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5:30 Welcome
Medical Students
Paloma Marin-Nevarez, SMS II and Angela Lee, SMS I
2017 Community Health Symposium Coordinators
Lloyd Minor, MD
Carl & Elizabeth Naumann Professorship for the Dean of the School of Medicine
Professor of Otolaryngology-HNS and, by courtesy, of Neurobiology and of
Bioengineering
Stanford University
Community Health Service & Research Poster Session
6:15 Opening Remarks
Mark Cullen, MD
Director, Stanford Center for Population Health Sciences
Senior Associate Dean for Research, Stanford School of Medicine
Professor of Medicine, General Medical Disciplines, Biomedical Data Science,
Health Research & Policy
Senior Fellow, Stanford Institute for Economic Policy Research
Stanford University
6:20 Introduction of Oral Presenters
Angela Lee, SMS I
2017 Community Health Symposium Coordinator
Oral Presentations
Nancy Nkansah-Mahaney, PharmD, MBA, SMS III
Developing a Scalable Curriculum for Underrepresented in Health
Professions Pipeline Program
Laila Soudi, MS
Greece's Failing Response to the Refugee Crisis
6:45 2017 Outstanding Community Partner Award
Paloma Marin-Nevarez, SMS II
2017 Community Health Symposium Coordinator
Bridge Clinical Research, Oakland, California
Javarcia Ivory, Stanford Undergraduate Student
Marcella Alsan, MD, Asst. Professor of Medicine, PCOR
Muslim Community Association, Santa Clara, California
Rania Awaad, MD, Clinical Instructor, Psychiatry & Behavioral Sciences
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6:50 Keynote Address: Developing a New Vision for Community Engagement in
Reproductive Health Research
Introduction by Rhonda McClinton-Brown, MPH
Executive Director, Office of Community Engagement, School of Medicine
Stanford University
Monica McLemore, PhD, MPH, RN
Assistant Professor, Family Health Care Nursing Department
Associate Director, Community Engaged Research - UCSF Preterm Birth Initiative -
California
Research Scientist, Advancing New Standards in Reproductive Health (ANSIRH)
University of California, San Francisco
7:20 Concluding Remarks
Mark Cullen, MD
Director, Stanford Center for Population Health Sciences
Senior Associate Dean for Research, Stanford School of Medicine
Professor of Medicine, General Medical Disciplines, Biomedical Data Science,
Health Research & Policy
Senior Fellow, Stanford Institute for Economic Policy Research
Stanford University
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At the University of California, San Francisco, Monica McLemore is an assistant
professor in the Family Health Care Nursing Department, an affiliated scientist
with Advancing New Standards in Reproductive Health, and a member of the
Bixby Center for Global Reproductive Health. She was recently named Associate
Director for Community Engaged Research for the UCSF Preterm Birth Initiative in
California. She maintains clinical practice as a public health and staff nurse at San
Francisco General Hospital in the Women’s Options Center. McLemore’s research
is geared toward understanding women’s health and wellness across the lifespan.
She is an elected member of the governing council for Population Reproductive
and Sexual Health section of the American Public Health Association and a
recipient of the 2015 teaching award from the American College of Nurse
Midwives. Additionally, she is one of 10 Culture of Health, Breakthrough Leaders
in Nursing a program of the Robert Wood Johnson Foundation, AARP, and the
Center to Champion Nursing in America. Her work embraces complex and
intersectional problems associated with sexual and reproductive health, including
health disparities, stigma, incarceration, unintended pregnancy, and difficulty
accessing services. Women of color are impacted in greater proportion by these
social determinants of health, and she sees her role as an advocate, connector,
and innovator of programs that directly target these determinants in the domains
of nursing and community health.
Monica McLemore, PhD, MPH, RN
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Bridge Clinical Research
Bridge Clinical Research is the premier clinical research organization dedicated to
providing all your diversity research needs. Our team specializes in clinical research
support including but not limited to, minority patient recruitment, investigator
training and site selection and analytics. Our clinical research network
is composed of practicing physicians with varied levels of clinical trials experience.
Through our computerized database, investigator sites and associated patients can
be quickly identified and screened against protocol inclusion and exclusion criteria.
Most investigators have been trained in Good Clinical Practice and prescreened by
Bridge.
Bridge Clinical Research, President & Chief Operating Officer, Owen Garrick, MD
For more information, please visit their website: www.bridgeclinical.com
Muslim Community Association
In cooperation with Muslim communities around the Bay Area, our mission is to:
live our faith as a congregation, inspired by the teachings of the Quran and Prophet
Muhammad (PBUH) as individuals and as a collective body, and to foster a mission
of peace, justice and compassion for all within our Mosque, our community and
the world.
Muslim Community Association, Nuzhath Quadri, LMFT and Christy Chase
For more information, please visit their website: www.mcabayarea.org
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Past Community Partner Award Recipients
BAY AREA NUTRITION & PHYSICAL ACTIVITY COLLABORATIVE (BANPAC)
COMMUNITY HEALTH PARTNERSHIP OF SANTA CLARA COUNTY
COLLECTIVE ROOTS
FAIR OAKS CLINIC OF THE SAN MATEO MEDICAL CENTER
FULL CIRCLE FARMS
INDIAN HEALTH CENTER OF SANTA CLARA VALLEY
INNVISION SHELTER NETWORK: OPPORTUNITY SERVICES CENTER
LATINAS CONTRA CANCER
MAYVIEW COMMUNITY HEALTH CENTER
NUESTRO CANTO DE SALUD OF EL CONCILIO OF SAN MATEO COUNTY
PUENTE A LA SALUD COMUNITARIA, OAXACA, MEXICO
PUENTE DE LA COSTA SUR
RAVENSWOOD CITY SCHOOL DISTRICT
RAVENSWOOD FAMILY HEALTH CENTER
REDWOOD CITY SCHOOL DISTRICT
SAN MATEO COUNTY HEALTH DEPARTMENT
SANTA CLARA PUBLIC HEALTH DEPARTMENT
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Poster Presentations
GROUP I: IMPROVING HEALTH CARE ACCESS,
SERVICE, AND QUALITY
1. Identifying and Developing Strategies for Improving Medication Adherence at a
Safety-Net HIV Clinic
Carlie Arbaugh, BS; Lorna Thornton, MD
Community Partner: Edison Clinic at San Mateo County Medical Center, Fair Oaks
Health Center, North County Clinic
2. Identifying and Assessing Disparities in Colorectal Cancer Screening Rates in a
Predominantly Latino Farming Region
Carlie Arbaugh, BS; Dale O’Brien, MD, MPH; Maria Morales; Erick Lopez;
Maximiliano Cuevas, MD
Community Partner: Cancer Patients Alliance
3. What Makes a "Healthy" Corner Store? Toward a Regional Assessment Tool for
the San Francisco Bay Area
Benjamin Chrisinger
Community Partner: Bay Area Healthy Corner Store Organizing Committee’s
Nutrition Standards Working Group
4. Collaborative Continuum of Care Model for Patients and Families with Dementia
Jennie L. Clark, MA, Gerontology; Rita Ghatak, PhD; Terese McManis, RN; Ann
Bilbrey, PhD; Dolores Gallagher-Thompson, PhD; Bonigut, Stefanie, MSW, ASQ
Community Partner: Alzheimer’s Association
5. Demographic, Psychosocial, and Behavioral Predictors of Diabetes Among Urban
American Indian and Alaska Native Adults
Luis Garcia, Haley Hadlin, FeiFei Qin, Jan Vasquez, Randall Stafford, Lisa Goldman
Rosas
Community Partner: American Indian Community Action Board
6. Redesigning Care for Low-Income Adult Patients with Type II Diabetes in a
