Where community practice meets scholarship
Our research asks why conditions exist in a neighborhood, who decided, and how communities use what they already have to change them. The social and political determinants of health run through all of it.
Education innovation
How people learn best: in context, building on what they already know, and reflecting on their own thinking. This pillar covers HPAC, self-organized learning environments, pathway programs into the health professions, and new school models, along with how universities, schools, and communities can partner to transform one another.
Community and neighborhood
Rethinking the roles we play in our neighborhoods and why that matters. This pillar draws on neighborhood leadership and social capital research, rural communities' assets, and the role of congregations and community institutions. Its core belief is that people should see themselves as leaders in their own communities.
Community safety and healing
Violence prevention, mental health, and healing as community conditions rather than individual problems. This pillar includes our work with credible-messenger violence interruption, workforce training standards for community violence intervention, and the role of group processes as civic infrastructure.
Measuring what matters
Communities deserve measures that capture what they value. Our tools include original measures of the non-cognitive factors behind academic achievement, the Composite Risk System and conflict mapping for community safety, and social return on investment models. We describe what each tool measures and what it has shown. The formulas and weighting are proprietary and are not published.
Research underway
HPAC, twelve years on
A retrospective of HPAC alumni and a series of papers on the program's impact, collaboration, and pathways into the health professions.
Student voices
A narrative inquiry written with former HPAC students from urban and rural communities.
Rural communities and their assets
How HPAC worked with rural Ohio's protective factors, and the Asset-Based Paradigm as a determinants framework for rural health.
Catalytic capital
How a credible-messenger violence interruption organization activates its assets and adapts over time.
Time, place, and the asset web
Bringing the Asset-Based Paradigm's models together with theories of time and place. Every community has a story.
Bias and infant mortality
How health care professionals' unconscious bias affects infant mortality in Cleveland.
Hope as infrastructure
A chapter in preparation on how HPAC built capacity in rural Ohio from 2012 to 2021, written from the program archive and survey data from 697 participants at the 2017 Scholars Day.
The argument
Resilience is a property of systems, not individuals. Between 2012 and 2021 rural Ohio lost hospitals, obstetric units and life expectancy through decisions made outside the county line. HPAC worked in those same places by attaching to assets already present, and students named and acted on problems they had no vote over.
What the data show
Across 173 HPAC sites, 79 were rural or small town and 38 were Appalachian. Students reported gains in adaptive capacity, use of community assets and bridging contact with people unlike themselves, and no change in generic academic confidence. Mental health led rural project themes about two to one.
The idea
Hope as infrastructure is the socially shared expectation of efficacy that repeated, visible success builds in a community. Sustainability means anchorage, not permanence: many replaceable anchors rather than one. And asset-based practice must never become an argument for austerity. Protective factors buffer; they do not replace investment.
Recent evaluation work
Cleveland Thrive CVI partnership (2026)
Evaluation lead for a seven-month community violence intervention partnership between Renounce Denounce and TYWIST in Glenville and Mt. Pleasant. The final report documents 73 young adults served across more than 1,000 sessions and an estimated societal return of about five dollars for every dollar invested. The return model's formulas are proprietary; the report shares results, not the weights.
Federal promise, community infrastructure (2026)
With LaRon Douglas Sr. and Angela Douglas: an asset-based analysis of a U.S. Department of Education grant implemented at a credible-messenger violence intervention program. Three lessons: compliance as developmental support, explicit partnership roles and payment, and the community assets that funders never count. Abstract submitted to the CCCOSW conference.
HPAC alumni tracing (2026)
A field manual, literature review and tracing methodology for finding HPAC alumni from 2011 to 2026 and measuring long-term outcomes without a join key to program records. Constructs: IDEAS skills, self-agency and hope, growth mindset, intrinsic motivation, belonging, funds of knowledge, and career trajectory.
What HPAC's own evaluations found, 2014 to 2018
HPAC ran a student survey every year it was housed at Northeast Ohio Medical University. The figures below are quoted from the program's own output files, with the year and the number of students behind each. Fall and spring respondents were not matched, so these are snapshots, not change scores, unless the file says otherwise.
2014 to 2015
278 survey cases; 38 students completed both the fall and spring survey. Three in four said they work hard at school (75 percent agreed or strongly agreed, 188 students). "I know what kind of work is best for me" drew strong agreement from 30 percent in the fall and 44 percent in the spring. Two thirds rated their health excellent or very good in the fall; nearly three quarters did in the spring.
2014-15 CORE survey frequency tables2015 to 2016
210 fall and 171 spring evaluations, and a combined research dataset of 482. On a one to five scale, confidence in health-career activities averaged 3.86 (481 students), motivation and interest in health careers 3.98 (425), and exposure to many cultures 4.35 (447). Agreement that HPAC students "come from many different cultures, races and ethnic groups" rose from 76 to 83 percent across the year.
2015-16 frequency tables; combined CORE and research aggregate, May 24, 20162016 to 2017
697 students completed the year-end evaluation, most at Scholars Day. Ratings of HPAC students on a ten-point scale rose from fall to spring for motivation (7.46 to 7.74), personal organization (7.32 to 7.60) and social connections (7.76 to 8.11). Between 66 and 69 percent said they learned the most or a lot about each step of a project, from identifying a health concern to evaluating the impact.
2016-17 year-end brief and Q12 output; the brief reports Wilcoxon p of .009, .006 and .0002017 to 2018
658 fall pre-tests and 489 spring post-tests. In the fall, 35 percent would be the first in their family to go to college, 45 percent wanted help preparing for tests, and 86 percent had friends in HPAC. Students rated HPAC students above their other peers on effort (4.41 against 3.47 of 5), being organized (4.36 against 3.39) and building connections to solve community problems (4.23 against 2.99). By spring the same comparison on a ten-point scale read 8.4 against 6.1 for motivation and 8.5 against 5.9 for identifying community resources.
