Community Engagement to Promote Health Equity Aisha Queen-Johnson, - PowerPoint PPT Presentation

Program in Medical Education for the Urban Underserved (PRIME-US) Community Engagement to Promote Health Equity Aisha Queen-Johnson, MSW Administrative Program Director Leigh Kimberg, MD Program Director Jolene Kokroko Medical Student Sidra Bonner Medical Student With special thanks for slides on community engagement courtesy of Paula Fleisher, MA and Roberto Vargas, MPH and Aisha Queen-Johnson, MSW, UCSF CTSI Community Engagement and Health Policy Program / UCSF Center for Community Engagement PRIME-US: http://meded.ucsf.edu/prime

Program in Medical Education for the Urban Underserved (PRIME-US) Community Engagement to Promote Health Equity AGENDA:  PRIME-US: Who we are  Health Equity: Why we do what we do  Community Engagement: How we do and teach what we do  Our students!: What they have accomplished

University of California PRIME (Programs in Medical Education) Legislative Initiative to:  Workforce development  Expand medical school classes by 10%  Increase the diversity of the physician workforce  Eliminate health and healthcare disparities in the diverse state of CA through education programs to train physician leaders  Funding  State public education funding (Prop 1D)  Foundation and individual donor funding  University of California Office of the President (UCOP) and individual medical school budgets Nation, C. et al. “Preparing for Change: The Plan, the Promise and the Parachute” in Academic Medicine. 82 ( 12 ):1139-1144, December 2007

University of California PRIME  UC Irvine (2004): Program in Medical Education for the Latino Community (PRIME—LC)  UCSF/JMP (2006 pilot): Program in Medical Education for the Urban Underserved (PRIME-US)  UC Davis (2007): Rural PRIME—Rural and Telemedicine  UCSD (2007): Program in Medical Education—Health Equity (PRIME-HEq)  UCLA (2008): Program in Medical Education—UCLA (UCLA PRIME)  UCD-UC Merced San Joaquin Valley (2011): Program in Medical Education—San Joaquin Valley (SJV PRIME) (UC Davis-UC Merced-UCSF Fresno) http://health.universityofcalifornia.edu/prime/

PRIME-US is a five year supplementary curricular tract at UCSF School of Medicine and the UC Berkeley-UCSF Joint Medical Program (JMP). http://meded.ucsf.edu/prime

PRIME-US’s mission is to nurture, support and equip medical students to become leaders in underserved care.

As we have evolved our mission has become more ambitious… “PRIME-US is an eco-system for creating health equity”* * Sofia Noori, MPH (final year PRIME-US student, personal communication, 10/16)

Health Equity: Everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care. Health equity means reducing and ultimately eliminating disparities in health and its determinants that adversely affect excluded or marginalized groups. Braveman P, Arkin E, Orleans T, Proctor D, and Plough A. What Is Health Equity? And What Difference Does a Definition Make? Princeton, NJ: Robert Wood Johnson Foundation, 2017. https://www.rwjf.org/content/dam/farm/reports/issue_briefs/2017/rwjf437393

http://nationalacademies.org/hmd/reports/2017/communities-in-action- 10 pathways-to-health-equity.aspx

Promoting Health Equity: University- Community Partnerships Hiring and community investment Admissions of students Research/ from under- CBPR/Data resourced communities University- Community Partnerships Clinical care of Community under- engagement resourced projects communities Advocacy for policies and programs

PRIME-US Community Engagement Curriculum  Community Engagement Curriculum  Community Engagement Project Requirement  Community Engagement Competencies  Mentorship and supervision provided  Reflection incorporated into all community engagement work  Grant supported program—foundation funding to PRIME-US supports student grant applications for projects

PRIME-US Community Engagement One Time Events  Outreach pipeline programs (1,000-2,000 students/year)  One time health education workshops (community)  One time educational events (UCSF/UCB)  Focus Groups, surveys Short Term Service Learning Projects—(months to yr)  Program evaluations  Policy and advocacy (legislative and other)  Youth workshops and extended mentorship work  Focus groups, key informant interviews, surveying

When mission and values are aligned, education is transformational…

What is Community Engagement?

