The Ethics and Practice of Digital Storytelling as a Methodology for Community-Based Participatory Research in Public Health
Moderator: Alice Fiddian-Green, PhD student, Department of Health Promotion and Practice, School of Public Health and Health Sciences, University of Massachusetts Amherst.
Presenters and Session Titles:
“An Ethics Framework for Digital Storytelling as a Multi-Purposed Public Health Method”: Aline Gubrium, PhD
Applying the Ethics Framework in Two Projects: (1) Louis Graham, MPH, DrPH, and Sarah Lowe, MPW: “Stakeholder Engagement and Ethical Planning for Digital Storytelling: The MOCHA Moving Forward Project” (2) Mary Paterno, CNM, PhD: “Digital Storytelling as Health Promotion and Data: Ethical Considerations from a Peer-Mentor Based Project to Address Perinatal Substance Use Disorder in a Rural Community"
Public health often mislocates its lineage in the medical sciences. Being foremost about people and what happens when people live together, the field is equally rooted in the humanistic and social sciences. By providing a focus that is more open to the rich and variegated tapestry of health and wellbeing, participatory visual and digital approaches, such as digital storytelling, enhance understandings of health and well being. If carried out responsibly, digital storytelling has the potential to function both as a vehicle for community-based health promotion, and as a method for collecting culture-centered data that can assist researchers and practitioners in better serving local communities. Based on a Freirian model, which promotes active engagement as participants construct stories to promote change through a group process, the goal of our digital storytelling practice is to provide a creative forum for expressing the generative themes or collective issues of community members. Beyond being mere data points, digital stories enliven statistics, make research meaningful, and position research participants as experts in their own right by inviting them to define relevant issues, broaden the evidence base, and create an emotional product that attracts and influences policymakers and the public at large. Finally, digital stories can be re-purposed for use in health communication campaigns (on and offline) to effect broad reach.
Published literature on the ethics of community-based participatory research methods grounded in personal storytelling and participatory media approaches is in short supply, as are advanced training opportunities for public health researchers interested in these approaches (Gubrium & Harper, 2013; Gubrium, Hill, and Flicker, 2014; Gubrium, Hill & Fiddian-Green, 2016). Based on their previous research and practice experiences with digital storytelling, Gubrium and colleagues (2014) discuss the “situated practice of ethics” for participatory visual and digital methods in public health research and practice. Specifically, they write about six common challenges faced by researchers, advocates, and health promotion practitioners alike: the fuzzy boundaries that arise when negotiating between research, advocacy/action, and health promotion practice when using these methods; tensions related to recruitment of participants and consent to participate; the complex considerations specific to the release of the digital materials produced in workshops; power issues as they relate to the shaping of both stories and digital media content; the potential for reproducing harm in visual/digital representation; and the promise of confidentiality/anonymity to research participants.
The proposed breakout session will provide a brief overview of the digital storytelling process (including discussion of recruitment, informed consent and release of materials, standard activities in the digital storytelling process, follow-up semi-structured interviews with participants, pre/post measures used to evaluate the impact of the process on participants, data analysis, and strategic communications based on produced digital stories). The session will enable participants to understand the myriad ethical issues that can present when carrying out community-based participatory research that employs digital storytelling as a methodology. By the end of the session, participants will be able to demonstrate critically enhanced awareness of ethical issues surrounding participatory visual and digital methodologies and identify effective ways to address these issues.
