What makes community research unique?
We first want to point out that Chelsea is a special community. The strength of the bonds of its members (and overall resiliency) and yet the depth of its needs seem to draw out the best in providers and researchers.
We are inspired to care for this diverse population and to study healthcare disparities in hopes of closing gaps. We emphasize research efforts which respond to community needs and priorities, studying topics of importance to the community such as health outcomes in multi-cultural populations, the social determinants of health, or health issues that impact Chelsea, such as substance use.
Our research often involves partnerships between researchers and community stakeholders towards common ends, and is often shared and disseminated within the community once completed, such as at our annual MGH Chelsea Community Research Day.
As much as possible, we aim to involve community partners from the development of the research question to the recruitment of participants, analysis of data and dissemination of the results.
What are some of the key issues that clinical care teams encounter in community healthcare?
Our patients have many barriers to accessing medical care including limited financial resources, reduced English proficiency, and mental health needs. They may be unfamiliar with the concepts of preventative care or other types of treatment due to their cultural background.
Transportation barriers and reduced education and health literacy impact adherence to diagnostic and treatment plans as well.
The MGH Chelsea Research Program offers an opportunity to discuss these clinical issues across disciplines and explore solutions that are innovative, resourceful, evidence-based and respond to the needs we observe.
What are some ways that your team is working to build relationships with other community health centers (MGH Revere, etc.)?
We invite colleagues from all of Mass General's community healthcare centers to attend and present at our monthly Roundtable meetings, as well as at our annual Research Day. We have regular participation from colleagues at MGH Revere, MGH Charlestown and MGH Boston. We have shared our model with administrators at MGH Charlestown, who are interested in starting a Roundtable at their healthcare center.
How can researchers and members of the community work together to further research goals? Are there examples of successful partnerships that we could mention?
At our second annual MGH Chelsea Community Research Day in October, our panel discussion featured two groups of research collaborators.
Primary care physician Hong Chen Cheung, MD, has been working with Robert Rapucci, executive director of the largest anti-poverty community agency in Chelsea called CAPIC, Inc. (Community Action Program Inner City) and with Ruben Rodriguez, director of the Hope of Christ Ministry, to identify the medical and spiritual needs of Chelsea's homeless.
Towards that end, she and her colleagues have been meeting with homeless individuals who reside under the Tobin Bridge, providing basic medical treatment and building relationships with hopes of encouraging them to seek the proper medical treatment, substance abuse treatment, and spiritual healing they need.
Dr. Chen Cheung, Repucci and Rodriguez reported on their efforts quite movingly at the event.
A newer but equally promising collaboration is between Martinos Center neuroscientist Eve Valera, PhD, and behavioral health social worker Georgia Green, LICSW, to screen women who have been victims of domestic violence for traumatic brain injuries.
- Learn more about Dr. Chen Cheung's Collaboration with CAPIC
- Learn more about Dr. Valera's collaboration with Georgia Green
Can the insights that come from community research projects be applied to the larger healthcare system? If so, do you have any examples?
Yes, we can think of a few examples. One example comes from our colleague, Efren Flores, MD, who presented his study of barriers in the care of radiology patients. He suggested that "no-show" appointments be re-conceptualized as "missed care opportunities," and several Departments have adapted this lexical change.
A second example is in regards to the work of Sanja Percac-Lima, MD, who piloted a patient navigation program 10 years ago for a group of patients from racial/ethnic minority groups who were at risk for cancer.
Working in conjunction with community health centers, the navigators reached out to those who were due for medical care and helped to guide them through the health care system and overcome barriers to accessing medical services.
This model has been expanded to other populations such as patients who have unstable housing, critical medical conditions, or are refugees, as it has been effective in increasing adherence to care and reducing cost of care across several high-risk populations.