1. San Francisco Department of Public Health
CHC Research: Innovation Will be Built on Experience The CHC Perspective
Irene V. Hilton DDS, MPH
San Francisco Department of Public Health
UCSF CANDO Center
November 3, 2009

2. University of California San Francisco- CANDO
Original cohort of 5 Centers to Reduce Oral Health Disparities
Initial community partners
San Francisco Department of Public Health
San Ysidro Community Health Center

3. The HC Conumdrum Populations with the poorest health status
Populations that could benefit most from results of research, the fastest
Populations that have traditionally not been represented in research

4. HC 2007 Demographics 2,808,418 dental users
28% of all HC populations African American
34% of all HC populations Hispanic
1% of all HC populations AI/AN
70% of all HC populations under 100% of FPL
21% between % FPL

5. The HC Concondrum Research activities NOT the primary mission of HC
The least infrastructure to support research
Knowledge
Data
Mistrust

6. Support for Successful Collaboration
Money
Time
Respect
Academic Institution
Health Center

7. Institution-Health Center Relationships
Innovators are those that already have relationships
Time & resources to initiate and maintain
Long-term/permanent to create trust

8. Health Center Infrastructure
Innovators have existing personnel familiar with research methodologies
Innovators have IT systems that can accommodate research data collection
Time & resources to initiate and maintain

9. Finding Common Ground
Issues HC & community identifies as important and of interest
What the institution has already been funded for and/or is interested in pursuing
Areas of expertise

10. Type of Research
Basic initial research i.e. disease prevalence, risk factors, cultural determinants
Retrospective
Qualitative
Clinical interventions
Effectiveness studies
Translation/ implementation studies
RCT very difficult

11. Translation/Implementation Activities
HC are already very good at this
Long history of exposure & adoption of new paradigms & clinical interventions
1996- ECC risk assessment & fluoride varnish
1998- Diabetes & oral health
2006- Medical-Dental integration
No data

12. What Health Centers Need
Resources/Money
Appropriate staffing/expertise
Supplies/Equipment
Clear well-thought-out protocols that work within or complementary to the existing clinic systems

13. Current Reality
Only a few HC could currently conduct any type of research activity
If desired by both partners, collaboration could be explored
Should be pursued because HC populations are most in need
Must be done in the right way or will fail

14. Conclusion
RESEARCHER