Moderator: Andy Lowe, Director of Program Management Resources, Outer Cape Health Services
Marta “Dikke” Hansen, MSW, Director of Behavioral Health
Andrew Jorgensen, MD, Associate Medical Director
The Outer Cape Cod, Massachusetts region is famed for its beauty as a summer vacation destination. For many residents and migrant workers serving the tourism industry; however, the intersection of isolation, little affordable housing, and limited transportation options can exacerbate problems due to mental health, substance abuse, and co-occurring conditions. Police, emergency responders, and EDs encounter this at-risk population disproportionately. Outer Cape Health Services, the local FQHC, proposed a novel solution: a Community Resource Navigator (CRN) program. The CRN Navigator works with community partners to identify at-risk individuals, engage them right in the community, and guide them to appropriate services/treatment. A modified Self-Sufficiency Matrix based on evidence from other Navigator programs is used as a tool to prioritize needs. The Navigator then helps clients attach themselves to options that make sense. The CRN program is a departure from classical case management approaches that features a light touch, with contact in the community rather than requiring clients to “come in” to the health center. A unique approach is that the Navigator uses a community-donated bicycle to pedal her way around the narrow Provincetown streets which can become virtually impassable during the busy summer tourism season. In addition, the Navigator sees clients in safe, accessible public spaces such as the public library. A critical success factor is community engagement that builds effective relationships with community partners such as police, EMTs, councils on aging, community mental health providers, etc. Since beginning the CRN program, data has been collected that provides some unexpected insights into how the Community Navigator approach can be both an outcome- and cost-effective alternative to traditional case management or social worker-oriented interventions. In addition, the CRN program is proposed as the basis for a research initiative under the auspices of the University of Massachusetts Medical School Center for Clinical and Translational Science.
Video includes Symposium welcome and introductions. Navigate to 12:20 in the video for beginning of keynote presentation.
Dr. Margarita Alegria has been instrumental in conducting research to eliminate disparities in mental health care. During this presentation, she will discuss major challenges of working across ethnic boundaries and propose alternative approaches to overcome them.
The therapeutic relationship has long been recognized as an essential factor in facilitating client engagement and retention in care. We know the challenges of establishing a relationship are amplified when cultural differences exist between client and provider, as an unfamiliarity and/or discomfort with a client’s beliefs, practices, understanding of etiology, acceptable approaches of treatment, and communication style create additional complexity. Recent studies have highlighted the unfortunate manifestations of such cultural disconnects, including: the presence of diagnostic bias with clients of color; and, structural and interpersonal barriers that get in the way of establishing rapport.
This presentation is designed to help improve shared decision making in the clinical encounter. Dr. Alegria will cover a variety of topics, including perspective taking; frequent attributional errors that providers make; and increasing receptivity to client participation and collaboration in decision making. Ways to improve the ability to listen, empathize and ask questions effectively will be discussed as will increased awareness of provider perceptions and misperceptions. These skills are not only important for patients and providers, but for everyone, particularly when interacting with those who are different in culture, background, and life circumstances.
Although Massachusetts currently has the highest rate of health insurance coverage in the nation, reports suggest health care consumers do not fully understand how their insurance works. Thus, the insured and uninsured populations alike need ongoing support in order to develop health insurance literacy, defined as the degree to which individuals obtain, process, and understand information about health insurance in order to make informed decisions about choosing and using their coverage, which in turn can lead to positive health outcomes. Educating consumers and giving them tools and resources are strategies that advance health insurance literacy. Since 2001, the Blue Cross Blue Shield of Massachusetts Foundation (the Foundation) has awarded over $5 million to community health centers and community-based organizations throughout Massachusetts, through its Connecting Consumers with Care (CCC) grant program, to conduct outreach, provide education and help consumers enroll in health insurance and access primary care. In 2015, the Foundation focused its CCC grant activities to improve health insurance literacy and engage consumers to utilize the health care system more effectively. Grantees have collected data on common measures, using adaptable data collection tools (e.g., brief client surveys), to assess changes in clients' knowledge, confidence, and/or preparedness to better navigate complex systems of coverage and care. The poster presentation will discuss: - the importance of health insurance literacy and its relevance to improving population and community health - strategies currently used to increase health insurance literacy among diverse populations, including successes and challenges - how the impact of these strategies was measured - how assessments were designed to reflect consumers' voices.
