C.H. Wilkins is vice president for health equity, Vanderbilt University Medical Center, and executive director, Meharry-Vanderbilt Alliance, Nashville, Tennessee; ORCID: https://orcid.org/0000-0002-8043-513X. P.M. Alberti is senior director of health equity research and policy, Association of American Medical Colleges, Washington, DC; ORCID: https://orcid.org/0000-0002-3381-4882.
Acad Med. 2019 Jun;94(6):763-767. doi: 10.1097/ACM.0000000000002711.
There is an increasing need for academic health centers (AHCs) to engage communities across their clinical, research, and educational missions. Although AHCs have a long-standing history of community service, a more comprehensive approach to working with communities is required to respond to shifts toward a population health paradigm, funder requirements for community engagement in research, and demands that medical education focus more on social and environmental determinants of health. Community engagement has been employed at many AHCs, though often in limited ways or relying heavily on students and faculty interested in serving communities. This limited involvement has been due, in part, to lack of infrastructure to support engagement, resource constraints, and the lack of a clear value proposition for long-term investments in community partnerships. However, there are compelling reasons for AHCs to take an enterprise-wide approach to working with communities. An enterprise-wide approach to community engagement will require reconsideration of communities, moving from viewing them as people or groups in need of service to seeing them as assets who can help AHCs better understand and address social determinants of health, enhance students' and trainees' ability to provide care, and increase the relevance and potential impact of research discoveries. To accomplish this, AHCs will need to establish the necessary infrastructure to support long-term community partnerships, adapt policies to support and reward engaged scholarship and teaching, and consider new ways of integrating community members in roles as advisors and collaborators across the AHC.
学术医疗中心（AHCs）越来越需要在其临床、研究和教育任务中与社区互动。尽管 AHCs 有着悠久的社区服务历史，但为了应对向人口健康模式的转变、研究中社区参与的资助者要求以及要求医学教育更加关注健康的社会和环境决定因素，需要采取更全面的方法与社区合作。社区参与已在许多 AHC 中得到应用，但通常是以有限的方式或以对服务社区感兴趣的学生和教师为基础。这种有限的参与部分是由于缺乏支持参与的基础设施、资源限制以及长期投资社区伙伴关系的明确价值主张的缺乏。然而，AHC 有充分的理由采取全机构范围的方法与社区合作。全机构范围的社区参与方法将需要重新考虑社区，从将其视为需要服务的人群或群体转变为将其视为可以帮助 AHC 更好地理解和解决健康的社会决定因素、增强学生和学员提供护理的能力以及提高研究发现的相关性和潜在影响的资产。为了实现这一目标，AHCs 将需要建立必要的基础设施来支持长期的社区伙伴关系，调整政策以支持和奖励参与的学术研究和教学，并考虑新的方法将社区成员整合为 AHC 中顾问和合作者的角色。
