Section 1: Program Design and Curriculum Planning€¦ · Section 1: Program Design and Curriculum Planning The long term objective of this project is to accelerate high impact community-engaged

Penn State College of Nursing (2568-PSU) Establishing Community-Based Research Networks Project Lead: Janice Penrod, PhD, RN

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ESTABLISHING COMMUNITY-BASED RESEARCH NETWORKS

Deliverable #3: Summary Report of Curriculum Planning and

Research Nurse Participant Conference

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Section 1: Program Design and Curriculum Planning

The long term objective of this project is to accelerate high impact community-engaged research (CEnR). The

overarching goal is to establish community-based research networks comprised of research nurses from the

Penn State College of Nursing and community stakeholders in order to identify, prioritize, and respond to the

community’s health needs in collaboration with Penn State researchers. In order to achieve these goals, we

will design and test a model for establishing community-based research networks that can be replicated in

other settings.

The curriculum plan was designed using a “design backward/deliver forward” approach. This process guides

developers to consider the highest level of desired outcomes and then work backward to design specific

learning activities. This approach ensures tight alignment as the desired outcomes are reflected in objectives

and, ultimately, in the learning activities. We applied a three step process in the “design backward” phase:

Outcomes & Objectives/ Learning Activity Alignment/ Learning Needs Assessment.

Outcomes & Objectives

In order to reach desired program outcomes, it is essential to focus attention on learner outcomes (i.e.,

research nurses and community partner learners). Thus, the curriculum plan is designed to address three

segments: the program model; research nurses; and community partners. Desired outcomes and objectives

for each segment are described below.

Program Model Segment Program Outcomes (as stated in proposal):

1. Development and testing of a model for building capacity for CEnR that supports active

engagement across all phases of patient centered outcomes and comparative effectiveness

research

2. Model of implementation and tools needs to implement model in other settings

3. Metrics for evaluating outcomes (of project objectives)

Program Objectives (as stated in proposal):

1. Provide training in community engagement, principles of CEnR, community-based participatory

research (CBPR) for research nurses, comparative effectiveness research (CER), and patient

centered outcomes research (PCOR).

2. Mentor research nurses in conducting a community assessment to identify community partners

relevant to their specialization.


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3. Provide training in basic research principles relevant to CER/PCOR, community engagement and the

potential impact of CEnR on the health of the community for community partners.

4. Mentor research nurse and community partner interactions to prioritize health needs of targeted

populations and expand stakeholder representation.

5. Facilitate linkages to the Penn State research community to develop robust CEnR that addresses

community needs through nurse-led initiatives.

Research Nurse-Participant Segment Learner Outcomes: By the conclusion of the two-year project, the research nurses will feel competent to

activate a community based network of stakeholders in order to collaboratively conceptualize,

implement, and disseminate research designed to improve health.

Learner Objectives: By the conclusion of the program, the research nurses will be able to:

1. Describe the principles of:

a. Community Engagement

b. Community Engaged Research

c. Community Based Participatory Research

d. Comparative Effectiveness Research

e. Patient Centered Outcomes Research

2. Conduct a community needs assessment to identify community needs and resources

3. Identify relevant stakeholders in the community by completing a stakeholder analysis

4. Form relationships with key stakeholders in the community

5. Demonstrate capacity to lead team meetings in order to achieve desired objectives

6. Apply the CHANGE (Community Health Assessment and Group Evaluation) collaboratively with

community partners to prioritize health needs

7. Communicate prioritized community needs to senior researchers in order to stimulate

collaborative research.

Community Partners Segment

Learner Outcomes: By the conclusion of the two-year project, identified community partners will feel

competent to engage in research conceptualization, operationalization, and dissemination to enhance the

health of the community.

Learner Objectives: By the conclusion of the program, the community stakeholders will be able to:

1. Differentiate varied approaches to engaged research in communities, including:

a. Community Engaged Research

b. Participatory research

c. Comparative Effectiveness Research

d. Patient Centered Outcomes Research

2. Discuss strategies for meaningful compensation of community partners

3. Contribute to implementation of the CHANGE model to prioritize community health needs


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4. Describe the community members’ roles in conceptualizing, implementing, and disseminating

research

5. Dialogue with nurse researchers and senior researchers to describe community health needs


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Learning Activity Alignment:

Working backward from the outcomes/objectives, learning activities were aligned. In this phase, the learning objectives were mapped

across the learning activities designed for the Research Nurse-Participant and Community Member Participant segments. Notations in the

following tables refer to the nature of the educational experience planned across the project period.

