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Community-based participatory research (CBPR) and patient/ community engaged research (P/CEnR) are shown to be effective approaches that improve health inequities, particularly among disadvantaged populations. While the science of CBPR demonstrates promising partnering practices that lead to effective interventions, there are institutional and structural barriers to creating and sustaining patient/community research within academic health centers (AHCs). As the field matures, there is a growing need to enhance patient/community leadership so that communities can set their own research agendas and priorities.
Methods:
Engage for Equity PLUS sought to address these challenges by implementing an engagement intervention aimed at transforming AHCs through supporting champion teams of academic, community, and patient partners to strengthen research infrastructures for P/CEnR. This paper uses a qualitative, case study analysis to describe how E2PLUS enabled champion teams at Stanford School of Medicine, Fred Hutchinson/University of Washington Cancer Consortium, and Morehouse School of Medicine to pursue institutional change strategies through coaching, workshops, contextual data analysis, and a community of practice.
Results:
This paper describes key themes of how E2Plus helped identify targets of change by a) using institutional data collection as core to generating critical consciousness of contextual conditions; b) implementing feasible E2PLUS strategies to leverage conditions for catalyzing a champion team for advocacy and achievable actions; c) identifying the critical role of patients/community members in stimulating change; and d) the role of continual collective reflection.
Conclusion:
We discuss the overall implications for E2 PLUS for other AHCs working toward sustainable community/patient engaged research policies and practices.
The Fred Hutch/University of Washington/Seattle Children’s Cancer Consortium’s (Consortium) Office of Community Outreach & Engagement (OCOE) joined Stanford Medicine and Morehouse School of Medicine in implementing Engage for Equity Plus (E2PLUS), a multi-institutional community of practice to learn and share patient-centered and community-engaged research (P/CEnR) practices. University of New Mexico (UNM) facilitated this collaboration.
Methods:
The Consortium formed a Champion Team of 12 people who participated in two virtual workshops facilitated by UNM. Consortium executive leadership (n = 4) participated in interviews, and investigators (n = 4) and community members/patient advocates (n = 8) participated in focus groups to provide institutional context regarding P/CEnR. This is a paper on the process and findings.
Results:
Through E2PLUS engagement, the Champion Team identified four strategies to address institutional health inequities: 1) increase participation of underrepresented groups at all levels of institutional leadership and advisory boards; 2) create an Office of Patient Engagement to train and support patients who participate in institutional initiatives and advise research teams; 3) expand community engagement training, resources, and institutional commitment to focus on community-identified social and health needs; and 4) establish an umbrella entity for health equity efforts across the Consortium.
Conclusion:
While the Consortium had longstanding community advisory boards and faculty and staff with P/CEnR expertise, it did not have centralized and institutionally supported P/CEnR resources, policies, and infrastructure. By participating in E2PLUS, the Champion Team received technical assistance to leverage qualitative data to influence strategies to guide the development of Consortium health equity infrastructure and capacity for P/CEnR in Washington.
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