"Access to healthcare is a human right": a constructivist study exploring the impact and potential of a hospital-community partnered COVID-19 community response team for Toronto homeless services and congregate living settings.

BACKGROUND: Individuals experiencing homelessness face unique physical and mental health challenges, increased morbidity, and premature mortality. COVID -19 creates a significant heightened risk for those living in congregate sheltering spaces. In March 2020, the COVID-19 Community Response Team formed at Women's College Hospital, to support Toronto shelters and congregate living sites to manage and prevent outbreaks of SARS-CoV-2 using a collaborative model of onsite mobile testing and infection prevention. From this, the Women's College COVID-19 vaccine program emerged, where 14 shelters were identified to co-design and support the administration of vaccine clinics within each shelter. This research seeks to evaluate the impact of this partnership model and its future potential in community-centered integrated care through three areas of inquiry: (1) vaccine program evaluation and lessons learned; (2) perceptions on hospital/community partnership; (3) opportunities to advance hospital-community partnerships. METHODS: Constructivist grounded theory was used to explore perceptions and experiences of this partnership from the voices of shelter administrators. Semi-structured interviews were conducted with administrators from 10 shelters using maximum variation purposive sampling. A constructivist-interpretive paradigm was used to determine coding and formation of themes: initial, focused, and theoretical. RESULTS: Data analysis revealed five main categories, 16 subcategories, and one core category. The core category "access to healthcare is a human right; understand our communities" emphasizes access to healthcare is a consistent barrier for the homeless population. The main categories revealed during a time of confusion, the hospital was seen as credible and trustworthy. However, the primary focus of many shelters lies in housing, and attention is often not placed on health resourcing, solidifying partnerships, accountability, and governance structures therein. Health advocacy, information sharing tables, formalized partnerships and educating health professionals were identified by shelter administrators as avenues to advance intersectoral relationship building. CONCLUSION: Hospital-community programs can alleviate some of the ongoing health concerns faced by shelters - during a time of COVID-19 or not. In preparation for future pandemics, access to care and cohesion within the health system requires the continuous engagement in relationship-building between hospitals and communities to support co-creation of innovative models of care, to promote health for all.

A framework for building comprehensive cancer center's capacity for bidirectional engagement.

PURPOSE: Community engagement has benefits for cancer centers' work and for its researchers. This study examined the experiences and perceptions of community engagement by members of the Case Comprehensive Cancer Center (Case CCC) to create and implement a framework to meet the needs of the entire cancer center. METHODS: This study included three phases: 1) Semi-structured interviews with 12 researchers from a basic science program to identify needs and suggestions for the support of community engagement; 2) Preliminary interview results informed the development of a survey of 86 cancer center members' about their awareness of and readiness to integrate community outreach and engagement into their research; and 3) The Case CCC Office of Community Outreach and Engagement reviewed the results from phases 1 and 2 to develop and then utilize a framework of engagement opportunities. RESULTS: In the interviews and surveys, cancer center members recognized the importance of community engagement and expressed an interest in participating in COE-organized opportunities for bidirectional engagement. While participation barriers include communication issues, limited awareness of opportunities, and competing priorities, members were open to learning new skills, changing approaches, and utilizing services to facilitate engagement. The framework outlines engagement opportunities ranging from high touch, low reach to low touch, and high reach and was used to develop specific services. CONCLUSION: This study identified varying needs around community engagement using an approach aimed at understanding the perspectives of a community of scientists. Implementing the framework enables reaching scientists in different ways and facilitates scientists' recognition of and engagement with opportunities.

The role of community outreach and engagement in evaluation of NCI Cancer Center Support Grants.

