Community-Academic Partnerships to Improve Hispanic Immigrant Health: Perspectives from a Doctoral Student

During my doctoral degree, I worked as a research assistant on a five–year National Institutes of Minority Health and Health Disparities (NIMHD)–funded study with the interdisciplinary research group the Mecklenburg Area Partnership for Primary Care Research (MAPPR). MAPPR is a practice–based research network designed to enhance healthcare access for underserved and vulnerable populations in Charlotte–Mecklenburg, NC. The core research team includes social and health scientists from the University of North Carolina at Charlotte and Carolinas Health-Care System.

MAPPR applies a community based participatory research (CBPR) approach, which involves community members and other stakeholders throughout the research process. During my time with MAPPR, I was actively involved in a study identifying the social determinants of health affecting Hispanic immigrants in Charlotte–Mecklenburg. I assisted with the design, implementation, and evaluation of interventions to decrease health disparities and enhance access to primary care for this group. Partners included health and social service providers, educators, Hispanic foreign–born residents and a Community Advisory Board (CAB), which included representatives from the local school system, the County Health Department, and the City of Charlotte. In this essay, I reflect on the experience of engaging in community–academic partnerships as part of the intervention phase and as a doctoral student working ‘on the ground’ as part of MAPPR.

The research team employed a variety of methods (key informant interviews, focus groups, a Photovoice project, and community forums) to develop the interventions in collaboration with community members and partners. The first part of the intervention consisted of nine neighborhood–based health interventions at two elementary schools in two high–need areas. These events offered free check–ups, education, and representatives from a wide variety of social and health services (all in Spanish), as well as childcare. The academic team collected data in the form of participant surveys and health outcomes data.¹ I recruited and trained over 50 volunteers that assisted in various capacities with the fairs—as interpreters, medical staff, in childcare, and as navigators, for instance. Without our community partners and committed volunteers, we would not have been able to hold these fairs. They were truly a collaborative effort that leveraged resources across sectors.

The community health interventions offered an opportunity for different groups to come together and learn from each other. Participants felt welcomed by friendly volunteers and volunteers reported learning more about the local Hispanic community. Volunteers and organizational representatives were also able to successfully connect with others. “It just builds comradery to see others outside of regular work environment,” a volunteer mentioned. Interestingly, immigrant participants were typically more positive about the intervention than the providers and organizational representatives. Participants were grateful to receive a check–up, speak with a provider, and receive information and education. Though emphasis was placed on getting participants connected to health and social services—to enhance sustainability of the intervention—providers and organizational representatives often felt frustrated by persistent financial, health insurance, or documentation status barriers. There are limited services available for low–income families and undocumented immigrants, and those services are typically already stretched thin.

We also encountered push–back and skepticism from some organizational representatives about research and sustainability components of our intervention. In one of the evaluation focus groups I facilitated, an organizational representative asked me: “you were asking us for some feedback, but who sees the recommendations and where does that go? I mean, I know you are trying to use it for another grant to continue but what ultimately is the outcome?” Another said: “It’s great all the information and the data and the research, and it’s obviously showing the needs out there, so what are we doing about those needs? (. . .) I know you have to sometimes follow what the grant says. (. .) But it makes me wonder if putting the research aspect of it should come as a second thing.” This points to the need for transparency when research teams are working with organizations and other partners. It also illustrates how the needs and goals of different stakeholders vary and meeting everyone’s objectives can be challenging...