I=Introduced; R=Reinforced; A= Applied

Table 1. Learning Activity Alignment: Research Nurse-Participants

LEARNER OBJECTIVES:

Differentiate varied approaches to engaged research in communities

Conduct a community needs assessment to identify community needs and resources

Identify relevant stakeholders in the community by completing a stakeholder analysis

Form relationships with key stakeholders in the community

Demonstrate capacity to lead team meetings in order to achieve desired objectives

Apply the CHANGE (Community Health Assessment and Group Evaluation) collaboratively with community partners to prioritize health needs

Communicate prioritized community needs to senior researchers in order to stimulate collaborative research.

Conference 1 (May 2016)

I I I I I I

Mentoring Sessions (May 2016-December 2017)

R

A A A R A

R

I

Conference 2 (February 2017)

A R R A R R

Grantsmanship R A A R A A


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Conference (September 2017)

Table 2. Learning Activity Alignment: Community Partner Participants

LEARNER OBJECTIVES:

Differentiate varied approaches to engaged research in communities

Discuss strategies for meaningful compensation of community partners

Contribute to implementation of the CHANGE model to prioritize community health needs

Describe the community members’ roles in conceptualizing, implementing, and disseminating research

Dialogue with nurse researchers and senior researchers to describe community health needs

Mentoring Sessions* (July 2016-December 2017)

I I R A

I A

I R A

Conference 2 (February 2017)

I R R R A

Grantsmanship**Conference (September 2017)

R R A A A

* Mentoring sessions include team mentoring and on-site group mentoring. Not all mentoring sessions will include community partners.

** Not all community partners are expected to attend the Grantsmanship Conference; therefore, this learning activity is designated as

Reinforcement and Application only


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Learning Needs Assessment

In the final phase of curriculum design, the needs of the individual learners are evaluated to specify the

content and process of learning activities in order to maximize growth toward objectives. In this project, a

Learning Needs Assessment was designed to guide curriculum development to best address the targeted

learners’ needs. A Likert scale was used to measure progression toward competency in each objective

(primary learner outcome).

Research Nurse Participants

The Learning Needs Assessment was implemented using online survey software (REDCap). This program

provides easy retrieval of group- and individual- level data. Group-level data is being used to direct “booster

sessions” as needed during the ongoing Mentoring Series. Individual-level data will be used in two ways. First,

each participant will be able to view earlier responses as they complete serial measurements to reinforce

progress toward goals. In addition, the Co-Leaders will monitor each individual’s progress toward achievement

of objectives in order to determine if any participants are lagging behind group progress. In these cases,

individualized remediation will be developed and implemented. (Please refer to Appendix A to review the

online survey format of the Learning Needs Assessment.)

During the recruitment phase research nurse participants completed a baseline assessment of competency in

each learning objective. These data informed the first learning activity, Conference 1. At the end of

Conference 1, the assessment was repeated to gauge movement toward objectives and to inform the content

for the Mentoring Series. The Learning Needs assessment will be administered every three months to monitor

progress toward achieving program objectives. Based on the curriculum map, our goal is to reach a rating of

competency in each objective as follows:

LEARNER OBJECTIVES (Nurse-Participants) Target Date for achieving Competency

OBJ 1: Describe the principles of: a. Community Engagement b. Community Engaged Research c. Community Based Participatory Research d. Comparative Effectiveness Research e. Patient Centered Outcomes Research

December 2016

OBJ 2: Conduct a community needs assessment to identify community needs and resources

September 2016

OBJ 3: Identify relevant stakeholders in the community by completing a stakeholder analysis

September 2016

OBJ 4: Form relationships with key stakeholders in the community

October 2016

OBJ 5: Demonstrate capacity to lead team meetings in order to achieve desired objectives

February 2017

OBJ 6: Apply the CHANGE (Community Health Assessment and Group Evaluation) collaboratively with community partners to prioritize health needs

June 2017


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OBJ 7: Communicate prioritized community needs to senior researchers in order to stimulate collaborative research

September 2017

Community Partner Participants

A similar protocol is planned for the community partner participants. The nurse-participants will be actively

engaging community partners in early fall of year 1. As the community partnerships are stabilized (i.e.,

member identified and committed to continued involvement), the baseline needs assessment will be

administered to community partner participants. These data will inform the curriculum development of

Conference 2 (February 2017). The survey will be administered again at the conclusion of Conference 2, then

repeated every three months to identify continued learning needs and to monitor progress toward

achievement of learning objectives. Co-Leaders will address group and individual needs via ongoing mentoring

sessions involving community partners and small group meetings, as needed.

