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Author: Jessica Famularo

Pediatrics: Lessons Learned and Future Directions for Improving Care of Children with Medical Complexity Through CISWH Project

The population of children with medical complexity (CMC) is steadily growing, and with it comes a rising awareness of the challenges faced by their families—lack of access to needed health and social services, financial hardship as the result of high expenses, and lost income and missed opportunities for improving outcomes. To address these needs, the Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau (MCHB) funded the Center for Innovation in Social Work and Health (CISWH) at Boston University’s School of Social Work (BUSSW) to lead the Collaborative Improvement and Innovation Network to Advance Care for Children with Medical Complexity (CMC CoIIN).

In a new seven-paper journal supplement published in Pediatrics, a group of CMC CoIIN leaders lay out lessons learned over the duration of the project (2017 – 2022), its impact, and the future of its work to improve child quality of life, family well-being and cost-effectiveness of care. The first article in the supplement gives an overview of CISWH’s CMC CoIIN project.

How a Collaborative Improvement and Innovation Network (CoIIN) Works

A CoIIN brings together groups of interdisciplinary teams of families, medical providers, policy makers, and payers to form a network aimed at identifying problems, developing and applying interventions, and evaluating the impact of said interventions using evidence-based processes. The separate teams come together regularly to share findings with one another and ensure that successes are spread throughout the network.

The CMC CoIIN had three goals for the project across ten state teams:

● Improve the quality of life for CMC
● Improve the well-being of their families
● Improve the cost-effectiveness of care of CMC

Equitable, Measurable Family Partnership and Core Values as Guiding Principles

Guided by nationally-recognized family leaders, clinical and implementation science experts, state-based teams, affiliate organizations, and individual families, the CMC CoIIN held equitable, measurable family partnership as a key principle in achieving its goals. The following are examples of strategies used to operationalize this guiding principle:

● Active family leader participation, serving on the project’s National Advisory Committee and as faculty, case presenters, moderators and learners in the COVID-19 and CMC Extension for Community Healthcare Outcomes (ECHO) medical education program.
● Training, technical assistance, and financial support for family leaders participating in the CMC CoIIN provided by the CISWH-based leadership team.
● Tools, resources, peer-mentoring support and coaching for family leaders provided by Family Voices.
● Use of the new Family Engagement in Systems Assessment Tool (FESAT) to help state teams measure levels of family engagement in systems-level work, and, based on this data, develop team-driven plans to increase it.
● A family leaders’ affinity group call every 6 weeks for shared problem-solving and peer-support.
● Required monthly reporting by state teams on family engagement activities and outcomes to the CISWH-based leadership team.

The CMC CoIIN also centered its work around three core values:

● Accountability: The CMC CoIIN leadership and state teams held themselves accountable to CMC and their families, ensuring that families were part of the process and empowered to share their perspectives.

● Transparency: The teams held honest conversations and were open to sharing both challenges and successes across teams and hierarchies. The network was committed to building a community of trust, encouraging teams to share their disappointments and challenges, in addition to identifying any “wins” as a source of valuable learning for everyone.

● Equity: In the CMC CoIIN, family leaders were treated as equals among clinicians and other team members. Family leaders themselves were required to be treated as equals with one another as well, regardless of experience, child’s age, diagnosis, or status as a paid family leader or volunteer.

What We Learned

Over five years, the CMC CoIIN made considerable progress in understanding and quantifying the challenges of families raising CMC, particularly during the COVID-19 pandemic.

While the CMC CoIIN made good progress on improving the quality of life for CMC and the well-being of their families, the network made fewer gains on improving cost effectiveness, largely because of the small number of CMC enrolled across all teams and the impacts of the pandemic—it was difficult to see meaningful change in claims and utilization data that could be directly credited to the CoIIN teams’ interventions.

As the first collaborative quality improvement network for improving the quality of life for CMC and their families, the CMC CoIIN gained valuable learnings and experience which could have implications for future improved care delivery for this growing population of children across the United States.