PURPOSE: National Cancer Institute (NCI)-designated cancer centers are required to consider their impact on the catchment area they serve. These activities are facilitated by community outreach and engagement (COE) activities as specified in the Cancer Center Support Grant (CCSG) request for applications. While the critical importance of COE activities to NCI-designated cancer centers is well known, it is less clear what impact the COE component has on the overall CCSG merit descriptor and score. METHODS: We undertook an online survey of all 62 NCI-designated Comprehensive and Clinical centers who reported their COE merit descriptor and overall CCSG priority score as of Fall 2021. RESULTS: Of 48 (77%) of responding centers, we identified a strong correlation between the COE merit descriptor and the overall numerical CCSG score received by the center (Spearman's rank correlation coefficient r = 0.360, p = 0.0053). When stratifying this relationship by center type, we observed a very strong correlation between COE and CCSG ratings for comprehensive cancer centers (n = 40; r = 0.544; p = 0.0003) but not for non-comprehensive cancer centers (n = 8; r = 0.073; p = 0.864). CONCLUSION: COE component merit descriptors for comprehensive cancer center CCSG evaluations are strongly correlated with the overall cancer center review score.

Learning from the universal, proactive outreach of the Brazilian Community Health Worker model: impact of a Community Health and Wellbeing Worker initiative on vaccination, cancer screening and NHS health check uptake in a deprived community in the UK.

BACKGROUND: Delays in preventative service uptake are increasing in the UK. Universal, comprehensive monthly outreach by Community Health and Wellbeing Workers (CHW), who are integrated at the GP practice and local authority, offer a promising alternative to general public health campaigns as it personalises health promotion and prevention of disease holistically at the household level. We sought to test the ability of this model, which is based on the Brazilian Family Health Strategy, to increase prevention uptake in the UK. METHODS: Analysis of primary care patient records for 662 households that were allocated to five CHWWs from July 2021. Primary outcome was the Composite Referral Completion Indicator (CRCI), a measure of how many health promotion activities were received by members of a household relative to the ones that they were eligible for during the period July 2021-April 2022. The CRCI was compared between the intervention group (those who had received at least one visit) and the control group (allocated households that were yet to receive a visit). A secondary outcome was the number of GP visits in the intervention and control groups during the study period and compared to a year prior. RESULTS: Intervention and control groups were largely comparable in terms of household occupancy and service eligibilities. A total of 2251 patients in 662 corresponding households were allocated to 5 CHWs and 160 households had received at least one visit during the intervention period. The remaining households were included in the control group. Overall service uptake was 40% higher in the intervention group compared to control group (CRCI: 0.21 ± 0.15 and 0.15 ± 0.19 respectively). Likelihood of immunisation uptake specifically was 47% higher and cancer screening and NHS Health Checks was 82% higher. The average number of GP consultations per household decreased by 7.4% in the intervention group over the first 10 months of the pilot compared to the 10 months preceding its start, compared with a 0.6% decrease in the control group. CONCLUSIONS: Despite the short study period these are promising findings in this deprived, traditionally hard to reach community and demonstrates potential for the Brazilian community health worker model to be impactful in the UK. Further analysis is needed to examine if this approach can reduce health inequalities and increase cost effectiveness of health promotion approaches.

Adapting a Research and Community Capacity-Building Program to Address Rural Cancer Burden and Facilitate Partnership Development Between Rural Community Stakeholders and an Urban Comprehensive Cancer Center.

While rural-urban cancer disparities persist, the research building capacity between rural communities and high-quality cancer centers remains limited. Thus, we describe how a National Cancer Institute-designated cancer center partnered with rural community stakeholders to adapt a cancer prevention-focused research and community capacity-building workshop. The workshop's goal was to strengthen community-academic partnerships and facilitate the development of sustainable well-resourced rural cancer-focused research. Researchers from the Siteman Cancer Center partnered with community leaders from rural counties in southern Illinois. We adapted the workshop from an existing evidence-based program. We analyzed changes in knowledge and research capacity and relevance to their community work. From February to May 2019, community partners guided all elements of the workshop development. Workshop participants were mostly White race (93%), had a college degree or beyond (75%), reported living in a rural community (93%), and represented an academic, faith-based, or healthcare institution (78%). Participants' mean knowledge scores of the presented content increased significantly after each session, from 9.3 to 9.9 for session 1 (p = 0.05) and 6.8 to 9.7 (p < 0.001) for session two. Through the workshop, participant scores also increased in research capacity skills, confidence, and their understanding of conducting research in the community. The workshop, co-curated and led by rural community leaders and researchers from Siteman Cancer Center, successfully increased knowledge of and interest in building cancer research capacity. Lessons from our work can inform the implementation of similar programs that address rural cancer health through research and community capacity building between rural community partners and urban cancer centers.

