Date of Award

January 2020

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Megan V. Smith

Abstract

“Community-Based Participatory Research 2.0” refers to a methodologic framework describing the process of scaling the New Haven MOMS Partnership, an existing participatory intervention, to new sites in Bridgeport, Connecticut and New York City.

Following a community-based participatory approach to the process of program differentiation within implementation science, informal team canvassing identified core components of the program: neighborhood hub sites, community mental health workers, and utilization of incentives. Community needs assessments were prepared, distributed, and analyzed to identify flexible program components. Assessments were tailored to specific communities and included the Center for Epidemiologic Studies-Depression Scale (CES-D), the Oslo-3 perceived social support scale, the Chicago Neighborhood Social Cohesion Questions (CNQ), and multiple demographic and site-specific questions.

For respondents in both Bridgeport (n = 135) and New York City (n = 173), the burden of depression amongst parenting women was significant. About 38.1% of respondents in Bridgeport and 57.1% in New York City were at risk for major depression and overall symptoms were more severe in New York. In both sites, women reported an unmet desire for mental healthcare as well as specific barriers to accessing traditional treatment and may thus benefit from the core components of the MOMS Partnership intervention. The first flexible program component included the content and distribution of the goals and needs assessment itself. Goals and needs assessment data also identified what type of incentives should be utilized in the program given reported basic needs in the community that were significantly associated with the burden of maternal depression, which included diaper need and food insecurity, indicating that the Diaper Bank may be an essential partnership and that diapers and food stamps may be useful incentives for participants. Program timings and languages were also identified in each needs assessment and will be addressed in ultimate program design.

The methodology of CBPR 2.0 thus asserts that an appropriate community-partnered and evidence-based approach to scaling interventions involves program differentiation, which should include identifying core components as well as flexible components, which is where community responsiveness should be seen as an essential component of replicating a program with fidelity.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 09/10/2021

Share

COinS