Learn more about topic-specific impacts of the CMC CoIIN through the January 2024 Pediatrics Supplement.

Social Work Leadership in Substance Use Treatment and Social Justice Advocacy: A Conversation with Dr. Nabila El-Bassel

Social Work Leadership in Substance Use Treatment and Social Justice Advocacy:
A Conversation with Dr. Nabila El-Bassel

A Virtual and In-Person Event

Friday, January 26, 2024
9:00AM – 11:00AM
Zoom; Boston University School of Social Work Conant Lounge
264 Bay State Road
Boston, MA 02215
View the Recording

A Panel Discussion Presented by the Center for Innovation in Social Work and Health at the BU School of Social Work and the Grayken Center for Addiction at Boston Medical Center

Join Dr. Nabila El-Bassel, director of the Social Intervention Group at Columbia University, for an engaging discussion as she explores the intersection of social work leadership in substance use treatment and social justice advocacy. Dr. El-Bassel will share insights from her work at the local, national, and global levels and engage in dialogue with BU School of Social Work (BUSSW) scholars about their work in substance use prevention, treatment, and social justice advocacy.

Moderated by CISWH Research Core Director Prof. Christina Lee, BUSSW faculty, including Profs. Ruth Paris, Jordana Muroff, Luis Alvarez-Hernandez, and Peter Treitler, will discuss their research projects, shedding light on the connections between social work, advocacy, and leadership.

Dr. El-Bassel is known for her work as the director of the Social Intervention Group at Columbia University, a multi-disciplinary center focused on prevention and interventions targeting HIV, drug use, and gender–based violence. Dr. El-Bassel’s work is funded extensively by the National Institute on Drug Abuse and the National Institute of Mental Health. She is seen as a national and international leader in the areas of global HIV and health.

Register Here

Accessibility:
Boston University strives to be accessible, inclusive, and diverse in its facilities, programming, and academic offerings. Your experience in this event is important to us. If you have a disability (including but not limited to learning or attention, mental health, concussion, vision, mobility, hearing, physical, or other health-related issues), require communication access services for the deaf or hard of hearing, or believe that you require a reasonable accommodation for another reason, please contact the event organizer at [email protected] to discuss your needs.

CISWH Board Member Dr. Vanessa Kerry Appointed WHO Director-General Special Envoy for Climate Change and Health

Dr. Vanessa Kerry, advisory board member for the Center for Innovation in Social Work & Health (CISWH), has been appointed the first-ever World Health Organization (WHO) Director-General Special Envoy for Climate Change and Health. In her new role, Dr. Kerry will raise awareness of the global impacts of climate change and advocate for strong policies and partnerships to promote the health of communities affected by global warming.

Dr. Kerry is the co-founder and CEO of Seed Global Health, director of the global Public Policy and Social Change program at Harvard Medical School and an associate professor of medicine at Harvard University. She is a renowned doctor and expert in global health who continues to play a pivotal role in climate and health advocacy.

“We are excited and proud to have Dr. Kerry as an advisor and resource in achieving the Center’s vision to be a global partner in cross-sector collaboration to promote health, health equity, and social justice, ” says Ellie Zambrano, CISWH executive director.

As a practicing critical care physician, Dr. Kerry is committed to furthering the conversation on the link between global health and economic growth, community development and national security.

Utilizing her extensive experience, Dr. Kerry hopes to use this leadership role as a way to shape policies, foster collaborations and drive transformative action to safeguard the health of current and future generations in the face of the climate crisis.

Read Full WHO Announcement Here.

