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Abstract
Engagement science can help healthcare providers understand promising practices that address health disparities. The Community Engagement in Early Recognition and Immediate Action in Stroke (CEERIAS) study began in 2014 with the aim of improving health outcomes related to stroke and addressing racial inequities among at-risk South Side Chicago neighbourhoods by engaging community members called ‘Stroke Promoters’ in designing and implementing a stroke preparedness programme. Launched in 2020, Phase II (2CEERIAS) furthered this aim by developing a replicable virtual platform for the programme in response to challenges prompted by the COVID-19 pandemic. The CEERIAS community engagement programme results provided meaningful data to South Side Chicago communities; nearly 40,000 ‘Pact to Act FAST’ pledges were collected over 11 months, and although early hospital arrival and emergency medical services (EMS) usage for confirmed stroke did not increase overall, early arrivals for suspected stroke increased significantly for men, younger people and black community members along with EMS usage for suspected stroke. The 2CEERIAS virtual programme collected nearly 3,800 new pledges in a 90-day window during the onset of the COVID-19 pandemic. The engagement of trusted nonclinical laypeople during both phases of the CEERIAS study demonstrates that community engagement can positively influence clinical outcomes and increase reach and sustainability for such efforts. The use of engagement science can also generate a deep sense of co-creation among community members, and the ‘social contract’ approach can effect behavioural change. The virtual adaption reinforced important engagement science principles for interventions aimed at eliminating stroke disparities. To this day, eight years after research support ended for the CEERIAS programme, community members trained as ‘Stroke Promoters’ remain connected to the researchers and continue to educate family and neighbours about stroke preparedness.
The full article is available to subscribers to the journal.
Author's Biography
Knitasha V. Washington , DHA, MHA, FACHE, brings more than 25 years of experience as a multidimensional healthcare leader focused on quality improvement, safety and health equity. Her career has spanned roles in healthcare administration, managed care, quality management, disparities research and policy. In these roles she serves as a change agent driving organisational performance improvement, quality and safety improvement as well as advising on health policy matters and leadership contributing to large-scale national public health campaigns. Dr Washington has international health professional training and experience with extensive knowledge of strategies to advance innovation and improve outcomes through community engagement, patient engagement and stakeholder alignment. As a health equity practitioner and social science researcher, her skill and expertise bridge population health methodologies with the applied science of health services delivery to improve quality, safety and equity outcomes. In 2014 she founded ATW Health Solutions, a U.S. Small Business Administration (SBA) 8(a), Women- Owned Small Business (WOSB) healthcare advisory and consulting firm based in Chicago, Illinois. ATW Health Solutions has earned national recognition for its work, partnering locally and nationally with public and privately held organisations and government agencies to transform health-care delivery systems from ordinary to best-in-class.
Neelum T. Aggarwal , MD, is a board-certified cognitive neurologist, clinical trialist and professor in the Department of Neurological Sciences at Rush University Medical Center. She is the Senior Examining Neurologist for the Rush Alzheimer’s Disease Center Clinical Core and the Cardiology Cognitive Clinic at the Rush Heart Center for Women, where she also serves as the Center’s Research Director. Dr Aggarwal’s clinical interests lie in the diagnosis and clinical management of people experiencing changes in cognitive function; mild cognitive, vascular cognitive impairment; and Alzheimer’s disease. She serves as the Rush Steering Committee member and Site principal investigator for multiple NIH-funded consortium-led clinical trials in cognition and prevention of Alzheimer’s disease (http://keck.usc.edu/ atri and http://www.adcs.org). Dr Aggarwal’s recent research interests include identifying how social determinants of health, cardiovascular disease and other novel risk factors for cognitive impairment — including sex and gender differences — may lead to strategies to prevent cognitive decline and dementia in women, minorities and older adults. Dr Aggarwal is co-investigator and neurologist for the MIND Study (Mediterranean-DASH Intervention for Neurodegenerative Delay — http://mind-diet-trial.org) and Co-Principal Investigator for the Chicago-based Community Engagement for Early Recognition and Immediate Action in Stroke (CEERIAS) grant, a study that addresses the socio-economic, race/ethnicity and sex and gender disparities in stroke awareness, barriers to health care access in Chicago’s minority communities (https://www.pcori.org/research-results/2014/does-community-education-program-helpincrease- early-hospital-arrival-and-ambulance-use-patients-who-experience-stroke-ceerias-study).
