNIQUE DISPARITIES THAT WE HAVE TO BE ABLE TO AND RESEARCH AND USE THE INFORMATION THAT WE HAVE AVAILABLE TO US TO BETTER DELIVER SERVICES AND ALSO CRAFT NEW RESEARCH A AGAIN DADS. THERE'S UNIQUE EXAMPLES AND DISTINCT EXAMPLES OF UNHEALTH DISPARITIES, MORTALITY, BURDEN OF DISEASE AND MANY CITIES THAT WE'RE WORKING THERE ARE VERY FEW OF THOSE COMMUNITIES THAT HAVE ACCESS TO RESEARCH OUTSIDE OF THEIR OWN VIGNETTE WORKS OF SERVICES. WHEN THEY SEEK SERVICES, IT'S USUALLY THROUGH AN EMERGENCY ROOM OR SOME OTHER TYPE OF URGENT CARE FACILITIES WHICH MINIMIZES THE A LOT FOR HEALTHCARE INTERVENTIONS TO BE ABLE TO SUPPORT THEM FROM A PRIMARY CARE STANDPOINT. NEXT SLIDE. I WANTED TO HIGHLIGHT THIS LANDMARK STUDY DONE BY THE INSTITUTE OF MEDICINE SEVERAL YEARS AGO ON UNEQUAL TREATMENT AND THIS STUDY SHOWED MANY DISPARITIES WITHIN HEALTHCARE AND ESPECIALLY AROUND RACIAL AND ETHNIC DISPARITIES IN HEALTHCARE DELIVERY SYSTEMS AND I WANT TO TALKING ABOUT SOME OF THE FINDINGS FROM THIS STUDY. NEXT SLIDE. THE IOM'S REPORT ON UNEQUAL TREATMENT IN 2016, FOUND THAT RACIAL AND ETHNIC DISPARITIES AND HEALTHCARE ASSOCIATED WITH WORSE OUTCOMES AND THAT THEY'RE IN THE SOCIAL AND INEQUALITIES AND WE SAW THERE'S EVIDENCE OF PERSISTENT RACIAL AND ETHNIC ETD EMPLOYMENT, HOUSING, TRANSPORTATION AND GENERAL ACCESS TO HEALTHCARE SERVICE 0 . BLACK FEMALE PATIENTS RECEIVE LESS THAN WHITE FEMALES AS PART OF THE OF THE STUDIES THAT WAS DONE AND ALSO, FEMALE PHYSICIANS IN CONTRAST WOULD PRESCRIBE HIGHER DOSES OF BLACK PATIENTS THAN WHITE PATIENTS AND AS A PART OF THE ANALYSIS AND SO AS WE SEE IN GENERAL WE'VE SEEN MANY STUDIES THAT HAVE DOCUMENTED THE PAST SEVERAL DECADES, ACCESS TO PAIN MEDICATIONS FOR AMERICANS AND FOR ADVANCEMENT AND DISEASE AND THERAPIES AND HOW MANY WHITE PATIENTS AND BLACK PATIENTS RECEIVED CARDIAC CATH ORGANIZATIONS AND DISPARITIES NEXT SLIDE. HEALTH DISPARITIES WITHIN THE UNITED STATES, THERE ARE MANY THAT WE'RE STILL STRUGGLING WITH AND WE SEE INFANT PORTAL TEE RAIDS AND HAVE IMPROVED BUT CONTINUE TO BE HIGHER THAN WHITES AND WE CONTINUE TO SEE IN CERTAIN STATES SUCH AS STATE WHERE I'M LOCATED IN TEXAS AND ALSO MISSISSIPPI AND ALABAMA, AND ALSO IT'S NOT UNUSUAL IN THE SOUTH TO SEE HIGH RATES OF INFANT MORTALITY AS WELL AS AFRICAN AMERICANS MATERNAL MORTALITY, AFRICAN AMERICAN WOMEN ARE FOUR TIMES MORE LIKELY THAN WHITE WOMEN TO DIE DURING PREGNANCY AND THIS IS ACROSS THE UNITED STATES BUT EVEN MORE SO WHEN CERTAIN SOUTHERN STATES AND WE SEE PATIENTS OF COLOR WHO RECEIVED UNSEEK TREATMENT BEING TREATED AT THE SAME FACILITY BY THE SAME PROVIDERS AND WHERE WHERE WE NEED TO DIG INTO IMPLICIT BIAS. NEXT SLIDE. I WANT TO TALK ABOUT SOME OF THE WORK THAT I HAD THE PRIVILEGE OF WORKING WITH DURING MY TIME AT HHS WHICH WAS WORKING THE SPACE OF HIV. HIV FOR MANY YEARS POPULATIONS HAD SIGNIFICANT BARRIERS TO GAIN ACCESS TO HEALTHCARE SERVICES BOTH FROM THE PREVENTATIVE STANDPOINT AND EARLIER INTERVENTION SERVICES TO DECREASE THE SEE QUELL A OF DISEASE FOR FOLKS WHO WERE LIVING WITH HIV AND ENDING UP WITH AN AIDS TO DIAGNOSIS. SINCE I'VE BEEN AFFECTED BY DIFFERENT AND AIDS SINCE THE EPIDEMIC'S BEGINNING WE SAW PRIMARILY EVEN THOUGH WE SAW EARLY IN THE EPIDEMIC WE HAD VAST MAJORITY OF GAY, WHITE MEN WHO WERE AFFECTED WITH HIV VERY QUICKLY WE SAW THE SHIFT INTO THE MINORITY POPULATIONS AND THEY RIP SENT 12% OF THE POPULATION BLACK PEOPLE ACCOUNT FOR A MUCH LARGER SHARE AND THEY REPRESENT 43% OF THE HIV DIAGNOSIS AND IT'S ESTIMATED THAT PEOPLE LIVING WITH HIV DISEASE IS 42% MORE THAN DEATHS AND PEOPLE LIVING OF ANY OTHER RACIAL ETHNIC GROUP IN THE UNITED STATES. THERE ARE CHALLENGES ASSOCIATED WITH HIV FOR PEOPLE OF COLOR AND ESPECIALLY FOR THE BLACK POPULATION IS LACK OF ACCESS TO CARE, POWER RATES OF SOME EX SEWALLLY TRANSMITTED DISEASES AND SMALLER SOCIAL NETWORKS OF SOCIAL SMALLEST AND SEXUAL NETWORKS AND A LACK OF HIV AWARENESS AND ONE OF THE BIGGEST CHALLENGES HAS BEEN SIGMA AND THIS EXISTS IN RURAL COMMUNITIES. NEXT SLIDE. HISPANIC AMERICANS COUNTED FOR 30% OF ALL HIV INFECTIONS IN THE LAST. >>Tara:DATA WAS AVAILABLE IN CS HAVE HIV OR AIDS AS COMPARED TO WHITE MALES AND HISPANIC FEMALES FOUR TIMES AS LIKELY TO HAVE HIV IN 2019 AS COMPARED TO WHITE FEMALES. THOSE DISPARITIES FOR THE AFRICAN AMERICAN AND HISPANIC COMMUNITY ARE SIGNIFICANT AS WE START TO SEE GREATER DIVERSITY IN OUR POPULATION AND EMERGING SCIENCE THAT HAS SIGNIFICANT BENEFITS AROUND PREP AND WE NEED TO MAKE SURE THAT WE'RE CONDUCTING RESEARCH THAT IS ALLOWING THE COMMUNITIES TO BE INVOLVED IN DRIVING MODELS THAT WILL ALLOW US TO GET INPUT AND FEEDBACK HOW BEST TO SERVE THEM AND CREATE NEW STRATEGIES TO ON THE HEALTHCARE SIDE TO ALLOW IMPROVEMENTS AND LIFE EXPECTANCY DECREASE IN THE TRANSMISSION OF DISEASE, AND ALSO GETTING PEOPLE INTO CARE AS FAST AS POSSIBLE WHEN THEY DO HAVE A DIAGNOSIS. SO INCREASING PREVENTION AS WELL AS ACCESS TO CARE. NEXT SLIDE. THE CURRENT STATE, AND I WANT TO USE AN EXAMPLE OF U.S. CANCER AND HEALTH DISPARITIES, WE SEE THAT AFRICAN AMERICAN MEN HAVE PROSTATE CANCER DEATH RATES MORE THAN TWICE THAT OF THAT FOR WHITE MEN. WE KNOW THAT HISPANIC CHILDREN ARE 20% MER LIKELY TO DEVELOP LEUKEMIA THAN NON-HISPANIC WHITE CHILDREN. ASIAN AND PACIFIC ISLANDER ADULTS ARE TWICE AS LIKELY TO DIE FROM STOMACH CANCER AS WHITE ADULTS AND AMERICAN INDIAN AND ALASKA NATIVE ADULTS ARE TWICE AS LIKE WILL HE TO DEVELOP LIVER AND BILE DUCT CANCER AS WHITE ADULTS. THIS IS SIGNIFICANT. AS WE LOOK AT SOME OF THE FACTORS ASSOCIATED WITH CANCER. CANCER IS A LEADING CAUSE OF DEATH IN THE UNITED STATES BUT MANY OF THESE POPULATIONS WE'VE TALKED ABOUT IN UNDER REPRESENTED MINORITY COMMUNITIES, ARE LESS LIKELY TO HAVE EARLY SCREENING, PERSISTENT SCREENING AND HAVING ACCESS TO EARLY TREATMENT, LATE DYING ME SIS IS ONE OF THE MAJOR BARRIERS TO INDIVIDUALS AND UNDERSERVED COMMUNITIES AND IN RURAL COMMUNITIES AND HAVING ACCESS TO GET SCREENING SERVICES THAT THEY NEED AND ALSO EARLY AND PROMPT TREATMENT. AND HEALTH DISPARITIES DON'T WORK IN ISOLATION AND THERE ARE, AS WAS INDICATED BY THE KAISER FAMILY IT'S VERY CHALLENGING TO BE ABLE TO ADDRESS HEALTH DISPARITIES AS A SINGLE VARIABLE. WE HAVE TO LOOK AT THE ENTIRE SPECTRUM FROM ECONOMICS TO NEIGHBORHOODS AND COMMUNITIES AND THE PHYSICAL ENVIRONMENT OF A GEOGRAPHIC AREA AND EDUCATION, EDUCATIONAL ATTAINMENT AND FOOD, AND FOOD SECURITY AND LOOKING AT COMMUNITY AND SAFETY AND LOOKING AT THE CONTEXT OF WHERE PEOPLE LIVE AND HOW MUCH VIOLENCE IS IN THOSE COMMUNITIES AND HOW PEOPLE INTERACT WITH THE PUBLIC SAFETY COMMUNITY. AND THEN, LAST BUT NOT LEAST, IS THE HEALTH-CARE SYSTEM MANY OF IT'S HEALTH COVERAGE AVAILABLE. ARE PHARMACIES AK EA ACCESSIBLEO WE HAVE ACCESS TO RESPECTFUL CARE FOR EVERYONE WHO EXISTS IN THAT COMMUNITY. AND ALL THESE VARIABLES LEAD TO A HEALTH AND WELL BEING METRIC, IT ALLOWS US TO ASSESS BETTER MORTALITY AND MORBIDITY. LIFE EXPECTANCY, HEATH CARE FUNCTIONAL LIMITATIONS AND USING THIS CONTEXT FOR ACCESS TO HEALTHCARE AND UNDERSTANDING PREVENTION MODALITY THAT CAN IMPROVE ONES LIFE EXPECTANCY AND THE MORTALITY OVER TIME, HOW THEY INTERACT WITH THE HEALTHCARE DELIVERY SYSTEM LANES INTO HOW DO WE CREATE A BETTER ECONOMIC MODEL FOR DELIVERING HEATH AND HEALTHCARE SERVICES. NEXT SLIDE. SO WHAT ARE SOME OF THE DIMENSIONS OF HEALTHCARE AND HEALTH DISPARITIES THAT WE NEED TO CONSIDER? ONE OF THE MOST IMPORTANT, AS WE'VE IDENTIFIED EARLIER, IS ACCESS TO CARE. WE NEED TO LOOK AT THIS SYSTEM AS A WHOLE AND WHAT ARE PROVIDERS WHO ARE PART OF THAT SYSTEM BRING TO THE TABLE AS A PART OF THEIR ABILITY TO IDENTIFY CULTURAL COMPETENCE AND HOW DO WE ADDRESS IMPLICIT BIAS FROM A SYSTEMS LEVEL AND HOW DO WE ADDRESS TRAINING AND WHEN WE'RE BUILDING THE NEXT PIPELINE OR NEW GENERATION OF HEALTHCARE PROVIDERS IN RESEARCHERS? ARE WE ADDRESSING CULTURAL COMPETITION AND IMPLICIT BUY AS PART OF OUR TEACHING OR RESEARCH IMPERATIVE OF ALL THE WORK WE'RE DOING AT THE BENCH AND WITHIN THE CLINICAL SYSTEMS. SYSTEMS QUALITY. HOW ARE WE ASSESSING THE QUALITY OF OUR HEALTHCARE DELIVERY SYSTEMS? ARE WE LOOKING AT PATIENT SAFETY FROM THAT HEALTH EQUITY AND HEALTH DISPARITIES CONTEXT. AND LAST BUT NOT LEAST, LOOKING AT THE SOCIAL DETERMINANTS NOT JUST ONE VARIABLE, AS AN INDICATER OF WHETHER OR NOT WE HAVE AN EQUITABLE AND A SOCIAL JUSTICE DETERMINANT BUT THE DETERMINANTS FROM A CONTEXT OF OF THE INDIVIDUAL AND COMMUNITY WHERE THEY LIVE. SO I WANTED TO SHARE WITH YOU ONE LOCAL EXAMPLE THAT WE'RE EXPERIENCING HERE IN THE FORT WORTH, TEXAS AREA AND THIS STUDY WAS PUBLISHED IN 2020 AND THE FALL OF 2020 RIGHT AS I WAS COMING, RIGHT BEFORE I GOT HERE TO TEXAS. THIS ARTICLE WAS PUBLISHED BY THE FORT WORTH BUSINESS JOURNAL AND IT WAS DONE IN CONSULTATION WITH THE UNIVERSITY OF TEXAS SOUTHWEST AND THEY LOOKED AT THESE COMMUNITIES ALL AROUND FORT WORTH AND THE DALLAS FORT WORTH AREA AND THEY IDENTIFIED 76104 ZIP CODE NEAR THE DOWNTOWN FORT WORTH AREA, THE LIFE EXPECTANCY IS 66.7 YEARS. 12 YEARS BELOW THE NATIONAL AVERAGE. MANY PEOPLE LIVED THERE LIVED WELL BELOW THE POVERTY LEVEL AND A LOT OF PEOPLE ARTICULATED THEY'RE JUST GETTING BY. THERE ARE VERY FEW ACCESS POINTS TO HEALTHCARE AND LIFE EXPECTANCY IN THE 76104 ZIP CODE IT IS MUCH LOWER THAN TEXAS IN GENERAL BUT IT'S ALSO MUCH LOWER THAN THE NATIONAL AFTERNOON. IT WAS 30 YEARS BETWEEN ZIP CODES ACROSS THE STATE IS IT STOOD OUT BECAUSE THERE ARE SO MANY OF THE SOCIAL DETERMINANTS THAT ARE LACKING AND THERE'S A LACK OF ACCESS TO HOUSING, ACCESS TO HEALTHCARE, AND ACCESS TO CLEAN WATER AND FOOD SECURITY AS A MAJOREL CHA ENGLISH THERE AND WE DID NOT CONSIDER SOME OF THE CHALLENGES IT COMMUNITY WAS HAVING WHEN BUILDING OUT THE HEALTHCARE ENTERPRISE AND NOW I THINK IT HAS THE ATTENTION OF THE CITY, THE COUNTY AND MANY OF THE SURROUNDING AREAS AS TO LOOK AT HOW ARE WE ADDRESSING THE AREAS LIKE 76104? AND IT'S VERY INTERESTING BECAUSE AS WE SEE FORT WORTH AS A DIVERSE AND GROWING, IT'S A THRIVTHRIVING COMMUNITY, IT'S NE 12th LARGEST CITY IN THE NATION BUT HAS THE WORST HEALTH OUTCOMES WORTH LIFE EXPECT ANTSY FOR THE STATE. BLACK AND WHITE WOMEN HAVE LONGER THAN THE MALE COUNTERPARTS. WE SEE VIOLENCE AND SUBSTANCE AND MENTAL HEALTH CHALLENGES BEING A MAJOR ISSUE FOR THIS PARTICULAR ZIP CODE AND WE SAW HISPANIC LIFE EXPECTANCY WAS THREE YEARS LONGER THAN WHITE BY 5.9 AND 5.9 LONGER THAN BLACK LIFE EXPECTANCY WITHIN THIS COMMUNITY. THIS IS A TALE OF DIFFERENT COMMUNITIES WITHIN ONE COMMUNITY. THE SUB POPULATIONS ARE UNIQUE AND DIFFERENT IN HOW THEY ACCESS SERVICE AND THE SOCIAL SUPPORT NETWORKS THAT SURROUND THESE INDIVIDUAL COMMUNITIES. THE BLACK COMMUNITY OF 76104, MANY OF THE CHILDREN HAVE LEFT FOR BETTER OPPORTUNITIES AND THE ELDERLY BLACK ARE LEFT IN THIS COMMUNITY WITH VERY FEW SUPPORT SYSTEMS AND FOR ACCESS TO HEALTHCARE, AND VERY LOW ECONOMIC INDICATORS AND SO I SEE THAT THERE'S A NODE FOR US NOW TO BRIDGE THIS GAP CREATING NEW OPPORTUNITIES FOR US TO DO RESEARCH IN THESE AREAS SUCH AS THIS OFTEN IN GENTRIFIED AREAS WE SEE THIS HAPPENING WHEN THERE'S A VERY POOR INCOME AREA AND NEW POPULATIONS COME IN AND CHANGE THE LANDSCAPE AND THE COST OF LIVING GOES UP DECREASING THE LIKELIHOOD OF INDIVIDUALS WHO ARE HISTORICALLY LIVING IN THE AREA OF BEING ABLE TO STAY IN THOSE COMMUNITIES AND THAT'S EXACTLY WHAT WE'RE STARTING TO SEE PLAY OUT IN 76104 SO MORE ON THE HEALTH OUTCOMES FOR FORT WORTH BUT I WANT TO MAKE SURE WE UNDERSTAND THAT THIS IS NOT UNIQUE. THIS IS HAPPENING ACROSS THE COUNTRY. SO I WANT TO LOOK AT THE AVERAGE LIFE EXPECTANCY BY COUNTIES ACROSS THE UNITED STATES AS WE SEE, THERE'S GREAT VARIATION. WE HAVE TO UNDERSTAND WHY MANY OF THESE ENVIRONMENTAL FACTORS ARE PLAYING INTO HEALTH OUTCOMES AND LIFE EXPECTANCY NOT ONLY BY COUNTY BUT EVEN SIP CODES AS I HAVE DESCRIBED IN FORT WORTH. I HOPE WE CAN USE OUR HEALTH DISPARITIES RESEARCH HERE AT THE TEXAS INSTITUTE FOR HEALTH DISPARITIES, BUT ALSO PARTNER WITH OUR COLLEAGUES ACROSS THE COUNTRY AND ACROSS THE WORLD TO BETTER UNDERSTAND WHAT ARE THE FINDINGS THAT HELP US TO BETTER UNDERSTAND HOW TO MEET THE NEEDS AND BUILD MODELS OF ENGAGEMENT THAT ALLOW COMMUNITY-BASED RESEARCH INCREASE LIKELIHOOD OF INFANT MORTALITY DECREASING AND LIKELIHOOD OF MATERNAL MORTALITY DECREASING TO HELP US TO ALL LIVE BETTER LIVES BUT HAVE BETTER HEALTH OUTCOMES IN GENERAL. NEXT SLIDE, PLEASE. SO NOW I WANT TO TRANSITION INTO THE FUTURE. I'M OPTIMISTIC. I THINK HEALTH DISPARITIES RESEARCH CAN HELP US CHART A NEW COURSE. I THINK THIS QUOTE TO THE BEST YOU CAN UNTIL YOU KNOW BETTER AND THEN WHEN YOU KNOW BETTER, DO BETTER. I THINK THIS IS A SEG WAY THAT WE NEED TO MOVE FORWARD AND USING THE RESEARCH THAT WE HAVE BEEN ABLE TO DEVELOP AROUND HEALTH DISPARITIES AND ALSO HEALTH EQUITY AND CULTURAL COMPETENCE TO BUILD OUT NEW AGENDAS FOR HEALTH DISPARITIES RESEARCH TO ENGAGE COMMUNITIES WHERE THEY LIVE, WORK AND PLAY AND ALLOW THEM TO DRIVE THE AGENDA AROUND HEATH EDUCATION AND HEALTH RESEARCH, PREVENTION MODELS, ACCESS TO CARE AND INFORMING PROVIDERS AND RESEARCHERS ON HOW BEST TO MEET THEM WHERE THEY ARE. WHAT ARE SOME OF THE CHALLENGES AND OPPORTUNITIES I THINK BEFORE US RIGHT NOW AND I THINK IT WAS SAID EARLIER IN THE PREVIOUS PRESENTATION, WE HAVE TO BUILD TRUST. WE HAVE TO CREATE OPPORTUNITIES FOR US TO ENGAGE WITH COMMUNITIES WHERE THEY ARE AND GIVE THEM THE OPPORTUNITY TO GUIDE AND DIRECT THE WORK THAT WE'RE DOING AND WE MUST UNDERSTAND THE PATHWAYS THAT MANY OF THE COMMUNITIES THAT ARE IN DIRE STRAITS THAT ARE HAVING SIGNIFICANT HEALTH DISPARITIES AND THOSE COMMUNITIES THAT ARE LEFT IN RURAL COMMUNITIES WITH NO ACCESS TO CARE, VERY LITTLE HEALTH EDUCATION, NO TRANSLATION SERVICES, AND NO CONCEPT OF HOW TO BRIDGE THATCULTURAL BETWEEN PROVIDERS AND THOSE OF A GIVEN COMMUNITY. CONSISTENT ENGAGEMENT. THIS IS A LESSON LEARNED FOR ME AS FORMERLY AS SOME OF THE WORK THAT WE DID IN HIV AND T.B. AND MALARIA IS CONSISTENT ENGAGEMENT. RESEARCH REQUIRES PARTICIPANTS AND THE ONLY WAY THAT WE CAN HAVE ACCESS TO PARTICIPANTS IS BY UNDERSTANDING THEIR JOURNEY IS TO BUILD A CONSISTENT ENGAGEMENT WITH THEM THAT ALLOWS THEM TO LEARN AS MUCH FROM US BUT ALSO FOR THEM TO LEARN, FOR US TO LEARN FROM THEM. GIVING THEM THE OPPORTUNITY TO GIVE US A LAY OF THE LAND FROM THEIR PERSPECTIVE, HAVING THEM IDENTIFIED THEIR PRIORITIES, ALONGSIDE OUR PRIORITIES AS IT RELATES TO THE RESEARCH WE NEED TO DEVELOP. INFORMATION FOR COMMUNITIES ON HOW TO ENGAGE IN RESEARCH AND THIS IS LIKE THE BEST SEG WAY OF THE FUTURE. IF COMMUNITIES CAN TELL US HOW THEY WANT TO BE APPROACHED, HOW BEST TO LEARN FROM THEM AND THEY CAN BE SUPPORTIVE OF OUR RESEARCH AGENDA IT BREAKS DOWN SOME OF THOSE AWKWARD BARRIERS AND WE'VE BEEN ABLE INFORM TO SOME OF THIS IN HIV AND WE'VE DONE THIS IN CARDIOVASCULAR RESEARCH WHERE WE HAVE PATIENTS TO IDENTIFY WHY DO YOU WANT TO BE INVOLVED IN RESEARCH AND WHAT WOULD IT TAKE TO KEEP YOU IN THE STUDY AND HOW CAN THIS STUDY ALLOW YOU TO BETTER INFORM YOUR COMMUNITY OF THE RISK OF CARD VASCULAR DISEASE OR CANCER RELATED CONDITIONS. BUILDING SUPPORT SYSTEMS AND HOW TO REACH COMMUNITIES. THIS IS A LESSON LEARNED FROM ME TALKING TO RESEARCHERS AT THE UNIVERSITY OF NORTH TEXAS HEALTH SCIENCE IS IS THE RESEARCHERS SAID TO US, I DON'T KNOW HOW BEST TO REACH THE COMMUNITIES THAT WE WANT TO TARGET. CASES MANAGERS, AND ALSO USING COMMUNITY HEALTH WORKERS TO BE ABLE TO DELIVER THOSE KINDS OF MESSAGES THAT RESINATE WITH COMMUNITIES BUT ALSO SUPPORT THE RESEARCHERS AND BEING ABLE TO CONTINUE THAT WORK AND LAST BUT NOT LEAST, BUILDING TOOL KITS. WHEN WE HAVE SUCCESS STORIES IT'S CRITICAL THAT WE SHARE EXPERIENCES AS WE START TO BUILD MODELS ACROSS DIVERSE COMMUNITIES AND I THINK HAVING COLLABORATING CENTERS IN DOING STUDIES WHERE WE CAN BUILD THESE NETWORKS OF SUCCESS, ALLOWS US TO BETTER UNDERSTAND HOW TO REPLICATE THOSE SUCCESSFUL MODELS AND ALSO EXPANDS AND ADVANCE THOSE THINGS GOING FORWARD. NEXT SLIDE. OF THE LESSONS LEARNED FROM MANY OF THE STUDIES THAT WE'VE DONE HERE AT THE UNIVERSITY OF NORTH TEXAS AND SOME OF THE WORK AT HRSA I WILL SHARE THIS WITH YOU, BEING INFORMED AND LEARN HOW BEST TO ENGAGE WITH THE COMMUNITIES. UNDERSTAND THE COMMUNITIES. THE FIRST VISIT TO THE COMMUNITY CANNOT BE TO ASK FOR PARTICIPANTS. IT HAS TO BE BUILDING A RELATIONSHIP PATHWAY AND UNDERSTANDING WHAT THE COMMUNITY NEEDS AND EXPECT FROM YOU OTHERS I RESEARCHERS, HEATH CARE PROVIDERERS PARTNER. BE GENUINE AND NOT JUST FOR THE SAKE OF THE RESEARCH YOU REALLY WANT TO BUILD A RELATIONSHIP WITH THE COMMUNITY AND ADVOCATE FOR THE COMMUNITY. USE YOUR RESEARCH AS A PLACE WHERE COMMUNITY CAN RELY TO ADVOCATE FOR HEM IN HEALTH AND OUTSIDE OF HEALTH MUCH OF THE WORK THAT WE DO IN THE HEALTH DISPARITIES RESEARCH ARENA A LOUSE US TO GET TO KNOW THE COMMUNITIES AND WE GET TO KNOW WHO THE PLAYERS ARE AND WE GET TO KNOW THE LEADERS ARE AND USE THAT INFORMATION TO HELP BROKER OPPORTUNITIES FOR THEM IN EDUCATION AND TRANSPORTATION AND ALSO IMPROVING THE ENVIROMENTAL HEALTH. IT GOES A LONG AWAY WHEN WE LEARN HOW TO BE A PART OF THE ADVOCACY ENGINE FOR A COMMUNITY COMMUNITY. EDUCATE PATIENTS, RESEARCHERS, THE COMMUNITY AND COLLEAGUES AND THIS IS ESPECIALLY IMPORTANT FOR OUR HEALTHCARE PROVIDERS AND RESEARCHERS TO UNDERSTAND THAT PATIENTS RESEARCH PARTICIPANTS CAN TEACH US A LOT ABOUT WHAT THEIR JOURNEY IS ALL ABOUT. USE THAT INFORMATION TO BETTER TOOL THE OUTREACH AND ENGAGEMENT AND ALSO THE EDUCATION COMPONENTS OF YOUR RESEARCH. RECOGNIZE OPPORTUNITIES TO ADDRESS THE STRUCTURAL DISPARITIES AND INEQUITIES AND THE RESEARCH THAT WE ARE PRODUCING AS A PART OF OUR STUDIES WHETHER IT'S AT NIH OR IN LOCAL COMMUNITIES OR FOUNDATION BASED RESEARCH I THINK IT'S IMPORTANT FOR US TO GIVE BACK THAT INFORMATION TO COMMUNITIES SO THEY UNDERSTAND HOW TO USE THOSE TOOLS AND RESEARCHES OR EVEN TO WRITE AN OP-ED PIECE BASED ON THE RESEARCH AND TO IMPROVE THE HEALTH EQUITY IN THEIR COMMUNITY. DEVELOP AND IMPLEMENT STRATEGIES TO IMPROVE HEALTHCARE AND EQUITY IN THIS SYSTEMS THAT IMPACT HEALTH AND IT'S SO IMPORTANT AS I MENTIONED BEFORE, FOR US TO BE PARTNERS IN THESE COMMUNITIES AND TO IMPLEMENT STRAT GOES THAT NOT ONLY GENERATE NEW RESEARCH AND SCIENTIFIC INNOVATION BUT THAT WE'RE USING IT AS AN OPPORTUNITY TO BUILD STRONGER COMMUNITIES AND BUILD STRONGER SYSTEMS THAT ALLOW CARE TO BE DELIVERED IN A WAY THAT WILL MEET THE NEEDS OF A GIVEN COMMUNITY NOT FOR THE SHORT TERM BUT FOR THE LONGER TERM. ONE OF THE MOST IMPORTANT LESSON AS A CLINICIAN WAS LISTEN TWICE AS MUCH AS WE TALK AND THAT