Sustaining collaborations between community-based organization leaders and academic researchers i... more Sustaining collaborations between community-based organization leaders and academic researchers in community-engaged research (CEnR) in the service of decreasing health inequities necessitates understanding the collaborations from an inter-organizational perspective. We assessed the perspectives of community leaders and university-based researchers conducting community-engaged research in a medium-sized city with a history of community-university tension. Our research team, included experts in CEnR and organizational theory, used qualitative methods and purposeful, snowball sampling to recruit local participants and performed key informant interviews from July 2011–May 2012. A community-based researcher interviewed 11 community leaders, a university-based researcher interviewed 12 university-based researchers. We interviewed participants until we reached thematic saturation and performed analyses using the constant comparative method. Unifying themes characterizing community leaders...
Sustaining collaborations between community-based organization leaders and academic researchers i... more Sustaining collaborations between community-based organization leaders and academic researchers in community-engaged research (CEnR) in the service of decreasing health inequities necessitates understanding the collaborations from an inter-organizational perspective. We assessed the perspectives of community leaders and university-based researchers conducting community-engaged research in a medium-sized city with a history of community-university tension. Our research team, included experts in CEnR and organizational theory, used qualitative methods and purposeful, snowball sampling to recruit local participants and performed key informant interviews from July 2011–May 2012. A community-based researcher interviewed 11 community leaders, a university-based researcher interviewed 12 university-based researchers. We interviewed participants until we reached thematic saturation and performed analyses using the constant comparative method. Unifying themes characterizing community leaders...
Sustaining collaborations between community-based organization leaders and academic researchers i... more Sustaining collaborations between community-based organization leaders and academic researchers in community-engaged research (CEnR) in the service of decreasing health inequities necessitates understanding the collaborations from an inter-organizational perspective. We assessed the perspectives of community leaders and university-based researchers conducting community-engaged research in a medium-sized city with a history of community-university tension. Our research team, included experts in CEnR and organizational theory, used qualitative methods and purposeful, snowball sampling to recruit local participants and performed key informant interviews from July 2011-May 2012. A community-based researcher interviewed 11 community leaders, a university-based researcher interviewed 12 university-based researchers. We interviewed participants until we reached thematic saturation and performed analyses using the constant comparative method. Unifying themes characterizing community leaders...
Journal of urban health : bulletin of the New York Academy of Medicine, Jan 23, 2017
Living in communities with persistent gun violence is associated with negative social, behavioral... more Living in communities with persistent gun violence is associated with negative social, behavioral, and health outcomes, analogous to those of a natural disaster. Taking a disaster-preparedness approach may identify targets for community-based action to respond to on-going gun violence. We assessed the relevance of adapting a disaster-preparedness approach to gun violence and, specifically, the relationship between perceived collective efficacy, its subscales of social cohesion and informal social control, and exposure to gun violence. In 2014, we conducted a cross-sectional study using a community-based participatory research approach in two neighborhoods in New Haven, CT, with high violent crime rates. Participants were ≥18 years of age and English speaking. We measured exposure to gun violence by adapting the Project on Human Development in Chicago Neighborhoods Exposure to Violence Scale. We examined the association between perceived collective efficacy, measured by the Sampson C...
We have described self-reported exposure to gun violence in an urban community of color to inform... more We have described self-reported exposure to gun violence in an urban community of color to inform the movement toward a public health approach to gun violence prevention. The Community Alliance for Research and Engagement at Yale School of Public Health conducted community health needs assessments to document chronic disease prevalence and risk, including exposure to gun violence. We conducted surveys with residents in six low-income neighborhoods in New Haven, Connecticut, using a neighborhood-stratified, population-based sample (n = 1189; weighted sample to represent the neighborhoods, n = 29 675). Exposure to violence is pervasive in these neighborhoods: 73% heard gunshots; many had family members or close friends hurt (29%) or killed (18%) by violent acts. Although all respondents live in low-income neighborhoods, exposure to violence differs by race/ethnicity and social class. Residents of color experienced significantly more violence than did White residents, with a particular...
