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  • 1503-GUMC: Engaging Black Faith Communities to Address Mental Health Disparities via Curriculum Development

    Breland-Noble, PI


    A. ABSTRACTVia the PCORI Eugene Washington Engagement Award program, our program team of a university researcher, a faithcommunity leader and a community mental health advocate, will employ our knowledge of African American culture andour outreach, research and clinical experiences to partner with faith communities, patients and stakeholders to empowerthem to conduct Patient Centered Outcomes Research (PCOR) and Comparative Effectiveness Research (CER) for youthmental illness. Based on our conversations with stakeholders and patients, we believe that our initial step toward this long-term goal should be aligned the PCORI mission. Therefore, we will engage our stakeholders to assist us in 1)understanding the gaps in African Americans knowledge about CER and PCOR in mental health and 2) designing acurriculum to address these gaps. Our engagement project is designed to increase the capacity of faith communities, youthand stakeholders to lead, design and conduct their own PCOR and CER studies.

    B. OUTREACH PLAN OVERVIEWFigure 1 depicts a set of targeted tasks to allow us to ensure patient and stakeholder engagement throughout the awardperiod. We describethe tasks following.B.1 PlanDevelopment: Needs Assessment. Outreach for our award is focused on generating interest and investment from faith communities or mental health Patient Centered Outcomes and Comparative Effectiveness Research. In the initial stages the goal is to make people aware of our team in NC and the Washington, DC area (see Fig. 2 Organization Chart) and provide them with information on our award and its goals. To do this, our leadership team, comprised of Dr. Breland-Noble (Program PI) and our community leads (Mrs. H. Kathy Williams in NC and Rev. Dr. Jalene Chase-Sands in the DC area) have focused on reaching to individuals and groups within our existing networks. We have achieved an average of 3-4 contacts per week with existing and potential partners (see list of Engagement Award Outreach Activities). As an example, we note that Dr. Breland-Noble has made weekly contact with various entities in the DC area who interact with African American and racially diverse youth. As early as August 2015, she met with Mr. Timothy Jones, Director, Healthy Connections and Project Lead, Hillsdale Programming for Marthas Table a not-for-profit organization founded by a doctoral level sociologist and a Jesuit priest (both from Georgetown University) to address the needs of homeless youth and families by providing food, education and clothing needs. The leadership team (Breland-Noble, Chase-Sands and Williams) set a goal, beginning in the second quarter and lasting through the end of the third quarter of the award period, to make 2-3 outreach contacts per week, per person (i.e. October 2015 March 2016) (target B.1.a). This outreach target will ensure that we generate enough interest in the program to have a cohort of persons for the Needs Assessment efforts.


