Background: Community Health Centers (CHCs), including federally qualified health centers and other safety-net settings, deliver primary health care to the most socioeconomically disadvantaged, including disproportionate numbers of racial and ethnic minorities and immigrant populations who have been impacted the most by COVID-19. What is often missing in PCOR/CER programs focused on addressing health disparities among vulnerable populations impacted by COVID-19 are partnerships that engage academic researchers, CHCs, and their patient and clinical stakeholders on an equal footing. Given the rapidly evolving challenges of COVID-19, it will be more important than ever to build capacity for stakeholder-engaged COVID-19 PCOR/CER by creating new approaches that break down these silos. 

Proposed Solution to the Problem: The project team will create effective, efficient, and sustainable infrastructure and processes that can be responsive to the needs of vulnerable populations disproportionately impacted by the ongoing effects of COVID-19. The team will prioritize health-equity-focused COVID-19 PCOR/CER topics within CHCs. To achieve this, the team will work within the San Francisco Bay Area Collaborative Research Network (SFBayCRN), UCSF’s primary care practice-based research network administered by the Clinical & Translational Science Institute (CTSI). The SFBayCRN’s mission is to facilitate mutually beneficial partnerships between researchers and community-based primary care organizations. Partners include three SFBayCRN organizations: the San Francisco Community Clinic Consortium (SFCCC), the Benioff Children’s Hospital Oakland federally qualified health center (BCHO-FQHC), and the Family Healthcare Network (FHCN) in Fresno and the Central Valley.  

Objectives:
The project’s aims are to:

• Aim 1: Describe the infrastructure and resources needed to operationalize stakeholder engagement between academia and CHCs for health-equity-focused COVID-19 PCOR/CER 
• Aim 2: Create sustainable infrastructure and resources that operationalize stakeholder engagement between academia and CHCs for health-equity-focused COVID-19 PCOR/CER 
• Aim 3: Identify prioritized health-equity-focused PCOR/CER topics related to COVID-19 within CHCs, match stakeholders based on priorities, and propose action plans for applications.

Activities:

• The team will first conduct focus groups with stakeholders to identify the infrastructure and resources needed to support priorities for health-equity-focused COVID-19 PCOR/CER between researchers and CHCs. The team will also conduct capacity mapping of the available resources within the UCSF CTSI, SFBayCRN, and each of the CHC partner organizations. 
• Then using focus groups and capacity mapping findings, the team will create infrastructure, processes, and resources that will break down silos between stakeholders and operationalize engagement on COVID-19-focused PCOR/CER. 
• Finally, in collaboration with partners, the team will identify prioritized health-equity-focused COVID-19 topics that will catalyze future PCOR/CER, connect/match stakeholders based on priorities, and propose action plans at the SFBayCRN Annual Meeting. 

Project Outcomes and Outputs: The project will create sustainable infrastructure and systematic processes that build capacity to operationalize stakeholder engagement for health-equity-focused PCOR and CER addressing COVID-19 topics within the SFBayCRN.
Specific outputs and deliverables of the project will include:

• Focus group results describing infrastructure and resources required to support academic-CHC partnerships for health equity COVID-19 PCOR/CER
• Results of infrastructure and asset mapping that support COVID-19 health equity PCOR/CER in CHCs.
• Infrastructure and resources created, including advisory board, resource manual for stakeholder-engaged research in CHCs, and template of memorandum of understanding.
• Prioritized health-equity-focused COVID-19 PCOR/CER topics and proposed action plans for research projects based on matchmaking at the SFBayCRN Annual Meeting

Patient and Stakeholder Engagement Plan: The stakeholder engagement plan includes creating a project-specific advisory board that will include patient, community, clinical, and research stakeholders from the SFCCC, BCHO-FQHC, FHCN, UCSF, and SFBayCRN. This board will meet every other month to provide oversight on all project activities, offer feedback, and make decisions and recommendations.

Project Collaborators:

• San Francisco Bay Area Collaborative Research Network (SFBayCRN)
• San Francisco Community Clinic Consortium (SFCCC)
• The Benioff Children’s Hospital Oakland federally qualified health center (BCHO-FQHC)
• The Family Healthcare Network (FHCN) in Fresno and the Central Valley