Department of Population Health, Dell Medical School, University of Texas at Austin, Austin, TX, USA.
St. David's Foundation, Austin, TX, USA.
J Community Health. 2021 Apr;46(2):420-427. doi: 10.1007/s10900-021-00972-7. Epub 2021 Feb 19.
The U.S. spends trillions annually on health care that affects only 16% of health outcomes, with 84% driven by social factors, behaviors, and the physical environment. Medical schools are focusing more on these social determinants of health. We describe an academic community engagement unit with unique methods for partnering with the surrounding community to improve its members' health. Annually, a Call for Ideas asked community members to identify important health problems and propose solutions. A panel of community members and academic researchers reviewed submitted ideas and selects those addressing significant issues, that are also feasible, can be accomplished in a year, and are potentially scalable. Financial, project development, and evaluation support is provided where needed. Three Calls for Ideas generated 268 ideas from 249 individuals: 35% focused on social and behavioral factors, 33% on health behaviors, 16% on health care, and 6% on the physical environment. Half were submitted by individuals and half by community service organizations. Twenty-four (9%) were selected for implementation; 19 have been successfully implemented while 5 are under development. People with lived experience can identify barriers to health in their communities and effective mitigating interventions. By seeking community leadership and mutual benefit, academicians can gain community members' trust and meet both community and academic needs by establishing true partnerships, recognizing power dynamics and structural biases, and using language and approaches that respect the importance and power of lived experiences in identifying approaches to enhancing community health.
美国每年在医疗保健上花费数万亿美元，但其仅对 16%的健康结果产生影响，而其余 84%则由社会因素、行为和物理环境驱动。医学院越来越关注这些健康的社会决定因素。我们描述了一个学术社区参与单位，该单位采用独特的方法与周边社区合作，以改善其成员的健康状况。每年，都会有一个“创意征集”呼吁社区成员识别重要的健康问题并提出解决方案。一个由社区成员和学术研究人员组成的小组会审查提交的创意，并选择那些解决重要问题、切实可行、能在一年内完成且具有潜在可扩展性的创意。必要时，会提供财务、项目开发和评估支持。三次“创意征集”共收到 249 位个人提交的 268 个创意：35%的创意关注社会和行为因素，33%的创意关注健康行为，16%的创意关注医疗保健，6%的创意关注物理环境。其中一半是个人提交的，另一半是社区服务组织提交的。有 24 个（9%）被选中实施；其中 19 个已成功实施，5 个正在开发中。有过亲身经历的人可以识别出他们社区中健康的障碍和有效的缓解干预措施。通过寻求社区领导和互利共赢，学者可以获得社区成员的信任，并通过建立真正的合作伙伴关系、认识到权力动态和结构性偏见，以及使用尊重生活经验在确定增强社区健康方法中的重要性和权力的语言和方法，满足社区和学术的需求。