    Needs Assessment

    Targets: B.1.a, B.1.b

    Curriculum Planning

    Targets B.1.c, B.1.d

    Process Evaluation


    Needs Assessment

    Target B.1.e

    Curriculum Development

    Targets B.1.f, B.1.g

    DraftPrelim Eval

    Process Evaluation

    Breland-Noble 1503-GUMC 1

  • We have planned a retreat for February 2016 where we will acclimate our program team, including the PI, Community Leads and a group of 15-20 youth, patients and stakeholders all of whom will become our core program team for the remainder of the award period (target B.1.b). In our original Workplan, we described being guided by the Seven Field Principles and Joness and Wellss Community Partnered Participatory Research Principles to create a vision for our program and a strategic plan for partnership and execution of the program. Therefore, our retreat activities will focus on 4 key practices; 1) Co-planning of activities/and Increasing Social Skills of Target Recipients; 2) Creating written agreements/Improving Bonding, Attachment and Connectedness; 3) Maintaining open communication/Rebuilding/Supporting the Village and 4) Ensuring that all partners understand the project, the work to be undertaken roles and responsibilities/Improving Self-esteem. Overall, our goal with the retreat is to provide 1.5 days of training to; a) learn of the knowledge gaps in FBMHP, CBPR, PCOR and CER; b) fill those gaps with knowledge dissemination and c) plan outreach and engagement to our larger patient and stakeholder groups in NC and DC. We are also aware of the import of disseminating knowledge on research ethics and we have identified a web-based program to help us impart knowledge on this topic to our core team (i.e. CIRTificaton - Community Involvement in Research Training for community researchers http://www.uic.edu/depts/mcam/CCTS/CIRTification/for-human-research.shtml). We want to ensure that program leadership understands the knowledge gaps of our core team of patients and stakeholders and fills those gaps through the retreat. Curriculum Planning. We must maintain the interest and goodwill of our approximately 25-member core team so that they can help guide the development of the curriculum deliverable (target B.1.c). To do this, we will track all communications with core team members and utilize our tested follow up strategies to keep our core team interested in the program. Examples of these efforts include periodic check-in phone calls and emails from Breland-Noble, Chase-Sands and Williams, postcard mailings and e-blasts, blog and social media updates to notify core team members (especially youth members) of our ongoing efforts and how they can participate. The Program Manager will maintain a Recruitment Process Log (RPL) (see Appendix) and will keep monthly contact data from the leadership groups outreach efforts. We will schedule 2 virtual meetings (via GotoMeeting or a similar platform) and 1 in-person meeting each on NC and DC area. The in-person meetings will be co-led by the respective community leads on the project and Dr. Breland-Noble will be physical present for both. The goal of the meetings is for the core team to articulate an overview and set of tasks necessary for achieving the curriculum deliverable at the end of the award period. In other words, these will be vision and mission setting meetings. Topics included are: a) ensuring that all partners can identify our primary deliverable; b) keeping them engaged in the program development process and c) providing space for the partners to specify what they think is needed to ensure our successful implementation of recruiting and engaging participants whose knowledge will serve a the basis for our curriculum (i.e. the 200 respondents needed Objective 2A of the Award Workplan). Process Evaluation. To fully support PCOR, FBMHP and CBPR, we must evaluate and adjust our process in implementing our work (target B.1.d). We will therefore employ the PRECEDE-PROCEED model of evaluation for public health promotion. The PRECEDE-PROCEED model was developed in the early 1970s as a mechanism of participatory evaluation involving researchers, stakeholders and communities1. Stated simply the model is focused on encouraging health promotion through social justice and empowerment, approaches with demonstrated utility for underserved populations. The title includes 2 acronyms as follows, Predisposing, Reinforcing, and Enabling Constructs in Educational/Environmental Diagnosis and Evaluation (PRECEDE) and Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development (PROCEED).

