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Practice-Based Community Health Research Prospectus—Spring 2021 |Page 1 of 30

EPH 542b: Practice-Based Community Health Research 2021

PROJECT PROSPECTUS

Table of Contents

COMMUNITY HEALTH ASSESSMENTS AND IMPACTS ......................................................................2

Organization: West Hartford Bloomfield Health Department .............................................................2

Project Title: COVID-19 Community Needs Assessment ..................................................................2

Organization: Yale New Haven Hospital ...............................................................................................4

Project Title: Community Health Needs Assessment (CHNA): Key Informant Survey ...................4

Organization: Yale Office of Sustainability ........................................................................................... 7

Project Title: Health Impact Assessments at Yale University: A closer look at Materials Management and Environmental Justice .......................................................................................... 7

SERVING VULNERABLE POPULATIONS ..............................................................................................9

Organization: Community Renewal Team (CRT) .................................................................................9

Project Title: The Impact of COVID on Seniors Served in Multiple Levels of Care ..........................9

Organization: HAVEN Free Clinic ....................................................................................................... 12

Project Title: Health and Social Impacts of COVID-19 on Uninsured Populations in the City of New Haven ....................................................................................................................................... 12

Organization: Amistad Catholic Worker ............................................................................................. 15

Project Title: Developing Transitional Housing Strategies in New Haven ..................................... 15

Organization: Hands on Hartford ....................................................................................................... 18

Project Title: Identification and Implementation of Effective Practices to Improve Medical Partnership and Outcomes for Supportive Housing Individuals, including Those Who are Immune-Compromised .................................................................................................................... 18

Organization: Leeway ......................................................................................................................... 20

Project Title: Planning for Urgent Specialty Chronic Care PLUS-CC ............................................ 20

TRAUMA-INFORMED EMPOWERMENT OF VULNERABLE YOUTH ...............................................23

Organization: DreamKit ......................................................................................................................23

Project Title: Understanding How Virtual Internships Improve Confidence, Leadership, and Stability Among Unstably Housed Youth ........................................................................................23

Organization: Huneebee Project ........................................................................................................ 26

Project Title: Assessing Needs of Transition-Age Youth in Foster Care in New Haven County .... 26

STRUCTURAL APPROACHES TO IMPROVING PUBLIC HEALTH ................................................... 29

Organization: Town of Hamden ......................................................................................................... 29

Project Title: Mobile Crisis Response Team Planning Study ......................................................... 29


COMMUNITY HEALTH ASSESSMENTS AND IMPACTS

Organization: West Hartford Bloomfield Health Department (WHBHD)

Project Title: COVID-19 Community Needs Assessment Students who work on this project will develop an understanding of the needs of local health departments and the Community Health Assessment planning process, together with skills in developing and adapting survey tools and survey administration.

Overview of Project

The West Hartford Bloomfield Health District is beginning the Community Health Assessment (CHA) planning and implementation process. Students will 1) identify and adapt a survey tool to provide an initial assessment of community/resident knowledge of COVID-19, seeking to identify misperceptions, and guide future educational trainings, 2) summarize initial findings to allow West Hartford Bloomfield Health Department to develop a plan to address issues identified in the survey, 3) analyze state and district data to determine local impacts of COVID-19 on the community and high-risk groups to guide priority interventions, and 4) revise/adapt surveys from other communities/organizations for distribution to WHBHD residents. A community health assessment is a systematic examination of the health status indicators for a given population used to identify key problems and assets in a community. The ultimate goal of a community health assessment is to develop strategies to address the community’s health needs and identified issues. In order to perform this community health assessment, WHBHD must identify data gaps as well as areas where primary data collection may be necessary. The student work is essential to successful completion of the CHA in a timely manner. Findings from this project will inform WHBHD’s Covid-19 CNA, which will serve as the basis for a health improvement plan. About West Hartford Bloomfield Health District

The West Hartford-Bloomfield Health District is a regional health department serving the towns of West Hartford and Bloomfield. It provides full-time professional public health population-based services to residents in both towns. The District is governed by an eight-member Board appointed by the elected bodies of the member towns. WHBHD provides for the community: immunization clinics, flu clinics, senior wellness clinics, communicable disease surveillance and follow-up, health education, restaurant inspection, lead and radon consultations, septic system plan and review, and swimming pool inspections. WHBHD serves multiple roles; it protects the environment, workplaces, housing, food and water, enforces laws that safeguard water, sewer and septic systems, landfills, food establishments, day care center, businesses and neighborhoods, prevents epidemics by working to eliminate the spread of certain diseases like measles and TB, encourages health behavior through health education efforts that stress prevention, watches over the health condition of the community gathering information that can be used for rapid response to emergencies and for planning programs, and assures public health through enforcement of state, federal and local laws. About the Project

The COVID-19 Community Needs Assessment (CNA) is in response to the global pandemic and to address health disparities and racism as a public health crisis. This assessment is an effort to capture emerging needs as well as forecast evolving needs in the upcoming months. The assessment will identify specific programs or target areas that have been most affected and will help to direct


resources as well as funding for the West Hartford Bloomfield Health District. Students will conduct focus groups with key informants; develop, distribute, and analyze community surveys regarding COVID-19 knowledge, to identify gaps for additional educational training; and analyze the district health data pertaining to COVID-19 to develop recommendations for policies, programs, and interventions. Similar surveys that have already been conducted in Connecticut include the University of Connecticut survey for Hartford and the Community Alliance for Research and Engagement survey conducted in New Haven. Community Health Assessments have been completed by other local health districts, the Connecticut Department of Public Health and our local hospitals. Our health district currently does not have a community needs assessment and this project is seen as beginning the process. West Hartford Bloomfield Health District has seen waves of positive cases, as the global pandemic has affected each community differently. February-April affected their most fragile older residents in Skilled Nursing and Assisted Living Facilities: 58.6 % of deaths occurred in individuals over 80 years of age, and 20% from individuals between 70-79 years of age. The shift presently is to a younger population, 0-29 year-olds and 30-39 year-olds with the warmer weather and outside activities. Disparities affect our African American residents with positive cases at 34.2 % and 38% of the deaths. West Hartford Bloomfield Health District will share a copy of the data, collected weekly, on cases of COVID -19 from the District with students for the project. Methodology

Needs Assessment – Qualitative and Quantitative.

• Survey development, adaptation, and distribution and conducting focus groups • Students may develop a survey to identify community knowledge of COVID-19, using

existing surveys from other organizations, and administer survey

• Students may conduct key informant interviews and focus group to further inform WHBHD COVID-19 educational trainings and interventions. Students would develop the focus group and interview discussion guide, transcribe data, and summarize key themes.

