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A mixed methods evaluation of a six-year primary care community safety net-academic partnership model
Alexandria Blacker1, Jonathan G Shaw1,2, Angeline Chi Ying Yu3
1Department of Medicine, Stanford University School of Medicine, Stanford, CA.
Abstract:
To expand the tripartite mission to advance health equity, academic medical centers (AMCs) need to look outside their walls. In 2018, Stanford's primary care division launched the Community Partnership Program (CPP) between their AMC and local safety-net community health centers (CHCs) to support the goals of meaningful community engagement and addressing local clinic capacity needs. The CPP embeds Stanford physician faculty in local CHCs through service agreements. This study aimed to characterize the experiences of CHC leaders and faculty involved in the CPP to better understand barriers and facilitators to program implementation and assess its success as a community-responsive partnership. Stanford's CPP faculty (n = 9/15) and representative CHC leadership (n = 9/11) from five partner CHCs participated in the study. The National Academy of Medicine's Assessing Community Engagement Conceptual Model guided an explanatory mixed methods study: cross-sectional survey followed by semi-structured interviews. A modified Enage for Equity Community Engagement Survey identified high- and low-scoring variables (Likert scale:1-strongly disagree/never to 5-strongly agree/always). Qualitative assessment explored facilitators and barriers to program implementation and success. Overwhelmingly, both CHC leaders and faculty (n = 18) highlighted the CPP's positive role in making their work meaningful (4.78 (0.5)) and trusting the partners they work with (4.50 (0.5)). Sufficient time (3.61 (1.0)) and financial support (3.33 (1.4)) to engage in the CPP were the lowest scoring variables. Qualitative results highlighted the importance of communication, trust, and institutional buy-in, the value of community-academic bridges, increased access to clinical care, development of community-aligned solutions, and the partnership's positive impact on well-being. A model of community-academic partnership with primary care faculty embedded in safety-net CHCs can be successful from both AMC and CHC perspectives. These findings offer pragmatic lessons that can support other AMCs in building their own capacity for equity-focused collaboration grounded in community-engaged principles.
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