"A vida como ela é" e o desenvolvimento de competências e autonomia na integração ensino-serviço-comunidade / "Life as it is" and the development of skills and autonomy in the teaching-service-community integration

A formação em Odontologia alinhada às demandas atuais de saúde tem sido uma agenda importante. O objetivo desta pesquisa foi compreender os aprendizados a partir dos estágios supervisionados na perspectiva do desenvolvimento de competências e autonomia, a partir da voz de estudantes de Odontologia. Utilizou-se pesquisa qualitativa, com dois gruposfocais, com 13 estudantes, de ambos os sexos,de um curso de Odontologia, de uma instituição federal de ensino noNordeste do Brasil. Procedeu-se à análise temática de conteúdo. Os Estágios Supervisionados da Saúde Coletiva atuam como oportunidades de ensino-aprendizagemavaliação, permitindo vivência nos serviços públicos de saúdelocais e territórios, sensibilizando o estudante para o cuidado integral e para a compreensão ampliada do processo saúde-doença. As vivências partemsempre da premissa de que o aprendizado está vinculado aos serviços de saúde e a um percurso construído coletivamente por todos. Portanto, a compreensão dos estudantes sobre a integração entre o ensino, o serviço e a comunidade, permitiram a articulação entre a teoria e a prática da Saúde Coletiva e o desenvolvimento de competências "socio-lógicas" implicadas aos contextos do trabalho em saúde. Com esse entendimento, os participantes reconheceram o princípio da educação pelo/com o trabalho e a importância de todos para troca e produção de conhecimentos e de saberes em saúde (AU).

Dentistry education aligned with current health demands has been an important topic on the agenda. The objective of this research was to understand the acquired knowledge in supervised internships in terms of the development of skills and autonomy, from the point of view of dentistry students. Qualitative research was used, with two focus groups, with 13 students of both genders, from a dentistry course, from a Federal Educational Institution in Northeastern Brazil. A thematic content analysis was performed. The Collective Health Supervised Internships act as teaching-learning evaluation opportunities, allowing experience in local public health services and territories, creating student awareness of comprehensive care and a broader understanding of the health-disease process. The experiences are always based on the premise that learning is linked to health services and to a path built collectively by everyone. Therefore, the students' understanding of the integration between teaching, service and community allowed the articulation between theory and practice of Collective Health and the development of "socio-logical" competencies involved in the contexts of work in healthcare. With this understanding, the participants recognized the principle of education through/with work and the importance of everyone to exchange and produce knowledge and health education (AU).

Formação em Odontologia sob o olhar da integração ensino, serviço e comunidade: um relato de experiência / Training in Dentistry under the view of integration teaching, service and community: an experience report

Este estudo se refere a um relato sobre a experiência vivenciada nos Estágios que ocorrem de forma articulada entre universidade, serviço de saúde e comunidade do curso de Odontologia da Universidade Estadual de Feira de Santana (Bahia, Brasil), após dez anos de implantação do novo currículo obedecendo às Diretrizes Curriculares Nacionais. Quanto aos resultados, observou-se um maior comprometimento social e criticidade dos discentes em relação à aplicação do conteúdo teórico-prático, adquirido ao longo da graduação, bem como a aproximação destes com os outros profissionais da Equipe de Saúde da Família e a busca em atender às necessidades de transformação e melhorias da sociedade. Para que os objetivos pedagógicos sejam plenamente alcançados, destaca- se a relevância, não só da capacitação docente e da existência de uma matriz curricular do curso estruturada a partir do conceito de integralidade, como também da sensibilização dos estudantes, da interlocução com os preceptores e da participação ativa de todos os protagonistas nos estágios, colaborando e retroalimentando a integração ensino-serviço-comunidade (AU).

