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UTHSCSA
DEAN’S MESSAGE
Center for Research to Advance Community Health
strives to improve South Texas health, healthcare
By Francisco González-Scarano, MD
Everyone deserves high-quality, cost-effective healthcare that de-
livers the best possible health outcomes. Achieving this requires iden-
tifying those advances that offer the greatest benefit to patients and
to define the best ways to provide this care to all members of the
community. This is preferably done through collaborative research
among investigators from many disciplines in partnership with rep-
resentative members of the community. The Center for Research to
Advance Community Health Center (ReACH) offers a broad-based
academic-community partnership that seeks to reduce gaps for those
with poor access to high-quality care, improve overall healthcare de-
livery and, ultimately, promote a healthier South Texas.
ReACH is a multidisciplinary collaboration supported by two in-
stitutions: the University of Texas Health Science Center at San An-
tonio and the University of Texas School of Public Health,
particularly through its San Antonio Regional Campus. ReACH’s
director is Barbara J. Turner, MD, a professor in the department of
medicine who came with me from the University of Pennsylvania
in 2010 to establish the center in partnership with the Health Sci-
ence Center’s vice president for research.
DIVERSE DISCIPLINES AT WORK
Currently, ReACH has 23 PhD and MD scholars from five institu-
tions: UT Health Science Center, UT San Antonio, South Texas Vet-
erans Health Care System, UT School of Public Health (San Antonio
Regional Campus) and UT College of Pharmacy. They are from di-
verse disciplines, including statistics, epidemiology, health services re- South Texas’ large medically underserved Hispanic population. In a
search, informatics, economics, psychology, anthropology, community
engagement and behavioral medicine. ReACH scholars currently are
working on a wide array of projects; a few examples include improving
outcomes of persons with uncontrolled diabetes or hypertension; pre-
venting liver damage and liver cancer through screening and treatment
of hepatitis C virus (HCV) infection; preventing and reducing obesity
in Hispanic families; improving functional outcomes of persons suf-
fering from chronic pain; and improving the overall healthcare of per-
sons with HIV.
The center also provides educational and research opportunities
for students. In the most recent School of Medicine Research Day,
held in May, ReACH MD/MPH students presented talks and
posters that described results from focus groups with persons re-
cently diagnosed with HCV infection, which explored their under-
standing of the disease, as well as results from an analysis of patients
newly diagnosed with HCV infection, showing that Hispanics who
were overweight or obese had three times greater risk of having se-
vere liver disease.
26 San Antonio Medicine • July 2015
Dr. Turner, who also is a practicing general internist at the Uni-
versity Health System’s Robert Green Campus downtown, cites part-
nerships with the South Texas Area Health Education
Center (AHEC) as the place “where the rubber really meets the
road.” She credits much of the success of ReACH to South Texas
AHEC Director Paula Winkler, MEd, who has more than 30 years
of experience developing linkages between academic programs and
community-based health promotion and disease prevention initia-
tives. With responsibilities for Bexar and 11 other counties, Ms.
Winkler maintains very effective community relationships that offer
the basis for ReACH’s collaborations with community providers and
patients.
COMMUNITY EDUCATION
The center also is guided by a community advisory board called
the Alliance, which is composed of 15 diverse community members
representing everything from the military to the city health depart-
ment and other communities. The advisory board meets monthly
to discuss ways to make ReACH’s work relevant and sustainable in
the community. Recently these discussions have focused on identi-
fying effective ways to educate the community about chronic pain
prevention and management, as it is the most common cause of dis-
ability and lost productivity in Texas and throughout the United
States.
The center also focuses on research that addresses the needs of
project funded by the Patient-Centered Outcomes Research Insti-
tute (PCORI), a government agency that funds research specifically
on patient decision-making and health outcomes, ReACH and the
South Central AHEC are partnering with community-based AgriL-
ife Extension programs in Karnes and Frio counties to elicit com-
munity members’ priorities for research to improve the function and
health of persons with chronic pain. The combined efforts of this
partnership engaged 65 primarily Hispanic community members
with chronic pain and their caregivers in a series of meetings and
focus groups. Most participants had used prescription pain killers
(opioids) for chronic pain and many had significant constraints in
their activities due to pain; it was evident that the healthcare system
and treatment with narcotics were not meeting their needs.
The groups generated a wide array of ideas to help community
members manage pain more effectively, such as affordable exercise
programs, education about stretching, and behavioral support, all
of which will guide ReACH’s community-based initiatives and re-
search. Working with local patient groups and local physicians has