Early reflections on the adaptation and dissemination of a race-based stress, trauma, and empowerment class for community churches

Nuha Alshabani, PhD (L), Devin Cromartie, MD, MPH (C), and Sarah Valentine, PhD (R) are recent awardees of the Blue Cross Blue Shield of Massachusetts (BCBSMA) Foundation grant entitled, “Adaptation and dissemination of a race-based stress, trauma, and empowerment class for community churches.”

“I feel grounded in this conversation, I feel that I can be my authentic self,” shared a clinician during our workgroup meeting today. Sitting in a (virtual) room full of BIPOC clinicians, I could feel the excitement building between us as we shared the personal and professional experiences that brought us together to work on adapting a race-based stress group for patients at Boston Medical Center (BMC).

This clinician workgroup is one of four advisory boards that will collectively support the adaptation and dissemination of a Race-Based Stress, Trauma, and Empowerment (RBSTE) group for Black patients at BMC, as well as Black community members in greater Boston. In response to the question, “What do patients need to support them in resisting oppression-based stress?” one clinician answered, a “relational and cultural approach.” Utilizing community-based participatory research (CBPR) methods, we also aim to take a relational and cultural approach to the project design, methods, and implementation. As such, our clinical experts, patients, community church leaders, and intervention developers are all collaborators in this work. While CBPR comes with some challenges (e.g., additional time or coordination), the benefits are much greater - the first of which is having a true partnership with the people we aim to serve. 

This partnership started long before I arrived at BMC; the focus on health equity and community-based work is one of the reasons I was drawn to the institution, and that foundation must be first named. Over the last few years, Dr. Devin Cromartie has been working to advance and sustain an existing partnership between the Department of Psychiatry at BMC and Black churches in Roxbury, MA. This includes a CBPR project to identify the mental health needs within the community. Since their founding, these churches including Roxbury Presbyterian, St. John’s Missionary Baptist Church, and Twelfth Baptist Church, have committed to social action for the Boston community.

To support Dr. Cromartie’s work, our team is facilitating the four advisory boards with the goal of the RBSTE group being delivered in churches by members of the church community. While the overall goal is to empower community partners to empower their members, I am also struck by how taking the CBPR approach empowers clinicians. In our workgroup today, the conversation began with team members minimizing their expertise and ended with an embracement of the wealth of knowledge they have to offer. Clinicians shared how for them, this work is not only personal but also political. Like our patients, they have found navigating the behavioral health system to be challenging at times due to the mismatch between some of our existing practices and the oppression-related distress that their patients face. In sharing these challenges with each other, I saw that not only were we working towards better care for our patients, but also towards better support for the clinicians who care for these patients. While this project is just beginning, I look forward to seeing how the community as a whole - patients, clinicians, church leaders, and researchers - collectively and relationally empower each other.

Written by Dr. Nuha Alshabani