Linking health education, civic engagement, and research at a large Federally Qualified Health Center to address health disparities

Abstract

Objective: To develop a framework for patient-centered research in a community health center.

Study setting: Primary organizational case-study data were collected at a large Federally Qualified Health Center (FQHC) in Southern California from 2019 to 2021.

Study design: Thirty stakeholders, including patients, community leaders, students, medical providers, and academic partners, participated in community-engagement capacity-building exercises and planning. These activities were guided by Community Based Participatory Principles and were part of an initiative to address health disparities by supporting patient and community-engaged research.

Data collection: The study included an iterative development process. Stakeholders participated in a total of 44 workgroup meetings and 7 full-group quarterly convenings. The minutes of the meetings from both workgroups and quarterly convenings were used to document the evolution of the initiative.

Principle findings: Stakeholders concluded that health equity research needs to be part of a larger engagement ecosystem and that, in some ways, engagement on research projects may be a later-stage form of engagement following patient/community and staff/researcher coeducation and cocapacity building efforts.

Conclusions: Community health center stakeholders viewed successful engagement of community members in patient-centered health equity research as involving a web of longitudinal, evolving internal and external relationships rather than discrete, time-limited, and single-project-based dyadic connections.

Keywords: Latinx; Social Determinants of Health; community medicine; federally qualified health centers; health disparities; health equity; participatory research.

FIGURE 1

Conceptual model linking health education, community‐based participatory research (CBPR), and policymaking. Adapted from Reference . ^aContexts include macrolevel factors such as a community's history and social‐economic factors. It also encompasses opportunities for members to build capacity for engaging in policy and research processes. ^bCBPR processes encompass research partnerships in action, including how these develop evidence for civic engagement and policy action. ^cPolicymaking considers strategies for action, including what policies stakeholders advocate for and how they are informed by evidence generated by research. ^dOutcomes focus on what political action is taken to create change and the impact of policy and program change on health outcomes [Color figure can be viewed at wileyonlinelibrary.com]