In Massachusetts, emerging adults aged 18-25 face of arrest, incarceration, and reincarceration than those of other age groups. In recent years, the state government and criminal legal system have formally recognized the significance of this period in which the brain finalizes its development – recognizing that young adults are more susceptible to external influence and risky behavior during this period. At the same time, a person’s risk for death by drug overdose in the first two weeks post-release from incarceration .Ěý

can help break the cycle of reincarceration for young adults. These include educational programming, family engagement, positive youth development, and prohibition of harmful correctional practices (e.g., solitary confinement). Proactive education around risk factors, overdose response, and safer use strategies is one tool we have for reducing fatal overdose in our communities. The Violence and Overdose Prevention Training for Incarcerated Young Adults Initiative, funded by the Â鶹´«Ă˝Ół»­ Innovation Incubator, provides skill-focused training around these topic areas to help incarcerated young adults avoid harmful outcomes related to violence and substance use, access employment, and avoid reincarceration.Ěý

Partnering for Change

Â鶹´«Ă˝Ół»­ has a long-standing relationship with , an organization that nurtures “the ambition of our most disconnected young people to trade violence and poverty for social and economic success.” Over the past several years, Â鶹´«Ă˝Ół»­ has partnered with UTEC on the Emerging Adult Re-Entry Initiative (EARI). This state-funded program bolsters programming with incarcerated young adults both pre- and post-release.

Partnering with UTEC on projects such as EARI makes it possible for Â鶹´«Ă˝Ół»­ to work inside Massachusetts’ correctional facilities. Through EARI, staff were exposed to the unique work of the BRAVE UNIT for emerging adults, which is modeled after juvenile facilities, emphasizing a therapeutic approach and an orientation toward re-entry.   

First Year Outcomes

In the first year of the Violence and Overdose Prevention Training for Incarcerated Young Adults Initiative, we trained eleven emerging adult residents and five older adult mentors of the BRAVE (Building Responsible Adults through Validation and Education) Unit at North Central Correctional Institute (NCCI) in Gardner, MA. NCCI houses individuals who have already been convicted and sentenced (as opposed to those awaiting trial or sentencing). This creates an environment where incarcerated men are settled into a long-term housing arrangement and have more time and motivation to pursue educational programming as well as build relationships with their mentors and other mentees.

Numerous training topics were covered including harm reduction, overdose rescue, trauma, pathways of recovery, stigma, conflict resolution, systemic violence, recovery, safety planning, and healthy masculinity. Participants practiced a variety of critical skills along the way, including overdose reversal, motivational interviewing, public speaking, and more. The learning culminated with an impressive set of “teach back” presentations, where pairs of participants worked together to train a new audience on a topic they learned. The materials and slides from these sessions were compiled into a booklet participants received at the conclusion of the training.  

This initiative was the Â鶹´«Ă˝Ół»­ team’s first significant engagement with young adults in the BRAVE Unit. Their kindness, engagement, curiosity, and critical thinking fueled powerful discussions that assumed little, but moved the needle of opinion significantly. At the end of our training, each participant received a certificate acknowledging their work along with verbal affirmations from staff and others.

On the Horizon

This project has deepened our partnership with UTEC. In the first year, 16 of the 23 members of the BRAVE Unit participated in the program. We anticipate a mix of old and new faces joining the second cohort.

The team is in the process of collecting feedback and suggestions from BRAVE members regarding future curricula to probe deeper into first-year topics while introducing new information, materials, and activities. Given the prominent impact of education and employment on recidivism risk, we are also exploring ways our training series could provide college or other post-secondary credit. This will mean bolstering hard and softs skill training to ensure participants are leaving with increased capacity to meet their future goals, whether that be pursuing further education pre- or post-release, securing stable employment (through UTEC’s Circling Home Fellows program), or sharing their knowledge with their community behind and outside the walls.

Ultimately, we envision a world where all people are equipped with the resources, knowledge, and skills to thrive at home in their communities and where incarceration is no longer the outcome for so many of our young adults across Massachusetts.  

The post The Violence & Overdose Prevention Training for Incarcerated Young Adults Initiative: an Â鶹´«Ă˝Ół»­ Innovation Incubator Project appeared first on Â鶹´«Ă˝Ół»­.

Doulas provide vital non-medical support during pregnancy, labor, and postpartum. Their assistance helps reduce adverse outcomes such as preterm labor, preterm birth, and non-medically necessary cesarean sections. Also, their care contributes to improved breastfeeding rates and lower rates of postpartum depression and anxiety.

The doula care landscape is rapidly evolving in Massachusetts. In December 2023, MassHealth, the state’s comprehensive health coverage for low-income residents, began reimbursing doulas leading to a surge in provider registrations. However, rural areas remain underserved, with fewer registered doulas and lower uptake of doula care among MassHealth-insured residents. With a reduced number of hospitals or long distances between hospitals, minimal access to public transportation, many residents of rural areas of Massachusetts have less access to obstetric care, particularly for high-risk pregnancies.

To support the understanding and dismantling of doula care barriers in rural Massachusetts, ±á¸éľ±´ˇâ€™s Innovation Incubator is funding the Rural Doula MassHealth Registration Initiative. Increasing access to local, culturally responsive doula care in rural areas will help prevent adverse pregnancy, birth, and postpartum health outcomes.

Our Approach

The team conducted a comprehensive assessment to learn about the challenges connected to doula care access. The assessment included an environmental scan, statewide survey, and interviews with doulas and maternal health experts. An advisory group comprised of doulas, researchers, and advocates was formed to help shape the strategy. Members of the group include:

• Hued Mama’s Co.
• The Massachusetts Law Reform Institute
• The Massachusetts Department of Public Health Doula Workforce Team
• Majestic Yoga Studio
• Boston Medical Center
• Beth Israel Deaconess Medical Center

The majority of these members are practicing doulas. Also, there are five additional rural and urban-based full-time practicing doulas joining the group.  During this process, the Â鶹´«Ă˝Ół»­ team built local and national relationships within the maternal health space, ensuring community wisdom and firsthand insights guided the work, bringing forth solutions that were responsive and equitable.