ABSTRACT Background: Between 2000-2010, New Haven experienced high rates of homicide (10/100,000 ... more ABSTRACT Background: Between 2000-2010, New Haven experienced high rates of homicide (10/100,000 residents per year), with the annual homicide rate tripling in the past five years. While New Haven experienced a violent crime rate of 4 per 1,000 residents in 2013, certain neighborhoods bore a greater burden, with violent crime rates up to 30 per 1,000 residents. This violence results in chronic community-level trauma and stress, undermining health, capacity, and productivity of these neighborhoods. Methods: Stakeholders from city, community, healthcare, and academic organizations created a partnership to prevent and respond to gun violence. We adapted the RAND Roadmap to Building Community Resilience, a framework to strengthen community resilience in natural disasters, to strengthen community resilience around episodes of gun violence. We developed a local intervention strategy to build community resilience through an iterative process of community engagement, involving 6 small informant groups and targeted assessment surveys of 43 residents. Results: 51% of participants reported having a trusted source of information following an episode of gun violence; most could not identify a trusted neighbor. Data supported a two-pronged strategy as a means of preventing and responding to gun violence: (1) creation and distribution of a Community Resilience Handbook for neighborhood residents to address selected levers of the RAND framework and (2) community organizing in two pilot neighborhoods with high crime rates and low social cohesion. Conclusion: Promoting community resilience by adapting a natural disaster framework is a novel approach to gun violence. This presentation will discuss the collaborative, its challenges and successes.
BACKGROUND: Patient-centeredness is a characteristic of high-quality medical care and requires en... more BACKGROUND: Patient-centeredness is a characteristic of high-quality medical care and requires engaging community members in health systems' decision-making. One key patient engagement strategy is patient, family, and community advisory boards/councils (PFACs), yet the evidence to guide PFACs is lacking. Systematic reviews on patient engagement may benefit from patient input, but feasibility is unclear. METHODS: A team of physicians, researchers, and a PFAC member conducted a systematic review to examine the impact of PFACs on health systems and describe optimal strategies for PFAC conduct. We searched MED-LINE, Embase, PsycINFO, CINAHL, Scopus, and Social Science Citation Index from inception through September 2016, as well as pre-identified websites. Two reviewers independently screened and abstracted data from studies, then assessed randomized studies for risk of bias and observational studies for quality using standardized measures. We performed a realist synthesis-which asks what works, for whom, under what circumstances-of abstracted data via 12 monthly meetings between investigators and two feedback sessions with a hospital-based PFAC. RESULTS: Eighteen articles describing 16 studies met study criteria. Randomized studies demonstrated moderate to high risk of bias and observational studies demonstrated poor to fair quality. Studies engaged patients at multiple levels of the health care system and suggested that in-person deliberation with health system leadership was most effective. Studies involving patient engagement in research focused on increasing study participation. PFAC recruitment was by nomination (n = 11) or not described (n = 5). No common measure of patient, family, or community engagement was identified. Realist synthesis was enriched by feedback from PFAC members. DISCUSSION: PFACs engage communities through individual projects but evidence of their impact on outcomes is lacking. A paucity of randomized controlled trials or high-quality observational studies guide strategies for engagement through PFACs. Standardized measurement tools for engagement are needed. Strategies for PFAC recruitment should be investigated and reported. PFAC members can feasibly contribute to systematic reviews. REGISTRATION AND FUNDING SOURCE: A protocol for record eligibility was developed a priori and was registered in the PROSPERO database of systematic reviews (registration number CRD42016052817). The Department of Veterans Affairs' Office of Academic Affiliations, through the National Clinician Scholars Program, funded this study.
In 2006, the sole black state senator of the Nebraska legislature, Ernie Chambers, and the Chairm... more In 2006, the sole black state senator of the Nebraska legislature, Ernie Chambers, and the Chairman of its Education Committee, Ron Raikes, proposed an amendment to a bill that sought to reconfigure the state's largest city, Omaha's, public school system. The principal legislation, LB 1024, approved by the body and signed into law by Governor Dave Heineman created the Learning Community, a multifaceted effort to address racial and socioeconomic disparities in educational funding and achievement. Amidst national attention and community uproar, the measure passed. No sooner had that happened than the local chapter of the NAACP and the Chicano Awareness Center filed suit in federal and state courts. Almost a year later, galvanized by the controversy and the societal fissures it exposed, both LB 1024 and the Chambers-Raikes amendment (AM 3142) were repealed, replaced by another bill which established Omaha's Learning Community. With the advent of the new legislation the city abandoned for once and for all race-based admission policies, instead privileging class-based policies. A collaborative of 11 suburban districts and one urban school district were to raise money for the schools under a redistributive system called the common tax levy. This paper is an exploration of one city's struggle with the mandates stemming from Brown v. The Board of Education. Omaha's experience is instructive in exploring how equal opportunity and educational parity are regarded 60 years after Brown.
