A community engagement program at Montefiore isn't like the others: Rather than lecturing information to its neighbors, the New York City-based system nurtures relationships with local influencers to quell distrust in healthcare.
The program is called BRAID — short for Bridging Research, Accurate Information and Dialogue. Damara Gutnick, MD, senior director of Montefiore's office of community and population health, told Becker's the initiative first started to dispute misconceptions about the COVID-19 vaccine and improve trust in the healthcare system at large.
BRAID recruits trusted messengers in the Bronx and Westchester neighborhoods, which include prominent community members in faith-based organizations, schools, libraries, shelters, food pantries, housing agencies and community-based groups.
In 2021 and 2022, between 50 and 60 influencers shared community concerns so clinicians and scientists could better understand where distrust was stemming from. Together, they codesigned messages that wove accurate health information in ways that mattered and made sense to the community.
"What makes it unique from other models is that it really aims to earn that trust with community leaders who are already trusted messengers or influencers," said Dr. Gutnick, who's also a professor at the Albert Einstein College of Medicine in New York City. "We're writing with them, we're publishing with them."
As these cohorts of eight to 12 people worked together, language moved from apathy to action, she said, as community leaders felt more empowered.
The program published its results in August.
"The one thing we learned that was really humbling to me is that there is significant distrust in healthcare," Dr. Gutnick said. "It's not just one or two people; it's throughout the community. It's because their personal experiences with the healthcare system often felt transactional, they said 'they only spent a few minutes with me.' They loved it when healthcare providers were able to talk to them as equals and get rid of their hierarchy. They said, 'If I had more experiences like this, I would have trusted the vaccine. I would have gotten the vaccine early. I would have trusted science.'"
For example, one mother part of BRAID was wary of the COVID-19 vaccine even though her husband almost died from COVID-19, Dr. Gutnick said. After participating in these conversations, she gained trust in the vaccine, deciding to use motherly guilt to influence her son to become vaccinated. It worked, and a week later she shared her success with her cohort.
BRAID is now evolving past fluid conversations between community influencers and clinicians, Dr. Gutnick said. It has now made a robust network that can create new program ideas and partnerships, and it constructed a space where clinicians can ask questions and community members can bring up other issues.
Those relationships are then strengthened like strands in a braid, which empower community influencers to spread trusted health information within their own spheres of influence.
The program is now recruiting between 24 and 36 people to help codesign messaging about results from a Montefiore-sponsored study, which is investigating the increased risk of dementia among Latino people.