Wisconsin Campus Compact
Civic Engagement Institute
March 26, 2015
Syed M. Ahmed, MD, MPH, DrPH
Senior Associate Dean for Community Engagement
Professor, Family and Community Medicine
Director, Community Engagement Key Function of
Clinical and Translational Science Institute of Southeastern Wisconsin
Medical College of Wisconsin
Email: sahmed@mcw.edu
“…the most valuable ‘product’ of education
are the ability to use knowledge and skill to
solve unscripted problems to explore the
frontiers of knowledge and understanding,
and to experience life in deeper way.”
(Lingenfelter, 2012)
Community
Ahmed, SM, Medical College of Wisconsin, 2010
Academic
4

Community Engagement in Research (CEnR)

Community Engagement in Research/ Community Engaged Research (CEnR)

Community Based Participatory Research (CBPR)

Community Academic Partnership (CAP)

Community Based Research (CBR) (Canada)

Community Based Participatory Action Research (CBPAR)

Dialogue Research

Involved Research (UK)

Community Engaged Scholarship

Action Research (AR)

Participatory Action Research (PAR)

Empowerment Research

Community Service

Service Learning
Community Perspective
 Community Demand
Can not be just “subject”
 Demand for elimination health disparities
Potent
alternative to “outside expert” driven research
 Active participation of the target population
 Incorporation of local knowledge which overcome
“community distrust” of academic research
 Provides resources (e.g. funds, training, job opportunities
for communities (Israel et al, 1998)
 Interest in the contextual factor (e.g. social, economical,
cultural, environmental, etc.)
Ahmed, SM, Medical College of Wisconsin, 2010
Academic Perspective
 Failure of “Traditional” research approaches:
 98% of Americans receive their health care outside of academic
medical centers
 The challenge of “Translational Research”
 Enhance the relevance and use of the research data by all
partners
 Funder Demand
Need to see impact
 IOM report 2003, Who Will Keep Public Healthy? Educating
public health professionals for the 21st century.
 IOM report 2013, The CTSA Program at NIH: Opportunities
for Advancing Clinical and Translational Research.
Ahmed, SM, Medical College of Wisconsin, 2010
7
PRINCIPLES OF COMMUNITY ENGAGEMENT
Defined
Community
& Program
Scope
Strong
CommunityAcademic
Partnership
Community
Equitable
Power and
Responsibility
Capacity
Building
Effective
Disseminatio
n Plan
Academic
Ahmed, SM, Medical College of Wisconsin, 2010
Based on: 5. Ahmed SM & Palermo AS. 2010. Community Engagement in Research: Frameworks for Education and Peer Review. American Journal of Public Health. Vol. 100,
No 8: 1380-1387.
 Slow evolution of CEnR
 Resistance to new concepts
 Questions of legitimacy as a research
paradigm
 Questions of lack of data on effectiveness
of CEnR
 Lack of leadership
 Lack of funding
Ahmed, SM, Medical College of Wisconsin, 2010
9
 “Novel” idea
 Lack of leadership
 Lack of faculty with CEnR expertise
 Lack of infrastructure support
 Faculty development issues
 IRB issues
 Missing “boat” vs. Jumping on “bandwagon”
Ahmed, SM, Medical College of Wisconsin, 2010
10
Number (%)
Mission
• Engagement language clearly delineated
and representing at least 20% of statement
12 (8.6)
• Engagement language clearly delineated
and representing less than 20% statement
10 (7.1)
Goldstein AO & Sobel Bearman R. Community Engagement in US and Canadian Medical Schools. Advances in Medical
Education and Practice. 2011:2; 43-49.
Community Service and Engagement
Number (%)
• Used as primary or major criteria in promotion
or tenure
10 (8.5)
• An area of excellence or one of a set of
standards included in promotion and tenure
30 (25.6)
• Taken into consideration in promotion and
tenure but is not a primary criteria or one of a
set of standards
29 (24.8)
• Not mentioned in consideration of promotion
and tenure
48 (41.0)
Goldstein AO & Sobel Bearman R. Community Engagement in US and Canadian Medical Schools. Advances in Medical
Education and Practice. 2011:2; 43-49.
Recipient of an AAMC medical school
award for outstanding community
service*
Number (%)
12 (9.6)
Four medical schools received Carnegie
Classification for Community Engagement**
*Goldstein AO & Sobel Bearman R. Community Engagement in US and Canadian Medical Schools. Advances in Medical Education and
Practice. 2011:2; 43-49.
**Carnegie Community Engagement Classification, Classified Campuses.
http://nerche.org/index.php?option=com_content&view=article&id=341&Itemid=92
 Lack of education/training
 Lack of role model
 Skepticism
 Promotion & tenure issues
 Lack of support: departmental &
institutional
 Considerable investment of time and energy
to build and sustain relationship
Ahmed, SM, Medical College of Wisconsin, 2010
14