Fall 2017 pre-test output (n 658; the file notes cleaning was incomplete); Spring 2018 post-test output (n 489)Eleven statements about health, asked of students and of clinicians
The same eleven Citizenship Health statements were put to 489 HPAC students in spring 2018 (rated 1, completely false, to 10, completely true) and to 103 attendees of the Family Medicine Education Consortium conference in Cleveland in November 2017 (five-point scale). The scales differ, so the two groups are read side by side, not subtracted.
- All people should have access to health care. Students 8.85 of 10. Clinicians: 92 percent very true.
- One person's illness impacts others. Students 8.67. Clinicians: 77 percent very true.
- Taking responsibility to care about the health of others is how community health improves. Students 8.63. Clinicians: 70 percent very true.
- The health care system is designed to be preventative. Students 7.03. Clinicians: 45 percent true or very true, 31 percent false or very false.
- Most people have a doctor they regularly talk with. Students 6.37. Clinicians: 33 percent true or very true.
- What people learned in elementary school helped them live a healthy life. Students 5.78, the lowest of the eleven.
Around the students
- Medical and pharmacy students at the Kick-Off (November 2, 2017). 137 NEOMED first-year students in 27 groups ran about 33 health stations for HPAC students. Of 49 surveyed, 39 said they learned something; 48 agreed that working with students from diverse backgrounds helps them become better health professionals. "There is a lot of diversity just within this small region of Ohio."
- Risky Behaviors ECHO (2016 to 2017). HPAC groups at Marietta, Warren Local, Monroe Central, Fort Frye and Frontier met by videoconference twice a month for an hour. Of 37 students answering afterwards, 34 agreed they had learned coping skills for drugs, alcohol, unhealthy relationships and peer pressure, and 33 called ECHO a safe place to ask advice. Internet access and scheduling were the barriers.
- Community health worker training (evaluated December 2017). 89 trainees finishing a MEDTAPP-funded course rated it excellent (67 percent) or good (27 percent); 82 percent were very likely to recommend it. Every one of 22 self-rated knowledge areas rose against the 132 verified pre-tests: "a lot of knowledge" of taking blood pressure went from 18 to 59 percent, CPR from 35 to 79 percent, connecting people with doctors from 23 to 67 percent. Pre and post groups were not matched.
- Health Scholars (HRSA Health Careers Opportunity Program, 2017 to 2018). College students at Baldwin Wallace, Cleveland State, Hiram and Youngstown State earned a stipend for 120 hours of program activity with a health professions navigator. 160 eligible participants by November 2017, 68 percent from underrepresented groups, 80 percent planning a health care career.
Where the name comes from: "Citizenship Health and Health Equity" (2017 draft)
A conference paper drafted in February 2017 argued that because the social determinants of health are the largest contributors to health and life expectancy, and health is a public good, health citizenship carries the same rights and responsibilities as any other kind of citizenship. HPAC was its case: a pipeline program built on the Asset-Based Paradigm that addresses educational, employment, health and community inequity together, brings in diverse stakeholders, and evaluates longitudinally. The draft reported that HPAC had grown from 20 students and 4 major partners in 2012 to approximately 2,000 students and more than 1,700 partnerships, that 90.4 percent of surveyed students expected to go to college, and that 84.4 percent of 529 Scholars Day 2016 respondents felt more connected to their community because of HPAC. The paper remains a draft; the Institute's reports and the Journal carry the idea forward.
"Citizenship Health and Health Equity: A Youth out of School Education Program Impacting Individual and Community Education," draft 1, February 4, 2017; figures repeated from the HPAC overview prepared for the Family Medicine Education ConsortiumThe instruments behind these figures are described in the research workspace and are not published. The tables themselves are in the HPAC Evaluation Dataset workbook, kept by the Institute.
A short reading list
- Dawes, D. E. (2020). The political determinants of health. Johns Hopkins University Press.
- Kretzmann, J. P., & McKnight, J. L. (1993). Building communities from the inside out. ACTA Publications.
- Norris, F. H., Stevens, S. P., Pfefferbaum, B., Wyche, K. F., & Pfefferbaum, R. L. (2008). Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness. American Journal of Community Psychology, 41, 127-150.
- Zeldin, S., Christens, B. D., & Powers, J. L. (2013). The psychology and practice of youth-adult partnership. American Journal of Community Psychology, 51, 385-397.
- Ozer, E. J., Newlan, S., Douglas, L., & Hubbard, E. (2013). "Bounded" empowerment: Analyzing tensions in the practice of youth-led participatory research in urban public schools. American Journal of Community Psychology.
- Wolff, T., Minkler, M., Wolfe, S. M., Berkowitz, B., Bowen, L., Butterfoss, F. D., Christens, B. D., Francisco, V. T., Himmelman, A. T., & Lee, K. S. (2017). Collaborating for equity and justice: Moving beyond collective impact. Nonprofit Quarterly.
- Thurber, C. A., Scanlin, M. M., Scheuler, L., & Henderson, K. A. (2007). Youth development outcomes of the camp experience: Evidence for multidimensional growth. Journal of Youth and Adolescence, 36, 241-254.
- Smathers, C. A., Washburn, L., Toomey, M., Johannes, E., Iaccopucci, A. M., & Johnston, K. (2018). Organizational readiness to engage in policy, system, and environment changes supporting positive youth development for health. Journal of Human Sciences and Extension, 6(2).
- Centers for Disease Control and Prevention. Healthy Communities Program sustainability planning guide.
Research collaborators
Drafts, data, instruments, and proprietary methods are kept in a restricted research workspace for approved collaborators.
Enter the research workspaceResearch data summary (restricted)