Community Clinic
Michelle E Hauser, MD, MPA; Evelyn V Haddad, MD; Bradd Silver, MD; Priscilla
Padilla-Romero, MPH, MPP; Rakhi Singh, MD
Community Partner: Fair Oaks Health Center
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7. Improving Preventative Health Care for African-American Men in the East Bay:
Evidence from a Randomized Control Feasibility Trial
Javarcia Ivory, Grant Graziani Owen Garrick, M.D., M.B.A., Marcella Alsan, M.D.,
M.P.H., Ph.D.,
Community Partner: Bridge Clinical
8. Implementation of a Mobile Lung Cancer Screening Computed Tomography
Program at Northern California Federally Qualified Health Centers
M. Khairy, S. Shariff-Marco, I. Cheng, G. Lin, A. Hsing, B. Singh, A. Leung, V.S. Nair
Community Partner: North East Medical Center, MayView Community Health
Center, Indian Health Center, Gardner Family Health Network
9. Kinder Ready: Exploring Feasibility of a Text-Messaging Intervention for School
Readiness in Santa Clara and San Mateo Counties
Paloma Marin-Nevarez, Kimmy Phan, Brenda Lu, Janine Bruce DrPH, Monica de la
Cruz, Lisa Chamberlain, MD, MPH
Community Partner: San Jose Libraries, ICAN, AACI
10. Implementing Primary Care Standing Orders at Planned Parenthood Mar Monte
AJ Millet
Community Partner: Dr. Miriam Sheinbein, Associate Director of Primary Care at
Planned Parenthood Mar Monte
11. San Mateo County Communicable Disease Annual Morbidity Report
Keon Pearson
Community Partners: San Mateo County Department of Public Health
12. Kinder Ready: Low-income Parents and Clinic Providers Perceptions of the
Feasibility of Using Technology to Promote School Readiness in a Clinical Setting
Paloma Marin-Nevarez, Monica De La Cruz, MPH, Kimmy Phan, Brenda Lu,
Reshma Thadani, MD, Lisa Chamberlain, MD, MPH, Janine Bruce, DrPH, MPH
Community Partner: Ravenswood Health Center
13. Greece’s Failing Response to the Refugee Crisis
Laila Soudi, MS; Hana Abu Hassan, MBBS MRCGP JBFM
Community Partner: Syrian American Medical Society
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GROUP II: PROMOTION OF HEALTH AWARENESS AND HEALTHCARE
ACCESS THROUGH EDUCATION
1. Patient-Centered Time Management in Outpatient Primary Care
Victoria Boggiano, Dr. Erika Schillinger MD, Dr. Tracy Rydel MD
Community Partner: Mayview Community Health Center
2. Of Sound Mind: Using Public Access TV for Community Outreach and to Raise
Dementia Awareness
Ann Choryan Bilbrey, PhD, Frederic T. Bockmann, MS, Nusha Askari, PhD and
Dolores Gallagher-Thompson, PhD, ABPP-Geronotology
Community Partner: MidPen Media Center
3. Community First Responder Training for Medical Emergencies: Empowering Bay
Area High School Students
Henry A. Curtis, M.D. FAAEM, Rebecca Walker, M.D., Jennifer A. Newberry, M.D.,
J.D., Rebecca Smith-Coggins, M.D.
Community Partners: San Francisco Unified School District, Career Technical
Education College and Career Readiness Department
4. American Spirit Brand Preference Among Smokers with Serious Mental Illness
Anna E. Epperson, PhD, Nicole E. Anzai, BA, Sebastien C. Fromont, MD, Sharon Hall,
PhD, Judith J. Prochaska, PhD, MPH
Community Partner: Alta Bates Medical Center
5. Implementation of a Chronic Health Education Program for Underserved
Populations in Santa Clara County, CA
Gunsagar Gulati, Anoop Manjunath, Ian Nelligan, Erika Schillinger, Rhonda
McClinton-Brown, Anna Hui
Community Partners: Barbara Lee Senior Center, Silicon Valley Gurudwara
6. Quality and Effectiveness of the Mid-Peninsula Brain Injury Peer Support Group
Jaclyn A Konopka, Alissa A Totman
Community Partner: Santa Clara Valley Medical Center Brain Injury Peer Support
Group
7. A Cluster-Randomized Trial to Assess a Sexual Assault Prevention Intervention in
Upper Primary School Adolescents in Nairobi, Kenya
Clea Sarnquist, DrPH, MPH, Michael Baiocchi, PhD, and the Stanford Gender-Based
Violence Prevention Collaboration.
Community Partners: No Means No Worldwide (US and global), Ujamaa (Kenya)
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GROUP III: BUILDING CAPACITY LOCALLY
AND GLOBALLY
1. Fostering Safe and Healthy Community Parks: Promoting Partnership Problem-
Solving (A Partnership with the Santa Clara County Public Health Department)
Naina J. Ahuja, Nicole M. Rodriguez, Sandra J. Winter, Ann Banchoff, Bonnie
Broderick, Jamina Hackett, Abby C. King
Community Partner: Santa Clara County Public Health Department
2. “EmPower Me,” a Physical Activity Program for Older Adults in Meals on Wheels:
a RE-AIM Informed Pilot Study
Megan Alexander, Lisa Goldman Rosas
Community Partner: The Health Trust Meals on Wheels
3. Muslim Community Association of Santa Clara and Stanford Muslims and Mental
Health Research Lab: Strengthening an emerging CBPR collaboration
Rania Awaad, MD; Sara Ali, MBBCH, Nuzhath Quadri, LMFT; Christine Chase, BS;
Lisa Goldmann Rosas, PHD, MPH
Community Partner: Muslim Community Association
4. Piloting a Free Clinic Model in Pescadero, California
Victoria Bawel and Ragini Phansalkar, Lina Mira
Community Partner: Puente de la Costa Sur
5. Stanford's First Community Advisory Board (CAB) for Clinical Research
Katherine Connors, Nicole Ventre, Jodi Prochaska, Jonathan Shaw, Jill Evans,
Rhonda McClinton-Brown, Anna Epperson
6. Raising Dementia Awareness from Within the Latino Community: Engaging
Community through Promotoras
Iliana Garcia-Ruiz, BA, Ann Choryan Bilbrey, PhD, Angelica Ceja, MS, Nusha Askari,
PhD, Julio Garcia, & Dolores Gallagher Thompson, PhD
Community Partner: Nuestra Casa
7. Improving Community Wellbeing in Rural Oaxaca through Grassroots
Community-Based Participatory Action Research
Nicole M Rodriguez, MS, Gabriel Garcia, MD, Catherine Heaney, PhD, Sandra J
Winter, PhD, Abby C King, PhD, Jackie Botts, Tatiana Baquero, Jeannette Rios,
Daniela Goni, Linda Shin
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8. Developing a Scalable Curriculum for Underrepresented in Health Professions
Pipeline Program
Nancy T. Nkansah, PharmD, MBA, Jane Binger, Ed.D, Cynthia Irvine, M.Ed.,
Fernando Mendoza, MD
Community Partner: Joe Bucher, West Valley College
9. Breakdancing with Boys and Girls Clubs of the Peninsula
Marina Post, MD and Nielson Weng
Community Partner: Belle Haven Elementary School Boys and Girls Clubs of the
Peninsula
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Abstracts
GROUP I: IMPROVING HEALTH CARE ACCESS,
SERVICE, AND QUALITY
1. Identifying and Developing Strategies for Improving Medication Adherence at a Safety-
Net HIV Clinic
Carlie Arbaugh, BS; Lorna Thornton, MD
Community Partner: Edison Clinic at San Mateo County Medical Center, Fair Oaks Health
Center, North County Clinic
Edison Clinic and Fair Oaks Health Center provide HIV care to marginalized patients in San
Mateo County, CA. Most HIV/AIDS patients in the San Mateo County Health System have
undetectable viral loads on antiretroviral (ARV) therapy. However, some patients have
higher viral loads, primarily due to lack of ARV medication adherence and/or engagement in
care. High viral loads (uncontrolled HIV) has negative implications for both the patient
(opportunistic infections, medication resistance, ongoing immune activation, inflammation)
and public (HIV transmission). A systematic literature review and chart review were
conducted to identify interventions in diverse populations. A chart review based on viremia
reports from May 2015 to June 2016 found that 94 of 470 patients (20%) had uncontrolled
HIV (at least one viral load 200). Patients with uncontrolled HIV were compared to a
random subset of patients with controlled HIV (all viral loads < 200) on demographic factors.