    Fig. 2

    Breland-Noble 1503-GUMC 2


  • The PRECEDE portion of the model occurs in four phases; a) identifying desired result; b) setting priorities, c) identifying environmental impact factors and 4) identifying policy impact factors. We will utilize the Recruitment Process Log (RPL) and will supplement this with a written inventory of all activities, participants and resources involved in shaping the building of our partnership. This documentation is aligned with the PRECEDE model in that allows the team to identify, the predisposing, enabling, and reinforcing factors that can affect the behaviors, attitudes,2 and environment of our community and stakeholder partners. PROCEED also involves 4 phases including a) implementation; b) process evaluation, c) impact evaluation and d) outcome evaluations2. In our program, PROCEED will entail having the core team partners articulate the partnership vision and respond to ongoing evaluation including measurement of partnership success and governance. Specifically, we will ask partners about their perspectives stakeholder participation in all aspects of our work (e.g. curriculum planning and outreach planning) and their perceptions of transparency of program leadership and ease of participation of the core team partners in leadership. Finally, we will assess partnership outcome success via results of capacity building efforts for partners, perceptions of team synergy and its correlate, conflict. B.2. Plan Implementation Needs Assessment. The goal at this stage is to recruit our respondents for our community needs assessment (Award Workplan Objective 2). Our target is 200 respondents (i.e. 150 adults and 50 youth) who will complete our measures and participate in a small group discussion (target B.1.e). As well, from this group of 200 respondents, 50 persons (35 adults and 15 youth) will also complete individual key informant interviews with the senior leadership team (Breland-Noble, Chase-Sands and Williams). Our primary mechanisms for recruiting these individuals will be Mrs. Williamss and Dr. Breland-Nobles presentation, Breaking the Silence and Stress in Teens. This engagement event is one that Dr. Breland-Noble and Mrs. Williams have given since 2007 and is highly effective. Replicating our strategic outreach from our published studies, we will also involve our core team and advisory board members and our DC faith community lead, Rev. Dr. Chase-Sands. We will engage core team members to promote our efforts via word of mouth referrals and will advertise on our program through our website and social media (e.g. Twitter and Instagram). We will utilize announcements by pastors, other faith leaders and our non-profit contacts (e.g. Marthas Table). We will also create print announcements for church bulletins, health fairs, websites, church newsletters and professional meetings (e.g. the Durham Ministerial Alliance). Finally, we will reach out to a culturally specific and unique entity among African Americans; African American fraternities and sororities and clubs, like Delta Sigma Theta Sorority, Inc., Phi Beta Sigma Fraternity, Inc., National Council of Negro Women, Inc., Jack and Jill and some girl and boy scout troops. Curriculum Development. At this stage, our goal is to maintain the positive momentum of our core team who will be tasked with helping us develop the key tenets of the curriculum and create a draft per Objective 3 of the Workplan. We will therefore plan a second retreat (possibly a full day on a Saturday) where we will reconvene the full compliment of the core team and share our summary findings from our needs assessment. We will still need our full compliment of core team members and will try to ensure that all can attend this second retreat (target B.1.f). Overall, we will seek to accommodate approximately 20 persons who will provide us with their perspectives on creating content for the previously designed outline (from the Plan Development stage). In subsequent weeks, the senior leadership team will take the recommendations from the retreat and create a draft curriculum. We anticipate using a virtual meeting platform (e.g. GoToMeeting) to obtain the core teams approval of a final draft. Subsequently, the senior leadership team will select 1 core team member from NC and a second from DC to receive the train the trainer course (target B.1.g) on the draft curriculum and he/she will then lead a training of the curriculum with core team embers in their respective local areas. The focus of this portion of the outreach is to determine a) the feasibility of having patients and stakeholders actually lead curriculum implementation and b) to gain key informant perspectives on the quality accessibility and feasibility of our curriculum for training patients and stakeholders in PCOR, CER, CBPR and FBMHP. Process Evaluation. We will utilize the same process articulated in the Plan Development phase but with a focus on the full two years of collaboration and engagement. C. CONCLUSION It is hoped that the aforementioned outreach and implementation plan will allow our team to meet the objectives of the Engagement Award and effectively illuminate the feasibility, acceptability and positive outcome potential of Faith Based Mental Health Promotion for PCOR and CER.

    Breland-Noble 1503-GUMC 3

  • Engagement Award Outreach Activities 1st Quarter

    Led by H. Kathy Williams NC Community Lead Past Events:

    1. July 11, 2015----Community Health Fair--- Time: 12:00 noon-4:00pm New Covenant Christian of the Triangle, Durham, North Carolina

    2. October 9, 2015------Durham County Library--North Regional-----Durham, North Carolina Time: 3:00-4:00pm Afterschool Program---Middle School Students from Carrington Middle School

    3. October 11, 2015-----Durham County Youth Missionary Department Mt. Level Baptist Church, Durham, North Carolina Time: 3:00-4:00 Youth from various churches in the New Hope Baptist Association

    4. October 14, 2015---Anita Wilson Ministries TV Program ---Youth Talk--Panel Discussion 4:30-6:30 PM Aired---Friday, October 24, 2015 and will air again on Friday, October 30th at 4:00pm

    Upcoming events:

    5. November 19, 2015: Edgecombe Community College-----Tarboro, North Carolina Time: 10:00-11:00 ( I need to confirm that time with them) Mental Health Stakeholders

    6. November 20, 2015 Play---When Enough Is Enough (Suicide Prevention and Awareness) 7:00 pm-----Hayti Heritage Center We are expected to share information about Depression Identification and Suicide Prevention

    7. December 10, 2015----Gate at Kinston Kinston, North Carolina Presentation on Breaking the Silence Youth---12-18 years old

    8. December 17, 2015-----Presentation at W. G. Pearson School Durham, North Carolina12:00-1:00 Presentation to parents for the children.

    9. Another presentation will be scheduled in January or February for Bladen County, North Carolina. Led by Dr. Alfiee M. Breland-Noble PI Past Events:

    1. Met in person with Timothy Jones of Marthas Table August 15, 2015 2. Disseminated AAKOMA Project Newsletter to DC and NC stakeholders September 2015 3. Announced PCORI Engagement Awar...