• Data collection and analysis • Students may analyze state and district data to determine impacts of COVID-19 on the

community and high-risk groups

• Students may summarize and analyze CHNA survey responses Special Skills of Students (3 requested)

With assistance from West Hartford Bloomfield staff, students should be able to:

• Develop, adapt, and distribute a survey

• Conduct virtual focus groups

• Summarize and analyze survey and focus group data • Develop plan to address issues identified in the survey and focus group

Resources Available to Students at Agency

• WHBHD can provide physical space for students and access to computers, while at the District

• WHBHD can provide phones for the time at the District office


Organization: Yale New Haven Hospital

Project Title: Community Health Needs Assessment (CHNA): Key Informant Survey Students who work on this project will develop an understanding of the Community Health Needs Assessment (CHNA) process as mandated by the Affordable Care Act, together with skills in survey development, administration and analysis. Overview of Project

Students who work on this project will collaborate with Yale New Haven Hospital (YNHH) and perform a key component of the CHNA implementation process, the key informant surveys. Students will 1) review previous survey tool and recommend modifications, 2) load survey tool into Qualtrics and test prior to dissemination, 3) monitor survey responses / results by region, 4) identify potential qualitative / interview questions and / or key informant respondent groups for qualitative analysis, and 5) develop final documents / presentation for us in the 2022 community needs assessment. A community health assessment is a systematic examination of the health status indicators for a given population used to identify key problems and assets in a community. The ultimate goal of a community health assessment is to develop strategies to address the community’s health needs and identified issues. In order to complete this community health assessment, YNHH must perform the key informant surveys to obtain data from persons who’s professional and/or organizational roles imply they have knowledge about specific characteristics of the population being studied as well as potential pathways and constraints for community change. The student work is essential to successful completion of the CHA in a timely manner. Findings from this project will inform YNHH’s CHNA, which will serve as the basis for a health improvement plan. About Yale New Haven Hospital

Yale New Haven Health includes Bridgeport Hospital, Greenwich Hospital, Lawrence + Memorial Hospital, Yale New Haven Hospital and Westerly Hospital and a physician foundation, Northeast Medical Group. With more than 27,000 employees and 6,082 medical staff, the Yale New Haven Health System had over 123,000 inpatient discharges in Fiscal Year 2019, 2.6 million outpatient encounters. Yale New Haven Health is committed to innovation and excellence in patient care, teaching, research and service to our communities. As part of the Yale New Haven Health System, corporate members may take advantage of services and clinical specialty networks designed to increase patient access to care, improve quality and safety and reduce costs. We remain committed to working with our corporate members, network participants and their affiliated physicians and other partners to find solutions that yield results. Corporate members can take advantage of integrated, centralized services designed to increase efficiencies and reduce costs: Budgeting, Business Development, Center for Healthcare Solutions, Charge Capture/Price Master, Clinical Integration and Population Health, Corporate Compliance, Corporate Facilities, Corporate Finance, Corporate Human Resources Information Services, Corporate Pharmacy Services, Corporate Supply Chain Management, Decision Support, Financial Planning, Government Affairs and Community Relations, Human Resources (including compensation and benefits), Information Technology Services, Institute for Excellence, Laboratory Medicine, Legal Services, Managed Care, Marketing and Communications, Payroll, Planning (Regulatory and Strategy), Quality and Performance Management, Reimbursement, Simulation Center, System Business Office, Treasury and Workers Compensation.


About the Project

Hospitals are required to conduct CHNAs every three years. One of the primary components of the assessment is a key informant survey. A key informant survey is a method of obtaining data from persons who’s professional and/or organizational roles imply they have knowledge about specific characteristics of the population being studied as well as potential pathways and constraints for community change. The objective for the project is for the students to conduct a key informant survey, utilize the findings to determine success of the 2019 health improvement plan and provide direction for 2022 efforts. Specifically, students will be asked to survey key leaders from communities served by four Connecticut hospitals. As mentioned above, Yale New Haven Health is required to conduct a CHNA every three years and a primary component of the CHNA is a key informant survey. YSPH Practicum or Student Consulting Groups have contributed to this work previously by conducting key informant surveys on behalf of the health system for three of our triennial CHNA cycles. Hospitals are required to conduct needs assessments every three years as such the key informant survey needs to be re-administered. This proposal is to build off of, but not duplicate, the key informant survey work previously and to utilize the 2019 community health improvement plan as part of the work. A copy of the 2018-2019 survey questions will be provided for reference purposes. Students are being asked to review the community health improvement plans for four community health improvement coalitions and review the common set of survey questions for key informants suggesting edits if / as needed. Students are expected to develop, administer and analyze results from the survey. Deliverables include PowerPoint presentation of results and a report for each of the four areas. A sample PowerPoint presentation from 2018-2019 is available for reference purposes. Although the survey will be conducted online, students will have the opportunity to add a qualitative aspect through interviews with key stakeholders. This addition would provide the students with a new aspect of the project that would provide them increased exposure to stakeholders. Methodology

Quantitative/Survey:

• Students would administer reviewed and revised survey to approximately 600 key informants using qualtrics.

o The number of surveys and the response rate varied in each region and by key informant group previously. Data from 2018 is below; similar response rates would be expected in 2021.

Bridgeport: 101 / 36% (58% health & human services / 42% gov & community) Greenwich: 109 / 32% (77% health & human services / 23% gov & community) NY (Greenwich): 102 / 14% (43% health & human services / 57% gov &

community) New Haven: 172 / 27% (51% health & human services / 49% gov & community) New London: 112 / 37% (65% health & human services / 35% gov & community) Westerly: 32 / 32% (60% health & human services / 40% gov & community)

Qualitative:

• Students may conduct qualitative interviews with potential key stakeholders, which would include developing the interview discussion guide, transcribing data, and summarizing key themes


o The sample size for this data collection method would depend on whether this method is used to bolster the response rates in particular stakeholder groups or to probe deeper based on the findings.

Special Skills of Students (3 or more requested)

• Ability to think and work independently

• Strong analytic skills. Resources Available to Students at Agency

• Students will be provided with in-kind resources such as internal staff and public health and data specific professionals from across the state

• Given these unprecedented times it is anticipated that most of the effort will be accomplished remotely


Organization: Yale Office of Sustainability

Project Title: Health Impact Assessments at Yale University: A closer look at Materials Management and Environmental Justice

Students who work on this project will pilot the process of conducting a rapid Health Impact Assessment (HIA) for the Yale Office of Sustainability, developing familiarity and emerging expertise in an important emergent community public health tool.

Overview of Project

The Yale Office of Sustainability (YOS) works to ensure that the university’s activities enhance environmental, social, and economic aspects of our community and the communities we impact. The YOS wants to learn more about the effects of the Yale waste management practices, and how those practices impact communities in Connecticut. This project will use Yale’s waste disposal system as a test case of the Health Impact Assessment process – which the WHO defines as “a practical approach used to judge the potential health effects of a policy, programme or project on a population, particularly on vulnerable or disadvantaged groups. Recommendations are produced for decision-makers and stakeholders, with the aim of maximising the proposal's positive health effects and minimising its negative health effects” – as a decision-making tool. In addition, the group will evaluate this process, and make recommendations on how to optimize the utility of the HIA process for university decision-making. The YOS sees this project as an opportunity to test the common methodology for conducting an HIA and assess how it might be modified for administrative decisions across various parts of the university (e.g. built environment, transportation systems, purchasing of goods and services, etc.). This work is part of a broader initiative within YOS and Yale to integrate improved health outcomes into operational decision-making. About Yale Office of Sustainability

The founding of the Office of Sustainability in 2005 is only an inflection point in the rich timeline of Yale’s engagement with sustainability to date. Yale’s intimate engagement with the environment started in 1900 with the founding of the School of Forestry, America’s first such institution, and has since evolved into an institution-wide movement that incorporates building construction; waste management; energy production; research; classroom instruction; local, national, and international collaboration; and much more. With the establishment of our office came the unification and augmentation of existing sustainable endeavors. Since then Yale has clarified its institutional vision for sustainability and codified its commitment to realizing that vision. The Office of Sustainability’s mission is to advance sustainability within the Yale community by acting as a catalyst for information exchange and facilitating capacity building, innovation, streamlined operations, and preparation of tomorrow’s sustainability leaders. About the Project

The Yale Sustainability Plan 2025 (YSP25) aims to “encourage decision-making and behavior that leads to a healthy, vibrant campus and surrounding community.” The goals in the plan aim to create a campus environment where people thrive, recognizing that many decisions around sustainability (e.g. transportation, food, energy, etc.) also provide windows of opportunity to enhance the health and well-being of our community. They are seeking strategies to help operational decision-makers be more intentional about considering how health and well-being can be a co-benefit of policies and procedures aimed to improve sustainability. This project will help YOS determine if health impact assessments can be a tool to advance this effort.