As expected, CD4 counts of uncontrolled HIV patients was significantly lower than that of
controlled HIV patients. Fewer uncontrolled HIV patients had a medical visit in the past 6
months, approaching significance. Total number of pill prescriptions was significantly higher
for older (> 50 years) than younger ( 50 years) patients, indicating larger pill burden. There
was a lot of missing data for homeless status and substance abuse, suggesting inconsistent
documentation. Interviews with healthcare providers and patients were also conducted and
used to inform the creation of an adherence questionnaire tool to identify barriers and
strategies to improve adherence.
2. Identifying and Assessing Disparities in Colorectal Cancer Screening Rates in a
Predominantly Latino Farming Region
Carlie Arbaugh, BS; Dale O’Brien, MD, MPH; Maria Morales; Erick Lopez; Maximiliano
Cuevas, MD
Community Partner: Cancer Patients Alliance
Latinos, especially undocumented and low income Latinos, have lower rates of colorectal
cancer (CRC) screening and other preventive medicine measures. Clinica de Salud del Valle
de Salinas (CSVS) is a network of Federally Qualified Health Centers in Salinas Valley and
surrounding Monterey County, California. CSVS provides healthcare to a majority immigrant
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Latino population (including indigenous peoples of Mexico and Central America), most of
whom work in the agriculture industry. One of CSVS’s many missions is to improve CRC
screening rates. With a chart review based on CRC screening data from March to June 2016,
we compared patients who completed CRC screening (with a fecal immunohistochemistry
test) to those who had been contacted and provided with a test, but who did not complete
screening. Those who completed CRC screening and those who did not did not differ
significantly in terms of age, preferred language and language barriers, homeless status,
migrant worker status, race, or ethnicity. There were a higher percentage of females who
completed CRC screening compared to males who completed screening, approaching
significance (p=0.06). However, this difference between male and female CRC screening
completion did not hold on examination of a subset of patients who identified as
farmworkers (seasonal plus migrant) nor those who identified as migrant (migrant only).
However, farmworker participants were too few in number to confer conclusive statistical
results. Interviews with CSVS patients and community members suggest that there is a
gender disparity in CRC screening, meriting further exploration and intervention.
3. What Makes a "Healthy" Corner Store? Toward a Regional Assessment Tool for the San
Francisco Bay Area
Benjamin Chrisinger
Community Partner: Bay Area Healthy Corner Store Organizing Committee’s Nutrition
Standards Working Group
Stakeholders around the country have implemented programs with corner store retailers to
help improve the availability of healthy foods in low-income areas without access to larger
food retailers. While many of these initiatives are subject to program local evaluation, a
variety of assessment tools and methods are often used assessment, making it difficult to
consider regional impacts or collaborate across municipalities. Public health officials and
researchers in the Bay Area convened a Working Group in Nov. 2015 to gather and
synthesize all types of "healthy corner store" assessment being used within the 9-county
region. An online survey was developed and sent to all convening attendees during Jul. 2016
to collect and classify the types of evaluations being used. The survey also encouraged
respondents to upload relevant survey instruments, including those they may have created
independently. Responses were accepted through Aug. 2016. Data were extracted from
these audit tools, including specific food items and/or nutritional standards, as well as store
features, such as the number of cash registers or participation in food assistance programs.
Group members interpreted key findings and themes from Sep-Dec 2016. Overall, 26
different types of tools were identified. Important differences in design/implementation of
these evaluations were evident, especially in terms of nutritional standards/terminology.
The Group identified opportunities to develop regional nutritional standards, which could
enable greater collaboration among public health and food retail stakeholders.6
respondents shared 15 types of assessment via the Survey. 5 additional respondents
provided 14 measures by email (some identical to those previously supplied).
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4. Collaborative Continuum of Care Model for Patients and Families with Dementia
Jennie L. Clark, MA, Gerontology; Rita Ghatak, PhD; Terese McManis, RN; Ann Bilbrey, PhD;
Dolores Gallagher-Thompson, PhD; Bonigut, Stefanie, MSW, ASQ
Community Partner: Alzheimer’s Association
An estimated 5.1 million Americans have dementia and this number is expected to triple by
2050. The Alzheimer’s Association estimates the annual cost of the disease at $226 billion.
Patients, families, and providers struggle with the complexities of this illness. The Memory
Support Program (MSP) at Stanford Health Care is a continuum of care model that follows
patients through the transitions of care offering a customized care plan to meet patient’s
individualized needs. The model has been strengthened with collaboration from our
community partner, the Alzheimer’s Association which offers support, education, and
advocacy for people with memory loss and their families. A quality improvement Qualtrics
survey was given to MSP participants (n=100). Survey revealed effectiveness of the program
with 100% reporting satisfaction. With focus on a customized care plan to meet
patient/family needs through the continuum, care coordination, home visits, and education
was endorsed as very valuable. Family caregivers felt ‘heard’ post-diagnosis. Linkages to
community resources such as the Alzheimer’s Association helped patient outcomes.
Dementia is a costly chronic condition and the MSP demonstrates an urgent need for the
U.S. health care system to find new models to deliver coordinated, patient-centered, and
cost-effective care. This MSP model and its interventions could be developed in other
medical settings focusing on transitions of care through the continuum of care.
5. Demographic, Psychosocial, and Behavioral Predictors of Diabetes among Urban
American Indian and Alaska Native Adults
Luis Garcia, Haley Hadlin, FeiFei Qin, Jan Vasquez, Randall Stafford, Lisa Goldman Rosas
Community Partner: American Indian Community Action Board
More than 29 million Americans had diabetes as of 2012, and rates of diagnosis were highest
among racial and ethnic minority groups. In particular, American Indian and Alaska Native
(AIAN) adults were twice as likely to be diagnosed with diabetes relative to non-Hispanic
Whites. Behavioral lifestyle interventions can effectively prevent diabetes, as evidenced by
the landmark Diabetes Prevention Program (DPP) trial. To inform effective behavioral
lifestyle interventions for AIAN adults, we used multivariable regression to evaluate the
association between demographic, psychosocial, and behavioral characteristics and Body
Mass Index (BMI) among AIAN adults. Data for this analysis were collected during a baseline
assessment of 207 AIAN adults participating in a randomized control trial comparing a
culturally-adapted DPP for AIAN adults to a standard DPP. The adapted DPP was modified in
collaboration with community members to include culturally-tailored strategies for
addressing mental health concerns and psychosocial stressors that might challenge the
successful implementation of lifestyle modifications. Prior to intervention, mean BMI was
37.3 kg/m
2
(SD 6.2 kg/m
2
) and the mean fasting serum concentration of glucose was 100.5
mg/dl (SD 10.6 kg/m
2
). The results of this analysis are useful for characterizing the study
sample prior to intervention and considering the efficacy of the intervention at the end of
the trial period.
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6. Redesigning Care for Low-Income Adult Patients with Type II Diabetes in a Community
Clinic
Michelle E Hauser, MD, MPA; Evelyn V Haddad, MD; Bradd Silver, MD; Priscilla Padilla-
Romero, MPH, MPP; Rakhi Singh, MD
Community Partner: Fair Oaks Health Center
Low-income and ethnic minority patients are disproportionately affected by type II diabetes.
