[MUSIC] Hi, my name is Chidnima Ibe and- >> This is Kim Gudzune. >> And today we're going 'to be talking about engaging community stakeholders in health equity research. So our objectives for this lecture are to define community based participatory research or CBPR. Review CBPR best practices and provides examples of CBPR in real world settings. >> So our first section's going to focus on a general overview of community and health inequalities. We'd like to start off with a quote from Healthy People 2010. Over the years, it has become clear that individual health is closely linked to community health. Likewise, community health is profoundly affected by the collective behaviors, attitudes and beliefs of everyone who lives in the community. Most importantly, partnerships, particularly when they reach out to non-traditional partners, can be among the most effective tools for improving health in communities. We'd now like to pause and have you all actually watch a video that gives some more insight on the community from actual community members in Baltimore, realizing that you all may be from different parts of the country, different parts of the world watching this. So please click on the link on the lecture page, which will take you to the video produced by the American Association of Medical Colleges. Now that you're back from watching that video, we hope that shed a lot of insight on what the community, particularly the community within Baltimore is like. I wanted to introduce a concept here which is the social ecological model, which really emphasizes the multi-level influences of the community on health disparities. So this is a figure that is concentric circles or circles embedded within one another, kind of looking like a clam shell, that really represents the different levels. At the center of the circles is the individual patient. There are factors there like race, socioeconomic status that can affect health and health disparities. The next level out we get to family and social support, here health and health disparities can be affected by family dynamics, family history, financial strain. The next circle out from that is the provider and clinical team, here things can be affected by knowledge of guidelines, technical skills, cultural competency. The next level out from that is organization or practice setting. Here things can be influenced by leadership, how important quality and equity is to the practice overall. And these things can influence care and either contribute to health disparities or inequalities. We have three more levels after this, the next being the local community environment, and this is where the rest of our talk is going to be focused on today. Here we can have income inequality, poverty levels, racial segregation, interpersonal discrimination, crime rates, food availability, all affecting health of an individual. The final two levels are state health policy environment and the final one is national health policy environment. Here we have things like healthcare exchanges, Medicaid expansion, national health initiatives that can all influence health all the way back down to that individual patient level. So now that we have this concept of sort of these stacking layers one upon another, it's also important to think about how these things actually interact with one another. So this figure takes us through some different factors, the first one being social conditions and policies, the next social context, social relationships, the third, individual demographics and individual risk behaviors, and finally, biologic responses and biologic and genetic pathways. So while these are four sort of distinct concepts and all of them can influence health, they actually can also influence one another. So that the social conditions or policies of a community may affect or have a relationship with something like individual demographics of that community. Ultimately then those feed in together and then lead to different health outcomes and in particular health disparities and inequalities. That wraps up our discussion on community and health inequalities, and we'll now transition to community-based participatory research. [MUSIC]
