Community Partnership: Supporting Rural Teens into Adulthood
How can researchers gain authentic insights into a community's unique needs and dynamics to best serve them?
An ongoing study following 600 young people in Salinas, California, a small city on California’s rural central coast, showcases how empowering a community to shape research leads to a rich understanding of their experiences and community-driven interventions that maximize their strengths.
Known as A Crecer, the study was launched in 2015 to investigate factors linked to health challenges for young people, including gang violence, unintended teen pregnancies, and mental health. The research team started following the cohort in 8th grade, and their findings highlight the vital role that family plays in positive youth development, reducing depressive symptoms, and enhancing reproductive health knowledge.
Read our Q&A with Marissa Raymond-Flesch, MD, MPH, Associate Professor of Pediatrics in the Division of Adolescent and Young Adult Medicine, who leads UC San Francisco's involvement in the project in collaboration with Research Triangle Institute (RTI), UC Berkeley, and the Monterey County Health Department. An expert in leveraging community voices to design impactful health interventions, Raymond-Flesch details how this project evolved with community input, her role on the team, and plans to follow the same participants into young adulthood to further assess what helps rural youth thrive.
Can you describe the A Crecer partnership?
Initially, the Monterey County Department of Health contacted Dr. Alexandra Minnis, an epidemiologist at RTI with experience in community violence and reproductive health in urban settings, seeking to investigate these issues in their rural context.
That first connection with the health department was crucial, as they helped shape the original grant application and connected the research team with other key community partners. Over the years, our community advisory network has evolved as the study participants aged from 8th grade to young adulthood and includes the local school district, the health department, numerous youth-serving community organizations, and, crucially, the parents and youths themselves.
How did you become involved in this work?
I joined the A Crecer team early in the project, during my Adolescent and Young Adult Medicine fellowship at UCSF. With my background in qualitative and community-based research, I led the formative focus groups with local youth and helped with key informant interviews with school officials and community organizations. These early interactions were pivotal in shaping our research agenda to align with their needs and priorities.
For example, concerns about mental health led us to expand our study. Addressing mental health and including interviews with parents became the focus of my first grant from the National Institutes of Health, which built upon the larger project.
What are the current goals of A Crecer?
The project's scope has broadened significantly from its original focus on understanding how exposure to community and gang violence impacts youth reproductive health. Now, our work seeks to understand youth's diverse trajectories–exploring what factors enable some to thrive while others face challenges.
Ultimately, we hope that by sharing our data with community partners, we can empower them to tailor their programs effectively and reach the children who need their services.
What is your role within the A Crecer partnership?
My contributions have centered around mental health outcomes, the effects of immigration policy on the community, and our qualitative research, including focus groups and in-depth interviews conducted throughout the project. As the team's physician, I also oversee the study's medical aspects, such as testing for sexually transmitted infections.
What are some key lessons learned from this partnership?
Research is most relevant and impactful when guided by the communities it aims to serve. Their insights shifted our focus to identifying ways to leverage the strengths of the community to support adolescents and young adults better. As we move into the next phase of this work, exploring potential interventions based on our findings, maintaining this strengths-based approach and continuing community engagement will be essential.
Support for the UCSF Department of Pediatrics helps drive community-driven solutions that improve youth well-being. Learn more about the A Crecer study.