Prior to this practice improvement project, only 26% of low-income, Latino adult patients at
Fair Oaks Health Center, a federally-qualified health center, met San Mateo County-defined
“perfect diabetes care” goals. The objective of this study was to Improve quality of care for
low-income, Spanish- and English-speaking adult patients with type II diabetes. We
developed a multi-component approach to address poor diabetes control in our clinic
population. This included collaborating with patients and a diverse clinic staff to identify key
barriers for patients both in and outside of the clinic. Based on feedback, the clinic wellness
team developed a protocol to achieve “perfect diabetes care” (hemoglobin A1c <8, BP
<140/90, smoking cessation, appropriate use of statins and aspirin). Additionally, the clinic
expanded the number of wellness education classes available in both Spanish and English.
The clinic also reorganized into care teams in order to provide more frequent follow-up for
patients’ medical, behavioral health, and social needs.
During the first year of the project (Nov 2014-Nov 2015), perfect diabetes care improved
from 26% to 40% of patients.: Engaging patients and the entire clinic team in a clinic-level
process redesign of diabetes and wellness care that addresses medical issues, social
determinants of health, behavioral health and general wellness can improve care of diabetes
among low-income Spanish- and English-speaking patients.
7. Improving Preventative Health Care for African-American Men in the East Bay: Evidence
from a Randomized Control Feasibility Trial
Javarcia Ivory, Grant Graziani Owen Garrick, M.D., M.B.A., Marcella Alsan, M.D., M.P.H.,
Ph.D.,
Community Partner: Bridge Clinical
African-American men as a population subgroup have the lowest life expectancies,
attributed to chronic, preventable illnesses. This lack of preventative care uptake could be
the result of mistrust of medical care systems; if true, physician-patient race concordance
could be used to combat this phenomenon. This project utilized a randomized feasibility
study to assess the role of race concordance on presentation rates for preventive care
among African-American men in the East Bay. A multivariate regression assessed whether
the intervention had an effect. The study involved two sites, several recruitment sites and a
clinic site, where presentation rates were recorded by provider race group and financial
incentive group. 215 men were surveyed and recruited, yielding 189 subjects for analysis.
Baseline characteristics were well balanced. Our presentation rate of 32.8% showed no
statistical difference between rates for provider race groups, but rates did differ across
financial incentive levels. OLS estimations suggest a fully scaled RCT would detect a race
concordance effect of 5.5 percentage points off the baseline in addition to an effect of 3.3
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percentage points for high degrees of patient medical trust as well as 14.9 percentage points
for low degrees of trust. This pilot demonstrated the logistical feasibility of performing a full
RCT. The data suggest a larger study would capture significant effects of the race
concordance intervention on patient care uptake, which could support policy changes
around the training of minority doctors.
8. Implementation of a Mobile Lung Cancer Screening Computed Tomography Program at
Northern California Federally Qualified Health Centers
M. Khairy, S. Shariff-Marco, I. Cheng, G. Lin, A. Hsing, B. Singh, A. Leung, V.S. Nair
Community Partner: North East Medical Center, MayView Community Health Center, Indian
Health Center, Gardner Family Health Network
Screening for lung cancer among high risk patients reduces mortality. However,
implementing lung cancer screening by low dose computed tomography (LDCT) is complex
and since smoking disproportionately affects those more financially disadvantaged, those
without adequate health insurance may not get screened. This study introduced a mobile
LDCT program for these patients. This project has four phases, including (1) physician
education and a brief survey on knowledge, attitudes, and practice on lung cancer screening;
(2) identification of LDCT eligible patients at each center using their electronic medical
records (3) a patient survey of LDCT eligible patients on knowledge, attitudes and intentions
for LDCT screening and (4) mobile LDCT screening on-site or near each site.
Four community health centers in Santa Clara County, caring for 110,000 patients, were
invited to participate. None have a lung cancer screening program, but all have breast,
cervical and colorectal cancer screening programs. All four centers were willing to
participate, interested in medical education on lung cancer screening, willing to answer a
survey about screening, and interested in referring appropriate patients. A process to screen
patients was identified using each center’s electronic medical record, and a phone consent
script, LDCT eligibility form, survey, and smoking cessation scripts were prepared. A mobile
CT trailer site was secured that will be parked near, or on, FQHC property to reduce patient
transportation obstacles. Implementing a mobile LDCT program at FQHCs is feasible and
FQHCs want to provide their patients with current standard of care.
9. Kinder Ready: Exploring Feasibility of a Text-Messaging Intervention for School
Readiness in Santa Clara and San Mateo Counties
Paloma Marin-Nevarez, Kimmy Phan, Brenda Lu, Janine Bruce DrPH, Monica de la Cruz, Lisa
Chamberlain, MD, MPH
Community Partner: San Jose Libraries, ICAN, AACI
Mobile technology is a promising medium for delivering school readiness strategies to
parents who cannot access early childhood education (ECE). Text messaging is widely used
in low-income communities. Pediatricians could utilize technology creatively to increase
access to ECE resources. Our aim was to examine access to technology, utilization and
barriers to technology access in low-income caregivers and to collect feedback from clinic
staff. The findings will be the foundation for a clinic-based intervention that promotes early
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learning and SR for children under 3. To date we have conducted five focus groups (2 Latino,
1 African American, and 2 Vietnamese) with 35 participants. Caregivers were recruited
utilizing evidence-based community engagement strategies. A multilingual survey was used
to collect quantitative data. Qualitative data were analyzed using an iterative transcript-
based coding analysis process. Parents are excited to receive school readiness information
from their pediatricians' office. Parents were concerned that the lack of individuality and
differentiation in the text messages was not appropriate for the individual needs of their
children. There are multiple barriers to fully utilizing and benefiting from educational tips. In
the clinic, it is believed that staff should serve as a connector for families to SR resources. An
online portal for communication exists, but it is not widely used. The clinic is actively working
to develop a texting system to communicate with parents around visit information. Despite
structural barriers, parents are nonetheless excited about the prospect of working alongside
their pediatrician in school readiness.
10. Implementing Primary Care Standing Orders at Planned Parenthood Mar Monte
AJ Millet
Community Partner: Dr. Miriam Sheinbein, Associate Director of Primary Care at Planned
Parenthood Mar Monte
The increased demand for primary care in the United States has spurred transformation in
care delivery. A core tenet of primary care practice transformation is team-based care.
Standing orders are documents that allow medical assistants to perform routine screenings,
blood tests, and vaccinations for specified patient populations without the prior approval of
a physician, improving clinic workflow and increasing rates of completion for preventive care
measures. Planned Parenthood Mar Monte is a network of community health centers
located throughout mid-California and Northern Nevada. To improve team-based care, this
summer, Planned Parenthood Mar Monte expanded its standing orders for medical
assistants in the primary care setting. The implementation process involved identification of
best practices for standing orders in community health center settings and development of
standing orders for medical assistants for preventive and chronic care in reach. Thirty-six
standing order documents for adult preventive care, adult immunizations, pediatric
immunizations, and chronic diabetes care measures were created. Sixteen standing orders
were implemented as official clinic policy in October 2016, and the remainder will be phased
in over the course of the next year. These documents will streamline workflow and promote
team-based care at the 11 Planned Parenthood Mar Monte community health centers with
primary care practices.
