The Bidirectional Community-Academic Engagement Model: A Response to Baquet

Baquet and colleagues¹ presented the Model of Bidirectional Community–Academic Engagement and Partnered Research, which is an East Coast, medically based, rural partnership model. Baquet claims that “Sharing grant funds was … an essential component of trust building,” crucial to building community trust in academic research collaborations, and is “replicable in other rural areas.” Our long-standing partnership involves a rural Midwest, non–medically focused teaching university and an agency on aging. This editorial, written by members of this partnership, presents the perspectives of several of our partnership’s academic partners related to the key steps and lesson learned proposed by Baquet. These perspectives support much of Baquet’s model. However, from our viewpoint, rural areas may not be structured on funding associated with research including clinical trials and biospecimen donations. Because leveraging of grants funds has not been our focus, considerations for further model development are made.

Care Connection coordinates senior centers in 22 communities with more than 60,000 seniors in Central Missouri.² Using registered nurses, social workers, exercise specialists, and other professional staff, Care Connection implements evidence-based wellness activities into an umbrella program called Living Well. A workforce of volunteers and university students helps deliver services. The University of Central Missouri (UCM) is in the Care Connection catchment area. In response to a request from Care Connection almost a decade ago, UCM established a partnership with Care Connection. The goal of the partnership was to deliver Living Well services with an eye on quality improvement based on national quality indicators. The Care Connection–UCM partnership has provided outcome evidence for the Living Well program.

One difference in Baquet’s partnership compared with the Care Connection-UCM partnership was in the aims. Baquet’s partnership aimed to decrease health disparities and reduce vulnerable populations’ fear of research. On the other hand, the Care Connection-UCM partnership team aims to promote healthy, independent lifestyles using quality measures that reflect healthcare quality.³ Our region is less racially and ethnically diverse than that described by Baquet. The region is larger geographically, and community members are less likely to be able to partake in clinical trials and biospecimen donations owing to lack of access more so than fear.

Dr. Baquet described three key components of the bidirectional rural community–academic partnership: the partnership, partnered research, and programs and outreach. Many of the components of Baquet’s model have worked for us throughout the partnership history. Our experience provided evidence that also supported a multidisciplinary approach. However, we found that grant fund sharing was not an essential component of trust building. In our partnership, the components are flipped: the partnership is primarily grounded in programs and outreach, not necessarily academic research. We identified teaching, service, and quality improvement as guiding principles. Our activities capitalize on programmatic community participation, sustainability, and service learning, which have become the goals, programs, and collaborative areas for research projects. This is a divergence from the model presented by Baquet et al.

The Care Connection-UCM Partnership believes that one of the factors that made our experience different has been the long-term engagement of the partners and the evolution of our partnership over time. During the past 10 years, we have developed a strategic view of linking community needs with university resources. This was reactionary at the time, but it is now leading to enhanced community capacity/engagement. The partnership has worked with existing policies as a priority, considering new policy initiatives when needed. We seek sustainability through programming and quality improvement, and although we are sharing and allocating resources, albeit in a different manner, the resources are not being leveraged in the partnership. Our teaching and service focus has led to student practitioner (and researcher) training instead of student researcher training. For us, trust in the rural community is paramount to success in a health partnership.⁴ The core values of the community, community trust, longevity of relationships, and limited resources seem to be in a different priority...