Sustaining collaborations between community-based organization leaders and academic researchers i... more Sustaining collaborations between community-based organization leaders and academic researchers in community-engaged research (CEnR) in the service of decreasing health inequities necessitates understanding the collaborations from an inter-organizational perspective. We assessed the perspectives of community leaders and university-based researchers conducting community-engaged research in a medium-sized city with a history of community-university tension. Our research team, included experts in CEnR and organizational theory, used qualitative methods and purposeful, snowball sampling to recruit local participants and performed key informant interviews from July 2011–May 2012. A community-based researcher interviewed 11 community leaders, a university-based researcher interviewed 12 university-based researchers. We interviewed participants until we reached thematic saturation and performed analyses using the constant comparative method. Unifying themes characterizing community leaders...
Sustaining collaborations between community-based organization leaders and academic researchers i... more Sustaining collaborations between community-based organization leaders and academic researchers in community-engaged research (CEnR) in the service of decreasing health inequities necessitates understanding the collaborations from an inter-organizational perspective. We assessed the perspectives of community leaders and university-based researchers conducting community-engaged research in a medium-sized city with a history of community-university tension. Our research team, included experts in CEnR and organizational theory, used qualitative methods and purposeful, snowball sampling to recruit local participants and performed key informant interviews from July 2011–May 2012. A community-based researcher interviewed 11 community leaders, a university-based researcher interviewed 12 university-based researchers. We interviewed participants until we reached thematic saturation and performed analyses using the constant comparative method. Unifying themes characterizing community leaders...
Sustaining collaborations between community-based organization leaders and academic researchers i... more Sustaining collaborations between community-based organization leaders and academic researchers in community-engaged research (CEnR) in the service of decreasing health inequities necessitates understanding the collaborations from an inter-organizational perspective. We assessed the perspectives of community leaders and university-based researchers conducting community-engaged research in a medium-sized city with a history of community-university tension. Our research team, included experts in CEnR and organizational theory, used qualitative methods and purposeful, snowball sampling to recruit local participants and performed key informant interviews from July 2011-May 2012. A community-based researcher interviewed 11 community leaders, a university-based researcher interviewed 12 university-based researchers. We interviewed participants until we reached thematic saturation and performed analyses using the constant comparative method. Unifying themes characterizing community leaders...
Journal of urban health : bulletin of the New York Academy of Medicine, Jan 23, 2017
Living in communities with persistent gun violence is associated with negative social, behavioral... more Living in communities with persistent gun violence is associated with negative social, behavioral, and health outcomes, analogous to those of a natural disaster. Taking a disaster-preparedness approach may identify targets for community-based action to respond to on-going gun violence. We assessed the relevance of adapting a disaster-preparedness approach to gun violence and, specifically, the relationship between perceived collective efficacy, its subscales of social cohesion and informal social control, and exposure to gun violence. In 2014, we conducted a cross-sectional study using a community-based participatory research approach in two neighborhoods in New Haven, CT, with high violent crime rates. Participants were ≥18 years of age and English speaking. We measured exposure to gun violence by adapting the Project on Human Development in Chicago Neighborhoods Exposure to Violence Scale. We examined the association between perceived collective efficacy, measured by the Sampson C...
We have described self-reported exposure to gun violence in an urban community of color to inform... more We have described self-reported exposure to gun violence in an urban community of color to inform the movement toward a public health approach to gun violence prevention. The Community Alliance for Research and Engagement at Yale School of Public Health conducted community health needs assessments to document chronic disease prevalence and risk, including exposure to gun violence. We conducted surveys with residents in six low-income neighborhoods in New Haven, Connecticut, using a neighborhood-stratified, population-based sample (n = 1189; weighted sample to represent the neighborhoods, n = 29 675). Exposure to violence is pervasive in these neighborhoods: 73% heard gunshots; many had family members or close friends hurt (29%) or killed (18%) by violent acts. Although all respondents live in low-income neighborhoods, exposure to violence differs by race/ethnicity and social class. Residents of color experienced significantly more violence than did White residents, with a particular...