IS OFTEN HARD FOR ME. I THINK THAT I'VE LEARNED AS MUCH FROM MY PATIENTS AS I'VE LEARNED FROM MY CLINICAL TRAINING. IT'S SO IMPORTANT FOR PATIENTS TO FEEL VALUED AND RESEARCH PARTICIPANTS NEED TO UNDERSTAND THAT THEY HAVE AS MUCH -- THEY HAVE AS MUCH VALUE IN THE STUDY AS A STUDY WILL MEAN TO THE GENERAL COMMUNITY OF RESEARCHERS AND THE POPULATION OF HEALTHCARE PROVIDERS. SO WHAT ARE SOME OF THE STRATEGIES THAT WE CAN BUILD TO IMPROVE COMMUNITY ENGAGE HEALTH DISPARITIES BUILD BETTER SYSTEMS OF HEALTH? I THINK FOR THIS COMMUNITY, IT'S TO DEVELOP A RESEARCH PROGRAM THAT STRIVES FOR AND IS COMMITTED TO THE FOLLOWING -- BUILDING AND SUSTAINING STRONG PARTNERSHIPS. NOT ONLY WITH RESEARCH PAR ANTS AND PATIENTS, BUT WITH OTHER COLLEAGUES AND THOSE ORGANIZATIONS THAT SUPPORT HEALTH AND HEALTH EQUITY WITHIN THE GIVEN COMMUNITY. DEVELOP ON GOING ENGAGEMENT AS I SAID BEFORE, DON'T DO RESEARCH FOR THE SAKE OF RESEARCH IN THESE UNDERSERVED COMMUNITIES, ESPECIALLY WHEN YOU ARE DEALING WITH HEALTH DISPARITIES, IT HAS FOR A PARTNERSHIP, A LONG AND THRIVING PARTNERSHIP THAT ALLOWS YOU TO BUILD TRUST, BUILD ENGAGEMENT, WHEREBY THEY UNDERSTAND THAT THEY'RE PART OF THE CALCULUS AND THEY'RE PART OF THE SOLUTION. TRANSPARENCY. RESEARCH PARTICIPANTS AND PATIENTS NEED TO UNDERSTAND THAT THEY HAVE A RIGHT TO INFORMATION. SHARE WITH THEM WHAT YOUR THOUGHTS AND IDEAS ARE AS THE RESEARCH IS EVOLVING AND HAVE OPEN COMMUNICATION. BE WILLING TO ACHE THE COUGH TOH QUESTIONS AND WHY YOU ARE DOING THIS STUDY IN THEIR COMMUNITY AND WHY IT HAS IMPORTANCE TO THE ENTIRE HEALTHCARE INDUSTRIES AND THE HEALTHCARE AS IT RELATES TO HEALING DISPARITIES AND MORE IMPORTANTLY, HOW IT WILL IMPACT THEM AS AN INDIVIDUAL AND AS A COMMUNITY. THE THOUGHTS AROUND MUTUAL BENEFITS, YOU KNOW, FOR THE RESEARCH SIDE OF THE WORLD, YOU KNOW, WE WANT TO IDENTIFY NEW TECHNOLOGIES, WE WANT TO DEVELOP SOLUTIONS THAT IMPROVE HEALTH OUTCOMES AND AND BETTER SERVE THOSE THAT ARE IN NEED. THERE'S A MUTUAL BENEFIT WE HAVE TO HAVE SOLUTIONS THAT HELP THE COMMUNITIES. THE INDIVIDUAL AS WELL AS THOSE THAT LIVE AROUND THEM AND SO BEING ABLE TO EXPLAIN WHAT YOU WILL GAIN FROM THE RESEARCH AND HOW THE RESEARCH WILL BENEFIT THEM GOES A LONG WAY WITH COMMUNITIES WHEN YOU ARE TRYING TO ENGAGE THEM AND BUILD THOSE RELATIONSHIPS. AND LAST BUT NOT LEAST, COMMUNITY FOCUS AND COMMUNITY-DRIVEN RESEARCH. ALLOW COMMUNITY TO HAVE A SAY AND THE RESEARCH OBJECTIVES AND ALLOW THEM TO HELP GUIDE THE ENTIRE DIRECTION OF WHERE THE RESEARCH IS GOING. AND HAVE THEM BE INFORMED BY THE LONG-TERM AND SHORT TERM IMPLICATIONS OF BUILDING RESEARCH PARTNERSHIPS AND HOW THAT CAN SUSTAIN BETTER OUTCOMES SIMILAR TO HEALTHCARE, LIFE EXPECTANCY, MORTALITY AND MORBIDITY LONGER TERM. I WILL SAY IS SOME OF THE IMPORTANT THINGS FOR RESEARCH, GO BACK TO WHAT WE HEARD EARLIER IS THAT WE HAVE TO HAVE STANDARDIZED MEASUREMENT AND WE NEED TO BUILD MODEL THAT'S CAN BE REPLICABLE AND EXPLAIN NA THAT TO POPULATIONS YOU WANT TO WORK WITH IN A RESEARCH PARTNERSHIP AND EXPLAIN TO THEM THAT WE HAVE TO CREATE OPPORTUNITIES FOR ENGAGESMENT AND THAT WE HAVE TO BE ABLE TO BRING MORE PEOPLE TO THE TABLE AND TO HAVE THEM UNDERSTAND HOW RESEARCH IMPACTS THEIR DAILY LIFE. I THINK IT'S ALSO CRITICAL FOR US TO DEVELOP PIPELINE PROGRAMS THAT WE RECRUIT FROM THE COMMUNITY AND SO THEY CAN BE PART OF THE RESEARCH OF FUTURE AS WELL STARTING WITH PARTNERSHIPS MUCH LIKE NIH FUNDING ALREADY WITH ELEMENTARY, MIDDLE AND HIGH SCHOOL STUDENTS AND BUILDING PIPELINES TO COLLEGE FOR STEM AND BUILDING STEM PROGRAMS THAT ARE FOCUSED ON GIVING OPPORTUNITIES FOR RESEARCH AND THEIR INTERNSHIPS AND COMING TO A PLACE WHERE WE CAN ADDRESS THE COMPETENCIES FOR MANY OF THOSE UNDERSERVED POPULATIONS. AND THE NEXT SLIDE, WHICH IS MY LAST SLIDE, I'D LIKE TO SEE US GET TO THE FUTURE STATE OF REMOVING THE BARRIERS. I'D LIKE US TO MOVE FROM EQUALITY, AND EQUITY, TO A JUSTICE APPROACH FOR RESEARCH AND ALSO FOR HEALTHCARE DISPARITIES. I SEE THIS AS AN OPPORTUNITY FOR US TO REMOVE SYSTEMIC BARRIERS AND SO THAT EVERYONE CAN SEE THE GAIN OF HEALTHCARE AND PUBLIC-HEALTH FROM THE SAME PERSPECTIVE. THAT WE ALL SEE OURSELVES AS A PART OF THE SOLUTION AND THAT WE GIVE EVERYONE THE OPPORTUNITY TO BE A PART OF THE RESEARCH AND THEY HAVE A PART IN BUILDING OUT BETTER RESEARCH A AGAIN DADS AND THAT WE ALL CAN BE COLLECTIVELY LOOKING AT BETTER HEALTH OUTCOMES AND DECREASED DISPARITIES OVER ALL. THANK YOU FOR HAVING TODAY AND I WOULD LIKE TO SAY THANK YOU TO NIH FOR THE INCREDIBLE WORK THAT YOU ARE DOING IN HEALTH DISPARITIES AND I LOOK FORWARD TO PARTNERING WITH YOU AND OUR UNIVERSITIES IS FUNDED FOR BOTH THE CEAL PROGRAM AND THE AIM AHEAD LOOKING HOW WE USE ART INITIAL INTELLIGENCE AND MACHINE LEARNING CREATING BETTER SOLUTIONS FOR DECREASING HEALTH DISPARITIES AND THE WORK THAT'S GOING ON As CROSS THE COUNTRY HAS GIVEN ME A LOT OF HOPE THAT WE WILL FIND BETTER SOLUTIONS FOR OUR COMMUNITIES AND NATION AND THAT WILL IMPACT THE GLOBAL COMMUNITY. IF YOU AND HTHANK YOU. >>THERE WAS A LOT OF EMOJIS COMING TOWARDS THE END OF HEARTS AND CLAPS AND I WILL GIVE YOU A CLAP TO TURN THEM INTO REALITY. WE REALLY APPRECIATE ALL THE REMARKS YOU HAVE GIVEN US. THERE WAS A QUESTION SO YOU HAVE IF AN OPPORTUNITY I WOULD INVITE YOU TO ANSWER THE QUESTION WHO. WE CAN CANNOT THANK YOU ENOUGH FOR ALL THESE REMARKS GETTING US STARTED WITH OUR DAY TODAY. WE HAVE A SHORT BREAK BEFORE WE GO INTO OUR NEXT PANEL. WE MIGHT HAVE ONLY TWO MINUTES TO DO SO AND FOR THOSE WATCHING US, WE WILL MOVE ON WITH OUR FIRST PANEL OF THE DAY SESSION WHICH IS DEFINITELY A VERY CURRENT TOPIC SINCE WE'RE STILL SURROUNDED BY SUCH THE PANDEMIC THANK YOU AGAIN Dr. ADAMS AND WE'LL SEE EVERYONE IN TWO MINUTES. >>WELCOME BACK, EVERYONE. IF YOU ARE JOINING US NOW, WE'LL BEGIN OUR SESSION 1 COMMUNITY ENGAGEMENT TO REDUCE HEALTH DISPARITIES LESSONS FROM A PANDEMIC. AND WE'RE GOING TO PASS IT TO Dr. HILL-PRYOR. PLEASE, GO AHEAD. >>GOOD AFTERNOON. I WOULD LIKE TO WELCOME EACH AND EVERY ONE OF US FOR JOINING USED TO. OUR FIRST SESSION OF TODAY'S WORKSHOP IS TITLED "COMMUNITY ENGAGEMENT TO REDUCE HEALTH DISPARITIES -- LESSONS FROM A PANDEMIC." THE OBJECTIVE OF THIS SESSION IS TO BRING TOGETHER MULTIPLE TAKE HOLDERS INCLUDING RESEARCHERS, HEALTHCARE PROVIDERS, COMMUNITY PARTNERS, AND FEDERAL STATE AND LOCAL GOVERNMENT OFFICIALS. TO DISCUSS THE STATE OF SCIENCE OF COMMUNITY ENGAGED HEALTH DISPARITIES RESEARCH, ESPECIALLY IN THE LIGHT OF THE EXPERIENCES AND LESSONS LEARNED FROM MANY NIH FUNDED COMMUNITY ENGAGE RESEARCH EFFORTS THAT ADJUST THE COMMUNITY ENGAGEMENT ALLIANCE STILL AND AGAINST COVID-19 DISPARITIES AND DISCUSS THE NOVEL METHODOLOGIES AND ADVANCEMENTS SHAPING THE FUTURE OF COMMUNITY ENGAGE HEATH DISPARITIES RESEARCH. I WOULD LIKE TO LEAVE YOU WITH A FEW KEY OVERARCHING DISCUSS POINTS TO BE MADE DURING THIS SESSION. HOW CAN LESSONED LEARNED THROUGH THE COMMUNITY ENGAGEMENT EFFORTS AND THE COVID-19 PANDEMIC HELP CONDUCT COMMUNITY ENGAGED RESEARCH AND REDUCE HEALTH DISPARITIES MOVING FORWARD? WHAT WORKS? WHAT DIDN'T, AND WHAT NEEDS TO CHANGE? I WOULD LIKE TO INTRODUCE THE CHAIR AND PANELLEST OF THIS SESSION. THE CHAIR OF SESSION ONE WILL BE RITA CARREON VICE PRESIDENT HEALTH AT UNIDOS, NORMALLY NATIONAL COUNCIL OF LA RAZA AND Dr. ALAN RICHMOND, EXECUTIVE DIRECTOR OF THE COMMUNITY CAMPUS MEMBERSHIP FOR HEALTH AND LISA MACON HARRISON, THE COUNTY AND CITY HEALTH OFFICIAL AND Dr. GRASS MA, ASSOCIATE DEAN HEALTH DISPARITIES DIRECTOR AND PROFESSOR CENTER FOR ASIAN HEALTH, VICE-CHAIR DEPARTMENT OF URBAN HEALTH AND POPULATION SCIENCE PROFESSOR URBAN HEALTH AT TEMPLE UNIVERSITY. WITHOUT FURTHER ADIEU, OUR CHAIR, RITA CARREON. >>THANK YOU, FOR THE INTRODUCTION AND I'M HONORED TO BE HERE AS PART OF THIS IMPORTANT CONVERSATION WITH THREE EXPERTS WORKING WITH COMMUNITIES AND THE INTERSECTION BETWEEN RESEARCH AND COMMUNITY ENGAGEMENT AND AS WE HEARD EARLIER THIS MORNING, IT'S NO SURPRISE HOW COVID-19 PANDEMIC FOR THAT MATTER, MULTIPLE CRISIS, IN COMMUNITIES CONTINUE TO OFTEN LEAVE LOCAL INDIVIDUALS, NEIGHBORHOODS WITH LIMITED ACCESS AND SUPPORT. AS Dr. TRENT ADAMS SHOWED CASED HOW IMPORTANT BETTER MODEL IS NEEDED FOR FORT WORTH, TEXAS AS AN EXAMPLE AND CONSISTENT ENGAGEMENTS SO, FOR ME IT'S AN HONOR TO BE HERE. SINCE THE START, WE'VE ADVOCATED FOR EQUITY ABLE AND RESEARCH IN OUR RESPONSE TO SERVING OUR COMMUNITIES AND ALONG THE WAY WE HAVE SEEN WHERE GAPS CONTINUE TO INCREASE DUE TO THE PANDEMIC AND LARGELY DUE TO THE COLLECTIVE WORK THAT WE'VE BEEN DOING AND THE KEY PROGRAMS LIKE CEAL AND RADX AND UP AND INVOLVING IN COMMUNITY AGE RESEARCH TAKES A SIGNIFICANT AMOUNT OF RACE. WE ALL KNOW THAT AND IT TAKES LISTENING AND IT TAKES FLEXIBILITY AND TRANSPARENCY AND TRUST ALONG THE PROCESS AND THROUGH RELATIONSHIP BUILDING AND TO A SOLUTIONS' BASED APPROACH ON HOW IMPORTANT WE THINK ABOUT HEALING AND HOW WE NAVIGATE HEALTHCARE. WE RECOGNIZE THAT WHETHER THIS IS DONE TO THE BEST OF OUR ABILITY. GREAT THINGS CAN BE A CHANGED. WHAT HAVE WE LEARNED THROUGH THE PROCESS? TO CENTER US IN TERMS OF ASKING EACH OF YOU, WE KNOW THAT COMMUNITY BASED ORGANIZATIONS AND COMMUNITY PARTNERS SUCH AS COMMUNITY HEALTH WORKERS, COMMUNITY HEALTH EMBASSADORS, HEALTH DEPARTMENT, HEALTH AGENCY HAVE BEEN INTEGRAL INTO A COMMUNITY GAGED RESEARCH. WHAT CAN BE DONE TO INCREASE THE STATE ABILITY OF CBOs AND COMMUNITY PARTNERS AND OFFER THEM AN EQUITABLE AND INCLUSIVE SUSTAINED PLATFORM? SO, I'LL START WITH YOU, AL. >>THANK YOU, A LOT. I'M TAKING IN SO MUCH ALREADY THIS MORNING, AS WE HAVE THIS VERY IMPORTANT CONVERSATION. I WANTED TO START BY AND I WAS INTENTIONAL ABOUT JOINING EARLY BECAUSE I WANTED TO HEAR TODAY FROM ELISEO AND OTHER PRESENTERS, Dr. TRENT ADAMS. BECAUSE I THINK THAT BOTH OF THEM ACTUALLY SERVE TO LIFT UP AND SURFACE IMPORTANT ISSUES THAT I WANT TO CONTINUE ON, IN PARTICULAR, ELISEO TALKING ABOUT THE IDEA OF YO CULTIVATING COMMUNITY ENGAGEMENT AND BUILDING TRUST FOR SUSTAINABLE PARTNERSHIPS. THAT RESINATED DEEPLY WITH ME AS A COMMUNITY LEADER, AS SOMEONE WHO HAS BEEN INVOLVED IN THE PAST TWO AND A HALF YEARS WITH THIS PANDEMIC. I'VE SAID TO PEOPLE THAT I BELIEVE THE PANDEMIC HAS BEEN THE GREATEST MOMENT FOR THOSE OF US WHO ENGAGE IN PUBLIC-HEALTH. WE WERE BUILT FOR THIS MOMENT. AND ALSO, COMMUNITIES WERE BUILT FOR THIS MOMENT IN TERMS OF REALLY FOCUSING IN ON SAVING LIVES. THE WORK THAT COMMUNITY BASED ORGANIZATIONS AND GROUPS HAVE BEEN DOING DURING THIS MOMENT, HAS BEEN AT A TIME OF PERSONAL TRAUMA, TO THEM AND THE LOSS OF LIFE SO THE COMMUNITIES THAT HAVE BEEN IMPACTED BY COVID-19 HAVE EXPERIENCED TREMENDOUS LOSS AND TREMENDOUS DEATH, AND PAIN AND GRIEF AT A LEVEL THAT QUITE FRANKLY I'M NOT SURE THAT PEOPLE HAVE EVEN HAD A MOMENT TO REALLY STOP AND TAKE ALL OF THAT IN AND YET IN SPITE OF ALL OF THAT PERHAPS BECAUSE OF THAT, COMMUNITY GROUPS HAVE REALLY STEPPED UP IN A WAY THAT WE'VE NEVER SEEN BEFORE. THE WORK OF LEADERS HAVE DONE THEIR FINIST AND THEY HAVE PERFORMED THEY WERE REALLY IN SURVIVAL MODE. COMMUNITIES HAVE DONE EVERYTHING THEY HAVE TO SAVE THE LIVES AND MINIMIZE DEATHS IN THEIR OWN COMMUNITIES AND I JUST WANT TO ACKNOWLEDGE THAT AND I THINK THAT WHAT ' ELISEO POINTED OUT D TO CULTIVATE THESE IMPORTANT RELATIONSHIPS AND THAT'S THE ISSUE. I THINK THERE'S CONSENSUS AMONG ALL OF US THAT TRUST IS IMPORTANT BUT TRUST HAS TO BE CULTIVATED AND THEN WE HAVE TO SUSTAIN THIS MOMENT OF TRUST FOR THE FUTURE. SO, ONE OF THE THINGS WE HAVE BEEN ASKING PEOPLE ALL ACROSS THE COUNTRY IS, IS THIS A MOMENT OR IS THIS A MOVEMENT? I LIKE FRAMING IT THAT WAY, BECAUSE IF WE'RE NOT CAREFUL, THIS WILL BE JUST A MOMENT, IT WOULD JUST BE A BLIP. WE HAVE SUPPORTED COMMUNITY ORGANIZATIONS AND LEADERS WITH SOME MONEY BUT REALLY AT THIS MOMENT, WHAT I'M HEARING IS THEY'RE REALLY CONCERNED ABOUT THE FUTURE. SUCH THAT IF WE'RE NOT CAREFUL AGAIN, THIS WILL BE JUST A MOMENT AND THE RESOURCES WILL GO AWAY AND THE INFRASTRUCTURE WILL DISAPPEAR AND THAT WAS REALLY ELISEO'S I THINK, THE WAY HE FRAMED IT, WAS THIS WHOLE NEED AND THE IMPORTANCE OF THE INFRASTRUCTURE THE SAME WAY THAT WE NEED A STRONG AND ROBUST RESEARCH INFRASTRUCTURE IN THIS NATION, WE NEED A COMPARABLE INFRASTRUCTURE FOR COMMUNITY-BASED ORGANIZATIONS AND COMMUNITY LEADERS TO TO THEIR WORK WELL INTO THE FUTURE. >>YES. I LOVE THIS. THE MOMENT OR IS IT A MOVEMENT. AND SO I'M GOING TO GO TO GRACE, GRACE, WHAT DO YOU THINK? I THINK HAS BEEN WITH A LOT OF OUR COMMUNITIES AND WE'VE BEEN ABLE TO CONSIST ENTERALLY CONSISTENTLY SHOW UP FOR OUR COMMUNITIES. WHAT DOES IT LOOK LIKE FOR THE COMMUNITIES THAT YOU WORKED WITH? >>YES, I THINK AL HAS SAID IT VERY WELL AND YOU KNOW, WITH THE COMMUNITY THAT WE WORK, WE REALLY NEED A GREATER INVESTMENTS AND IN TERMS OF COMMUNITIES RESEARCH CAPACITY BUILDING, AND INFRASTRUCTURE, AND TRUST BUILDING SO THIS NOT ONLY INCLUDING RESOURCES WE NEED TO TRAIN A MULTILINGUAL COMMUNITY HEALTH WORKERS, DIVERSIFY THE COMMUNITIES RESEARCH WORKFORCE AND THE INFRASTRUCTURE NEEDS TO BE SUSTAINABLE SO THAT WE CAN ADDRESS FUTURE PRICES AND ISSUES WITH OUR COMMUNITY AND IN ADDITION I THINK COMMUNITIES BASED PRINCIPLES THAT REALLY NEED TO BE APPLIED IN THE VERY AUTHENTIC AND SINCERE WAY AND SO OVER THE PAST TWO DECADES, THE PRINCIPLES HAVE GUIDED MANY OF OUR STUDIES AT THE CENTER FOR AGING HEALTH IN PARTNERSHIP WITH OUR COMMUNITY LEADERS SO WHICH THEY HAVE NOT ONLY ENHANCED THE PARTICIPATION AND THE ENROLLMENT AND THE HIGH RETENTION BUT REALLY HAVE A TEM DEMONSTRATEDA PARTNERSHIP AND RELATIONSHIP AND I THINK THAT THIS THIS SUSTAINABLE PARTNERSHIP INFRASTRUCTURE COULD GO A LONG WAY. SO, THEREFORE, IT IS VERY IMPORTANT FER US TO THINK ABOUT AND REQUIRE WHEN WE PUT OUT RESEARCH FUNDING OPPORTUNITIES WHO IS NEEDED TO BE INCLUDED IN THE FUTURE RESEARCH AT WHAT LEVEL OF SUBPOENA OR THE SHOULD GO TO THE THE COMMUNITY PARTNERS SO THAT THEY HAVE EQUAL SHARE OF THE CHINA DRIVEN ITEMS TO ADDRESS NEEDS IN THE COMMUNITY SO WHEN WE HAVE THESE KIND OF PRINCIPLES APPLIED I THINK THE RELATIONSHIP, THE TRUSTED BUILDING COULD BE GOING A LONG WAY. >>LISA, HOW HAVE YOU SEEN THE COMMUNITY PARTNERSHIPS FORM IN A VERY INCLUSIVE WAY, SUSTAINABLE WAY, NOT ONLY THE INFRASTRUCTURE? WHAT CAN YOU ADD TO OUR CONVERSATION AROUND REALLY RETHINKING ABOUT OUR SYSTEMS? >>YEAH, SO THANK YOU FOR THE QUESTION AND IT'S SO WONDERFUL TO HEAR THE CO-PANELISTS TOO. I'VE ENJOYED THE WHOLE MORNING WITH YOU ALL ON THIS TOPIC AND IT'S SO CRITICAL. I CAN SHARE WITH YOU FROM THE PERSPECTIVE AS A LOW HEALTH DIRECTOR, WHO HAS TO SEEK FUNDING OUTSIDE OF JUST THE NORMAL LOCAL STATE AND FEDERAL RESEARCHES FOR LOCAL PUBLIC-HEALTH AND EMERGENCY RESPONSE AND PANDEMIC RESPONSE AND THERE'S A PERCEPTION OUT THERE AND THAT A LOCAL HEALTH DEPARTMENT HAS PLENTY OF RESOURCES TO DO GREAT WORK AND PARTNER TO BE ACHIEVE HEALTH STRATEGIST AND CONVENE COALITION AND BUILD TRUST AND CONNECTIVITY BUT THERE'S ALSO A STRONG PERCEPTION AND REALITY THAT SHARING RESOURCE AND POWER IS NOT AS EASY TO DO AND SO MY SUGGESTION WOULD BE FOR US TO WORK DIFFERENTLY AT A POLICY CHANGE LEVEL SO OUR FUNDING MORE FLEXIBILITY AND THE LAST THING I WANT TO DO IS GET SOME OF MY INVOLVED IN A OFFICE MANMENT AND BUDGET AUDIT AND SO SOME OF THE THINGS THAT WE ARE RESTRICTED BY, IN THE WORLD OF GOVERNMENTAL LOCAL PUBLIC-HEALTH OR GOVERNMENTAL STATE PUBLIC-HEALTH, ARE THOSE RESTRICTIONS AND FUNDING VERY SPECIFIC AND TIME LIMITED VERY, VERY, VERY AUDIT HEAVY SO WHEN IT COMES TO SHARING POWER AND RESOURCES LIKE OUR VALUES AND THREE CARRY US THROUGH TOWARDS OUR SYSTEMS OUR STRUCTURES AND OUR FUNDING A COULDN'T ABILITY DOESN'T ALLOW FOR IT VERY OFTEN AND IT IS FRUSTRATING SO, ONE OF THE WAYS WE'VE TRIED TO DO A BETTER JOB WITH THIS IS WE HAVE DEVISED A RURAL ACADEMIC HEALTH AT THE PRESENT TIME WHERE WE HAVE RESOURCES FROM UNIVERSITY SYSTEMS AND FROM COMMUNITY BASED ORGANIZATIONS IN OTHER WAYS THAT ARE CREATIVE BUT VERY MUCH ALLOWED ACCORDING TO ACCOUNTANTS AND INFORMS TO MAKE SURE THAT THEY DON'T GET IN TROUBLE GETTING SOME OF OUR THAT WERE BUILT THAT WORK WELL AND HELP US REACH MORE SOCIALLY CONNECTION POINTS THAT OF INFRASTRUCTURE AND BUILDING AND SUSTAINING THAT AND I DO WANT TO PIVOT US TO THINKING ABOUT, WE'VE BROUGHT COMMUNITY GAGED RESEARCH IN REGARDS TO VISIBILITY IN A PLATFORM FOR MANY COMMUNITIES TO BE INVOLVED AND WITH RESEARCHERS BUT YOU KNOW, HAVE SOME MARGINALIZED COMMUNITIES STILL BE RELATIVELY NEGLECTED AND HAVE WE ADDRESSED SOME OF THE ISSUES AND GRACE, YOU MENTIONED LANGUAGE. AS ONE THING AND IN TERMS OF EQUITY AND INCLUSIVITY AND CAN YOU TALK A LITTLE BIT ABOUT THAT? >>AS YOU MENTIONED, THESE DIVERSE COMMUNITIES ARE VULNERABLE, ESPECIALLY THOSE LAKE LATIN X AND WITH ALSO LOW HEALTH LITERACY SO THERE ARE UNDER STUDYING OFTEN TIMES EXCLUDED FROM THE DATA COLLECTIONS ESPECIALLY AT THE LARGER COHORT AND EFFORTS AND SOME OF THEM ARE LEFT AND OUT, THE COMMUNITY ENGAGED WORK I THINK THAT THE DATA DESEGREGATION AND THE IMPORTANCE OF LANGUAGE ACCESS AND BECAUSE THESE ARE VERY, VERY IMPORTANT IF WE DON'T HAVE OUR TOOLS AND TOOL KITS IN THE CULTURAL AND PROPER WAY YOU ARE GOING TO LEAVE OUT THIS POPULATION SO THE RESOURCES SHOULD BE PROVIDED WORK AND ALSO, MORE RESOURCES NEED FOR BETTER TOOLS AND TOOL KITS TO ENGAGE THE COMMUNITY AND RIGHT SEARCHERS TOGETHER AND WE NEED TO DEVELOP EDUCATIONAL TEMPLATE TO THE COMMUNITIES ORGANIZATIONS CAN ALSO USE TO ADAPT TO THEIR OWN NEEDS AND EVEN WITH THE INSTRUMENTS HOW WE CAN CULTURALLY VALIDATE IT AND WE HAVE NIH TOOL KITS AND THE COMMON SURVEYS AND THAT COULD BE TRANSLATED IN MANY DIFFERENT AND THE DATA AND NER STILL VERY CHALLENGING AND OFTEN TIMES AND MULTILINGUAL AND ASSISTANCE AND FOR PEOPLE TO COMBAT THE BARRIERS OF THESE MATTERS AND SO THE DATA AND AND IT TAKES AND IT WILL NEVER HAPPEN. >>IT'S IMPORTANT TO START AND THERE ARE A LOT OF CHALLENGES WE CONTINUE TO HAVE? EVEN MISINFORMATION FOR EXAMPLE, OR HAVING ACCURATE TIMELY INFORMATION AND IT TAKES TIME IF WE DEVELOP MATERIALS IN ENGLISH AT FIRST IT TAKES TIME TO TRANSLATE INTO THOSE LANGUAGE AND OR EVEN, WHAT YOU HAVE SEEN AND SO I WANT TO JUST SPICK UP SOMETHING THAT RACE AND HIGHLIGHTED AND SHE STARTED TALKING ABOUT HEALTH LITERACY AND WHICH THEN? TERMS OF THE WORK WE HAVE BEFORE US THAT HAVE REALLY INCREASED UNDERSTANDING ABOUT RESEARCH AND TO WHAT IS LOOKING WHAT IS OCCURRING AND THE RESEARCH AND THE SCIENTIFIC AND WE SAW THAT AND RELUCTANCE ON THE PART OF MANY PEOPLE USING TO WAS REALLY BASED ON THE FACT THAT THEY HAD LIMITED TO KNOW