Community Action Research Experience (CARE)
Community Action Research Experience (CARE) is a program designed to train family medicine residents in community action research and equip them with the knowledge, skills, and attitudes to adequately engage their community and at the same time care for underserved populations, thereby reducing health disparities in the Dallas County area. It was born out of the concern that current training models may not adequately prepare practicing physicians to partner with and impact the health of their communities.
Community action research/community based participatory research (CBPR) is defined as a collaborative approach to research that equally involves all partners in the research process. CBPR has the aim of combining knowledge with action and achieving social change to improve health outcomes and eliminate health disparities.
Goals and Objectives
The overarching goal of the CARE program is to teach family medicine residents community action research skills that will increase their community engagement. The program’s objectives are to:
- Design, pilot, implement, and evaluate a residency curriculum in Community Action Research for local use and national dissemination
- Provide in-depth training for residents committed to enter fellowships or practices that focus on underserved care
- Bridge the gap in UT Southwestern’s community training pipeline between our medical student programs and fellowship in Community Action Research.
The CARE program responds to the needs of the underserved Dallas population. If lack of insurance, poverty, unsafe living conditions, environmental contamination, or other factors are contributing to illness and disease, then a collaborative effort is needed to remedy these conditions. The community-based action research approach is a collaborative endeavor to grow a model for understanding health and disease determinants and supporting mechanisms to promote healthier lives.
Design and implementation
The three-year CARE curriculum in Community Action Research focuses on two levels of resident commitment, namely: an innovative four-week block rotation for PGY2 residents, and an intensive three-year cumulative studies Community Action Research pathway, leading to an area of concentration in Community Action Research for two residents per year. In the PGY3 year, CARE pathway residents spend three elective months engaged with a community partner, providing service and completing a community-based research project that is strongly expected to be of publishable and/or fundable quality.
Projects and Outcomes
Currently in its fourth year, CARE has graduated three residents and one fellow. The fellow was also a CARE resident and has proceeded, along with our most recent graduate, to serve in an underserved community. We currently have seven enrolled residents in the program.
The didactics component of the program has been very rewarding, based on positive feedback we have consistently received from program participants. The classes included CBPR research methods, statistical tools, and dissemination skills. Community engagement has been considerably viable with many of our residents prominent in the planning, organizing, and implementation activities, in collaboration with our community partners at health fairs, in underserved care, and in program development.
Presentations and Publications
- The CARE program has been presented at several professional meetings including the TAFP 59th Annual session (2008) and 42nd STFM annual conference (2009), where it received an outstanding evaluation. At the latter, all the evaluators thought the program curriculum should be uploaded to STFM's Family Medicine Digital Resource Library (FMDRL). The program has been published as a letter to the editor in the March, 2009, edition of the Family Medicine Journal.
- Results from the Shared Medical Appointment (SMA) study have been presented at several professional conferences (TAFP, NAPCRG etc). The study poster won a first place award at the 2009 TAFP conference in Arlington, Texas. The manuscript has been published in the American Journal of Managed Care (June, 2011). .
- The Osteoporosis study has been presented at three professional meetings (TAFP, NAPCRG, APHA). The study poster won a second place award at the 2008 TAFP conference. The manuscript has been published in the Journal of Community Health.
- The Health Care Barriers project has been presented at two professional conferences, first as a poster at the 2009 NAPCRG conference in Montreal, Canada, and as an oral presentation at the 2009 APHA national conference in Philadelphia, Pennsylvania.
- Abstracts from the three current residents’ projects have been submitted for presentation at upcoming conferences.
- A CARE Program Handbook is currently being compiled for publication as a tool for disseminating the CARE model to other Family Medicine residency programs across the country.
All CARE graduates have expressed a considerably high degree of satisfaction with the content and implementation of the program and have stated that it was worth their time and effort. They have also reported improved research and statistical skills and also have been able to draw a relationship between those skills and the quality of care they give to their patients.