The UCSF Family and Community Medicine Residency Program's Advocacy, Community Engagement, Quality Improvement, and Leadership Academy (ACQILA) helps trainees develop knowledge, attitudes, and skills to promote equity and health for vulnerable populations, inside and outside clinical walls. The longitudinal curriculum focuses on understanding the comprehensive needs of the ZSFG patient population (R1 year), strengthening non-clinical skills that can help leaders take action to improve population and community health (R2 year), and applying those skills in community-engaged leadership projects (R3 year). Residents have the option of working on established, ongoing projects or pursuing individual interests.
Summer Urban Health Leadership Academy (SUHLA) Projects
Residents have the option of working on logitudinal projects with the Summer Urban Health Leadership Academy (SUHLA), a pipeline program designed by UCSF/SFGH Family and Community Medicine residents and faculty to encourage local public high school students to explore healthcare related fields and ultimately to increase diversity in the healthcare workforce.
Angeli Bueno, Spring 2019: FACES for the Future/Music and Memory
Dr. Bueno facilitated the Winter 2019 FACES/Music and Memory sessions alongside FCM faculty member Dr. Manuel Tapia. FACES is a 10-week long healthcare internship program at SFGH and Laguna Honda Hospital for juniors and seniors at John O'Connell High School. It is a pipeline program aimed at increasing the diversity in the healthcare workforce. Dr. Bueno guided students from John O'Connell High School through interactions with geriatric patients on the ACE unit at SFGH. She also worked on streamlining the curriculum around shadowing at the Family Health Center to provide both students and residents with a more cohesive experience.
Teresa Gomez and Alma Sanchez, Fall 2017: Music and Memory: Curriculum for SUHLA Student Participants
Drs. Gomez and Sanchez contributed to the FACES for the Future program, a eight-week internship program for high-schoolers, by developing a curriculum focused on themes of interpersonal and patient-centered communication, professionalism and medical knowledge, specifically dementia and how it affects elderly patients. Of note, this project was a continuation of the Music and Memory project that created a unique opportunity for high school students to interact with elderly patients in a hospital setting. Every Wednesday morning, two 12th grade students met with family medicine residents and/or faculty for didactics. After each didactic session, the students were accompanied into the hospital, where they were able apply their knowledge and interviewing skills to meaningfully interact with patients on the ACE unit. The students completed pre- and post-surveys, which demonstrated students’ increased comfort in interacting with elderly patients and a new understanding of dementia and the importance of music in these patients’ lives.
Meredith Mirrer, Antonio Olivarez, and Maggie Dietrich, Summer 2017: Music and Memory: Creating meaningful patient engagement opportunities for pipeline students
Drs. Mirrer, Olivarez, and Dietrich contributed to the SUHLA pipeline Health Professions Exposure Curriculum by designing a unique opportunity for high school students to interact with patients. Through their work with the ACE unit team and the SUHLA fellows, they developed a meaningful patient engagement experience for high school students to meet and interview hospitalized patients. Students completed a training session with Family Medicine residents focused on themes of interpersonal and patient-centered communication, as well as professionalism, prior to their participation on the wards. After interviewing patients on the ACE unit, the students were able to provide personalized therapeutic listening experiences for patients, and listen to music with them. Upon completion of the interviews, they held a debriefing session with the students and conducted a focus group to plan future sessions.
Kenneth Payan, Fall 2016: Mentoring Program
Dr. Payan developed a questionnaire and an email template to facilitate the process of connecting SUHLA Fellows to UCSF mentors who are involved in community engagement projects and/or advocacy work. He found mentors for SUHLA Fellows who participated summer 2016, and developed learning objectives and discussion questions for the high school students who will be participating in SUHLA summer of 2017 that promote reflection, critical thinking and professional growth during their clinical shadowing experiences at the FHC. Dr. Payan constructed a plan to coordinate the clinical rotations for the high school students to shadow.