Definition of “Community”

Communities are not mono-liths

Lack of trust of academia

Not Same missions / goals / priorities

Lack of understanding of CEnR

Lack of understanding of roles / responsibilities

Lack of skills in developing partnerships with academics

Funding issues

Who owns data?

Who disseminates?

Considerable investment of time and energy to build and sustain
relationship

Location of “power” in the partnership
Ahmed, SM, Medical College of Wisconsin, 2010
15
Healthier
Wisconsin
Partnership
Program
Healthier
Wisconsin
Leadership
Institute
Advancing a
Healthier
Wisconsin
Community
Engagement
Key Function:
Science Cafés
CTSI SMART
Teams
Clinical and
Translational
Science
Institute
CEnR Course
Medical Legal
Partnership for
Children
Reach Out &
Read-MKE
Personal
Responsibility
Ed Program
InterInstitutional
Programs
Hmong Health
Education
MKE
Adolescent
Health Program
Family & Community
Medicine:
Center for Healthy Communities
& Research
Residency Programs with
Waukesha, St. Joe’s Hospital, and
Columbia St. Mary’s
Injury Research Center
Violence Prevention
Initiative
Health Equity and Urban
Clinical Care Partnerships
Psychiatry:
Departmental
Programs
MCW Library
Services
Community
Engagement
Mission
(Senior Associate
Dean for
Community
Engagement)
Institute of Health and
Society:
Inter-Departmental:
Center for AIDS
Intervention Research
Pediatrics:
Degree Programs:
Medical Student Programs:
Urban and Community Health Pathway
MPH/PhD in Public & Community Health
(IHS)
Center for the
Advancement for
Underserved Children
Center for Clinical
Effectiveness Research
Project Ujima
Global Health Pathway
Educational
Programs
MS in Clinical Translational Science
Primary Care Post-doc Fellowship
Undergrad/High School:
Events:
Courses & Groups:
AIM Summer Program
CEnR
Conferences/
Webinars/Work
shops
Global Health Organization
ROADS Summer Program
SMART Teams
MCW Council on AIDS
Saturday Clinic
 MCW Faculty Community Engagement Survey
is the first survey of its kind by MCW to
gather campus- wide data on CE activities
 Issued July-August 2014
 Five survey questions:





CEnR & CBPR Projects,
Publications,
Coursework,
Awards, and
Outreach activities
Total Number of CE Activities Reported
600
500
483
400
300
200
143
100
101
75
54
0
1
CBPR Projects
Publications
Courses
Awards
Outreach
Of the 658 MCW faculty
members who submitted
survey responses, 42.86%
reported communityengagement activities over
the past 12 months. These
community engaged faculty
represented 17.80% of all
MCW Faculty who were
included in the survey
distribution, both reporting
and non-reporting.
% of MCW Faculty at Reporting
Community Engagement Activities
Faculty- Emeritus
Faculty - Term
Faculty - Full-Time
Faculty - Total
Faculty - Part-Time
0.00%
2.41%
%of all Faculty
10.64%
18.93%
17.80%
0.00%
50.00%
% of Respondents
62.50%
42.77%
42.99%
Social Networking Analysis
Preliminary Visualization of Funding Cycles: Projects and Partners
SNA of HWPP Funding Years 2005-2008
MCW C-A Partnerships
SNA of HWPP Funding Years 2009-2013
MCW C-A Partnerships
DryHootch iPeer: A Social & Technology Support Program for Veteran Mental Health
Improve access to trained peer mentor support for younger veterans at risk for mental
health problems on college campuses using a combination of face-to-face and smartphone
interventions.
Marquette is a partner in 4 other projects
Community Partners
• Dryhootch
• Marquette University
• Mental Health America
• UW-Milwaukee
• Edgewood College
• Waukesha Technical College
• VA (Linked in this project
through jointly appointed
faculty at MCW)
UW-Milwaukee is a partner in 3 other projects
 Qualitative Content Analysis of 109 final reports from
community-academic partnerships written for the Healthier
Wisconsin Partnership Program.
 Used method described by Altheide (1):
 Familiarization with the context of the information source.
 Familiarization with 6-10 relevant examples and select a unit
of analysis
 List several items or categories to guide data
 Test the protocol by applying it to several documents
 Revise the protocol following the testing of additional cases
Attribute
Definition
Community
Involvement
Involvement of the community in projects outside of the
partnerships including references to using surveys as a means of
engagement.
Collaboration
Explicit or implied references to work or accomplishments
completed in collaboration.
Communication
All items related to communication including written, verbal and
the physical translation of documents.
RelationshipBuilding
Aspects of the partnership that relate to trust and respect.
Attribute
Definition
Best Practices
Partnerships describing the use of peer-reviewed material including
the use of evidence-based tools.
Clarity
Aspects of project that need clarification or insight gained as a result
of something that occurred during the process of the project.
Strategic
Planning
Partnerships developing a plan or objectives gained from
information gathered during the process of the project. Strategic
planning may include the use of an “advisory committee.”
Potential Challenge
Definition
Sustainability
Continuing at least a portion of the project after the grant has
concluded.
Administration
Administrative aspects of the partnership including aspects of
human resources, budgeting, and finance.
Adjustment to Plan
Making adjustments from the original partnership plan or
proposal. “Adjustment of the Plan” differs from an adjustment
due to a strategic plan process.
Time
All aspects related to time.
Table 3. Mean and Standard Deviations for Scientific and Health Literacy Areas. The following table outlines
the means, standard deviations and difference values between pre-Café ratings and retrospective pre-ratings for
each of the self-reported measures of scientific and health literacy
*Paired samples t-test: statistically significant at p< .001, one-tailed Scale of 1=low to 7=high
Mean
Post-Scores
(N= 141)
s.d.
Mean
Retrospective
Pre-Scores
(N=141)
6.2*
0.9
5.5
1.5
.70
Ability to tell what information is trustworthy or not on [this Science
Café’s topic]
6.1*
1.1
5.4
1.5
.65
Ability to find other sources of information on [this Science Café’s topic]
6.2*
1.1
5.7
1.4
.52
Ability to speak to a scientist or a health researcher
6.2*
1.1
5.6
1.5
.60
General understanding of the methods used by scientists
6.0*
1.1
5.5
1.5
.50
Scientific and Health Literacy Areas
s.d.
Difference
(95% CI)
I am confident in my…
Ability to talk about [today’s Science Café topic] with a health care provider
•
•
•
Increase in self-rated confidence in scientific and health literacy on the topic post Science café
No difference between repeat and new attendees
Continue to use scale to evaluate impact of Science Café on attendees self-reported confidence in scientific and
health literacy
 Community Engagement is as much as an
art as it is a science.
 “When facing a difficult task, act as if it is
impossible to fall. When going after Moby
Dick, bring along the tartar sauce.”—Anon
 Never doubt that a small group of
thoughtful, committed citizens can change
the world; indeed, it's the only thing that
ever has.-- Margaret Mead