This study refers to a report on the experience in the Internships that occur in an articulated way between the university, the health service, and the community of the Dentistry course at the State University of Feira de Santana (Bahia, Brazil), after ten years of implementation of the new curriculum obeying the National Curriculum Guidelines. As the result, there was a significant social commitment and criticality of the students about the application of theoretical and practical content, acquired during graduation, as well as the approximation of these with other professionals of the Family Health Team and the search for meet society's needs for transformation and improvement. For the pedagogical objectives to be fully achieved, the relevance is highlighted, not only of teacher training and the existence of a curricular matrix of the course structured on the concept of comprehensiveness but also of student awareness, dialogue with preceptors, and the active participation of all the protagonists in the internships, collaborating and providing feedback to the teaching-service-community integration (AU).

Estágio Comunitário Interprofissional na formação do estudante de Odontologia: relato de experiência da Universidade Federal de Goiás / Interprofessional Community Internship in Dental Student Education: experience report of the Federal University of Goiás

O Sistema Único de Saúde configura-se como um potente cenário de atuação e campo de formação interprofissional, principalmente,no que se refere aos estágios supervisionados. Esse relato de experiência (RE) tem como objetivo descrever o processo de construção do Estágio Comunitário Interprofissional (ECI) da Universidade Federal de Goiás na perspectiva da formação do cirurgião-dentista. A construção parte das experiências vivenciadas e refletidas pelas autoras/sujeitos do RE: as professoras do estágio em cada curso (enfermagem, nutrição, medicinae odontologia) e a coordenadora da integração ensino-serviço-comunidade do campus do município onde ocorre o estágio. Foram ainda consultados os planos de ensino e projetos pedagógicos dos cursos envolvidos, as memórias das oficinas avaliativas realizadas ao longo do estágioe o Manual do Estágio Comunitário. O contexto do ECI, o processo ensino-aprendizagem na formação interprofissional do estudante de odontologia, a busca da sustentabilidade do estágio e a potencialidade da aprendizagem informal são apresentados e discutidos. Considera-se os avanços históricos alcançados no percurso do ECI e os dispositivos que favorecem tais mudanças na perspectiva da educação e prática interprofissional, além dos potenciais pontos de evolução do estágio para garantir a formação integral do cirurgião-dentista, no que tange às competências colaborativas (AU).

The Unified Health System (SUS) in Brazil is a powerful scenario for action and a field of interprofessional education, particularly with regard to supervised internships. This experiencereport (ER) describes the structure of the interprofessional community internship (ICI) at the Federal Universityof Goiás from the perspective of dental education. The articleis based on the experiences and reflectionsofthe authorsand subjectsof the ER: the faculty of each study program (Dentistry, Medicine, Nursing, and Nutrition) and the coordinator for the integration of teaching, service, and community on the campus where the internshiptakes place. The pedagogical projects and teaching plans of the participating programs, the evaluation workshops during the internship, and the community internship manualwere also consulted.The ICI context, the learning process in interprofessional dental student education, the sustainability of the internship, and the potential of informal learning are presented and discussed. The historical advances made during the ICIand the means by which such changes in the perspective of education and interprofessional practice are fostered, as well as the potential points of development of the internshipto ensure the holistic education of dental studentsin terms of collaborativeskills, are considered (AU).

A formação interprofissional na saúde indígena: a experiência do projeto "Huka Katu"­a FORP-USPno Xingu / Interprofessional education in indigenous health: the experience of the "Huka Katu" Project -FORP-USPin Xingu