Kimmy Chela, Fall 2016: Curriculum Development—High School Students
The specific objectives of this project were to obtain feedback on a reproductive health and justice curriculum used to teach high school students and to use the feedback to further improve the curriculum. Three questionnaires were developed: 1. to assess the high school students’ knowledge prior to the workshop so that the curriculum could be tailored accordingly, 2. to obtain an evaluation by the high school students immediately after the workshop for feedback, 3. to obtain an evaluation by the SUHLA fellows after the workshop for feedback.
Migdalia Ordonez, Spring 2016: Curriculum Development—Fellows
The Summer Urban Health and Leadership Academy Fellowship needed assistance with curriculum development to provide fellows with transparent goals and objectives and have documentation for future residents to utilize in fellowship seminar planning. Dr. Ordonoez utilized Socrative evaluations completed during last year's SUHLA fellowship to determine needs and interest of specific speakers/activities. She also completed a thorough literature review for curriculum development, social determinants of health, and caring for vulnerable populations to develop specific goals and objectives. She developed an evaluation for fellows to complete pre- and post-fellowship to determine knowledge base, effectiveness of goals, objectives, speakers, and activities.
Lauren Wolchock, Fall 2015: Grant Writing
Dr. Wolchock's goals were to identify potential funding sources and create a draft grant proposal to help seek continued funding for the Summer Urban Health Leadership Academy (SUHLA). SUHLA benefited from support and funding through the UCSF Department of Family and Community Medicine and state grants in its inaugural summer in 2015, but we will need to seek a broader funding base in this and future years. We are very proud of what our first SUHLA participants accomplished and have every confidence that future generations of residents will ensure that SUHLA continues to grow and thrive—and there is plenty of room for interested residents to get involved now!
Mission Boys & Girls Club Projects
Through the ACQILA program, four third-year residents partnered with the Mission Boys and Girls Club (B&GC) to develop a reproductive health curriculum with B&GC teens, and to train interested teens as peer educators.
Marina Cervantes, Emilia De Marchis, and Sky Lee, Fall 2016, Winter 2017, and Spring 2017: Curriculum Development
Through a partnership with the Boys and Girls Club of the Mission, Drs. Cervantes, De Marchis, and Lee led efforts to create a peer-education curriculum on topics of sexual health. They worked closely with high school peer educators, educating them on topics of birth control, puberty, sexual health, health advocacy, and leadership. Partnering with a local community organization gave residents valuable experience in building relationships outside of the hospital, and enabled them to use their medical knowledge to target high yield adolescent health topics, and equip the involved teens with the skills to disseminate their knowledge to their peers and enhance their leadership skills.
Ignacio Becerra-Licha and Danielle Alkov, Winter 2016: Curriculum Development—High School Students
Drs. Becerra-Licha and Alkov contributed to the SUHLA pipeline project by creating a Health Professions Exposure Curriculum aimed at increasing high school student interest in health related fields. Using the FACES core competencies as a guide, they developed four clinical skills sessions that exposed the high school students to vital signs, human organs, health field communication and patient simulation models. After completing the clinical skills sessions, students showed an improvement in test scores as compared to pretest values as well as showing an 8% increase interest in a health careers.
Nathan Stern, Winter 2016: Curriculum Development—Fellows
Using data gathered from last year’s Fellowship and interviews with the prior Fellows, Dr. Stern evaluated the prior curriculum and created a draft of this year’s curriculum. He also worked to create a timeline for the Fellowship and an application to be distributed to possible Fellows.
Emily Guh, Summer 2016: Partnership Development
Dr. Guh re-established the relationship between the UCSF FCM residency and the Boys and Girls Club Mission Clubhouse and laid the foundation for a peer health advocacy and teen mentorship program. While adolescence is an incredible period of growth in a person's life, it can also be vulnerable time. The goal of this project was to create a partnership with a community organization whose purpose is to educate adolescents on topics pertinent to leading healthy relationships by using a structure that fosters mentorship and leadership.