Assessment of Diet in Patients with Inflammatory Bowel Disease: A Collaboration of Behavioral and Basic Scientists
Introduction: Clinical research to develop treatment for inflammatory bowel disease (IBD) is focusing on a nutritional regimen restricting certain carbohydrates while incorporating the use of an optimal diet that includes pre- and probiotic foods. Current assessments are not able to measure elements of this nutritional regimen, thus we developed a food frequency questionnaire (FFQ). This FFQ will be utilized in a prospective study of IBD patients following an anti-inflammatory diet (IBD-AID) developed by us and used clinically at UMASS. We will track the bacterial communities inhabiting the microbiome of patients to determine diet-dependent changes, and their relation with patient wellbeing.
Objectives: 1) Develop an FFQ capable of identifying dietary components important to IBD: prebiotics, probiotics, beneficial nutrient intake, and avoidance of certain foods. 2) Determine diet-dependent changes of the gut microbiome.
Hypothesis: This study will show the microbiome of patients adopting the IBD-AID converge to one or more healthy 'enterotype' signatures, as compared to a non-IBD-AID control group.
Experimental design: Patients record daily FFQ. Foods and food groups (270) are categorized and grouped according to criteria of interest. Each food has a referent by which the patient can compare their own consumption. A scoring system satisfying dietary guidelines and components of the IBD-AID will be utilized. Twice per week patients collect stool samples for microbiome analysis. Microbiome composition and ecological metrics are compared to identify components influenced by the IBD-AID, and to separate bacterial 'enterotype' signatures of patients before, during and after diet intervention. We are currently recruiting patients.
Youth Outcomes of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) in the Child Trauma Training Center (CTTC)
Objectives: Exposure to trauma among youth is common and can cause behavioral, social and functioning problems. Use of evidence-based trauma treatment can reduce post-traumatic stress (PTSD) symptoms and behavioral problems. This poster highlights the outcomes of youth who participated in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) provided by clinicians who were trained through the University of Massachusetts Medical School (UMMS) Child Trauma Training Center (CTTC).
Methods: 308 youth ages 6-18 were enrolled into the CTTC evaluation with a mean age of 11.31 years (SD = 3.5); over half were female (58.1%), the majority were white (62.3%) and 37% were Hispanic. Data was collected by clinicians at three different time points: baseline, six-months and discharge through REDCap using the following measures: Child Behavior Checklist (CBCL), UCLA PTSD Index and the Social Connectedness survey.
Results: The results of the UCLA PTSD Index indicated that youth experienced significantly fewer Re-experiencing (baseline [M = 9.67]; discharge [M = 6.36]), Avoidance/Numbing (baseline [M = 10.55]; discharge [M = 8.63], and Arousal symptoms (baseline [M = 11.46]; discharge [M = 9.02]), as well as less severe symptoms (baseline [M = 33.43]; discharge [M = 24.71]) overall. The CBCL revealed youth experienced fewer Internalizing (baseline [M = 64.51]; discharge [M = 62.18]), Externalizing (baseline [M = 64.51]; discharge [M = 62.18]) and total problem behaviors (baseline [M = 65.48]; discharge [M = 61.82]) overall compared to baseline. Additionally, youth reported significantly better change in Social Connectedness (M = 4.32) compared to baseline (M = 4.06).
Conclusion and Discussion: Results of the youth and parent/caregiver reports of PTSD symptoms, behavioral problems and social connectedness indicates that youth and parent/caregivers noticed significantly fewer and less severe PTSD symptoms, fewer behavioral problems and improvement in social connectedness compared to baseline. These results adequately show positive child outcomes as a result of TF-CBT treatment in the context of CTTC’s framework.
Background: Amyotrophic Lateral Sclerosis (ALS) is a progressive and fatal neuromuscular disease with an etiology not yet fully understood. The Massachusetts Argeo Paul Cellucci ALS Registry is a unique population-based surveillance system used to monitor the occurrence of ALS throughout the state and to explore possible environmental causes of the disease.