Para o alcance dos princípios do Sistema Único de Saúde é necessária a formação de profissionais de saúde integrados à rede de saúde e que reconheçam a necessidade das diferentes realidades brasileiras, como a atenção aos povos indígenas. O objetivo é apresentar um relato de experiência para a reorientação do modelo formador priorizando a integração ensino-serviço-comunidade e a contribuição da Faculdade de Odontologia de Ribeirão Preto da Universidade de São Paulo para a efetivação das Políticas Públicas de Educação e Saúde, explorando sua interface com a Política Nacional de Atenção à Saúde dos Povos Indígenas e a Política Nacional de Saúde Bucal. As ações formativas propostas no Projeto "Huka Katu" envolvem a reorientação do modelo formador e assistencialjunto à comunidade. As etapas preparatória e operacional são desenvolvidas nas disciplinas optativas livres -Atenção à Saúde Bucal em Populações Indígenas I e II. No período da pandemia da COVID-19, a disciplina I tem se desenvolvido em ambiente virtual com uso de metodologias ativas de ensino-aprendizagem e abordagem do cuidado intercultural. A disciplina II é desenvolvida no contexto da atenção primária nas aldeias do Parque Indígena do Xingu, com ênfase na integralidade da atenção em saúde e aprendizagem pela vivência do trabalho em saúde indígena, junto a equipes multiprofissionais. O Projeto tem contribuído na formação de profissionais de saúde para o trabalho em equipe colaborativo, com egressos envolvidos diretamente na assistência ou na gestão de saúde no subsistema de saúde indígena (AU).

To achieve the principles of the Sistema Único de Saúde, it is necessary to improve health professionals' education who are integrated into the health network and who recognize the need for different Brazilian realities, such as indigenous peoples' health care. The objective is to present an experience report for the reorientation of the educational model prioritizing the teaching-service-community integration and the contribution of the Ribeirão Preto School of Dentistry, University of São Paulo, to the implementation of Public Education and Health Policies, exploring its interface with the National Health Care Policy for Indigenous Peoples and the National Oral Health Policy. The education actions proposed in the "Huka Katu" Project involve the reorientation of the training and assistance model to the community. The preparatory and operational stages are developed in the open elective courses -Oral Health Care in Indigenous Populations I andII. During COVID-19 pandemic, Course I was carried out in a virtual environment using active teaching-learning methodologies and an approach to intercultural care. Course II is developed in the context of primary care in the villages of the Xingu Indigenous Park, with emphasis on comprehensive health care and learning through the experience of working in indigenous health, together with multidisciplinary teams. The Project has contributed to the training of health professionals for collaborative teamwork, with graduates directly involved in health care or management in the indigenous health subsystem (AU).

Espaços promotores de saúde na Atenção Básica: a experiência dos graduandos de Odontologia da Universidade Estadual da Paraíba / Health-promoting spaces in Primary Health Care: the experience of undergraduate dentistry students at the State University of Paraíba

O estudo tem por objetivo relatar a experiência de um grupo de acadêmicos de Odontologia da Universidade Estadual da Paraíba, ocorridano segundo semestre de 2018, durante o processo de formação de um espaço promotor de saúde que proporcionou o encontro da cultura e arte com o Sistema Único de Saúde na Unidade de Saúde da Família (USF) Argemiro de Figueiredo, situada no município de Campina Grande. A construção deste espaço ocorreu durante o Estágio na Estratégia Saúde da Família I, componente curricular ofertado no quarto semestredo curso. Tal ambiente foi criado a partir da realização da vivência intitulada de "Grafite que traz vida", como também por meiodo processo de construção da Horta Comunitária na USF em questão. As atividades citadas foram marcadas pela forte interação entre acadêmicos, comunidade, equipe de saúde e equipamentos sociais presentes na área adstrita à USF, permitindo, assim, o fortalecimento do vínculo entre equipe de saúdee população. Neste processo de vivência em comunidade, observou-se a importância da presença de acadêmicos de Odontologia no cenário da Atenção Básica (AB). Tal presença possibilitou que os mesmos reconhecessem a relevância do cuidado integral, entendendo, assim, que o papel do cirurgião-dentista na AB vai muito além dagarantia de assistência em saúde bucal para a população. Além disso, a construção de um espaço promotor de saúde permitiu o fortalecimento dos laços entre os usuários e trabalhadores fazendo com que a comunidade compreendesse o espaço da UBS para além da doença (AU).