REDCap surveys are very user-friendly. While we anticipate that our partners will be able to access and

complete the online survey, we have contingency plans in case a community participant does not have access

or is uncertain about their capacity to complete the survey. First, we will provide support by guiding the nurse-

participants to facilitate access or provide support to individuals needing help. Second, if this approach is

inconvenient or rejected by the community partner, we will revert to paper copy of the survey. In this case,

the responses be entered on the paper form will be entered into the survey program by the Co-Leader so that

the data set is complete. Based on the curriculum map, our goal is to reach a rating of competency in each

objective as follows:

LEARNER OBJECTIVES (Community Partner-Participants) Target Date for achieving Competency

OBJ 1: Differentiate varied approaches to engaged research in communities, including:

a. Community Engaged Research b. Participatory research c. Comparative Effectiveness Research d. Patient Centered Outcomes Research

March 2017

OBJ 2: Discuss strategies for meaningful compensation of community partners

June 2017

OBJ 3: Contribute to implementation of the CHANGE model to prioritize community health needs

June 2017

OBJ 4: Describe the community members’ roles in conceptualizing, implementing, and disseminating research

September 2017

OBJ 5: Dialogue with nurse researchers and senior researchers to describe community health needs

September 2017

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SECTION 2: RESEARCH NURSE CONFERENCE

Curriculum Development for Nurse-Participant Training Conference

The key content areas for the Nurse-Participant Training Conference were community engagement,

principles of community-engaged research (CEnR), community-based participatory research (CBPR)

methods (CBPR), comparative effectiveness research (CER), and patient-centered outcomes research

(PCOR). Each nurse-participant completed a self-assessment of their knowledge related to each of our

specific objectives for the training conference (see Appendix A). These results assisted with our decisions

on the weight and depth of content to include in each of our identified key areas. Using these data, specific

objectives, content, and learning activities were designed for the research nurse-participant conference.

As noted in our project proposal, we did not want our curriculum to duplicate readily available and vetted

teaching-learning products, such as those previously made available by Clinical and Translational Science

Award (CTSA) program institutions. Therefore, the second step in our curriculum development process was

to conduct a thorough review of currently available teaching-learning materials, online lessons, and

webinar content in our key content areas. We began by reviewing training products made available by

CTSA member institutions, the Agency for Healthcare Research and Quality (AHRQ), and PCORI, as we had

previously identified these organizations as ideal sources for training materials. Next, we collaborated with

our colleagues in the College of Medicine, Penn State’s Clinical Sciences and Translational Institute (CTSI),

and the College of Nursing’s research librarian to conduct a broader search. Through this process we

identified 29 unique content sources to evaluate, including online training modules, curricula, research

guides, and organizational reports. The Project Leader (Penrod) and Co-Leader (Hill) reviewed these

materials for their fit with the Nurse-Participant Training Conference objectives. We selected some content

for direct inclusion and other content to be adapted for our project’s specific needs.

Once our curriculum content was drafted, we vetted this content with experts in community based

research to ensure that our content was comprehensive. Following their positive feedback, we developed

the specific content, learning activities, and evaluation strategies for each segment of the training.

Conference Summary

The Establishing a Community-Based Research Network conference was held on May 18 & 19, 2016 at the

Penn Stater Conference Center Hotel. The conference was approved for 12.25 hours of continuing nursing

education units through the Penn State College of Nursing (an approved provider of continuing education

by the PA State Nurses Association, an accredited approver by the American Nurses Credentialing Center’s

Commission on Accreditation). A total of 27 nurse participants from eight Penn State campuses attended

the two-day conference, representing eight unique communities across the Commonwealth of

Pennsylvania: Abington, Altoona, Erie, Fayette, Mont Alto, Schuylkill, State College, and Worthington-

Scranton areas. (See map below for geographic distribution.)

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Each participant was provided a Conference binder including:

Participant Directory (photos and full contact information)

CBRN Overview (copy of the Memorandum of Understanding and project proposal)

Content slides

Activity worksheets

Supplemental materials for each session

Principles of Community Engagement (2nd Ed.)

Community Health and Group Evaluation (CHANGE) Action Guide

Community Health Needs Assessment for the home community

During the first day of the conference, we introduced the Community Based Research Network (CBRN)

project, the project team, nurse participants, and project objectives. The curriculum focused on defining

communities, the principles of community engagement (including the Clinical and Translational Science

Awards Consortium book of the same name), community needs assessment, as well as the process of

stakeholder identification, analysis, and communication. Didactic content was integrated with active

practice applying the concepts learned to the participants’ communities and areas of interest. Over a

dinner meeting, Dr. Eugene Lengerich presented to the group and engaged them in discussion regarding

his successful experiences with community engagement in the Northern Appalachia Cancer Network, a

community-academic partnership begun in 1992 to reduce cancer health disparities in rural communities

of Pennsylvania and New York.