KNOWLEDGE ABOUT SCIENTIFIC DISCOVERY THAT HAD BEEN OCCURRING FOR YEARS AND YEARS AND INSIDE OF THE MOST ELITE AND PRESTIGIOUS UNIVERSITIES AND IN THIS CRAIG AND GLOBALLY, RIGHT. SO WE HAVE TO DO NA BUT THE OTHER THING IS WORK THAT WE'VE DONE AND WITH AFRICAN IMMIGRANTS AND THEIR THEIR HOME COUNTRIES AND LOW COST AND SO I THINK THAT WE HAVE TO THE ONE OF THE THINGS THAT I SAID EARLIER ON IS THAT I FELT LIKE WE WERE BEING BEAT DOWN AND BY NONTRADITIONAL AT THE OUTSET OF THE PANDEMIC WE WERE LOSING THE BATTLE AND COMMUNICATE AND BECAUSE OF TRADITIONAL COMMUNICATION SOURCES AND MANY OF OUR COMMUNITIES ARE USING NONTRADITIONAL SOURCES AND THIS IS WHERE WE REALLY NEED TO TAKE NOTE OF ENGAGE INFLUENCE AND NONTRADITIONAL PLATFORMS LIKE WHAT'S APP AND THOSE PLATFORMS NEED TO BE IN THE LANGUAGE THAT IS MOST COMFORTABLE FOR PEOPLE AND THAT MAY NOT BE ENGLISH AND A LOT OF TIMES IT'S NOT. SO, THEY ARE IDEAS AND SUGGESTIONS TO HOW WE MOVE FORWARD AGAIN IN INCREASING AND ENHANCING RESEARCH LITERALLY THAT IS SO DESPERATELY NEEDED. >>IT'S LIKE GOING BACK TO KINDERGARTEN AND ASKING WHY AND MAKING SURE WE HAVE VERY SIMPLIFIED LANGUAGE BUT ALSO IN THE RIGHT SPACES. TO BE ABLE TO DO THAT AND LISA, DID YOU FIND THAT SAME THING AS ONE OF THE HEALTH DIRECTORS IN A RURAL COMMUNITY EVEN? LIKE HOW DID THAT INFORMATION OR LACK OF INFORMATION WAS COMING TO YOUR NEIGHBORHOODS? >>ABSOLUTELY, YES, THE LACK OF INFORMATION AND THE NEW TYPES OF SHARING INFORMATION AND THEN THE MISS AND DISINFORMATION WAS JUST HARD TO KEEP UP WITH CERTAINLY WHEN WE DON'T TRADITIONALLY AND LOCAL HEALTH DEPARTMENTS OR IN RURAL COMMUNITIES AND IT'S THE COMMUNICATION THAT THAT FONDATIONAL CAPABILITY THAT WE CAN NOW IDENTIFY FOR ALL PUBLIC-HEALTH WORKERS AND COMMUNITY HEALTH WORKERS TO PARTNER ON AND IMPROVE UPON IS HERE AND IS NOW AND WE NEED TO GET BETTER AT IT CERTAINLY AND IT'S SORT OF BUILDS ON WHAT I WAS GOING TO SAY TO YOUR PREVIOUS QUESTIONS THAT IT'S A TWO-FOLD CHALLENGE IN REALIZING WHAT IS HAPPENING SOME PLACES AND SO ACROSS RURAL AND URBAN THERE'S CERTAINLY A DISPARITY ON THE AVAILABILITY OF DATA AND THE NUMBERS TO BE STATISTICALLY SIGNIFICANT AND OR THE APPROACHES TO BE AS EVIDENCE-BASED AS WE WOULD LIKE. IT'S 11 TIMES REALLIEN INCREDIBLE WORK AND NO ONE IS TELLING THE STORY AND NO ONE IS COLLECTING THE DATA AND JUST LIKE WE HAVE A SHORTAGE OF EPIDEMIOLOGISTS, AVAILABLE IN A LOCAL HEALTH DEPARTMENT IN A RURAL UNDERST UNDERSERVED AREA,O HAVE A SHORTAGE OF THOSE DOING QI AND EVALUATION MEASURES AND SO THERE ARE SO MANY OPPORTUNITIES TO SORT OF MARRY THOSE WHO WERE REALLY GOOD AT QI AND EVALUATIONS MEASURES AND STORYTELLING AND WITH THOSE COMMUNITY COALITIONS AND GROUPS AT LOCAL HEALTH DEPARTMENT LEVELS WHERE GOOD WORK IS HAPPENING AND WE JUST DON'T KNOW ABOUT IT. >>YEAH, BREAKING IT DOWN AGAIN. THE IMPORTANCE GOING BACK TO OUR WORKFORCE AND NOT ONLY THE PUBLIC-HEALTH WORKFORCE BUT ALSO THE RESEARCHERS, THE. >>Tara: DATA ANNALISTS AND THE FOLKS IN TERMS OF HOW COLLECTIVELY WE ARE ALL CONNECTED AND IN THIS WORK AND SO, I GUESS FOR ME BEFORE WE OPEN IT UP TO QUESTIONS AND I JUST CAN'T BELIEVE IT'S ALSO TIME BUT YOU KNOW, I THINK I WANTED TO SPEND IN MORE SIGNIFICANT TIME ON JUST ON WHAT HAVE WE LEARNED AND WHAT IS SOMETHING WE WANT TO SHARE AND WHAT'S THAT ONE LESSON AND THE HEIGHT OF COVID FROM THE EARLIER DAYS AND I APPRECIATE NIH BEING ABLE TO HOST THIS SPACE FOR US TO BE ABLE TO REFLECT ON WHAT WE'VE ALL GONE THROUGH BUT ALSO WHAT OUR COMMUNITIES HAVE GONE TO AND SO WHEN WE THINK ABOUT THE IMPORTANCE OF LOOKING TOWARDS THE FUTURE, TOWARDS HEALTH EQUITY, TOWARDS THE NEXT CRISIS, YOU KNOW, WE CAN SAY THAT THE CURRENT, THERE'S A NUMBER OF CURRENT CRISISES AND SUCH AS MENTAL HEALTH, SUCH AS FOOD CRISIS, THE ECONOMIC POTENTIAL THAT THAT CAN LAY IN MANY OF OUR COMMUNITIES AND IN THE WORK, THE DAILY WORK THAT YOU ALL HAVE BEEN DOING AND WHAT IS THAT ONE LESSON OR TWO OR THREE? YOU KNOW, THAT YOU WANT TO ENSURE THAT EVERYONE THAT IS HERE TODAY WITH US CAN TAKE BACK AND BE ABLE TO IMPLEMENT SO GRACE, I'LL START WITH YOU. >>OK. YOU KNOW, THERE ARE MANY LESSONS WE HAVE LEARNED THROUGH THIS PANDEMIC BUT I'M GOING TO SHARE ONE. I THINK THE ACADEMIC COMMUNITY PARTNERSHIP IS INTEGRAL AND CRITICAL TO ADDRESSING HEALTH DISPARITIES, ESPECIALLY IN HARD TO REACH VULNERABLE COMMUNITIES WHO HAVE LIMITED ACCESS TO CARE DUE TO SOCIAL DETERMINANTS OF HEALTH. SO ONE OF THE RECOMMENDATIONS THAT WE DISCUSSED IN THE INTEREST GROUP WHICH IS LESSON LEARNED FROM THE COVID PANDEMIC AND WE HAVE DISCUSSED EXTENSIVELY AT OUR BIWEEKLY MEETING WHICH IS EMPHASIZING REQUIRING COMMUNITY ENGAGEMENT IN THE LEADERSHIP SHOULD BE A PREREQUISITE BY ALL PUBLIC-HEALTH RESPONSES WHETHER WE'RE AT A CRISIS OR NOT. SO IF WE CAN MAKE THIS HAPPEN, I THINK THIS COULD REALLY HELP US TO BUILD A SUSTAINABLE TRUSTED PARTNERSHIP AND THE INFRASTRUCTURE TO MOVE FORWARD IN THE FUTURE. ABSOLUTELY. AND BEING ABLE TO GET PAID AND HAVING THOSE RESOURCES I THINK ARE JUST AS IMPORTANT. >>YES. >>AL -- >>I' I HAVE NOT MET ONE COMMUNY LEADER, IN ANY COMMUNITY ACROSS THE U.S., THAT WAS NOT WILLING TO STEP FORWARD AT THIS MOMENT. MY TAKEAWAY IS THAT COMMUNITY-BASED ORGANIZATIONS, COMMUNITY LEADERS, CARE ABOUT THEIR COMMUNITY. LAST WEEK, WE WERE, MANY OF US WERE AT THE AMERICAN PUBLIC-HEALTH ASSOCIATION MEETING THERE WAS A CEAL PANEL, THE LAST PANEL OF THE DAY, I TOOK NOTE OF THE FACT THAT THE COMMUNITY LEADERS THAT REPRESENTED DIVERSE COMMUNITIES, THROUGH MULTIPLE PU CEAL COMMUT WAS MY COMMUNITY. SOMETIMES WE TALK ABOUT THE COMMUNITY IN KIND OF ABSTRACT TERMS BUT THESE COMMUNITY LEADERS SAID, MY COMMUNITY, OUR COMMUNITY. AND THAT LANGUAGE, THE CHOICE OF THAT LANGUAGE, PERSONALIZED THE PANDEMIC AND SUCH THAT AGAIN THAT COMMUNITIES ARE VERY INTERESTED IN SAVING LIVES AND WORKING IN THEIR COMMUNITIES AND MAKING A DIFFERENCE AND JUST HELPING THAT THEY WANT TO BE IN PARTNERSHIP WITH HEALTH DEPARTMENTS, THEY WANT TO BE IN PARTNERSHIP WITH ACADEMIC RESEARCHES AND THEY NEED THE RESOURCES TO DO THAT AND I RECEIVED A REPORT WHERE I LIVE AND SAYING WHAT IS NEXT? HOW CAN YOU HELP US TO SUSTAIN THIS INFRASTRUCTURE? TOE NOTTO ME IT'S THE KEY TAKEA. DO COMMUNITIES WANT TO BE INVOLVED? IT'S HOW CAN WE SUPPORT THEM AND BEING FULLY ENGAGE AND IN PARTNERSHIP WITH US. >>YES. >>IT'S THAT WHOLE SENSE OF BELONGING TOO AND WHEN YOU TALK ABOUT MY COMMUNITY OR OUR COMMUNITY, AND IT'S THAT SENSE OF WE ARE ALL AB T ABDICATING FE NEEDS OF OUR COMMUNITY AND WHAT WE LEARN AND THE PAIN AND THE TRAUMA WE HEARD. I KNOW LISA, YOU'VE HEARD LOOKING AT TRAM INFORMED APPROACH AND WHAT IS YOUR LESSON THAT YOU'VE SEEN? >>YEAH, WELL, I THINK FOR ME, IT'S JUST A REITERATION THAT RELATIONSHIPS IF CONNECTIONS ARE SO CRITICAL TO THE SUCCESS OF PARTNERSHIPS, THAT THIS IS PRETTY BASIC STU STUFF AND WE'VE LEARNED ABOUT IT AND TALKED ABOUT IT IN OUR OWN LANGUAGES AND STILL IT RINGS TRUE SO FOR US IT'S SO IMPORTANT TO BE PRESENT AND TO MEET PEOPLE WHERE THEY ARE AND TO VALUE THOSE RELATIONSHIPS AND THE RALPH SPEAKER I HEARD BEFORE THIS SPAN HE WILL, BROUGHT UP THE QUOTE ABOUT DOING THE BEST WE CAN UNTIL WE KNOW BETTER AND WHEN WE KNOW BETTER DO BETTER. I WOULD ALSO WANT TO BRING MYA'S OTHER QUOTE THAT I LIKED SO MUCH THAT SAYS I'VE LEARNED THAT PEOPLE WILL FORGET WHAT YOU SAID, PEOPLE WILL FORGET WHAT YOU DID BUT PEOPLE WILL NEVER FORGET HOW YOU MAKE THEM FEEL. AND AT THE ESSENCE OF THAT RELATIONSHIP, CONNECTIVITY AND TRUST, IS THAT IS THAT FEELING PIECE WITH WHICH IS WHY THAT WORK, BEHAVIORAL WORK INTEGRATED CARE AND APPROACHES THAT CONNECT ACADEMIC AND LOCAL PRACTICE CONNECTIONS INCLUDING COMMUNITY BASED ORGANIZATIONS AND COMMUNITY HEALTH WORKERS, IT'S ALL A PIECE OF A PUZZLE THAT IS ALL CREDITCRITICAL DOING THIS WO IN A DIFFERENT PIECE OF THAT PUZZLE. IT'S NICE TO BRING MYA INTO THE CONVERSATION. >>SHE ALWAYS HAS BETTER WORDS THAT I DO. >>YES. >>YES, WE LOVE OUR POETS. THE ONE THING, I GUESS GOING BACK TO EVEN THE DIGITAL WORLD, YOU KNOW, BECAUSE OFTEN TIMES THAT CAN BE THAT LACK OF CONNECTIVITY BUT IT ALSO COULD BE THE MOST, THE ONLY THING THAT CONNECTS PEOPLE AND BECAUSE YOU HAVE HEARD HEARD SO MUCH IN THE SOCIAL ISOLATION TA WE ALL WENT THROUGH BUT IN CERTAINLY COMMUNITIES YOU SAW IT MOST. HOW TO WE MAKE THE CONNECTION BETWEEN THE SENSE OF BELONGING AND HOW PEOPLE FEEL AND ALSO THIS LEVER WHERE WE CAN CONNECT AND GET THE RIGHT INFORMATION AND NOW YOU MENTIONED WHAT'S APP AS A CRITICAL TOOL AND THAT IT'S USED ACROSS THE WORLD AND FROM ALL MY EXPERIENCE AND THAT MANY PEOPLE WERE GETTING MOST INFORMATION IN LANGUAGE FROM OTHER COUNTRIES FIRST AND BECAUSE OF JUST NOT HAVING THAT INFORMATION AS ACCURATE OR WHAT'S IT THE RIGHT INFORMATION TO? DO YOU HAVE THESE OTHER INFLUENCERS THAT ARE NOT TOWING IT AND HOW DO YOU REGULATE THAT! ANY INSIGHTS ON HOW DO WE THINK ABOUT IT AND TRYING TO, WE'RE DOING THE BEST THAT WE CAN TO ENSURE THAT PEOPLE HAVE ACCESS TO THIS INFORMATION. IS THERE ANYTHING ELSE THAT WE'RE MISSING? >>YOU WERE RIGHT, WE HAVE BEENEN FIND IN A SERIES OF LISTENING SESSIONS AND AROUND LONG COVID AND AS PART OF THAT CONVERSATION, THE IDEA SURFACED FROM SEVERAL INDIVIDUALS FROM MULTIPLE COMMUNITIES THAT THEY WERE RECEIVING INFORMATION AROUND LONG COVID TREATMENT AND THROUGH WHAT IS COMING SIMILAR AND KINDS OF PLATFORMS FROM OTHER PLACES, NOT IN THE U.S. AND SO THEY WERE USING KIND OF HERBAL PRODUCTS AND SIMILAR KINDS OF THINGS TO TREAT THE SYMPTOMS OF LONG COVID SO I THINK THAT AGAIN IT SUGGESTS THAT WE HAVE TO BE ENGAGE IN MULTIPLE STRATEGIES AS PEOPLE AND ALL OF US KNOW TO COUNT A MISINFORMATION AND DISPOSITION AND ALSO TO LOOK TO OTHER PLACES FOR ANSWERS. I THINK, WE SAID EARLIER THAT THE PANDEMIC EQUALIZED THE GLOBE AND I IT WAS ONE OF THOSE MOMENTS WHERE THERE WAS NO DIFFERENCE BETWEEN THE U.S. AND OTHER OTHER COUNTRIES AND WHERE ALL SUFFERING SO WHAT ARE THE LESSONS WE CAN LEARN FROM OUR GLOBAL PARTNERS ABOUT WHAT ARE THE LESSON WE CAN LEARN FROM OTHER COMMUNITIES AND BASED ORGANIZATIONS AND LEADERS AND VIETNAM AND SOUTH AMERICA AND EUROPE, WE HAVE TO TAKE ALL OF THIS AND BECAUSE PEOPLE ARE GETTING THEIR INFORMATION FROM SO MANY SOURCES AND IT'S JUST THIS IS A DIFFERENT GAME AND EVERY TEXTBOOK IN PUBLIC-HEALTH COMMUNICATION HAS BEEN REWRITTEN. WHAT WE THOUGHT WE KNOW ABOUT PUBLIC-HEALTH AND HEALTH COMMUNICATIONS, AND WE HAVE NEW STRATEGIES AND NEW FORMS OF ENGAGEMENT AND THEY HAVE RE SOURCING GLOBALLY. >>THANK YOU, RACE. AND THE TECHNOLOGY REALLY HAS CHANGED AND THE PANDEMIC HAS CHANGED OUR WAY OF GETTING INFORMATION AND ALSO HOW WE UTILIZE THAT INFORMATION AND I THINK ONE OF THE THINGS THAT WE NEED TO CONTINUE TO BUILT IS A SOCIAL COHESION AND THIS PANDEMIC HAS PUT A LOT OF US INTO THE SOCIAL ISOLATION AND CONTINUE AND I THINK WE HAVE WE HAVE A BETTER NETWORK AND THE CHANNELS O COUNTER THESE MISINFORMATION WITH THIS INFORMATION AND WE NEED TO BE REALLY MORE SENSITIVE TO THE CONTEXTUAL LIFE AND THE COMMUNITY BACKGROUND IN TERMS OF PUT CULTURALLY AND THE LING WISH TICKLY PROPER INFORMATION AND WHEN THEY CAN'T GET THE INFORMATION AND IN THEIR OWN LANGUAGE AND THEY GO TO THE OTHER CHANNELS BECAUSE IF EVERYTHING IS IN ENGLISH, IT WILL HAVE A LOT OF BARRIERS FOR THESE PEOPLE BECAUSE THIS IS A COUNTRY WITH A LOT OF IMMIGRANTS AND WE NEED TO BE CONTINUED TO BE SENSITIVE WHEN WE DEVELOP STRATEGIES AND EVEN NEEDS THAT NEEDS TO BE MORE ADDRESSING THE NEEDS OF THOSE POPULATIONS. >>THE TIME IS NOW AND I THINK GOING BACK TO YOUR, IS THIS THE MOMENT OR MOVEMENT AND I KNOW THAT ALL OF US ARE SIGNIFICANTLY ALSO TIRED AND ALSO JUST HAVE GONE THROUGH SO MUCH OVER OUR PERSONAL LIVES AND ALSO IN THE FAMILIES AND THAT WE'VE WORKS WITH AND THE COMMUNITIES THAT WE'VE BEEN INVOLVED WITH BUT IT GIVES ME A SENSE OF WE NEED TO TAKE THIS OPPORTUNITY TO HIGHLIGHT SOME CRITICAL CHANGES TO BE BOLD IN OUR APPROACH AND TO BE ABLE TO THINK ABOUT WHAT CAN EQUITY AND INCLUSIVENESS LOOK LIKE FOR OUR COMMUNITIES AND ESPECIALLY THOSE THAT HAVE BEEN MARGINALIZED AND THOSE THAT HAVE NOT HAD THAT VOICE AND SO ANY THOUGHTS BEFORE I KNOW I'M GETTING A LOT OF PINGS WITH WE'VE GOT A NUMBER OF QUESTIONS AND SO I WANT TO PIVOT TO THE QUESTIONS FROM OUR ATTEND'YS, OFTEN TIMES WE DON'T ASK HOW ARE YOU TAKING CARE OF YOURSELVES TO ENSURE OUR COMMUNITIES ARE FRONT AND CENTER? >>ALWAYS A GREAT QUESTION IN ANY EASY ANSWER ALWAYS IS TO TURN TOWARDS THE PUBLIC-HEALTH WORK WORSE THAT WE'RE WITH AND DECIDE EVERY DAY AND IT'S A TIRING TIME AND NOW THAT WE HAVE REACHED THE PHASES OF COVID RESPONSE WHERE THAT FEELS VERY ROUTINE NOW, NOW ALL THE OTHER THINGS AND EMERGING DISEASE ISSUES AND OTHER WORK THAT WE WERE DOING PRIOR TO SNAPPED BACK MUCH LIKE THE AIRLINES FELT WHEN POEM STARTED TRAVELING AGAIN AND I THINK MOST OF THE WORK HEALTH WORKFORCE FELLS LIKE OH MY GOODNESS, FAMILY PLANNING AND CHILD HEALTH AND MEDICATION ASSISTED TREATMENT AND JAIL HEALTH ALL OF THOSE THINGS ARE STILL IMPORTANT ASIDE FROM COVID RESPONSE SO IS IT'S A TOUGH TIME BUT THE FACT YOU'VE BEEN IN THE TRENCHES WITH YOUR COMMUNITY MEMBERS AND PARTNERS AND THROUGH SOME REALLY TOUGH TIMES MAKES YOU WANT TO SHOW UP EVERYDAY AND BE THERE FOR THEM AGAIN TOMORROW AND SO, THAT'S HOW WE KEEP ON KEEPING ON AND IS SORT OF HOLDING EACH OTHER UP IN THE FORK WORSE. >>IT'S GREAT. GIS. >>I THINK WHAT LISA SAID IS IT'S WELL AIKEN AND I THINK THAT WE WILL NEED TO NOT ONLY TAKE CARE OF TAKE CARE OF OURSELVES AND THE FAMILY AND AGAIN, I THINK THAT THIS COHESION AND ALSO NOT ONLY WE NEED TO LOOK AT THE MENTAL HEALTH AND ALSO OURSELF PHYSICAL HEALTH AND TO GIVE UP THE RESILIENCE SO THAT WE CAN HELP OUR COMMUNITIES AND I THINK THAT THIS IS THE MESSAGE HA WE NEED TO CONTINUE AND TO EMBRACE. >> >>MY ANSWER IS NOT ENOUGH. [LAUGHTER] >>I FEEL LIKE WE'RE KIND OF LIKE AT THE MOMENT WHERE WE'RE ABLE TO BREATH AND AT THIS TWO AND A HALF YEAR MARK AND SO I LOOK FORWARD TO THE HOLIDAYS COMING UP AND I MAY BE ABLE TO TAKE TIME TO JUST REST I THINK THAT THE OTHER PIECE THAT I'M MOST HOPEFUL FOR IS THE SUM PASS PROJECT AND SIMILAR PROJECTS TO REALLY HELP INCREASE THE PIPELINE AND I'M TRULY INTERESTED IN ENGAGING MORE YOUNG PEOPLE AND I RECOGNIZED THE AGING WORKFORCE AND WE HAVE A ROLE IN RESPONSIBILITY THERE SO I THINK THAT ALL EFFORTS TO TRY AND PASS ONTO THE NEXT GENERATION AND WHAT WE'VE LEARNED IN THIS MOMENT WILL GIVE ME A SENSE OF RELIEF THAT WE'RE IN GOOD HANDS AND THAT WE CAN KIND OF STEP BACK SUCH AS THAT SOME OF OUR YOUNGER LEADERS AND MORE DIVERSE LEADERS QUITE FRANKLY, CAN STEP FORWARD AND RESPOND TO THE ON GOING HEALTH ISSUES. I'LL JUST SAY THAT ONE OF THE THINGS THAT RESINATES WITH ME ABOUT ALL OF THIS IS THE FACT WHEN I SAY MOMENT OR A MOVEMENT, FOR A LOT OF PEOPLE, IN THE PRESENTATION BY Dr. TRENT ADAMS AND THE WORK OF THE INSTITINSTITUTE OF MINORITY OF H DISPARITIES, FOR MANY PEOPLE THEY LIVE THIS EVERYDAY. WHAT WOULD HAPPEN, CAN YOU IMAGINE WHEN A PANDEMIC IS EVERY DAY, AND THAT THOUGHT KIND OF SURFACES FOR ME AND I THINK FOR A LOT OF PEOPLE IN OUR COMMUNITIES AND MY COMMUNITIES, AFRICAN AMERICAN COMMUNITIES, LOW INCOME COMMUNITIES, IT'S EVERY DAY AND SO HOW DO WE SUPPORT THEM THROUGH THE EFFORT CHALLENGES THAT THEY HAVE AND PROVIDING THE RESOURCES EVERY SINGLE DAY TO HELP PEOPLE AND I KNOW IN MY COMMUNITY, IT'S NOT JUST HELP BUT THE SOCIAL PERMANENT OF HEALTH THAT IS REALLY IMPACTING PEOPLE IS THE ESCALATING HOUSE OF HOUSING AND IT'S REALLY ACROSS THIS COUNTRY AND I'M SO CONCERNED ABOUT IT AND WE HAVE TO HAVE MORE AFFORDABLE HOUSING BECAUSE THAT'S STRESSING A LOT OF PEOPLE OUT SO, THANK YOU. >>CHOOSING HAVING A HOME OVER THE FOOD AND THE TABLE AND YOU KNOW, ENSURING THAT YOU ARE ABLE TO HAVE GAS TO BE ABLE TO GO TO WORK AND THESE ARE CONSIST EVENTUALLY KIND OF THE CIRCLE THAT EVERYDAY PEOPLE ARE ENSURING THAT AND THE THEY'RE DEALING WITH IN A NUMBER OF DIFFERENT WAYS AND SO, THANK YOU AND ONE OF THE THINGS HERE IS TO STILL TAKE CARE OF YOURSELF AND ALSO ENSURE YOU ARE LISTENING AND YOU ARE INSURING THE FUNDING AND INFRASTRUCTURE IS AT PLAY AND THE FUNDING IS PLEX A FLEXID NOT RESTRICTED AND WE NEED TO MENTOR OUR YOUNGER COMMUNITIES, COMMUNITIES OF COLOR, AND HAVING A WORKFORCE THAT CAN CONTINUE TO BE AS AUTHENTIC AND SINCERE IN DIFFERENT WAYS AND LIT ARE SEE PLAYING A MAJOR CONTROL AND LANGUAGE AND RESOURCES THAT NEED TO BE INVESTED IN A NUMBER OF DIFFERENT WAYS SO THERE'S SO MUCH TO IMPACT AND I DIDN'T TAKE NOTES AND YOU MAY HAVE ALSO SO I'M GOING TO OPEN IT UP TO CRYSTAL AND LOOK AND SEE IF WE HAVE, I KNOW WE HAVE A NUMBER OF QUESTIONS SO I'M NOT SURE IF I'M THE LEAD ON THIS ONE OR -- [LAUGHTER] >>CRYSTAL, CAN YOU HELP US UNTANGLE ALL THESE AMAZING QUESTIONS WE'RE GETTING FROM THE AUDIENCE. >>AND YOU ARE ON MUTE STILL. >>THANK YOU, YES, I WILL PITCH THE QUESTIONS FOR YOU SO WE CAN GO THROUGH THEM. I TO WANT TO LET THE AUDIENCE KNOW THAT IF THEY'RE WE WILL INCLUDE THE QUESTIONS IN THE REPORT SO THEY CAN KNOW THAT THEY WERE INCLUDED IN THE WORKSHOP, OK. AND THEY RUN INTO BARRIERS AT UNIVERSITY OF NORTH CAROLINA. IT'S WHERE THEY'RE FROM. THIS CAME FROM ELIZABETH. HOW ARE WE USING COMMUNITY ENGAGEMENT AND COLLABORATIONS TO SUSTAINABLE CHANGES? FOR EXAMPLE, WITH THE TRUST, WE MAY HAVE GAINED FROM COVID VACCINES, HOW CAN THE COMMUNITY ORGANIZATIONS IMPROVE OTHER VACCINATIONS SUCH AS FLU, HPV, ET CETERA. >>WELL, ACTUALLY I'M INVOLVED IN A PROJECT FUNDED, IT'S A VACCINE EQUITY PROJECT AND WE ARE FOCUSED ON NOT JUST COVID BUT ALSO TAUGHT VACCINES IN GENERAL AND HAVING AN ADULT WELLNESS APPROACH IS A STRATEGY THAT I THINK THAT WE NEED TO REALLY EMBRACE AND SO WE'RE USING THIS AS A MOMENT TO REALLY TALK ABOUT COVID, AROUND SHINGLES AND IN PARTICULAR IN THE FLU AND THEN WE'RE HEARING OTHER ISSUES THAT SURFACE OF PARENTS CONCERNED ABOUT THE RESPIRATORY CONDITIONS THAT HAVE EMERGED AND PARTICULAR FOR CHILDREN SO WORE JUST TRYING TO USE THE SAME LEVEL OF ENERGY AND SOME OF THE ENERGY THAT WE HAVE LED TO PIVOT TOWARDS SOME OF THE OTHER TAUGHT VACCINE ISSUES AND DO SOME EDUCATION AT THE SAME TIME AND THAT IS DISTINGUISHING BETWEEN THE FACT YOU ARE VACCINATED FOR COVID DOESN'T MEAN THAT YOU ARE ALSO VACCINATED AGAINST THE FLUE SO THERE'S A LOT OF EDUCATION THAT IS STILL IMPORTANT. >>THE SKEPTICISM AROUND VACCINATION DURING COVID ENCROACHED ON SOME OF THE OTHER VACCINES SO AS MUCH AS WE WANT TO CA CAPITALIZE AND GROW WITH COMMUNITY TO BUILD CONFIDENCE IN THE SCIENTIFIC PROCESSES, I FEEL LIKE WE HAVE A BUMPY ROAD AHEAD US OF WHEREAS PRIOR TO COVID, WE DIDN'T HAVE NEARLY AS MANY QUESTIONS OR AS MUCH CONCERNS OR AS