The study aims to report the experience of a group of dentistry students from the State University of Paraíba, which took place in the second semester of 2018, during the process of forming a health-promoting space that provided the meeting of culture and art with the System Health Unit at the Family Health Unit (FHU) Argemiro de Figueiredo, located in the municipality of Campina Grande. The construction of this space took place during the Internship in the Family Health Strategy I, a curricular component offered in the fourth semester of the course. Such an environment was created from the experience entitled "Graffiti that brings life", as well as through the construction process of the Community Garden in that FHU. The aforementioned activities were marked by the strong interaction between academics, the community, the health team, and social equipment present in the area assigned to the FHU, allowing the strengthening of the bond between the health team and the population. In this process of living in the community, it was observed the importance of the presence of dentistry students in the Primary Care (PC) scenario. Such presence enabled them to recognize the relevance of comprehensive care, understanding that the role of the dental surgeon in PC goes far beyond guaranteeing oral health care for the population. Also, the construction of a health-promoting spaceallowed the strengthening of ties between users and workers, enabling the community to understand the BHU space in addition to the disease (AU).

Community-funded integrated care outreach clinics as a capacity building strategy to expand access to health care in remote areas of Uganda.

Most Ugandans live in rural, medically underserved communities where geography and poverty lead to reduced access to healthcare. We present a novel low-cost approach for supplemental primary care financing through 1) pooling community wealth to cover overhead costs for outreach clinic activities and 2) issuing microfinance loans to motorcycle taxi entrepreneurs to overcome gaps in access to transportation. The intervention described here, which leverages community participation as a means to extend the reach of government health service delivery, was developed and implemented by Health Access Connect (HAC), a non-governmental organization based in Uganda. HAC began its work in August 2015 in the Lake Victoria region and now serves over 40 sites in Uganda across 5 districts, helping government health-care workers to provide over 1,300 patient services per month (and over 35,000 since the program's inception) with an average administrative cost of $6.24 per patient service in 2020. In this article, we demonstrate how integrated and appropriately resourced monthly outreach clinics, based on a microfinance-linked model of wealth pooling and government cooperation, can expand the capacity of government-provided healthcare to reach more patients living in remote communities. This scalable, sustainable, and flexible model is responsive to shifting needs of patients and health systems and presents an alternative approach to healthcare financing in low-resource settings. More rigorous evaluation of health outcomes stemming from such community-based models of service delivery is warranted.

Formación de promotores de salud sobre VIH/Sida en estudiantes de Ciencias Médicas / Training of HIV / AIDS health promoters in Medical Sciences students

RESUMEN La formación integral de los universitarios, a través de los diferentes programas, los cursos propios, optativos / electivos, con el macrocurrículo, el microcurrículo y las diferentes mallas de formación de cada carrera, garantizan un profesional preparado, con amplios recursos para su desempeño posterior. Los cursos propios están bien establecidos por las asignaturas rectoras en cada semestre, y los optativos / electivos pueden ser preestablecidos en el colectivo de asignatura. El objetivo principal es enriquecer el acervo de cada educando. En la presente comunicación se destacó la importancia de la formación de promotores de salud en los estudiantes de las Ciencias Médicas a través de los cursos optativos / electivos. Se aspira a una formación integral del educando que se encuentra en las universidades cubanas, y que el conocimiento científico les permita, una vez graduados, brindar una atención holística a la población en el radio de acción que les corresponda.

ABSTRACT Comprehensive training of university students through the different programs, their own optional or elective courses, the macro-curriculum, the micro-curriculum and the different training curriculums of each career guarantee well-prepared professionals, with ample resources for their subsequent performance. The own courses are well-established by the guiding subjects in each semester, and the optional or elective ones can be pre-established in the subject group. The main objective is to enrich the individual wealth of each student. In this communication, the importance of training health promoters in Medical Sciences students through the optional or elective courses was highlighted. A comprehensive training of the student found in Cuban universities is aspired, as well as that their scientific knowledge, once they graduate, allows them to provide a holistic attention to the population in the radius of action that corresponds to them.

