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CCHERS NewsLetter
Spring 2003
(Feature Article)
CCHERS Funded by NIH for National Center for Reducing
Disparities in Asthma
The Asthma Center on Community Environment and Social Stress
(ACCESS), a partnership between the Center for Community
Health Education Research and Service, Inc. (CCHERS), the
Channing Laboratory at Brigham and Women's Hospital and
the Harvard School of Public Health, was funded in October
by the National Heart Lung and Blood Institute (NHLBI) of
the National Institutes of Health (NIH) as one of five national
centers for reducing racial, ethnic, and socioeconomic health
disparities in asthma.
The funding strategy is unusual among the NIH Institutes
in requiring a partnership between a "research intensive
institution" and a "minority serving institution"
submitting a single proposal but two separate applications.
The funding was awarded in two separate grants to the two
partnering institutions. According to NHLBI Director, Dr.
Claude Lenfant, "The partnering institutions in each
Center will teach each other and build opportunities in
this scientific area of reducing health disparities. We
envision the research intensive institutions becoming more
adept in applying resources to culturally responsive research
and the minority-serving institutions gaining organizational
infrastructure and experience for future research."
CCHERS is the only community-based organization among the
five centers and the ten institutions that were funded.
This unique partnership will focus its study of asthma
disparities in key neighborhoods of Boston through the CCHERS
network of participating community health centers. Academic
and community researchers will, (1) conduct comprehensive
community assessments; (2) determine the role of socioeconomic
and environmental exposures; (3) determine the role of genetics
in modifying the risk of social/physical environment; and
(4) evaluate the effectiveness of existing asthma interventions.
The effort will by led by Dr. Cynthia Piltch on the CCHERS
side and Dr. Rosalind Wright on the Harvard side and also
includes a focus on training that promotes collaboration
between the academy and the community; and development of
a model for community-based participatory research to reduce
disparities.
ACCESS will be guided by a Community Advisory Board composed
of a diverse group of individuals - community residents,
families, practitioners, opinion leaders and others to share
their special knowledge and expertise on community, academy,
health, and/or asthma to advise and support the work of
the Center.
Contact: Dr. Dawna Thomas, ACCESS Project Director, CCHERS
- daw.thomas@neu.edu
(Secondary Articles)
Community Advocacy Program Partners with Greater Boston
Legal Services
The community health centers that comprise the Community
Advocacy Program (CAP) of CCHERS will soon have legal advocates
along with the case management advocates in their domestic
violence program on site at the health centers. The CAP
and Greater Boston Legal Services (GBLS) Family Law Unit
have developed a unique collaboration to strengthen the
services offered to victims of domestic violence in Dorchester.
GBLS lawyers and advocates will be on site at the health
centers to provide clients with direct access to legal services.
GBLS Staff Attorney, Abbe Hershberg believes "a partnership
between the CAP program and legal services is an ideal way
to provide a more holistic approach to client service, to
be more responsive to community need, to better reach clients
of color and cultural and linguistic minorities, and to
use community legal education to increase family law knowledge
for health center advocates, staff and clients."
Monthly intake and client information sessions will occur
at Bowdoin Street, Codman Square, Dimock, Dorchester House,
Little House, Neponset, and Uphams Corner health centers.
Staff of GBLS will meet directly with referred clients for
intakes for legal advice and/or representation if appropriate.
General sessions will be held to educate clients about their
rights and the legal system.
Contact: Sue Chandler, Director, Community Advocacy Program,
CCHERS - s.chandler@neu.edu
Clinical Pharmacy Practices Achieve Cost Savings and Patient
Compliance
The Boston Clinical Pharmacy Practice Network (BCPPN),
a demonstration project funded by the Health Resources and
Services Administration, Bureau of Primary Health Care,
Office of Pharmacy Affairs is demonstrating that the introduction
of clinical pharmacists into primary care teams improves
compliance and patient outcomes, and ultimately reduces
the costs associated with care. The collaborating partners
are CCHERS, Northeastern University School of Pharmacy and
four community health centers (Harvard Street, Neponset,
Uphams Corner and Whittier Street).
Clinical pharmacists, faculty members at Northeastern provide
disease case management and clinical pharmacy care to community
health center patients. The focus is on those chronic diseases
most disproportionately affecting racial and ethnic minorities
in urban communities, pediatric asthma, diabetes, and hypertension.
These health center based pharmacy practices also provide
valuable clinical experiences for up to eighty pharmacy
doctoral students.
The project seeks to inform federal and state policy makers
with regard to the availability and affordability of prescriptions
drugs, particularly those purchased through the section
340B Drug Pricing Program of the Public Health Service Act;
and to the cost savings of an expanded role for clinical
pharmacists by improving patient compliance and outcomes
for underserved populations.
