A Community Health Center’s Perspective on the

Feasibility, Reality and Benefits of Research

Myechia Minter-Jordan MD, MBA

President and CEOThe Dimock Center

Goals for our discussion today Develop an understanding of the potential

strategies for research engagement Understand how to develop and maintain

community education on research principles Develop a strategy for engaging your health

center in community based participatory research

Develop a strategy for engaging academia in community based initiatives

Understand the pros and cons- and be prepared for them

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Topics to be Covered

Different models of approaching research IRB, Ethics Committee, Education and Engagement

Dimock’s decision making process- what did we decide and why?

Engaging in research What makes sense for your organization

Dimock’s experience Challenges and benefits of engaging in research

Our Mission

At Dimock, we believe every life is precious. We commit to enhance the quality of life of each individual we serve, of the people we employ, and the communities in which we live by providing accessible, comprehensive, innovative, culturally competent health and human services.

Our Vision

Our Vision is a healthy community where we make a difference in every life.

Behavioral Health Child and Family Health Services

Detox Early Head Start Pedi

Outpatient addiction services

Head Start Adult

Adult/Pediatric MH Preschool Eye

Recovery Homes  Early Intervention Dental

Shelter  GED HIV

Residential Svcs    OB GYN

Over 17,000 patients and 70,000 visits/yr

What is an IRB? Local independent committee that reviews and

approves human subject research before it can begin

Main responsibility: to protect the rights and welfare of human research subjects

• Including vulnerable populations

Ensures No “Conflicts of Interest

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Why is an IRB Significant for a community health center?

All institutions that accept research funding from the federal government must have IRB review of research involving human subjects

Even if a given research project does not involve federal funds, ethical principles and good clinical practice call for review and approval (by an IRB) to provide public assurance that the rights, safety, and well being of participants are protected!

Patients, families and clients served at community health centers often represent our most vulnerable patients

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Approaches/Models to engagement in research

Ethics Committee Local IRB Review

Organization/Institution has its own IRB Utilize Other IRB (cede review, affiliations)

Organization/Institution relies on another IRB for single studies or all studies

IRB Reciprocity Multiple sites form a consortium Utilize one of the IRBs (from consortium) for review of a

collaborative protocol (e.g. Harvard Catalyst) Central IRB

Independent/Commercial IRB (pay for service)8

Why did we think about this issue?

Multiple requests for research Lack of internal knowledge about how to

conduct research Increased reliance on academic partners Need for community input Ongoing data collection- what could we

learn from it? Ethics Committee vs. IRB

Creating a Research Community

Role of the Community Health Center : Close gap between community and researchers (build

trust) Share information with the community at start of the

study, during the study and at the end(results) Share community concerns – be their voice! Offer diversity (race, gender cultural background) Help define the research community

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Challenges

Cultural challenges- think “Champion” Infrastructure-consider partnerships Research vs. productivity- grants? Research vs. Mission Building a business case Organizational buy-in

The Dimock Experience

Connection with HSPH Compilation of policies/procedures/forms Initial Training Choosing members Filing of necessary documentation Creation of a research champion Ongoing training

TrainingThose individuals involved in the conduct of research must have a basic understanding of:•Historical background and landmark documents•federal regulations and research ethics and how they relate to their individual role in the project•important research-related definitions such as: Human Subject, Research, and Informed Consent•an IRB; what it is, what rules it must follow and why

Training should be initial and ongoing!

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How to Fulfill Training Requirements

CITI Training

Alternative Training

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Benefits Involvement of the health center board-

consumers! Leverage patient relationships to engage in

efforts to improve care Autonomy- choosing what is best for your

patients Enhancing and creating partnerships Recruitment and retention of providers

More Benefits…

Make use of your HIT Direct impact on care delivery Funding opportunities Staffing Increasing the visibility of your

organization

The Dimock IRB- status update Study review examples

1. Focus groups to assess acceptability of pre-exposure prophylaxis of HIV among Black Women

2. Sex differences in Infants activity preferences 3. Survey to Assess Acceptability of HIV Pre-Exposure

Prophylaxis among Black women 4. A Comparison of Individual Versus Practice Level

Operationalizations of the Medical Home 5. Using Recovery Support Navigators and Incentives to

Improve Substance Abuse 6. Medicaid Client Outcomes and Costs 

The Dimock IRB- status update Cultural change-excitement and engagement Impact on patient care- e.g. internet usage study Enhanced recruitment and retention Ongoing training Ceding General perspectives on research at Dimock Ongoing academic collaborations

Top Ten Reasons Engage in Research

1. Your patients 2. Your community 3. Your providers 4. Your care delivery 5. Your organization 6. Partnerships 7. Use of Data 8. Funding 9. Influence 10. Visibility and Prestige

Contact Information

Myechia Minter-Jordan MD, MBA President and CEO The Dimock Center

Email: mminterj@dimock.org