Addressing institutional and community barriers to development and implementation of community-engaged research through competency-based academic and community training.

Introduction: The National Center for Advancing Translational Sciences (NCATS) focuses on reducing barriers to effective translational research that rapidly translates science to clinical and community interventions to improve individual and community health. Community-Engaged Research (CEnR) plays a crucial role in this process by bridging gaps between research and practice. It effectively generates bi-directional knowledge and communication by engaging patients and communities throughout the translation research process. Skills development, however, is critical to enable investigators and communities to establish successful partnerships in research. While there are many independent CEnR education programs nationally, few curricula are mapped to identified domains and competencies. Assessment of current community engagement educational frameworks and competencies: We located three comprehensive efforts to identify CEnR domains and competencies that we aligned to inform development of our curriculum, which we then mapped to these competencies. The first, undertaken by the NCATS Joint Workgroup on Researcher Training and Education and Community Capacity Building (JWG) was developed to assess training opportunities for academic researchers and community partners to increase their capacity to meaningfully engage collaborators in translational research. The JWG identified curricula, resources, tools, strategies, and models for innovative training programs and community engagement in all stages of research. It also conducted a gap analysis of deficiencies in available resources. Using Competency Mapping, they developed a framework for curriculum mapping that included eight domains, each with two to five competencies of knowledge, attitudes, and skills. The second aligned community-engaged research competencies with online training resources across the CTSA consortium, while the third was focused on Dissemination and Implementation training. Actionable recommendations: Further informed by a conceptual model to advance health equity, we have adapted and integrated these components into a set of modules designed to educate and empower investigators, trainees, students, and community partners to engage in effective CEnR. Discussion: This curriculum fills an important gap in our workforce development and helps to meet needs of our community partners. Following program evaluation and validation, we will offer the curriculum for use and further evaluation by other groups interested in using or adapting it for their own programming.

The Gulf Coast Health Alliance: Health Risks Related to the Macondo Spill (GC-HARMS) Study: Self-Reported Health Effects.

The Deepwater Horizon (DWH) explosion in 2010 is the largest oil spill (Macondo) in U.S. HISTORY: We focused on gaining an understanding of the physical health and mental health effects attributable to the Macondo oil spill. This is a report of a cross-sectional cohort study (wave 1) to establish 'baseline' findings and meant to provide descriptive information to be used for a multi-wave, longitudinal study. Gulf Coast Health Alliance: health Risks related to the Macondo Spill (GC-HARMS) uses a Community-Based Participatory Research approach, thus including multi-disciplinary, multi-institutional academic partners and representatives of three communities impacted by the spill. Three research sites were selected for human sampling along the Gulf of Mexico coast including two from Mississippi and one from Louisiana, with Galveston, Texas, serving as a comparison site, given that it was not directly impacted by the spill. One hundred participants were selected from each community, representing adults, seniors and children, with approximately equal numbers of males and females in each group. Participants completed initial assessments including completion of a 'baseline' survey and, rigorous physical assessments. Results from wave 1 data collection reported herein reveal changes in self-reported physical health and mental health status following the oil spill, disparities in access to healthcare, and associations between mental health and emotional conditions related to displacement/unemployment. Few environmental health studies have been conducted in communities impacted by significant oil spills. Results imply potential prolonged effects on mental health and community vulnerability.

Ethical issues in patient-centered outcomes research and comparative effectiveness research: a pilot study of community dialogue.

Community bioethics dialogues were held on the topic of patient-centered outcomes research (PCOR) and comparative effectiveness research (CER). Participants were 65 and older and represented either a lower income, African American group (A) or a higher income White group (B). Participants were presented with a variety of background reading and study materials. Meetings were held 2 hr per week for 6 weeks. The groups showed both independence in judgment from the investigators and diversity of opinion between the two groups. Group B addressed more topics than Group A and in some instances explored additional policy nuances. Members of Group A appeared more cognizant of issues of social justice that affect vulnerable populations and appeared leery of approaches that suggested possible disrespect for their own personal experiences. Future plans call for both repeating the dialogue with additional, diverse community groups and repeating community bioethics dialogues on new topics with the same groups.

COLLABORATING WITH THE COMMUNITY: THE EXTRA-TERRITORIAL TRANSLATIONAL RESEARCH TEAM.

The purpose of the present study is to suggest a revision of the team science concept to the more inclusive extra-territorial research team (ETRT). Translational thinking is largely marked by the perception of the team as a thing-like structure at the center of the scientific activity. Collaboration accordingly involves bringing external others (e.g., scientists, community members, and clinicians) into the team through limited or dependent participation. We suggest that a promising and innovative way to see the team is as an idea: a schema for assembling and managing relationships among otherwise disparate individuals with vested interests in the problem at hand. Thus, the ETRT can be seen as a process as well as an object. We provide a case study derived from a qualitative analysis of the impact of the logic of translational science on a team assessment of environmental health following an off-coast oil disaster. The ETRT in question displayed the following principles of constructive relationship management: a high sense of adventure given the quick pace and timeliness given the relevance of the oil spill to all team members; regular meetings in the community to avoid the appearance of academic hegemony; open access by lay as well as institutional scientists; integration of emergency management coordinators into the group; and the languages of public health, environmental pharmacology/toxicology and coastal culture seamlessly interwoven in discussion. The ETRT model is an appropriate strategy for mobilizing and integrating the knowledge and skills needed for comprehensive science and service responses, especially during crisis.

Gender differences in risk behaviors among high school youth.

The US Centers for Disease Control and Prevention's (CDC) Youth Risk Behavior Surveillance System (YRBSS) demonstrates that American youth engage in a wide variety of risky behaviors.(1) The frequency and type of these behaviors often differ by a number of factors, such as socioeconomic status, race, and ethnicity. For example, results of the 2011 YRBSS revealed that white high school students were most likely to have texted or e-mailed while driving or been bullied on school property, while black high school students were most likely to have engaged in risky sexual behaviors, to have been physically inactive, and to be obese.(1) Conversely, Hispanic high school students were most likely to have ridden with a driver who had been drinking alcohol; to have ever used cocaine, inhalants, or ecstasy; and to have failed to use protection to prevent pregnancy during last sexual intercourse.(1) However, it is difficult to discern whether differences in risk-taking behaviors between and among ethnic groups can actually be attributed to differences in group norms, socioeconomic status, or cultural beliefs regarding acceptance or rejection of such behaviors,(1) suggesting a need for more comprehensive regional investigations.