The BUSSW Statement: Supreme Court Decision on the Use of Race in Admission Decisions

Dear BUSSW Community, 

By now you may have heard about the Supreme Court’s decision today, June 29, 2023, regarding the use of race in considering applicants’ admission to colleges and universities. This is deeply disappointing news and one that is a set back and at odds with the values and mission of BU and our School.  Please see President Brown’s letter in response to the announcement in which he affirms BU’s enduring commitment to working within the parameters of the law to continue to support and grow the diversity of our student body, and a story in BU Today that shares reaction from the BU community.

As President Brown explains, BU is reviewing the decision to better understand the implications for the University.  However, I want to unequivocally state that the SCOTUS decision in no way changes our commitment to a diverse student community.  We will redouble our efforts to grow and support racial and ethnic diversity at our School and will work closely with central administration to ensure we do so within the parameters of the law.  We will not let this decision hinder our ongoing efforts to recruit students from underrepresented communities and we will continue to support them in their journey as they apply to and attend BUSSW. 

As we have always done when evaluating student applications, we will continue to holistically consider an individual’s background and experiences and their potential for success and contribution to society – guided by our School’s vision and mission.  It is our intention to maintain those financial aid policies that open our doors to economically disadvantaged students – policies that have made our student body the most diverse in our School’s history. And finally, to the extent permitted by law, we will maintain those programs that support students from diverse backgrounds and embed them in our community.  Guided by our professional values and commitment to a more just society, the School will continue its robust program of research and scholarship to further advance social, racial, and economic justice. 

As we continue to learn more about the implications of the decision, we will keep you updated on programmatic and policy changes we may need to consider.  We are open to hearing thoughts and ideas from our community to help inform the strategies we will develop to navigate this new landscape.  We want to also ensure that everyone understands the ramifications of this decision and the parameters that we will need to work within moving forward.   

Sincerely,

Dean Jorge Delva

Taking Action: Social Work and Civic Health

Eleanor Zambrano, CISWH executive director, presented “Taking Action: Social Work and Civic Health” at the McLean Hospital Annual Golda Edinburg Lecture on March 30, 2023. This annual event honors the late Golda Edinburg, (MSW ’46). She was invaluable in developing the McLean social work department, and was recognized not only at McLean but throughout the country for her contributions to social work practice.

In this year’s lecture, Zambrano shed light on the Center for Innovation in Social Work and Health’s work, civic health engagement, and ways to discover your power as a practitioner.

“Social work is the fastest-growing profession in healthcare in the United States, according to the Bureau of Labor Statistics. Between 2021 and 2031, the social work profession will grow by almost 10%, faster than the average for all other occupations in the US,” Zambrano said. ”Part of what makes our profession unique is that we recognize how human behavior is impacted by the social environment, and we understand that the obstacles experienced by the communities we serve are more often than not barriers that are created by policies and systems.”

Zambrano highlighted the professional code of ethics that calls on social workers to address social problems, respect the self-determination of individuals and utilize civic engagement within interventions. It is important for social workers to engage with political processes and systems. By connecting clients and community members to the democratic process, Zambrano hopes that social workers can continue to break political and systemic barriers.

WBUR’s Cognoscenti: Prof. López and BU Students Witness the Effects of Immigration Policies on Migrant Families at the US/Mexico Border

In an op ed published in WBUR’s Cognoscenti, Prof. Luz M. López shares how the implementation of Title 42, a program that gave border patrol agents the authority to override immigration laws that protected asylum seekers, created the dangerous conditions that migrants are still stranded in today.

Prof. López, director of the global health core at the Center for Innovation in Social Work & Health (CISWH) and a clinical professor at BU School of Social Work (BUSSW), accompanied a group of Boston University students to the Rio Grande Valley through the Border Studies Program, led by Center on Forced Displacement. During the trip, students saw first-hand the detrimental effects of U.S. immigration policies on migrant families.

Prof. López visualizes the Border Studies Program as a learning opportunity for students, but also as an avenue of additional support for migrants and overburdened staff at the border.