Preliminary Insights 

The statewide survey captured responses from 53 doulas currently providing services across Massachusetts. Survey demographics reflect:

• 66% of respondents report that they provide services in rural areas of Massachusetts.
• 70% of respondents report that they provide at least some services through MassHealth.
• 85% or more of respondents reporting they provide services to low-income clients, Black and Hispanic or Latina/o/x/e clients, and clients not born in the United States.

The team was struck by the sheer amount of labor involved in providing doula care. Doulas can bill for time spent directly with clients. Yet, many essential aspects of their work, such as preparation, travel, and extended hours during labor and delivery (often 24-48 hours), are difficult or impossible to reimburse under current systems, including MassHealth. The commitment and depth of care doulas provide far exceeds what is formally recognized or compensated. 

We asked doulas to help us understand what they perceived as the biggest barriers to serving clients in Massachusetts.

• Â鶹´«Ă˝Ół»­ 63% of doulas said that it is difficult to make a living providing doula care; that rate was substantially higher among doulas who identify as BIPOC (78%).
• MassHealth enrolled doulas and doulas that serve rural clients identified low reimbursement rates as their biggest barrier to serving clients.
• While 28% of all respondents indicated that hospital policies prevent them from attending births, 41% of doulas who serve rural populations reported this challenge.

When asked about the largest barriers for clients in rural areas receiving doula care, 87% of doulas stated low client awareness of services. Other responses included:

• 62% – Long travel distances to care facilities.
• 58% – Doula care not provided in the client’s preferred language.
• 56% – Limited number of doulas in rural areas.
• 53% – Challenges finding doulas in rural areas who share the clients’ racial, ethnic, and/or cultural background.
• 55% – Lack of transportation for clients of rural-serving doulas.

Next Steps

As data analysis continues, insights will shape a community engagement plan. In December 2025, a public report and presentation of findings will be released.  

Year two of the initiative will focus on foundational efforts, laying the groundwork for a longer-term strategy. The strategy will include policy and advocacy development responsive to:

• Increasing client awareness of doula services and benefits.
• Improving doulas’ ability to enroll through the MassHealth program.
• Working with our state and national partners to advocate for doula autonomy and increased reimbursement rates for doula services, and more as they are further integrated into the Massachusetts medical system.
• Continuing support for enhanced doula training and networking in Massachusetts.

With a deeper understanding of these issues, the team can collaborate with their expansive network of doulas, researchers, and maternal health providers to increase the number of doulas registered with MassHealth, particularly in Western Massachusetts and Cape Cod.

The post Improving Maternal Support by Expanding Doula Access in Rural Massachusetts: an Â鶹´«Ă˝Ół»­ Innovation Incubator Project appeared first on Â鶹´«Ă˝Ół»­.

A in Maternal Health report recognizes “Racism, not race, is a primary driver of the social determinants of health. It drives inequities in housing, income, and education, especially among communities of color.” compared to white women in Massachusetts. The state has implemented several policies and programs to address the social determinants of health contributing to maternal mortality disparities. However, there are opportunities to reduce racial disparities at the local level across the state.Ěý

The Black Maternal Health Advocacy Project, funded by ±á¸éľ±´ˇâ€™s Innovation Incubator, focuses on maternal disparities at the local level. Â鶹´«Ă˝Ół»­ is collaborating with five communities in Massachusetts to design advocacy strategies that directly address Black maternal mortality and morbidity disparities. The goal is to close the critical gaps in local and municipal maternal health policies, ensuring community-driven solutions shape lasting changes.

Our Approach  

The project team grounded its approach in two key frameworks. The ensured social, economic, and physical determinants and historical and contemporary injustices were evaluated in relation to Black maternal mortality and morbidity.

±á¸éľ±´ˇâ€™s Health Equity Framework grounded the project’s approach in community engagement. This framework supports a community-driven and led approach. Centering lived experience and building local capacity shifts power and amplifies advocacy strategies aligned with community priorities.

Progress Thus Far

The team completed three key milestones: data synthesis, an environmental scan, and a policy scan. These milestones articulated:

• Where changes should be prioritized. PSE change strategies are ways to make lasting, sustainable changes to support improved environments and behaviors in communities.
• What existing local-level PSE changes have been implemented in communities successfully.
• How to go about advocating for change in Massachusetts communities.  

Using secondary data and community asset analyses, the team prioritized five communities: Boston (Mattapan), Brockton/Randolph, New Bedford/Fall River, Springfield, and Worcester. Communities were selected based on the priority population of Black birthing people and maternal/infant health outcomes.

 An environmental scan revealed several organizations and individuals working to advance maternal health equity in each of the selected communities. The policy scan activities uncovered examples of local PSE changes, along with advocacy strategies that garnered support for a policy or allocation of resources for the sustainability of local public health initiatives. Examples of local PSE changes include:

• Policy: – A universal and unconditional prenatal and infant cash prescription program in which moms receive $1,500 during pregnancy, and babies receive $500/month for 6-12 months until age 1.
• Systems: – A project that collects, publishes, and shares maternal and infant health hospital data. The data helps parents make informed decisions on where to receive care, and the involved hospitals commit to creating action plans to improve care for Black birthing people.
• Environmental: – A program that partners with employers to create a more inclusive work environment that supports breastfeeding mothers in Boston.

These examples of best practices, strategies, and local policies will be shared with the five priority communities.  

With foundational research complete, the team is now engaging directly with communities. They are building relationships with midwives, doctors, doulas, nurses, public health professionals, researchers, subject matter experts, community health workers, and coalition leaders to co-create solutions rooted in lived experience and expertise. 

