a community health center’s perspective on the feasibility, reality and benefits of research
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A Community Health Center’s Perspective on the Feasibility, Reality and Benefits of Research. Myechia Minter-Jordan MD, MBA President and CEO The Dimock Center. Goals for our discussion today. Develop an understanding of the potential strategies for research engagement - PowerPoint PPT PresentationTRANSCRIPT
A Community Health Center’s Perspective on the
Feasibility, Reality and Benefits of Research
Myechia Minter-Jordan MD, MBA
President and CEOThe Dimock Center
Goals for our discussion today Develop an understanding of the potential
strategies for research engagement Understand how to develop and maintain
community education on research principles Develop a strategy for engaging your health
center in community based participatory research
Develop a strategy for engaging academia in community based initiatives
Understand the pros and cons- and be prepared for them
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Topics to be Covered
Different models of approaching research IRB, Ethics Committee, Education and Engagement
Dimock’s decision making process- what did we decide and why?
Engaging in research What makes sense for your organization
Dimock’s experience Challenges and benefits of engaging in research
Our Mission
At Dimock, we believe every life is precious. We commit to enhance the quality of life of each individual we serve, of the people we employ, and the communities in which we live by providing accessible, comprehensive, innovative, culturally competent health and human services.
Our Vision
Our Vision is a healthy community where we make a difference in every life.
Behavioral Health Child and Family Health Services
Detox Early Head Start Pedi
Outpatient addiction services
Head Start Adult
Adult/Pediatric MH Preschool Eye
Recovery Homes Early Intervention Dental
Shelter GED HIV
Residential Svcs OB GYN
Over 17,000 patients and 70,000 visits/yr
What is an IRB? Local independent committee that reviews and
approves human subject research before it can begin
Main responsibility: to protect the rights and welfare of human research subjects
• Including vulnerable populations
Ensures No “Conflicts of Interest
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Why is an IRB Significant for a community health center?
All institutions that accept research funding from the federal government must have IRB review of research involving human subjects
Even if a given research project does not involve federal funds, ethical principles and good clinical practice call for review and approval (by an IRB) to provide public assurance that the rights, safety, and well being of participants are protected!
Patients, families and clients served at community health centers often represent our most vulnerable patients
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Approaches/Models to engagement in research
Ethics Committee Local IRB Review
Organization/Institution has its own IRB Utilize Other IRB (cede review, affiliations)
Organization/Institution relies on another IRB for single studies or all studies
IRB Reciprocity Multiple sites form a consortium Utilize one of the IRBs (from consortium) for review of a
collaborative protocol (e.g. Harvard Catalyst) Central IRB
Independent/Commercial IRB (pay for service)8
Why did we think about this issue?
Multiple requests for research Lack of internal knowledge about how to
conduct research Increased reliance on academic partners Need for community input Ongoing data collection- what could we
learn from it? Ethics Committee vs. IRB
Creating a Research Community
Role of the Community Health Center : Close gap between community and researchers (build
trust) Share information with the community at start of the
study, during the study and at the end(results) Share community concerns – be their voice! Offer diversity (race, gender cultural background) Help define the research community
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Challenges
Cultural challenges- think “Champion” Infrastructure-consider partnerships Research vs. productivity- grants? Research vs. Mission Building a business case Organizational buy-in
The Dimock Experience
Connection with HSPH Compilation of policies/procedures/forms Initial Training Choosing members Filing of necessary documentation Creation of a research champion Ongoing training
TrainingThose individuals involved in the conduct of research must have a basic understanding of:•Historical background and landmark documents•federal regulations and research ethics and how they relate to their individual role in the project•important research-related definitions such as: Human Subject, Research, and Informed Consent•an IRB; what it is, what rules it must follow and why
Training should be initial and ongoing!
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How to Fulfill Training Requirements
CITI Training
Alternative Training
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Benefits Involvement of the health center board-
consumers! Leverage patient relationships to engage in
efforts to improve care Autonomy- choosing what is best for your
patients Enhancing and creating partnerships Recruitment and retention of providers
More Benefits…
Make use of your HIT Direct impact on care delivery Funding opportunities Staffing Increasing the visibility of your
organization
The Dimock IRB- status update Study review examples
1. Focus groups to assess acceptability of pre-exposure prophylaxis of HIV among Black Women
2. Sex differences in Infants activity preferences 3. Survey to Assess Acceptability of HIV Pre-Exposure
Prophylaxis among Black women 4. A Comparison of Individual Versus Practice Level
Operationalizations of the Medical Home 5. Using Recovery Support Navigators and Incentives to
Improve Substance Abuse 6. Medicaid Client Outcomes and Costs
The Dimock IRB- status update Cultural change-excitement and engagement Impact on patient care- e.g. internet usage study Enhanced recruitment and retention Ongoing training Ceding General perspectives on research at Dimock Ongoing academic collaborations
Top Ten Reasons Engage in Research
1. Your patients 2. Your community 3. Your providers 4. Your care delivery 5. Your organization 6. Partnerships 7. Use of Data 8. Funding 9. Influence 10. Visibility and Prestige
Contact Information
Myechia Minter-Jordan MD, MBA President and CEO The Dimock Center
Email: [email protected]