MANY CONSPIRACY THEORIES TO DEBUNK. YOU ARE FOCUSING ON THE POSITIVE WITH TA QUESTION AND I APPRECIATE THAT BUT WE HAVE A LOT OF WORK TO DO TO REBUILD SOME TRUST AND COMMUNITY AS WELL AND THAT IS A TOUGH ROAD. >>I AGREE WITH BOTH LISA AND AL. AND BECAUSE THESE COMMUNITIES OFTEN TIMES THEY SAID IT'S TIME TO GET FLU SHOT AND THEY SAID I JUST HAVE A VACCINE AND SO I THINK, WHEN WE GO BACK TO THE HEALTH LITERACY, AND IN THEIR OWN LANGUAGES, BECAUSE PEOPLE SOMETIMES GET A FATIGUE IN TERMS OF VACCINES AND HOW MANY VACCINES I'M GOING TO GET AND THEY GOT IT LAST YEAR AND NOW THEY ARE EXPERIENCING ALL OF THESE VACCINES HESITANCY SO WE'RE AT THE DIFFERENT LEVEL NOW AND MORE IS HOW CAN WE DEVELOP A STRATEGY TO HELP PEOPLE TO OVERCOME THE VACCINE HESITANCY. >>YEAH. >>GRACE'S COMMENT MAKES ME THINK ABOUT LIKE WE NEED TO BE HONEST WITH PEOPLE AND WE NEED TO TELL THEM WHAT WE KNOW AND WHAT WE DO NO RIGHT SO GRACE YOUR POINT IS TAKEN, IS LIKE, AROUND THE BOOSTER IF WE OVER PROMISE, WHEN WE COME BACK AND SAY NEXT YEAR YOU HAVE TO GET ANOTHER SHOT AND SO WE HAVE TO BE CAREFUL ABOUT OUR MESSAGING AND COMMUNICATIONS TO PEOPLE AND NOW MORE THAN EVER BEFORE US, PEOPLE WILL JUST TURN OFF BY THIS MISINFORMATION. YOU MENTIONED THE ELEMENT OF YOU KNOW, ENSURING THAT PEOPLE HAVE THAT A LOT OF OUR FAMILIES LIVE IN NOT ONLY MIXED STATUS BUT ALSO, WITH DIFFERENT GENERATIONS WITHIN THE HOME AND SO ONE OF THE THINGS THAT I JUST RECENTLY SAW LA LATINO PARENTS AND THOSE NATURED WERE MORE LIKELY TO VACCINATE THEIR KIDS AND SO WHAT DOES THAT INFLUENCE LOOK LIKE FOR THE WHOLE HEALTH OF THE FAMILY AND HOW WE NEED TO ENSURE THAT WE HAVE THOSE ACCURATE TIMELY INFORMATIONS. OUT THERE. >> >>THE NEXT QUESTION. FROM ANNA FROM THE AUDIENCE AND I DO BELIEVE THAT LISA SAID THEY WOULD LIKE TO TAKE A STAB AT THIS ONE INITIALLY AND THE QUESTION IS, ONE POINT IS THAT COMMUNITY ENGAGEMENT MUST BE CONSISTENT AND ON GOING AND NOT JUST PROJECT TO PROJECT IT TAKES TIME EFFORT AND RESOURCES TO ESTABLISH AND MAINTAIN THESE COMMUNITY ACADEMIC PARTNERSHIPS HOW FUNDERS WANT A FOCUS O ON TO FLY IN AND ASK QUESTIONS AND ZOOM BACKOUT AND SAY THANK YOU AND WE FEEL WE'RE REALLY GOOD AT OUR JOBS WHEN WE GIVE FEEDBACK ABOUT WHAT WE LEARNED TO THE GROUP PROVIDING US INFORMATION THAT FEELS LIKE A CLOSED LOOP AND IT'S NOT ALWAYS EVERYTHING THAT WE NEED TO BE DOING TO THINK ABOUT THAT AUTHENTIC LONG-TERM PARTNERSHIPS AND AS FAR AS WHAT I HAVE TRIED TO AND IN NORTH AMERICA AND TO HAVE LONGSTANDING AND ACADEMIC AND INSTITUTIONS AND UNC CHAPEL HILL WHO HAS AFRICAN AMERICAN WOMEN AND DIABETES AND PREVENTION AND HEART DISEASE AND PREVENTION AND CHRONIC DISEASE AND INDICATORS AND SHE HAS BEEN A PARTNER SITTING IN THIS LOCAL HEALTH DEPARTMENT EVERY WEDNESDAY GOING ON 10 YEARS NOW AND IN ADDITION AND DUKE UNIVERSITY SCHOOL OF NURSING HAS A PROFESSOR WHO DOES SIMILARLY COME TO THE HEALTH DEPARTMENT AND EVALUATE THE WORK THAT WE'RE DOING AND SIT WITH OUR NURSES AS THEY'RE ENTERING INTO SURVEILLANCE SYSTEMS AND TO LEARN THE PROGRAMS AND PROCESSES THAT WE'RE UNDER AND TO HELP HELP TO DO THIS WORK AND THE EVENT OF TIME IS THE AUTHENTICITY IT WILL TAKE A LITTLE BIT MORE THAN JUST THAT AND ALL THOSE MEASURES ARE GOOD AND I'M NOT CRITICIZING THE FACT THAT WE'RE GETTING BETTER AT SHARING INFORMATION BACK WITH THOSE WE COLLECTED IT FROM OR WE'RE INCLUDING THEY'RE COMMITTED TO AND SHOWING SORT OF MODELING THE WAY HOW WE DO THAT BETTER SO THOSE ARE TWO GOOD STEPS ALONG THE WAY BUT I THINK THAT INVESTMENTS OF TIME AND SORT OF CREATING MORE ACADEMIC PARTNERSHIPS AND EVEN THROUGH COMMUNITY-BASED ORGANIZATIONS WHERE OUR COMMUNITY HEALTH WORKERS ARE ANOTHER OPPORTUNITY FOR THAT. THIS IS SUCH A IMPORTANT COMMENT AND QUESTION AND I THINK LONG-TERM SUSTAINABLE RELATIONSHIPS IS NOT JUST WHEN THE PROJECT IS HERE, YOU CAN GO TO THE COMMUNITY AND YOU NEED TO BE THERE SO IT'S WHEN YOU HAVE A PROJECT TO FOCUS ON CANCER BUT THE COMMUNITY REALLY NEEDS SOME HELP WITH THE DIABETES SO YOU HAVE TO RESPOND YOU CAN'T JUST FOCUS ON ONE ISSUE THAT IS INTERESTED IN THE FUNDED RESEARCH PROJECTS AND SO WE NEED TO HAVE THAT KIND OF MENTALITY TO ADDRESS THE NEEDS OF THE COMMUNITIES WHEN IT'S NEEDED. AND WE NEED TO THINK ABOUT THE PROJECT THAT'S BENEFICIAL TO THE COMMUNITY SO THAT IS VERY IMPORTANT TO BUILD A SUSTAINABLE AS WELL AS TRUST. >>THAT MAY BE OUR FINAL QUESTIONS IF NO ONE ELSE HAS A RESPONSE TO THE PREVIOUS QUESTIONS. MARIA. THANKS FOR THE WONDERFUL PRESENTATIONS AND SHE HAS TWO QUESTIONS AND HOW CAN WE MEASURE THE RESPONSIVENESS OF A COMMUNITY ENGAGE PROJECT AND THE SECOND IS WHAT CAN BE DONE SO MORE NON COMMUNITY BASED ENGAGEMENT RESEARCHERS ARE AWARE OF THE UNIQUE TYPES OF EVENTS. >>THOSE ARE EXCELLENT QUESTIONS AND HARD TO COME UP WITH REALLY GOOD QUESTIONS AND I DON'T HAVE EVIDENCE AROUND WHAT IS GOOD AND CONNECTIONS ON A LOT OF INTERVENTIONS DELIVERED OR DATA COLLECTED NECESSARILY BUT THEY'RE THE BASIS FOR FINDING OUT THAT ANSWER SO TO HELP WITH THAT QUESTION AND ANSWER. >>WE CAN A LOT HAVE A LOT OF TOOLS AND DO A LOT OF THAT IN INSTRUMENTS AND BUT THERE'S THAT REPLACES JUST TALKING TO PEOPLE, RIGHT AND THEY'LL BE HONEST AND SAY TO YOU WHAT THEY'RE REALLY THINK AND HOW THEY FEEL ABOUT THIS PARTNERSHIP AND GRACE, WHAT DO YOU THINK IF. >>I THINK YOU ARE ABSOLUTELY RIGHT. IT SHOULD BE DRIVEN BY THE COMMUNITY NEEDS AND OTHERWISE, THERE'S NO, I WOULD SAY, THERE'S NO USE TO DO THE RESEARCH AND IF THERE'S NO NEEDS THERE SO, IF AGAIN GOING BACK TO CBPR PRINCIPLE YOU NEED TO START TOGETHER FROM THE PLANNING PROCESS AND CONCEPTS. IT TAKES TIME. IT LAST LONG AND THE COMMUNITY IS INTERESTED EPIDEMIC IS INTERESTED AND SOME OF OUR EVIDENCE-BASED INTERVENTIONS IN THE END HAS STAYED IN THE COMMUNITY ORGANIZATION FOR LONG TIMES AND WE WANT TO INSTITUTIONALIZED THOSE EVIDENCE BASED INTERVENTIONS AS A PART OF THEIR DAILY PRACTICE. IT COULD BE IN THE PART OF THE COMMON PRACTICES. >>IT WAS ONE THING GOING BACK TO THE FUNDER IT'S BEING FLEXIBLE ABOUT HOW WHAT ARE THOSE COMMUNITIES NEEDS AND INCLUDING THAT INTO THE RFA OR IF YOU ARE WHATEVER YOU WANT TO CALL IT, RIGHT. BEING AS BROAD AS POSSIBLE, WHERE YOU INVOLVE AND YOU HAVE THAT PARTNER FROM THE BEGINNING OF THE REQUEST FOR THE PROPOSAL IS SUPER IMPORTANT AND MANY OF OUR CBOs AT THE HEIGHT OF IT WE WANT TO FLEXIBILITY AND WE JUST PROVIDED MONEY AND CASH BECAUSE AT THE END OF THE DAY, THEY NEEDED TO PROVIDE CASH TO COMMUNITIES SO THEY MAKE THEIR RENT OR PURCHASE FOOD AND SO THAT IS NOT SOMETHING THAT YOU MEASURE BUT THEN SOMETHING THAT IS IMPORTANT, RIGHT. >>I WANT TO REMIND EVERYBODY OF A TOOL THAT IS COMMON ACROSS THE NATION THAT YOU CAN TAP INTO AS AN OPPORTUNITY AS THE COMMUNITY HEALTH ASSESSMENTS THAT LOCAL COMMUNITIES WE ASSESS THEN TIER COMMUNITY WITH QUALITATIVE DATA COLLECTION PRIMARY AND SECONDARY LAX EFFORTS AND THOSE ARE BUILT IN OPPORTUNITIES WHERE WE'RE PLANNING TO TALK WITH COMMUNITY ABOUT HEY, WHAT DO YOU NEED FROM US AND TO TALK WITH COMMUNITY DURING THAT PROCESS IS EASY FOR RESEARCHERS SO I WANTED TO REMIND PEOPLE OF COMMUNITY HEALTH ASSESSMENT THAT'S EXIST. >>THIS WAS A WONDERFUL SESSION AND TO KICKOFF OUR WORKSHOP AND WITH THAT BEING SAID I'D LIKE TO THANK ALL OF OUR PANELISTS THE ATTEND'S FOR THE QUESTIONS AND QUESTIONS THAT WERE POSED APPROXIMATE COMMENTS AND NOW I WILL GIVE THE MIC BACK OVER TO NAR STAND OWE. >>THANK YOU. >>THANK YOU. >>THANK YOU. >>ENJOYED IT. >>THANK YOU. >> >>THANK YOU, VERY MUCH, EVERYONE. THANK YOU FOR THE PANELISTS AND THANK YOU CHRIS OWE PEEL PRIOR FOR LEADING US IN THIS MODERATION AND NOW WE TAKE MUCH-DESERVED BREAK WHICH FOR US HERE IN BETHESDA WILL SERVE AS A LUNCH BREAK BUT MAYBE YOUR BREAKFAST AND MAYBE IT'S YOUR DINNER AND MAYBE IT'S A LATE-NIGHT NARC SO WE WILL GATHER BACK THE WHICH IS PLANNING SO FOR US HERE IT WILL BE 1:30 BUT WHATEVER YOU MAY BE, IT WILL BE 30 MINUTES FROM NOW SO ENJOY YOUR BREAK. THANK YOU. >>WELCOME BACK, EVERYONE. A PLEASURE AFTER EVERYONE HAS HAD A CHANCE TO PAUSE AND EAT WE WELLCOME Dr. ROPER AND SO Dr. ROPER, PLEASE, TAKE IT AWAY. >>THANK YOU, FERNANDO. WE'VE GAINED MOMENTUM THOUGH A LITTLE BIT OF A BREAK FROM THE FIRST SESSION. SO, OUR SESSION IS PLANNING FOR AND MEASURING BY-DIRECTIONAL COMMUNITY ENGAGEMENT TO CONDUCT RESOURCE TO ADVANCE HEALTH EQUITY AND HOW LUCKY FOR US, WE ARE IN THE MONTH OF THE NATIVE AMERICAN HERITAGE MONTH AND ONE OF OUR MANY IMPORTANT MEMBERS OF OUR COMMUNITY OUTREACH. WE WILL GO BY FIRST NAMES IN OUR DISCUSSION AND WE HAVE OUR CHAIR, Dr. AGUILAR-GAXIOLA FROM U.C DAVIS AND HE IS A HEALTH EQUITY EXPERTS. YOU NOTICE IN OUR PRIOR SESSIONS, THEY MENTIONED THE NATIONAL ACADEMY OF SCIENCE MEANINGFUL COMMUNITY ENGAGEMENT AND CONCEPTUAL MODEL THROUGH TRANSFORMED HEALTH SYSTEMS AND HE IS ONE OF THE CO-AUTHORS AND WE ARE REALLY LUCKY THAT WE TOO HAVE SOME PEOPLE FROM THE FIELD WHO ARE COMMUNITY REPRESENTATIVES, WHO WORK WITH THE COMMUNITY, AND Ms. CHARLENE OR TEASE IS A COMMUNITY REN SEN TIVE FROM THE COLORADO COMMUNITY ENGAGEMENT ALLIANCE SHE'S AN EXPERIENCED COACH AND TRAINER COMMITTED TO IMPROVING HEALTH COMMITMENT HEALTH AND MsL SALDOVAL AND Dr. DONALD NEASE IN. IMPROVING HEALTHCARE AND Dr. PATRICK JOHANSON FROM THE NORTHWEST PBRN AND RESEARCHERS CHRONIC DISEASE, PREVENTION, MANAGEMENT AND RURAL INDIGENOUS PEOPLE. WE ALSO HAVE Dr. FREEMAN. WE WILL HAVE THREE DISCUSSIONS SESSIONS WITH 10 MINUTES EACH AND SERGIO WILL LEAD THOSE AND AT THE END. , AND WE'RE LUCKY AS WE SEEK TO REALLY GARNER FROM THEM INSIGHTS ON HOW WE CAN RECOGNIZE AND INREINFORCE PARTY WITH THE TRADITIONAL RESEARCH. SO THANK YOU. I TURN IT OVER TO YOU AND OUR WONDERFUL TEAM. >>THANK YOU SO MUCH. CAN YOU HEAR ME. >>IT'S POLITICIAN TO BE HERE WITH MY COLLEAGUES AND MEMBERS DISTINGUISHED MEMBERS OF THE PANEL AND ON A TOPIC THAT IS VERY, VERY IMPORTANT AS A BUILDING BLOCK AND TO ADVANCING HEALTH MENTAL HEALTH COMMIT AND THIS IS A QUEEN STEP IN REACHING TO WHAT I CONSIDERED A NORTH STAR. NEXT. AS YOU MENTIONED, REBECA, IT IS REALLY IMPORTANT TO HAVE A FRAMEWORK, A ROADMAP, AS TO WHY PLANNING AND MEASURING BIDIRECTIONAL COMMUNICATIONS MATTER AND I'M SHARING WITH YOU A VERY REANNE WORK BY THE NATIONAL ACADEMY OF MEDICINE AND WE'VE BEEN WORKING FOR ALMOST FOUR YEARS AND THERE'S AN ORGANIZING COMMITTEE OF ABOUT 32 MEMBERS AND I HAVE THEY HONOR AND PLEASURE TO BE THE COULD CHAIR OF THAT WORK AND WE RELEASED THIS PAST FEBRUARY THIS ASSESSING COMMUNITY ENGAGEMENT CONCEPTUAL MODEL AND WE HAVE MEASURES FROM A REVIEW AND ALSO I AM PATH STORIES AND THEN EARLY THIS COMING SPRING, THE REPORT ITSELF BUT WHAT I WOULD LIKE TO BRING TO YOUR ATTENTION IS NEXT CENTRAL TAL TEE OF COMMUNITIES ENGAGEMENT AND NEXT, PLEASE. YEAH. THANK YOU. THANK YOU. THE CENTRAL TRAL TEE OF COMMUNITY ENGAGEMENT AND COMMUNITY ENGAGEMENT IS INFORMED AS YOU CAN SEE, IN THE OUTER CIRCLE. BIDIRECTIONAL COMMUNICATIONS AND IT'S AS I MENTIONED THIS IS A VERY IMPORTANT BUILDING BLOCK AND WHAT IS IMPORTANT TO HIGHLIGHT HERE IS THE CONNECTION BETWEEN COMMUNITY ENGAGEMENT AND THE NORTH STAR ADVANCING HEALTH EQUITY AND THROUGH SYSTEMS FOR HEALTH AND ADVANCING HEALTH EQUITY IS THE TOPIC OF THIS TWO-DAY WORKSHOP, SO, IT IS IMPORTANT. AND WHAT YOU SEE IN THOSE FOUR BUCKETS, EXPANDED KNOWLEDGE, ET CETERA, THOSE ARE KEY DOMAINS AND WITHIN SPECIFIC KEY ELEMENTS WHAT WE HAVE DONE IS IDENTIFIED MEASURES THAT THAT INTO THOSE ELEMENTS AND IT HIGHLIGHTS BIDIRECTIONAL, NOT ONLY COMMUNICATIONS BUT DIRECTIONAL LEARNING AND ALL OF THESE, BY THE WAY, IS IN CIRCLE BY THE DRIVERS OF HEALTH AND WHAT YOU SEE IN THE BIG OVAL IS THE DRIVERS OF CHANGING HEALTH HEALTHCARE AND INCLUDING THE SOCIAL, POLITICAL RACIAL AND ECONOMIC AND HISTORICAL AND ENVIRONMENTAL CONTEXT AND ALL OF THIS IS IN CONTEXT AS OUR PREVIOUS PANELISTS MENTIONED ALSO, AS YOU SAY AS Dr. PEREZ-STABLE MENTIONED THAT. NEXT IN THIS I WOULD LIKE TO CHAIR WITH YOU WORK THAT WE HAVE DONE ON THE IMPORTANCE OF FOCUSING EFFORTS ON DIVERSE, EQUITY AND INCLUSION ACTIONS THIS IS FROM TRANSLATIONAL AWARDED PROGRAMS AND THIS IS A MAJOR PUBLIC INVESTMENT YOU KNOW, NEARLY $600 MILLION A YEAR AND THERE ARE 63 ACADEMY HEALTH CENTERS THAT ARE BEING FUNDED SO, WHAT WE DID TWO YEARS AGO IS TO FOCUS WORK ON THE IMPORTANCE OF DIVERSITY, EQUITY AND INCLUSION AND WITHIN THAT WORK, WE CENTERED ON THE SIGNS OF ADVANCING HEATH EQUITY AND THROUGH COMMUNITY ENGAGEMENT APPROACHES TOWARDS A GREAT EXTENT SO I WANT TO SHARE WITH YOU JUST A FEW THOUGHTS, NEXT, COMING FROM THIS PARTICULAR PAPER AND IN THIS ONE, THESE ARE ONCE AGAIN COMMUNITY CENTER RECOMMENDATIONS AND BOTH TO CONDUCT RESEARCH WITH THE COMMUNITY OR IN THE COMMUNITIES BUT WITH THE COMMUNITIES WHICH IS VERY PORT ANTS. CONDUCTING RESEARCH WITH THE COMMUNITY AND IT'S TO HOLD REGULAR LISTENING AND REPORTING SESSIONS WITH COMMUNITIES TO THE DETERMINE WHAT MATTERS TO THEM AND LISTENING TO THEM AND SHARE FINDINGS WITH COMMUNITIES AND SEEK ANY INCORPORATE THEIR FEEDBACK SO THE DATA IS CAPTURES WHAT TO THEM AND THE CONNECT RESEARCH FORMENT COMMUNITY HAS LIE THED, IS TO FUND THE STATUS THAT BUILD CAPACITY AND EMPOWER COMMUNITY TO IMPROVE HEALTH AND TRAINED RESEARCH THEMES IN CULTURAL HUMAN I WILL TOO BIDIRECTIONAL COMMUNICATIONS AND REQUIRE TRAINING FOR THE THEM IN THE PRINCIPLES WITH COMMUNITY ENGAGEMENT WHICH WE ARE ABOUT TO RELEASE THE THIRD EDITION AND THE RELEASING LAST YEAR SO WITH IT AS A FRAMEWORK, I WOULD LIKE TO WELCOME ONCE AGAIN OUR PANELS AND HARRY POTTER US GAIN A BETTER UNDERSTANDING ABOUT THIS TOPIC. AND WHAT I WOULD LIKE TO DO IS IF YOU CAN STOP SHARING THE SLIDES SO WE CAN SEE OUR PANELIST I WOULD APPRECIATE IT. OK, SO WITH THIS, LET ME ASK YOU, THE FIRST QUESTION THAT WE PREPARED, AND THAT I WANT TO GIVE A WARM WELCOME TO OUR PANELISTS, INCLUDING ELMORE FREEMAN AS WELL. THIS FIRST QUESTION IS DIRECTED TOWARDS SHARLEEN AND TO SOL AND YOUR INPUT OF CRITICAL IMPORTANCE FOR US. HOW SHOULD RESEARCHERS DEMONSTRATE THAT THEY MEASURE UP TO COMMUNITY NEEDS AND THE EXPECTATIONS AND. >>THANK YOU SO MUCH AND I APPRECIATE BEING SHARE TO THE FOLKS THAT CROSSED OVER BECAUSE OF COVID AND COMPLICATIONS AND IT'S IMPORTANT IN OUR STATE AND I KNOW ACROSS THE NATION AND THE WORLD SO I WANT TO START THERE. WHEN I GOT THE QUESTIONS IT WAS IMPORTANT AND I HAVE SO MANY THINGS THAT I CAN TALK ABOUT AND THEY WANTED THE CONCEPT OF TIME. HOW DO WE KNOW THAT RESEARCHERS PART IS PAYING ATTENTION AND EVEN CULTURAL READY NEGOTIATION ON BEHALF OF THE RESEARCH TEAM AND WE LOOK AT READINESS FOR COMMUNITIES AND WE ALSO HAVE TO LOOK AT READINESS FOR PROJECT TIMELINE AND RIGHT IN THE MIDDLE OF A PANDEMIC WHERE PEOPLE ARE WAR HE'D AND WORRIED AND BRINGING THE ELEMENT TO IT AND DARE I SAY WE SHOULD BE VULNERABLE OF THE AND I BELIEVE IT'S PART OF THE CONTINUE AROUND BEING CULTURAL HUMILITY SO WHAT IS THAT LOOK LIKE AND PAYING ATTENTION AND THE OTHER BIG THING THAT FOLKS SHARED WITH THE FUNDING AND UNDER REPRESENTED COMMUNITIES HAD A LOT OF MONEY AND THE MONEY CAME AND PARTNERSHIP BUT WHAT DIDN'T ALWAYS COME WAS CAPACITY BUILDING WITH THE FUNDS BUT THEY WERE PRINCIPLES YOU TALKED ABOUT AND WHAT IS AUTHENTIC PARTNERSHIP RIGHT AND SO, WE BUILT CAPACITY OR WE IT LEFT THE MONEY IN THE COMMUNITY SO IT'S PART OF THE ECONOMIC DEVELOPMENT TAKEN AWAY DURING COVID AND THE OTHER THING WAS IT ADDED THE INCREASE OF WORKFORCE AND I KNOW WORKFORCE IS IMPORTANT WHEN YOU TALK ABOUT PUBLIC-HEALTH AND HEALTH RESEARCH AND BUILDING CAPACITY WE ALSO INCREASED AND THE WORKFORCE SO THAT THE WORKFORCE LOOKS LIKE THE COMMUNITY THEY'RE SERVING AND KNOWING THERE'S STILL AN OUTSIDE ERROR INSIDER AND WHEN YOU BECOME PART OF A RESEARCH SYSTEM BUT IT'S SO IMPORTANT. >>YOU BROUGHT TO BEAR SEVERAL KEY WITH THE IMPACT OF COVID AS WELL SO THANK YOU FOR STARTING THIS AND SO, WE WOULD LOVE TO HAVE YOUR COMMENTS AS WELL. >>THANK YOU. SO, ONE WAY THAT WE CAN TEM ON STRAIGHT IS BY BEING IN TOUCH WITH A COMMUNITY BUY ENSURING THAT WE'RE GIVEN THEM THE OPPORTUNITY AND TO SHARE IT'S IMPORTANT TO GATHER INFORMATION BUT IN ORDER TO GET WE NODE TO BE FLEXIBLE IN THE PROCESS IF WE COME UP WITH LANGUAGE SUFFICIENT TO TELL PEOPLE WE'RE NOT GOING TO SHARE THIS INFORMATION BUT IF THE COMMUNITY SAYS WE HAD NEED MORE TO BE A PART OF THIS PROJECT WE NEED TO IN TURNING BE FLEXIBLE AND PROVIDE THEM WITH WHATEVER IT IS THEY NED TO THEY CAN FEEL SAFE AND ADDRESSING THOSE THINGS AND EXAMPLE THAT I WOULD LIKE TO GIVE OF HOW THIS HAPPENED SUCCESSFULLY IS, THE FLEXIBILITY AT THE CU TEAM HAD SO THEY DIDN'T HAVE CONNECTIONS SO WHAT THEY DID DO TO BE EFFECTIVE THEY REACHED OUT TO TRUSTED COMMUNITY MEMBERS LIKE MYSELF AND SO NOT EVERYONE WORKS 8-5 AND SOME PEOPLE I MET AT 8:00 A LOT NIGHT AND FIRST THING IN THE MORNING AND THE INITIAL STEPS OF THE PROJECT, I WOULD LITERALLY DROP OFF A SURVEY AT SOMEONE'S DOORSTEP AND THEN I WOULD HAVE TO PICK IT UP THE NEXT DAY BECAUSE THEY DIDN'T WANT ANY FORM OF CONTACTING SO WE HAVE TO BE WILLING TO ACCOMMODATE THE COMMUNITIES THAT WE WANT TO BE REPRESENTED IN THE INFORMATION AND WE NEED TO BE JUST NOT JUST WILLING TO MEET THEM WHERE THEY ARE BUT JUST TO KNOW THAT JUST BECAUSE SOMETHING MIGHT BE SUFFICIENT FOR US, IT MIGHT NOT BEING ENOUGH FOR THEM ALSO I WOULD LIKE TO MENTION INDIGENOUS COMMUNITIES AND LEEK THE ONES WE HAVE IN CALIFORNIA AND WE HAVE THEM EVERYWHERE AND NOW I'M GOING TO ASK DON AND PATRICK AND I HAVE A QUESTION FOR YOU AS WELL. GIVEN WHAT I ASKED SHARLEEN AND SOL, PLEASE, ELABORATE ON HOW RESEARCHERS LIKE YOU, LIKE YOURSELVES, SHOULD PLAN FOR A MEASURE YOUR THINGS PREPAREDNESS TO CONDUCT COMMUNITIES ENGAGE MIND OUTLRESEARCH FOR EQUAL FOO. >>THANK YOU FOR THE OPPORTUNITY TO BE WITH THIS GREAT PANEL TODAY AND YOU KNOW, I THINK FOR THOSE OF US ON THE RESEARCH SIDE, I TRY TO THINK ABOUT THIS WORK AS A JOURNEY AND WE ALL ENTER IT AT DIFFERENT POINTS AND SOME ENTER IT WITH VERY LITTLE EXPERIENCE AND IF FOLKS HAVE HAD EXPERIENCE IT'S REALLY THEN IMPORTANT TO FOLLOW-UP WITH THE QUESTION OF HOW HAS YOUR WORK AND HOW HAVE YOU CHANGED? AS A RESULT OF YOUR WORK WITH COMMUNITY? BECAUSE, HONESTLY IF IT HASN'T EVOLVED OR CHANGED, AND IF YOU HAVEN'T CHANGED AND GROWN, BECAUSE OF FOR WORK WITH COMMUNITY, THEN YOU PROBABLY HAVE NOT ENGAGE VERY AUTHENTICALLY AND I THINK THAT WE HAD A LOT OF CRAZY IDEAS ABOUT HOW WE WOULD DO THIS AND WE WENT INTO COMMUNITY AND COMMUNITY SAID, WELL, SINCE THIS IS OK, THIS STUFF, YEAH, WE GOT TO CHANGE THAT. THAT WAS SO IMPORTANT. SO THOSE ARE THE THINGS THAT I LOOKED FOR AND THEN, LASTLY, FOR FOLKS WHO HAVEN'T HAD THE EXPERIENCE, TRAINING, TRAINING IS SO