# Presentation: 020697

## National Advisory Research Resources Council Meeting

**National Advisory Research Resources Council Meeting**

**Engaging Underserved Communities as Partners**

- Sergio Aguilar-Gaxiola, MD, PhD
- Professor of Clinical Internal Medicine
- Director, Center for Reducing Health Disparities
- Director, Community Engagement UCD CTSC
- UC Davis School of Medicine
- Bethesda, MD
- May 14, 2008

## Important Goals when Working with Underserved Communities

**Important Goals when Working with Underserved Communities**

- Source: IOM Report “Examining the Health Disparities Research Plan of the National Institutes of Health: Unfinished Business”, 2006

- Include underserved communities in research
- Increase of URM researchers
- Increase the diversity of the workforce
- Address health disparities vigorously
- Disseminate research results widely

## Learning How to Reduce Disparities

- We need direct input from underserved communities.
- Not an easy task. Underserved communities may be:
- Unaware of potential benefits.
- Not ready to participate in research/policy processes.
- Suspicious and distrustful of health services.

## “Go in search of people. Begin with what they know.  Build on what     they have”

**“****Go in search of people. Begin with what they know.  Build on what     they have”**
- Chinese proverb

## Community Engagement at UC Davis

**Community Engagement at UC Davis**

**California Department of Mental Health Prevention and Early Intervention Needs Assessment for California’s Underserved Communities**
- 	to reach out and engage communities that have been underserved by public health/mental health services and solicit their input on communities’ needs, concerns, strengths, and resources.

## Outreach Methods

**Outreach Methods**

- Identify specific underserved communities;
- Interview key informants to focus on specific needs within communities;
- Work with “cultural brokers” or community health representatives to develop outreach strategies;
- Conduct focus groups with community members about health needs, community assets, etc.;
- Provide feedback to communities about the impact of the information collected on policy and services.

## Participants

- 	30 focus groups were conducted primarily in community-based locations in 10 counties across California
**specific ethnic groups**: African American, Native American, Native Hawaiian, and Pacific Islander, Asian (including Hmong, Cambodian, and Chinese), and Latino (Mexican and Central and South American);
**other underserved groups** (LGBTQ, foster youth, young adults with juvenile justice history, and older adults) from rural and urban locations;
**community-based providers** that serve these communities.

## Key Findings

**mental health problems** in underserved communities;
**problems accessing mental health care and quality of services received;**
**social determinants** **of health** such as poverty and discrimination;
**social exclusion** of underserved communities based on current and historical experiences with government agencies

## Community Assets

- Individual and community resiliency
- Traditional and spiritual healers
- Religious leaders
- Informal and formal support networks (family and friendships, reconnection to native cultures, role models and mentors)
- Community-based organizations
- Social service/Health programs

## Project Outcomes

- Reports:
- “Building Partnerships: Key Considerations when Engaging Underserved Communities Under the MHSA”
- “Engaging the Underserved: Personal Accounts of Communities on Mental Health Needs and Prevention and Early Intervention”
- Dissemination of findings
- Ongoing partnerships with community agencies and underserved groups

## Building Partnerships: Key Considerations When Engaging Underserved Communities Under the MHSA

**Building Partnerships: Key Considerations When Engaging Underserved Communities Under the MHSA**

**Purpose of the Report:**
- Introduce guiding principles of community engagement with underserved communities;
- Outline some guiding questions to assist counties in their community outreach and stakeholder processes;
- Suggest specific strategies that California Counties Mental Health Departments might employ to nurture sustained partnerships with communities.

**Notes:**
We need direct input from underserved communities. Not an easy task. Underserved communities may be: 
Unaware of potential benefits, Not ready to participate in policy process, Suspicious and distrustful of mental health services.

## Recommended Strategies

- Identifying underserved communities within your county
- Establishing bi-directional relationships
- Finding community representatives
- Facilitating meetings and exchanging information
- Engaging community representatives and maximizing the opportunity for developing trust in communication
- Using the information once it is collected
- Making sure the voices are heard and integrated into programmatic plans
- Building ongoing partnerships

**Notes:**
We need direct input from underserved communities. Not an easy task. Underserved communities may be: 
Unaware of potential benefits, Not ready to participate in policy process, Suspicious and distrustful of mental health services.

## Examples of other Community Engaged Research at UC Davis

- National Demonstration of Early Detection, Intervention and Prevention in Psychosis in Adolescents and Young Adults (Carter, PI)
- Reducing Disparities in Depression Care for Ethnically Diverse Older Men (Hinton, PI)
- Community Partnerships with Pediatricians for Healthy Children (Pan, PI)
- Transforming Education and Community Health (TEACH) Program (Henderson, PI)
- Community Lactation Assistance Project (Chantry, PI)
- National Faith-Based and National Community Cardiovascular Disease Prevention Programs for High-Risk Women (Villablanca, PI)
- Epidemiology of Dementia in an Urban Community (DeCarli, PI)

## Community-Based Research

**Community-Based Research**

*Opportunities for Inclusion*

- Source: Taylor, NCRR, 2007