Next Steps

In November, the project team will launch a website featuring statewide and community-level maternal health data. Resources related to maternal health, advocacy, and a directory to connect individuals, organizations, and coalitions across Massachusetts will be included. In addition, the site will have an intake form for people to contribute initiatives, organizations, coalitions, or resources – fostering collaboration and learning.

As the work progresses, the team will meet with partners in each priority community. Together they will explore local maternal health efforts, identify barriers to policy change, and co-develop advocacy strategies rooted in community experience.

The post Addressing Black Maternal Health in Massachusetts: an Â鶹´«Ă˝Ół»­ Innovation Incubator Project appeared first on Â鶹´«Ă˝Ół»­.

Â鶹´«Ă˝Ół»­ (Â鶹´«Ă˝Ół»­) looks forward to participating in the  in Washington, DC on November 2-5, 2025! Below, you’ll find a list of our team members attending the conference, information on presentations, and curated content and resources to learn more about us. We hope to see you there! 

Conference registration is required for session attendance.

Monday, November 3, 2025

Tuesday, November 4, 2025

Attendees from Â鶹´«Ă˝Ół»­

• Zhaniya Aldekeyeva
• Edward Alexander
• Lisa Aslan
• Mo Barbosa
• Hannah Carliner
• Ariadna Capasso
• Brittany Chen
• Eva Chow
• Angelica Fontes
• Meghan Guptill
• Melissa Mercado (HAVI)
• Erin Miller (HAVI)
• Kathleen McCabe
• Victoria Nemeth
• Tammy Sakala Stossel (HAVI)
• Allyson Shifley
• Ariel Slifka
• Steve Ridini
• Liliana Ruiz Fischer (HAVI)
• Stephanie Walker
• Ben Wood

The post Â鶹´«Ă˝Ół»­ at APHA 2025 appeared first on Â鶹´«Ă˝Ół»­.

M-TAC delivers free training and technical assistance to problem gambling treatment and recovery providers across Massachusetts. Since 2022, Â鶹´«Ă˝Ół»­ has managed M-TAC, leveraging its long history of developing and implementing effective capacity building programs. Â鶹´«Ă˝Ół»­ partnered with addiction and gambling disorder experts at the Division on Addiction at the Cambridge Health Alliance (CHA) to ensure that the program was built upon evidence-based research. Together, these partners work to improve the problem gambling treatment infrastructure that makes recovery possible.

M-TAC’s approach

Through its thoughtful approach to workforce development, M-TAC ensures that behavioral health professionals have the knowledge and skills they need to deliver high-quality problem gambling treatment and recovery services. The program provides:

Course excerpt

M-TAC’s content explores the intersection of problem gambling with identity, substance use, and mental health disorders. This clip is an excerpt from the asynchronous training module: “Addiction Among Those Minoritized by Race or Ethnicity.”

Impact and Evaluation Efforts

M-TAC works to address the effects of gambling expansion on the health and well-being of individuals, families, and communities in Massachusetts. Since July 1, 2022, M-TAC has hosted 65 trainings, yielding over 1,400 participants through January 2025. These engagements translate into a growing body of providers who can offer effective treatment for problem gambling.

An additional component of M-TAC’s work includes increasing awareness and education of screening and assessment tools for Gambling Disorder. Gambling problems often go undetected and untreated, due in part to limited screening, training, and capacity. Unlike other addictions, problem gambling has no obvious physical signs or symptoms. To confront this challenge, the Massachusetts Department of Public Health’s (OPGS) and M-TAC launched a statewide initiative empowering more Massachusetts-based organizations to host Gambling Disorder Screening Day events.

Gambling Disorder Screening Day (GDSD)

GDSD is an international grassroots effort to raise awareness of gambling harm and screening for gambling disorder. To build upon this foundation, M-TAC launched an effort in 2024 to encourage and support organizations in Massachusetts to host their own GDSD events to increase the number of clients being screened for problem gambling. Through this effort, M-TAC provided funding, training, and technical assistance to two cohorts of organizations planning to host events. Below is a snapshot of the initiative and its results.

Feedback about the program was very positive.

This was a great opportunity to help our community better understand the issue of problem gambling and to help inform folks that support, treatment, and recovery are all possible.

GDSD awardee

What’s next for M-TAC?

M-TAC has introduced two new MA PGS certificate tracks, empowering allied health professionals to identify and address problem gambling and related issues. This includes recovery coaches, community health workers, peer gambling ambassadors, and more. By expanding the types of professionals eligible to apply for certification, M-TAC can further grow the state’s capacity to address problem gambling. The program seeks to introduce ~100 additional MA PGS-certified professionals into the treatment and recovery workforce. Meanwhile, the M-TAC team is developing new courses and educational materials to align with program expansion while continuing to meet the needs of the treatment and recovery support workforce.

Leadership

Amanda K. Henry, MPH
Managing Director, Strategic Planning & Organizational Effectiveness

Heather Sumba, MS
Associate Director, Strategic Planning and Organizational Effectiveness

Juliana Libardi Maia, MA
Associate Director, Problem Gambling Services

The post Building statewide capacity for problem gambling treatment appeared first on Â鶹´«Ă˝Ół»­.

Last Modified: 2/1/2025

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This initiative involved a multi-phased approach to examine the department’s equity practices, develop a forward-thinking strategic plan, and equip staff with the tools to enact meaningful change. Recognizing the diverse needs of its divisions – public health, behavioral health, primary care, developmental disabilities, and administration – the project sought to align organizational culture and the department’s mission of equitable service delivery. At its heart, the initiative represented Lincoln County’s commitment to nurture an environment where equity is a value, outcome, and daily practice.

How it worked

±á¸éľ±´ˇâ€™s Health Equity Framework served as the underpinning for the overarching project as well as each individual phase. Central to this framework is the belief that advancing equity requires challenging entrenched narratives, fostering authentic engagement, and addressing power imbalances—principles that guided Lincoln County HHS throughout this process.

