The DFM continues to seek the advancement of partnered and participatory research activities in Sun Valley and other communities. We learned many lessons and continue to move forward from partnered community programs to participatory research. In aggregate, it is precisely the nurtured strong community ties that distinguish this community partnership, built from a person-by-person or family-by-family intervention that honors the community’s
view of health priorities and addresses them alongside our
own program agendas. Because the DFM and all involved with these projects are also affected by the community members’ successes and challenges, we are motivated to develop further programs, and we are able to learn from the experiences acquired while enjoying the benefits of being part of such a vibrant and resourceful community. One of the authors (G.M.) participated as a medical student and was motivated to seek advanced CBPR training in the Robert Wood Johnson Clinical Scholars program.25
Overall, UCLA faculty has gained better insight on the benefits of continuity in working with communities.
Within our experience are many implications for other academic departments of medicine. It takes a long time for community research to yield concrete results, and our lessons learned in almost a decade of sustaining a high level of community engagement may inform other departments seeking to develop community programs. Furthermore, our partnered projects provide an important opportunity for medical students and residents to become involved with partnered and participatory projects and learn about community medicine. Students learn the process of conducting scholarly community research with the active participation of community members. They actively engage with community promotoras, our academic–community champion physician, and local policy stakeholders. We also offer community medicine rotations for family medicine residents and elective clerkships for UCLA and Charles R. Drew University medical students. Many of the participating students are from underserved communities themselves. Overall, experiences for students and faculty have been positive and have contributed greatly to the sustainability of our partnerships.
Our experience demonstrates that it is possible for academic medicine departments to sustain long-term scholarly community engagement and generate innovative products that build community capacity. The high value of our programs to the community may help ensure sustainability despite financial challenges. For example, funding is coming to an end for the promotoras in our walking groups, but the promotoras have begun the planning phase of a new community nonprofit organization that will focus on the health needs of Sun Valley and sustaining the walking groups.
It is important to highlight the significance of data collection for our community research projects. Participants learn about ethical issues (i.e., randomization) and limitations of data collection in underserved communities. Not only does data collection provide a scholarly community-research experience for students, faculty, and community, but it also helps inform and shape programs. The formative research data collected from our asthma screenings were needed to conceive our community walking groups program. Subsequently, the focus group, family survey, and community stakeholder data were essential to the design of the walking groups.
Looking ahead, we plan to study the effect of the asthma screening program and family intervention sessions on intermediate outcomes for asthma (emergency department visits, hospitalizations, frequency and severity of symptoms, and use of controller medications) and quality of life.26
Our control group will receive standard asthma care from their primary care providers. We are also currently conducting a small pilot weight-loss intervention for participants in the walking groups. Promotoras
and medical students have collected baseline data from 98 participants. We aim to determine the effect of weekly weighing versus no weighing on participant weight loss and walking group attendance. In addition, we will explore how community walking is related to participants’ depression scores.
After nearly a decade of community-partnered and community-participatory initiatives involving a needs assessment, HPSA and MUA community designation, school-based asthma screening, a community walking groups project, and a new comprehensive primary care clinic, the community trusts the UCLA DFM enough to join in participatory research. This collaboration only occurred after we earned the community’s overall trust and demonstrated we could provide a concrete service that they needed and valued: access to affordable, high-quality primary care for all children and families in the community.