Contact: Gregory Ewing, Project Director, Boston Clinical
Pharmacy Practice Network, CCHERS - g.ewing@neu.edu
CCHERS Receives Funding to Organize and Coordinate Regional
CCPH Network
Community Campus Partnerships for Health (CCPH), a national
organization that builds the capacity of communities and
higher education institutions to develop and sustain partnerships
that improve health through service learning, community-based
participatory research, community health coalitions, and
other collaborative strategies has awarded a grant to CCHERS
to serve as the organizational home of the New England Regional
CCPH Network.
Since its inception in 1996, CCPH's programs, products
and activities have primarily been aimed at the national
level. However in January 2003, CCPH launched four regional
networks as a strategy for advancing its mission and providing
greater value to its members. With a growing network of
over 1000 communities and campuses nationally, the regional
networks are intended to support and invigorate local community-campus
partnerships through such activities networking meetings,
information exchange, professional development and membership
expansion. These partnerships are powerful tools for improving
health professions education, promoting civic responsibility
and contributing to the overall health of the community.
"The regional network will provide a way to insure
the necessary communication and connection between CCPH
at the national level with the grassroots efforts of its
membership at the community level," according to Elmer
Freeman, Executive Director of CCHERS and Chairman Elect
of the Board of Directors of CCPH. Individuals that represent
the University of Massachusetts Medical School, Northeastern
University Bouvé College of Health Sciences, and
the Health Services Partnership of Dorchester join CCHERS,
as the lead agency for the New England network, on the steering
committee.
Contact: Beverley Russell, Director Health Professions
Education, CCHERS - be.russell@neu.edu
Health Careers Academy Receives Five Year Charter Renewal
The Health Careers Academy (HCa) founded by the CCHERS
partnership in 1995 as a pilot high school of the Boston
Public Schools which then became a Horace Mann Charter School
in 1998, received a five-year renewal of its charter from
the State Department of Education in February. In a letter
to Board Chairman, Elmer Freeman and Headmaster, Albert
Holland, Commissioner of Education, David Driscoll stated,
"the charter school initiative is a key component of
education reform in Massachusetts, and your school has proved
what a strong vision, high standards and hard work can accomplish
for the students of Massachusetts."
A small college preparatory high school, located on the
campus of Northeastern University, the HCa is part of a
seamless pathway for students leading into the health professions.
Through internships and job shadowing programs, HCa students
gain valuable workplace experience in community health centers,
hospitals, pharmacies, nursing homes and public health programs,
which help the students discover career interests.
Through its strong partnership with Northeastern University,
students of the HCa have access to state-of-the-art university
level facilities and selected courses. HCa offers students
exposure to college … and a close nurturing environment
at the same time.
Contact: Albert D. Holland, Headmaster, Health Careers
Academy - aholland@boston.k12.ma.us
News Briefs
DPH Study of Domestic Violence Programs at State's CHCs
The Massachusetts Department of Public Health (MDPH) engaged
CCHERS to survey community health centers (CHCs) in Massachusetts
about their domestic-violence related services and activities.
Areas reviewed included screening, assessment and intervention,
information and referral of victims, as well as training
and other institutionalized initiatives. Through the collaborative
efforts of the Project Advisory Committee, comprised of
government and community-based representatives, the survey
was completed by the vast majority (76%) of the state's
CHCs. Results of the survey have led the MDPH to fund CCHERS
to conduct site visits to seven of the CHCs identified to
have comprehensive protocols for addressing domestic violence.
This effort will explore how the protocols "come to
life" in the centers and offer insights about potential
"best practices" among CHCs with domestic violence-related
services. The information will help the state officials
identify needs and implement policy initiatives to increase
resources and support in this area.
Contact: Cynthia Piltch, Director, Research and Evaluation,
CCHERS - c.piltch@neu.edu
CCHERS Hosts Discussion on Racism and Heart Disease
After viewing the video documentary, "The Angry Heart:
The Impact of Racism on Heart Disease Among African Americans"
a panel of distinguished health professionals and community
representatives discussed the association between disproportionately
higher rates of cardiovascular disease morbidity and mortality
among African Americans in a forum sponsored by CCHERS,
the Cardiopulmonary Exercise Sciences, and African American
Studies Departments of Northeastern University.
The Angry Heart documents the story of now 45 year old
Keith Hartgrove, who experienced two heart attacks and underwent
quadruple bypass surgery. While the many experts interviewed
in the video recognize the variety of factors contributing
to health status, they make it clear that for African-Americans
"such factors are inseparable from racism, and from
the discrimination, poverty, segregation, substandard education,
and day-to-day tensions which racism engenders."
Contact: For Video - Fanlight Productions, (800) 937-4113,
www.fanlight.com
Bilingual/Bicultural Outreach Workers Trained in Focus
Group Methodology
With support from the Blue Cross Blue Shield of Massachusetts
Foundation, CCHERS staff have designed a curriculum and
trained a group of Vietnamese outreach staff from Dorchester
House, Little House and Neponset health centers in how to
conduct and analyze community focus groups. The project
has produced a curriculum for training non-researchers in
focus group moderation and established some valuable research
related infrastructure at the three health centers. At Neponset
Health Center, once the domestic violence focus groups were
completed, managers approached the team trained by CCHERS
to ask them to conduct other focus groups with the Vietnamese
community around health center patient satisfaction, and
culturally competent services.