Encampment Health Collaborative
Milana PeBenito, Fall 2017: Providing Health Care at Homeless Encampments
Despite the wealth of medical resources available to all residents of San Francisco, our neighbors who are surviving homelessness face tremendous barriers to accessing care, including lack of basic food and shelter, and the general disorganization that results from constant displacement and harassment. These barriers result in high rates of avoidable morbidity and mortality, including a disproportionate burden of infectious diseases such as Hepatitis C, HIV, gonorrhea, and chlamydia, as well as unintended pregnancy and addiction. Dr. PeBenito participated in the Encampment Health Collaborative with the goal of helping patients living in encampments to access low barrier high yield medical care to minimize the burdens of disease. Dr. PeBenito brought medical care, food, clean works and needs, and kindness directly to the street to partner with patients to engage with medical care and overcome barriers to wellness.
Jen Karlin and Judy Hong sFNP, Summer 2017: Providing Health Care at Homeless Encampments: Establishing medical and follow-up protocols and developing education materials for providers and patients
The Encampment Health Collaborative is an initiative that has brought together community-based organizations, the department of public health, and physician residents from UCSF with the goal of providing on-the-spot access to health care for people living in the homeless encampments in San Francisco. Priorities include harm reduction (syringe access, narcan training), testing and treatment for STDs, HIV treatment and prevention (with PREP), testing for other communicable infectious diseases, vaccinations, family planning, and screening and treatment for opioid addiction. The initiative also aims to connect patients with primary care providers whom they can trust. Dr. Karlin have helped to establish the medical protocols for preparation for the event (organizing providers and orientation materials), protocols and materials for the day of event flow, and tracking protocols for patient follow-up. Dr. Karlin also developed education materials for the provider manual about low-barrier access to health care, patient education materials, and resources for follow up including directions and maps for follow up care.
Advocacy Projects
Ryan Huerto, Spring 2019: Workforce Diversity and Widening the Pipeline to Medicine
Workforce diversity among healthcare providers has been shown to improve patient health outcomes, and thus remains a priority for many of our residents. Dr. Huerto aimed to widen the pipeline to healthcare careers for underrepesented minority (URM) pre-health students through career exposure, academic support, college counseling, mentorship and increased visibility of URM healthcare providers.
Chantal Lunderville, Fall 2017: Promoting Trainee Driven Advocacy and Curriculum
Through Physicians for a National Health Program (PNHP), Dr. Lunderville led the residency program in hosting workshops and information sessions about single payer and SB562, as well as developed self-assessments and surveys to understand residents’ and students’ prior skills sets and specific advocacy interests. She then created programming to suit their goals including a Writing For Change Workshop and guidance and support on a social media campaign. She also created a template for future UCSF FCM third year residents interested in advocacy during their elective months, specifically geared towards teaching advocacy to students and learners, engaging political figures, writing, and public speaking.
Nicole Person-Rennell, Spring 2017: CAFP Reproductive Health Resolution Project
To advocate for reproductive health in the setting of increasing political adversity and emphasize reproductive health within the scope of family medicine, Dr. Person-Rennell developed an advocacy plan through the California Academy of Family Physicians. After identifying an area of need by reviewing AAFP materials and discussing with faculty mentors, she utilized the CAFP resolution guidelines and drafted a resolution to include full spectrum family planning and gynecologic procedures into AAFP website and promotional materials. She presented this resolution at the CAFP All Member Advocacy Meeting in March, 2017 in Sacramento and requested presentation at the AAFP meeting.
Leah Rorvig, Summer 2016: Op-Ed
Dr. Rorvig crafted an op-ed voicing the physician perspective in favor of cannabis legalization. This was published in the Huffington Post.
Suzanne Barakat, Summer 2016: TED Talk
Dr. Barakat gave a TED talk on Islamophobia.
Anna Loeb, Spring 2016: Family Planning Advocacy
For her ACQILA project, Dr. Loeb wanted to use the opportunity to gain more advocacy experience, particularly around issues of family planning. First, she had the opportunity to go to the Capitol in Washington D.C. to participate in the EACH Woman Act Lobby Day to advocate for restoring public insurance coverage of abortion care. She wrote an article about my experience for the TEACH blog: http://www.teachtraining.org/lobby-day-experience/. She also co-wrote and presented a resolution to the CAFP asking that the CAFP advocate that over-the-counter emergency contraception be a covered benefit under Medi-Cal.