This project consisted of three phases:

1. Assessment. The initiative began with an honest examination of the organization’s culture and practices through an equity assessment. The assessment process used staff surveys, focus groups, and community conversations to establish a clear baseline of the department’s strengths and areas for growth.
2. Strategic planning. Assessment findings informed the creation of a three-year strategic plan that prioritized four key areas: access to care, community engagement, staff voice, and organizational culture.
3. Capacity building. Staff training sessions strengthened the department’s capacity to address power imbalances and foster a shared understanding of equity principles. These sessions emphasized the importance of collaboration and accountability, ensuring that staff at all levels felt empowered to contribute to this effort.

Continuous, authentic engagement. A key strength of this project was the inclusion of a Staff Advisory Committee. This committee played a pivotal role in shaping the project’s direction, serving as champions of equity and stewards of organizational change. Their ideas and feedback helped facilitate a process that was inclusive, relevant, and responsive to the needs of both the organization and the community. This dynamic approach ensured that equity was not merely an outcome, but a continuous and evolving process, integrated into the core of Lincoln County’s mission and identity.

Impact

±á¸éľ±´ˇâ€™s framework illustrates that equity-driven culture change – a shared set of values, beliefs, and behaviors – is most effective when embedded into daily operations through thoughtful shifts in policies and practices. By grounding the work in the Framework, the department equipped staff with the language, tools, and confidence needed to confront inequities both within the organization and in the broader community. This culture shift has sparked conversations, collaboration, and a renewed commitment to equity as a shared responsibility among staff.

This initiative stands as a powerful example of what is possible when local health departments prioritize internal change as the first step to advance equity. By fostering alignment and accountability within their walls, Lincoln County HHS is paving the way for more compassionate and effective service delivery, positioning themselves as leaders in the ongoing pursuit of health equity and justice.

The success of this initiative was further recognized on a national stage when Lincoln County HHS and Â鶹´«Ă˝Ół»­ were selected to present their work at the National Association of County and City Health Officials NACCHO 360 Conference in 2023. This honor highlights the significance and replicability of this project, offering an inspiring example for other health departments striving to advance equity. By sharing their journey, Lincoln County HHS is leading the work locally, while also contributing to a larger evolution of public health systems across the country.

Equity is the soul of social justice in public health – when we dismantle barriers within our systems and reimagine how we serve, we honor the humanity of all people and ignite lasting transformation for generations to come.

Jennifer Masdea
Director, Health and Racial Equity, Â鶹´«Ă˝Ół»­

Why it worked

While assessments are vital for identifying strengths and gaps, they often leave local health departments without the tools or guidance needed to act on their findings. By integrating capacity building and strategic planning, this project goes beyond the traditional approach of standalone assessments in favor of a cohesive, wraparound approach to advance equity at the local level. This approach ensures insights gained through assessment translate into effective strategies and sustainable results.

The project’s capacity building sessions equipped staff with the shared language, knowledge, and frameworks needed to understand and address equity challenges. These sessions fostered collaboration, trust, and a sense of shared ownership, cultivating and supporting future collective action. The addition of a strategic planning phase provided a roadmap for success, with clear priorities, measurable goals, and actionable strategies that align with the organization’s values and mission.

What makes this project unique is its holistic approach. The integration of equity as a process and outcome ensures that the work is data-driven and deeply rooted in organizational culture and capacity, creating a model that other health departments can replicate or adapt.

The work we did with Â鶹´«Ă˝Ół»­ helped us lay the foundation for our teams that equity is intrinsic to the work we do.

Florence Pourtal
Public Health Division Director

Looking ahead

The results of this project set the direction for Lincoln County’s new strategic plan. Equity is now central to the organization’s mission and embedded throughout their redefined vision, values, and guiding principles. Soon, Lincoln County will further this work by rehiring a position within the Public Health division that will focus on equity and community partnerships.

Leadership

Valerie Polletta, MSc
Managing Director, Community & Culture Transformation

Meghan Guptill, MPH
Associate Director, Research & Evaluation

Jennifer Masdea, MPH
Director, Health & Racial Equity

Kevin Myers, MSPH
Director, Planning & Facilitation

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We believe that it is not only possible but imperative to address emergent needs in the field for an organization to remain relevant and compelling. To do this, philanthropic organizations must creatively shift their investment strategies at pivotal moments. ±á¸éľ±´ˇâ€™s Pivot framework (Figure 1) offers guidance on how to realize these changes while remaining true to the organization’s purpose. Using our work with a long-time client, we illustrate how to implement investment shifting activities.

The Jeffress Trust Pivot

The Thomas F. and Kate Miller Memorial Trust (herein the Trust) has worked with Â鶹´«Ă˝Ół»­ since 2013. The Trust provides funding to Virginia-based scientists conducting research in bioinformatics, astrophysics, drug development, and material science to benefit residents of Virginia.

Below is a synopsis of how the Pivot framework informed our work with the Trust.

Step 1: Identify the need for change. In 2019, the Trust engaged Â鶹´«Ă˝Ół»­ to explore opportunities to shift investments. To ensure the revised program remained tied to the mission, the Trust and Â鶹´«Ă˝Ół»­ established guardrails on potential future investment options. By limiting potential investments to those that would support work done by Virginia-based organizations for the benefit of Virginia residents, the partners guaranteed that the new program would align with the Trust’s mission.

Step 2: Develop a workplan. Once the need was stated, our team and the Trust developed a workplan. Together, we set a timeline to address questions of interest, expand current program guidelines, and design a new funding opportunity.

Step 3: Conduct a landscape scan. To create a high-impact, targeted investment strategy, our team needed to better understand Virginia’s most pressing health concerns and funding landscape. Our landscape scan aggregated data from secondary sources, funders, and key informant interviews from community-serving organizations and other stakeholders.