11. San Mateo County Communicable Disease Annual Morbidity Report
Keon Pearson
Community Partners: San Mateo County Department of Public Health
San Mateo County’s Communicable Disease (CD) Control Unit oversees the case follow-up
and management of all non-tuberculosis and non-sexually transmitted Title 17 diseases that
are reportable in California. Though the CD Control Unit has a quarterly report with simple
frequencies and a section to highlight a specific disease, they have not yet explored historical
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trends or examined the data in depth for select higher morbidity diseases. The goal of the
project was to work closely with the CD Control Unit to design a longitudinal morbidity and
mortality report of infectious diseases in San Mateo County using the data collected from
2011 to 2015 and to explore trends, demographics, and risk factors of selected diseases in
the San Mateo County population. The San Mateo County Department of Public Health
serves a highly diverse population. San Mateo County is diverse along class, race, and ethnic
dimensions. Per the 2010 US Census, the population in San Mateo County is 718,451. The
racial makeup of the County is 41.1% White, 26.9% Asian subpopulations, 25.4% Hispanic or
Latino, 3% African American, 1.6% Pacific Islander, .9% American Indian, and 4.4% Two or
more races. An easy-to-use template was developed to allow annual reporting on infectious
disease trends and a mechanism for analysis of longitudinal trends. This new reporting
system will help the CD Control Unit inform practices within clinics and hospitals, advise state
and national regulation, and support other essential functions within academic and
collaborating non-governmental organizations.
12. Kinder Ready: Low-income Parents and Clinic Providers Perceptions of the Feasibility
of Using Technology to Promote School Readiness in a Clinical Setting
Paloma Marin-Nevarez, Monica De La Cruz, MPH, Kimmy Phan, Brenda Lu, Reshma Thadani,
MD, Lisa Chamberlain, MD, MPH, Janine Bruce, DrPH, MPH
Community Partner: Ravenswood Health Center
Income and racial disparities disproportionally impact school readiness (SR) among the most
vulnerable children. Mobile technology is a promising medium for delivering SR strategies to
parents with limited access to early childhood education. Pediatricians have the potential to
use technology in a clinic setting to empower parents to promote SR. To examine the
perceptions of low-income parents and pediatric clinic staff regarding the feasibility of
implementing a technology-based school readiness intervention in a clinical setting. A
diverse group of low-income parents participated in focus groups to explore access and
utilization of mobile technology, and attitudes and barriers toward participating in a
technology-based intervention. Clinic administrators and providers participated in
interviews and focus groups to explore attitudes and barriers to implementing a SR texting
intervention. Parents reported technology as regularly-used and convenient. Parents cited
housing insecurity, unstable work schedules, multiple jobs, and the effect of mental health
as significant barriers to engaging in SR activities. Parents were excited to discuss SR with
their child’s pediatrician.
13. Greece’s Failing Response to the Refugee Crisis
Laila Soudi, MS; Hana Abu Hassan, MBBS MRCGP JBFM
Community Partner: Syrian American Medical Society
In 2016, Greece received 169,459 refugees and migrants, the majority (87%) of whom came
from Syria, Afghanistan, and Iraq. Still suffering from the 2008 financial crisis, Greece was
severely unprepared to host refugees after the European Union’s decision to shut the Balkan
states. As a result, over 80,000 refugees remain in Greece today in conditions that have been
deemed “unfit for animals” (The Guardian). Through focus groups conducted on the border
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of Greece and Macedonia with refugees as well as representatives of major NGOs and the
Greek Ministry of Health, this study identified the major barriers and facilitators for
providing and accessing physical and mental health services. While variable, major barriers
identified included the following: lack of medical supplies, lack of Arabic-speaking personnel
on the ground, lack of other basic necessities such as food, lack of trust among refugees
themselves for medical professionals, and stigma in seeking mental health treatment.
Facilitators included a triage-based referral network among NGOs, proximity of clinic to
refugee camp, and the presence of mental health professionals from the same culture as
refugees. Identifying the major barriers and facilitators to providing and seeking health
services among NGOs, the ministry as well as refugees, respectively, is imperative in ensuring
better health outcomes for refugees.
GROUP II: PROMOTION OF HEALTH AWARENESS AND HEALTHCARE
ACCESS THROUGH EDUCATION
1. Patient-Centered Time Management in Outpatient Primary Care
Victoria Boggiano, Dr. Erika Schillinger MD, Dr. Tracy Rydel MD
Community Partner: Mayview Community Health Center
In 2013-2014, 326 patient logs submitted by 216 medical students during the Stanford
School of Medicine family medicine core clerkship, were analyzed to assess students’
perceptions of patient-centered care. It was found that students identified many of the
benefits of patient-centered care; however, they also highlighted challenges they faced in
being patient-centered. Many challenges centered around communication barriers,
mentioned by 45% of students. Additionally, 13% of students specifically mentioned the
extra time and effort that being patient-centered requires. In busy community health
centers, particularly those that see patients from poor and minority groups, patient-
centeredness is of the utmost importance. This study piloted an innovative, hands-on
curriculum that teaches medical students new skills around patient-centeredness, to
address some of these perceived challenges. The initial focus is patient-centered time
management. A flipped classroom curriculum was designed about patient-centered time
management that includes two short video clips, followed with thirty minutes of didactics
during the required family medicine core clerkship at Stanford. There is little in the literature
about how to effectively teach students how to be patient-centered and manage time well
in a primary care setting. The flipped classroom curriculum is intended to fill this gap, by
providing students with a cadre of tools that they can use during the busy primary care visit,
to use time wisely while ensuring that the patient’s voice is heard and respected.
2. Of Sound Mind: Using Public Access TV for Community Outreach and to Raise Dementia
Awareness
Ann Choryan Bilbrey, PhD, Frederic T. Bockmann, MS, Nusha Askari, PhD and Dolores
Gallagher-Thompson, PhD, ABPP-Geronotology
Community Partners: MidPen Media Center
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Every day, Americans spend on average 2.8 hours watching television (TV). After retirement,
the time spent watching TV increases. Public-access television (PATV) is a non-commercial
media where the general public can create content programming, which is shown through
cable TV specialty channels. While there is limited marketing research on the audiences of
PATV, Chen and colleagues (2013) found PATV remains relevant, especially for
underprivileged populations who have been shown to rely on TV to gather information on
health concerns. In a 2009 survey of Spanish speakers in Baltimore City, 82.4% obtain their
health information through TV. While abundant information concerning dementia exists for
those with access to the internet, there is limited approachable information available
through the TV. Of Sound Mind was designed to address multiple needs, including the need
for accurate, research-based information about dementia and healthy cognitive aging, which
can be scarce on most TV programming. The development of a public access talk show can
be split into production and content. Production will contain the steps needed to produce
a talk show, including securing a partnership with a local public access studio. Content
describes the material being covered, guest recruitment, and establishing credibility. The
direct and indirect benefits for the organization producing the talk show are explored, and
with the inability to gain direct viewership numbers, methods of determining success are
reviewed. Finally, the future plans for Of Sound Mind are discussed.
3. Community First Responder Training for Medical Emergencies: Empowering Bay Area
High School Students
Henry A. Curtis, M.D. FAAEM, Rebecca Walker, M.D., Jennifer A. Newberry, M.D., J.D.,
Rebecca Smith-Coggins, M.D.
Community Partner: San Francisco Unified School District, Career Technical Education College
and Career Readiness Department
Building community resilience for medical emergencies involves complimenting the EMS
system with local community resources. An important community resource, the community
first responder (CFR) is a layperson whose actions prior to the arrival of the professional first
responders can benefit people with medical emergencies. In order to act as a CFR, the
layperson must have the specific knowledge of what to do for the presenting emergency,
the tools to take action, and the individual empowerment to drive the propensity to act.