Methods: The Registry gathers annual reports of ALS cases from physicians, hospitals, and clinics in accordance with state regulations. Medical records are obtained and abstracted for each case, and eligible cases are reviewed by a consulting neurologist to confirm diagnosis. Necessary clinical and demographic information are recorded in a database and used by the Massachusetts Department of Public Health (MDPH) to prepare reports containing community-specific and statewide prevalence and incidence estimates. The data are also used to investigate spatial and temporal patterns and constitute a rich resource for researchers to explore environmental risk factors and whether they may impact disease rates.
Results and Conclusion: The result is a first-in-the-nation registry that allows for complete ascertainment of all reported cases. From 2007-2011, 826 new ALS cases were reported to MDPH. The age-adjusted incidence rate was 2.2 people per 100,000 per year, and the age-adjusted prevalence rate was 5.6 per 100,000 per year - both comparable to the range of estimates reported in scientific literature. MDPH evaluated ALS occurrence similarly by community and other variables like age and family history. Data are available to inform patient service needs and epidemiologic studies. Researchers can apply for access with the MDPH's IRB.
Raising Physician Awareness to Reduce Childhood Lead Exposure: The Massachusetts Community Lead Progress Report
Massachusetts has been at the forefront of childhood lead poisoning prevention, enacting one of the nation's first Lead Laws in the 1970's. The Massachusetts Lead Law is stringent, requiring universal screening of children for lead poisoning multiple times before age three, and the removal or covering of lead paint hazards in all homes built before 1978 where a child under age six lives. Owing to such a robust law, Massachusetts screening rates are high and the prevalence and incidence of lead poisoning has been steadily decreasing since 2000. Despite these successes, there is wide variation in screening and prevalence rates at the community level, with some communities showing a need for a more targeted approach. Additionally, scientific evidence increasingly suggests that even low levels of lead exposure cause severe and irreversible health effects, underlining the fact that lead remains a significant health risk for children in Massachusetts. To address these concerns, Massachusetts DPH has developed a direct mailing tool for physician outreach providing community-specific indicators of childhood lead screening and exposure and highlighting areas of needed improvement in screening, follow-up, and prevention. The Childhood Lead Poisoning Community Progress Report focuses on awareness of the CDC reference level of 5 µg/dL and the dangers of low-level lead exposure, educating medical providers on their role in preventing lead exposure by screening all children, following proper testing practices, and educating parents on available resources. Qualitative and quantitative approaches will be used to measure the impact of the Community Progress Report over time.
Background: Community Engaged Research (CEnR) as a means to address health disparities has emphasized the necessity for community members to partner with researchers. The Boston University CTSI identified the local need to increase the number and diversity of community members ready and willing to engage in the research process.
Methods: Connecting Community to Research (CCR) was designed to train community groups interested in improving the health of their community. Trainings were adapted from existing curricula with input from a 12 member advisory panel. The goal was to help trainees understand the various roles they can play along the research process. In a 1-2 hour training, participants were guided through an introduction to CEnR and learned how sharing their stories could inform research. The training concluded with an evaluation survey and opportunities to get connected to loco-regional projects.
Results: From December 2015 to November 2016, 100 participants of diverse backgrounds were trained at 7 sessions: 56% identified as White, 35% African American, and 6% other races. Evaluation data indicated: 94% of trainees understood how research could address a community concern, 82% understood how to use their stories to inform research, and 53% intended to participate as an advocate in research.
Conclusion: These data suggest trainings like CCR can increase the number and diversity of community members willing to engage in research. While this introductory training generated positive results, additional trainings with varying levels of skill development may be needed to further empower community members to engage as partners in research.