IMPORTANT AND SURGERY YO, YOU MENTIONED THAT LOTS OF TIME FOR SELF-REFLECTION BECAUSE YOU ARE GOING TO BE CHALLENGED, YOU ARE GOING TO BE CHALLENGED AND YOU ARE GOING TO GO OUTSIDE YOUR COMFORT ZONE AND YOU NEED THE TIME TO PROCESS THAT AND COME BACK AND AGAIN, EXPERIENCE THAT CHANGE. >>YEAH, I KNOW. THANK YOU, YOU CONNECTED MANY DOTS THERE, I MEAN IMPORTANT DOTS THAT ALSO RESINATE PRETTY MUCH. TO YOU KNOW WHAT, WHEN YOU WERE DESCRIBING GENUINE, WORK WITH COMMUNITIES, AND YOU WERE TALKING ABOUT REALLY, REALLY TAKING TIME AN AND IT REMINDS MF WHAT ELISEO COMMUNITY ENGAGEMENT HAPPENS AT THE SPEED OF TRUST AND YOU KNOW THAT WE REALLY WE NEED TO INVEST TIME TO BUILD TRUST AND ALSO FROM THE RESEARCH ENTITIES TO BUILD TRUSTWORTHINESS, TO CREATE SO WE CAN TRUST AND HUMILITY PLAYS AN IMPORTANT ROLE. LET ME GO TO YOU, PATRICK, I WOULD LOVE TO HEAR YOUR THOUGHTS. >>THANK YOU. IT'S AN HONOR TO BE HERE TODAY AND I'M SORRY, THERE I AM. AS I'M SITTING FROM A TERRITORY IN MARYLAND I WANT TO RECOGNIZE THAT THIS HAS ALWAYS BEEN A PLACE OF LEARNING KNOWLEDGE AND INSTRUCTION. THE CONVERSATIONS THAT WE HAVE TODAY, THE TERRITORY ALSO INCLUDES THE NATIONAL INSTITUTES OF HEALTH THAT IS PART OF THAT LEARNING MOVING FORWARD AND I WANT TO THANK YOU, SERGIO, FOR ACKNOWLEDGING INDIGENOUS PEOPLE IN THIS CONTEXT. I DO THINK THAT IT'S IMPORTANT TO NOTE THAT WE SEE A CROSS CUTTING THEME ABOUT TIME HERE BECAUSE QUOTE THAT TIME IS BUILT AT THIS, TRUST IS BUILT AT THE SPEED OF TIME ASK SO I THINK THAT'S SOMETHING THAT WE HAVE TO CONSIDER IN WALKING INTO THESE COMMUNITIES THAT HAVE, FOR MANY REASONS, BEEN HISTORICALLY MARGINALIZED AND NOT PART OF THE RESEARCH -- EVEN BEFORE I ENGAGE IN A RESEARCH PROJECT WITH THE PARTICULAR COMMUNITY, I TROY TO BUILD RELATIONSHIP WITH THE LEADERS FROM THAT COMMUNITY EX I PAY THEM AS GUEST LECTURES IN MY CLASS AND THEY COME AND TEACH MY STUDENTS AND THAT IS THE NATIOINITIALICEBREAKER AND FACIF BUILDING A RELATIONSHIP AND I THINK THE OTHER THING IS TO CONSIDER IS YOU KNOW, SMALL IS BEAUTIFUL AND STARTING OUT WITH THE SMALL PROJECT, AND IT MAY JUST MEAN THAT YOU HAVE A STUDENT FROM THAT COMMUNITY WORKING ON A COMMUNITY-BASED PROJECT AND IT LEADS TO SOMETHING O'ER IT MAY NOT LEAD TO SOMETHING BUT I THINK, STARTING OUT SMALL, IT'S SOMETHING WHERE YOU CAN GUARANTEE OR HOPE LOOV HAVE A SUCCESSFUL OUTCOME AS A WAY TO START AND WE TALKED ABOUT THE PANDEMIC AND IT'S REALLY PUT A DIFFERENT LENSE ON THIS WHOLE ASPECT OF COMMUNITY ENGAGEMENT AND ONE THING I WANT TODAY TALK ABOUT IS WORKING WITH COMMUNITY-BASED ORGANIZATIONS AND 501C3s AND I RECENTLY STARTED AT WASHINGTON STATE UNIVERSITY AND ANOTHER THING TO TALK ABOUT ALSO IS STAFF TURNOVER. I WAS AN INCH PROJECT AND THE REASON TO DEALT WITH COMMUNITY RELATIONS, LEFT RIGHT AT THE BEGINNING OF THE PANDEMIC AND SO I WAS TASKED WITH OUTREACH FOR PURPOSES WITH NORTHERN INDIANS WHO ARE THE VULNERABLE AND ADAPTING AND "ALWAYS GOOD NEWS" RESEARCH AND PROTOCOLS TO BE CULTURALLY ATTUNED TO THE NEEDS OF AMERICAN IT AND ONE THING THAT WE DID WE PARTNERED WITH THE AMERICAN NATIONAL COUNCIL ON AMERICAN INDIAN AGING AND THERE WAS A TIME LAST SUMMER WHEN THE MORE OPEN IN TERMS OF ENGAGING WITH AMERICAN INDIANS AND THEY SAID, COME TO OUR ANNUAL CONFERENCE AND SURVEY OUR MEMBERS AND THERE AND WE ALSO TALKED ABOUT WHAT OUR BENEFITS TO THE COMMUNITY BASED ORGANIZATION IT WASN'T JUST ABOUT US EXTRACTING INFORMATION FOR OUR DATA NEEDS, BUT WE ALSO HAVE QUESTIONS THAT WE THEY RAN THE ANALYSIS AND HAVE DEVELOPED TWO PAGES FOR DISSEMINATION FOR THE NATIONAL INDIAN COUNCIL ON AGING SO I THINK IT'S A SPECTRUM BUT I WOULD JUST CLOSE IN SAYING THAT YOU NEED THE TIME TO BUILD THESE RELATIONS AND YOU HAVE TO CONSIDER IT'S BIDIRECTIONAL LEARNING AND THAT IS WHY, YOU KNOW, THE INITIAL APPROACH FOR ME HAS TO BRING COMMUNITY FOLKS AS INSTRUCTORS TO OUR STUDENTS. >>THANK YOU, EXCELLENT POINTS. I ALSO REALLY LIKE THAT YOU PROVIDED THAT EXAMPLE. THAT REALLY CAPTURES THE IMPORTANCE OF CREATING RELATIONSHIPS AND BUILDING TRUST CREATE ENVIRONMENT TO NURTURE THE RELATIONSHIPS THROUGH BIDIRECTIONAL COMMUNICATIONS AND DOESN'T HAVE TO BE DIRECTIONAL AS I'M SURE ALL OF US WOULD AGREE. UNLESS REBECA, TELLS ME OTHERWISE, I THINK THAT WE HAVE A LITTLE BIT OF TIME TO FOLLOW-UP BEFORE I ASK YOU THE NEXT QUESTION. WE'RE DOING REALLY WELL, I THINK, ON TIME. SO, LET ME ASK YOU THIS QUESTION, WHEN WE THINK ABOUT THE BUILDING RELATIONSHIPS, CREATING THE CONDITIONS TO ENGAGE MEANINGFULLY, IN BIDIRECTIONAL MULTI-DIRECTIONAL COMMUNICATIONS, HOW DO YOU KNOW HOW DO YOU MEASURE THAT IS THE CASE. WHAT IS YOUR -- THE INDICATORS THAT ALLOW YOU TO SEE THAT THAT IS THE CASE AND LET ME GO BACK TO OUR COMMUNITY MEMBERS AND I'M GOING IT START WITH YOU AND WITH CHARLENE AND THEN I'LL COME TO YOU, PATRICK. >>I LIKE TO FOCUS ON THE IMPORTANCE OF US BEING IN TUNE WITH THE COMMUNITY AND REALLY PAYING ATTENTION AND WE TALK ABOUT AND IT'S. >>THERE ARE LANGUAGES THAT ARE SPOKEN AND IT'S IMPORTANT TO BRING ABSOLUTELY EVERYONE ON BOARDS AND IN ADDITION TO THAT, IT'S LIBELING, LIKE, YOU NEED TE THAT NOT EVERYONE HAS THE ABILITY TO READ AND WRITE AND IT'S SOMETHING THAT WE ASSUME COMING IN. WE NEED TO MAKE SURE THAT WE ARE ENGAGING AS MANY PEOPLE AS POSSIBLE SO THAT WE DON'T GET THE SAME RESULTS ALL THE TIME AND WE HAVE A FULL REPRESENTATION OF THE PEOPLE THAT WE'RE BRINGING INTO OUR PROJECTS AND JUST BEING AWARE THAT THERE IS MORE THAN THE LANGUAGE BARRIERS. WE ARE INTERPRETER THE QUESTION THE WAY THE COMMUNITIES CAN UNDERSTAND THEM. AND SO, JUST BEING REALLY AWARE THAT THE WAY THAT WE COMMUNICATE IS EXTREMELY IMPORTANT, AND WE ALWAYS HAVE TO COMMUNICATE IN A WAY THAT A THE TOPIC THAT IS ASKED. >>I'M SO GLAD THAT YOU MENTIONED THE LAYERS OF COMPETITION COMPLEXITY BY LANGU. WE ARE WORKING NEAR CALIFORNIA WITH MISTAKE OF COMMUNITIES AND THAT ARE 11 VARIANTS THAT WE HAVE BEEN WORKING WITH WITH AND COMMUNICATING, YOU KNOW, WE HAVE TO SELECTS THE THREE MOST SPOKEN VARIANTS. I CAN ONLY IMAGINE THE TREMENDOUS REACH DIVERSITY ONCE AGAIN BY LANGUAGE AND THE OTHER THING THAT IS OF CRITICAL IMPORTANCE IS (INAUDIBLE) EMERGING AS KEY ASPECT ESPECIALLY DURING THE PANDEMIC. LET ME GO TO YOU, ANY COMMENTS ABOUT THIS, THE QUESTION THAT I ASKED ABOUT HOW DO YOU KNOW WHEN YOU HAVE ENGAGE SUCCESSFULLY, ESPECIALLY, IN MULTI DIRECTIONAL OR BIDIRECTIONAL COMMUNICATIONS. >>YEAH, YOU KNOW, THAT'S A GREAT QUESTION AND ONE THE THINGS THAT, WHEN I SHARED ONE OF THE THINGS THAT COMMUNITY CAME AND THEY DEMANDED, THESE WERE THEY DEMANDS IN ORDER TO PARTNER WITH US, THAT COMES REALLY FROM A SOCIAL JUSTICE VIEWPOINT AND SO WHEN HE WELCOME LOOK AT THESE FRAMEWORKS, RIGHT, COMMUNITY KNOWS SOCIAL JUSTICE, THEY KNOW CULTURAL INTEGRITY FRAMEWORKS SO WE HAD IT RESEARCH FOR TEAM SO THEY TALKED ABOUT LANGUAGE JUSTICE AND HOW WE HAVE TO TRANSLATE AND INTERPRET THAT SOMETIMES INTO COMMUNITY AND WHAT THAT LOOKS LIKE AND WE HAVE TO GO BACK AND WE DO THAT ON THE OTHER END AS WELL AND SOMETIMES IN SPANISH AND SOMETIMES IT'S OTHER LANGUAGES AND IN COLORADO, WE WERE WORKING WITH LATINOS IN THE VALLEY WHICH YOU KNOW, THEY HAVE THEIR OWN DIALECT OF SPANISH AND SO WE HAD LANGUAGE JUSTICE AND WHAT DOES IT LOOK LIKE AND WE WORK, WE'RE WORKING ACTUALLY TOWARDS BEST PRACTICES AND WITH ANYONE THAT WORKS AND THE OTHER THING WE WERE WORKING WITH THE SOMALI COMMUNITY AND SO WE COULDN'T TAKE THAT FOR GRANTED AND WE HAD TO START AT THE BEGINNING, AND NOT BECAUSE WE HAD A ROADMAP TO LOOKING AT HOW FOLKS IN THE VALLEY WERE TALKING BUT HOW WE HAD TO BE OPEN TO THAT INTERPRET TAIR RADA FOR THE SO MOLLY COMMUNITY SO I FELT LIKE WE'VE GONE BACK SEVERAL DECADES TO REMIND OURSELVES THAT'S NOT ABOUT LUCKY CUTTER WE HAVE FOLKS THAT WANT TO ENGAGE AND WANT TO BE A PART OF THE PROCESS AND SO WE HAVE TO BE HUMBLE AND AT TIMES STARTING AT THE BEGINNING WITH COMMUNITIES. >>EXCELLENT COMMENTS. I REALLY, REALLY LIKE THEM. LET ME GO TO YOU NOW PATRICK. SAME QUESTIONS, HOW DO YOU KNOW AND IF YOU HAVE MEASURES THAT YOU HAVE USED, TO LOOK AT BIDIRECTIONAL COMMUNICATION IT WOULD BE GREAT I THINK FOR THE AUDIENCE AND FOR THEIR OWN LANGUAGE AND PUBLICATIONS AND TO ME, THAT IS A METRIC AND THE LOCAL RURAL NEWSPAPER IN A WAY THAT IS APPROPRIATE FOR THEIR AUDIENCE AND IT'S IMPORTANT. >>IF I CUT YOU OFF, I'M SORRY, THIS IS A GREAT POINT. WHAT ARE THE RESULTS BEING DISSEMINATED AND HOW AND ARE THEY ACTING ON THE RESULTS. AND ONE THING I JUST WANTED TO COMMENT ON JUST IN TERMS AND SOVEREIGN NATIONS AND TRIBAL NATIONS THERE'S A STRUCTURE WITHIN THE FACIAL INSTITUTED OF HEALTH, NATIVE AMERICAN RESEARCH CENTERS FOR HEALTH, AND THE FUNDS HAVE TO GO THROUGH A FEDERALLY RECOGNIZED TRIBAL ORGANIZATION AND THE SPLIT BETWEEN THE ACADEMIC INSTITUTION AND THE TRIBE, YOU KNOW, A MINIMUM OF TWO-THIRDS I BELIEVE HAS TO GO TO THE TRIBAL ORGANIZATIONS SO PERHAPS THIS IS A MODEL, YOU KNOW, THAT COULD BE USED WITH OTHER COMMUNITIES THAT EXPERIENCE HEALTH DISPARITIES BUT THIS IS SOMETHING BECAUSE OF THE UNIQUE SOVEREIGN STATUS OF THE AMERICAN IND I DON'T KNOW TRIBAL NATIONS THAT EXIST AND I WANTED TO MENTION ONE EXPERIENCE THAT I HAD IN WORKING WITH TROUBLE COMMUNITIETRWORK TRIBALN THE MOST FLEXIBILITY AND UNTIL THE END THEY ENDED UP NOT GOING WITH FEDERAL RESOURCES THEY WENT WITH PRIVATE FOUNDATIONS BECAUSE THE END OF THE STUDY, THE PRIVATE FOUNDATION SAID THAT WE DO CARE IF YOU DES SEM NATURE SEM NATURE THERESULTS AND IT WAT BECAUSE IN THEIR VIEW. >>CLEARLY THE AUDIENCE IS RELATING TO THAT AS THEY RESPOND TO YOUR COMMENTS. >>DON, YOUR COMMENTS -- >>YEAH, THANK YOU. YOU KNOW, I THINK WHEN WE THINK ABOUT MEASUREMENT, IT'S REALLY IMPORTANT FOR US TO FIRST ASK OURSELVES, WHAT IS THE PURPOSE OF THE MEASUREMENT? ARE WE TRYING TO MEASURE SOMETHING BECAUSE WE WANT TO PROVE THAT WE'VE ARRIVED, THAT THE AUTHENTICKEN BEST OF MY AUTO LEARN HOW WE CAN CONTINUALLY IMPROVE AND I THINK THAT THE LATTER IS ACTUALLY, ESPECIALLY IMPORTANT WITH THE WORK AND COMMUNITY ENGAGEMENT IN THAT WHEN WE MEASURE THINGS, WE'RE LOOKING FOR THAT GROWTH, WE'RE LOOKING FOR THAT CONTINUAL IMPROVEMENT. A GOOD EXAMPLE OF THAT IS A TOOL THAT WE USE, HERE WITHIN OUR COLORADO CLINICAL AND TRANSLATIONAL SCIENCES INSTITUTE, WITH OUR COMMUNITY ENGAGEMENT PILOT AWARDEES AND THE COLLECTIVE CAPACITY BUILDING TOOLS AND WHAT THAT TOOL DOES IS IT ASKS EACH OF THE PARTNERS, THEY ACTUALLY COMPLETE THIS TOGETHER AND WHAT HAS BEEN THE GROWTH OF THEIR PARTNERSHIP IN VARIOUS WAYS, VARIOUS PARAMETERS AS THEY HAVE BEEN APPROACHING THE WORK THEY'VE BEEN ACTUALLY DOING THE WORK AND WORKING TOGETHER, AND LOOKING FOR GROWTH AND WHAT HAVE BEEN THE RESULTS OF THAT IN TERMS OF THEIR CAPACITIES AND WORK TOGETHER. AND SO, THAT'S ONE OF THE PERHAPS BPRINCIPLES THAT IS IMPS I THINK ABOUT MEASUREMENT. >>THANK YOU SO MUCH FOR THOSE COMMENTS AND YOU KNOW, MY GOODNESS, THE FOUR OF YOU ARE VERY EXPERIENCED WORKING WITH COMMUNITIES FROM VARIOUS ANGLES THAT YOU HAVE. IT'S A WONDERFUL, YOU KNOW, THE IMAGERY THAT COMES TO ME IS LIKE BUILDING A QUILT WITH TIVE PIECES OF EXAMINING TOGETHER TO A UNIFIED, YOU KNOW, REALLY WONDERFUL COMPOSITION OF YOUR VARIOUS THOUGHTS AND SEW THANK YOU SO MUCH FOR YOUR COMMENTS AND SHARING YOUR EXPERIENCES AS WELL. WELL, WE HAVE ONE LAST QUESTION THAT I WOULD LIKE TO BRING TO YOUR ATTENTION AND IT IS IF YOU CAN SHARE OTHER PRAGMATIC INSIGHTS THAT YOU HAVE COLLECTED AT THE INTERFACE BETWEEN RESEARCHERS AND THE COMMUNITY AS YOU WORK TO PROMOTING A DANCE HEALTH EQUITY AND I WOULD LIKE TO START WITH YOU BECAUSE I HEARD ABOUT A HOLISTIC HEALTH OR CULTURAL HELP AND IT'S I THINK IT'S A VERY IMPORTANT AND HELPFUL CONCEPT. >>YEAH, THANK YOU. I THINK YOU KNOW, SOMETIMES HEALTH LIT ARE SEE AS A CONCEPT IS A VERY SORT OF WESTERN ORIENTATION AND PARTICULARLY AROUND OUR OWN SORT OF WESTERN OR DARE I SAY COLONIAL APPROACH TO HEALTH. MANY INDIGENOUS, MOST INDIGENOUS CULTURES IF NOT ALL, AS WELL AS FOLKS WHO HAVE EMIGRATED TO THIS COUNTRY AND BRING WITH THEM A CULTURAL SENSE OF WHAT BOTH PHYSICAL AND SPIRITUAL HEALTH MEANS. AND I THINK WE NEGLECT THAT TO OUR PERIL AND IT'S IMPORTANT TO REALLY TRY TO DIVE INTO THAT WITH FOLKS YOU ARE ENGAGING WITH WITH COMMUNITIES. WHAT DOES HEALTH MEAN TO THEM? WHAT ARE THEIR PRACTICES AROUND THAT THEN TROY AND FIND WAYS TO BRIDGE WITH THAT AND TO LEARN FROM THAT I THINK THAT'S INCREDIBLY IMPORTANT AND I THINK WE'VE SEEN WAYS, SHARLEEN MENTIONED OUR WORK WITH THE SOMALIA COMMUNITY AND MANY OF THE PRACTICES THAT WE WERE ASKING FOLKS TO ENGAGE IN DURING THE HEIGHT OF THE PANDEMIC, AND IN TERMS OF HANDWASHING AND YOU KNOW, KEEPING CLEAN, THOSE KINDS OF THINGS, ARE ACTUALLY EMBEDDED IN THEIR CULTURE AND SO THEY'RE LIKE, YEAH, WE ALREADY DO THAT AND THAT'S PART OF OUR CULTURE AROUND MAINTAINING HEALTH AND IT WAS SO COOL AND SO VALUABLE TO HEAR THEM TALK ABOUT THAT AND SEE IT AS A PLACE WHERE WE CAN BRIDGE ACROSS THE CULTURES. >>YEAH, WELL, THANK YOU SO MUCH, DON. AND I AM LOOKING AT THE TIME. MY GOODNESS, IT'S IN THE BLINK OF AN EYE, REBECA, THAT THINGS, YOU KNOW, WE ONLY HAVE LIKE 17 MINUTES AND WE NED TO ENGAGE IN SOME QUESTIONS AND COMMENTS. ANSWERS. THE SAME QUESTION I'LL COME TO YOU PATRICK AND THEN, SOL. >>IF YOU CAN BE A LITTLE BIT BRIEFER THAT WOULD BE GREAT SO WE CAN ALLOW SOME TIME FOR QUESTIONS AND ANSWERS. >>YES, SO I CAN TALK ABOUT THE INDIGENOUS COMMUNITIES HERE ON COLORADO AND I WOULD SAY THAT IF YOU LISTEN TO THEM, THEY TALK ABOUT SPIRITUAL HEATH, HOLISTIC HEALTH, AND THE WAYS OF FAMILIES AND IN TIME AND ALL OF THE THINGS THAT WE'RE TALKING ABOUT RIGHT, THESE ARE LABELS AND WORDS THAT WE USE SO HEALTH LITERACY, AND IT'S USED DIFFERENTLY AND IT'S ONLY A COMPONENT OF WHAT MAKES ALL COMMUNITIES SO I HEAR YOU THERE AND I THINK THE NARRATIVE AROUND CHANGING SOME OF THE WORDS THAT WE USE, IN RESEARCH, AND ACROSS THE BOARD, CHANGING THOSE NARRATIVES COULD ALSO BE VERY ENGAGING FOR FOLKS AND HELP WITH THE TRANSLATION AND HOW LITERALLY CAN THE INTERPRETATION OF WHAT WE'RE ASKING, AND HOW WORE ASKING PEOPLE TO PARTNER WITH US. >>EXCELLENT. THANK YOU SO MUCH, CHARLENE. PATRICK. >>I WOULD JUST ADD, WE RECENTLY COMPLETED FOCUS GROUPS WITH RURAL PATIENTS WHO HAVE A DIAGNOSIS OF CANCER AND WE'VE ASKED THEM ABOUT COVID-19 ON OUR LIVES AND ONE THING THAT HAS IN THROUGH ALL THE FOCUS GROUPS IS HOW FAITH PLAYS AN IMPORTANT ROLE IN THEIR HEALTH AND THAT WAS PART OF OUR IT'S EMERGED AND IT SPEAKS TO THIS WHOLE IN THIS CASE FAT IS A PART OF THAT AND WHEN WE CONSIDERED THE EXCESSIVE MORTALITY IN OUR COMMUNITIES DURING COVID AND DECIMATION BASICALLY OF THE LIFE EXPECTANCY SO THERE IS A LOT OF GRIEF AND WE NEED TO FOCUS ON THAT AS WELL. >>SO WHEN WE REACH OUT TO IMPACTED COMMUNITY MEMBERS AND ALLOW THEM TO ADVOCATE FOR THEMSELVES AND WE LISTEN, THEN WE HAVE THE OPPORTUNITY TO TRULY BE ABLE TO LEARN ABOUT THEIR CULTURE AND MOVE FORWARD WITH WHATEVER IT IS OUR OBJECTIVE IS IN A RESPECTFUL WAY IN WHICH WORE STILL HONORING THEIR CULTURE AND TRADITION. I'M AN IMMIGRANT AS WELL AND I KNOW THAT YOU ARE AS WELL AND I ANTICIPATE THAT WE'RE WORKING WITH SIMILAR COMMUNITIES AS WELL. WE'D LOVE TO GET TO KNOW MORE ABOUT THE WORK THAT I KNEW DON AND I KNOW THE FANTASTIC WORK THAT HE IS DOING IN COLORADO I AM DELIGHTED TO MEET YOU SO I HOPE THAT WE CAN CONDITION WITH THAT CONVERSATIONS. WITH THAT, REBECA, DO WE HAVE SOME QUESTIONS YOU WANT TO OPEN IN. >>WE DO. SO THANK YOU ALL SO MUCH. IN RESPONSE TO PATRICK'S COMMENTS, PERHAPS MORE FEDERAL FUNDING GUIDELINES NEED TO BE PUT SOMETHING SIMILAR IN PLACE AND YOU TALKED ABOUT THE TRIBAL GOVERNMENT GUIDELINES TO ENSURE THAT COMMUNITY PARTNERS RECEIVE A SUBSTANTIAL AMOUNT OF THE FUNDING. SO THAT IT'S NOT EVEN UP BY ACADEMIC INSTITUTIONS AND DIRECT RATES SO THIS IS AN ANSWERED QUESTION AND I PUT IN THE LINK, YOU ARE WELCOME TO -- I ALSO NOTED THAT THE NIH TRIBAL HEALTH RESEARCH ORGANIZATION IS A GREAT RESOURCE BUT DON AND SERGIO, WHAT IT COMES TO NOT JUST WITH TROUBLE GOVERNMENT GETTING THE COMMUNITY PAID PROMPT LOW AND EFFICIENTLY, DO YOU HAVE ANY SUGGESTIONS ON HOW YOU CAN FACILITATE AND THAT AND HAVE FACILITATED. >>LET ME CLARIFY THAT, YOU SAI- >>HOW DO YOU PAY THEM? FINANCIALLY? >>PAY THEM. OH, THAT'S A VERY IMPORTANT ONE. SO, PLEASE, GO AHEAD. >>OTHER MECHANISMS WHICH CAN BE AND WHAT ARE SOME STRATEGIES THAT YOU HAVE PARTNERSHIPS TO MAKE SURE THAT YOUR COMMUNITY PARTNERS GET PAID PROMPTLY. THE WORK WITH THE FIVE TRIBAL COMMUNITIES IN MAINE WHERE THE GRAND TEE WAS ONE THE TRIBES SO I THINK THE MOST EXPEDITIOUS WAY IS THE ACADEMIC INSTITUTION IS THE SUBCONTRACT TO THE COMMUNITY BASED ORGANIZATION OR THE TRIBE AND I THINK THAT IN TERMS OF WORKING WITH COMMUNITIES TO GET THEM PAID EFFECTIVELY, YOU HAVE TO HAVE, I MEAN, IN TERMS OF THE FIRST OF ALL THE BALANCE I THINK YOU HAVE TO HAVE AN UP FRONT DISCUSSION ABOUT THE BUDGET AND THAT'S WHERE THE TIME BUILT INTO THE RELATIONSHIP REQUIRES SO THAT YOU CAN ARTICULATE WHAT ARE THE DIFFERENT NEEDS AND YOU DON'T RUSH INTO SUBMITTING A GRANT WITHOUT KNOWING WHAT EACH PARTY REQUIRES. >>THANK YOU, PATRICK. >>EXCELLENT, YEAH. >>I AGREE WITH PATRICK'S COMMENTS, ESPECIALLY IF YOU YOUR COMMUNITY PARTNERS AND ACTUALLY BE THE GRANTEE, THE PRIME, THAT IS THE IDEAL SITUATION AND WHEN THAT IS NOT POSSIBLE, A LOT OF TIMES WE WORK WITH ONE OF OUR COLORADO PUBLIC HEAD INSTITUTES, TRAIL HEAD INSTITUTE THAT SERVICE AS A FISCAL AGENT FOR US AND SO WE ACTUALLY PASSED DOLLARS FROM THE UNIVERSITY TO THEM AND THEN THEY'RE THE ONES THAT THEY'RE ABLE TO PROCESS, YOU KNOW, PAYMENTS AND THINGS FOR COMMUNITIES MEMBERS, MUCH MORE RAPIDLY THAN IF WE WERE WORKING THROUGH THE UNIVERSITY BISSEN TEEN PROCESSES TO GET PAYMENTS OUT TO COMMUNITY MEMBERS AND COMMUNITY-BASED ORGANIZATIONS. SO THAT IS HAN BEEN EFFECTIVE STRATEGY FOR US FOR MANY YEARS AND. >>WHAT YOU -- THE TWO OF YOU MENTIONED, IS CEAL AND WITH RADX NATIONAL NETWORK, IT'S A CRITICAL IMPORTANCE TO REALLY PAY THE COMMUNITY-BASED ORGANIZATIONS SOME TIME AND NOT TO DEFAULT AND IT IS A ABSOLUTELY IMPORTANT TO HAVE THAT COMMITMENT AND TO BE AS TRANSPARENT AND AS PUTTING THINGS ON THE TABLE AS POSSIBLE. AND TO BE RECEPTIVE ABOUT THE FEEDBACK, THE COMMENTS THAT OUR COMMUNITY PARTNERS HAVE AND I TOTALLY AGREE WITH YOU, DON, MECHANISMS AND CAM PASS AND THEY MENTION EARLIER AND EARLIER TODAY AND OUR FOCUS ON THE COMMUNITY, BASIC ORGANIZATIONS AND THEY ARE THE ONES WHO ARE GOING TO HAVE CONTROL OF EVERY SOURCES AND THEY ARE GOING TO REACH OUT TO THIS IS WHAT IS NEEDED AS WELL, LONG-TERM COMMENTS. SO THAT IS WONDERFUL AND WE HAVE BEEN THROUGH THE