The YSP25 includes a number of goals around materials management, including an effort to increase waste diversion, particularly through reuse. As we communicate to the campus community about the importance of this effort, we are hoping to better understand what (if any) health impacts result from our waste processing. For example, when municipal solid waste (MSW) is collected from trash bins across campus, it is consolidated in dumpsters and trucked to a waste-to-energy facility in Bridgeport, CT, where it is combusted to generate electricity. Recycling is also collected and trucked to a local materials reclamation facility (MRF), where the materials are sorted (by people and machines) into separate commodities and sold to be recycled into new products. Food waste is sent to a waste-to-energy facility in Southington, CT, and is processed into biogas via anaerobic digestion. As the University promotes waste reduction, they are curious to learn about any potential social or health impacts associated with our waste management practices. For example, what community impacts result from Yale’s municipal waste disposal system? Are there any air quality impacts associated with the trash-to-energy process? If so, should we include that in messaging to encourage more waste diversion? Should that impact decision-making around contracts and services? Methodology

Health Impact Assessment • Students will carry out the identified series of steps for a rapid HIA (Screening, Scoping,

Appraisal, Reporting, and Monitoring) to identify the potential health impacts of the Yale waste processing system.

• Students may then evaluate the HIA approach and the results that come from it. o Students may work with preceptor to determine evaluation criteria for this process to

develop conclusions and recommendations for future HIAs

• To include the broader community, students may provide a list of key stakeholders for potential key informant interviews

Special Skills of Students (3-5 requested)

• Students should have the ability to work independently and as a team • Good oral and written communication skills

• Knowledge of/experience with HIA helpful, but not essential Resources Available to Students at Agency

• Work will be conducted remotely due to health considerations o If in-person gatherings are permitted at some point and university offices resume pre-

COVID status, office space may be available at the Office of Sustainability (70 Whitney Ave.).


SERVING VULNERABLE POPULATIONS

Organization: Community Renewal Team (CRT)

Project Title: The Impact of COVID on Seniors Served in Multiple Levels of Care Students who work on this project will develop an understanding of social impacts of COVID-19 on residents in long term care facilities, together with social interventions/activities currently being used to alleviate social isolation.

Overview of Project

The COVID pandemic has taken a toll on Connecticut’s seniors, particularly ones who are low-income, minorities and/or living in congregate settings. There is substantial evidence showing the ill effects of social isolation on the elderly. According to the CDC, the public health risks of loneliness among the elderly include dementia, depression, and other medical conditions. Working alongside CRT, students will 1) identify different methods used to provide social interaction for clients receiving different levels of care and assess their benefits in limiting depression, anxiety, and cognitive decline and the facility in using the methods during a period of social isolation, 2) identify more granularly, any differences between efficacy of specific computer technologies among different populations (i.e., people with hearing impairment, people with greater degrees of dementia, etc.), and 3) using the literature search and data from staff and client questionnaires and assessment tools, determine which activities could be deemed “best practices”. The results from this project will give CRT feedback about on-going interventions that will enable them to improve their current programs and their use of virtual counseling and telemedicine. In addition, through this analysis, they will see what, if any, services might qualify as best practices and we will present data to the CT Department of Mental Health and Addiction Services plus the North Central Area Agency on Aging. About Community Renewal Team

Serving Hartford and Middlesex counties, CRT’s is the state’s oldest and largest community action agency. Inaugurated in 1963, our mission is “Preparing Our Community to Meet Life’s Challenges.” In order to serve our mission, the agency operates a wide variety of programs including, but not limited to, Behavioral Health Services, Elderly Nutrition, Assisted Living, Homeless Shelters and Supportive Housing (including a project that enables low-income grandparents to live with their grandchildren), basic needs, money management, etc. In 2019, we provided services for over 56,300 individuals. Approximately one-half were at or below 100% of the federal poverty level; in fact, nearly one-quarter of the households lived at or under 50% of the federal poverty level. These clients ranged from infancy to old age. Over 60% were people of color and over 35% were Hispanic. Diversity and inclusion are cornerstones of our agency and we seek to hire staff that mirrors the communities that we serve. Currently, close to 70% of our workforce is composed of people of color including the nearly 60% of our agency’s management/professional staff. Our commitment to diversity is more than these demographics. We hire individuals with lived experiences matching our participants. For example, the case manager for our Generations program, formerly lived in this housing complex and our HIV-related programs have typically included individuals from the LGBTQ community.


About the Project The COVID pandemic has taken a toll on Connecticut’s seniors, particularly ones who are low-income, minorities and/or living in congregate settings. However, while information on nursing home residents is detailed, such data is not mandatory for assisted living facilities or senior housing projects. While the state has initiated efforts to close this information gap, it remains substantial. During the early and most serious months of the pandemic in Connecticut, specifically April and May, it was reported that 93% of the state’s fatalities were among people age 60 and over and 85% were among nursing home residents. An August 20th report by Mathematica stated that 74% of all COVID-related deaths in CT were among residents of long-term care facilities. However, both the case and death rates were considerably higher in nursing homes than assisted living facilities. Their analysis found that in nursing homes, 50% of residents in 26% of the nursing homes contracted COVID-19 and 20% of residents died in 50% of the homes. Whereas, only 3% of these residences had a 50% “COVID contract rate” and only 3% had more than a 20% death rate. The gaps between different levels of care has led CRT to seek to explore the different avenues that have been taken to protect seniors from COVID at different care levels. The physical threats of COVID have been and are continuing to be studied diligently by researchers. Researchers are aware of another issue that can put seniors at risk – social isolation – but it is not being studied nearly as much, particularly not as it pertains specifically to the Age of COVID. As the lethality of COVID among seniors has grown, more measures have been enacted to keep the elderly physically safe – PPE for staff, hygiene, the use of masks, social distancing, etc. But at what cost? It is already known that social isolation can be as dangerous to seniors as smoking or obesity. Social isolation and loneliness among seniors have been linked to high blood pressure, heart attacks, strokes, depression, anxiety, and cognitive decline. Therefore, our Seniors Services staff want to understand the effects of the safety measures that have been pursued, particularly social isolation, on seniors. Staff would like to see what measures worked to lessen loneliness (e.g., Face Timing with relatives, Zoom get-togethers with peers, even video games) among the elderly and which, if any, could be deemed best practices that could be shared with providers statewide. Methodology

Qualitative and Quantitative:

• Students may conduct a literature search/review to identify best practices and methods to provide social interaction for clients receiving different levels of care

• Students may develop, adapt, and distribute questionnaires of staff and clients to understand different needs at different facilities

• Students may use validated instruments to assess emotional and cognitive functioning and compare with those completed prior to the pandemic

Special Skills of Students (5 requested)

• Good interpersonal and analytical skills

• Prior interactions with elderly individuals (either personally or through classes) would be an asset.



• Students will have access to prior assessments and insurance information pertaining to medical records. All such information will be confidential and will be treated as such. [CRT’s confidential policies will be shared with each student at the start of the project.]

• Socially-distanced space for students will be provided. We expect that students will use their own computers and cellphones.


Organization: HAVEN Free Clinic

Project Title: Health and Social Impacts of COVID-19 on Uninsured Populations in the City of New Haven Students who work on this project will develop an understanding of clients using the HAVEN Free clinic, and will develop skills in survey construction, distribution and analysis.

