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K.cain presentation pbrn festival_12.07.2013
1. Working with Communities
Katrice D. Cain, MA
Program Development Manager
Case Center for Reducing Health Disparities
The Intersection of Primary Care & Public Health: Practice-Based Research Workshop
2013 Ohio Practice-Based Research Festival 2.0
December 7, 2013
2. Overview
• Brief overview of the Center for Reducing Health
Disparities
• Community Engagement in Research
• Current Work:
– Community Partnership Committee and
Community Resident Researchers
– Cultural Competency in Research
– CBR Consult Service for Researchers
2013 Ohio Practice-Based Research Festival 2.0
December 7, 2013
3. Case Center for Reducing
Health Disparities
• Ash Sehgal, MD, Director
• 2004- Created by CWRU and MHMC
• 2007- Funded through a P60 & CTSC grant
from the NIH
2013 Ohio Practice-Based Research Festival 2.0 - December 7, 2013
4. Community Engagement
The process of working collaboratively with and through
groups of people affiliated by geographic proximity, special
interest, or similar situations to address issues affecting the
well-being of those people
Centers for Disease Control and Prevention. (1997). Principles of community engagement (1st ed.) Atlanta (GA): CDC/ATSDR Committee on
Community Engagement.
2013 Ohio Practice-Based Research Festival 2.0 - December 7, 2013
5. Community Engagement in Research
• Involves the community in each step of the research
process
• Requires listening and responding to the needs of the
community
• Focuses on building upon community strengths and
assets
• Includes disseminating research findings to the
community
2013 Ohio Practice-Based Research Festival 2.0 - December 7, 2013
6. Benefits of Community Engagement
• Builds rapport
• Dispels myths about research- “Helicopter
Research”
• Improves community health outcomes
• Reduces health disparities
• Increases success rates of research studies
2013 Ohio Practice-Based Research Festival 2.0 - December 7, 2013
7. Community Partnership Committee
• Reviews activities, identifies optimal
approaches to engaging Cleveland’s
communities and institutions, and develops
ideas for new projects
• Comprised of:
– Community Residents
– Research Study Participants
– Community-Based Providers
– Faculty engaged in Community-Based Research
2013 Ohio Practice-Based Research Festival 2.0 - December 7, 2013
8. Community Resident Researchers
• 30+ community resident researchers in Cleveland
• Training Program Includes:
• Overview of the research process
• Research Ethics
• How to discuss research studies with the community
• Continuing Research Education Credit (CREC)
Certified
2013 Ohio Practice-Based Research Festival 2.0 - December 7, 2013
9. Community Resident Researchers
• Discuss ideas with researchers and staff
• Participate in collecting research data
• Review study materials (i.e. research flyers or
questionnaires)
• Lead and/or participate in focus groups
• Help to explain research studies to study participants
• Review research study results
2013 Ohio Practice-Based Research Festival 2.0 - December 7, 2013
10. Cultural Competency
• The ability to work effectively with individuals of
different cultural backgrounds
• A lack of cultural competence on the part of
researchers may hinder their ability to engage certain
communities
• There is an increasing need to develop and
implement research studies that are culturally
relevant to the needs of various cultural groups
2013 Ohio Practice-Based Research Festival 2.0 - December 7, 2013
11. The Importance of
Cultural Competency
– Enables researchers to understand the needs and
perspectives of different groups
– Increases community outreach and engagement
– Contextualizes research knowledge
– Increases the community relevance of research
findings
2013 Ohio Practice-Based Research Festival 2.0 - December 7, 2013
12. Cultural Competency and the
Research Process
Research
Question
Study Design
Recruitment
Data Collection
Analysis
Dissemination of
Findings
2013 Ohio Practice-Based Research Festival 2.0 - December 7, 2013
13. Cultural Competency
• Increasing researcher’s knowledge,
awareness, skill, and confidence through:
– Seminars
– Education Trainings
– Presentations
– Book Clubs
– Toolkit for Researchers
2013 Ohio Practice-Based Research Festival 2.0 - December 7, 2013
14. Community-Based Research
Consult Service
• Community-Based Research (CBR) takes place in community
settings and involves community members in the design and
conduct of research
• CBR Consult Service assists faculty members, researchers,
residents, students, community members, and community
organizations in developing quality community-based
research
2013 Ohio Practice-Based Research Festival 2.0 - December 7, 2013
15. Community-Based Research
Consult Service
• Provided assistance to 31 Researchers (faculty members,
physicians, students, residents, and community members)
and 11 Community-Based Organizations
2013 Ohio Practice-Based Research Festival 2.0 - December 7, 2013
17. Spanish Translation Service
• Spanish translations/adaptions and English
back translations for the following:
• Questionnaires
• Study Instruments
• Flyers
• Consent Forms
2013 Ohio Practice-Based Research Festival 2.0 - December 7, 2013
18. CBR in Action
• Collaboration between the CRHD and licensed
massage therapists
• Primary Aim: Determine the effectiveness of
intradialytic massage on the frequency and severity of
cramping among hemodialysis patients prone to lower
extremity cramping during treatment.
• Received funding through a PBRN Microgrant
2013 Ohio Practice-Based Research Festival 2.0 - December 7, 2013
19. Effectiveness of Intradialytic Massage
on Cramping in Dialysis Patients
• Participants included 32 (16 intervention, 16
control) hemodialysis patients
• 3 licensed massage therapists were trained in
the study massage technique and tested for
inter-therapist consistency
2013 Ohio Practice-Based Research Festival 2.0 - December 7, 2013
20. Effectiveness of Intradialytic Massage
on Cramping in Dialysis Patients
• Intervention group received a 20
minute massage during each
hemodialysis treatment for 2 weeks
(6 massage sessions)
• Control group received usual care
by dialysis staff
• All participants were interviewed
by study staff at the beginning and
end of the study regarding his or
her experience with cramping pain
2013 Ohio Practice-Based Research Festival 2.0 - December 7, 2013
21. Effectiveness of Intradialytic Massage on
Cramping in Dialysis Patients
Intervention
n = 11
Control
n = 15
5.4 (0.8)
0
mean (SD), n
3.2 (2.4)
2.5 (3.3)
0.05
Baseline cramping at dialysis (interview), mean (SD), n
2.7 (2.3)
2.5 (1.7)
1
Change in cramping at home from pre -study to post
study (interview), mean (SD), n
-2.5 (2.4)
-0.3 (1.0)
0.005
Change in cramping at dialysis from pre-study to post
study (interview), mean (SD), n
-1.6 (2.7)
-0.9 (1.5)
0.44
Total massages received, mean (SD), n
Baseline cramping at home (interview),
P value
2013 Ohio Practice-Based Research Festival 2.0 - December 7, 2013
22. Effectiveness of Intradialytic Massage
on Cramping in Dialysis Patients
• Important Considerations
– Knowledge and Awareness of Target Population
– Respect of Persons and Rapport Building
– Clear explanation of Informed Consent Form
– Participant Stipend ($25 Giant Eagle Gift Card)
• Future Directions: Design study on larger scale
2013 Ohio Practice-Based Research Festival 2.0 - December 7, 2013
23. Conclusion
• Seek and incorporate community input
• Establish bi-directional relationships with the
community
• Incorporate cultural considerations into all
aspects of the research process
• Turn data into action!
• Disseminate research findings to the
community
2013 Ohio Practice-Based Research Festival 2.0 - December 7, 2013