Multiple community initiatives focus on instilling specific knowledge and distributing
equipment such as first aid kits and automated external defibrillators in the community. Few
focus on promoting individual empowerment, which actually enablers people to act in an
emergency. A prospective, randomized trial was conducted to determine whether
empowerment training embedded into a community first responder course for bay area high
school students would improve the potential to act in emergencies and the actual helping
rate in emergencies. Subjects were randomized into 1 of 6 groups. 3 groups had
empowerment training and 3 did not. The possible training methods included hands-on
workshops, video based learning, and a control group discussion of careers in medicine.
Three study instruments measured the potential to act in an emergency: Knowledge,
Equipment Craft, and an Individual Community Related Empowerment Scale. One study
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instrument measured the self-reported actual rate of helping in an emergency, termed the
helping rate. Analysis is pending at the time of this writing.
4. American Spirit Brand Preference Among Smokers with Serious Mental Illness
Anna E. Epperson, PhD, Nicole E. Anzai, BA, Sebastien C. Fromont, MD, Sharon Hall, PhD,
Judith J. Prochaska, PhD, MPH
Community Partners: Alta Bates Medical Center
Overall smoking prevalence in the US has declined, however, smoking remains high for
certain vulnerable groups, such as those with mental illness, where smoking rates approach
45% to 60%. Perhaps in response to consumer concerns, tobacco brands such as Natural
American Spirit (AS) have incorporated positive health-oriented language of “natural” and
“addictive-free.” With a focus on a vulnerable group - smokers with mental illness - we
examined sociodemographic and tobacco-related factors associated with preference for AS
cigarettes. Adult smokers were recruited during acute psychiatric hospitalization in the San
Francisco Bay Area between 2009–2013. The sample (N=956; M age = 38.7, SD=13.5) was
49% female and identified as 23% African American, 15% Latino, 44% White, and 18% Other.
Participants listed their cigarette brands and completed measures of demographics, health,
and tobacco-related behaviors. AS cigarettes were identified as a top brand by 16% (n=153).
Logistic regression analyses indicated that the likelihood of preference for AS was
significantly higher for participants of higher SES (ß = 1.08) who were younger (ß = 1.30),
more highly educated (ß = 1.18), reported better health (ß = 1.20), and a low-fat diet (ß
= 1.57), p < .05. African Americans were less likely to report a preference for AS cigarettes
compared to Whites (ß = 0.19). Younger, more highly educated individuals, with higher SES,
better self-rated health and healthier diets may select AS cigarettes because they perceive
them to be healthier. Notably, measures of tobacco use and addiction did not differ for AS
relative to other brands.
5. Implementation of a Chronic Health Education Program for Underserved Populations in
Santa Clara County, CA
Gunsagar Gulati, Anoop Manjunath, Ian Nelligan, Erika Schillinger, Rhonda McClinton-
Brown, Anna Hui
Community Partners: Barbara Lee Senior Center, Silicon Valley Gurudwara
Chronic health conditions (CHCs), like hypertension, diabetes, obesity, osteoporosis,
musculoskeletal pain, and depression, are some of the most common, lifestyle-impairing
diseases seen in patients in Santa Clara County. Asian and South Asians immigrants from low
socioeconomic backgrounds and seniors above the age of 65 are at the highest risk of
developing poorly managed CHCs. We developed a CHC education program that uses
information sharing, motivational interviewing, and health coaching to increase health
literacy and motivate behavioral changes in target underserved populations. Our chronic
health education program was offered weekly at the Milpitas Barbara Lee Senior Center and
monthly at the Silicon Valley Gurudwara. The curriculum was developed with the help of the
UNC Nutrition in Medicine Project, O’Connor Hospital Body Language course, Stanford
University School of Medicine curriculum, and Valley Health Center Milpitas. We find that
22
although self-reported rates of exercise and dietary choices are within healthy ranges in
Asian/South Asians and seniors, BMI and self-reported health satisfaction remain poor in
these communities. We also recognize that health education programs are an effective
model for increasing knowledge and motivating behavioral change in seniors and
Asians/South Asians of Santa Clara valley.
6. Quality and Effectiveness of the Mid-Peninsula Brain Injury Peer Support Group
Jaclyn A Konopka, Alissa A Totman
Community Partners: Santa Clara Valley Medical Center Brain Injury Peer Support Group
The incidence of traumatic brain injury in the United States is very high with approximately
1.7 million cases per year. After their injury, many of these individuals face persistent
symptoms and disabilities that greatly impact their lives. These symptoms can be extremely
isolating and frustrating leading many brain injured individuals to not feel well understood
by society, family, and friends, as well as to find it difficult to develop new friendships. This
leads some to develop depression or to have suicidal thoughts. In fact, traumatic brain injury
patients are at an increased risk of developing depression and anxiety compared to the
general population. Furthermore, these individuals also have fewer opportunities to engage
in social interactions with others. In combination, this makes it especially important to
provide support services for individuals with brain injury. In 2015, the Mid-Peninsula Brian
Injury Support Group was founded. This support group is providing a previously nonexistent
service to individuals with brain injury in the Mid-Peninsula community. To evaluate the
group’s quality and effectiveness, brain injury members who volunteered their time were
interviewed and surveyed. This investigation aims at determining the Mid-Peninsula Brain
Injury Peer Support Group’s most beneficial components and how members’ needs can be
better assessed.
7. A Cluster-Randomized Trial to Assess a Sexual Assault Prevention Intervention in Upper
Primary School Adolescents in Nairobi, Kenya
Clea Sarnquist, DrPH, MPH, Michael Baiocchi, PhD, and the Stanford Gender-Based Violence
Prevention Collaboration.
Community Partners: No Means No Worldwide (US and global)l Ujamaa (Kenya)
In Kenya, up to 46% of women report childhood sexual assault. That percentage is likely
higher in urban informal settlements, where up to 25% of secondary-school girls report
sexual assault annually. To determine if a 6-wk classroom-based girl’s empowerment
program, in parallel with a boy’s educational program, significantly reduced the incidence of
sexual assault in primary schools in Nairobi's informal settlements. Secondary objectives
included changes in self-efficacy, disclosure rates, and distribution of perpetrators. The
study was a cluster-randomized controlled trial in upper primary schools (girls aged 10-15).
The intervention included 12 hours of behavior-change and skills training in empowerment
and self-defense. Analysis utilized a generalized mixed models approach. Included in the
analysis were 14 schools with 3,147 girls from the intervention group and 14 schools with
2,539 girls from the control group. We estimate a 3.7% decrease, p=0.03 and 95% CI=(0.4%,
8.0%), in risk of sexual assault in the intervention group due to the intervention (initially 7.3%
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at baseline). We estimate an increase in mean generalized self-efficacy score of 0.19
(baseline average 3.1, on a 14 scale), p=0.0004 and 95% CI=(0.08, 0.39). The intervention
reduced sexual violence in this population. The intervention group reported a 50% lower
incidence of rape (3.6% versus 7.3%) and a significant increase in self-efficacy during follow-
up than the control group. High self-efficacy is associated with fewer experiences of
violence, so improving self-efficacy may be an important way to decrease sexual assault.
GROUP III: BUILDING CAPACITY LOCALLY
AND GLOBALLY
1. Fostering Safe and Healthy Community Parks: Promoting Partnership Problem-Solving
(A Partnership with the Santa Clara County Public Health Department)
Naina J. Ahuja, Nicole M. Rodriguez, Sandra J. Winter, Ann Banchoff, Bonnie Broderick,
Jamina Hackett, Abby C. King
Community Partner: Santa Clara County Public Health Department
The local environment in which we spend time impacts our ability to lead healthy, active
lives. To create tailored, innovative and sustainable improvements in local environments
that better support a healthy community, diverse perspectives about neighborhood assets
and shortcomings are vital. In the Our Voice initiative, a multi-sectoral team of community
members (citizen scientists), the Santa Clara County Public Health Department (SCCPHD),
Somos Mayfair (a community organization supporting families) and Stanford Prevention
Research Center researchers worked together to conduct technology-enabled
neighborhood environmental assessments from which data were extracted to drive local
environment improvements. This unique partnership allowed for integration of research
into public health programs to assess and support the community health effort. Partnership
benefits included: for citizen scientists, feelings of empowerment; for SCCPHD,
incorporation of technology-based neighborhood environmental assessment tools and
scientific methods to enhance its work; for Somos Mayfair, a route to forwarding its mission
to address systemic inequalities; and for researchers, further development of the Our Voice
methodology. An unanticipated outcome was the evolution of the project’s purpose.
