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Structural racism inflicts a disproportionate burden of stress and trauma within Black communities, resulting in physical and mental health inequities that impact Black youth. Yet few multilevel interventions exist to address these deeply rooted inequities from a preventive standpoint, and even fewer are informed by the participatory input of the impacted communities. To bridge these gaps, we developed a community-based prevention strategy that promotes agency and active resistance to structural racism, Youth Empowered Advocating for Health (YEAH), and implemented it across various settings. We outline the development, implementation, and expansion of YEAH as a tool for promoting optimal health among Black communities. Lastly, we discuss lessons learned and offer a framework outlining key principles for prevention scientists to partner with Black youth and engage them in translational science to address structural racism. This framework is aimed at driving policies, practices, and procedures that promote equitable and sustainable change for and with Black communities.
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Natural experiments are often used for answering research questions in which randomization is implausible. Effective recruitment strategies are well documented for observational cohort studies and clinical trials, unlike recruitment methods for time-sensitive natural experiments. In this time-sensitive study of the impact of a minimum wage policy, we aimed to recruit 900 low-wage workers in Minneapolis, Minnesota and Raleigh, North Carolina. We present our recruitment strategies, challenges, and successes for participant screening and enrollment of a difficult-to-reach population.
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Concepts of culture and diversity are necessary considerations in the scientific application of theory generation and developmental processes of preventive interventions; yet, culture and/or diversity are often overlooked until later stages (e.g., adaptation [T3] and dissemination [T4]) of the translational science process. Here, we present a conceptual framework focused on the seamless incorporation of culture and diversity throughout the various stages of the translational science process (T1-T5). Informed by a community-engaged research approach, this framework guides integration of cultural and diversity considerations at each phase with emphasis on the importance and value of "citizen scientists" being research partners to promote ecological validity. The integrated partnership covers the first phase of intervention development through final phases that ultimately facilitate more global, universal translation of changes in attitudes, norms, and systems. Our comprehensive model for incorporating culture and diversity into translational research provides a basis for further discussion and translational science development.
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Cultura , Pesquisa Translacional Biomédica , Humanos , Modelos Teóricos , Participação do Paciente , Pesquisa Translacional Biomédica/métodosRESUMO
To reduce current HIV disparities among African American youth, it is imperative to find effective ways to extend the reach of evidence-based HIV prevention. One promising community resource to support this effort is faith-based organizations (FBOs), a credible and respected resource in the African American community. This paper describes the experiences, perceptions, and challenges that African American FBOs and faith leaders face in engaging in adolescent HIV prevention and highlights facilitators and barriers to implementing HIV prevention in African American FBOs. The findings suggest that African American FBOs and faith-based leaders are uniquely positioned to be instrumental resources in reducing African American youth HIV disparities.
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Negro ou Afro-Americano , Infecções por HIV/prevenção & controle , Promoção da Saúde/métodos , Religião e Medicina , Adolescente , Adulto , Idoso , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
This article presents information on an Affordable Care Act-mandated community health needs assessment process, which brought four hospitals and a foundation in Pennsylvania together to imbue the assessment with community contributions. Community health needs assessments that engage underserved communities can be powerful symbols of hospitals' interest in and commitment to finding solutions.
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Área Carente de Assistência Médica , Avaliação das Necessidades/legislação & jurisprudência , Patient Protection and Affordable Care Act , Humanos , Avaliação das Necessidades/organização & administração , Avaliação das Necessidades/normas , PennsylvaniaRESUMO
African American adolescents are at increased risk for HIV/AIDS. Using a community-based participatory research approach, we engaged three black churches in adapting an evidence-based HIV prevention intervention, Focus on Youth (FOY)+ImPACT, for faith settings. To identify potential adaptations to increase FOY's relevance, utility, and efficacy for faith settings, we conducted eight focus groups pre- and post-intervention. Recommendations for maintaining FOY's core elements and enhancing its cultural authenticity include the following: incorporating faith tools, building pastor capacity, strengthening parent-child communication skills, and expanding social support for parents and youth. Engaging faith communities in adapting and implementing evidence-based HIV prevention programs could reduce HIV/AIDS disparities.