ABSTRACT Background: Between 2000-2010, New Haven experienced high rates of homicide (10/100,000 ... more ABSTRACT Background: Between 2000-2010, New Haven experienced high rates of homicide (10/100,000 residents per year), with the annual homicide rate tripling in the past five years. While New Haven experienced a violent crime rate of 4 per 1,000 residents in 2013, certain neighborhoods bore a greater burden, with violent crime rates up to 30 per 1,000 residents. This violence results in chronic community-level trauma and stress, undermining health, capacity, and productivity of these neighborhoods. Methods: Stakeholders from city, community, healthcare, and academic organizations created a partnership to prevent and respond to gun violence. We adapted the RAND Roadmap to Building Community Resilience, a framework to strengthen community resilience in natural disasters, to strengthen community resilience around episodes of gun violence. We developed a local intervention strategy to build community resilience through an iterative process of community engagement, involving 6 small informant groups and targeted assessment surveys of 43 residents. Results: 51% of participants reported having a trusted source of information following an episode of gun violence; most could not identify a trusted neighbor. Data supported a two-pronged strategy as a means of preventing and responding to gun violence: (1) creation and distribution of a Community Resilience Handbook for neighborhood residents to address selected levers of the RAND framework and (2) community organizing in two pilot neighborhoods with high crime rates and low social cohesion. Conclusion: Promoting community resilience by adapting a natural disaster framework is a novel approach to gun violence. This presentation will discuss the collaborative, its challenges and successes.
BACKGROUND: Patient-centeredness is a characteristic of high-quality medical care and requires en... more BACKGROUND: Patient-centeredness is a characteristic of high-quality medical care and requires engaging community members in health systems' decision-making. One key patient engagement strategy is patient, family, and community advisory boards/councils (PFACs), yet the evidence to guide PFACs is lacking. Systematic reviews on patient engagement may benefit from patient input, but feasibility is unclear. METHODS: A team of physicians, researchers, and a PFAC member conducted a systematic review to examine the impact of PFACs on health systems and describe optimal strategies for PFAC conduct. We searched MED-LINE, Embase, PsycINFO, CINAHL, Scopus, and Social Science Citation Index from inception through September 2016, as well as pre-identified websites. Two reviewers independently screened and abstracted data from studies, then assessed randomized studies for risk of bias and observational studies for quality using standardized measures. We performed a realist synthesis-which asks what works, for whom, under what circumstances-of abstracted data via 12 monthly meetings between investigators and two feedback sessions with a hospital-based PFAC. RESULTS: Eighteen articles describing 16 studies met study criteria. Randomized studies demonstrated moderate to high risk of bias and observational studies demonstrated poor to fair quality. Studies engaged patients at multiple levels of the health care system and suggested that in-person deliberation with health system leadership was most effective. Studies involving patient engagement in research focused on increasing study participation. PFAC recruitment was by nomination (n = 11) or not described (n = 5). No common measure of patient, family, or community engagement was identified. Realist synthesis was enriched by feedback from PFAC members. DISCUSSION: PFACs engage communities through individual projects but evidence of their impact on outcomes is lacking. A paucity of randomized controlled trials or high-quality observational studies guide strategies for engagement through PFACs. Standardized measurement tools for engagement are needed. Strategies for PFAC recruitment should be investigated and reported. PFAC members can feasibly contribute to systematic reviews. REGISTRATION AND FUNDING SOURCE: A protocol for record eligibility was developed a priori and was registered in the PROSPERO database of systematic reviews (registration number CRD42016052817). The Department of Veterans Affairs' Office of Academic Affiliations, through the National Clinician Scholars Program, funded this study.
In 2006, the sole black state senator of the Nebraska legislature, Ernie Chambers, and the Chairm... more In 2006, the sole black state senator of the Nebraska legislature, Ernie Chambers, and the Chairman of its Education Committee, Ron Raikes, proposed an amendment to a bill that sought to reconfigure the state's largest city, Omaha's, public school system. The principal legislation, LB 1024, approved by the body and signed into law by Governor Dave Heineman created the Learning Community, a multifaceted effort to address racial and socioeconomic disparities in educational funding and achievement. Amidst national attention and community uproar, the measure passed. No sooner had that happened than the local chapter of the NAACP and the Chicano Awareness Center filed suit in federal and state courts. Almost a year later, galvanized by the controversy and the societal fissures it exposed, both LB 1024 and the Chambers-Raikes amendment (AM 3142) were repealed, replaced by another bill which established Omaha's Learning Community. With the advent of the new legislation the city abandoned for once and for all race-based admission policies, instead privileging class-based policies. A collaborative of 11 suburban districts and one urban school district were to raise money for the schools under a redistributive system called the common tax levy. This paper is an exploration of one city's struggle with the mandates stemming from Brown v. The Board of Education. Omaha's experience is instructive in exploring how equal opportunity and educational parity are regarded 60 years after Brown.
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Papers by Ann T. Greene