Lamercie Saint-Hilaire and Diana Wu, Winter 2016: An Anti-Oppression Curriculum for Healthcare Providers
As family medicine physicians, lectures on social determinants of health are essential to our training, but they often focus on well-known systemic disparities and lack self reflection. Drs. Saint-Hilaire and Wu sought to reframe the discussion by developing a curriculum to promote ownership of the complicit nature of oppression and offer strategies to be an agent for change. Results from pre- and post-surveys showed statistically significant improvement in participants’ ability to understand, assess, and address unconscious bias and allyship.
Community Engagement Projects
Kira Levy, Spring 2019: Community Engagement: CARECEN
Dr. Levy partnered with CARECEN, a program that supports Latino, immigrant, and under-resourced families in the San Francisco Bay Area with legal assistance, family wellness, and health promotion. Her goal was to build a relationship between the Family Health Center and CARECEN so that patients would have better access and awareness of the services available in the community. Dr. Levy arranged to teach a refresher course to health workers at CARECEN and reviewed the curricula used by CARECEN to teach about diabetes, healthy eating, cholesterol, and oral health. CARECEN is setting up workshps at the FHC to exposure patients to their resources.
Kenji Taylor, Spring 2018: The Cut Hypertension Program (CHP)
Black men have the highest rates of hypertension-related death of any other demographic group. Dr. Taylor partnered with researchers and coaches from the Centers for Excellence in Primary (CEPC) to provide health coach training to barbers in the Bay Area and barbershop-based outreach to improve rates of uncontrolled hypertension among African American men. Participants in the program reported an increase in confidence in their abilities to define various health conditions, such as hypertension and diabetes, as well as discuss ways to manage these conditions. The CHP continues to work with barbers to indentify community-specific needs and resource, while supporting barber-led barbershop-based events to promote health advocacy in their community.
Jolie LeBlanc and Hannah Snyder, Spring 2017: Substance Use Outreach for Jail Health
This was a partnership with Five Keys Charter School to provide high quality information about substance use disorders and their management to San Francisco County Jail inmates and their Five Keys Charter School case managers. Inmates learned about substance use effects on the brain and the body, substance treatment, and harm reduction. Case managers learned about the effects of incarceration on health, including diet, traumatic brain injuries, mental health, substance use, and motivational interviewing.
Floria Chi, Winter 2016: Professional Development Training about Victims of Trafficking
Working with community organizations, Newcomers Health Program, Medical Legal Partnership, and the Behavioral Health Team, Dr. Chi developed a standardized algorithm for screening and referring patients who are suspected victims of trafficking, and the Family Health Center providers will be trained on its use. Next steps that interested residents could take on include: assessing implementation of the algorithm, patient experiences, provider attitudes and practices; maintaining relationships with community organizations serving this population; and ensuring accessibility and sustainability of the algorithm.
Nazneen Uddin, Fall 2015: Muslim Fellowship
The San Francisco Muslim Fellowship is an initiative to bring together English-speaking Muslim brothers and sisters who otherwise feel disconnected from the Muslim community, such as individuals who have a current or past history of housing instability, prison or jail time, violence, or drug use. Our goal is to create an open, welcoming, and confidential space to discuss life and faith to heal and re-establish a sense of community.
Meghan Woods, Fall 2015: Street Level Health Project
Dr. Woods led the Street Level Health Project, in which each homeless person is treated as a whole person and physicians work on addressing his or her needs with our co-located services and referrals to our long-term partner organizations. Our model uses both direct services to meet immediate needs and multi-faceted advocacy strategy to combat upstream causes of poor health. The Immigrant Rights and Empowerment program offers a space for low-wage workers to come together, as well as an organizing body, called La Colectiva, to increase job referral, leadership development and occupational health knowledge. The Health Access Program provides a free multi-lingual drop-in medical clinic, healthcare navigation, herbal and nutrition consultations, psychologist consultations, food bank and meals. We are also developing a food justice program.
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