PAN DEEMIA HAVE TO BE REALLY BE RESOURCEFUL ON HOW TO INCENTIVIZE LET'S SAY OUR COMMUNITY NOT COMMUNITY PARTNERS AND PARTICIPANTS OF TESTING AND VACCINATIONS AND IN A WAY THAT THEY CAN EASILY UTILIZE LIES IN OUR CASE THAT WE HAVE GIVEN DIFFERENT CARDS FOR EXAMPLE WITH NO PAPERWORK AND OTHER MEANS THAT WE NEED TO BE ONCE AGAIN TO MAKE THINGS HAPPEN AND WE DO SOMETHING SEEN IN OUR DONE THAT WE WORK WITH COMMUNITIES PARTNERS AND COMMUNITY BASED ORGANIZATIONS SO THEY DO THE HIRING OF PROMOTE FOR EXAMPLE OR COMMUNITIES BECAUSE THEY TEND TO BE MUCH FASTER THAN US AND ALSO, THEY WORK WITH THE OTHER COMMUNITY BASED ORGANIZATIONS. THIS HAS BEEN A GOOD MODEL FOR US. REBECA. >>THANK YOU FOR THOSE WONDERFUL DISCUSSIONS. CHARLENE WANTED TO FOLLOW-UP A LITTLE BIT ABOUT WHAT PAYMENT SHOULD BE LIKE. CHARLENE? >>YEAH, YOU KNOW, I THINK IT'S AWESOME THAT WE HAVE KNEES INSTITUTIONS AND PARTNERS THAT WELCOME PAY QUICKLY BUT ALSO, YOU ARE EVEN MORE IMPORTANT AS HOW MUCH WE PAY COMMUNITY AND COMMUNITY PARTNERS AND WE HAVE A SAYING WHEN WE MEET PEOPLE THAT WE WANT TO PAY FAIR NOT FREE AND THERE'S A HISTORY OF COMMUNITIES GIVING THEIR TALENTS, THEIR ASSETS, THEIR EXPERIENCE, AND EVERYTHING, THEY BRING THAT TO THE TABLE AND WE DON'T PAY THEM EQUALLY SO IF WE TALK ABOUT HEALTH EQUITY, WE ALSO HAVE TO TALK ABOUT FINANCIAL EQUITY AND PARTNERSHIPS SO AGAIN, WE SAY FREE AND WE SAY FAIR NOT FREE AND WE WILL LOOK TO SEE THAT THEY'RE BEING PAID AND WE WANT TO MAKE SURE THAT IF THEY'RE BRINGING THEIR EXPERIENCE TO THE TABLE, THAT WE VALUE THAT AND WE MATCH IT WITH DOLLARS AND THAT ALSO HELPS KEEP THE MONEY IN COMMUNITY AND BUILDS THAT ECONOMIC BASE FOR COMMUNITY. >>SO, THANK YOU. WE HAD SOME QUESTIONS WITH RESPECT TO HOW RECOMMENDATIONS FOR HOW YOU CAN CAN DISCERN WHO OR WHAT IS IN EFFECTIVE AND RECOMMENDED APPROACH FOR FACILITATING CULTURAL HUMILITY LEARNING SESSIONS AND ANYBODY CARE TO SOL OR PATRICK, DO YOU WANT TO TOKE SPA THAT AND HOW FOLKS CAN GET UP TO SPEED TO REALLY UNDERSTAND A GOOD RESOURCE AND APPROACH FOR CULTURAL HUMILITY LEARNING SESSIONS? >>OR HAVE ANY EXAMPLES THAT YOU CARE TO SHARE? >>SO, I'LL GO. IT'S A VULNERABLE PLACE TO BE, RIGHT, SO WE TALKED ABOUT IT AT THE VERY BEGINNING AND RESEARCH TEAMS ARE WILLING TO BE COURAGEOUS AND VULNERABLE AND LEARN ABOUT THE COMMUNITIES THEY'RE SERVING AND REMEMBER THAT WE ON RESEARCH TEAMS WE ARE SERVING COMMUNITIES AND SO WE HAVE TO KNOW WHO THEY ARE AND SHOW UP AND WE HAVE TO DO IT ON OUR OWN TIME SOMETIMES, SOMETIMES WITHOUT FUNDING AND I SHARE THAT ACROSS THE BOARD WITH EVERYBODY, AND I WOULD BE LONG TO ONE OF THE SOME OF THE COMMUNITIES IN COLORADO THAT I SEARCH BUT I NEVER TAKE THAT FOR GRANTED AND I REMIND MYSELF I'M A GUEST WHEN I'M WORKING ON BOW HALF OF THE UNIVERSITY AND I ALSO HAVE TO DO MY WORK SO YOU KNOW, BE HUMBLE AND BE OPEN AND LISTEN AND I THINK SOL HAS SHARED LISTENING TO COMMUNITIES AND THEY'RE THE EXPERTS, EVEN WHEN YOU ARE PART OF THAT COMMUNITY, YOU HAVE TO BE HUMBLE AND YOU HAVE TO GO AND KNOW THAT YOU ARE BEING A SERVANT. AND SO THERE ARE MANY, MANY TOOLS OUT THERE THAT I WILL SHARE WITH YOU THE OTHER THING THAT I'LL SAY THIS THAT FOLKS HAVE TO DEAL WITH THIS FRAGILITY AND THEY HAVE TO DEAL WITH THE DECOLONIZATION THAT PEOPLE WANT AND NEED IN RESEARCH AND THEY HAVE TO LOOK AT WHAT IS THAT LOOK LIKE IN BUILDING COMMUNITIES AND SUPPORTING COMMUNITIES AND LETTING COMMUNITIES BUILD THEIR OWN AND NOT WORKING SILOS AND COMMUNICATIONS IN IMPORTANT ALL OF THESE PIECES ARE PART OF HEALTHY RELATIONSHIPS AND THERE ARE THE MESSENGER HAS TO REFLECT THE PERSON THAT IS ON THEIR JOURNEY OR WORKING TOWARDS WHAT THAT LOOKS LIKE SO, I WISH I CAN GIVE YOU ONE OR TWO BUT AGAIN I'M NOT GOING TO DO COOKIE CUTTER FOR THE LEARNING, I SHOULD BE RETIRING BUT I'M ALSO A STUDENT AND SO I WOULD ININCLUDED MYSELF. >>I WOULD BE A LITTLE BIT AND THIS IS HEALTH PROFESSIONS EDUCATION AND MEDICINE EDUCATION AND IMPLICIT BIAS AND WHAT THEY FOUND IS THAT TRANSFORMATIVE LEARNING THEORY WHICH ENCLOUDS DISCOMFORT, REPRESENTS A VITAL COMPONENT OF BIAS RELATED INSTRUCTION AND BECAUSE THIS WHOLE, AND I THINK IT GOES BACK TO YOUR POINT ABOUT DEALING WITH FRAGILITY AND YOU HAVE TO DO THAT AND PROPOFOL ASSUMPTIONS HELD BY THE LEARNER AND ABOUT IMPLICIT BIAS AND IT HAS TO BE A SAFE SPACE AND YOU HAVE TO BE ABLE TO DEAL WITH YOUR FRAGIL FRAGILITY. >>I LOVE THAT THE COMMENTS THAT YOU MADE AND ONE THING THAT IN THIS IS RELATED TO HUMILITY THAT IT IS VERY MUCH RELATED TO TRUSTWORTHINESS WHEN WE ARE WILLING TO BE VULNERABLE WITH OUR COMMUNITIES AND ALLOW CREATE A SAFE SPACE FOR THEM AS WELL WE GET AT A VERY, AT ANOTHER LEVEL OF RELATIONSHIPS TALKING ABOUT BILATERAL COMMUNICATIONS SO BIDIRECTIONAL COMMUNICATIONS AND SO I THINK THAT VULNERABILITY INVITES VULNERABILITY AND WE HAVE BONDS, WE CREATE BONDS, THAT ARE SO MUCH, SO MEANINGFUL, YOU KNOW, THAT IT'S DIRECTLY RELATED TO BUILDING INTEREST A AND. >>THANK YOU ALL. I'LL LET YOU CLOSE IT OUT YOU'VE GIVEN US A LOT TO THINK ABOUT AND TO LOOK AT AND SO THANK YOU VERY MUCH WE LOOK FORWARD TO THE BENEFIT AS WE PROBE THESE ISSUES MORE HERE. THANK YOU, THANK YOU. >>THANK YOU. >>AND TO I JUST MAKE 20 SECOND COMMENT? >>SURE. >>OK. IN JUST THAT -- WHAT IS REMARKABLE ABOUT THIS PANEL AND ALL THE THINGS THAT WE'RE DISCUSSING, IS HOW MUCH THIS IS WITH WHAT ELISEO PRESENTED TO US AND ELISEO PEREZ-STABLE AT THE END OF HIS ADDRESS THIS MORNING AND WHEN HE TALKED ABOUT COMMUNITY ENGAGE RESEARCH TO REDUCE HEALTH DISPARITIES AND WHAT IS NEEDED. AND THE TWO THINGS THAT COME OUT OF THAT IS THAT EQUAL PARTNERSHIPS AMONG COMMUNITY ORGANIZATIONS AND RESEARCHERS AND OTHER SECTORS, IN BUILD MUTUAL TRUST FOR SUSTAINABLE LONG-TERM RELATIONSHIPS AND I THINK THAT IS WHAT WE OUGHT TO FOCUS ON IN LONG-TERM RELATIONSHIPS THAT WE ARE THERE TO CONTINUE TO DO A PARTNER WITH COMMUNITIES PARTNERS AND THAT IS GOING BACK TO YOU. >>WE'LL HAVE YOU CARRY US FORWARD. THANK YOU, PATRICK, DON, SOL AND CHAR AND SERGIO. >>THANK YOU AND TO ALL THE PANELISTS, I LIKE THIS PANEL THAT IT GIVES A VOICE TO THE COMMUNITY AND WHICH IS THE MOST IMPORTANT PERHAPS STAKEHOLDER AS WE CONSIDERED THE RESEARCH AND THE COMMUNITY BRIDGING. NOW IF YOU ARE IN BETHESDA, WE'RE GOING TO TAKE A BREAK TO UP TO 2:45 BUT WHERE YOU MAY BE IN THE WORLD, THIS WILL BE A 15-MINUTE BREAK SO, PLEASE ENJOY YOUR 15 MINUTES BREAK AND GET REFRESHMENTS AND WE KNOW WE'LL GATHER BACK AS WE'RE GOING TO ENGAGE IN OUR THIRD SESSION WHICH IS ADDRESSING HEALTH INEQUITIES THROUGH COMMUNITY ENGAGEMENT. THANK YOU, VERY MUCH. WELCOME BACK, EVERYONE. NOW WE ROW ASSUME OUR DAY BY GOING TO THE THIRD AND FINAL PANEL. NOW IT'S MY PLEASURE TO HAND OVER THE BA TOLL TO MARY MASTERSON WHO WILL MODERATE OUR NEXT PANEL ON ADDRESSING HEALTH EQUITIES THROUGH COMMUNITY ENGAGEMENT. >>THANK YOU, FERNANDO. THIS IS BEEN A GREAT WORKSHOP SO FAR AND WE'RE SO HAPPY THAT YOU HAVE STAYED WITH US THIS WHOLE DAY AND MY NAME IS MARY MASTERSON AND I AM A PROGRAM OFFICIAL WITHIN THE CENTER OF TRANSLATION RESEARCH AND IMPLEMENTATION SCIENCE AND YES, THIS IS OUR LAST SESSION. SO, I WOULD LIKE TO NOW BRIEFLY INTRODUCE THE THREE SESSION PANELISTS AND OUR CHAIR. NOTE, IF YOU WANT MORE DETAILED DESCRIPTION OF THE PANELIST BACKGROUND I WOULD RECOMMEND YOU REVIEW THE WORKSHOP BOOKLET SHARED EARLIER. THE SESSION CHAIR, Dr. KEITH FERDINAND IS A PROFESSOR OF MEDICINE AT TULANE UNIVERSITY SCHOOL OF MEDICINE. A LIFELONG ADVOCATE AND RESEARCHER FOCUSES ON IMPROVE I PATIENT CARE THROUGH THE ELIMINATION OF HEALTH DISPARITIES AND Dr. VALERIE BLUE BIRD JERNIGAN THE CENTER OF HEALTH RESEARCH AND POLICY AT OKLAHOMA STATE UNIVERSITY CENTER FOR HEALTH SCIENCES. Dr. JERNAPHOTOGRAPHICING ON HEALTH IN INDIGENOUS COMMUNITIES. Dr. JILL JOHNSTON, IS A ASSOCIATE PROFESSOR AND THE DIRECTOR OF COMMUNITY ENGAGEMENT WITHIN THE DIVISION OF ENVIRONMENTAL HEALTH A LOT THE UNIVERSITY OF SOUTHERN CALIFORNIA. HER RESEARCH FOCUSES ON ADDRESSING UNEQUAL EXPOSURE TO HARMFUL CONTAMINANTS THAT AFFECT THE HEALTH OF THE WORKING POOR AND COMMUNITIES OF COLOR. OUR FINAL PANELIST, Dr. PEARL MCELFISH FROM THE HEALTH AND RESEARCH AT THE UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES. HER RESEARCH FOCUSES ON HEALTH SYSTEMS TRANSFORMATION. AND REDUCING HEALTH DISPARITIES AS IT PERTAINS TO CHRONIC AND INFECTIOUS DISEASES. EACH OF THE PANELISTS HAVE EACH RECOGNIZED THE IMPORTANCE OF COMMUNITY ENGAGEMENT AND AN COMPONENT FOR THE DEVELOPMENT OF MEANINGFUL INTERVENTIONS TO CIRCUMVENT HEALTH INEQUITIES. WE'RE VERY EXCITE TODAY LEARN FROM THE REAL WORLD EXAMPLES AND LESSONS LEARNED. NOW, BEFORE I HAND IT OFF TO Dr. FERDINAND, AS I STATED DURING THE BREAK BUT I WANTED TO SAY IT ONE MORE TIME, PREVIOUSLY, ATTEND'S, WE GENERALLY APPRECIATE YOUR ACTIVE PARTICIPATION IN THESE DISCUSSIONS THUS FAR. PLEASE, KEEP IT UP. PLEASE REMEMBER TO ENTER YOUR QUESTIONS WITH NOT THE Q&A BOX TO FURTHER ENHANCE THIS UPCOMING DISCUSSION. AND WITH THAT, I WOULD LIKE TO HAND OFF TO Dr. FERDINAND. >>THANK YOU, Dr. MASTERSON. I'M SO PLEASED TO BE PART OF THIS LAST PART ADDRESSING HEALTH INEQUITIES THROUGH COMMUNITY ENGAGEMENT. I HAVE TULANE UNIVERSITY BUT I'M GOING TO TELL YOU A SECRET, I USED TULANE AS A VEHICLE. MY ADDRESSING LANGUAGE AND EXPERIENCES IN THE COMMUNITY GOES BACK TO 1994, WITH THE DIRECTOR OF NHLBI AND HE GAVE A GRANT CALLED HEALTHY HEART COMMUNITY PREVENTION PROJECTS AND WE PIONEERS IN BALTIMORE GOING TO BARBERSHOPS, BEAUTY SHOPS, SPORTING EVENTS AND RIGHT NOW, WE WERE ON GOING AND I ALSO WORKED WITH CEAL, ONE OF THE EFFORTS TO OVERCOME THE HESITANCY FOR RESEARCH VACCINES AND UPTAKE OF VACCINES IN LOUISIANA AND CEAL DID A GREAT JOB WITH THE AFRICAN AMERICAN POPULATION HAS SUPERSEDED THAT OF THE GENERAL POPULATION AND MOST RECENTLY I'M WORKING WITH A GROUP CALLED CHERISH, IT'S PART OF THE DECIPHER PROGRAM AND THE GROUP COORDINATED INTERVENTIONS AND PREVENTION TO CONTROL HEART AND LUNG DISEASE RISK SO THIS IS SOMETHING THAT WE'RE GOING TO INTO 42 CHURCHES TO MAKE A DIFFERENCE IN IMPLEMENTING THE SCIENCE OF INTERVENTION. SO THAT BEING SAID, THAT WAS A LOT, WE'RE GOING TO GO IN ORDER. Dr. JERNIGAN, WHEN YOU TO YOURSELF, SAY ABOUT WHAT YOU'VE BEEN DOING. I DON'T THINK YOU CAN GO BACK TO 1994 BUT TELL US WHAT YOU ARE DOING. >>HELLO! GREAT. HELLO, EVERYONE. THANK YOU FOR THE OPPORTUNITY TO PARTICIPATE IN THIS EXCELLENT WEBINAR. I'M VALERIE BLUE BIRD JERNIGAN I'M FROM OKLAHOMA AND AN INTERVENTIONIST BY TRAINING AND MY FOCUS IS ON COMMUNITY-BASED INTERVENTION, SCIENCE WITH INDIGENOUS COMMUNITIES AND SPECIFICALLY WITHIN THE AREAS OF POLICY, SYSTEMS AND ENVIRONMENTAL INTERVENTIONS AND TO REDUCE CARDIOVASCULAR DISEASE RISK FACTORS AND MOST OF MY WORK HAS BEEN IMPROVING INDIGENOUS FOOD SYSTEMS TO INCREASE ACCESS TO HEALTHY FOODS AND REDUCE RISK FOR CHRONIC CONDITIONS. I'D LED A NUMBER OF RO1 STUDIES AND INCLUDING THE THRIVE STUDY WHICH WAS THE FIRST HEALTHY FOOD INTERVENTION IN NATIVE OWNED AND OPERATED CONVENIENT STORES AND I IMPLEMENTED THE FRESH STUDY WHICH IS A FARM-TO-SCHOOL INTERVENTION AND WE ARE DOING A COMMUNITY SUPPORTED AGRICULTURE INTERVENTION RIGHT NOW AND I'M EXCITE TO BE HERE TODAY. >>GREAT. Dr. JOHNSTON. >>GOOD AFTERNOON, EVERYONE. IT'S A PLEASURE TO BE HERE AND BEYOND THIS PANEL. SO, I AM AN EXPOSURE SCIENCE AND ENVIRONMENTAL EPIDEMIOLOGIST BY TRAINING AND MY WORK REALLY CENTERS AROUND COMMUNITY COLLABORATIONS TO UNDERSTAND SORT OF INDUSTRIAL POLLUTION SOURCES AND THEIR IMPACTS ON COMMUNITY HEALTH AND HOW THAT CAN BE USED WITH POLICY CHANGES OR SOLUTIONS THAT ARE NEEDED AND IN TERMS OF MY ORIENTATION INTO THIS WORK, I'M FROM SOUTH TEXAS AND I LIVED IN A COMMUNITY THAT WAS HEAVILY IMPACTED BY GROUNDWATER CONTAMINATION AND OTHER SORT OF POLLUTION SOURCES WORKED AS A COMMUNITY ORGANIZER FOR DECADES AND SO THAT INTERFACE WITH TALKING TO SCIENTISTS, REGULATORS, KIND OF THE LACK OF THE ABILITY OF THOSE ENTITIES TO PROVIDE LANGUAGE AND AND UNDERSTAND AND HOW BOTH INFLUENCE MY DECISION TO GO INTO ACADEMIA AND ALSO KIND OF INFORM THE WORK OF THAT, I DO NOW, WHICH IS THE LARGELY CENTERED IN SOUTHERN CALIFORNIA OR LARGELY WITH LATIN X POPULATIONS IN BOTH URBAN AND RURAL CONTEXT, AND THROUGH BOTH MATERNAL HEALTH COHORTS AS WELL AS CHILDREN'S BORDER HEALTH COHORTS. SO, I HAVE A SICK CHILD WHO HAS ONE OF THE RESPIRATORY DISEASES SO, THERE'S MAYBE SOME NOISE IN THE BACKGROUND. APOLOGIES FOR THAT. >>WE UNDERSTAND, FAMILY FIRST. >>THANK YOU, IT'S A PLEASURE TO BE HERE. I AM A COMMUNITY-BASED RESEARCHER AND TEND TO WORK ACROSS A NUMBER OF DIFFERENT AREAS REALLY BASED ON WHAT THE COMMUNITY DESIRES AND SO MY CURRENT WORK FOCUSES ON THE MATERNAL CHILD HEALTH, DIABETES AND CARDIOVASCULAR DISEASE AND FOCUSED ON COVID AND I THINK RELATED TO LANGUAGE, WE TOO WERE RADX AND CEAL GRANTEES AND IN ADDITION TO THE WORK WE DID WITH RADX AND S CEAL REALLY WORKED TN A TRI LINGUAL CONTACT TRACING CENTER EARLY IN THE PANDEMIC AND THEN HAVE SHIFTED THAT CONTACT TRACING CENTER TO TESTING AND THEN VACCINATIONS WHICH WAS REALLY CRITICAL WHEN IN THE COUNTIES WE SERVED, THE 75% WERE TO PACIFIC ISLANDERS AND HISPANIC COMMUNITY MEMBERS THAT DID NOT SPEAK ENGLISH AND THEN THE NECESSITY TO HAVE BOTH CULTURALLY PRE PRE AT AND LINGUISTICALLY APPROPRIATE SERVICES FOR THOSE COMMUNITIES, IT'S IMPORTANT ALL OF THE TIME AND IT WAS PARTICULARLY IMPORTANT THROUGH COVID AND SO, NIH PA CORY FUNDED MOST IMPORTANTLY COMMUNITY ENGAGE AND POWER TMORE THAN 50% OF OUR TEAS HISPANIC WITH COMMUNITY HEALTH AND RESEARCH MANY OF I KNOW WE'RE COVERING A LOT OF TERRITORY IN A COUPLE OF MINUTES. >>THAT'S OK. EACH OF US SHOULD NOW DISCUSS HOW WE ARE GOING TO IMPROVE INCLUSIVE PARTICIPATION AND INTERVENTIONS. I'LL GO FIRST. IT COULD BE ANY COMMUNITY. RURAL COMMUNITY, NATIVE HAWAIIAN PACIFIC ISLAND, NATIVE AMERICAN, AFRICAN AMERICAN, ASIAN AMERICAN, WHATEVER IS THE COMMUNITY YOU WANT TO ADDRESS. LET ME ADDRESS THE NEW ORLEANS COMMUNITIES. THERE'S A LOT OF DISTRUST AMONG OLDER AFRICAN AMERICANS AND IT'S NOT JUST BASED ON HAVING POOR HEALTH LIT ARE LITERACY OR EDU. IT WAS SEGREGATED IN THE DEEP SOUTH AND WHITE AND BLACK HOSPITALS AND EVEN WITHIN A LARGE HOSPITAL THERE MIGHT BE A WHITE WARD AND A COLORED WARD AND MANY DOCTOR WOULDN'T SEE BLACK PATIENTS OR IF IT WAS IT WAS ON A SPECIAL DAY. MANY OF YOUR OLDER PATIENTS IN THEIR 60s, AND 70s AND 80s WILL NOT ARTICULATE THIS BUT THEY WERE RAISED WITH A LOT OF DISTRUST, ONE OF THE THINGS THAT WE'RE DOING FOR INSTANCE WITH OUR CHERISH CHURCH INTERVENTIONS IS WE HAVE A COMMUNITY ADVISORY BOARD WHO DOESN'T SIT ON THE SIDE, THEY'RE INTEGRAL TO THE DEVELOPMENT OF THE PROTOCOLS NO FINDING THE CHURCHES AND GETTING THE APPROVAL OF THE LEADERS OF THE CHURCH INDUSTRY AND IT'S NOT AN INDUSTRY AND BEFORE WE GET APPROVAL BEFORE WE MOVE FORWARD SO ONE OF THE FIRST THINGS WE WANT TO DO IS WHEN ANY SORT OF RESEARCH PROJECTS IT'S INVOLVED THE COMMUNITY AND DON'T BE USING THEM AS WINDOW DRESSING, IT'S AN INTEGRAL PART OF PROTOCOL DEVELOPMENT AND OUTREACH. I HAVE IT BY ORDER BUT YOU GUYS CAN FEEL FREE TO JUMP IN BEFOREHAND, JUST JUMP IN AND TELL ME SOMETHING PRACTICAL HA YOU ARE DOING IN ORDER TO OVERCOME SOME OF THESE BARRIERS. >>WELL, I CAN START AND I THOUGHT IT WAS VERY IMPORTANT IN THE PLANNING OF THIS CONFERENCE AND THIS SESSION, THE QUESTION OF LANGUAGE BECAUSE IT IS OFTEN SO DIFFERENT IN TERMS OF HOW WE AS ACADEMIC RESEARCHERS ARE PUBLIC-HEALTH RESEARCHERS MIGHT USE SPECIFIC LANGUAGE AND HOW ARE COMMUNITY RESEARCH PARTNERS MIGHT USE OTHER TYPES OF LANGUAGES TO DESCRIBE CERTAIN EXPERIENCES AND SO ACTUALLY STARTING WITH THAT IS ONE OF THE MOST IMPORTANT ENGAGEMENT PRACTICES THAT I HAVE LEARNED OVER TIME. IF YOU TAK FOR EXAMPLE, MY EXPERIENCE WORKING IN THE AREA OF OBESITY AND CARDIOVASCULAR DISEASE I'VE HEARD MY NATIVE COMMUNITY PARTNERS USE THE PHRASE "HOLDING OUR WEIGHT" TO DESCRIBE OBESITY AND I FOUND MYSELF WORKING IN THIS FRAMEWORK OF PUBLIC-HEALTH AND INTERVENTION SCIENCE THAT AT ITS CORE, I WOULD SAY EVEN IN SPITE OF OUR COMMUNITY ENGAGE APPROACHES, REALLY MEDICAL EYESES THE EXPERIENCE AND WE PRIVILEGED THIN BODIES OVER LARGER BODIES AND WE OFTEN PRIVILEGE WHITE BODIES OVER THE BODIES OF INDIGENOUS PEOPLE AND PEOPLE OF COLOR AND SO I'VE HAD TO RECONCIL THOSE PERSPECTIVES IN MY CAREER AND I'VE REALLY SORT OF COPED WITH THAT BY FOCUSING ON THOSE STRUCTURAL DETERMINANTS AS AN INTERVENTIONIST. SO, I BEGAN IN ANY PARTNERSHIP IN ANY ENGAGEMENT WITH THE COMMUNITY BY ALWAYS CONSIDERING THE ISSUE THAT THE COMMUNITY WANTS TO WORK ON WITHIN THAT BROADER CONTEXT OF THE COMMUNITIES AND SOCIETY. AND ANOTHER EXAMPLE FOR MY WORK IS YOU KNOW, WHEN WE THINK ABOUT FOOD FOCUSED INTERVENTIONS, IT FOCUS ON LET'S IMPROVE HEALTHY ACCESS AND CONSUMPTION OF FOODS WITH THE NATIVE COMMUNITIES AND IVORY VICED THAT BASED ON THE LANGUAGE COMMUNITIES WHICH WHICH IS REALLY LESS ABOUT CONSUMPTION AND MORE ABOUT RELATIONSHIPS WITH THE FOODS BECAUSE FOODS IN MANY OF OUR NATIVE COMMUNITIES SOs ASPECT IS REALLY ONLY PART OF THE OVER ALL HOLLIS PICK VIEWPOINT OF HEALTH AND NATIVE COMMUNITIES SO WHEN WE PLAY CLOSE ATTENTION TO LANGUAGE THAT CAN GUIDE OUR ENGAGEMENT PROCESSES AND THE RIGHT WAY TOEN BEIGE WITH COMMUNITIES MOVING FORWARD. >>THAT'S A LOT OF IN SIGHT. WE'RE GOING TO HAVE THE ABILITY AT THE END TO ADDRESS ANY QUESTIONS AND ANSWERS SO FEEL FREE TO PUT YOUR QUESTIONS IN THE BOX AND WE WILL BRING THEM OUT TOWARDS THE END OF THE DISCUSSION. GIVE US SOME REALLY PRACTICAL INSIGHTS ON HOW WE CAN OVERCOME SOME OF THESE INEQUITIES AND COMMUNITY ENGAGEMENT? >>>>VERY SIMILAR TO WHAT YOU SAID AND WHAT WAS SAID ABOUT LISTENING TO THE COMMUNITY AND THE SMALL THINGS. I THINK AS COMMUNITY ENGAGE RESEARCHERS WE OFTEN ASK THE BIG QUESTION BUT UNDERSTANDING THE SMALL LANGUAGE ASPECT SHOW THEM THAT WE'RE LISTENING AND A FEW EXAMPLES OF HOW WE'VE DONE THAT AND I MAKING SURE WHERE MEETINGS ARE HELD AND THE TIME THEY'RE HELD IS NOT AT THE UNIVERSITY BUT YOU KNOW THE EASIEST PLACE IN THE COMMUNITY AND WE HAVE ALWAYS HAD TOES FACILITATED BY A COMMUNITY MEMBER AND IN LANGUAGE WHICH I THINK AUTOMATICALLY ADVANTAGES THE PARTICIPANTS SO MARCH OF SPANISH SPEAKING AND THE COMMUNITY CAN TALK ABOUT THEMSELVES AND WE ALSO SOME PHYSICIANS AND RESEARCHERS WHO SPEAK THOSE LANGUAGES AND FOR THOSE PEOPLE NOT PART OF THOSE COMMUNITIES, THEY REALLY HAVE TO GET TO CHOSE WHAT THEY ELECT THEM AND ON AND I THINK IT REALLY ADVANTAGES AND SHIFTS THAT CORE OF POWER AND A REALLY IMPORTANT WAY SO THOSE ARE TWO PRACTICAL THINGS AND I'LL SAY MAYBE SOME FLIP SIDE OF WHEN WE'VE LISTENED