Step 4: Recommend funding options. Guided by the scan data, Â鶹´«Ă˝Ół»­ and the Trust discussed various funding approaches and potential outcomes. We confirmed the program should maintain its commitment to funding state-specific projects as decided on/informed by Virginia residents. This action maintains the Trust’s mission of benefitting the people of Virginia and research in chemical, medical or other scientific fields. The data also illuminated the need to support research that centered community voice, facilitated collaboration among organizations, and built capacity in topics related to health equity. The Trust addressed these needs in the program’s funding design.

Step 5: Refine program design. Â鶹´«Ă˝Ół»­ requested feedback on initial drafts of the funding design from various individuals and organizations. This feedback helped refine the program and enhance the Trust’s confidence in their decision to pivot to a new funding area. Also, it deepened the relationship between the Trust and Virginia-based organizations engaged in health equity work.

Step 6: Implement and iterate. The Trust and Â鶹´«Ă˝Ół»­ successfully built a mission-aligned program, embedded with principles that empower those affected by funding. The program announced its inaugural cohort of awardees in 2022. Positive feedback flowed in from stakeholders across the state. The Trust and Â鶹´«Ă˝Ół»­ frequently seek feedback to inform future iterations of the program.

Step 7: Continue learning. One of the Trust’s key listening methods is convening awardees to discuss projects, lessons learned, and opportunities to augment the impact of their work. The Trust is excited to support continued learning across this network of organizations to further advance health equity in Virginia.

A Final Note

The Trust will soon announce its third cohort of recipients. We invite you to read more about the work of current awardees and follow their progress.

Â鶹´«Ă˝Ół»­ seeks to address the root causes of health across all its funding mechanisms. Contact our experienced and trusted team members to learn how we can support you.

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The Jeffress Trust has announced the 2025 recipients of its Awards Program in Research Advancing Health Equity. Congratulations to the awardees!

Scroll on to see the 2023 and 2024 recipients.

2025 Awardees

Partnership/Collaborative Establishment Awards

Enhancing Mental Health Equity: Evaluating Non-Crisis Mobile Mental Health Services

Sabrina Burress, MA HS, MA CMHC, LPC, NCC 

ARROW Project

In partnership with Shenandoah LGBTQ Center, Life Works Project Inc. & Gypsy Hill House 

This project aims to improve access to non-crisis mental health services for underserved communities, especially those that are low-income or marginalized, by using mobile health technologies to reduce barriers like distance, cost, and stigma. With support from the Jeffress Trust, the team will launch and sustain research that evaluates the accessibility, quality, and equity of mobile mental health care through mixed-methods studies. This funding will also support direct community engagement, data collection, and the development of recommendations for scaling services. By centering community voices, the project seeks to identify best practices, promote health equity, and build a replicable model for expanding mental health support across diverse populations.

Developing Culturally Relevant Media To Bridge Information Gaps For African Americans With Uncontrolled Epilepsy: A Community Collaboration

Sandra Dewar, PhD, RN, FAES, FAAN

Virginia Commonwealth University School of Medicine

In partnership with The Epilepsy Foundation

Uncontrolled epilepsy is unpredictable and highly stigmatized, affecting African Americans in the U.S. at three times the rate of Caucasians. This population faces greater barriers to care, lower treatment adherence, and reduced engagement in wellness practices, often due to low health literacy. A recent study by VCU’s epilepsy team found that not knowing others with epilepsy or discussing the condition contributes to isolation, lack of information, and lower quality of life. With support from the Jeffress Trust, the team will produce a professional video series featuring lived experiences of African Americans in Virginia with epilepsy. Community members will be compensated for their input, and the series will be tested in focus groups before its statewide launch—bringing visibility to a community that is often overlooked.

Community Engagement to Reduce Structural Language Barriers to Healthcare Access and Inclusion Along the Route 1 Corridor in Prince William County

Evelyn B. Kelly, MPH

Institute for Public Health Innovation

In partnership with Prince William Health District (PWHD), Edu-Futuro, National Alliance on Mental Illness Prince William Chapter (NAMI PW)

In partnership with the Prince William Health District, Edu-Futuro, NAMI Prince William, and other local organizations, the Institute for Public Health Innovation (IPHI) will explore a culturally responsive model for sharing health information and addressing healthcare hesitancy among immigrant communities along Prince William County’s Route 1 Corridor. Building on the 2025 Community Health Assessment, the project will engage residents to identify root causes of health disparities through participatory mapping and feedback sessions. With support from the Jeffress Trust, IPHI will strengthen cross-sector collaboration, expand training, and elevate community voices to shape local health priorities. The project aims to improve access to care, enhance social supports, and create a replicable model for community-led health interventions.

Breaking Barriers to Bacterial Vaginosis Testing: Advancing Prenatal Health Equity in Virginia through Community-Engaged Women-Centered Research and Action (EMPOWER)

Reem Sharaf-Alddin, MD, MPH, CPH

CONRAD, Old Dominion University

In partnership with Loving Steps and Child Health Investment Program (CHIP)  

Bacterial Vaginosis (BV) affects about 27% of pregnant women in the U.S., with African American women disproportionately impacted and also at higher risk for gestational diabetes, a contributing factor to BV. Untreated BV is linked to preterm birth, which can lead to long-term health issues for offspring. Despite its serious consequences, awareness and screening remain low, especially among African American women. To address this, the EMPOWER partnership—led by ODU and community organizations—will engage women in Eastern Virginia through education, surveys, interviews, and focus groups to identify socio-behavioral barriers to BV testing. Supported by the Jeffress Trust Partnership Collaboration Award, this initiative builds a sustainable community-academic partnership to promote maternal health equity, inform public health policy, and lay the groundwork for future research and action.