While the community partner was interested in the park itself, the residents identified
challenges accessing the park, shifting the focus to park access from quality. Communication
and commitment to shared values can help ensure that the challenges in engaging in multi-
sectoral partnerships for community change do not outweigh the anticipated benefits.
2. “EmPower Me,” a Physical Activity Program for Older Adults in Meals on Wheels: a RE-
AIM Informed Pilot Study
Megan Alexander, Lisa Goldman Rosas
Community Partner: The Health Trust Meals on Wheels
Physical activity in older adults has well-documented impacts on quality of life,
hospitalization rates, healthcare costs, and mortality. However, most older adults fall short
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of recommended guidelines, and this is especially true for those who are home-bound. It is
critical that we identify effective physical activity promotion programs for the high-priority,
yet hard-to-reach, home-bound population of older adults. Partnering with Meals on Wheels
is one way to do this. Megan Alexander, a master’s student in Stanford’s Community Health
and Prevention Research program, designed a randomized, controlled pilot study to test the
acceptability and feasibility of offering a novel physical activity promotion program named
EmPower Me, in partnership with a local Meals on Wheels organization. The EmPower Me
intervention is based on the National Institute of Aging’s Go4Life campaign, and it is
grounded in social learning theory. In this study, quantitative outcome measures of interest
include changes in physical activity levels, sedentary behavior, and the psychosocial
variables of attitude, perceived control, and self-efficacy. Qualitative outcome measures of
interest include relative ease of program adoption, thoughts on program components, and
areas for future program improvement (according to both participants and study staff). The
study’s results will (1) inform how the Health Trust implements EmPower Me in the future
by pointing to its success as is or to distinct opportunities for improvement, and (2) suggest
whether it is appropriate to share this exercise program with Meals on Wheels programs
across the country, which serve 2.5 million older adults every day.
3. Muslim Community Association of Santa Clara and Stanford Muslims and Mental Health
Research Lab: Strengthening an emerging CBPR collaboration
Rania Awaad, MD; Sara Ali, MBBCH, Nuzhath Quadri, LMFT; Christine Chase, BS; Lisa
Goldman Rosas, PHD, MPH
Community Partner: Muslim Community Association
The complex relationship between race/ethnicity, class, culture, religiosity, health status,
social-political tensions and public perception impacts the probability that a Muslim with
emotional distress will seek out MH services. Lack of religiously and culturally sensitive MH
services further put Muslims at risk of developing psychosocial stressors. The aim of this
project is to establish a community-university partnership between the Muslim Community
Association (MCA) and the Stanford Department of Psychiatry to understand the MH needs
of Muslims residing in the Bay Area and strengthen community mobilization to address those
needs. The MCA-Stanford research team developed a community advisory board (CAB) by
recruiting key stakeholders that represent the ethnically diverse Muslim population residing
in the Bay Area. The MCA-Stanford research team used Newman’s framework to guide the
formation, operation, and maintenance of the CAB. Recruited members participated in
monthly meetings through which they were engaged in the research process, conducted
focus groups, and received training on principles of CBPR. CAB members conducted 4 focus
groups that explored barriers and facilitators to utilization of MH services. Analysis of the
focus groups revealed that spirituality is an important component of MH treatment for
Muslims and that the role of Imam is crucial in early identification and further referral to
professional care. Barriers to seeking professional help included: 1- MH stigma in both
American culture within the Muslim community 2- lack of MH awareness 3- perceiving
symptoms as lack of faith or result of superstitious factors 4-lack of culturally and religiously
sensitive MH professionals.
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4. Piloting a Free Clinic Model in Pescadero, California
Victoria Bawel and Ragini Phansalkar, Lina Mira
Community Partners: Puente de la Costa Sur
Many individuals in Pescadero, California, face barriers in accessing healthcare, such as
transportation to the nearest fully operational clinic in Half Moon Bay and rural isolation. To
address these barriers, San Mateo County Health System operates a Thursday evening clinic
for Pescadero residents with public insurance at Puente de la Costa Sur, a community based
organization. Uninsured and privately insured patients are unable to obtain care at this
clinic. To increase healthcare access, Cardinal Free Clinics (CFC) and the Center for
Innovation in Global Health (CIGH) partnered with Puente to pilot a free Sunday clinic on
three dates, under the traditional CFC model of transitional care. A general survey was
conducted at a health fair in Pescadero and more detailed patient surveys were collected on
clinic days about insurance, barriers to care, and reasons for attending the Sunday clinic.
Puente, CFC, and CIGH are in the process of determining how our partnership may best
benefit and improve the health of the Pescadero community. During the three clinic days,
physicians saw 21 patients, of which 17 had public insurance. Most patients attended the
clinic for a basic health check or for musculoskeletal pain. Since most of the patients who
came to the pilot clinic have public insurance, we believe that supporting the current public
healthcare infrastructure in Pescadero will be more effective in increasing healthcare access
than the implementation of a separate CFC clinic.
5. Stanford's first Community Advisory Board (CAB) for Clinical Research
Katherine Connors, Nicole Ventre, Jodi Prochaska, Jonathan Shaw, Jill Evans, Rhonda
McClinton-Brown, Anna Epperson
Launched March 2016 by Stanford Center for Clinical Research, in partnership with the Office
of Community Engagement, the CAB is a forum to engage researchers and the community.
The CAB aims to (1) enable community members to advise on research processes that are
inclusive of our diverse community; and (2) provide feedback to investigators on recruitment
strategies, including reaching specific populations. The CAB consists of 20 invited members
(health providers, education leaders, city council, parents, etc.) with diverse racial, ethnic,
age, and geographic (<40 miles from Stanford) representation. Members received training
on research process, ethics, responsibilities, and expectations. Meetings occur every two
months on a weekday evening, with a brief research presentation, followed by Q&A
discussion. Meeting minutes are provided to the investigators, and members complete a
post-meeting questionnaire. Our Advisors facilitate an in-depth evaluation biannually. To
date, we have had four research presentations and one in-depth evaluation. Overall,
feedback from CAB members and researchers has been very positive. Members appreciated
different member perspectives, though felt diversity in socioeconomic status and education
lacking. Eighty percent of members agreed that the CAB was accomplishing its goals, and
100% felt the work of the CAB was important to the community as a whole. For investigators,
the percent of CAB recommendations they anticipated implementing ranged from 10-80%.
This was influenced by stage of research (early-stage teams could implement more).
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However, mid-stage teams valued the feedback for incorporating into future projects. All
teams felt the CAB was useful and would recommend to other investigators.
6. Raising Dementia Awareness from Within the Latino Community: Engaging Community
through Promotoras
Iliana Garcia-Ruiz, BA, Ann Choryan Bilbrey, PhD, Angelica Ceja, MS, Nusha Askari, PhD, Julio
Garcia, & Dolores Gallagher Thompson, PhD
Community Partner: Nuestra Casa
A Dementia Awareness Campaign (DAC) was created in collaboration with Nuestra Casa, a
Latino community-based education organization. This poster will focus on the partnership
between this stakeholder and Stanford Alzheimer’s Disease Research Center (ADRC), the
campaign itself, and how success was measured. To better understand the local Latino
community, a collaboration between Nuestra Casa and the Stanford ADRC was created.
