You Know a Tree by Its Fruit: Growing a Fellowship Program for Community Partnered Mental Health Disparities Research in an Academic Medical Center

IntroductionDespite increasing attention to developing community research partnerships to improve health and reduce health disparities, competencies supporting these aims remain underemphasized in health professional education programs. Many medical researchers continue to believe that collaboration interferes with science's pace as training paradigms emphasize autonomy of the scientist's judgment and vision (1). Academic medical centers can move these norms to more effectively address community health concerns and create ethnically and racially diverse research institutions (2). This paper describes the integration of educational goals within an academic health system's clinical psychology program to promote community research collaborations. Implications as the Program of Research and Innovation in Disparities Education (PRIDE) expanded recruiting to medical students and family medicine residents within the University of Rochester Medical Center (URMC) are discussed.Emerging national prioritiesIt is one thing to know that eating healthy and exercising regularly in tandem promotes weight loss, but what if there are neither grocery stores selling produce nor safe streets where you live and obesity and diabetes rates continue to rise in your community? In 2006, the National Institutes of Health's (NIH) Clinical and Translational Science Awards program (CTSA), a premiere mechanism supporting medical centers' clinical research enterprises, responded to community needs. It mandated that core resources promote community engagement in research and translational research to facilitate the application of basic science advances (3). The CTSA program defines community engagement broadly as, ...the intersection of the complementary efforts of members of the lay community, community non-profit organizations, health practitioners and medical and public health researchers to improve health...founded on mutual understanding and trust, between communities and local academic institutions, (p. 4) (4) Community engagement often occurs as coordination or collaboration among academic-community partnerships or coalitions so that research can fuel changes in practices, programs and policies (5). The NIH Director's Council of Public Representatives (COPR) describes the community engagement process as one that, ...supports mutual respect of values, strategies, and actions for authentic partnership of people affiliated with or self-identified by geographic proximity, special interest, or similar situations to address issues affecting the well-being of the community of focus....It requires academic members to become part of the community and community members to become part of the research team, thereby creating a unique working and learning environment before, during, and after the research, (p. 1) (5) COPR emphasizes ideals such as ensuring processes exist so that community members remain on the teams driving every step of these research projects. Expertise in developing and maintaining these unique science contexts is needed.Relevance for health disparities education and research in mental health topicsDisparities in mental health exist around inadequate access to needed healthcare. Health disparities research focuses on health conditions that are persistently more prevalent in groups such as racial and ethnic minorities, low income or medically underserved communities (6). Blacks and to a lesser extent, Latinos, are less likely than Whites to seek and receive adequate mental health treatment in current treatment systems (7). Despite health promotion programs that build on traditional public health models, minority and low-income communities' disparities continue (8). Community-based research, another venue of community health improvement, often occurs with academics leading research. In many cases communities aren't involved in decisions about planning or implementing research projects situated in daily contexts; they have little input into intervention studies designed to help them (9, 10). …