Background: While use of PCOR/community-engaged/community-based participatory research (CBPR) principles is growing, institutional commitment, incentives, and policies within Academic Health Centers (AHCs) that support patient stakeholder involvement is haphazard or nonexistent. Three major institutional challenges exist: (a) institutions and community engagement cores often do not have the capacity (e.g., tools, techniques, coaching,) for sufficient training for researchers seeking to engage in authentic patient and community engagement; (b) there is limited understanding of institutional structures or processes that matter most for promoting and sustaining PCOR/CER using CEnR/CBPR approaches; and (c) there is no standard on how to achieve institutional commitment to health equity reflected within individual patient and CEnR projects, as they make up the “DNA” of health equity research.

Proposed Solution to the Problem: The University of New Mexico with three national partners (see below), will seek to address institutional barriers using its evidence-based Engage for Equity (E2) metrics, workshops, and tools, which have been validated at the partnership level to scale up to E2 PLUS, which adds new strategies of: conducting institutional assessments; creating champion teams of six to eight members; providing coaching to champions; providing workshops; and creating a multi-institution community of practice.

Objectives: The long-term objective is to strengthen institutional research support for PCOR/CER using CEnR/CBPR approaches. Toward this objective, the project team proposes to test feasibility of implementing the E2 PLUS intervention:
Aim 1: Assess institutional factors in three distinct institutions to promote and sustain PCOR/CER using CEnR/CBPR approaches.
Aim 2: Implement E2 PLUS using coaching for champion teams and workshops, and track changes in team capacity to promote institutional changes in research support capacities, structures, and processes.
Aim 3: Co-create a community of practice for the three participating institutions.

Activities:
Aim 1: Recruit champion teams; institutional assessments through surveys, ethnographic observations, and focus groups.
Aim 2: Provide two Engage for Equity workshops for 25 patients/community members and community-engaged institutional leaders; identify leverage points for change, monthly coaching of teams.
Aim 3: Quarterly co-learning community of practice meetings. National conference in Albuquerque in second year.

Projected Outcomes and Outputs:
Short term: Formation of champion teams with patient/community members; comprehensive analysis of institutional facilitators and barriers.
Medium term: Champion team engagement in coaching; development of action plans to leverage institutional changes.
Long Term: Enhanced capacity of champion teams to demonstrate actions to strengthen patient/community engagement; co-creation of community of practice.

Dissemination products include: refined institutional assessment tools; refined E2 PLUS tools and workshops including coaching guide, and analysis of best practices for implementation at the institutional level.

Patient and Stakeholder Engagement Plan: A strong focus of this PCOR proposal is to bring together representatives (up to 25 per institution) that represent researchers/ staff; patients and community/patient advisory members; and academic leaders. To implement project activities, the team will recruit champion teams (8-10 people) and name a patient/community co-lead at each institution, for monthly meetings. Working groups will invite larger group to stay involved in all activities.

Project Collaborators: Morehouse School of Medicine, Prevention Research Center; Fred Hutchison Cancer Center Office of Community Outreach and Engagement; and Stanford School of Medicine CTSA and Cancer Center Community Engagement.
Consultants include: Alan Richmond, MSW, Community Campus Partnerships for Health; and Tung Nguyen, MD, University of California, San Francisco.