Background: After Mercy Hospital closed, the Public Health Management Corporation Public Health Campus on Cedar (Cedar) opened on its site. According to our survey 3 years later, only 17.6% of households in the catchment area used Cedar's services. A history of hospital closures and the former hospital's reputation contributed to deep community mistrust in local health care institutions. Objectives: This study examined community awareness of Cedar, willingness to try its services, and trust as a predictive factor. Methods: Using a community-based participatory research approach, the evaluation team, a community advisory board, and an evaluation committee developed a representative household survey. Chi-sqare & logistic regression were used to predict who was most likely to be aware of and most willing to use Cedar campus. Results: Almost 60% of respondents were unaware that Cedar is now operating on the former hospital site and 58.8% reported willingness to use its services. The outcome of a step wise regression model revealed that the strongest adjusted odds ratio (AOR) in predicting awareness of Cedar were living in the neighborhood more than 2 years (AOR = 2.89, P = .014), followed by African-American race, having 3+ daily servings of fruits and vegetables, and two factors relating to trust (experience with the campus and thinking provider skills were important for building trust; P <= .05 each). Significant predictors of willingness to try Cedar included having asthma, (AOR = 3.0, P = .001) and not having a heart condition (AOR = 4.27, P = .002), followed by 3+ daily servings of fruits and vegetables and perceiving transparency was important to building trust (P <= .05). Conclusion: Community mistrust continues to limit Cedar's reach. Trust building efforts that center on transparency, provider quality, and awareness can increase utilization and a campaign targeting residents with specific chronic conditions can ensure health equity.
Background: Pregnant and parenting youth experiencing homelessness (PPYEH) and their children face significant health challenges, yet few interventions exist to address their health needs. The purpose of this community-based participatory research was to evaluate the preliminary effectiveness of a site-based health empowerment program to improve health, health care access, and reproductive health among PPYEH living in emergency shelter or transitional living programs. Methods: This mixed-methods study included intake, exit, and follow-up surveys with PPYEH, as well as a focus group and semistructured interviews with PPYEH and shelter staff. We conducted descriptive analyses of quantitative data to assess program satisfaction, mental health, contraceptive use and access, and thematic analysis of qualitative data. Results: Our evaluation demonstrated high program satisfaction, improved mental health, and enhanced access to reproductive resources and acceptability of contraceptive options. PPYEH and staff reported Empowering Parents for Wellness in Shelter connected youth with primary, dental, vision, sexual, and mental health care, which promoted youth resilience and agency in navigating the health care system. PPYEH felt their health improved through increased knowledge of topics including nutrition, allergies, healthy relationships, and sexually transmitted infections. Every interviewed participant recommended expanding Empowering Parents for Wellness in Shelter to other shelters. Conclusion: Our findings suggest that site-based health empowerment programs embedded within shelters and housing programs may represent an acceptable and promising strategy to increase health care access, improve child and adolescent health, and support reproductive goals. The program underscores the importance of centering the voices of those with lived experiences of homelessness in the co-creation of programs that address their unique health needs.
Background: Colonias are unincorporated communities along the U.S.-Mexico border that face systemic environmental and public health challenges. Long-standing infrastructural deficiencies, socioeconomic hardship, and historical mistrust have hindered effective community partnerships. Objectives: This study aimed to implement and evaluate a community-based participatory research approach tailored to promote environmental health equity, build trust, and foster meaningful participation among colonia residents in Hidalgo County, South Texas. Methods: The Juntos para un Mejor Mariana (Together for a Better Tomorrow) program developed a multifaceted engagement strategy, including the formation of three Community Advisory Boards, citizen science activities, family workshops, and training Promotora-Researchers. A community health assessment was conducted with 100 participants, combining survey data with biomarker collection (urine, blood, toenail) to assess environmental exposures. Results: The initiative achieved high participation and retention: 96.2% survey completion, 81.0% initial urine sample submission, 75.0% urine resampling after 1 year, 80.0% blood sample submission, and 77.0% toenail sample collection. The program also led to the establishment of sustained community-based activities. Conclusions: Community-based participatory research strategies rooted in local partnership and cultural relevance can overcome barriers to participation in environmental justice communities. This model demonstrated strong community agency, high data collection rates, and durable program impact-offering a replicable approach for advancing health equity in vulnerable border regions.
Abstract: Background: The Cure Violence model, a widely implemented community violence intervention, has shown mixed effectiveness, highlighting the need for locally tailored adaptations. Objectives: This study presents a novel mixed-methods, participatory approach for capturing and interpreting participant experiences to adapt the community violence intervention for Southwest Philadelphia. Methods: Penn Community Violence Prevention staff, a community advisory board, and other stakeholders participated in iterative workshops, interviews, and SenseMaker sessions. Guided by implementation science frameworks, we used a five-step process to identify multilevel barriers and facilitators, generate and refine implementation strategies, and prioritize strategies using SenseMaker dyads, triads, and visual dashboards. Lessons Learned: The participatory process using Sense-Maker enhanced stakeholder engagement, structured implementation strategies, and provided interactive data visualizations to support decision-making. Addressing power dynamics and maintaining engagement post adaptation were critical to success. Conclusions: This study introduces a structured, participatory framework for community violence intervention adaptation, demonstrating the value of integrating novel data collection and visualization methods.
Abstract: Objectives: To reflect on personal experiences in community health centers (CHCs) and federally qualified health centers to highlight mentorship as an underutilized tool for addressing oral health workforce shortages, recruitment, and retention. Methods: Narrative reflection based on the author's lived experiences as a dentist in CHCs since graduation and as an adjunct faculty mentor, synthesized with literature from 2020 to 2025. Results: Financial incentives dominate CHC strategies, but mentorship fosters confidence and retention for new graduates. The proposed CHC Mentorship Integration Framework offers a structured approach to bridge post-graduation gaps. The CHC Mentorship Integration Framework comprises three interconnected components: formal on-site one-on-one clinical mentorship, structured professional development training over 6 to 12 months, and peer/network-based support. Conclusions: Prioritizing mentorship over monetary benefits can transform CHCs into appealing career destinations, advancing equitable oral health access through resilient, mission-aligned teams.
