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Penn State CTSI: Building the Foundation for Rural Health Equity

Rural residents often don’t have easy access to health care for a variety of reasons, including a lack of health care facilities within the community or nearby communities; limited transportation to get to appointments or lack of resources or insurance. Rural communities also see higher rates of behaviors that lead to poor health conditions, such as a higher incidence of substance abuse and a decreased likelihood of consistent physical exercise.

With 95% of Pennsylvanians living within 30 minutes of a Penn State Campus, Penn State is uniquely positioned to address residents’ psychological and physical health in rural Commonwealth communities. As one of a handful of CTSA (Clinical and Translational Science Award) programs with a rural focus, Penn State Clinical and Translational Science Institute’s (CTSI) mission is to foster collaborative research and provide the necessary tools and resources to help new or proven discoveries reach the people who need it most.

Two continued partnerships to address rural health disparities

The most recent renewal of Penn State’s Clinical and Translational Science Award allows CTSI to continue investing in key partnerships between the institute and two primarily rural-focused health networks—Sharon, Pa.-based Primary Health Network and Pittsburgh-based Allegheny Health Network. These collaborations add to Penn State CTSI’s commitment to addressing rural health disparities.

Primary Health Network (PHN), a federally qualified health center with nearly 50 health center sites, serves approximately 75,000 patients across the Commonwealth. Penn State CTSI has partnered with PHN to receive feedback on innovative research collaborations, methods, and to improve the integration of clinical research into health care practice across the state, particularly in central and western rural Pa.

A virtual workshop with PHN clinicians and staff and Penn State researcher teams, kicked off the collaboration between the two organizations, with discussions focused on social determinants of health, health literacy and mental health. The event provided Penn State investigators with real-world insight into the challenges in these areas faced by rural health providers and identified opportunities for future research collaborations to advance health equity.

“Penn State and Penn State Health have long been recognized for visionary research and high-quality clinical services,” said George Garrow, the CEO at Primary Health Network. “Because of the respect and trust that Pennsylvanians have for the University, I believe Penn State is best-positioned to lead efforts at improving the health and health care of communities across the entire state and region.”

The CTSI partnership with Allegheny Health Network (AHN), an integrated health system that serves 29 Pennsylvania counties, brings frontline clinicians together with Penn State researchers. Together, they collaborate on research to address the needs of communities in western Pennsylvania and expand research education opportunities. For example, Penn State CTSI and AHN have developed a clinical research practice course and internship program, which is currently offered at several Penn State campuses, including Greater Allegheny, New Kensington and University Park.

Penn State CTSI has partnered on a joint request for applications (RFA) with AHN and Highmark Inc. to advance its mission of translating research into impacts on human health. The CTSI engaged Keith LeJeune, senior vice president of research and innovation, AHN, to serve on the Institute’s Executive Council. LeJeune has been invaluable in identifying cross-institutional areas for synergistic clinical and translational research efforts. The first collaborative initiative is a $100,000 pilot funding opportunity for research teams that include Penn State researchers and AHN researchers and clinicians. The awarded pilots are aimed at promoting population health, including preventing, predicting, diagnosing and/or treating human disease. A total of seven cross-institution pilot projects were supported, several with a rural focus.

“These pilot projects have the potential to impact the health and well-being of the communities we serve and demonstrate that improved health outcomes correlate with lower health care utilization rates and costs,” said LeJeune. “Working with the CTSI has afforded the ability to engage the Penn State research community at Hershey and University Park in ways that we simply could not otherwise.”

Addressing rural health disparities through our Community-engaged Research Core

The Community-Engaged Research Core (CERC) offers tools and resources to Penn State researchers and the community to assist in forming strategic partnerships, the inclusion of communities as partners in research, and developing community health coalitions.

Community members serve on the CERC to bring new perspectives that might otherwise be overlooked by the academic team. This also allows community participants to understand Penn State’s effect on its communities and the role of research throughout the University.

“As clinicians or researchers, we often don’t have lived experience with a disease and don’t know the community contexts of our patients. We have limited information about individuals and may not be able to fully advise them about the best treatment choices. Further, the majority of research is done within the academic centers, which are typically located in urban or suburban, but not rural, areas. To provide quality care and develop the most meaningful, impactful research, we need to partner with patients and communities. Therefore, the CERC focuses on engaging patients and communities as research partners through the community-driven research day events, Community Engagement Studios, and applying the principles of Community-Engaged Research (CER) in research conducted by our Penn State faculty.” – Aleksandra Zgierska, MD, PhD, co-lead, Penn State CTSI Community-Engaged Research Core (CERC)

Bonnie Kent, operation manager and community liaison for Northern Dauphin Human Services Center, has served on the CERC for more than five years to bring the community voice to the core’s mission.

“Since joining Penn State CTSI, I’ve seen the impact these extraordinary professionals are having in our rural communities of northern Dauphin County,” said Kent. “For instance, through SCOPE (Student-run Collaborative Outreach Program for Health Equity), medical students provide access to care to underserved populations through local events. Other examples include The Walk by Faith program, the Introduction of the Project ECHO program to our local physicians, and the Community Health Equity & Engagement Research (CHEER) Initiative which will be providing six community members the opportunity to become certified Community Health Workers in 2023.“

Additionally, the CERC hosts an annual community-driven research day, which includes real-world facilitated discussions between researchers and community members. This day, designed to connect Penn State researchers with community organizations, is planned and developed with community stakeholders, who identify areas of community need and interest. Similarly, the CTSI CERC also offers researchers a one-time Community Engagement Studio, a 90-minute meeting where community members give feedback and advice to improve and inform Penn State research projects.

Addressing rural health through training the next generation

Another major focus of the CTSI is training graduate students and junior faculty scholars by providing support for their training expenses, salary and research support. Five of eight junior faculty engaged in the CTSI’s career development program are focusing their work on understanding health problems in rural health settings. Scholars will also be engaged with frontline experiences in rural health, facilitated by our partnership with PHN.

“We are thrilled to partner with PHN and are encouraging our scholars to gain experience working directly with patients in rural health care settings or indirectly by analyzing data to better understand the health challenges of people in rural settings,” says Chris Sciamanna, MD, MPH, director of the Penn State CTSI KL2 Program.

About Penn State Clinical and Translational Science Institute

Established in 2007, Penn State Clinical and Translational Science Institute (CTSI) serves as a cornerstone for the clinical and translational sciences at Penn State. The CTSI’s mission is to support and enhance research by providing the training, tools and resources needed to 1) foster collaborative research across disciplines and 2) translate research discoveries into practice. It accomplishes its mission through interdisciplinary collaboration and innovative approaches to predict, prevent and treat disease; providing researchers across the University with access to resources that enhance and rigorously evaluate the impact of clinical and translational research; training a new generation of health professionals and researchers; and successfully sharing and disseminating data, discoveries and new knowledge with researchers, health providers, other institutions and the community at large.

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