Overview of Project

COVID-19 data and statistics on uninsured populations in New Haven is seriously limited. An important population of uninsured individuals are undocumented immigrants, as they are ineligible for Medicaid and Marketplace coverage and therefore rely on free clinics like HAVEN and federally qualified health centers. For this project, students will work with HAVEN Free Clinic to 1) perform a landscape analysis that accounts for the existing gaps in data currently available and subsequent health and social needs in uninsured populations in the city of New Haven and determines how best to collect primary data that supplements the existing secondary data from uninsured individuals who are not necessarily housed in a single database, 2) develop survey questionnaire to collect data on the health and social impact of COVID-19 on uninsured populations that other data sources do not already collect, 3) collect survey responses from uninsured populations in the city of New Haven, and 4) analyze subsequent data and use results to inform recommendations for HAVEN (and potentially government officials) to meet the gaps. The project results will be used to inform HAVEN Free Clinic’s direction in the upcoming year so as to best meet the health and social needs of its client population. The findings may inspire, but are not necessarily limited to, establishing partnerships with existing community organizations, funding new health or social start-ups, and pursuing policy advocacy at the local and state level. About HAVEN Free Clinic

The HAVEN Free Clinic is a student-run primary care clinic that partners with Yale University to provide uninsured and undocumented adults in the New Haven community access to comprehensive, high-quality health care free of charge. Our model is unique because we include members across various disciplines in health care and provide a range of services that address both health and social needs, including primary and reproductive health care, social services, medical debt assistance, free medications and diagnostics, free specialty referrals, a medical-legal partnership, and behavioral health counseling. We encourage and incorporate principles of diversity, equity, and inclusion in our volunteer recruitment, trainings, and volunteer-focused events. Following the murders of Ahmaud Arbery, Breonna Taylor, George Floyd, Tony McDade, James Scurlock, David McAtee, and Sean Monterrosa, HAVEN issued a statement in solidarity with the Black Lives Matter movement and everyone fighting for the liberation of Black and Brown individuals. We believe this work is inextricable from our own. Our statement is linked here. We committed to taking the following concrete steps:

• We are in the process of developing a curriculum for our volunteers to unlearn race-based medicine, to be implemented this fall term. As part of this, Lakai Legg is leading our Community Relations & Engagement Committee on a speaker series focused on health equity work.

• This fall term, we preferentially selected volunteers who have taken a health/social justice course (such as courses in AFAM, ERM, and HSHM).


• We are continuing to work towards establishing a community advisory board, by 2021, to create an avenue for community partners to give us direction and feedback as part of our quality improvement work.

About the Project

At the beginning of the pandemic, medical professionals and health advocates warned of the pandemic’s impact on vulnerable populations that would exacerbate existing health inequities. For instance, Connecticut’s public health officials urged the public to stay home and call their doctor before seeking in-person medical care, but this ignored the uninsured population’s lack of access to primary care providers. Health professionals speculate that without a bridge into the healthcare system and access to reliable and up to date information of COVID-19, uninsured people are unable to receive both medical care and information on testing and treatment options. Additionally, telehealth has been widely adopted by healthcare organizations to adapt to the pandemic. However, we are concerned this rapid shift may have excluded many uninsured patients who are unable to afford phone and internet bills as a result of job insecurity and poverty. Without access to a computer or phone, people are both unable to receive medical care and unable to access updated information necessary to receive testing and treatment. Furthermore, the pandemic’s negative impact on the economy has resulted in high job loss, most especially for people already facing financial instability. Even prior to the pandemic, HAVEN had seen first-hand many patients’ average medical debt exceed their average annual income-- we suspect this debt has only worsened through the pandemic. HAVEN also treats a majority of undocumented immigrants who face serious job challenges. Some expressed worry that their new job in high-risk settings would put them and their family at increased risk of infection. Others reported that with so few jobs and their current immigration status they do not want to report being exploited by employers as they cannot report illegal mistreatment or abuse without risking deportation. Without data collection, HAVEN is one of the many New Haven organizations who remain unaware of the extent and impact of the pandemic on uninsured populations’ health and social wellbeing. Indeed, Trump’s executive order to exclude immigrants from the census and the public charge ruling means undocumented immigrants, an important portion of the uninsured population, may be underrepresented in any survey or study due to fear of being deported. Even with HAVEN patient narratives, their experiences still remain just a subset of our understanding of the broader community impact. We believe a sound study design and systematic data collection is necessary to truly and accurately document the impact of COVID-19 on our clients. Methodology

Mixed Methods: Quantitative and Qualitative

• Students will develop, adapt, and conduct a survey to serve as a type of community needs assessment (can be conducted using a similar model as DataHaven in their community health needs assessments).

o They propose a rapid assessment that focuses data collection on a limited number of variables to balance information needed and timeliness

o They are open to adapting the Covid-19 impact scale to the intended population with an additional 1-3 qualitative questions to more directly address specific HAVEN questions.

o Participants can be identified through a network analysis through (virtual) events hosted by relevant community organizations (which we will provide the list of).

• Students may collect and analyze survey results and present key findings in a short report

https://www.nlm.nih.gov/dr2/Coronavirus_Impact_Scale.pdf


• Landscape analysis: Students may identify the key players in New Haven or Connecticut that are relevant to this area of research: uninsured or undocumented populations.


• Students with experience or knowledge on conducting community health needs assessments

• Some experience with survey design. • Bilingual skills (English and Spanish) a plus


• We can provide computer time and telephones if needed on Saturday clinic days (8am-2pm) and remote EPIC access for data sources if required.


Organization: Amistad Catholic Worker

Project Title: Developing Transitional Housing Strategies in New Haven Students who work on this project will develop an understanding of current emergency and long-term approaches to addressing homelessness, together with skills in qualitative interviewing and compilation of best practices drawing on web-based materials, grey literature and peer-reviewed literature.

Overview of Project

The purpose of this project is to provide evidence-based recommendations for policy, ordinances, code enforcement, funding, and community support to introduce proven, successful models of transitional housing to greater New Haven. The primary objective of this project is to develop and present policy and near-term practical recommendations for transitional housing for New Haven's homeless population with particular emphasis on hard-to-house street population. This includes outlining specific practices by city governments that affirmatively support and enable transitional housing. Among the "best practices" ideas to be highlighted in the recommendations would be those points of influence, collaboration, and communication (especially involving local government) that would increase the chances of successfully implementing transitional housing policies), Additionally, if possible, the recommendations would include an appendix/repository of practical reference information (example resident agreements, by-laws, site plans, typical operating budget, etc.) that can be used to fashion a template or "kit" for small, transitional community formation.

A secondary objective would be to create a qualitative summary of issues and concerns of each of the major stakeholders affected by the creation of transitional housing sites (residents themselves, local neighbors and merchants, etc.). This could be the basis for validation/testing within New Haven's own stakeholder community as well as a tool for the conduct of the project itself. The findings and associated deliverables can be a key work product for policy makers at the City government, relevant non-profit agencies and key legislators in Hartford. At a practical level, portions of the findings can be a tool for "jump-starting" transitional housing communities in greater New Haven.

About Amistad Catholic Worker

The Amistad Catholic Worker is a neighborhood-based house of hospitality, intentional community, social action and mutual aid collective, dedicated to the daily practice of The Works of Mercy, nonviolence, personalism and prayer. We have an open door for meals, we offer sustenance, companionship and solidarity in one of the most stressed residential areas in the city of New Haven. Founded in 1994, The Amistad Catholic Worker has become a bridge for hundreds of students eager to integrate hands-on experience of the struggles of New Haven’s poor with their university education. Our community members have supervised internships, acted as mentors and spiritual directors, for both graduate and undergraduate students in Yale’s Schools of Forestry, Divinity, Law and Social Work, among others. We have diligently worked to counter a common narrative that presents neighborhoods like The Hill as hostile, threatening and “off limits” to the university. At the same time, we pride ourselves on having helped to unleash the incredible gifts, creativity and power for positive social change that these students bring to our city.