Advancing Access to Cancer Screening: Building Capacity for A Faith-Based Navigation Program

Arnethea Sutton, PhD

Virginia Commonwealth University School of Medicine

In partnership with First Baptist Church of South Richmond, Virginia Massey Comprehensive Cancer Center (MCCC) & Facts and Faith Fridays

Black Virginians experience the highest cancer mortality rate in the state, driven in part by limited access to timely, quality screening and the lingering effects of the COVID-19 pandemic on screening recovery. To address these disparities, VCU Massey Comprehensive Cancer Center and First Baptist Church of South Richmond are partnering to develop a faith-based cancer screening navigation program that connects Black communities of faith—and surrounding neighborhoods—with essential screening services. With support from the Jeffress Trust Award, this initiative will build a sustainable, community-facing model for cancer education and navigation, strengthen partnerships, and lay the foundation for long-term efforts to reduce racial disparities in cancer outcomes.

COLOR Theory: Creating Community Partnerships To Combat Implicit Bias For Equitable Birth Outcomes

Kenda Sutton EL

Birth in Color

In partnership with Virginia Commonwealth University & Creating Healthier Communities (CHC) & Lynchburg Hospital

Black women in the U.S. face the highest maternal mortality rate—more than twice that of white women—due to systemic issues like limited access to quality care, provider bias, and social determinants of health. To address these disparities in Virginia, Birth in Color is leading a community-academic partnership with CHC, Lynchburg Hospital, and VCU to develop and pilot a community-informed provider bias training. The project will establish a Community Coalition Board of Black birthing people, partners, doulas, and providers to guide the training and ensure it reflects lived experiences. With support from the Jeffress Trust, the team will implement the COLOR Theory framework, strengthen community engagement, and build a scalable model to improve maternal health outcomes and influence statewide policy.

Research Awards

Virginia Tribal Nations TRUTH (Trust, Research, Understand, Teach and Heal) Project

Katherine Tossas, PhD

Virginia Commonwealth University School of Medicine

In partnership with Chickahominy Indian Tribe and Tribal Health and Wellness Working Group

Building on the Chickahominy TRUTH Project, this initiative will expand to all 11 Tribal Nations in Virginia to investigate the root causes of persistent cancer disparities among Native Americans and identify solutions through community-based participatory research. Findings from the original project revealed the need to examine how structural barriers—like environmental pollution and healthcare inequities—shape beliefs about cancer and influence prevention efforts. With support from the Jeffress Trust Research Award, the Virginia Native Nations Against Cancer (VANNAC) project will collaborate with Tribal leaders to explore these drivers, train Community Health Workers, and develop culturally grounded strategies for cancer prevention and care. This award helps establish a sustainable, Tribal-led research infrastructure that centers Native voices and advances equity in cancer outcomes across generations.

Evaluating How CHW Training And Certification Improve Employability

Shanteny Jackson, MA, CCHW, CSAC

Virginia Community Health Worker Association (VACHWA)

In partnership with Dr. Obasanjo

Community Health Workers (CHWs) play a vital role in improving health access in underserved communities, yet many face the same social and economic challenges as those they serve. This project explores how CHW training and certification can lead to stable careers and economic mobility for individuals from low-income backgrounds. With support from the Jeffress Trust Research Award, the Virginia Community Health Workers Association will study how certification opens pathways to sustainable employment while empowering CHWs to address health inequities through lived experience. This research will strengthen CHW-led organizations, expand access to care, and build a model for workforce development rooted in community health.

2024 Awardees

Partnership/Collaborative Establishment Awards

Advancing Health Equity for Birthing People With Substance Use Disorders: Capacity Building Of A Community Partnership Team For Intervention Development And Implementation Research 

Caitlin Martin, MD, MPH 
Virginia Commonwealth University
in collaboration with Urban Baby Beginnings, Rams in Recovery & OB MOTIVATE Clinic 

Data demonstrates that structural racism is a key driver of large gaps in treatment continuity experienced by Black birthing individuals with substance use disorder in central Virginia. VCU and collaborators will develop and implement a patient navigation model specifically for Black birthing people with SUD. This model will incorporate peer recovery support specialists, doulas, and people with lived experience as Black birthing parents with addiction.  

RVA Latino Youth Coalition: A Community-Academic Partnership to Support The Mental Health Of Latino Youth In Richmond 

Gabriela LeĂłn-PĂ©rez, PhD
Virginia Commonwealth University
in partnership with Waymakers Foundation, Richmond Public Schools, the City of Richmond’s Office of Immigrant and Refugee Engagement & Virginia Department of Health 

The mental health problems experienced by Latino immigrant youth in Richmond, Virginia are well-documented. To address these inequities, VCU and collaborators will create a community-academic partnership – the RVA Latino Youth Coalition. The project team will establish Youth and Parent Advisory Groups comprising Latino community members to advise the coalition, facilitate a community-informed strategic planning process, and conduct a participatory community assessment to identify the drivers of mental health inequities and existing mental health resources and services available to Latino youth in Richmond. 

Building Enclave Solidarity to Improve Health Outcomes 

Carol Cleaveland, PhD
George Mason University
in collaboration with Gainesville-Haymarket Rotary Foundation & Georgetown South Community Foundation 

Undocumented Latino immigrants experience pronounced health inequities, often exacerbated by a lack of health insurance. GMU and collaborators will establish a research consortium to improve access to preventative care for undocumented Latino immigrants by strengthening social networks and knowledge-sharing among community members. The team will develop a strategic plan, with the aim to deliver vaccines and preventative health services to 10,000 Latino individuals living in low-income neighborhoods. 

Virginia Healthy Pantry Initiative

Meaghan Butler 
in collaboration with Blue Ridge Area Food Bank, Capital Area Food Bank, Feed More, Inc., Feeding Southwest Virginia, Fredericksburg Regional Food Bank, Foodbank of Southeastern Virginia and the Eastern Shore, Virginia Peninsula Foodbank 

Led by the Federation of Virginia Food Banks, the Virginia Healthy Pantry Initiative (HPI) is a statewide movement of advocates and pantries committed to breaking the cycle of food insecurity and poor health. More than half of Virginia’s 1,100 pantries have already joined the Healthy Pantry Initiative. The Federation seeks funding to better understand the practices’ successes and challenges at scale and ensure equitable access for people and places most in need. Collaborators have committed to regular peer support, data sharing, and consistent evaluation practices with a vision to improve hunger and health outcomes for more than 800,000 Virginians facing hunger. 