WELL, WE HAVE STARTED PUTTING ALL OF OUR ADVERTISERS IN ALL THREE LANGUAGES AND WE'VE HEARD BACK FROM THE COMMUNITY IS THAT HELPS THEM FEEL LIKE THEY BUILDING SO FOR THE COMMUNITIES WORKING WITH, THEY'RE IMMIGRANT COMMUNITIES THAT ARE OFTEN VERY OVERTLY BEING ABLE TO MAKE SURE THINGS ARE TROY LINGUAL ON SIGNAGE AND ALL OF OUR VANS AND WE CONVINCED OTHER ORGANIZATIONS TO DO THE SAME, IT GIVES A MESSAGE OF YOU BUILDING HERE EVEN IF THE PEOPLE SPEAK ENGLISH VERY WELL AND HAVE THAT AS JUST A VERY SOLID YOU BELONG AND THE OTHER THING BOTH WITH RESEARCH AND THEN ALSO JUST HOW TO DO RESEARCH AND LANGUAGE IS SIS SEM NATION OF THE RESULTS BACK AND THIS UNDERSTANDING THAT THE OWNER SHIP OF THE INFORMATION IS THE COMMUNITIES AND ONE OF THINK AH-HA MOMENTS THIS YEAR WAS IN A COMMUNITY ORGANIZATIONS LEADER DESCRIBING THE PART OF IT WAS THE OWNERSHIP OF THE RESULTS BACK AND THAT IT ALSO SHOWED THAT THE COMMUNITY THAT THEY HAD AGENCIES SO THEY PARTICIPATED AND THEY LENDED THEIR VOICE AND WE WERE ABLE TO SHOW POLICY CHANGES BASED ON THAT THE RESULTS WERE MORE AND AND FELT IT WAS IMPORTANT AND I'LL END THERE SO Dr. JOHNSON HAS TIME TO WEIGH IN. >>YOU ARTICULATED SOMETHING SO WELL, WE HAD A CHERISHED BOARD MEETING, A STEERING COMMITTEE AND WE WERE DECIDING WHETHER AND WE'LL BE LEADING IN OUR COMMUNITY YES IN OUR RESEARCH AND AND I WOULDN'T DO THAT AND WE'LL GO OUT TO VARIOUS PARTS OF THE COMMUNITIES CENTERS OR IF THERE'S A LARGE CHURCH WHICH CAN BE WITH ALL THE CONGREGATIONS WE MAY DO IT THAT WAY BUT YOU ARE RIGHT, TELLING COMMUNITIES ORGANIZATIONS AND THEY ARE TRYING TO SUPPORT A RESEARCH INTERVENTIONS AND YOU NODE TO COME DOWN TO ACADEMIC SITES XY AND Z SO I'M GLAD YOU ARTICULATED THAT. DID YOU MAKE A COMMENT YET? >>IT'S Dr. JOHNSON AND I KNOW YOU ARE WITH SICK CHILD BUT GO AHEAD. >>I SAW THAT CHILD BUT THAT'S FINE. THAT'S OK. >>YOU EMPHASIZE A LOT OF KEY POINTS THAT YOU CONSIDERED TO HERE AS WELL SO SORT OF CONTINUING ON THE THREAT OF LANGUAGE AND YOU'VE WORKED TO HAVE OUR MEETINGS AND WORKSHOPS AND UTING A LANGUAGE JUSTICE FRAMEWORK SO MAKING EVERYONE PARTICIPATE IN THE LANGUAGE THAT THEY SPEAK AND FEEL MOST COMFORTABLE IN AS YOU MENTIONED LIKE TRADING OFF PRESENTATIONS AND WE'LL DO KIND OF ONE PRESENTATION IN SPANISH AND PEOPLE WITH NO INTERPRETATION AND ANOTHER ONE IN SPANISH AND SO IT TRADES OFF WHO LISTENING WITH THE INTERPRETATION AND SPACES AND MORE ENGAGING FOR PEOPLE TO FEEL COMFORTABLE TO TALKING ABOUT THE DIVERSE PLAYERS IN A ROOM AND I THINK THAT ALSO JUST AS WE HEARD FROM OTHER SESSIONS JUST BUILDING RELATIONSHIPS FOR A LONG-TERM AND I KNOW WHEN I OFTEN SORT OF START COLLABORATING WITH COMMUNITIES, COMMUNITY-BASED ORGANIZATIONS, THEY DON'T WANT RESEARCHERS TO COME IN WITH A GRANT WHAT THEIR CONCERNS ABOUT AND BEFORE YOU START TALKING ABOUT GRANTS OR SPECIFIC RESEARCH AND IT HELPS WITH SUSTAINABILITY AS DIFFERENT THINGS HAPPEN IN THE COMMUNITY ARE POISE TO BE MORE READY TO RESPOND TO THINGS LIKE COVID OR THE PANDEMIC BECAUSE WE HAVE THESE RELATIONSHIPS ESTABLISHED AND THEN ALSO WE FOUND WHEN DOING INTERVIEWS WHY THEY PARTICIPATE IN THE HEALTH STUDIES AS REALLY WE GET FEEDBACK THEY WANT TO LEARN MORE AND BUILD THAT POWER TO ADDRESS THESE CONCERNS SO IT GOES IN POINT WITH THE COMMENTS AROUND THE IMPORTANCE OF DISSEMINATION OF THE INFORMATION AND TRAINING OF COMMUNITY RESIDENTS NOT ONLY TO PERHAPS TO BE RESEARCHERS IN THE STUDY WILL YOU ALSO MAKE SURE THEY'RE EQUIPPED WITH UNDERSTANDING THE AIR POLLUTION EXPOSURES ARE AND THE HEALTH EFFECTS MAY BE AND THE SOURCES ARE AND WHAT ARE THE REGULATORY FRAMEWORKS AROUND IT AND SO IN THIS CASE THERE'S ANOTHER TANGIBLE BENEFIT THAT PARTICIPATING IN THESE COLLABORATIONS WITH ACADEMIC CAN PROVIDE FOR PARTICIPANTS IN THESE SPACE AND LASTLY JUST TO EMPHASIZING THE POLITICAL CONTEXT HAPPENING IT'S KEY AND THINKING THEE THESE STUDIES SO ONE IS WORKS WITH IMMIGRANT WOMEN, WAS LAUNCHED AT A TIME WHEN THERE WAS A LOT OF NATIONAL FEAR AROUND KIND OF BEING AN IMMIGRANT AND THIS COUNTRY AND NOT SPEAKING ENGLISH AND WHAT IT MEANS TO PARTICIPATE OR ENGAGE IN SOMETHING THAT WAS FEDERALLY FUNDED AND SO, THOSE CONVERSATIONS WE REALLY SHIFTED SOME OF OUR APPROACHES BOTH IN TERMS OF ENGAGING AND RECRUITING PEOPLE AND ALSO THE TYPES OF QUESTIONS OR INFORMATION WE WERE COLLECTING TO REALLY BE RESPONSIVE AND SENSITIVE TO A LOT OF THE FEAR HAPPENING AT THE TIME. >>THAT WAS A GOOD ANSWER AND I APPRECIATE THE BREADTH OF WHAT YOU JUST SAID. ONE OF THE THINGS THAT CAME UP HOW DO YOU KNOW THAT YOU ARE DOING THE RIGHT THING? I'LL GO FIRST WHAT WE DO IN NEW ORLEANS. ONE THING IS THAT IF ONE OF THE PRINCIPLE INVESTIGATORS IS NOT FROM THE COMMUNITY, AND I'M FROM THE COMMUNITY, I RECEIVED MYSELF AS A MEMBER OF THE COMMUNITY AND I PUT THE TULANE DRESSING UP THERE TO HAVE AN OFFICIAL TITLE. IF YOU DON'T HAVE AN INVESTIGATOR WHO IS A MEMBER OF THE COMMUNITY, MAKE SURE THAT THE RESEARCH STAFF, THE SUPPORT STAFF THAT YOU HIRE PEOPLE FROM THE COMMUNITY BECAUSE THEY WILL HELP TRANSLATES, NOT JUST IN TERMS OF ENGLISH AS A SECOND LANGUAGE, BUT IN TERMS OF UNDERSTANDING WHAT THE RESEARCH IS ABOUT. I HAVE A LITTLE JOKE I TELL AND YOU CAN SPEND A LOT OF TIME AS A CLINICIAN TALKING TO A PATIENT ABOUT THIS GREAT THINK STUDY WITH A BREAK THROUGH DRUG OR DEVICE AND THE PERSON WILL SIT THERE PATIENTLY AND THEY WILL ASK DO YOU THINK I SHOULD DO THIS AND WHATEVER THE RECEPTIONIST SAYS HAS A PROFOUND IMPACT SO IT'S GOOD TO ENGAGE COMMUNITY MEMBERS AS PART OF YOUR RESEARCH STAFF BECAUSE IF YOU DON'T, THEY'RE GOING TO GET THAT INPUT AND THE INPUT MAY BE LESS THAN IS DESIRABLE SO LET'S TALK ABOUT HOW WE CAN EFFECTIVELY MEASURE RESPONSIVENESS OF COMMUNITY ENGAGE PROJECTS AND I'M JUST GOING TO GET OUT OF THE ALPHABETICAL. SPEAK UP. HOW CAN WE MEASURE? HOW DO YOU KNOW YOU ARE DOING THE RIGHT THING? >>I WOULD SAY THAT COMMUNITY ENGAGED RESEARCH FOR ME INVOLVES MY ROLE AS BOTH A COMMUNITY-BASED PARTICIPATORY RESEARCHERS AND AN INDIGENOUS PERSON AND AN INDIGENOUS RESEARCHER. AND SO, I HAVE RELATIONAL RESPONSIBILITIES TO MY COMMUNITY AND THAT MEANS THAT I AM BEHOLDEN TO MY PARTNER'S TO PRIORITIZE COMMUNITIES NEEDS AND GOALS THAT ARE ALIGNED WITH THE COMMUNITY AND I CENTER CO LEARNING AS A PRIORITY AND I HAVE SEEN THE IMPACT THAT THAT HAS ON THIS SCIENCE AND IT ACTUALLY PRODUCES FARBER SCIENCE AND MY WORK USING A CVPRR AND ORIENTATION I'VE SEEN THAT, YOU KNOW, WHEN WE INVOLVE COMMUNITY MEMBERS AND ALL STAGES OF THE RESEARCH PROCESS, FROM THE DEVELOPMENT OF THE RESEARCH QUESTIONS AND ALL THE WAY THROUGH DATA COLLECTION AND EVALUATION ADVERTISE SEM NATION, THE WORK IS ELEVATED AND IT DIFFERENCE DRIVES ACCURATE THEOD LEADS TO PRAGMATIC TRIALS WHICH ARE ESSENTIAL TO REDUCING HEALTH DISPARITIES AND ACHIEVING HEALTH EQUITY AND ENGAGEMENT IS AN ACTIVE PROCESS OF THE HARMS THAT HAVE BEEN CONDUCTED UNDER THIS GUISE OF MEDICINE AND MISTRUST HAS HAPPENED BECAUSE OF PAST AND NOT SO PAD AND ENGAGING THE COMMUNITIES IN AN HONOR AND TEN TICK WAY FROM THE BEGINNING. IT'S RELATION' IMPORTANT ALSO TO SPEAK HONESTLY ABOUT ENGAGEMENT AND WHAT THAT MEANS IN TERMS OF STEPPING BACK AND CENTERS INDIGENOUS PEOPLE, CENTERS COMMUNITY MEMBERS AND I THINK AS A FIELD, PUBLIC-HEALTH RESEARCH, WE'VE GOTTEN TIRED OF HEARING FROM THE NON NATIVE RESEARCHERS WHO WORK WITH NATIVE COMMUNITIES. PARTNER PRESENTATIONS ARE FINE BUT I THINK THAT WE'RE HUNG RE TO HEAR DIRECTLY FROM THE SOURCE AND THE COMMUNITIES THEMSELVES AND NOT INDIVIDUALS SPEAKING ON OUR BEHALF WHICH I THINK IS JUST FURTHER OTHERS OF OUR COMMUNITIES. SO I THINK AS RESEARCHERS, WE HAVE TO LOOK AT OUR POSITIONALITY AND AM I SPEAKING ON THIS AND CAN I OFFER IT TO A COMMUNITY MEMBER THAT CAN BETTER REPRESENT THE WORK OR AT LEAST CO PRESENT WITH ME. >>SO, I THINK THAT IS REALLY INTEGRATING WHAT I WAS SUGGESTING THAT YOU YOURSELF IDENTIFIES PART OF THE COMMUNITY BUT SUPPOSE THEY DO HAVE SOMEONE WHO IS AS SENSITIVE OF THE BACKGROUND, YOU DON'T HOLD THAT AGAINST ANYONE. PATE OF YOUR RESEARCH TEAM HAS TO BE SOMEONE FROM THAT COMMUNITY AND IF IT'S CONTINUE NOT THE CHIEF INVESTIGATOR OF THE PRINCIPLE INVESTIGATOR, SOMEONE WHO IS IN THE LEADERSHIP HAS TO BE BROUGHT IN FROM THAT COMMUNITY AND ONE OF THE THINGS THAT COMES UP, A LOT IS STIGMA AND IN THE BLACK COMMUNITY THEY CAN TELL YOU ABOUT THE SYPHILIS STUDY, THE TUS GEE-GEE STUDY OR CELLS USED FOR CANCER RESEARCH AND THEY MIGHT NOT TELL YOU WHERE OR WITH IT'S BUT THE HISTORY OF PEOPLE INTO THE COMMUNITY AND MISUSING THE QUESTIONS THAT ARE BEING ASKED SO, ANY OF YOU HAVE TO DEAL WITH THAT? IT'S EVEN BEYOND MISTRUST IT'S ALMOST AN ACTIVE AVOIDANCE OF PARTICIPATING IF RESEARCH BECAUSE OF A PERCEIVED HISTORICAL HARM. >>WE ALL EXPERIENCE IT AND I THINK BACK TO VALERIE'S POINT AND NOT JUST TALKING ABOUT IT WHEN IT'S IN THE HISTORICAL AND IT'S TRAUMA WHEN THOSE THINGS ARE HAPPENING OVER AND OVER TODAY AND 20 OR 40 YEARS AGO IT'S NOT IN THE DISTANT HISTORY AND I THINK RECOGNIZING THAT AND BEING HUMBLE IN THE DISCUSSION OF IT AS OPPOSED TRYING TO CONVINCE IT'S OVER AND WE CAN MOVE ON AND I DON'T IT'S A VERY SATISFACTORY ANSWER BUT JUST REALLY NOT DISMISSING, MAKING SURE WE DO DISMISS IT AS SOMETHING THAT IS HISTORICAL AND NOT CONTEMPORARY IS AN IMPORTANT COMPONENT TO BUILDING THAT TRUST. >>NO, NO, DON'T GLOSS OVER THAT AT ALL. AND I THINK FOR THOSE OF US WHO COME FROM STABLE ENVIRONMENTS FOR THE SOCIAL DETERMINANTS OF HEALTH WHO MAY NOT SEE THEMSELVES IN DISADVANTAGED POPULATION, YOU SHOULD RECOGNIZE THAT WHEN YOU HAVE INDIGENOUS POPULATIONS AND YOU TALK ABOUT THE STEALING OF THEIR HANDS OR THE BRINGING OF INFECTIOUS DISEASES SO YOU HAVE, BLACK POPULATIONS AND THE SOUTH AND YOU TALK ABOUT THE DISCRIMINATION WITHIN HEALTHCARE AND IN NEW ORLEANS, WHEN WE TALK ABOUT KATRINA, THESE THINGS, OK, YOU ARE 35, YOU ARE 25, AND FOR YOU IT'S HISTORY, FOR A PERSON WHO HAS A GRANT PARENT, WHO MAY HAVE LIVED THOSE EXPERIENCES AND EVEN A PARENT WHOSE LIVED THOSE EXPERIENCES, THEY HAVE BEEN VERY SENSITIVE TO THAT SO, PLEASE, I SUGGEST ALL OF US WHO ARE RESEARCHERS, RECOGNIZE THAT THE FEARS AND CONCERNS AND SOME POPULATIONS IS NOT JUST BASED ON IGNORANCE OR LACK OF UNDERSTANDING, IT'S BASED ON A REAL HISTORY OF THE DISCRIMINATION AND LIVED EXPERIENCES AND WHAT ABOUT IN MIGRANT POPULATIONS AND I'M NOT DOING ALPHABETICAL SO YOU HAVE TO JUMP IF OR I'LL CALL ON YOU. WHAT ABOUT IN POPULATIONS WHERE THE POPULATION MAY NOT BE IN ONE PLACE FOR A LONG PERIOD OF TIME. HOW DO YOU ESTABLISH TRUST IN RELATIONSHIP IN THOSE POPULATIONS? YOU MIGHT BE THE LEAD PERSON ON THAT, JILL? >>YEAH, THANK YOU. I THINK A LOT OF MY WORK PARTNERS WITH COMMUNITY BASED ORGANIZATIONS THERE AND LOCAL IN THE COMMUNITY SO I THINK WHEN WE'RE TALKING ABOUT FARM WORKERS AND OTHER MIGRATORY POPULATIONS HAVING THAT RELATIONSHIP WITH AN ENTITY IN THE COMMUNITY TRUSTED IT'S WAY TO HELP FACILITATING CONVERSATIONS WITH THAT POPULATION AND BUILDING THOSE RELATIONSHIPS EVEN THOUGH IF IT'S TRANSIENT, OFTEN TIMES YOU MAY HAVE SO YOU CAN KNOW MEMBERS OF THE COMMUNITY EVEN IF THEY MOVE AROUND MORE THAN OTHERS SO I THINK THAT REALLY GOING BACK TO WHAT WE WERE TALKING ABOUT EARLIER, HAVING MPIs FROM THE MOUNT BASED ORGANIZATION CAN HELP THE RESOURCES AND SPACES WE CAN USE AND SO I THINK BUILDING ON THESE ISSUES WITH TRAUMA AND IT'S THAT IN MANY CASES IT'S ON GOING AND WHEN WE DEAL WITH TELLING OR WORKING WITH COMMUNITIES THAT ARE DEALING WITH LIKE LEAD POISONED SOIL AND DIFFERENT OTHER KINDS OF CONTAMINATIONS, RIGHT, IT'S THIS ON GOING CURRENT CRISIS THAT IS COMPOUNDING UPON OTHER FACTORS AND THAT IS BEING DEALT WITH IN THE COMMUNITY AND SO THINKING THROUGH AND REALLY LEVERAGING ALL THAT EXPERTISE TO TALK ABOUT HOW WE SHARE THIS INFORMATION AND THINK THROUGH WHAT THE SOLUTION SHOULD BE WHEN WE KNOW THIS IS A IMMEDIATE CRISIS AND FACING COMMUNITY MEMBERS AND HOW YOU BALANCE THAT WITH ACTUALLY DOING THE RESEARCH TOO AND WHAT THAT LOOKS LIKE IN TERMS OF COMMUNITY PRIORITIES AND THEY ARE KEY CONVERSATIONS TO HAVE ENTERING INTO SORT OF RESEARCH PHASE. >>SO YOU MAKE YOUR EFFORTS TO A PARTICULAR LONGSTANDING ORGANIZATION EVEN IF THERE IS SOME DEGREE OF MIGRATION WITHIN A PARTICULAR FAMILY. I DON'T KNOW IF YOU TEAL WITH MIGRANT COMMUNITIES, IS THERE THERE ANY QUESTION ON HOW YOU CAN INVOLVE THOSE COMMUNITIES AND RESEARCH AND OUTREACH WHO MAY BE TO SOMEWHAT TRANCE TO BE TEE IF IT DOESN'T FIT YOUR EXPERIENCE THAT'S FINE, I'M JUST ASKING A QUESTION. >>DO YOU WANT TO GO FIRST? >>I DON'T WORK WITH MIGRANT COMMUNITIES. >>I THINK FOR THE MARSHAL WE HAVE ESTABLISHED RELATIONSHIPS WITH THE OTHER AREAS THEY FREQUENTLY TRAVEL TO OKLAHOMA, WASHINGTON, THE REPUBLIC OF THE MARSHAL ISLANDS AND OF COURSE IT DOESN'T MEAN EVERYONE BUT IT'S VERY IMPORTANT, FOR EXAMPLE, TO MAKE SURE SOME OF THE MEDICATIONS THAT WORE PRE PRIORING ARE AVAILABLE AND THEY TRAVEL TO THE RMI AND THEY HAVE DONE OUR BEST TO SOME OF THE INTERVENTIONS THAT MIGHT BE DEVELOPED IN ONE PLACE TO BE IMPLEMENTED ACROSS NOW GRANTED, IT DOESN'T CAPTURE EVERYWHERE BUT BEING ABLE TO DO THAT AND REALLY ALL OF YOU HAVE SAID, MAKING SURE IS ONE OF THE CROW P.I.s IS OF THE COMMUNITY AND THAT WHAT IS YOU ARE DOING IT AND I THINK IT REQUIRES FLEXIBILITY ON OUR FUNDERS PART OF JUST KNOWING THAT LONGITUDINAL STUDIES ARE MORE DIFFICULT AND WE MAY RECRUITMENT IN ONE STATE AND FOLLOW-UP APPOINTMENTS IN ANOTHER STATE AND SO IT DOES REALLY MEAN HAVING -- WE ARE NOT FULLY INSIDERS AND I'M CURIOUS HOW THE SPEAKERS INSIDERS, OUTSIDERS OR BOTH. I'M GOING TO TELL YOU, WHY CONSIDER MYSELF AN OUTSIDER. AS I MENTIONED I CONSIDER MYSELF AN EXTENSION OF THE COMMUNITY BUT THIS PERSON SAYS THAT BY ALL EDUCATIONS, TO SOME EXTENT, EVEN IF YOU APPROXIMATE FROM MARGINALIZED IDENTITY WE'RE NOT INSIDERS. HOW DO YOU ANSWER THAT? >>I'M A CHALK TAU PERSON AND IT DOES NOT MEAN THAT I HAVE ANY KIND OF COM ROW HENCE I HAVE UNDERSTANDING OF ANOTHER PERSONS EXPERIENCE. I TAKE THAT VERY SERIOUSLY AND IT CAN CAN BE A RISK TO ACT AS A GATEKEEPER OR ACT AS A IT'S IDENTIFYING YOURSELF AS AN ALLY THING AND YOU KNOW IT'S NOT UP TO YOU TO IDENTIFY AS AN ALLY BUT UP TO THE COMMUNITY TO IDENTIFY YOU AS THAT. I SEE MYSELF AS A PERSON WHO UNDERSTAND MY OWN EXPERIENCE AND I HAVE OTHER EXPERIENCES THAT ARE OFTEN IN COMMON WITH MANY INDIGENOUS COMMUNITIES THAT I WORK WITH AND INYOU HAD BECAUSE OF THAT RISK OF MAKING ASSUMPTIONS THAT WE HAVE SOME ADDRESSING HEALTH AND ONE IS WE TALKED ABOUT PA HISS PA TORI RESEARCH AND IT'S NOT A PRINCIPLE INVESTIGATOR SOMEWHERE WITHIN THE STRUCTURE OF THAT PROJECT WE SHOULD HAVE PERSONS WHO PART OF THAT COMMUNITY AND I KIND OF PUT A LITTLE TWIST AND SAID COMMUNITY ADVISORY BOARDS SHOULD BE INVOLVED ALL OF THE WAY FROM THE BEGINNING NOT JUST AS A TAG ALONG BUT EVEN IN TERMS OF PROTOCOLS DEVELOPMENT. WE HAD A REALLY NICE NUANCE RESPONSE AND I DON'T KNOW REMEMBER WHO SAID IT. ONE OF YOU GUYS, THAT IF YOU ARE GOING TO HOLD A MEETING AND IN POSSIBLE AND COME DOWN TO YOUR ACADEMIC CENTER AND WE HAD A DISCUSSION ABOUT IT THIS MORNING AND ABOUT HOLDING A MINISTER ALLIANCE MEETING FOR OUR LEADERS IN SOME OF THE CHURCHES WE'RE GOING TO DO AND IT DIDN'T CROSS OUR MIND TO COME TO TULANE I JUST HEARD SOMETHING VERY NUANCE FROM Dr. JERNAGAN AND EVEN IF WE'RE NOT PART OF THE COMMUNITY, LET'S NOT FORGET THERE ARE OTHER EXPERIENCES THAT SOME PEOPLE FEEL WE CAN'T REALLY UNDERSTAND TO SOME DEGREE OF DEPTH. MY ONLY PUSH BACK ON THAT IS IF YOU ARE FROM THE COMMUNITY YOU SHOULD STILL BE TIED NO THE COMMUNITY AT A LEVEL THAT WILL ALLOW YOU TO BE SENSITIVE, EVEN FOR THOSE THINGS YOU MAY NOT HAVE EXPERIENCED I HOPE I CAN SENSITIVE TO SOME OF THOSE THINGS PEOPLE ARE GOING TO. AND THE NEEDS TO FOCUS RESEARCH IN OUR OWN COMMUNITIES SO THIS GOES BACK TO PIPELINE AND TRYING TO STIMULATE PEOPLE TO NOT JUST BE PARTICIPANTS BUT LEADERS SO WE CAN STUDY AND UNDERSTAND FOR INSTANCE HOW THE SOCIAL DETERMINANTS OF HEALTH EFFECT HEALTH IN OUR OWN COMMUNITIES AND ANY ONE OF YOU GUYS JUMP IN AND I'M NOT GOING TO DO IT ALPHABETICAL AND I WILL JUST LET ANYONE SPEAK. >>I CAN START IT OFF. I KNOW ONE ORIENTATION OF WORK THAT I FIND REALLY EXCITING IS WORKING WITH YOUNG FOLKS, ESPECIALLY THOSE LIKE LIVING IN THESE HEALTH DISPARITIES OR ENVIRONMENTAL JUSTICE COMMUNITIES AND SOME OF THE RESEARCH AND THE ENGAGEMENT THERE'S BEEN AN ASK RIGHT AND AN EXCITEMENT FROM THEM TO LIKE LEARN MORE TO BE ABLE TO CONDUCT THEIR OWN RESEARCH, COLLECT THEIR OWN DATA, RIGHT AND SORT OF HAVE ACCESS TO SOME OF THE RESOURCES WE HAVE INSIDE THE UNIVERSITY THAT IS HARDER FOR COMMUNITY-BASED ORGANIZATIONS TO ACCESS. SO ONE EXAMPLE IS TRAINING PEOPLE TO COLLECT THEIR OWN AIR POLLUTION DATA AND SO WE TRAINED AND WE HAVE THE EQUIPMENT TO LARGELY HIGH SCHOOL YOUTH AND THEY KIND OF DESIGNED THE QUESTIONS THEY WANT TO LOOK AT WITH COLLECTING THIS KIND OF DATA WHICH SUPPORT THEM AND HAVING TO ANALYZE IT AND PRESENT IT AND THEN THEY PRESENT THEIR WORK TO OTHERS AND PRESENT IT TO THEIR CLASSROOMS AND IT'S A WAY TO ENGAGE THEM IN SCIENCE AND LOOKING AT NUMBERS AND OTHER THINGS THAT THIS IS DATA THEY CAN TAKE AND SO TO ME I'M THINKING THROUGH LIKE HOW WE CAN REALLY BUILD ON A LOT OF THEIR ENERGY AND -- >>I'LL BE BRIEF AND I'M GOING TO HOPEFULLY NOT TOO DIVISIVE OF AN ANSWER BUT I THINK THAT WE ABSOLUTELY NEED TO ENCOURAGE COMMUNITY ENGAGED RESEARCH COMMUNITY PARTNERS RESEARCH ACROSS THE CONTINUUM ALL THE WAY TO CBPR BUT I'M ALSO CONCERNED THAT THERE SEEMS TO BE A TREND NOW THAT LIKE JUST SPRINKLES CBPR ON TO EVERYTHING AND I THINK THAT THAT CAN BE MORE HARMFUL TO THE COMMUNITY ENGAGE RESEARCH AND TO COMMUNITY PARTICIPATION SO I THINK WE NEED TO BE VERY CAREFUL ABOUT JUST SAYING WE WANT TO DO THIS AND YEAH, TACK ON COMMUNITY ENGAGEMENT AND I'VE SEEN THAT MOST OFTEN WITH SOME OF THE STANDARDIZED PROTOCOLS WHERE THERE'S NATIONWIDE STANDARDIZED PROTOCOLS SO WE WANT NO CHANGES BUT WE ALSO ARE SAYING WE WANT IT TO BE COMMUNITY ENGAGED O OR ALL BASIC SCIENCES ALSO NODE TO HAVE THIS ELEMENT OF COMMUNITY ENGAGEMENT SO I KNOW THAT'S A LITTLE BIT OF A DIVISIVE ANSWER AND I THINK WE NEED MUCH MORE COMMUNITY ENGAGE RESEARCH BUT I ALSO THINK WE DON'T NEED TO DILUTE WHAT IT MEANS TO BE COMMUNITY ENGAGE RESEARCH TO INCENDIARYINSINUATE IT CAN BE SE ONTO THE STANDARD WAY THAT RESEARCH IS CONDUCTED. >>THAT'S WHAT WE CALL BACK HOME IN NEW ORLEANS, KEEPING IT REAL. IT'S NOT ENOUGH TO KEEP PEOPLE ON A STUDY AND CALL IT RESEARCH WHEN EVERYTHING WAS ALREADY SET UP AND THE TRAINED STATION AND NOW YOU WANT HIM TO JUMP ON THE CABOOSE, IT BREAKS IT DOWN A LITTLE