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Negro ou Afro-Americano , Pesquisa Participativa Baseada na Comunidade/métodos , Medicina Baseada em Evidências , Infecções por HIV/prevenção & controle , Promoção da Saúde/métodos , Religião e Medicina , Adolescente , Comportamento do Adolescente , Feminino , Grupos Focais , Humanos , Masculino , Relações Pais-Filho , Avaliação de Programas e Projetos de Saúde , Apoio SocialRESUMO
There is an increasing call for HIV prevention programs that target social determinants of HIV. The purpose of this study was to examine the experiences and perceptions of 12 African American adolescents to identify important social and community targets for HIV prevention. We used photovoice methodology to engage adolescents in a critical analysis of their experiences to arrive at a deeper understanding of the social determinants of HIV and determine specific action steps to reduce HIV risk. Analyses revealed a variety of social and environmental factors that affect the lives of African American adolescents by creating conditions that put them at greater risk for HIV. Study findings support mobilizing community action through raising awareness and advocating for increased neighborhood resources and institutional support. We conclude with research and practice implications for community-relevant HIV prevention among African American youth.
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Negro ou Afro-Americano/psicologia , Infecções por HIV/prevenção & controle , Infecções por HIV/psicologia , Fotografação , Psicologia do Adolescente , Populações Vulneráveis/psicologia , Adolescente , Feminino , Humanos , Masculino , Projetos Piloto , Pesquisa QualitativaRESUMO
BACKGROUND: Community-based participatory research (CBPR) strives for equitable collaboration among community and academic partners throughout the research process. To build the capacity of academia to function as effective research partners with communities, the North Carolina Translational and Clinical Sciences Institute (NC TraCS), home of the University of North Carolina at Chapel Hill (UNC-CH)'s Clinical and Translational Sciences Award (CTSA), developed a community engagement consulting model. This new model harnesses the expertise of community partners with CBPR experience and compensates them equitably to provide technical assistance to community-academic research partnerships. OBJECTIVES: This paper describes approaches to valuing community expertise, the importance of equitable compensation for community partners, the impact on the community partners, opportunities for institutional change, and the constraints faced in model implementation. METHODS: Community Experts (CEs) are independent contractor consultants. CEs were interviewed to evaluate their satisfaction with their engagement and compensation for their work. LESSONS LEARNED: (1) CEs have knowledge, power, and credibility to push for systems change. (2) Changes were needed within the university to facilitate successful consultation to community-academic partnerships. (3) Sustaining the CE role requires staff support, continued compensation, increased opportunities for engagement, and careful consideration of position demands. (4) The role provides benefits beyond financial compensation. (5) Opportunities to gather deepened relationships within the partnership and built collective knowledge that strengthened the project. CONCLUSIONS: Leveraging CE expertise and compensating them for their role benefits both university and community. Creating a place for community expertise within academia is an important step toward equitably including the community in research.
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Pesquisa Participativa Baseada na Comunidade , Relações Comunidade-Instituição , Compensação e Reparação , Consultores , Serviços Contratados/economia , Fortalecimento Institucional , Humanos , North Carolina , Papel (figurativo)RESUMO
BACKGROUND: This article describes the process our community-academic partnership used to lay the groundwork for successful implementation of an adolescent-focused, evidence-based HIV/AIDS prevention curriculum in two Black churches. OBJECTIVES: We highlight the challenges encountered and lessons learned in building a relationship with two churches, garnering the pastor's support, and implementing the curriculum within church youth groups. METHODS: We engaged a Community Advisory Board (CAB) made up of youth, parents, and diverse faith leaders to ensure community relevance and guide project development, implementation, and evaluation. LESSONS LEARNED: Using a community-based participatory research (CBPR) approach helped us to (1) engage diverse, intergenerational community members, (2) initiate a "culturally humble" process to build relationships with faith leaders, (3) remain responsive to stakeholder concerns, and (4) open the door to HIV prevention in the Black church. CONCLUSIONS: Finding effective and responsive ways to implement HIV/AIDS prevention in faith settings is facilitated by engaging diverse partners throughout the research process.