Graphic medicine, or the use of comics in healthcare, is a growing field within medical humanities that is of particular interest to those concerned with health literacy and medical education. Currently, this field is being explored on several fronts at the Lamar Soutter Library in an effort to provide key resources for study and to build community awareness of the potential uses of comics in medicine. These efforts include a scoping review study funded by the Gold Foundation to determine how comics are currently used in medicine and to what effect; the creation of book club kits on specific medical topics - from cancer to PTSD to LGBTQ health - to be made available to the entire New England region; a growing collection of graphic novels available for borrowing from the library; outreach to area libraries, educators, and researchers who may be interested in the role comics can play in health literacy; the creation of book and citation lists for easy browsing; an ongoing effort to host speaking events with cartoonists and medical professionals engaged in graphic medicine; and an upcoming webinar to provide an overview of the field to any interested. In the future, we hope to partner with other community members to develop targeted comics to aid those in the community better understand their health.
Development of a Health Promotion Program: Targeting Adolescent Behaviors and Attitudes Toward Prescription Opioids
The current opioid epidemic kills an estimated four people every day in Massachusetts and is considered one of the greatest health threats to adolescents. Massachusetts state data indicates opioid addiction is a public health crisis, which requires the development of a health promotion program for adolescents and legislative action. The innovative eight-week middle school-based program Promote Opioid Prevention Program 4 Youth (POPPY) is implemented during Health and Wellness classes. POPPY is based on the Social Cognitive Theory, focusing on environmental and health behaviors. The goals of this distinct program are to: reduce adolescents' misuse of prescription opioid medication, increase adolescents' self-efficacy to make healthy decisions regarding misuse of prescription opioid medication, and to foster an environment conducive to preventing misuse of prescription opioid medication, while building social and self-management skills. The POPPY health promotion program will provide education that leads to development of health-related decision-making skills. Ultimately, healthier decisions lead to a reduction in opioid misuse risk factors such as peer pressure, social influence, curiosity, and experimentation. Protecting youth from health risks is critical to preventing fatalities associated with chronic conditions such as drug addiction that can lead to the onset of other major illnesses later-on in adulthood.
Sibling Support Program: A Family-Centered Mental Health Initiative was developed at the Eunice Kennedy Shriver Center of the University of Massachusetts Medical School. The project is currently implemented at Cambridge Health Alliance in Cambridge, Massachusetts as an IRB-approved research study, and at another Boston-based hospital as a Quality Improvement (QI) initiative. The program was also piloted at Boston Children's Hospital in Boston, Massachusetts. The project explores the impact of mental illness on typically developing siblings and caregivers of children with psychiatric needs. Project goals: to increase resiliency and mitigate the trauma commonly experienced by siblings of children admitted for psychiatric hospitalization; to build skills, competency and confidence among parents; to help restore family stability post-discharge; to build capacity among medical practitioners. Interventions include psycho-educational groups for caregivers, and sibling support groups for children growing up alongside the patient. Participants complete surveys following the intervention to report on knowledge learned, satisfaction level, and behavioral change anticipated by the participant. Over 1,500 participants have participated in this innovative program that utilizes parent mentors and medical trainees to deliver interventions, with high satisfaction scores among participants. Results suggest that a child's mental illness can be traumatic for family members, and that sharing stories can alleviate the stress and anxiety related to living in a home with a child with mental illness. The program serves as a training rotation for psychiatry residents through Harvard Medical School.