Excerpt from “I traveled with my students to the Rio Grande Valley. I hope what they saw will stay with them” by Luz Marilis López, originally published in WBUR’s Cognoscenti:

“‘[My students] not only saw immigration policies in action, they observed the resilience of the families who had escaped political conflict, violent crime and economic upheaval.’

‘As we move forward from this shameful chapter of our history, we must dispel the myth that migrants and asylum seekers are criminals or here to steal jobs. Let’s focus instead on the hardworking families who deserve a second chance at stability and safety — then fund the resources and programs that will help them get it,’ López says.”

Read the Full Article

CISWH’s Black Women First Initiative Uses Participatory Art to Promote Health and Empower Client Voices

Art can be an impactful tool to process emotions and grief, spark capacity for empathy, and promote healing. In a new research brief, the Black Women First Initiative (BWF), a project from the Center for Innovation in Social Work & Health at BU School of Social Work (BUSSW), shares how the team utilizes art therapy and other arts-based interventions—including photography, filmmaking, and theater—to build community and reduce social isolation and stigma amongst Black women living with HIV.

“Overall, the arts settle people and bring them together. There is something in it for every human. We are all drawn to the beauty of a voice or music or a painting or a story,” say the authors. “Agencies need to look outside of the usual ways to increase engagement and introducing the arts is a great place to start.”

These approaches foster emotional connections, reduce social isolation, address stigma and provide education to the HIV community. Art can also be an avenue for people with HIV to express harm and health from traumatic experiences they encounter in health care settings. These approaches prioritize the voices of Black women with HIV, and provide more holistic forms of care.

The Black Women First Initiative, featuring a team of researchers from BUSSW including alumni Melanie Rocco (SSW’21) and Mahlet Meshesha (SSW’19) and Profs. Judith Scott and Linda Sprague Martinez, supports the design, implementation, and evaluation of evidence-informed resources for Black women with HIV, including stigma reduction, trauma-informed care, health literacy, and expanded delivery of HIV care services.

Read the full brief here.

5/2: The 2023 Hubie Jones Lecture in Urban Health With Dr. Joseph Betancourt

Health Leadership for Health Justice

Tuesday, May 2, 2023

5:30 – 7:00 PM 

Zoom; George Sherman Union Auditorium, 775 Commonwealth Ave, Boston, MA

A Hybrid Event Presented by

 Center for Innovation in Social Work & Health

 

View the Recording

Watch the 2023 Hubie Jones Lecture in Urban Health featuring Dr. Joseph Betancourtm, hosted by the Center for Innovation in Social Work & Health at the BU School of Social Work . Dr. Betancourt, president of the Commonwealth Fund and associate professor of medicine at Harvard Medical School, shares his vision for eliminating racial and ethnic disparities in medical care by developing anti-racist leaders in social work and public health.

Program:
5:30 pm: Opening remarks by Ellie Zambrano, CISWH executive director
5:35 pm: Introduction by Dean Jorge Delva, BU School of Social Work
5:37 pm: Dr. Joseph Betancourt presents
6:10 pm: Break
6:15 pm: Q&A with Dr. Joseph Betancourt
6:50 pm: Closing remarks by Ellie Zambrano

Content Level: Intermediate

Continuing Education Credit Info:
The target audience of this lecture and discussion is LICSW, LCSW, LSW, LSWA and other health care professionals. Health Leadership for Health Justice  is approved by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program to be offered by the Center for Innovation in Social Work and Health as an individual course. Individual courses, not providers, are approved at the course level. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. ACE course approval period: 5/2/2023 – 5/2/2025. Social workers completing this course receive 1.5 continuing education credits.

1.5 national continuing education credits (free) are available to social workers licensed in the United States after the completion of a brief post-event quiz. The event will provide intermediate-level content and must be attended live in order to receive CE credits. If you would like to receive credits, please provide your license number during registration. The post-event quiz will be sent out at the end of the event and will be a Qualtrics quiz. Applicants will need a score of 70% or higher to receive the CE certificate, which will be sent via email. Questions? Contact [email protected].

