The Cultural Ambassadors program is a partnership of the Yale New Haven Health, Yale School of Medicine/Yale Medicine, and Yale Center for Clinical Investigation with community leaders from the African Methodist Episcopal (AME) Zion Churches of Connecticut and Junta (non-profit organization serving Hispanic community) that addresses health information gaps and supports community awareness of clinical trials. The program fosters open dialogue about opportunities to participate in clinical trials and uses community feedback to build trust. How does this practice build trustworthiness? The partnerships create a space for open and honest communication and the opportunity to learn from community members about their interest in and concerns about clinical trials, in order to increase participation from historically marginalized populations.
How It Works
The Cultural Ambassadors program is a bi-directional partnership between Yale Center for Clinical Investigation, the African Methodist Episcopal (AME) Zion Churches of Connecticut and Junta (Latino community based non-profit organization) created to address health information gaps and to support clinical trial awareness in the community.
Skills and Competencies
Traditional community engagement principles, supplemented with extensive education for members of the AME Zion and Junta (including training from IRB to explain informed consent and patient rights, biostatisticians to describe sample sizes and statistical significance, and perhaps most importantly ongoing education by faculty with clinicians to understand disease processes and answer any medical-related questions).
Prior to 2010, despite being a safety-net hospital with a large minority population, very few minorities participated in clinical research, including clinical trials even if they had exhausted standard treatment options. In order to create a systematic way to increase community participation, diverse focus groups were held (50% minority, age 17-81, broad education ranging from 8th grade to individuals with 2 PhDs), and the results were that not a single minority participant said they would participate in clinical trials due to lack of trust of the medical community based upon prior mistreatment. Subsequent minority-only focus groups shared that in order to rebuild trust, an essential step would be to create a partnership with the AME Zion Church and Junta, since these groups were respected and trusted within the community.
Prior to 2010, clinical studies had a 2-4% minority participation rate. The impact of the Cultural Ambassadors has significantly helped build trust between the communities we serve and our clinical programs. When the Cultural Ambassadors are engaged in a study, the minority participation rate can be as high as 22%-92%. Since 2010, clinical studies have grown 900% due to many factors, and now 31% of all clinical study participants are minorities. This helps improve the health of our communities and reduce health disparities.
The foundation of this program includes having open dialogue about an opportunity and using the feedback to build trust. The success of this program has led to conversations with other academic centers and we are partnering with the Health Management Academy to help identify other health systems that are interested in improving and growing relationships with their own communities. The principles of this program can be applied at any location, as long as there is a desire to listen and build long term collaboration.