Engaging Underserved Communities in COVID-19 Health Equity Implementation Research: An Analysis of Community Engagement Resource Needs and Costs
Engaging Underserved Communities in COVID-19 Health Equity Implementation Research: An Analysis of Community Engagement Resource Needs and Costs
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DOI：
10.3389/frhs.2022.850427
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发表时间：
2022-03-17
期刊：
影响因子：
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通讯作者：
Rabin, Adrienn Borsika
中科院分区：
文献类型：
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作者：
Stadnick, Nicole A.;Cain, Kelli L.;Rabin, Adrienn Borsika
背景：有意义的社区参与有助于有效实施和维持公平的公共卫生干预措施。需要大量资源来确保社区参与以文化敏感、值得信赖的方式进行，从而优化积极的公共卫生成果。然而，最适合让社区有意义地参与实施研究的资源类型和成本尚未得到充分记录。本研究的目标是 (1) 描述一种实用方法，用于系统地跟踪和记录社区参与活动所使用的资源，(2) 报告实施研究各个阶段的资源，以及 (3) 为社区参与健康公平实施研究的规划和预算提供建议。方法：社区参与合作伙伴在社区参与的三个阶段（启动、早期、维护）中完成了社区参与活动的人时跟踪日志。 两个实施研究项目，旨在促进服务欠缺社区的 COVID-19 检测和疫苗接种的公平性。这两个项目都在 4 个月内与各自的社区咨询委员会 (CAB) 完成了为期 6 次的变革理论（即，就当前和期望的条件进行了促进小组讨论，最终确定了一系列战略变革的优先事项），社区咨询委员会 (CAB) 包括社区组织者、发起人、联邦合格的健康中心提供者和管理人员以及公共卫生研究人员。报告的促进社区成员参与的工时在项目阶段内和跨项目阶段进行了记录和总结。结果：对于这两个项目，启动阶段需要的工时数最多 (M = 60)，其次是维护阶段 (M = 53) 和早期阶段 (M = 47)。在启动阶段，总共进行了 5 项社区参与活动，其中识别和邀请 CAB 成员所花费的人时数最多（M = 19）。在早期阶段，CAB 会议期间总共开展了 11 项社区参与活动，并协调和领导现场口译（西班牙语），占用的人时数最多（M = 10）。维护阶段包括 11 项社区参与活动，其中将 CAB 材料书面翻译成西班牙语花费了最多的工时 (M = 10)。 结论：研究结果表明，启动期间需要投入最多的资源。尽管活动更加多样化，但在社区参与西班牙语翻译的后期阶段，所需资源有所减少，而在研究的后期阶段则需要最多的资源。这项研究通过提供务实的跟踪和测量方法以及规划和评估成本的建议来促进社区参与和实施科学文献，以促进有意义的社区参与公共卫生实施研究。
Background: Meaningful community engagement is instrumental to effective implementation and sustainment of equitable public health interventions. Significant resources are necessary to ensure that community engagement takes place in culturally sensitive, trusted ways that optimize positive public health outcomes. However, the types and costs of resources best suited to enable meaningful community engagement in implementation research are not well-documented. This study's objectives are (1) to describe a pragmatic method for systematically tracking and documenting resources utilized for community engagement activities, (2) report resources across phases of implementation research, and (3) provide recommendations for planning and budgeting for community engagement in health equity implementation research.Methods: Community engagement partners completed a tracking log of their person-hours for community engagement activities across three phases of community engagement (startup, early, maintenance) in two implementation research projects to promote equity in COVID-19 testing and vaccination for underserved communities. Both projects completed a six-session Theory of Change (i.e., a facilitated group discussion about current and desired conditions that culminated with a set of priorities for strategic change making) over 4 months with respective Community Advisory Boards (CAB) that included community organizers, promotores, federally qualified health center providers and administrators, and public health researchers. The reported person-hours that facilitated community member engagement were documented and summarized within and across project phases.Results: For both projects, the startup phase required the highest number of person-hours (M = 60), followed by the maintenance (M = 53) and early phase (M = 47). Within the startup phase, a total of 5 community engagement activities occurred with identifying and inviting CAB members incurring the greatest number of person-hours (M = 19). Within the early phase, a total of 11 community engagement activities occurred with coordinating and leading live interpretation (Spanish) during CAB sessions incurring the greatest number of person-hours (M = 10). The maintenance phase included 11 community engagement activities with time dedicated to written translation of CAB materials into Spanish incurring the greatest number of person-hours (M = 10).Conclusions: Study findings indicate that the most significant investment of resources is required in the startup period. Needed resources decreased, albeit with a greater diversity of activities, in later phases of community engagement with Spanish language translation requiring most in the later stage of the study. This study contributes to the community engagement and implementation science literature by providing a pragmatic tracking and measurement approach and recommendations for planning for and assessing costs to facilitate meaningful community engagement in public health implementation research.