Who Are Community Partners? ■ Clinics/hospitals ■ Community based organizations ■ Community leaders/ advocates ■ Patients ■ Public agencies, (i.e. Departments of Public Health) ■ Policymakers

Who Are Academic Partners? ■ Students and Trainees ■ Faculty and Staff (Clinicians, Researchers, Policy experts, Educators) Slide courtesy of Paula Fleisher, MA and Roberto Vargas, MPH and Aisha Queen-Johnson, MSW UCSF CTSI Community Engagement and Health Policy Program / UCSF Center for Community Engagement

Community Engagement: Principles and Practices

Principles and Practices  Approach the relationship with humility  Demonstrate commitment  Ensure mutual benefit  Build on strengths  Be clear about roles  Be all in

“ Cultural humility incorporates a lifelong commitment to self-evaluation and critique, to redressing the power imbalances in the physician- patient dynamic, and to developing mutually beneficial and non-paternalistic partnerships with communities on behalf of individuals and defined populations.” Melanie Tervalon, MD Turvalon, M. a. M.-G., Jann (1998). "Cultural Humility vs Cultural Competence: A Critical Distinction in Defining Physician Training Outcomes in Multicultural Education." Journal of Health Care for the Poor and Underserved 9 (2): 117-125.

Cultural Humility ■ Recognize that cultural gaps exist - in communication, timelines, training, information needs and resources, how information is disseminated and used. ■ You have expertise and so does your partner. ■ Ensure academic program and institutional accountability to community partner

Demonstrate Commitment Do your homework- community assessment Introductions - be introduced and make introductions Discuss best forms of communication Be clear on timelines

Communication  Schedule regular check-in times  Are you meeting your deadlines?  Do you need to reexamine goals?  Share where you are at in the process

Ensuring Mutual Benefit  Negotiate roles  Sustainability of partnership  Clearly identify individual goals

Role Clarity  Share facilitation  Document agreed upon tasks  MOU

Reflection  Added component in our community work  Supports cultural humility practice

Take away points:  Approach potential community partners with questions, curiosity and humility  Trust-building is essential to success  Structures support clear roles  Benefit is mutual  Check in along the way - evaluate the process  Reflection is critical for learning

PRIME-US Community Engagement One Time Events  Outreach pipeline programs (1,000-2,000 students/year)  One time health education workshops (community)  One time educational events (UCSF)  Focus Groups, surveys Short Term Service Learning Projects—(months to yr)  Program evaluations  Policy and advocacy (legislative and other)  Youth workshops and extended mentorship work  Focus groups, key informant interviews, surveying

PRIME-US Community Learning... “We learn from the community” “We learn in the community” “We learn about the historical and structural factors that provide context for why there are health disparities” “We learn about communities through a strength and asset based perspective” C apstone (final year) students, 10/16

PRIME-US Community Engagement Student leadership:  Partnership with CivicsCorp—Sidra Bonner and Faby Molina  Partnership with Youth Creating Change—Jolene Kokroko and Olivia Park

CivicsCorps and PRIME-US (http://blogs.kqed.org/stateofhealth/2014/11/13/through- photos-oakland-youth-focus-on-neighborhood-health-video/ )

Youth C Creati ting ng Change ge UC UCSF F PRIME ME-Ur Urban Under erser erved Olivia P Park, M MS2 And And Jolene K Kokroko, MS MS2

Par artic ticipants ts and G Goal als • Youth e empower erment nt • Advoc ocacy cy • Ment ntorship ip • Learn f from m the c commun mmunity • Lead ader ership ip s skills

Pho hotovoic ice P Project t

Children’s P Playgr ground, 2 2015 015 Philli lip Crawthrone one

Teen enag age K e Kids ds’ A Appet etite, e, 2 2015 Khy hya Brown wnlee

T-Shirt D t Design ign P Project

Art Ex Exhibit I it Insta tallatio ion

Ar Art Exh xhibit: This s is N Not ot N Norm ormal

Summer er W Workshops

Lessons L Lear arned • Set etting ing g goal als • Cons nsis isten ency • Good Good c com ommunity • Regu gular c r check-ins/ s/ reflec ections ns • Closure re

Than ank y k you!