About the Project

As of September 2020, it has been estimated by members of the Coordinated Action Networks, which includes major New Haven stakeholders addressing homelessness, that there will be approximately 300 unhoused individuals on the streets of greater New Haven. Despite a significant and successful crash effort to increase the number of housed in the midst of the epidemic, this is roughly twice the "typical" number, due to the expiration of summer hotel contracts, the significantly-reduced operating capacity of standard homeless shelters (e.g. Columbus House et al), the closure of an overflow shelter, the delayed contracting of warming centers (which are not housing facilities), and the increasing number of people in distress as the economic and health effects of the pandemic continue to grow. In the Summer of 2020, Amistad Catholic Worker (a house of hospitality and one of 175 Catholic Worker communities in the United States) acted as a catalyst to establish a tent encampment on unoccupied land at a city park on the West River in New Haven. There have previously been encampments in various parts of New Haven, ultimately demolished by the City. The collective organizing the current encampment has taken care to follow CDC guidelines in spacing of tents, and, to the extent they can, provide for hygiene and community behavior appropriate to conditions during the pandemic. At the encampment site there is currently running potable water, garbage collection service, and portable toilets serviced by the City. The community has been successfully self-sustaining and self-governing, and is occupied by approximately 20 residents. It was recently visited by Mayor Elicker and other City officials who have taken the interim decision to continue to permit the encampment. This encampment is not a solution, however, but an example. It faces a number of challenges as winter approaches and its residents are currently improvising adaptations in the expectation that they will have no choice but to survive the winter there. At the same time, it has become clear that elsewhere there are alternative transitional housing options, often starting with encampments just like the one on West River, that have evolved into sustainable transitional housing solutions. Often they have become part of a larger spectrum of housing solutions (from structured encampments benefiting from city services, to "villages" of non-tent structures). In cities like Eugene and Portland, Oregon, such solutions have existed for twenty years. For the foreseeable future, "shelters" as conceived of by the City of New Haven and its providers will be inadequate both in capacity and operating model – their quasi-carceral facilities will continue to be rejected by many homeless who affirmatively elect to sleep on the street. Accordingly, this project proposes to learn, analyze, and develop recommendations for New Haven stakeholders to provide solutions for transitional housing instead of denying that there is a problem, building upon well-established solutions that have been endorsed and accommodated by multiple different city governments and are, in most cases, self-governed and one or even two orders of magnitude cheaper to operate than traditional facilities. Methodologies

• Landscape analysis of websites and online resources of organizations focused on housing solutions with an eye to identifying creative options both within the United States and globally

• Literature review of peer-reviewed and grey literature to identify innovative approaches to providing housing


Qualitative • The bulk of the assembled information will be qualitative definitions of best practices

and experiences.

• In some cases, it’s possible a minimal amount of standard financial analysis (DCF, NPV) might be desirable for analyzing potential return on capital, program effectiveness, etc.

Special Skills of Students

• It would be desirable for students to have field experience in health care and public health

• Having had face-to-face experience on the street and in communities with "people with lived experience" is required


• Amistad Catholic Worker has been in New Haven for over 25 years and can make introductions to a broad range of community members, including Mayor Elicker and his staff, who will be stakeholders in the project


Organization: Hands on Hartford

Project Title: Identification and Implementation of Effective Practices to Improve Medical Partnership and Outcomes for Supportive Housing Individuals, including Those Who are Immune Compromised Students who work on this project will develop an understanding of challenges of accessing primary care for clients in supportive housing, together with skills in qualitative interviewing and compilation of best practices drawing on web-based materials, grey literature and peer-reviewed literature.

Overview of Project

Hands on Hartford has noted that a number of their residents do not have a primary care provider (PCP). In addition, many of those that do have a PCP do not regularly attend appointments with them or with other specialized physicians to whom they are referred. As a result, Hands on Hartford is looking to analyze the reasons for this and to develop, implement, and analyze the effectiveness of an approach to improve care attendance and thus improve the health status of those we serve. For this project students will: 1) identify national best practices and successful practices used by similiar agencies that promote regular attendance to medical care, 2) identify existing tools that assess experience of health care utilization, and then adapt such existing tools to include 1-3 qualitative questions to be used to identify persons served experience of medical care at key providers used by agency, and 3) along with direct care staff, develop strategies for staff to use with persons served that are guided by the information gathered. For Hands on Hartford in particular, the results of this initiative will give their Case Managers an understanding of factors at play in making effective referrals to medical providers, and an arsenal of interventions that support people’s attendance at medical appointments. About Hands on Hartford

Hands On Hartford (HOH) was founded in 1969 as Center City Churches. In partnership with others, they strengthen community in Hartford by responding faithfully to people in need through programs that change lives and renew human possibility. They serve Hartford's low-income residents in the areas of food, housing, and health supports. Between 1969 and 2000, they created Hartford’s first senior center, first soup kitchen, first emergency shelter, first psychiatric group home, the city’s first and largest congregate residence for people with HIV/AIDS, a food pantry/resource/advocacy center and various children’s programs. During that time, they established Connecticut’s first and Hartford’s only weekend senior meals program, the state’s first supportive housing for people with HIV/AIDS, and the state’s first Family School Connection child abuse prevention program. In 2007 they became the state’s first affiliate of the Hands On Network (now called Global Points of Light). They created a community engagement/direct human services model that is unique within GPL and within CT. They currently provide Housing Services to 72 individuals/families, Community Meals, a Food Pantry, School Backpack Program, Faces of Homelessness (a Speaker Program to promote awareness), and have a Community Engagement Program designed at developing volunteer opportunities and increasing community action and involvement. About the Project

HOH provides supported housing services to 72 formerly homeless persons or people at risk of homelessness. Of them 61are living with HIV/AIDS. The remainder were unstably housed persons


referred as a result of frequent Emergency Room visits. Almost all of the individuals we serve have comorbid medical conditions such as diabetes and hypertension. Our goal is to ensure that all persons served have access to and are comfortable receiving the appropriate level of medical care to maintain or improve their health status. In a recent audit of charts, it was discovered that 13 of 72 residents in supported housing programs did not have an identified PCP. In additions, of those who had a PCP identified, 10 had not attended an appointment in over a year. While a small subset of residents are in good health, most of the persons served are HIV positive or have been referred due to high utilization of Emergency Services. In many cases these visits serve as a substitute for consistent primary care. Most of the persons we serve have multiple medical and behavioral health conditions. We lack specific data in this regard, but an anecdotal review supports this. Therefore, we believe that most people we serve would require visits more frequently than once a year, as well as visits with specialists. While staff may make assumptions as to the reasons for this, we do not have the expertise, time or resources to undertake an analysis of the reasons or to develop, implement and analyze the effectiveness of an approach to improve care attendance and thus improve the health status of those we serve. Methodology

Mixed Method: Qualitative and Quantitative

• Students may identify any best practices or practices identified as effective by agencies similar to Hands on Hartford.

• Students may develop, identify, or adapt a survey of experiences/satisfaction with medical provider appointments and administer it (up to 72 participants)

• Students may develop questions for and conduct either individual interviews or small focus groups to discuss access and comfort with medical providers and with Hand of Hartford’s assistance with these appointments is desired

• Students may develop a data collection methodology with limited time impact on Direct Care Staff is essential to the success of the initiative.


• We would very much like to work with students who are comfortable interacting directly with the people we serve and with front line staff. I

• Individuals who are conversant with instrument/survey design and with the capacity to develop simple database design and entry systems would be very helpful


• When on site, students would have an open workspace, equipped with computer, phone and internet access.

o In general, due to some space limitations, it would be better if not all three students were on site at the same time so as to ensure the availability of these resources.

