Community Engagement, Transformation, and Innovation (Yale CTSA Hub)

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Abstract

Yale School of Medicine (YSM) and its Yale Center for Clinical Investigation (YCCI) has had great success addressing the issue of minority participation in clinical trials. Two elements that are key to the successes at Yale are electronic health record strategies and community engagement, through the Cultural Ambassador program (partnership between Yale, the African Methodist Episcopal Zion Church (AME Zion), and local community-based organizational leaders). In 2010, the YCCI met with community leaders from Junta, one of the oldest Latino community-based non-profits in New Haven, and the AME Zion, one of the oldest African American congregations in the US. The result was the creation of the Yale Cultural Ambassadors Program as an element of the Yale “Help Us Discover” initiative. This program differed from previous efforts to engage historically underrepresented minority (URM) communities in research by directly working with local church and advocacy leaders and Yale faculty to develop new clinical research awareness and recruitment strategies. In March 2015, the “Help Us Discover program” was greatly enhanced by integration of Yale’s enterprise-wide electronic health record (EHR). The decision has allowed us to focus on many direct-to-patient innovations using our EHR, including the development of a direct-to-patient research portal in the MyChart patient portal. One of the great benefits of the Yale Cultural Ambassadors Program and clinical trials diversity efforts are they serve as ready to engage standing platforms which are disease /research agnostic. The combined strategies enabled Yale to recruit more than 27,000 patients to research studies in FY20, with underrepresented minority (URM) populations making up 31% of all participants in clinical research at Yale (increased from ~3% in 2010). The high impact of the program was a driving factor resulting in the above referenced MOU with the FDA OMHHE.

References:
1. Memorandum of Understanding Between U.S. Department of Health and Human Services, Food and Drug Administration, Office of the Chief Scientist, Office of Minority Health; and Yale University. 2018 April 20. Retrieved from https://www.fda.gov/about-fda/academic-mous/mou-225-18-015
2. Arajo R, Johnson T, Spinner J. Advancing Clinical Trial Diversity Through Community Engagement. 2019 October. Retrieved from https://globalforum.diaglobal.org/issue/october-2019/advancing-clinical…
3. Improve Diversity in Clinical Trials. https://mrctcenter.org/diversity-in-clinical-trials/. Accessed 2020 October 15
4. Think Medium: Access to Clinical Research and an Approach to Advancing Health Equity https://www.youtube.com/watch?v=y_hsnrNmu8o
5. December 30, 2020, episode 72, of the Fireside Chat with Gary Bisbee is entitled “Yale Cultural Ambassador Program: Access to Clinical Research and an Approach to Advancing Health Equity.” (https://www.firesidechatpodcast.com/)
6. Diverse group of students part of new internship with Yale School of Medicine https://www.wtnh.com/news/health/coronavirus/diverse-group-of-students-…, Posted: Jul 22, 2021 / 05:59 PM EDT / Updated: Jul 22, 2021 / 06:00 PM EDT
7. Preparing Young Students of Color to Seize Opportunities in Health Care, https://medicine.yale.edu/news-article/preparing-students-of-color-to-s….
8. YCCI Exposures Pilot Program; https://medicine.yale.edu/ycci/education/internshipaddprograms/exposure…
9. YCCI meet past interns: https://medicine.yale.edu/ycci/education/internshipaddprograms/past-int…

Authors
Tesheia
Johnson
Director of Clinical Research for Yale School of Medicine
Allen
Hsiao
Associate Professor of Pediatrics and of Emergency Medicine, Chief Medical Information Officer
Brian
Smith
Deputy Dean for Clinical and Translational Research