After multiple meetings, a Dementia Awareness Campaign was created which includes
training of Promotoras (lay community members who provide basic outreach services
including raising health literacy) to talk with clients about dementia, assisting clients in
recognizing significant memory change, and provide education on speaking with their doctor
about memory problems. Also included is a description of the promotion of the Dementia
Awareness Campaign. An evaluation was performed on the effectiveness and usefulness of
the training material and the community receptiveness of the lecture material.
7. Improving Community Wellbeing in Rural Oaxaca through Grassroots Community-Based
Participatory Action Research
Nicole M Rodriguez, MS, Gabriel Garcia, MD, Catherine Heaney, PhD, Sandra J Winter, PhD,
Abby C King, PhD, Jackie Botts, Tatiana Baquero, Jeannette Rios, Daniela Goni, Linda Shin
This study investigated community wellbeing and localized social-environmental
determinants of health in two marginalized rural communities in Oaxaca, Mexico.
Participants (n=40) were selected through a partnership with a local non-profit, Niño a Niño,
an organization that focuses on grassroots community empowerment through family
education. This investigation involved: 1) an open-ended wellbeing interview to assess
perceptions and priorities surrounding wellbeing, 2) a community health photo-audio
assessment where participants captured specific aspects of their community that affected
their wellbeing, and 3) a wellbeing questionnaire that is being used internationally through
the team at the Stanford Prevention Research Center’s Wellness Living Laboratory (WELL) to
understand key topics in cross-cultural wellbeing. Preliminary analysis of the wellbeing
measures suggests that strong social connectedness, interactions with nature, and
spirituality/religion contribute to community wellbeing in this area, while financial
limitations and government instability detract from wellbeing. Following the photo-audio
assessments, study participants convened in facilitated community meetings to review the
photographs and text narratives, discuss critical themes, and vote for community priorities.
Participants identified major community concerns to be agricultural sustainability, water
resources, and pollution. These findings have been incorporated into Niño a Niño’s
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community health project plan for the upcoming year. This work has expanded WELL’s
research to understand similarities and differences in wellbeing across cultures.
8. Developing a Scalable Curriculum for Underrepresented in Health Professions Pipeline
Program
Nancy T. Nkansah, PharmD, MBA, Jane Binger, Ed.D, Cynthia Irvine, M.Ed., Fernando
Mendoza, MD
Community Partner: Joe Bucher, West Valley College
The proportion of Latinos and African-Americans (AA) pursuing graduate level health
professional careers has plateaued over the past 30 years, while federal funding to support
pipeline programs to address this need has significantly declined. Limited diversity
contributes to health disparities such as less health care access, stunted patient
communication, and poorer health outcomes. This project uses design-thinking
methodology to develop a scalable curriculum using technology focused on preparing
undergraduate students underrepresented in health care professions for pursuit of
doctorate level health care professions. Instead of designing a curriculum without
considering student needs, the objective is to use design-thinking methodology (i.e.,
empathy, ideate, prototype, test) to have key stakeholders (i.e., students; college
administrators/faculty; health professionals and employers) engage in the process of
curriculum development. This methodology is highly successful in creating innovative
solutions to long standing community-based problems and results in strong stakeholder buy-
in and satisfaction through early engagement in the process. In addition, the methodology
allows for rapid prototyping, allowing us to quickly evaluate innovations for effectiveness
and scalability and iterate. The designed curriculum has been provided for colleges
throughout California and a college in Florida. Curricular effectiveness will be evaluated via
quantitative (e.g. Post-session Likert-scale based surveys, transfer rates to 4-year colleges)
and qualitative mechanisms (e.g. structured student and program advisor feedback).
9. Breakdancing with Boys and Girls Clubs of the Peninsula
Marina Post, MD and Nielson Weng
Community Partner: Belle Haven Elementary School Boys and Girls Clubs of the Peninsula
Socioeconomic status (SES) inequalities are associated with significant health inequalities for
youth worldwide. Resources are needed beyond those currently available in low SES
communities for bolstering physical and mental health, as well as academic achievement. A
breakdancing activity for the Boys and Girls Clubs of the Peninsula at their site at Belle Haven
Elementary School in East Menlo Park was started in 2012 and continued with leadership of
Stanford psychiatrists, graduate students, medical students, and undergraduates. Objectives
of this breakdancing activity include utilizing breakdancing as a way for youth to feel
increased self-efficacy, develop further coping skills, and to have positive relationships with
members of the Stanford academic community. The approach to leading the breakdancing
activity is to promote excitement of students with learning that with practice, they can do
inspiring dance moves and discover new, creative, and healthy ways to use their bodies and
minds. Main important outcomes are student enjoyment of the breakdancing activity, pride
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in their participation in the activity, and positive relationships with writer and other group
members and guests. Outcomes included qualitative feedback (written anonymous) was
obtained from students in the breakdancing activity at Belle Haven Elementary School Boys
and Girls Club from February to October, 2014, average ages 10-11 years old, with groups of
6-12 students. The majority of the students endorsed feeling positively during most of the
breakdancing activity, and noted enjoyment of various aspects of the activity such as
learning new moves, doing a move well, dancing "freestyle," and being with friends and
trusted adults. In summary, the Boys and Girls club has been a valuable resource for low-
income children, and has accommodated enjoyable and beneficial breakdancing activities
with students. It would be important for the Boys and Girls Club breakdancing activity to be
continued and expanded to incorporate new learning opportunities for youth.
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“There is unequivocal evidence that social, environment,
and behavioral factors accruing over the life-course are
by far the strongest predictors of health and disease. The
Center for Population Health Sciences is committed to
partnering with communities locally and globally to
advance our understanding of the complicated
intersections among these factors leading to the
transformation of health of individuals and communities.”
Mark Cullen, MD
Senior Associate Dean for Research
Director, Stanford Center for Population Health Sciences
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THE OFFICE OF COMMUNITY ENGAGEMENT
STANFORD CENTER FOR POPULATION HEALTH SCIENCES &
THE STANFORD CENTER FOR CLINICAL & TRANSLATIONAL RESEARCH & EDUCATION
The following Stanford-based programs support substantive student
engagement in community health:
Asian Liver Center
Practice of Medicine Population Health Curriculum
Scholarly Concentration in Community Health
Center for Education in Family and Community Medicine
Center of Excellence in Diversity
Stanford Community Health Advocacy Program
Stanford Pediatric Advocacy Program
Stanford Prevention Research Center
Valley Foundation Fellowship Program
Haas Center for Public Service
Special Thanks to
Keynote Speaker, Monica McLemore, PhD, MPH, RN
Dean Lloyd Minor, MD
Senior Associate Dean for Research and Director, Stanford Center for Population
Health Sciences, Mark Cullen, MD
Symposium Coordinators, Paloma Marin-Nevarez, SMS II and Angela Lee, SMS I
Photographer, Stanford Schor, SMS III
Pianist, Sheun Aluko, SMS II
Medical Student and Undergraduate Student Volunteers
Office of Community Engagement
Rhonda McClinton-Brown, MPH
Nell Curran, MPH Jorge De Luna, MPH • Glenda Estioko
Former OCE Staff: Jill Evans, MPH • Evelyn Ho, MPH
The mission of the Office of Community Engagement is to be a local, national, and
international leader in developing innovative models of engagement and to develop
community-responsive research, education, and training programs aimed at building
leaders in Population Health Sciences and improving the health of underserved
populations locally and globally.
The purpose of the Office of Community Engagement is to identify and bridge the
intersection between community-defined health needs and the School of Medicine’s
mission of medical education, research, and patient care. Our priorities are to create
and sustain meaningful partnerships with community-based agencies and not-for-
profits and to build a cadre of physicians with the knowledge and skills to impact
health at a population level.