• The Manager of the Housing Programs will be made available to the students to provide context and information as needed, and also to facilitate any interactions with the persons served or with other staff.


Organization: Leeway

Project Title: Planning for Urgent Specialty Chronic Care PLUS-CC Students who work on this project will develop an understanding of chronic care needs of Leeway residential clients, and the emerging approaches for addressing such complex needs. Students will also develop skills in qualitative interviewing and compilation of best practices drawing on web-based materials, grey literature and peer-reviewed literature.

Overview of Project

In planning for more effective Urgent Care, participating Yale Public Health students can develop and refine skills that transfer classroom techniques to actual practice research such as the following: 1) define public health issue from varying points of view of a consumer, health care institution, the community and cost administrator; 2) Apply basic research skills by developing a research plan then conducting and/or refining a needs assessment through a literature search, data analysis, data gathering and interviews. Identifying and massaging data is critical. Interviewing skills include development of forms to induce useful responses for qualitative data that is actual, not presumed and offers tabulatable results that relate to project objectives. Evaluation measures for the student project will be included in the research plan. 3. Use and develop meaningful reports within public and selected health care electronic records from local and national sources from literature and reports to assess alternative solutions to urgent care for consumers with primary, specialty and emergency complex needs often including HIV/AIDS. 4. Enhance teamwork. 5. Compose a clear and persuasive narrative report and presentation for Leeway staff using appropriate visuals (Charts, graphs, etc. are welcome) About Leeway

Leeway began with a concept by a Yale graduate student Catherine Kennedy, Leeway's founder, for in-patient skilled, humane, comfortable in-patient treatment for HIV/AIDS patients. Drawing also from community volunteering, she envisioned Leeway's underlying and ongoing principles of serving HIV/AIDS consumers with highest quality medical services for holistic care respectfully delivered in an in-patient attractive environment, free from stigma, bias or judgement. Leeway's ancillary services have always included physical and occupational therapy, appropriate recreation and daily living skills training. Yale referred consumers to Leeway from its community. Yale continues to participate by contributing and identifying funds, locating space, staffing of specialized medical skills, identifying board members, offering on-going expertise, advice and volunteers. Yale students have been seminal in developing programs through practicums, internships, and volunteering. Particular examples include the development of an Alumni organization to maintain healthful connections to graduates from all of Leeway's programs. Internships, participation in developing projects, and underwriting through Yale grants have also been contributed. Students have been critical to program development of supportive housing and recreational programming among other efforts. Public Health students worked on data collection measures for a change in State requirements for information. Today Leeway has evolved into a multi-purpose organization. 30 HIV/AIDS acute care inpatients live in highly skilled nursing (SNF): 30 additional subacute residents with HIV/AIDS or Hepatitis C live in a slightly less restrictive residential setting (RCH) ; and 41 chronic care tenants live in supportive housing (SHP) in 3 buildings, 2 of which Leeway constructed exclusively and one in a partnership. In addition, SHP dispersed units in the community are case managed by Leeway. SHP tenants must be formerly homeless individuals with mental health and /or substance use diagnoses. Each client is


served for chronic care with the same humane principles. Leeway consumers (and the DSS funded project participants) constitute the chronic care population individuals to be served by more effective primary, specialized and emergency urgent care. Leeway's Skilled Nursing Facility Mission Statement: Leeway, an integral part of the continuum of AIDS care, is committed to being a center of excellence in providing inpatient rehabilitative and palliative care so that those with chronic care needs and particularly with HIV/AIDS can live as independently as possible. This expert care is respectfully provided with compassion and without regard to race, national origin, age religion handicap, gender or sexual orientation. Leeway's focus is on the integration of mind, body and spirit. We are committed to promoting quality of life and dignity to consumers. Leeway's Residential Care Housing Mission Statement: Leeway's Residential Care Facility, an integral part of its responsibility for chronic care with a historic emphasis on the continuum of AIDS care. Leeway is committed to being a center of excellence in providing residential, personal and supplemental care so that those with chronic conditions including HIV/AIDS, Hepatitis C, and/or related conditions can live as independently as possible. This expert care is respectfully provided with compassion and without regard to race, national origin, age, religion, handicap, gender or sexual orientation with the focus on the integration of body, mind and spirit. We are committed to promoting quality of life and dignity to all.

About the Project

While profuse services exist in the clinics in the catchment area, Leeway believes there is a gap in current nearby primary, specialized and emergency services particular to complex chronic care including HIV/AIDS care. Too often services are distant and unavailable for an immediate response after hours or on weekends. Patient records from various sources are not always readily available. Consumers therefore wait too long and as a consequence sometimes are admitted to a hospital unnecessarily. Staff arrangements, service burdens, transportation and high reduceable costs seem to result. As an initial planning segment in Leeway's continuous pursuit of better health outcomes, less costly solutions, and more efficiency we are asking for students to help find alternatives to delivering urgent care though a literature search, data gathering, data analysis and interviews to benefit residents or residential facilities and those out in the world with complex chronic care conditions. Methodology

1. Develop Work Plan for a specific Student Research Project to examine alternatives to improve Leeway specialized, primary, specialized and emergency urgent care. Students may determine credible alternative configurations of urgent care through a logic model, literature review to identify approaches to meeting primary, specialized and emergency care needs, data analysis, data gathering and practice review. Create evaluation measures to guide student progress and achievement.

Team activity with Leeway staff.

2. Needs analysis: Define needs through examination of data at Leeway and public records (Point and Click Care, CT Medicaid, government sources). A recent DSS funded study referred to as the Community Living Model provides specific information based on surveys. Other data to be mined and gathered by YPH students may be found in HOPWA reports, in Supportive Housing


6 month required reports, at emergency rooms, hospitals, clinics, transportation sources and from Leeway consumers and staff probing perceptions as well as data. Information regarding coordination of records, wait times for service, mortality rates and the costs thereof are also germane. Literature and practice review of effective urgent care treatment around the globe should be examined along with critical evaluations of each option to identify approaches to meeting primary, specialty and emergency needs.

Team activity followed by delegated responsibilities for different information and varying sources of data.

3. Develop instruments to interview Leeway consumers and staff administrators of current urgent/emergency care providers, that can be tabulated. Consumer evaluation of emergency services must include effective delivery, barriers and gaps. Clinics and emergency room material should be surveyed. Sensitivity to the importance of qualitative as opposed to quantitative data are critical. Discriminating actual feelings from those that are presumed feelings is a critical professional skill. Leeway's experience and judgement about appropriate use of current emergency services, referencing particularly transportation should be surveyed.

Team activity with Leeway staff 4. After testing survey instruments, interview selected respondents and tabulate.

Delegated tasks to individuals and subgroups of students overseen by Leeway staff 5. Analyze data and create formats (some electronic displays are assumed) to demonstrate

specific gaps and opportunities that have been identified by Leeway staff and others. Individual, delegated subgroups and Leeway staff.

6. Envision prospects for urgent care. Team overseen by Leeway

7. Write a narrative report and create a presentation with visuals for presentation to Leeway staff and Executives. Leeway hopes to be invited to the Yale Public School of Health classroom final presentation for questions and answers.

Team with oversight from Yale and Leeway


Verbal and interviewing skills, research skills, and work experience in the healthcare field.


• Availability of Leeway staff expertise, experience, and perception and in data location, analysis and reporting, and in public health topics

• Supervisory assistance

• Curated access to Leeway consumers from SNF, RCH and SHP

• PPE

• Desks in designated spaces • Computers

• Telephone


TRAUMA-INFORMED EMPOWERMENT OF VULNERABLE YOUTH

Organization: DreamKit

Project Title: Understanding How Virtual Internships Improve Confidence, Leadership, and Stability Among Unstably Housed Youth Students who work on this project will develop an understanding of approaches to assessing learning and skill development, together with skills in qualitative interviewing and compilation of best practices drawing on web-based materials, grey literature and peer-reviewed literature.

