Towards a learning healthcare community in the Bronx: evaluating the Bridging Research, Accurate Information and Dialogue (BRAID) model.

Abstract

Background: Learning healthcare communities (LHCCs) have been proposed as a next-generation evolution of learning health systems that can advance health equity; however, a practical mechanism for enabling the active and continuous community engagement required for one has not yet been described in the literature. Recognizing that community-based participatory research (CBPR) could potentially meet this need, a team at the Montefiore Medical Center/Albert Einstein College of Medicine designed a novel evidence-based CBPR model - Bridging Research, Accurate Information and Dialogue (BRAID) - that initiates meaningful, longitudinal dialogues to foster bidirectional trust between researchers, clinicians, scientists and communities.

Methods: A mixed-methods cohort study of two BRAID cohorts was conducted between 2022 and 2023. Eligible participants were recruited from the Bronx, New York, United States and convened in a series of conversation circles. Multimodal data was collected from all participants, including quantitative pre- and post-series surveys and same-day conversation circle feedback forms. Surveys were administered using SurveyMonkey and descriptive statistics were completed in Excel and SPSS.

Results: A total of 42 participants were enrolled, most of whom were people of colour who had not participated in research before. Among them, 40 participants provided at least one response to a same-day conversation circle feedback form, which reflected consistently positive experiences with BRAID. This was consistent with evidence from the post-series survey, in which every one of the 36 respondents stated that they would either definitely (83.3%, N = 30/36) or probably (16.7%, N = 6/36) recommend participation in BRAID to someone like them. Of note, 91.7% (N = 33/36) had already disseminated health information learned through BRAID downstream and 84.4% (N = 27/32) indicated that BRAID strengthened their trust in science and research, highlighting unique and distinguishing features of the model.

Conclusions: Our quantitative evidence suggests that BRAID is effective, efficient and scalable, with experiential evidence supporting that it is reproducible. These factors suggest that BRAID implementation can facilitate rapid, bidirectional information sharing that builds trust between healthcare organizations and communities. This has laid the groundwork for an LHCC in the Bronx, with the potential to be adopted by healthcare organizations elsewhere.