Learning Objectives:

  • Explain how social influences—such as lower levels of education, overall lower socioeconomic status, inadequate and unsafe housing, racism, and living in close proximity to environmental hazards—disproportionately affect minority populations and thus contribute to disparities and poorer health outcomes.
  • Examine ways social work and healthcare leaders must identify and address such disparities in their organizations
  • Apply a model for an organizational focus on inclusion and building a culture in which care teams and patients feel valued, respected, and engaged.

Accessibility:
Boston University strives to be accessible, inclusive, and diverse in its facilities, programming, and academic offerings. Your experience in this event is important to us. If you have a disability (including but not limited to learning or attention, mental health, concussion, vision, mobility, hearing, physical, or other health-related issues), require communication access services for the deaf or hard of hearing, or believe that you require a reasonable accommodation for another reason, please contact the event organizer at [email protected] to discuss your needs.

About Dr. Joseph Betancourt
Joseph R. Betancourt, M.D., M.P.H., is president of the Commonwealth Fund, a private foundation promoting a high-performing, equitable healthcare system that achieves better access, improved quality, and greater efficiency, particularly for people of color, people with low income, and those who are uninsured. One of the nation’s preeminent leaders in health care, equity, quality, and community health, Betancourt formerly served as the senior vice president for Equity and Community Health at Massachusetts General Hospital (MGH), overseeing the organization’s diversity, equity, inclusion, and community health portfolio, including its Center for Diversity and Inclusion, Disparities Solutions Center, Center for Community Health Improvement, and centers focused on gun violence prevention, community health innovation, immigrant health, and global health. Previously, Betancourt led the Mass General Brigham (MGB) system’s COVID Equity and Community Health response and served as vice president and chief equity and inclusion officer at MGH, where he helped develop and launch the organization’s Structural Equity Ten-Point Plan and MGB’s United Against Racism Initiative. As director of MGH’s Disparities Solutions Center, which he founded, Betancourt worked to develop the capacity of healthcare organizations to improve quality, address disparities, and achieve equity. The center’s Disparities Leadership Program worked with more than 350 operating healthcare systems across the country, providing guidance on how they can improve quality and value in the care of diverse, minority, and vulnerable populations.

An author of nearly 80 peer-reviewed articles, Betancourt has served on several Institute of Medicine committees, including the committee that produced the seminal report Unequal Treatment: Confronting Racial/Ethnic Disparities in Health Care. He is an associate professor of medicine at Harvard Medical School and a board-certified internist, focusing on Spanish-speaking and minority populations. He earned his M.D. from the University of Medicine and Dentistry of New Jersey and completed an internal medicine residency at New York Hospital–Cornell Medical Center. Following his residency, he was a member of one of the first classes in the Commonwealth Fund–Harvard University Fellowship in Minority Health Policy, where he earned an M.P.H.

About Hubie Jones
Hubie Jones (’57), dean emeritus and the School of Social Work dean from 1977 to 1993 helped shape Boston’s civic landscape for over forty-five years and has been integral in numerous community organizations within Boston’s African American population and throughout all Boston neighborhoods.

As associate and executive director at Roxbury Multi-Service Center in 1967, his Task Force on Children Out of School (now Massachusetts Advocacy Center) published the report The Way We Go to School: The Exclusion of Children in Boston, which led to the first-in-the-nation enactment of two landmark laws that focused on special education and bi-lingual education.

In 2010, Jones received the Purpose Prize, a national prize awarded to select individuals over 60 carrying out encore careers and using their skills and experience to make a difference in their communities and the nation.

Established by an anonymous donor, the Hubie Jones Lecture in Urban Health fund is partially endowed at $50,000. Additional support is being sought from alumni and friends. To make a donation in support of the fund, please click here to make a contribution.

