Karen Emmons, PhD, is faculty lead of our Community Engagement program and professor of social and behavioral sciences at the Harvard T.H. Chan School of Public Health (HSPH).
What lessons does the coronavirus crisis offer about the importance of community engagement?
Given the longstanding issues that we have in this country around social determinants of health and inequities, we should expect that anything with such a profound impact on our country and our way of life would have a differential impact on various communities.
Community engagement allows us and our community partners to understand the ways in which possible responses, policies, and programs would impact different groups. With strong community partnerships, we’ve been able to quickly get a sense of what’s happening on the ground. Our community health center partners have been decimated, in terms of their financial circumstances and staffing, which affects their ability to care for the populations they have served so well for so long. We have to think through how social distancing works when you have a community like Chelsea that is extraordinarily dense and the majority of people live in high rises, and where you have many people who are essential workers and need public transportation to get to jobs. Community partnerships have also been invaluable in the huge effort at contact tracing in Massachusetts.
“We have to think through how social distancing works when you have a community like Chelsea that is extraordinarily dense and the majority of people live in high rises, and where you have many people who are essential workers and need public transportation to get to jobs.”
Has the Community Engagement Program been involved in contact tracing or other responses to COVID-19?
We’ve been involved from the very beginning in helping the governor build the infrastructure and volunteer labor force needed for contact tracing. Governor Baker reached out to Harvard T.H. Chan School of Public Health and to all the universities in the city asking for help. Through Harvard Catalyst, we brought in the informatics team and the REDCap team (Research Electronic Data Capture), and they worked tirelessly to build the data system that enabled students from among the 1100 volunteers for the Academic Public Health Volunteer Corps to quickly start contact tracing. Because of our relationships in the community, we were also able to connect the state with our community partners and community health centers.
The Community Engagement Program provides two-way information-sharing pathways. In terms of COVID-19, there’s a tremendous amount of work going on in the homeless community to understand the impact on them and on shelters. And we have folks in infectious disease who are trying to understand the disease spread. We connected those two sets of people, and it’s been really valuable.
We’ve also created a four-part series around COVID-19 along with community engagement programs at the three other CTSIs [Clinical and Translational Science Institutes, the collaborative network of which Harvard Catalyst is part] in Massachusetts. This webinar series included a talk by Yonatan Grad, MD, PhD, on the development of herd immunity and vaccines, among others.
What are the two projects doing that Community Engagement funded after the symposium in October of 2018 on healthy child weight?
These two projects very much illustrate our program’s efforts to find ways to get scientific evidence translated into practice. One is looking at accelerating the uptake of WIC, the Women, Infant, and Children nutrition program. About seven million people in the U.S. have been fed by the WIC program, but although it’s available to pregnant women and families with children up to age five, it’s not used very much in families with older children. To find out how WIC could be improved, Eric Rimm, ScD, and his colleagues are partnering with the Massachusetts WIC programs to understand why people drop out of the program.
The other study we funded, led by investigators Caroline Dunn, MS, and Erica Kenney, ScD, MPH, looks at childcare and early education settings to understand how to improve the uptake of policies designed to increase children’s wellness. For example, there are new regulations around the quality of food they should be offering, for example, but adoption has been slow. These regulations are really great ways to improve children’s health, but that won’t happen if they are not followed.
“We’ve been involved from the very beginning in helping the governor build the infrastructure and volunteer labor force needed for contact tracing.”
Much of your research has been on community-based approaches to cancer prevention. How has your thinking on how best to do this evolved?
I’ve increasingly focused on implementation science, which is essentially asking the question: How do we take what we know and use that knowledge for everybody, in every setting? In bringing my work in implementation science together with disparities, I’ve also realized the importance of context and two-way learning. We can come into a community health center or a community housing site and say, “This is the science, and this is what should be done.” But we’re not going to do a good job at translating our science if we don’t think about the context and understand the setting and resource constraints. There’s as much important knowledge in that setting as I have in all of my papers, and probably more.
A good example is the new Implementation Science Center for Cancer Control Equity, for which Elsie Taveras, MD, MPH, and I received funding last September. We are partnering with 30 community health centers in Massachusetts to build an infrastructure for how to translate more of our science to community practice with a focus on equity. Together we’re thinking through strategies for re-engaging people to return for primary care post COVID-19. Some cancer screening can be done at home, for example.
You detoured away from Harvard for three years to be vice president for research at Kaiser Permanente. Are you glad you returned?
Kaiser was terrific and I learned a lot about business and how research operates in a business environment. But at Harvard, research is a major driving force and I’m at heart a research nerd. I missed the energy and inquiry that students bring to an academic institution. To have direct access to my community partners, students, and mentees brings me great joy and is a true gift.