The Urban American Indian Traditional Spirituality Program: Promoting Indigenous Spiritual Practices for Health Equity.

Beginning in 2009, Detroit's urban American Indian health center entered into a collaborative and participatory partnership with a university research team. The purpose of the partnership was to incorporate Indigenous traditional healing practices into the health and wellness services at this center. Following extensive consultation with stakeholders at the center, we were commissioned by local decision-makers to develop a program tailored for members of the urban American Indian community that would introduce and orient these individuals to meaningful participation in Indigenous traditional spirituality. The Urban American Indian Traditional Spirituality Program is a structured curriculum for American Indian community members that introduces and orients participants to meaningful engagement with sacred practices associated with the sweat lodge ceremony. The signature innovation of this program was the recasting of traditional socialization practices into a structured, didactic curriculum that could initiate an enduring spiritual devotional life for American Indian participants toward improved health and well-being. Created primarily "by Indians, for Indians," the collaboratively designed curriculum draws on cultural strengths and spiritual empowerment to advance health equity for these marginalized populations.

Is expanding service through an outreach programme enough to improve immunisation uptake? A qualitative study in Indonesia.

In 1983, the Indonesian government established Pos Pelayanan Terpadu (Integrated Health Post) - commonly known as Posyandu, an outreach programme for improving mothers' and children's health, including immunisation. However, child immunisation coverage is still far below national and world targets. There is also wide variation among regions, with low rates found in areas outside Java. This study aimed to explore mothers' experiences in immunising their children through Posyandu in East Nusa Tenggara, and West Sumatera, two provinces located outside Java Island. Fifty-three mothers were involved in six Focus Group Discussion (FGDs). The discussions were recorded and transcribed verbatim in the original language. The transcripts were translated into English, coded with Nvivo, and analysed for common themes. This study showed that the success of the immunisation programme through Posyandu relied on the role of community-based health workers. Their ability to integrate with the community increased people's trust. This trust encouraged mothers to immunise their children, despite their limited knowledge about immunisation. The other barrier often encountered by the mothers in immunising their children was that the fathers did not allow them to do so. Therefore, collaborative work with the whole community is needed to improve the performance of an outreach programme.

The Community-Academic Aging Research Network: A Pipeline for Dissemination.

BACKGROUND/OBJECTIVES: The Community-Academic Aging Research Network (CAARN) was created to increase the capacity and effectiveness of Wisconsin's Aging Network and the University of Wisconsin to conduct community-based research related to aging. The purpose of this article is to describe CAARN's infrastructure, outcomes, and lessons learned. DESIGN: Using principles of community-based participatory research, CAARN engages stakeholders to participate in the design, development, and testing of older adult health interventions that address community needs, are sustainable, and improve health equity. SETTING: Academic healthcare and community organizations. PARTICIPANTS: Researchers, community members, and community organizations. INTERVENTION: CAARN matches academic and community partners to develop and test evidence-based programs to be distributed by a dissemination partner. MEASUREMENTS: Number of partnerships and funding received. RESULTS: CAARN has facilitated 33 projects since its inception in 2010 (30 including rural populations), involving 46 academic investigators, 52 Wisconsin counties, and 1 tribe. These projects have garnered 52 grants totaling $20 million in extramural and $3 million in intramural funding. Four proven interventions are being prepared for national dissemination by the Wisconsin Institute for Healthy Aging: one to improve physical activity; one to reduce bowel and bladder incontinence; one to reduce sedentary behavior; and one to reduce falls risk among Latinx older adults. Additionally, one intervention to improve balance using a modified tai chi program is being disseminated by another organization. CONCLUSION: CAARN's innovative structure creates a pipeline to dissemination by designing for real-world settings through inclusion of stakeholders in the early stages of design and by packaging community-based health interventions for older adults so they can be disseminated after the research has been completed. These interventions provide opportunities for clinicians to engage with community organizations to improve the health of their patients through self-management. J Am Geriatr Soc 68:1325-1333, 2020.

Language, Culture, and Collectivism: Uniting Coalition Partners and Promoting Holistic Health in the Menominee Nation.