Research Award

(Re)Building Trust in Tap Water through Community Advocacy and Action 

Sarah Holland 
in collaboration with Virginia Tech and Virginia Community Health Workers Association 

Mistrust in and subsequent avoidance of tap water has critical implications for health equity. The project will employ iterative cycles of participatory action research in geographically focused communities across Virginia that are most impacted by water inequities. Community health workers serving as water advocates will play an integral role in facilitating the research process, sharing findings back to community members, and (re)building trust in tap water. Acknowledging that water issues and solutions are highly localized, this project lays the groundwork for the development of a statewide network of communities that act, advocate, and engage in local decision-making to advance water security. 

2023 Awardees

Partnership/Collaborative Establishment Awards

Impact of Medical-Legal Partnership (MLP) Collaborative Upon Social Determinants of Health of Low-Income Individuals in Rural Southwest Virginia

Matthew Loos, MD, FACS, MBA
Ballad Health, in partnership with Appalachian School of Law – Virginia Tech – STRONG Accountable Care Community

Despite the establishment of numerous MLPs throughout the U.S., there are few published studies on the impact of MLPs on healthcare and outcomes. This collaborative project establishes an Advisory Council to collectively study and develop MLP best practices for programmatic and coordinated community response. We anticipate the data will illuminate how health-harming legal needs are impacted through MLP intervention with free legal services to address social determinants of health (SDOH).

Centering Black Voices: An Exploration Of Current And Historical Black Breastfeeding Experiences In Their Own Words

Sara Rothenberg, MPH
Eastern Virginia Medical School, in partnership with The Consortium for Infant and Child Health – SonShine and Rainbows Lactation – From the Start Holistic Doula Services – #757Breastfeeds

The project seeks to address and uproot structural racism that underpins maternal and child health inequities by centering Black voices, building community capacity, and decolonizing breastfeeding research.  Through sustainable, respectful collaboration, this project will lay the groundwork for future research, publication, and more effective public health strategies for advancing maternal child health equity.

Advancing Health Equity through a Regional Coalition for Reducing Opioid and Substance Use

Shuntay Z. Tarver, PhD, MSW
Old Dominion University, in partnership with African American Creative Community Series – James Barry Robinson Institute – Hampton-Newport News Community Services Board

There is a critical need in Virginia to reduce opioid and substance use (O/SU) and overdose-related deaths. The project seeks to advance health equity by developing a culturally-informed, data-driven regional coalition. The desired outcome is to decrease O/SU and overdose-related deaths among Black and low-income families within the cities of Norfolk, Hampton, and Newport News, VA.

Research Awards

Keep People Covered: Analyzing the Medicaid Unwinding and Redetermination Process through a Person-Centered, Racial Equity Lens

Freddy Mejia
The Commonwealth Institute for Fiscal Analysis, in partnership with Sacred Heart Center – Peter Paul Development Center – Virginia Poverty Law Center – Virginia Community Voice

In April 2023, Virginia will begin to review all Medicaid enrollees’ eligibility, a process called “unwinding” and start ending coverage for those found ineligible. The unwinding process will require enrollees to update contact information and submit all required paperwork in a timely fashion. Caught in the middle of this process are approximately 160,000 individuals and families who remain eligible but are most at risk of losing coverage because of administrative hurdles and/or language access issues. The current administration in Virginia has not shared its posture on the Medicaid redetermination process. This is concerning to advocates due to national research from the Department of Health and Human Services. Research estimates children, Black, and Latino individuals are most likely to be disenrolled while still being eligible for coverage.

At the core of this project are three goals:

• First, through research and analysis, act as a watchdog that brings accountability and an equity focused lens on a complex process that may leave individuals and families uninsured on account of technicalities.
• Second, drive education efforts to help as many people as possible weather the “unwinding” storm and preserve their health insurance.
• Third, leverage the research to change systems to improve the current redetermination process in the moment and create better health access programs, processes, and communications in the future.

Using a participatory research approach combined with analysis of data from EnrollVA and state agencies, and advocacy action we can achieve both meaningful research findings and changes in public policies. We plan to create and maintain a real-time dashboard that can inform decisions during the three year period. Additionally, we will disseminate findings with strategic communications and coordinate with our partners including members of the Collective Work coalition focused on racial justice and the Health Equity Action Leaders program.

Uncovering Immune Inflammatory Axes of Racial Disparities Linked with Gestational Weight Gain in Pregnant Women

Sepideh Dolatshahi, PhD
University of Virginia

Obese Black women experience an increased risk of inadequate Gestational Weight Gain (iGWG) compared to White women within the same BMI groups. Importantly, obesity and iGWG are both associated with adverse pregnancy outcomes such as preterm birth, which in turn predispose the newborn to a myriad of early-life health complications. As such, concurrent higher prevalence of iGWG and obesity in non-Hispanic Black women points to distinct profiles of Social Determinants of Health (SDoH) that separately drive these risk factors to birth disparities.

The proposed study aims to dissect these two hypothesized distinct pathways of racial disparities from the root/trunk (SDoH) to the middle branches (perturbed baseline immunity and the immune remodeling) to the outer leaves (adverse clinical outcomes) of the tree. While sparse attempts to stratify the contributors to obesity and iGWG as they relate to pregnancy outcomes have been published, these studies are essentially lacking in the Virginia. Moreover, African Americans have been underrepresented in immunological studies of pregnancy.

To address these limitations, we will use innovative systems biology and data-driven statistical modeling approaches to examine a unique cohort of racially diverse pregnant women of Virginia. By combining SDoH information with high-plex maternal and placental measurements, we anticipate that we will identify novel social and immune axes that may inform the design of preventative, diagnostic, and therapeutic strategies that will improve pregnancy outcomes.

