In 2013, the Mailman Center partnered with community coalitions in the economically challenged areas of Overtown, an historically Black community, and East Little Havana, known for its largely immigrant Hispanic population, to address health outcome disparities.
“Much of child health is driven by where children live, go to school, and play, and how their family is doing,” said study author Jeffrey P. Brosco M.D., Ph.D., professor and associate chair (Population Health) of the Department of Pediatrics at the Miller School, and associate director of the Mailman Center.
To measurably improve health at the population level in communities requires an “all-in” partnership between academic institutions and people who live and work in those communities, according to Dr. Brosco.
“Folks from Overtown and East Little Havana are part of our leadership team at the Mailman Center, and many of our faculty and staff are part of their leadership teams in the community agencies. Many of our grants are codirected with people in each community,” Dr. Brosco said.
Study authors, including Miller School researchers and students, and community leaders in Overtown and East Little Havana, compared three indicators of child wellbeing — high school graduation rates, the proportion of 16- to 19-year-olds in school or employed (connected youth), and kindergarten readiness — over time in the CAP communities versus several nearby communities.
They found high school graduation rates and kindergarten readiness rose dramatically from 2011 to 2017 in the CAP communities but not in the socioeconomically similar comparison communities. Scientific thinking, a measure within kindergarten readiness, improved by more than 400% in Overtown, while it worsened by about 22% in comparison communities. Other dramatic improvements were seen in the kindergarten readiness category of mathematical thinking, which improved by about 363% in Overtown, while it too declined in the comparison communities. High school graduation rates improved during the study period by more than 21% in Overtown and 25% in East Little Havana, compared to a 2% decline in comparison communities. The researchers, however, did not find an improvement in either CAP community in the connected youth measure, which improved slightly in the comparison area.
While there are many other factors why child readiness may improve, the improvements in children’s wellbeing in CAP compared to non-CAP neighborhoods provides important insight into the benefits of academic-community partnerships.
“The fact that we found positive results was less important than the bigger picture of the Miller School’s all-in commitment to making the CAP work,” Dr. Brosco said. “We said we are not just going to look at how many grants we write, papers we publish, people we educate, or patients we see; we wanted to see if we can improve health at a population level in the community. This isn’t about any one project or one study, it is all the work we do with leaders in those communities to establish a shared set of goals and objectives and then a variety of ways to collaborate on them.”
Overtown Children and Youth Coalition’s partnership with the Mailman Center is critical to the community’s overall well-being, sustainability, and growth, according to the Coalition’s Executive Director Graylyn Swilley Woods, Ph.D., who is an author on the study.
“The enormity of resources, the wealth of knowledge, expertise, and intellectual contribution help connect resources to the community, ultimately strengthening and impacting system and community-wide change and development,” Dr. Swilley Woods said. “Significantly, the partnership contributes to a collaborative learning network that aligns academic and community expertise. The arrangement better informs academic partners from an endogenous perspective that is inclusive and mutually beneficial to both the community and university.”
CAPs are an important vehicle to drive community-level work, said study author Renae Schmidt, M.P.H., senior research associate in the Department of Public Health Sciences at the Miller School and a strategic research analyst with the Overtown Children and Youth Coalition.
“It was valuable early in my career to participate in research guided by the voices of the people that the results could impact,” Schmidt said. “Being part of such a dynamic and cross-disciplinary team informing the work, I will remain in tune to opportunities in academia and community to collaboratively approach common goals. Looking back, it was such a unique and important experience.”
According to Schmidt, as part of its commitment to CAPs, Miller School researchers should continue to find ways to collectively drive research programs and resources, as well as measure and evaluate the impact of partnership work on population health.
Coauthors of this study, published in the Maternal and Child Health Journal, are: Daniel Armstrong, Ph.D., professor of pediatrics at the Miller School; Viviana E. Horigian, M.D., M.H.A., professor in public health sciences at the Miller School; Betty Alonso, President and CEO of ConnectFamilias; Douglene Jackson, Ph.D., OTR/L, LMT, ATP, assistant professor of Clinical Pediatrics and associate director of Community Engagement at the Mailman Center; Ruby Natale, Ph.D., associate professor of Clinical Pediatrics at the Miller School; Jason Jent, associate professor; Michelle Schladant, Ph.D., assistant director of the Mailman Center; and Saliha Nelson, Board of Directors chair at the Overtown Children and Youth Coalition.
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