About the Hubie Jones Lecture in Urban Health
The Hubie Jones Lecture in Urban Health is an annual symposium that addresses vexing health issues, featuring national and international leaders at the intersection of health and social justice. The series was established in 2012 by an anonymous donor to honor the vision of Hubie Jones and is hosted by the Center for Innovation in Social Work & Health.

Alumni and friends are encouraged to continue Hubie’s legacy through donations to the Hubie Jones Fund for Urban Social Work Practice. Your support will fund scholarships that help deserving students pursue an MSW degree, as well as research and programs in service of the BU School of Social Work’s urban mission. To make a donation, please click here.

New Grant for CISWH Executive Director and BU Colleagues Supports Linguistic Interpreters Working with Trauma Patients

Interpreters working with medical patients who have experienced forced displacement are often exposed to their clients’ traumatic experiences, otherwise known as vicarious trauma. Unlike social workers, psychologists, and other clinicians; linguistic interpreters frequently lack the institutional support for managing this indirect trauma and its impact on their mental health. This can lead to poor patient care and decreased work engagement.

The Center for Innovation in Social Work & Health (CISWH) executive director Eleanor Zambrano, in partnership with a team of Boston University faculty and experts at the Boston University School of Medicine (BUSM) and the Immigration and Refugee Health Center (IRHC) at Boston Medical Center (BMC), received a one-year seed grant from the Boston University Center on Forced Displacement (BUCFD). Through the grant, the team will study the experiences of interpreters working with forcibly displaced people to understand how vicarious trauma impacts interpreter well-being and their ability to provide quality care.

“We are committed to building stronger partnerships focused on health equity research,” says Zambrano. “CISWH’s partnerships and research continues to expand the impact of social work within public health in order to improve the health and well-being of vulnerable populations.”

The researchers will interview and gather quantitative data, including demographics and a life events inventory, from 20 participating interpreters currently employed at BMC. With a better understanding of interpreters’ experiences, the team will use the research findings to develop sustainable training programs and other hospital systems of support to meet their unique needs.

Members of the research team include:

  • Resham Gellatly, PhD, assistant professor, Department of Psychiatry at BUSM and clinical psychologist; Boston Center for Refugee Health and Human Rights (BCRHHR) at BMC
  • Sarah Kimball, MD, assistant professor at BUSM; affiliate faculty member at CFD; and director of the BMC IRHC
  • Nuha Alshabani, PhD, postdoctoral fellow at BMC

Learn more about the 2023 CFD grants here.

CISWH Partner, University of Global Health Equity in Rwanda, Launches Community-Based Education Program for International Students

Photo by Paul Kagame, provided under Creative Commons License CC BY-NC-ND 2.0

The University of Global Health Equity (UGHE) in Rwanda, a partner of the Center for Innovation in Social Work & Health (CISWH) at the BU School of Social Work (BUSSW), is now accepting applications for its first Community-Based Education Global Scholars Program (CBE Global).

In this 3-week immersive summer certificate program, students from around the world studying social work, public health, and related fields will travel to Rwanda to learn about the innovative, community-driven work happening in rural communities. Students will work alongside activists and community leaders to tackle inequities in health. By the end of the 3 weeks, participants will be able to:

  • assess and identify community strengths and assets that advance health and wellness
  • remove paternalistic techniques from professional practice and organizational culture
  • co-develop community health programs
  • identify racism, colonialism and other determinants of poor health and act towards dismantling these structures
  • advocate for equity in education and other socio-economic rights
  • effectively collaborate with communities

UGHE will host the first cohort of CBE global students from July 17 to August 3, 2023.

UGHE brings a new approach to recruiting and training health professionals. An initiative of Partners In Health (PIH), which was co-founded by CISWH board member, the late Dr. Paul Farmer, and led by internationally recognized faculty and staff from around the world, UGHE is an independent university that builds on PIH’s three decades of experience in delivering health services to some of the world’s poorest communities.

Learn more about the program.
Apply Here.