Overview of Project

The DreamKit virtual Youth Specialists internship is a stepping-stone for their members, housing insecure youth, to gain the leadership, entrepreneurial, and professional skills needed to transition into full time employment. For this project students will create a project proposal for DreamKit’s virtual Youth Specialist internship opportunity. We are relying on students to recommend multiple scales for DreamKit to utilize in evaluating the strength of the virtual Youth Specialist internship. Broadly, this project will create virtual internship opportunities for current DreamKit members to join the team so they can create recommendations for new app features and programs. Specifically, students will: 1) help DreamKit understand the incredibly new landscape of virtual internships and what makes them successful among vulnerable populations, 2) ensure that existing metrics for this project are accurate and conduct additional stakeholder research to provide recommendations to their existing list of metrics, and 3) develop an interview guide to better understand Youth Specialists’ experience with their virtual internship. Students will not be conducting these interviews, but instead create a framework for the DreamKit team to later utilize. The resulting data and proposal will be submitted to the City of New Haven to seek funding for implementation. About DreamKit

DreamKit (dreamkitapp.com) is a web-based app that catalogues and amplifies the resilience of young adults experiencing homelessness. Overall, we connect youth with virtual resources, financially reward their growth, and share their progress with the community.

At its core, DreamKit is a web-based app for unstably housed youth that gamifies the independent living skills required for employment, social, and housing stability. DreamKit users are couch surfing, sleeping in a shelter, staying with a friend or family member temporarily, or sleeping at a place not meant for human habitation – and this unstable living situation intensifies their need for productive, safe, and income generating activities.

The content of DreamKit’s curriculum is designed by young people in the community for local young people experiencing homelessness. Skill modules, in the form of videos and articles, are carefully chosen and crafted to help unstably housed youth build personal, professional, educational, and social skills. DreamKit members receive $5 gift cards (max $50/week) for completing online Activities, and build profiles that reflect their progress to be shared with potential employers.

About the Project

COVID has highlighted in stark contrast the deep and pervasive divide caused by unequal access to digital technologies. Internet access may be the single most impactful capacity for education and innovation, but youth struggling with housing insecurity often lack access – a necessary tool to their pathway towards stable housing and employment.


At a time when they should be developing their potential, these youth are forced to focus on pursuing immediate needs like food and shelter. Early interventions can unlock that promise - potential innovations and contributions of this young population are lost as cycles of poverty take hold. 75% of homeless youth are currently unemployed compared to 16% unemployment among their housed counterparts, causing them to fall farther behind their counterparts. The most common complaint from their employers and service providers is the difficulty of irregular communication. Youth will often have their phones turned off because they reached their monthly data limit, or if they’re in an area with no wifi (which has only intensified due to COVID and the shutdown of many public places with free WIFI). One service provider noted, “COVID has made it even more necessary to provide phones, WIFI, and other technology to our clients, with almost all services moving towards virtual platforms.” Students will create a project proposal for DreamKit’s virtual Youth Specialist internship opportunity. They are relying on students to recommend multiple scales for DreamKit to utilize in evaluating the strength of the virtual Youth Specialist internship. The virtual Youth Specialists internship is a stepping-stone for members to gain the leadership, entrepreneurial, and professional skills needed to transition into full time employment. Students will recommend scales to help track this progress. This proposal will be submitted to the City of New Haven to seek funding for implementation. DreamKit has an idea what this project should look like, but wants students to conduct stakeholder interviews with current DreamKit users (youth experiencing homelessness) and local employers to inform how this project is operationalized. Broadly, this project will create virtual internship opportunities for current DreamKit members to join the team so they can create recommendations for new app features and programs. Since the field of virtual internships is still very new, they are requesting students help us flesh out this model so that it is accessible and rewarding for our Youth Specialists. Methodology

Qualitative: • Students may review DreamKits existing project proposal and recommend additional scales to

utilize to track social-emotional outcomes of our Youth Specialist interns.

• Students may conduct a literature review on best practices in creating leadership experiences for homeless youth.

o Additional information regarding trauma informed care is also desired

• Students may conduct an in-depth needs assessment with two different groups of stakeholders: DreamKit users and local employers

o Students will interview DreamKit users (n=10) to better understand their barriers towards employment, in addition to employers (n=10) who can describe their barriers in hiring homeless youth.

• Students may use key findings to inform how DreamKit as an organization can better track youth progress through this internship program and recommend a variety of scales to measure improvements in health outcomes among vulnerable youth.

Special Skills of Students (3-5 requested)

• Students should have a curiosity about the growing digital divide as a byproduct of COVID and how equitable access to technology can provide new opportunities for community engagement.


• Students should also be interested in best practices around trauma informed care as it pertains to qualitative interviewing with a high risk and vulnerable population.

o All interview participants will have either current or past experience with homelessness, so students should enter into each conversation with empathy and positivity.


• These interviews will all be conducted virtually. Students will have access to the knowledge and lived experience of our team, which includes faculty, researchers, New Haven activists, and unstably housed youth.


Organization: Huneebee Project

Project Title: Assessing Needs of Transition-Age Youth in Foster Care in New Haven County Students who work on this project will develop an understanding of the needs of young adults who spent time in foster care, together with skills in qualitative interviewing, extraction and compilation of web-based data on the needs of such young adults, and compilation of best practices drawing on web-based materials, grey literature and peer-reviewed literature. Overview of Project

Huneebee Project seeks to involve youth and young adults between the ages of 15-23 in New Haven, Connecticut with past or present child protective and/or foster care involvement in transferable job skills training and employment opportunities through beekeeping in community spaces. The main objective of this project is to evaluate the needs of youth in foster care in New Haven county, and to evaluate these needs in a way that will allow us to develop appropriate, responsive programming. In addition, they hope that this project will address New Haven’s longstanding history of segregation and oppressive power dynamics, which have bred mistrust between the Yale community and greater New Haven community. For this project, students will better define the needs of the target population by: 1) identifying existing data and gaps in data around mental health, emotional support needs and sense of self-efficacy, 2) gathering and organizing socio-economic data (high school and college enrollment, employment rate, living conditions, access to primary care, enrollment in health insurance, history with the criminal justice system), 3) gathering information on existing independent living training (within foster homes and/or through DCF/therapeutic foster care agencies), and 4) identifying existing social/emotional resources accessible to youth (i.e. mental health care/emotional support/self-empowerment) in New Haven county. Additionally, students will actively involve Huneebee youth employees in the project by collaborating with a Huneebee youth liaison throughout the project. About Huneebee Project

Huneebee Project is a social enterprise in the process of obtaining non-profit certification that partners with Gather New Haven, the Yale Child Study Center, and community gardens in under-resourced neighborhoods in New Haven. Huneebee involves youth between the ages of 15-23 with past or present child protective or foster care involvement in merging beekeeping and gardening in community spaces with the creative arts and entrepreneurship. Through 4-month-long therapeutic Beekeepers in Residence job skills training programs, continued employment opportunities, and bee apprenticeships, youth experience a variety of educational experiences, opportunities for personal and professional growth, and develop meaningful relationships and pro-social skills. Youth build, paint, and install honey bee hives, monitor food levels, and address issues of pest control using natural methods. They plant pollinator-friendly green spaces. They maintain and harvest various medicinal flowers and herbs from these green spaces, including chamomile, anise hyssop, lemon balm, and mint, with the intentions of developing and marketing varieties of tea. They harvest honey and beeswax from the honey bee hives they’ve installed and maintained, and power an online marketplace that currently includes jarred honey, pollinator seed packets, ceramic planters and vases, and, in time, will include beeswax candles.


