1. Holly Kiger, RN, MN, CNS
Research Navigator
Southern California Clinical and Translational Science Institute
NIMH Outreach Partner with Mental Health America Los Angeles
323-369-8648
kiger@usc.edu
Community Engaged Research
For NIMH Outreach Partnership
Annual Meeting
April 2014

2. COMMUNITY ENGAGED RESEARCH
• Overview of Clinical and Translational Science
Awards (CTSAs)
• Overview of Community Engaged Research
• Recovery Oriented Care Collaborative —an example
of a Community Engaged Research project with our NIMH
Outreach Partner-Mental Health American Los Angeles
• Resources for you to get involved

3. RESEARCH DEVELOPMENT ……THE OLD WAY

4. RESEARCH FINDINGS

5. RESEARCH DISSEMINATION……..THE OLD WAY

6. Create 60 Clinical and Translational Science
Institutes (CTSI) to serve as bridges
between research and the community

7. New members 2010
Members
CTSA States
Participating Institutions
CLINICAL AND TRANSLATIONAL SCIENCE AWARDS

8. New members 2010
Members
CTSA States
Participating Institutions
SoCal Consortium:
• Southern California CTSI
(at USC)
• UC San Diego
• Scripps
• UCLA
• Providence Health &
Services Southern CA
• MHALA
SOUTHERN CALIFORNIA CTSA CONSORTIUM

9. WHAT IS A CTSI?
Southern California Clinical and Translational
Science Institute (SC CTSI)
Preclinical Translation
and Regulatory
Support
Biostatistics &
Bioinformatics
Resources
Translational Research
Informatics
Research
Development
Clinical
Translation
Education, Career Development
& Ethics
SOUTHERN CALIFORNIA CLINICAL AND TRANSLATIONAL
SCIENCE INSTITUTE

10. IDENTIFY COMMUNITY MENTAL
HEALTH RESEARCH PRIORITIES
FOSTER NEW
ACADEMIC/COMMUNITY
PARTNERSHIPS
team matchmaking
training consultation
1
2
PROVIDE PROGRAM SUPPORT
IMPLEMENT
EVALUATE
DISSEMINATE
3
4
Mental Health/Physical
Health Integration
Age
specific
services
Access to Services
Paraprofessional
approaches
Implementing
and sustaining
EBP
Cost
effectiveness
Integration of
substance abuse
treatments
Multicultural
barriers
Research assistance with specific
projects
Track pilot projectsMentor post docs
Spirituality and
MH
New project development

11. • I am a mental health nurse and I worked as a colleague of Dave
Pilon, CEO of MHALA for over 20 years
• Three years ago I moved to SC CTSI as Research Navigator in
Community Engagement
• Academic/Community Projects with MHALA:
• Met with Dave to discuss potential projects
• Connected him with researcher from USC School of
Business to do pilot work moving MHALA to evidence based
practice status
• Invited MHALA to join PBRN group
• Invited MHALA to collaborate on NIMH Outreach Partnership,
including our Special Project-Promotores Research Training
Institute
PROJECTS WITH OUR NIMH OUTREACH PARTNER: MHALA

12. • Pilot testing of a “Health Navigator” project-- training persons
with severe mental illness to improve their access and usage of
primary medical care (instead of emergency rooms). Now have
a PCORI grant to complete a larger RCT.
• Pilot testing mindfulness interventions for children in after
school programs.
• Validation of a mental health screening tool for children
entering foster care
• Pilot testing of a 12-week, psycho-educational curriculum
designed to reduce substance use in Hispanic youth.
$1 MILLION ANNUALLY FOR SC-CTSI PILOT PROJECTS

13. OTHER GOALS
Present research findings to
providers, partners, policy-
makers, consumers and
advocates
One way—monthly e-
newsletter to 700+ and
posted on LACDMH website

14. WHAT IS COMMUNITY-ENGAGED RESEARCH?
• A framework or approach for conducting
research
• Requires partnership development between
academic and community partners
• May be used with both qualitative (focus groups;
interviews) and quantitative methods
• Recognizes and builds on community strengths,
interests and perspectives

15. Traditional Research Process
Step 5: Interpret, write papers & Disseminate Results to
Peers and Academic Community
Step 4: Analyze Data
Step 3: Intervention or Data Collection
Data Collection Instruments Designed Researcher Recruits Community Subjects
Step 2: Research Plan Developed
Community Selected Funds Secured
Step 1: Problem Identified by Researcher

16. Community-Engaged Approach
Step 6: Disseminate Results to Community AND
Academics
Step 5: Interpretation of Data with Community
Step 4: Analyze Data – Bring Results to Community
Step 3: Intervention or Data Collection
All parties involved in design of data Collection instruments Community assists in participant recruitment
Step 2: Research Plan Developed
Meetings with community members and researchers to determine best approach
Step 1: Problem Identified by Stakeholder
Could be community member or researcher

17. BARRIERS TO CONDUCTING COMMUNITY-ENGAGED RESEARCH
• Many researchers aren’t connected to CBOs
• Takes more time and money
• Need manuscripts in peer-reviewed journals for
their career
• Researchers have to give up some control to
community partners
• Poor communication and unrealistic expectations
can lead to conflicts between academic and
community partners