Contact: Cynthia Piltch, Director, Research and Evaluation,
CCHERS - c.piltch@neu.edu
News of Our Partners
Two New Health Centers Join CCHERS Partnership
At its Annual Meeting in January, the CCHERS Board of Directors
voted to admit Brookside Community Health Center and Southern
Jamaica Plain Health Center into the CCHERS partnership.
Affiliated with the Brigham and Women's Hospital, the centers
will be represented on the Board of CCHERS by their respective
executive directors Paula McNichols and Tom Kieffer.
Boston Public Health Commission "Undoing Racism"
In its CDC funded projects in Racial Ethnic Approaches
to Community Health (REACH 2010), the Boston Public Health
Commission (BPHC) has turned its focus to "undoing
racism." The Commission has sponsored on-going workshops
for its staff, contractors, community residents, and public
health practitioners conducted by the People's Institute
for Survival and Beyond, "designed to educate, challenge,
and empower people to undo the racist structures that hinder
social change." Through this effort the Commission
has put their focus on racism as the key to eliminating
persistent health disparities.
Surgeon General Speaks at Opening of Institute
United States Surgeon General Richard Carmona served as
the keynote speaker at a symposium on urban health issues
and the opening of Northeastern University's new Institute
on Urban Health Research under the direction of Distinguished
Professor Hortensia Amaro. "The Institute will prepare
students and faculty to be leaders in urban health research,
develop research partnerships, and translate research into
practice and community-based service," says Dr. Amaro.
Bouvé College of Health Sciences Puts "Health
in Motion"
The Bouvé College of Health Sciences has put its
comprehensive health education and screening van "Health
In Motion: Reaching Out to You" on the road and its
coming to a community health fair near you.
East Boston to Open 340B Pharmacy
The East Boston Neighborhood Health Center announced the
opening of its 340B pharmacy in which the center will own
the pharmacy and contract with a pharmacy management firm
to run it. The center recognizes the benefits of increased
access for patients, physician/pharmacist collaboration,
development of disease management programs, and savings
in costs of care.
Congratulations to Mattapan CHC as Citizen's Community
Champion
Citizen's Bank named Mattpan Community Health Center as
the first recipient of its Community Champions Award recognizing
its exemplary services to the community. The center received
a $25,000 unrestricted grant, media coverage and public
service announcements from NECN, volunteers from staff of
Citizens and NECN, and public relations support.
BMC/BUSM Receive $150,000 Grant from Harvard Pilgrim
Health Care
A new video produced by Boston Medical Center, "Making
Your Home Safe for Children with Asthma," with a grant
from Harvard Pilgrim Health Care was distributed to Boston
HealthNet Health Centers. According to Dr. Susan Steinbach,
Chief of Pediatric Asthma & Allergy at BMC, "it
is a unique disease management tool that not only educates,
but opens dialogue between patient, caregiver and physician."
Executive Director's Corner
This past winter I was invited to participate as a member
of an expert panel convened by the Research Triangle Institute
on behalf of the Agency for Healthcare Research and Quality
and several of the institutes at the National Institutes
of Health to define and identify principles of "community
based participatory research (CBPR)." Our initial efforts
focused on distinguishing between CBPR, participatory action
research, participatory research, action research and related
models having to do with conducting research in communities.
This increased interest in CBPR emanates from increased
emphasis on research that includes communities, is respectful
of communities and seeks to shift the old paradigms in which
academic researchers have engaged with communities but there
has been very little if any benefit to the communities and/or
people being studied. Additionally and probably more importantly
there has been increased emphasis from funders on "partnerships"
the promote change, seeks long-term sustainability and knowledge
transfer.
The experts identified those factors that they believed
distinguished CBPR from all of the others and they all centered
on common principles of partnership:
¢ Joint identification of research priorities with
the community.
¢ Joint ownership or research findings and recommendations.
¢ Building capacity in the community for engaging in
research.
¢ Sharing power and equity in the distribution of resources.
The funding of the CCHERS/Harvard ACCESS partnership (see
page 1) represents a new way of thinking with regard to
how to fund community-based partnerships for conducting
meaningful and relevant research. The strategy of the National
Heart Lung and Blood Institute to award two separate grants
based on a single proposal that details the roles of the
individual partners addresses all of the issues identified
above.
We should hope that this establishes a precedent to be
supported and followed by other government and private funders
that will lead to the development of meaningful partnerships
between the community and the academy.
CCHERS firmly believes that the answer to eliminating racial/ethnic
disparities in health lies in the promotion of partnerships
with communities that ensure the engagement of communities
of color as equal partners in the research being conducted.
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