Â鶹´«Ă˝Ół»­ the Trust

The Thomas F. and Kate Miller Jeffress Memorial Trust, founded in 1981 by Robert M. Jeffress in memory of his parents, is guided by its mission to benefit the people of Virginia and their research in chemical, medical, or other scientific fields. Since its founding, the Jeffress Memorial Trust has been a steadfast benefactor in support of scientists and research across the state of Virginia supporting mathematical modeling/simulations and analytics in bioinformatics, astrophysics, mathematical biology, drug development, and material science. To further the mission of the Jeffress Trust to benefit the people of Virginia, the program was changed in 2022 to the Jeffress Trust Awards Program in Research Advancing Health Equity.

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Background

The CHI framework as we know it rose to prominence in the mid-1990s by way of the Institute of Medicine Committee on Using Performance Monitoring to Improve Community Health (). Later, the Affordable Care Act (ACA) spurred the IRS to introduce new regulatory requirements for tax-exempt organizations. This included implementing regular community health needs assessments and implementation plans () and the introduction of accreditation for local and state public health departments ().

±á¸éľ±´ˇâ€™s Approach to Community Health Improvement Work

±á¸éľ±´ˇâ€™s staff has a long track record of supporting CHI processes in many hospitals and health departments. Health departments and care providers alike maximize the benefits of CHI work when they invest in the full cycle of the process. As seen in Figure 1, ±á¸éľ±´ˇâ€™s Approach to CHI work comprises six steps:

• Assessment
• Prioritization
• Planning
• Implementation
• Monitoring
• Evaluation

Each of these steps builds upon the previous step, creating a comprehensive and intentional process with health equity at the core. Community engagement is the essential element at each phase of the CHI process. Integrating community engagement and leadership ensures health equity is a focus and outcome of CHI work. As our framework demonstrates, ±á¸éľ±´ˇâ€™s approach to CHI reflects a deep commitment to equitable community engagement. (See our approach in action.)

Sticking Points

CHI work often stagnates after planning. Four of the most common reasons include:

• Inadequate time and resources
• Insufficient community engagement
• Unclear systems of accountability
• Lack of integration with practices and systems

Does this describe your institution? Here are a few practical strategies to support completion of the CHI cycle:

Inadequate time and resources.

Community engagement is rarely (if ever) the only initiative underway at any moment. Like any other effort, community engagement work vies for limited resources. Even if financial resources are not a limiting factor, time certainly is. Strategic plans only last for three to five years, and organizational and community leaders have competing priorities; additionally, CHI work is often added to plates without adjusting other priorities. What do you do when your team or institution does not – or cannot – allocate sufficient time or resources to conduct deep, continuous community engagement?

STRATEGY: Provide sufficient resources (including dedicated time and funding) for staff and community leaders conducting CHI work.

Community members are essential to successful CHI work. Engagement starts at the beginning; it both informs and integrates with the methods and approaches outlined in the assessment, continues as appropriate through each phase, and influences planning for the next round of the cycle. Ensure that you factor in fair compensation for the time and the lived experience of community members and the staff who work with them. This means meeting residents where they’re at and when they’re available, providing translation services, and rebalancing responsibilities—during AND beyond the assessment phase.

Insufficient community engagement.

Improving community health requires deep, authentic, sustained community engagement. By limiting your engagement to the people that you work with regularly in the assessment and planning processes or relying on secondary data, you are likely missing the voices of those most impacted. Offering limited options for participation or failing to follow up in future phases can damage relationships with the community. How can you deepen your community engagement work efficiently and effectively?

STRATEGY: Create varied and recurring opportunities for power shifting and decision making.

Community engagement that considers the different needs within the community can increase the likelihood of your CHI work creating impact. Identify opportunities for sustained engagement throughout the process, such as multiple community meetings at a variety of times (considering varying work and caregiving schedules of participants). Collaborate with existing coalitions and community groups to reach folks in places where they already congregate.

Ultimately, the community should strongly influence the selection of priorities based on what is important and relevant to them, as well as the development, implementation, and improvement of the strategies put into place. Use the to explore how you might lift up community voice and incorporate public participation strategy

Unclear systems of accountability.

Generating community impact requires collective effort within complex institutions and among diverse stakeholders. Typically, a single unit is not responsible for all parts of the CHI process. However, the work can end up falling on the shoulders of one individual or department, or tasks can be lost in the shuffle of unclear systems of accountability, drastically limiting your potential impact.

STRATEGY: Coordinate communication among partners.

When partner engagement is done well (authentically and sustained), your hospital or health department will not be solely responsible for all CHI work. Careful coordination of communication and outreach is needed when there are multiple stakeholders responsible for the plan. Defining roles at the project outset, as well as setting a schedule for regular monitoring and reporting are critical steps to ensuring accountability, continuous buy-in, and impact.

Lack of integration with practices and systems.

Hospitals and health departments often struggle to implement a plan that is not sufficiently integrated with their other work, does not have internal and external investment and support, and is not regularly monitored and reported.

STRATEGY: Integrate with existing practices and systems.

Thoroughly integrating CHI work with other critical work will ensure that the work gets done. Identify areas where CHI work intersects with existing practices and systems. Look into other initiatives happening in your community and identify places where you might collaborate on data collection, engagement, dissemination, and more. Considering existing avenues can streamline your work and build stronger partnerships with anchor institutions and community members.

Next steps

The CHI process offers an opportunity to create healthy, equitable communities. Authentic, sustained community engagement throughout the CHI process is critical to success. Pour the time, dedication, care, and feeding into your process and the impact will be worth the effort.

Learn more about ±á¸éľ±´ˇâ€™s CHI work and team.

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Suggested citation: Community Health Improvement Lens (2024), illustration by Â鶹´«Ă˝Ół»­.

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