Asthma remains one of the most common chronic diseases among children in the United States today. Surveillance is limited to national and state estimates which can vary over time and by population (CDC/NCHS, National Health Interview Survey, 2012). It is estimated that anywhere from 14% to 50% of children with asthma remain undiagnosed. The Massachusetts Department of Public Health's Bureau of Environmental Health (MDPH/BEH) has been conducting a successful and comprehensive statewide school-based asthma surveillance program since 2002. Partnering with school nurses throughout the state, we request aggregate information via a one-page survey. The survey is distributed to all public, private, charter and virtual schools in Massachusetts (n=1800). Variables collected include number of students with asthma by gender, grade (K-8), race/ethnicity and community of residence. Therefore, we can estimate prevalence by school and community. Now entering the 15th year, the program has a near 100% survey response rate. This successful surveillance effort reveals a statewide asthma prevalence of 12.4%, one of the highest rates in the nation and suggests approximately 85,000 students in Massachusetts carry the diagnosis. Furthermore, trends over the last 10 years of data collection indicate asthma to be higher among males than females for this age group (~5-14). School-based pediatric asthma surveillance demonstrates the important role school nurses play in surveillance. The feasibility of using school health records as a secondary data source will be highlighted as a reliable, aggregate, community-based source of data.
Putting Health Equity Front and Center in Community Health Improvement by Empowering, Listening to, and Respecting Community Voices
In 2016, the Worcester Division of Public Health, Coalition for a Healthy Greater Worcester (CHGW), UMass Memorial and Fallon Health, released the 2016 Community Health Improvement Plan (CHIP). The CHIP spans nine priority areas, with 31 objectives and 100 strategies with measurable outcomes. The focus is on social determinants of health, with health equity as the overarching goal. This goal will only be achieved if we empower, listen to, and respect community voices throughout the CHIP implementation process. CHGW presents a mechanism for community participation. A community-based structure which is open, transparent, and provides support in all areas of implementation, is being developed. A Steering Committee of residents and representatives from different sectors provides overall direction. Subcommittees provide support in each of four areas - community engagement, resource and development, research and evaluation, and policy and advocacy. Quarterly meetings in each priority area provide structure for reporting progress being made and requesting support. The Community Engagement subcommittee will work to build and maintain participation for each group which is universally inclusive and representative of the diverse organizations and residents of the region. The group will create a plan for ongoing community engagement at each stage of the process and in each focus area. The Research and Evaluation subcommittee, in addition to measuring progress for each strategy, will develop benchmarks for evaluating community engagement. We anticipate improved progress toward CHIP outcomes as the community becomes more involved and is more representative of the population, driving momentum toward health equity.
Background: Residents of Springfield, Massachusetts experience disproportionately poorer health compared to the rest of the state. Springfield's community of color population (39.5% Hispanic/Latino; 21.6% Black; 2% Asian) experiences high rates of poverty, unemployment, and low educational attainment leading to large health disparities. Objective: The overall objective of the PCORI-funded Project ACCCES is to develop capacity to conduct community engaged research (CEnR) in Springfield that is based on patient and community needs, can be more easily translated, and improves community health. This engagement framework will be applied to development of patient-centered comparative effectiveness research proposals. Methods: In the project's first phase, we conducted focus groups with patients, community organization leaders, and physicians to better understand the most pressing health needs of the community, past research experiences, and important considerations for building community-academic partnerships. We then convened a multi-stakeholder Advisory Board to inform all Project ACCCES activities. In the second phase, we developed and implemented two half-day workshops to give participants the knowledge and tools to conduct CEnR and to begin to build community-academic partnerships in the areas of perinatal/maternal-child health, mental health/substance use, chronic disease/nutrition, and respiratory health. The third phase is currently underway and is focused on convening research partnership action groups that will seek to address Springfield residents' health needs through culturally appropriate interventions. The final phases will entail dissemination of both the process used to develop new collaborations to conduct CEnR in an underserved community and the workshop template, and development of structures to foster sustainability of partnerships.