Huneebee Project believes that all youth should be empowered and supported in building a promising future, and all youth should be able to rely on and trust in the availability of resources (emotional, physical, social, etc.) to do so. Further, their connection to, discovery, and development of these resources should happen in a way that preserves and highlights their dignity and pride. We believe that a social enterprise that facilitates kinship, mutuality with nature, mentorship, future oriented conversation, and community partnerships can support this vision. About the Project

Huneebee Project seeks to involve youth and young adults between the ages of 15-23 in New Haven, Connecticut with past or present child protective and/or foster care involvement in transferable job skills training and employment opportunities through beekeeping in community spaces. We prioritize servicing youth and young adults with foster care involvement because we know that foster care alumni, in disproportionate numbers, are not securing jobs, homes, or support services. They are likely to struggle with health and mental health issues, lack access to health care, experience severe economic hardship, have insufficient educational opportunities, and have poor support networks. For instance, a study conducted on Adult Functioning of Former Foster Youth by University of Chicago finds that by age 21, 49% of former foster care involved youth are unemployed, 23% of former foster care involved youth do not have a high school diploma, 25% of former foster care involved youth have experienced homelessness, 54% of former foster care involved youth present with mental health needs, and 25% of former foster care involved youth meet criteria for PTSD. These needs are further amplified and compounded by the systems intended to support and rehabilitate; the child protective and foster care systems are under-resourced and can come with varying gaps in service. These gaps frequently lead to exacerbating existing traumas or the introduction of new traumas, as well as contribute to perpetuating systems of oppression and to inadequate attention to a variety of needs, including mental health and job skill training. Unfortunately the data we rely upon to inform program development examines nationwide trends. Limited data specific to youth in foster care in New Haven county is available. Further, the national data we reference above is outdated, seeing as it was presented in 2010. In addition to the gaps in available data on the needs of the population Huneebee Project exists to support, we hope that this project will address New Haven’s longstanding history of segregation and oppressive power dynamics, which have bred mistrust between the Yale community and greater New Haven community. To that end, we intend for this project to be designed and executed in a way that actively involves Huneebee youth employees and encourages transparency and collaboration. We believe that a social enterprise that empowers our youth and that facilitates kinship and community partnerships can inspire other organizations and groups to think innovatively and collaboratively. And we would like for this project to create a model for respectful, empowering collaboration that can be replicated by others. Methodology

Qualitative • Students may conduct a needs assessment through review of existing literature, review of

Huneebee Project’s existing demographical data on participants, and interviews with Huneebee youth (which may involve developing a interview discussion guide, transcribing data, and summarizing key themes)

o Students will collaborate with Huneebee Project coordinators to identify relevant and missing data of interest specific to New Haven county.


• Data collection may occur through use of databases, interviews with local policy makers, and interviews with past and future Huneebee Project Beekeepers in Residence graduates. Throughout, students will create and maintain a comprehensive database to gather and organize relevant data.

• Students will prepare for and attend pre- and post-project meetings with Huneebee youth employees to support collaboration and transparency.

o A pre-appointed youth liaison will attend and observe weekly meetings, as an opportunity to learn, to offer consultation, and to relay updates to broader Huneebee youth community.


• We hope to involve individuals with demonstrated emotional intelligence, motivation to explore above-mentioned topics and themes, curiosity, and open-mindedness.

• Students should have a familiarity or interest in mental health care, as well as an interest in collaborating with a young, diverse, underserved population. S

• Students should present with a willingness to learn, to expel the “expert hat,” and to engage in unbiased dialogue.


• Students will have access to completed pre- and post-measures from the past 3 cohorts of Beekeepers in Residence trainees, as well as demographical information on all past participants.

• This project will largely be completed remotely, with the support and guidance from a team of Huneebee Project leaders, youth, and volunteers.


STRUCTURAL APPROACHES TO IMPROVING PUBLIC HEALTH

Organization: Town of Hamden

Project Title: Mobile Crisis Response Team Planning Study Students who work on this project will develop an understanding of emergency response and community safety needs that have traditionally been addressed by police, together with an understanding of emerging alternatives. Students will also develop skills in qualitative interviewing, extraction, compilation and analysis of web-based data, and compilation of best practices drawing on web-based materials, grey literature and peer-reviewed literature. Overview of Project

Police aren’t trained for many situations they come across, and the fact that they are armed could escalate tensions. The Town of Hamden is looking for new system that could be led by social workers and other healthcare experts for low acuity calls that can lead to de-escalation, harm reduction, and connecting people to services. For this project, students will: 1) research other models of social workers and healthcare experts responding to calls, 2) examine Hamden’s emergency call types and frequency in which social workers or other healthcare experts could be the best responders (these include behavioral and mental health, substance abuse, and homelessness issues), 3) analyze costs of incorporating social workers and other healthcare experts into response, and 4) make recommendations of best practices for Hamden. The potential use for project results is to implement a new pilot program for the Town of Hamden. About the Town of Hamden

The Keefe Community Center and Hamden Police Department are part of the Town of Hamden. The mission of the Keefe Community Center is to provide assistance and opportunity to primarily low to moderate income residents. It houses the town department of Community Services, Community Development, and Youth Services, and several partner agencies. The Police Department’s mission is to, “preserve the peace, deter and prevent crime, apprehend offenders, pursue justice for victims, promote traffic safety, and educate the public.” The town of Hamden Police Department and the Community Development Office at the Keefe Community Center have partnered to bring outreach, humanitarian and community relations services to the town via the HPD Community Liaison – Neighborhood Initiative Unit, Hamden Community Development, Hamden Youth Services and Hamden Public Schools. Examples of this collaboration include, 1) engaging with the unsheltered homeless population in town and getting them the services they need through partnerships with the Cornell Scott Hill Health Center and Columbus House, 2) working together to put on large scale mobile pantry food distributions and holding food drives, and 3) holding Hamden’s first gun buyback and gun safety event. About the Project

This project comes out of the timely national debate about reimagining the role of police. Are the police the best responders for certain kinds of calls? The recent Connecticut Police Accountability Bill asks municipalities to investigate the potential of using social workers for call response. A summary of the bill states, “The bill requires each municipal police department to evaluate the feasibility and potential impact of the department using social workers to respond to calls for assistance (either


remotely or in person) or go with a police officer on calls where a social worker’s experience and training could provide help. The evaluation must consider whether (1) responses to certain calls and community interactions could be managed entirely by social workers or benefit from their help and (2) the municipality would benefit from employing, contracting with, or otherwise engaging social workers to help the police department. Police departments may consider using mobile crisis teams or implementing a regional approach with other municipalities as part of any process to engage, or further engage, social workers to help the departments.” The Town of Hamden Police Department operates the Central Communications (911 Call Center) for the Public Safety Services (Police, Fire and EMS) for the entire town. Central Communications dispatchers receive calls for service and / or emergency calls and dispatch the appropriate service depending on call type and incident. A case number, call type and responding service or unit, for each incident reported is created by the dispatcher at the time the intake of the call / incident. At the conclusion of each incident, a record is created in the Law Enforcement Administrative System (LEAS) database operated by NEXGEN service. The records created is dependent on the call type, which could be either by way of Computer Aided Dispatch (CAD) notes or full incident reports documented by the assigned unit in LEAS. The type of service (Police, Fire, EMS) and unit that is dispatched and assigned to each incident is determined by Police and Fire Administration policies and programed CAD data for each type of incident and location. The type of call is determined by the discretion of the

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EPH 542b: Practice-Based Community Health Research 2020...Practice-Based Community Health Research...

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