The Community Mental Health and Cancer Prevention Partnership Project

1. The Community Mental Health and Cancer Prevention Partnership Project PI: Elisa Weiss, PhD Co-I: Hayley Thompson, PhD Dept. of Epidemiology and Population Health April 12, 2010 Health Inequities Think Tank Meeting

2. Overview of the Project • Two-year pilot study to identify feasible strategies to improve access to mental health care in the Bronx, in the context of efforts to promote timely, age-appropriate utilization of cancer screening services. • Study recognizes that effectively responding to the complexities surrounding health care access and utilization by diverse Bronx residents will necessitate working with the community from the inception of the research process.

3. Background • In meetings to discuss cancer-related projects, CBOs in the Bronx reported a dearth of mental health services to staff and investigators of the Community Assessment and Capacity Building Core. • Literature indicates that untreated mental illness hinders preventive healthcare, including cancer screening; regular care for mental illness increases likelihood of regular screening. • Roughly half of Bronx is designated Mental Health Professional Shortage area by HRSA, making obtaining care particularly challenging.

4. ICTR Grant Mechanism • 2 years of pilot funding to support “community-engaged research” from the Einstein-Montefiore Institute for Clinical and Translational Research (ICTR) • Project must be launched through one of Einstein’s NIH-funded centers (Cancer Center). • Over 60% of funding must go back to the community.

5. Specific Aims • Describe the individual-level and system-level barriers and facilitators to accessing mental health services in the Bronx. • Begin to identify how the lack of sufficient mental healthcare in the Bronx affects use of cancer screening services for breast, cervical, prostate, and colon cancer. • Understand past and current efforts to address inadequate access to mental health care in the Bronx and their outcomes. • Build a sustainable partnership with a range of key stakeholders in the Bronx that will develop a grant applications to improve mental health services and preventive care in the Bronx.

6. Conceptual Framework • Behavioral ecological framework (see figure) • Community-Based Participatory Research Methods (CBPR) • Working Group of 6 Bronx CBOs and project investigators/staff www.cdc.gov 2010

7. The Working Group – 6 CBOs • Bronx Works • Good Shepherds • Love, Power, and Grace • Montefiore Family Health Center • Neighborhood Initiatives Development Corp. (NIDC) • Phipps CDC

8. Working Group - Project Investigators and Staff • Elisa Weiss, Ph.D. (Sociology), Partnership Research • Hayley Thompson, Ph.D. (Psychology), Medical Mistrust Research • Pamela Valera, Ph.D. (Social Work), Qualitative Research • Joanna Dognin, Psy.D. (Psychology), Access to Mental Health Care • Jennifer Erb-Downward, M.P.H, Community Organizing • Abigail Williams, M.P.H., Qualitative Research • Nicole Maysonet, Community Administrative Assistant • Research Assistant

9. Research DesignYear 1 (2010) The Working Group will: • Create a qualitative interview guide that relates to the aims. • Select appropriate stakeholders from social service and health delivery organizations as well as community leaders to participate in approximately 40 qualitative interviews. • Interpret the qualitative data gathered. • Identify organizations to be part of a larger partnership for Year 2.

10. Research DesignYear 2 (2011) • Build on the Working Group to create a sustainable, multi-sector Bronx partnership that will use the data collected in the first year as a basis for discussion about how we can improve access to mental health care and utilization of cancer screening services among those with mental health needs. • Develop intervention strategies and begin to develop a grant proposal to fund one or more of these strategies.

11. Partnership Evaluation to Maximize Partnership Functioning • 2-3 evaluation points in year 2 • Evaluation will be anonymous, web-based survey (based on Elisa Weiss’s published work) • Evaluation will facilitate discussion and allow for mid-course adjustments as needed

12. Individual Benefits and costs to member Participation and roles Expectations Satisfaction Commitment Ownership Group Administration and management Meeting quality Leadership Group Synergy Communication Decision-making Efficiency Sufficiency of financial and non-financial resources Trust Conflict and Cooperation Perceived Progress Partnership Characteristics for Evaluation

13. Future Plans • Study will serve as a launching point for the Community Mental Health and Cancer Prevention Partnership, an ongoing platform for CBPR Research in area of mental health and cancer screening • Development of future grants and interventions

14. Questions/Comments??

15. THANK YOU

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