BIT. ANY COMMENT ON THAT, WHERE THERE'S A QUESTION ON HOW WE CAN REACH BACK INTO THE COMMUNITY AND DEVELOP RESEARCH AT A YOUNGER AGE BUT Dr. MCELFISH SAID EVEN WITH ON GOING RESEARCH, NOT JUST TACKING ON OF SOME VOICES FROM THE COMMUNITY AND SAYING IT'S A COMMUNITY PARTICIPATORY RESEARCH? >>I MEAN, IT HAPPENS ALL THE TIME AND I GUESS, WE SHOULD BE RESPONSIBLE TO OUR COLLEAGUES TO SAY, YOU KNOW, THAT'S NOT THE KIND OF WORK THAT I DO. AND I CAN'T PARTICIPATE IN THAT. AND ALSO, YOU KNOW, JUST MAKE SURE THAT WHEN WE'RE SITTING ON THE REVIEW PANELS, THAT WE NOTE THAT AND I THINK THAT THERE'S MORE AND MORE AWARENESS AROUND MISUSE OF THE TERM COMMUNITY BASED PARTICIPATORY ENGAGE RESEARCH AND THERE ARE PRINCIPLES OUT THERE AND THERE ARE, I'M ON THE BOARD OF THE EDITORIAL BOARD OF HEALTH -- SEVERAL JOURNALS THAT FOCUS ON THIS AND WE REVIEW BASED ON THE CRITERIA, THAT ARE THERE ACTIVELY COMMUNITY MEMBERS WHO ARE CO-AUTHORS AND IS THERE EVIDENCE OF TRUE INVOLVEMENT IN ENGAGEMENT FROM THE BEGINNING AND YOU KNOW, THERE ARE A LOT OF WAYS TO REALLY LOOK AT THIS CRITICALLY AND TAKE SERIOUSLY THE SCIENCE OF COMMUNITY ENGAGE WORK AND TAKE SERIOUSLY COMMUNITY LAY KNOWLEDGE THAT'S BEING OFFERED IN PARTNERSHIP WITH WESTERN SCIENCE TO ACHIEVE HEALTH EQUITY. IF WORE REALLY DOING THE WORK, THEN THAT KNOWLEDGE AND WHO IT BELONGS TO, WHICH IS THE COMMUNITY, SHOULD BE PRIVILEGED AND IT'S NOT JUST, YOU KNOW, HOW MANY OF THESE PANELS HAVE I DONE WHERE THEY SAY OH WE CAN GET A COMMUNITY MEMBER ON AND ASSUMING THEY DO NED TO PRACTICE OR THEY DON'T NEED THE QUESTIONS IN ADVANCE THEY ALWAYS JUST TALK FROM THE CUFF. THEY'RE NOT AS SERIOUS AS WE ARE. I THINK THAT JUST PRIVILEGING WESTERN SCIENCE IN THE DEGREES IS SOMETHING WE NEED TO UNLEARN. >>BEAUTIFUL, SO, THE TEACHING POINTS ARE STARTING TO ACCUMULATE NOW AND THIS IS NOT JUST HACKING ON SOME MEMBER OF THE COMMUNITY AND CALLING IT COMMUNITY PARTICIPATORY RESEARCH AND I'M NOT ASKING TO COME DOWN TO BE THE BIG MEETING SO THEY CAN LEARN ABOUT THE RESEARCH WHEN IT'S BEEN DONE AND INVESTIGATING SHOULD BE DONE IN THE COMMUNITY BUT WITH HAND AND HAND WITH THE COMMUNITY IN DEVELOPING PROPERTIES PROTOCOLSS MISTRUST AND DISTRUST AND HOPEFULLY I WAS ABLE TO CONVINCE SOME OF YOU IT'S NOT JUST BECAUSE PEOPLE ARE IGNORANT OR BACKYARDS THAT THEIR LIVED EXPERIENCES ARE THE LIVED EXPERIENCES OF THEIR PARENTS AND THEIR GRAND PARENTS ARE REAL AND THEY WILL EFFECT HOW THEY SEE RESEARCH AND HOW THEY SEE HEALTHCARE IN GENERAL AND SOME OF THE CO ADHERENCE THAT YOU SEE IN THE SOUTH IS BECAUSE THEY JUST DO TRUST THESE GUYS AND YOU WRITE A PRESCRIPTION FOR SIX OR SID MEDS AND THEY ASK THEIR DAUGHTER AND YOU THINK YOU WANT TO TAKE ALL THIS MEDICINE AND YOU SAY MOM I DON'T TRUST THOSE GUYS SO WE NEED TO OVERCOME THAT. YOU GUYS, YOU ARE ALL SMART AND DIVERSE AND ASK EACH OTHER QUESTIONS, I'M QUIET. >>SO, I WILL START A WITH A QUESTION AS YOU DESCRIBE YOURSELVES AS DOING INTERVENTION WORK. WHEN YOU DO THIS COMMUNITY-BASED INTERVENTIONS BUT OFTEN TIMES WE KNOW SOME OF THE PROBLEMS ARE REALLY SYSTEM-LEVEL PROBLEMS NOT REALLY LIKE INDIVIDUAL BEHAVIOR, SO HOW DO YOU THINK ABOUT THAT OR INCORPORATE THAT AND I'M EXCITED TO LEARN MORE ABOUT THAT ASPECT. >>THAT'S BEEN THE HISTORY OF MY WORK BECAUSE I WANTED TO AVOID SOME OF THAT SORT OF FURTHER STIGMATIZING HEALTH WORK SO I FOCUSED MOSTLY ON STRUCTURAL ISSUES AND WHAT I FOUND IS SPECIAL WILL HE STARTING 20 YEARS AGO WHEN I FIRST STARTED GETTING MY OWN GRANTS, THAT THE DATA, THE MEASURES AVAILABLE TO TRACK STRUCTURE CHANGES, TO THE VARIOUS SYSTEMS OR INSTITUTIONS THAT WE WANTED TO INTERVENE UPON, THERE REALLY WAS A DERTH OF MEASURES AND INDICATORS AND WE NEEDED TO ALMOST DEVELOP OUR OWN AND SO ESPECIALLY WITH INDIGENOUS POPULATIONS, YOU SEE SOME OF THE MEASURES THAT COME OUT ARE THINGS LIKE THE CDC SAYS HEY, YOU SHOULD INTERVENE AT THE ENVIRONMENTAL LEVELS IF YOU WANT TO ADDRESS OBESITY SO WE WOULD TAKE SORT OF THOSE RECOMMENDATIONS AND WE WOULD ADAPT THEM WITHIN THE CONTEXT OF SOVEREIGN INDIGENOUS NATIONS AND SO WE WOULD SAY WELL, WHAT DO WE NEED TO CHANGE TO MAKE THIS RELEVANT AND HOW WOULD WE TRACK THIS USING THE COMMUNITIES OWN CONTEXT AND PRIORITIES AND THEIR OWN GOALS AND SO THAT IS KIND OF SOME OF THE WAYS WE'VE DONE THAT AND IT'S ALWAYS FOCUSED ON THE SOURCE AS BEST WE CAN SO RATHER THAN SAYING LET'S IMPLEMENT A HEALTHY FOOD INTERVENTIONS, WE'RE LOOKING AT, FOR EXAMPLE, IN THE CURRENT RO1, A COMMUNITY SUPPORTED AGRICULTURE PROGRAM SO WE CAN'T SOLVE LONG-TERM SUSTAINABLE -- WE CAN'T CREATE LONG-TERM SUSTAINABLE IMPROVEMENTS AND HEALTH, BY JUST DELIVERING HEALTHY FOOD BOXES WHERE ARE THEY GETTING THEIR FOOD AND HOW ARE WE ABLE TO IMPROVE THIS IN A LONG-TERM SUSTAINABLE WAY AND SO THOSE ARE THE QUESTIONS THAT WE ASK AT BEGINNING AND I TEND TO PARTNER WITH THE COMMUNITIES TO HAVE A LEVEL OF CAPACITY I LOOK FORWARD COMMUNITIES WHO WANT TO TEST HYPOTHESIS AND THEY HAVE QUESTIONS AND THAT THEY WANT TO ASSESS AND WE ARE EMBEDDING SUSTAINABLE AND THE POTENTIAL TO SCALE UP FOR POLICY. >>WE DO VERY SIMILAR THINGS AND THE COMBINATION OF INDIVIDUALS LEVEL INTERVENTIONS, HOSPITALS TO WORK TOGETHER FOR A BERRIEN TRANSITION OF CARE AND EMBEDDING COMMUNITY HEALTH WORKERS THROUGHOUT THE PROCESS AND ALSO WORKING WITH OUR STATE TO CHANGE THE POLICIES SO THAT WOMEN ARE NOT CUT OFF FROM MEDICAID AT 6 0 DAYS AND ALSO WORK WITH THE STATE TO DO A MEDICAID INNOVATION SO COMMUNITY HEALTH WORKERS ARE COVERED BY MEDICAID AFTER THIS INTERVENTION IS TESTED SO THAT PERSON SYSTEMS POLICY WORKING ALL OF THOSE LEVELS AT THE SAME TIME IT'S DIFFICULT BUT IT'S CRITICAL TO IN YOU ARE NOT GOING TO LEARN THAT YOU WILL WORK TOWARDS EQUITABLE CHANGES. >>THERE'S A QUESTION HERE AND I DON'T KNOW AN EASY ANSWER. THE QUESTION IS, THAT THE ERA COMMONS I.D. REQUIREMENT IS A SIGNIFICANT BARRIER TO INCLUDING COMMUNITY BASED ORGANIZATIONS AS CO PIs AND HOW DO YOU OVERCOME THAT? ANYONE HAS COME ACROSS THAT AS A CONCERN? >>THE ERA COMMONS THE REQUIREMENT TO DO THE CITY TRAINING IS TOUGH FOR THEM TO GET ACCESS AS COMMUNITY RESEARCHERS AND THE INABILITY TO BILL AND PAY IN ADVANCE SO THOSE ARE SOME THINGS THAT COULD BE EASY FIXES FOR NIH AND YOU KNOW, MAKING THAT MORE ACCESSIBLE AND ALL OF THOSE THREE THINGS AND MORE TIME. IF WE'RE MEANT TO BE INTERVENING AT MULTIPLE LEVELS, IT'S A LOT MORE DIFFICULT TO DO THAT THAN IT IS TO DO HEY, I'M GOING TO GO INTO A CLINIC AND IMPLEMENT A INTERVENTION IN A RELATIVELY CONTROLLED ENVIRONMENT AND GIVE US MORE TIME. THAT'S THE WAY WE WILL BE SUCCESSFUL. >>TIME HAS GONE BY SO FAST AND WE HAVE A LOT OF OTHER ISSUES WE CAN TACKLE BUT I'M GOING TO SUGGEST THINK JUST FOR A MINUTE, SOMETHING THAT IS A TAKE HOME THAT'S FOR THE PEOPLE WHO HAVE LISTENED TO THIS DISCUSSION AND IT'S VERY DETAILED DISCUSSION THAT WE'VE HAD ON HOW TO ENGAGE IN THE COMMUNITY TO MAKE A DIFFERENCE. ONE THING, MAYBE TWO, WOULD REALLY BRIEFLY. MINE WOULD BE, WORKING IN THE COMMUNITY, SERVE THE COMMUNITY, DON'T BRING THEM AFTER YOU'VE DEVELOPED A PROTOCOL AND ASKED THEM WHEN TO COME IN AND RUBBER STAMP IT. YOU HAVE TO BE PART OF THE COMMUNITY ON THE FRONT END AND THE MIDDLE END AND THE BACK END. TAKE HOME, I'M GOING TO GO ALPHABETICAL ORDER. >>TAKE HOME MESSAGE. >>BE TRANSPARENT AND BE HONEST WITH YOUR REASONS FOR DOING THE WORK AND REALLY ASK YOURSELF IF YOU ARE THE BEST PERSON TO BE DOING THIS KIND OF WORK OR IF PERHAPS SOMEONE ELSE MIGHT BE BETTER SUITED FOR THAT. AND THAT GOES FOR NATIVES AND NON NATIVES. YOU KNOW, REALLY LOOK AT IF YOU ARE THE RIGHT PERSON TO DO THIS WORK AND YOUR MOTIVATIONS ARE ALIGNED WITH THE COMMUNITIES AND IF YOU ARE ABLE TO GIVE THE WORK THE APPROPRIATE THOUGHTFULNESS AND DEDICATES THAT IS NEEDED. >>BEAUTIFUL, MAKE A DIFFERENCE BUT BE REAL ABOUT THAT. Dr. JOHNSTON. >>ALONG THOSE LINES I WOULD THINK OF DEVELOPING ACTION-ORIENTED RESEARCH SO REALLY THINKING THROUGH PROJECTS THAT CAN END UP WITH RESULTS THAT CAN INFORM THE COMMUNITY AND INFORM POLICY AND HELP MOVE US TOWARDS SOLUTIONS. >>AND LAST BUT NOT LEAST, Dr. MCELFISH. >>IT'S FOR FUNDERS IN UNIVERSITIES TO REALLY LOOK AT HOW THEY CAN CHANGE AND HOW WE CAN CAN CHANGE AND I THINK WE FOCUS A LOT ON HOW DO WE BUILD THE CAPACITY OF THE COMMUNITY TO JUMP THROUGH OUR HOOPS AND WE NEED TO TAKE A HARD LOOK AT WHY HAVE WE MADE THE BARRIERS TO PARTNERSHIP SO ERRONEOUS, SO DIFFICULT THAT PEOPLE, IT MAKES IT TOO DIFFICULT TO PARTICIPATE SO I THINK THAT I WISH WE WOULD STOP FOCUSING ON WHAT IS IT THAT COMMUNITY CAN TO AND WHAT CAN WE DO TO MAKE THIS EASIER. SO THAT THE PARTICIPATION FROM THE COMMUNITY JUST IS NOT AS DIFFICULT AS IT IS TODAY. >>I APPRECIATE YOUR INSIGHTS. I'M SO PLEASED TO BE PART OF THIS PANEL. ALL OF YOU WERE SO HONEST AND REAL IN YOUR REMARKS, I'LL BRING IT BACK TO Dr. MASTER SON BEFORE WE CLOSE FOR THE DAY AND THANK YOU AGAIN AND THANK YOU EVERYONE WHO STAYED ONTO THE END. HOPEFULLY WE WERE ABLE TO GIVE YOU SOME CONSTRUCTIVE OPPORTUNITIES TO LOOK AT COMMUNITY PARTICIPATORY RESEARCH FROM A DIFFERENT POINT OF VIEW. >>I AM VERY APPRECIATIVE OF ALL OF YOUR INSIGHTS DURING THIS DISCUSSION. ESPECIALLY I WANTED TO THANK Dr. FERDINAND TO BE CHAIRING AND THE DOCTOR FOR ALL OF YOUR INSIGHTS. THIS IS ONE OF THE REASONS WHY WE LOVE HOLDING WORKSHOPS WITH THE COMMUNITY AND RESEARCHERS. IT HELPS IDENTIFY WHAT BARRIERS AND FACILITATORS TRULY DO EXIST AND HOW WE AS A COMMUNITY CAN HELP RECTIFY THOSE SITUATIONS. I THINK IT WAS AN EASTERLY YEAR COMMENT ABOUT THE VETS FROM CEAL BUT SCIENCE MUST MOVE AT THE SPEED OF TRUST AND I THINK THIS DECISION TRULY DID EMPHASIS THE IMPORTANCE THAT WE NEED TO SLOW DOWN IN ORDER TO TRULY MAKE REAL PROBLEM. WITH THAT, I WILL HAND IT OFF TO CREDIT BRUNO TO PROVIDE THE NEXT SEGMENT FOR THE CLOSING COMMENTS. >>THANK YOU, Dr. MASTERSON AND THANK YOU TO ALL THE PANELISTS. THERE'S A WITHIN DERFUL PANEL CLOSING OUR SEQUENCE OF PANELS TODAY. BUT IT'S NOT YET THE END. SO DON'T LEAVE US JUST YET. WE HAVE A COUPLE MORE WORDS TO BE SHARED WITH YOU AND REWINDING EVERYONE WHO IS INI DON'TING US TODAY, TOMORROW WE HAVE ONE MORE DAY OF THIS WORKSHOP SO WHEN WORE PLANNING THIS WORKSHOP, WE HAD A CHANCE TO HEAR FROM THE LEADERSHIP FROM THE NATIONAL INSTITUTE OF AGING NIA AND NATIONAL ININSTITUTE OF MINORITY INDISPARITIES AND THERE WAS OVERLAPPING WITH THE NATIONAL HEART AND LUNG AND BLOOD INSTITUTE IN SUPPORTING THESE EFFORTS THAT BROUGHT US HERE TODAY TRYING TO ADVANCE THE SCIENCE OF HEALTH DISPARITIES RESEARCH SO GIVEN THAT WE HAVE A CHANCE TO HEAR FROM Dr. PEREZ-STABLE IN OUR OPENING REMARKS IT WAS ONLY NATURAL TO ALSO HAVE A CHANCE TO HEAR FROM NIA AS WE MOVE TOWARDS THE END OF TODAY'S WORKSHOP. SO I WOULD LIKE TO INVITE Dr. PATRICIA JONES, THE DIRECTOR OF THE OFFICE OF SPECIAL POPULATIONS IN THE NATIONAL INSTITUTE OF AGING FOR OUR CLOSING REMARKS AND THEY WILL BE FOLLOWED BY Dr. ILLIAS. >>THANK YOU VERY MUCH. IT'S A PRIVILEGE AND PLEASURE TO JOIN YOU TODAY. I'VE HAD THE OPPORTUNITY TO STAY ON THE FULL DAY AND HEAR THE CONVERSATIONS AND IT WAS VERY, VERY INSIGHTFUL AND VERY RICH. TAPPING INTO THE POINT THAT WAS JUST REITERATED THAT SCIENCE MUST MOVE AT THE SPEED OF TRUST AND THAT POINT CANNOT BE UNDER SCORED AND AS Dr. PEREZ-STABLE OPENED THIS MEETING TODAY, WITH HIS REMARKS AND PROVIDING A VERY THOUGHTFUL REVIEW OF POINTS TO CONSIDER IN HIS PRESENTATION TITLE COMMUNITY ENGAGED SCIENCE TO REDUCE HEALTH DISPARITIES RESEARCH, WE WERE REMINDED OF THE IMPORTANCE OF STANDARDIZING OUR MEASUREMENTS OF SOCIAL AND DEMOGRAPHIC FACTORS THAT IMPACT HEALTH, FOSTERING COMMUNITY ENGAGEMENT AND BUILDING TRUST WITH AN EYE TOWARDS SUSTAINABLE PARTNERSHIPS AND FACILITATING THE DISCOVERY OF SCIENCE USING BIG DATA AND TO BE THE FULL COME FOR PROMOTING HEALTH DI DIVERSI. Dr. SYLVIA TRENT ADAMS WITH THE IMPORTANT WORK WE'LL CALLED TO DO IN OUR KEYNOTE SPEAKER AND PROVIDING THOUGHT PROVOKING OVERVIEW OF HEALTH DISPARITIES AND CLARIFYING THE DISTINCTION IN BEING MINDFUL OF OUR VOCABULARY YOU LAR HOW WE SPEAKF HEALTH AND HEALTH DISPARITIES AND REMINDING US OF THE DIMENSIONS THAT WE SHOULD BE CONSIDERING AS WE EMBARK IN THIS SPACE OF RESEARCH IN PARTICULAR, BEING MINDFUL OF ACCESS TO CARE, SYSTEMS LEVEL ATTITUDES THAT ARE HELD BY HEATH CARE PROVIDERS AND SYSTEMS LEVEL QUALITY AND THE SOCIAL DETERMINANTS OF HEALTH AND OUR FIRST PANEL, SESSION OF PANEL SPEAKERS CONTINUED THIS THEME AND TOOK US FURTHER INTO EXPLORING AND DISCUSSING COMMUNITIEN FAGEMCOMMUNITY ENGAE HAD THE OPPORTUNITY TO FURTHER UNPACK THE IMPORTANCE OF PLANNING AND MEASURING BIDIRECTIONAL COMMUNITY ENGAGEMENT AND IT SET THE STAGE FOR VERY RICH CONVERSATION AROUND MEASUREMENT AND BEING INTENTIONAL ABOUT WHY WE EMBARK IN MEASURING ITEMS. ARE WE HERE TO FROM THE GROW THE FIELD OR TO PURSUE OTHER INTERESTS WE WERE REMINDED BY Dr. DON NEASE GROWING THE FIELD AND UNDER SCORING AND PROVIDING DATA AND INFORMATION THAT WOULD FURTHER DEMONSTRATE AND ENHANCE QUALITY OF OUR PROGRAMS. WE ALSO HAD AN OPPORTUNITY TO HEAR FROM OUR THIRD PANEL OF SPEAKERS AS WE JUST CONCLUDED LOOK AGO AT THE IMPORTANCE OF ADDRESSING HEALTH EQUITIES AND PROVIDING A SOLID AND CLEAR PERSPECTIVE ON CONCRETE EXAMPLES HOW TO USE LANGUAGE TO FURTHER OUR PERSPECTIVES AND INFORM OUR THINKING AND IT REMINDED ME OF A POINT THAT WAS RAISED IN OUR SECOND PANEL AS SOMEONE ASKED THE QUESTION AROUND WHAT IS OUR METRIC FOR SUCCESS AND ONE OF OUR SPEAKERS, REMINDED US THAT THE TRUE METRICS FOR SUCCESS FOR THEM WAS LOOKING AT HOW THE COMMUNITY MEMBERS IDENTIFIED AND FURTHER DISSEMINATED THE INFORMATION USING THEIR OWN LOCAL LANGUAGE AND THEIR OWN LOCAL COMMUNICATIONS CHANNELS AND RESOURCES THAT ARE IMPORTANT TO THEM AND NOT NECESSARILY HOLDING DEAR TO OUR TRADITIONAL ACADEMIC MEASURES OF SOUTHBOUND SUCCESS.WITH THAT IN MIND WE EXD WE HAVE OPPORTUNITIES TO HEAR THE IMPORTANCE OF CO-LEADING, CO CO-LEADING AND OWE SHARING WITH A EYE TOWARDS CO LEARNING FROM OUR COMMUNITY MEMBERS AND JUST BEING THOUGHTFUL ABOUT WHO IS THE BEST REPRESENTATIVE AND VOICE BROUGHT FORWARD AND SHARED ON THE PLATFORM AS WE'RE BRINGING FORWARD OUR FINDINGS AND OUR RESULTS IN A PUBLIC SPACE. AS WE PREPARE TO MOVE TO DAY TWO AND LOOK FROM THE AT THE ROLE OF COMMUNITY ENGAGE RESEARCH AND THE GLOBAL CONTEXT AND ALSO FURTHER EXPLORING THE IMPORTANCE OF COMMUNITY ENGAGEMENT, I JUST WANT TO TAKE THIS MOMENT TO FURTHER UNDERSCORE THE IMPORTANCE OF THE PRINCIPLES OF COMMUNITY ENGAGEMENT, THIS WAS HIGHLIGHTED IN THE NATIONAL ACADEMY ARTICLES THAT WE WERE REMINDED OF AND IT CERTAINLY GIS USGIVES US AN OPPORTUNITY TO BE TAUGHTFUL AND ENGAGING IN HEALTH RESEARCH INCORPORATING HEALTH COMMUNITY ENGAGE RESEARCH PRINCIPLES AND WITH THAT IN MIND, WE ALSO HAVE COVERED TODAY AND WE HAVE AN OPPORTUNITY INFORM FURTHER EXPLORE TOMORROW AND OUR CONVERSATIONS AND SOMEONE MENTIONED THIS OUR LAST PANEL BEING THE UTILITY OF COMMUNITY BASED PARTICIPATORY RESEARCH AND WHERE THERE'S AN OPPORTUNITY TO EXPLORE MORE BROADLY PARTICIPATORY ACTION RESEARCHER AND P.A.R. AND OFTEN TIMES IN OUR LITERATURE WE SEE C. B.P. R. BUT THERE ARE OTHER TOOLS AND RESEARCHERS THAT FALL UNDERSTAND ACTION RESEARCH THAT MAY ALSO INFORM THE PARTNERSHIPS AND COLLABORATION THAT'S ARE ABSOLUTELY ESSENTIAL IN DOING THIS WORK AND SO WITH THAT IN MIND, I ALSO WANT TO JUST UNDERSCORE Dr. PEREZ-STABLE OPENED TODAY AND HIGHLIGHTING THE NATIONAL INSTITUTE OF MINORITY HEALTH AND HEALTH DISPARITIES RESEARCH FRAMEWORK AND COMMENTED ON HIS EXCELLENT CONTRIBUTIONS AS HE WAS A PART OF THE TEAM THAT HELPED DEVELOP THAT FRAMEWORK AND IT REMINDS US TO LEVERAGE THE TOOLS AND RESOURCES WE HAVE IN FRONT OF US TO GO FORWARD AND FURTHER THE FIELD AND TO LEVERAGE WHAT WE KNOW, USE WHAT WE KNOW TO MOVE FOR QUICKLY AS WE'RE TRYING TO MOVE FORWARD IN TERMS OF ESTABLISHING OUR WORK. SO, I WILL STOP HERE AND JUST AS A REMINDER A NOTE AS WE LOOK TOMORROW AT THE BROADER PERSPECTIVE OF BIG DATA AND GLOBAL SETTINGS, AND OTHER OPPORTUNITIES THAT WE ARE ALSO MINDFUL OF OUR TOOLS AND RESOURCES THAT HAVE BEEN VETTED AND AVAILABLE TO US, TODAY, AND WITH THAT I WILL TURN BACK TO MY COLLEAGUES AT THE NATIONAL INSTITUTE OF HEART LUNG AND BLOOD. >>THANK YOU, SO MUCH, Dr. JONES, FOR HELPING US CLOSE OUT OUR DAY AND I WANT TO ALSO TAKE SOME TIME TO THANK OUR NIA AS WELL AS COLLEAGUES WHO ARE SUPPORTING THIS WORKSHOP AND THIS WORK AND WE WANT TO HIGHLIGHT THE FACT THAT THIS IS AN NIH PRIORITY AND IT'S NOT SPECIFIC TO INSTITUTES. YOU SAID SOME OF THE THINGS TO ROW MINDS EVERYONE THAT THIS IS A TWO-DAY WORKSHOP SO WE HOPE A LOT OF YOU WILL JOIN TOMORROW AS WE TALK ABOUT THE IMPORTANCE OF COMMUNITY ENGAGED RESEARCH AND COMBATING GLOBAL HEALTH DISPARITIES AND THERE WILL BE A SESSION ON DATA SCIENCE AND COMMUNITY ENGAGEMENT EFFORTS LOOKING BOTH AT THE PAST, PRESENT AND FUTURE OF THAT SPACE AND WE'LL SEND WITH A SESSION ON ADVANCING EXCELLENT ENGAGEMENT AND RESEARCH AND THERE'S GOING TO BE A LOT OF INFORMATION YOU WILL TAKEAWAY ALMOST SEEMS LIKE WE NEED A SESSION FOR EACH ONE OF THESE TOPICS AND WE NEED SEPARATE WORKSHOPS SO HOPEFULLY THIS WILL BE THE START OF MANY, MANY OTHER ENDEAVORED IN THIS SPACE AND I WANTED TO THANK A LOT OF OUR PANEL AISTS, OUR CHAIRS, OUR SPEAKERS, OUR KEYNOTE SPEAKERS AND EVERYBODY WHO ATTENDED AND STUCK WITH US FOR THE WHOLE DAY. AND WE AGAIN HOPE THAT YOU WILL JOIN US AGAIN TOMORROW AND WE WILL NOT ONLY HAVE THESE SESSIONS BUT WE ARE GOING TO BE HONORED TO Dr. GEORGE MENSA TALK AND Dr. LISA COOPER WHO WILL BE GIVE OUR KEYNOTE ADDRESS. COUPLE OF LOGISTICS, WE HAVE A PARTICIPANT HANDBOOK THAT WAS SHARED ON THE CHAT AND WE'LL HAVE THAT ON OUR WELCOME BACK SIGHT AS WELL WITH MORE DETAILS BIOS OF OUR WONDERFUL PARTICIPANTS THAT WE DIDN'T GIVE THEM JUSTICE WHEN WE INTRODUCED THEM SO TAKE A LOOK AT THEREBY R BIOS AND WE WILL ININCLUDED THE QUESTIONS THAT WERE NOT ANSWERED IN OUR REPORT OR OUR WEBSITE AND WE GOT A LOT OF QUESTIONS ABOUT THE RECORDING SLIDES AND WE WILL POST THE IT ON OUR WEB PAGE AND WE WILL POST OUR SLIDES AS WELL FROM THE PERMISSION OF OUR SPEAKERS AND OTHER PANELISTS WHO SHARED THEM. WITH THAT, I DON'T THINK THERE'S ANY REASON FOR US TO HOLD YOU HOSTAGE FOR THE NEXT SEVEN MINUTES. THANK YOU SO MUCH, EVERYONE, FORAY TENDING AND Dr. BRUNO, IF YOU SO MUCH FOR LEADING US THROUGH THE DAY. THANK YOU FOR OUR PLANNING COMMITTEE! AMIR, CAT A, MARY, CRYSTAL, AND REBECA ROPER. YOU GUYS ARE AMAZING AND I ALSO WANT TO PUT IN A QUICK THANK YOU TO OUR SUPPORT TEAM READ BY RASHAWN AND WE COULDN'T DO THOSE THINGS WITHOUT THEM. SO THANK YOU. SEE YOU ALL TOMORROW, BYE. >>THANK YOU, EVERYONE.