18. RATIONALE FOR COMMUNITY-ENGAGED RESEARCH
• Complex health and social problems ill-
suited to “outside expert” research
• Increasing interest in health disparities
• Disappointing results with introducing
“Evidence Based Practices” in the real world
• Increasing community demands for
collaborative efforts
• Increasing funder interests in community-
driven versus community-placed research

19. SOUTHERN CALIFORNIA CLINICAL AND TRANSLATIONAL
SCIENCE INSTITUTE
Recovery Oriented Care Collaborative
A Practice Based Research Network (PBRN)
focused on the integration of physical and mental
health of persons with severe mental illness
A PBRN is defined as a group of providers who come together to
study topics/questions directly impacting their practice, engage
researchers in answering those questions, and use the results to
improve service delivery.

20. RECOVERY ORIENTED CARE COLLABORATIVE
• Funding: SC CTSI Pilot, July 1, 2012-June 30, 2013
• Project PIs
o John Brekke, PhD, USC School of Social Work
o Rebecca Gaba, PhD, Didi Hirsch Mental Health Services
o Co-Investigator: Lyndee Knox, Ph.D., Chief Executive Officer, L.A.
Net
• Mental Health Agency Partners (contract agencies with Los
Angeles County Department of Mental Health)
o Mental Health America Los Angeles
o Didi Hirsch Community Mental Health Center
o Exodus Recovery
o Pacific Clinics

21. ROCC PROCESS
• Formalize partner relationships
o MOUs with 4 based mental agency organizations
o Establish steering committee
• Assemble the research team
o SC CTSI
o USC School of Social Work
o Community partners
• Select research question using reflective practitioner
process
• Conduct card study
• Analyze results
• Disseminate results

22. FOLLOW-UP
ROCC researchers analyzed
findings and are in the process of
presenting findings to the ROCC,
community members and other
researchers.
STEP 1: GENERATION
ROCC members polled 20 mental health
providers from four participating agencies at an
all day forum. We identified 99 potential
research questions that were then categorized
into 23 domains by post doctoral Fellows.
STEP 2: SELECTION
At a second all day forum, 10 topics were
discussed and refined into researchable
questions. Identified questions were
evaluated based on criteria*. A score
was given for each criterion. These
scores were tallied up for a composite
score for each question. The four
highest-scoring questions advanced to
the next step.
Criteria*
1) Will it change my
practice?
2) Will it change my
colleagues’ practices?
3) Is it feasible?
4) Is it publishable?
5) Is it fundable?
6) Is there a provider
champion?
* Knox & Lomonaco, 2005
STEP 3: EVALUATION
Following the forum, the Fellows
added literature reviews for the four
highest scoring topics and created
sample card studies for each
research question.
STEP 4: VOTE
ROCC members voted
electronically for their
preferred research
question for the card
study.
STEP 5: STUDY
The selected card study was refined
and piloted by the research team.
Following Institutional Review Board
approval data collection occurred
over several weeks at ROCC
member sites. place at member
sites.
Card Study* *Westfall et al., 2011
A card study is a simple, immediate, and cost-effective method for gathering
observational data by clinicians at the point of care. Requiring less than a
minute to complete, the survey consists of patient demographic information, a
qualifying question and, for those who qualify, follow-up questions. Patient
identifiers are not collected. PBRNs use card studies because they make it
easy to gather data across sites.
Reflective Practitioner Steps
REFLECTIVE PRACTITIONER PROCESS

23. CARD STUDY QUESTION AND FINDINGS
Research Question: “What is the impact of integrated healthcare services
on emergency room and primary care usage; physical health; mental health;
lifestyle; and ability to meet mental health treatment plan goals and overall
satisfaction with services?”
Sample: 237 participants with serious mental illness from 4 clinics
• Didi Hirsch (n = 52)
• Exodus Recovery (n = 99)
• Mental Health America (n = 48)
• Pacific Clinics (n= 38)
The majority of the sample had been receiving services for at
least 6 months (79%)

24. SAMPLE FINDINGS

25. SAMPLE FINDINGS

26. SAMPLE FINDINGS

27. SAMPLE FINDINGS

28. RECOVERY ORIENTED CARE COLLABORATIVE
NEXT STEPS
• Disseminate research findings
o ROCC members
o Los Angeles County Department of Mental Health
o Potential new ROCC members
o White paper
o Professional journals
o Local, state, and national conferences
• Decide on next research project
• Secure funding

29. Resources
For a list of CTSAs: https://www.ctsacentral.org/institutions
Other Potential Research Partners:
• Schools of Nursing, Social Work, or Psychology
• Authors of relevant research articles
For more information about Community Engaged Research
• A Quick Start Guide to Conducting Community Engaged Research
http://sc-ctsi.org/assets/ce/Booklet.pdf
• Community Engaged Research 101 video
http://vimeopro.com/scctsiecde/sc-ctsi-ecde-studio-
catalog/video/55632203
For information about PBRNs: http://pbrn.ahrq.gov/
More information: Contact Holly Kiger @ kiger@usc.edu
or 323-369-8648