Chicopee and Springfield School Collaboration with UMass Amherst (UMA): Alcohol and Opioid Screening, Brief Intervention and Referral to Treatment
The UMA nursing undergraduate training program, SBIRT: The Power of Nursing to Change Health, builds on a SAMHSA curriculum that is integrated into existing psychiatric/mental health, pediatric/young adult and community nursing courses that incorporate alcohol and substance abuse disorders. Student nurses will apply these new skills in their community and medical/surgical rotations in partnership with the Chicopee and Springfield Public Schools. High School survey data indicate that on average 67.5% of high school students have consumed alcohol with 40.1% indicating one drink in the last 30 days, and another 22.2% having five or more drinks in the last 30 days. Use typically begins during early adolescence and the first alcohol exposure peaking during grades 7 to 9. The SBIRT project has the potential to significantly impact early intervention and treatment for youth in Massachusetts by increasing the number of nurses trained in SBIRT and practicing in the public school. The UMA SBIRT Team completed the first training session October 2016 incorporating EBP into training and evaluation. Subsequent to the first training efforts, the team invited state and regional SAMHSA officials, the MA School Nurses organization and the MA Office of Elder Affairs to participate in SBIRT trainings. Community collaboration is critical to the success of the Power of Nursing to Change Health.
Healthy Kids & Families: Overcoming Social, Environmental and Family Barriers to Childhood Obesity Prevention
Healthy Kids & Families, the applied research project of the UMass Worcester Prevention Research Center, is testing the impact of a community health worker (CHW)-delivered intervention aimed at helping families overcome barriers to childhood obesity prevention. The intervention addresses social, environmental, and family issues that may pose as barriers to healthy choices. The intervention is compared to a comparison condition consisting of a CHW-delivered intervention aimed at helping families improve positive parenting skills. The intervention and comparison condition are identical in format, Both use multiple delivery modalities to maintain novelty and prevent attrition/burden. These include home visits, telephone contacts, print (literacy sensitive newsletters), social media (Facebook), and community events. Parents and children will complete scheduled assessments at baseline, 6-, 12-, 18- and 24-month follow-up. Study participants are 240 parent-child dyads recruited from nine elementary schools. Inclusion criteria include: adult and their K-6th grade children attending a participating school, have access to a telephone, speak English or Spanish, and plan to live in the neighborhood for at least two years. Exclusion criteria include medical condition or advice from a doctor that precludes the child from walking or eating fruits and vegetables. Healthy Kids & Families is being implemented in racial/ethnically diverse underserved communities in Worcester, Massachusetts. Funded by the US Centers for Disease Control and Prevention, it involves a partnership between UMass Worcester Prevention Research Center of UMass Medical School, the Worcester Public Schools, and Oak Hill Community Development Corporation.
Case Management & Medication Addiction Treatment for Individuals Leaving Jail: The Bridge/El Puente Program in Hampden County
The Bridge/El Puente program will serve 300 newly released inmates from the Hampden County Correctional Center (HCCC) over 3 years. Inmates have a history of opiate and/or alcohol addiction, and are at high risk or are diagnosed with HIV or HCV. HCCC is now offering medication assisted treatment (MAT), extended release naltrexone (Vivitrol), buprenorphine and methadone, prior to release. Bi-cultural/bi-lingual case managers help inmates to continue or to start MAT once back in the community. This includes bridge prescriptions, addressing insurance issues, setting up first appointment and logistical help with getting to MAT appointments. Additionally, Bridge case managers address the often-large array of other needs newly released people struggle with upon return to the community. Bridge/El Puente is funded by SAMHSA/CSAT. In our second year, we recently obtained IRB approval to examine differences in outcomes between inmates who choose buprenorphine, naltrexone or methadone prior to release from jail and those who reject/are not offered MAT prior to release despite having an opioid use disorder. While many do start MAT once back in the community, we are interested in understanding whether initiation of MAT while in jail significantly improves outcomes.
List of posters presented at the 6th annual Community Engagement and Research Symposium, held Friday, March 3, 2017, at the University of Massachusetts Medical School, Worcester, MA.
Some presenters agreed to make the full text of their posters available; these posters can be viewed in the symposium's Poster Archive.
Breakout Session descriptions for the 6th annual Community Engagement and Research Symposium, held Friday, March 3, 2017, at the University of Massachusetts Medical School, Worcester, MA.