Recent perspectives on Indigenous health have recognized language, culture, and values as central to well-being and recovery from historical trauma. Health coalitions, which identify community health concerns and mobilize members to implement strategies for change, have begun to shift their focus from programs to policy, systems, and environmental change but have been slower to recognize the possibilities of centering Indigenous ways of being in their work. This article details a case study of the Menominee Wellness Initiative, an Indigenous health coalition that has increasingly made language, culture, and collective values the focus of their health promotion work, and often due to the participation and influence of community organizers in the coalition. The study is presented as a collaborative writing effort between coalition members and academic partners. Qualitative data were gathered through observations of coalition meetings; in-depth, semistructured interviews with coalition members; and interactive data analysis discussions within the collaborative writing team. In the results, we describe how the shift in the coalition's framework came to be and the influence this shift has had on the coalition, its activities, and its community impacts. These findings illustrate and extend understanding of several principles of Collaborating for Equity and Justice and supports literature and practice related to health promotion through the centering of Indigenous ways.

Improving Health Care Career Pipeline Programs for Underrepresented Students: Program Design that Makes a Difference.

BACKGROUND: Health care career pipeline training programs are one solution to increasing the number of minority and underrepresented health care providers. The Chicago Cancer Health Equity Collaborative (ChicagoCHEC) Research Fellows Program, a tri-institutional effort between the University of Illinois at Chicago (UIC), Northeastern Illinois University (NEIU), and Northwestern University (NU), provides a holistic, 8-week summer research fellowship that facilitates self-reflection, professional development, and exposes and guides the novice undergraduate and postbaccalaureate student toward a health care career inclusive of research and scientific discovery. OBJECTIVES: The number of underrepresented students achieving health care careers is minimal. We outline curriculum development, innovation, lessons learned, and selected outcomes from the first three cohorts of the ChicagoCHEC Research Fellows program. METHODS: A tri-institutional, collaborative curricular team was formed consisting of research faculty and staff at NEIU, UIC and NU. Once accepted, fellows experience a cohort model curriculum with particular emphasis to mindful inclusion of nontraditional students. The ChicagoCHEC Research Fellows Program uses evidence-based mentorship models, group reflection, and extensive program evaluation to continuously improve its program model. CONCLUSIONS: The 48 fellow alumni from the first 3 years reported high satisfaction with the program and will continued to be tracked for academic success. The ChicagoCHEC Research Fellows program will continue to provide academic and professional tools, sponsorship, and mentorship opportunities to underrepresented students as they progress toward health care careers. A program such as the ChicagoCHEC Fellows Program can serve as a useful model for increasing the number of minority researchers in health care careers.

Partnering with Native Communities to Develop a Culturally Grounded Intervention for Substance Use Disorder.

Studies have documented serious disparities in drug and alcohol-related morbidity and mortality among American Indians and Alaska Natives (AI/ANs) compared to other ethnic groups in the U.S. despite high rates of abstinence in these groups. Further complicating these health disparities are barriers to accessing evidence-based treatments that are culturally appropriate and acceptable. As part of a research program to promote health equity in rural communities, we developed an academic-community partnership to create a culturally grounded intervention for adults with substance use disorder (SUD) residing on a rural AI reservation. We describe the early phases of our long-term Community Based Participatory Research project and report findings from the first study we conducted. This key informant interview study consisted of in-depth qualitative interviews with 25 tribal members knowledgeable about substance use and recovery on the reservation. The goal was to understand social norms and cultural conceptualizations of substance use to inform the development of a sustainable, community-driven intervention. Participants reported that a holistic approach to recovery that emphasizes spiritual, cultural, and interpersonal harmony and connectedness was important to the community and would be necessary for the intervention to succeed. They also emphasized the need for a multi-level intervention targeting individuals, families, and the community as a whole. Through this initial study, we not only gained valuable information that will be used to guide future research and treatment efforts, but we also strengthened our partnership and built trust with the community. In this manuscript we tell the story of the development of our project and describe our shared vision for future directions.