The second day of the conference included introducing, comparing, and contrasting community-based

participatory research, comparative effectiveness research, and patient-centered outcomes research,

including the overlap in these research approaches. In the afternoon, Dr. Sheridan Miyamoto joined the

group and presented regarding her program of research, including her role in the PCORI-funded project,

Patient and Provider Engagement and Empowerment through Technology (P2E2T2) Program to Improve

Health in Diabetes. Our final day concluded with introduction of the group mentorship model that will be

used to advance the CBRN over the coming months, as well as bringing the group together in collaboration

around their areas of research interest and discussing next steps.

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Conference Evaluation

The conference was extremely well received by participants, as evidenced by the evaluation ratings

obtained through the Continuing Education evaluation presented below.

CE Program Content & Speaker Evaluation

Scale: 1= Poor, 2 = Fair, 3 = Good, 4 = Excellent

Participants commented on the “most helpful” parts of the session, including:

Stakeholders; approaching those in the community

Very comprehensive

Discussion of difference between CBPR, CER, PCOR

The entire session

Every part through the 2 days

Review of all forms of research and parts of project

All of it

Group work

Activities Guest speakers

Mean Rating

Achievement of learning outcomes

1. Describe the Principles of Community Engagement and community-engaged research

3.79

2. Identify the value of a community needs assessment (CNA) prior to community engagement

3.83

3. Identify relevant stakeholders in the community 3.93

4. Discuss challenges and benefits of community engaged research 3.79

5. Describe the principles of community based participatory research 3.79

6. Describe the principles of Comparative Effectiveness Research 3.69

7. Describe the principles of Patient Centered Outcomes Research 3.79

8. Describe group mentoring 3.72

Resources and materials used were beneficial (i.e. videos, handouts, PowerPoint, case studies, activities, etc.)

3.93

I would recommend this course to a colleague 100% (n=29)

Teaching effectiveness (Janice Penrod, PhD, RN) 4.00

Teaching effectiveness (Nikki Hill, PhD, RN) 3.97

Teaching effectiveness (Eugene Lengerich, DVM, MS) 3.86

Teaching effectiveness (Sheridan Miyamoto, FNP, PhD) 4.00

Overall quality of “Establishing a Community-Based Research Network” 3.93

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Post-Conference Learning Needs Assessment

At the conclusion of Conference 1, the research nurses again completed the Learning Needs Assessment in

order to measure progress on the identified objectives. Mean scores improved for all objectives, and those

emphasized in the Conference 1 program demonstrated higher levels of improvement. It is important to

note that when we aligned learning activities and objectives, this conference was designed as introductory.

However, as noted by the green shading below, several project objectives have already met the desired

outcome of “competency” based on participant self-assessment. This achievement amplifies the success of

our detailed curriculum planning process. These data will continue to guide project activities, as the

objectives are emphasized in subsequent learning activities designed to reinforce and apply content.

Learning Needs Assessment: Group Means Pre- and Post-Conference

Scale: 1=Not Competent, 2=Somewhat Competent, 3=Competent, 4=Highly Competent

Objective Pre-Conference 1

Baseline Post-

Conference 1

Describe the principles of Community Engagement 2.1 3.0

Describe the principles of Community-Engaged Research (CEnR)

1.8 3.0

Describe the principles of Community-Based Participatory Research (CBPR)

1.9 3.0

Describe the principles of Comparative Effectiveness Research (CER)

1.5 3.0

Describe the principles of Patient Centered Outcomes Research (PCOR)

2.1 3.0

Conduct a community needs assessment to identify community needs and resources

2.4 2.9

Identify relevant stakeholders in the community by completing a stakeholder analysis

2.3 3.1

Form relationships with key stakeholders in the community

2.7 3.0

Demonstrate capacity to lead team meetings in order to achieve desired objectives

2.6 2.9

Apply the CHANGE (Community Health Assessment and Group Evaluation) model collaboratively with community partners to prioritize health needs

1.6 2.2

Communicate prioritized community needs to senior researchers in order to stimulate collaborative research

2.2 2.6

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Appendix A. Learning Needs Self-Assessment

Documents

Section 1: Program Design and Curriculum Planning€¦ · Section 1: Program Design and Curriculum Planning The long term objective of this project is to accelerate high impact community-engaged