NYU-CUNY Prevention Research Center Approach
The NYU-CUNY Prevention Research Center (NYU-CUNY PRC), a partnership between NYU Langone and the CUNY Graduate School of Public Health and Health Policy, focuses on addressing the leading causes of poor health. Our work follows the Consolidated Framework for Implementation Research and a population health equity framework. Our approach is guided by the principles of community-based participatory research, implementation science, systems science, and innovation methodologies.
Community-Based Participatory Research
Unlike “traditional” health research, community-based participatory research (CBPR) calls for the active and equal partnership of community stakeholders. CBPR empowers researchers and their communities to develop research together and translate these findings into effective practice.1
CBPR features several fundamental principles:
- promote active collaboration and participation at every stage of research
- facilitate co-learning and capacity-building
- ensure research and interventions are community-driven and culturally appropriate
- define community as a unit of identity
CBPR can yield benefits for both communities and researchers as it fosters trusting relationships and enhances the quantity and quality of collected data. This approach also increases use and relevance of research questions and collected data, promotes dissemination of findings, and facilitates infrastructure building and sustainability.
Implementation science is the study of methods to promote the integration of evidence-based interventions into practice and policy to improve the quality of healthcare. Drawing from several well-established frameworks, this research includes the study of influences on professional, patient, and organizational behavior as well as their effects on the sustainable uptake, adoption, and implementation of evidence-based interventions.2-4
Implementation science has several goals:
- investigate and address major facilitators and barriers that impact effective implementation
- investigate new approaches to improve health programming
- determine a causal relationship between the intervention and its impact
- increase the number of evidence-based interventions that are implemented in real-world practices
- promote the real-world sustainability of public health programs and interventions
Systems science goes beyond traditional socio-ecological models of health to uncover and intervene on the structures and feedback loops that underlie complex public health challenges. Increasingly, systems science is being applied to address policy-resistant problems in public health, such as infectious diseases, chronic diseases, and persistent health disparities. Systems science incorporates both qualitative and computational methods and seeks to tackle the following features of complex public health issues that are often difficult to address using public health’s conventional toolbox:
- a high degree of heterogeneity among actors, factors, and sectors that contribute to a public health challenge and its potential solutions
- inter-relatedness and inter-dependencies across these actors, factors, and sectors, including their behaviors and their effects
- a dynamic (time-varying) and nonlinear web of causes and effects
- unpredictability of the overall system, including emergent properties, tipping phenomena—meaning a small change in one part of the system may have a disproportionate effect on the overall system—and the ability of the system to constantly self-adapt
- frequent delays in the system
- unintended consequences from interventions on the system or its components
To advance transdisciplinary research and to develop and scale up innovative public health solutions, the NYU-CUNY PRC seeks to develop new collaborations and integrate theoretical frameworks and methodologies from a wide array of disciplines, some of which have historically had very limited interaction with the field of public health. Some examples include the fields of design, urban planning, architecture, management sciences, and social entrepreneurship. In light of the complexity of public health challenges today, innovating across fields is increasingly critical.
Community Health Workers Model
Several NYU-CUNY PRC initiatives promote the community health worker (CHW) model to build capacity and leadership in diverse communities.
Role of Community Health Workers
CHWs are frontline public health workers who are trusted members of the community they serve. They are known by a variety of job titles, including outreach workers, community aides, community health advisors or representatives, promotores(as) de saldud, and lay health workers.
This close relationship allows CHWs to be a bridge between health and social services and the community, facilitating access to services and improving the quality and cultural competence of service delivery. CHWs also build individual and community capacity by increasing health knowledge and self-sufficiency through activities ranging from outreach, community education, and informal counseling to social support and advocacy.
CHWs take on multiple roles in the healthcare system:
- bringing in individuals unfamiliar to the healthcare system
- providing cultural linkages and social support
- overcoming distrust
- contributing to better patient–provider communication
- providing patient and community education and counseling
- monitoring health status of individuals and assuring adherence to medical care regimens
The use of CHWs is a cost-effective and asset-based approach for improving community health and wellbeing.5-7
NYU-CUNY PRC’s research on CHW effectiveness is cited as part of the evidence base for the latest guidelines in the Center for Disease Control and Prevention’s Community Preventive Guide and Agency for Healthcare Research and Quality Innovations Exchange recommending the deployment of CHWs within healthcare teams to support cardiovascular disease and diabetes prevention and management efforts.
- Kwon SC … Islam NS. Implementing health promotion activities using community-engaged approaches in Asian American faith-based organizations in New York City and New Jersey. Transl Behav Med. 2017. DOI.
- Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: The RE-AIM framework. Am J Public Health. 1999. DOI.
- Damschroder LJ … Lowery JC. Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implement Sci. 2009. DOI.
- Feinberg A … Thorpe LE. A cohort review approach evaluating community health worker programs in New York City, 2015-2017. Prev Chronic Dis. 2019. DOI.
- Lopez PM … Thorpe LE. A place-based community health worker program: Feasibility and early outcomes, New York City, 2015. Am J Prev Med. 2017. DOI.
- Islam NS … Chau TS. Evaluation of a community health worker pilot intervention to improve diabetes management in Bangladeshi immigrants with type 2 diabetes in New York City. Diabetes Educ. 2013. DOI.
- Islam NS … Chau TS. A randomized-controlled, pilot intervention on diabetes prevention and healthy lifestyles in the New York City Korean community. J Community Health. 2013. DOI.