Shyam Prabhakaran , MD, is Professor and Chair of Neurology at the University of Chicago. He trained at New York Presbyterian Hospital-Cornell for Neurology Residency and New York Presbyterian Hospital-Columbia for Vascular Neurology Fellowship. He also has an MS in Epidemiology from the Columbia Mailman School of Public Health. Dr Prabhakaran is stroke researcher with interests in imaging of intracranial stenosis, stroke systems of care and stroke epidemiology. He leads numerous research programmes, including the ongoing MYRIAD study of imaging biomarkers of intracranial atherosclerosis, the E-SPEED study focused on pre-hospital and inter-hospital barriers to timely stroke treatment in Chicago, and the THESIS study targeting diagnostic error for acute stroke in the emergency department. Dr Prabhakaran is an elected fellow of the American Neurological Association and American Heart Association’s Stroke Council and serves on numerous national guideline committees and working groups to advance stroke care.
Desiree Collins Bradley is the Patient Network Lead for ATW Health Solutions. In this position she has strategic oversight of the patient engagement activities and developments of the Patient Partner Innovation Community (PPIC). PPIC is an independent patient engagement network sponsored by ATW that offers alternative opportunities for learning and dissemination for patients, clinicians and others in the healthcare ecosystem. Desiree served as Faculty for the Centers for Medicare & Medicaid Services (CMS), Transforming Clinical Practice Initiatives (TCPI) and CMS’s Office of Minority Health Diabetes Prevention. In this work, she has also collaborated with the American College of Physicians (ACP), American Academy of Family Physicians (AAFP), NCQA, HHS, ADA, CDC, FDA, Kaiser Permanente and Aetna. Desiree is involved in several committees, including the Newborn Center Family Advisory Committee, of which she is the co-chair and one of the founding members. She is also Family Adviser for the Vermont Oxford Network, which focuses on NICU improvement projects globally, and the Project Coordinator for Project DOCC Houston, a non-profit organisation focusing on the importance of partnerships between physicians and families of those taking care of a chronically ill or disabled family member.
Kellie Goodson , MS, CPXP, is a thought leader in the areas of health equity and person/patient and family engagement (PFE) in health-care quality and safety improvement. She has worked with multiple health systems to improve patient outcomes using the lens of health disparities identification and resolution paired with the tenets of quality improvement and patient engagement. At ATW Health Solutions, Kellie leads efforts to include patient voices in health-care improvement efforts, helping organisations understand how to build partnerships with patients, families and community members to transform health-care delivery and outcomes. Previously, Kellie co-led national Affinity Groups for the topics of PFE and health equity for the Centers for Medicare and Medicaid Services and has served on national committees for the National Quality Forum and the Institute for Patient- and Family-Centered Care.
Alexis Malfesi , MSHS, is a Health Insurance Specialist with the Center for Medicare and Medicaid Innovation, where she focuses on developing strategies that promote person-centred care and the incorporation of patient and family perspectives across CMMI’s portfolio of models. Prior to joining the Innovation Centre, Alexis was a Director at Discern Health, part of Real Chemistry, where she led the development of quality strategies for providers, health plans and life sciences organisations to be successful in value-based payment environments. Previously, Alexis supported the implementation of innovative payment models through building learning systems for CMMI model participants and developed clinical quality measures for use in public reporting programmes while she was with The Lewin Group. She has a background in anthropology and an MSHS in Health Care Quality from George Washington University.
Theresa Schmidt , MA, CSPO, is a healthcare thought leader with 17 years of experience in research, policy, quality and technology. At Real Chemistry, she leverages her background in qualitative and quantitative methodologies, patient-centred quality measurement and improvement and value-based care to help partners achieve their goals. Theresa previously served as the Chief Data and Quality Officer for the National Partnership for Hospice Innovation, where she led the Data and Quality Initiative, and as Vice President of Strategy at Healthsperien. Theresa has also worked at Avalere Health, where she directed large-scale projects in the Data Analytics Practice and was the Product Manager for Avalere Quality Measures Navigator. She previously served as the Manager of Education at eHealth Data Solutions, where she worked closely with nursing homes across the United States to improve quality and manage reimbursement. Theresa has an MA in Sociology from The Ohio State University and a BA in Sociology and English from Oberlin College.
Citation
Washington, Knitasha V., Aggarwal, Neelum T., Prabhakaran, Shyam, Bradley, Desiree Collins, Goodson, Kellie, Malfesi, Alexis and Schmidt, Theresa (2023, September 1). Community engagement for early recognition and immediate action in stroke (CEERIAS): Pre and post COVID-19. In the Management in Healthcare: A Peer-Reviewed Journal, Volume 8, Issue 1. https://doi.org/10.69554/QJDX4787.Publications LLP