With over 35 years of experience as a public health physician and educator, Manoj Sharma has provided leadership for health and nonprofit agencies locally, nationally, and around the world. Now he's focusing his research on participatory process evaluation to strengthen partnerships across the state of Nevada while improving the health and well-being of our communities.
A range of existing disparities in Nevada subpopulations were exacerbated by the COVID-19 pandemic. Examples include a significant disconnect between rural and urban health care systems, a wide gap in the logistics for the underserved populations of racial and ethnic minorities, and an unequal burden of morbidity and mortality.
Sharma’s work to evaluate the efforts to address these disparities has earned him UNLV’s 2023 Community Engagement Award for Community-Based Research, presented at this year’s Academic Achievement Awards.
“The health system in Nevada is structured in a way that presents several disparities in how health care is accessed and delivered,” says Sharma. “The focus of this participatory process evaluation is to gauge the activities being implemented for the underserved and marginalized groups in Nevada.”
To conduct this evaluation, Sharma, professor and chair of the social and behavioral health department in the School of Public Health, received a Health Disparity Grant in July 2021 from the Centers for Disease Control and Prevention (CDC) administered by the Nevada Department of Health and Human Services. The project was initially awarded $700,000 through May 2023, and a $390,000 extension is now pending to fund the project for an additional year.
This research involved 22 partner organizations made up of government entities, community-based organizations, and private bodies that operate and deliver public health services within Nevada. Encompassing urban, rural, and frontier areas, partners included the Nevada Office of Minority Health, Nevada Cancer Coalition, Healthy Communities Coalition Southern Nevada Health District, Washoe County Health District, Carson City Health and Human Services, Aging and Disability Services Division, Chronic Disease Prevention and Health Promotion, and the Nevada Minority Health and Equity Coalition.
Sharma, and his team of six graduate research assistants from the School of Public Health, developed protocols for community-based participatory evaluation. This included the development of focus group discussion guides, instructions for interviewing community health workers, procedures for personnel, a statewide cross-sectional survey of satisfaction from stakeholders regarding services provided, and process for observing key meetings and events that served the community.
“In community-based participation evaluation, the skill levels of all stakeholders are enhanced through dialogue, training, meetings, and consultations, which is the backbone of our process evaluation,” explained Sharma.
The process evaluation conducted is based on activities within four strategies:
- Expand existing and/or develop new mitigation and prevention resources and services to reduce COVID-19-related disparities among populations at higher risk and that are underserved.
- Increase and improve data collection and reporting for populations experiencing a disproportionate burden of COVID-19 infection, severe illness, and death to guide the response to the COVID-19 pandemic.
- Build, leverage, and expand infrastructure support for COVID-19 prevention and control among populations that are at higher risk and underserved.
- Mobilize partners and collaborators to advance health equity and address social determinants of health as they relate to COVID-19 health disparities among populations at higher risk and underserved.
One of the principal functions of a process evaluation is the use of evaluation data to inform programming policies and practices. Researchers used a community-based participatory model that Sharma developed and tested over the years called the RQFSM model, which measures Reach, Quality control, Fidelity of the program, Satisfaction, and Management of the program.
This work has had a tangible impact. In addition to increasing community care and awareness through community health workers, Sharma and his team were also able to identify needy populations through grant strategies. For partners, they have been able to successfully showcase and further their own work through evidence, recommendations, and guidance they have received through this evaluation.
“Our project has produced detailed process evaluation reports and presentations that have benefited our community partners by way of enhancing their programmatic endeavors, ensuring sustained funding for their efforts, and bringing national recognition,” said Sharma. “These products are likely to be used by future participatory evaluations in our state and beyond.”
Lily Helzer, chronic disease prevention and health promotion section manager for the Department of Health and Human Services Nevada Division of Public and Behavioral Health, praised Sharma for his work.
“The process evaluation provided by Dr. Sharma has truly been participatory and has enhanced the capabilities of all those involved in this undertaking,” said Helzer. “His RQFSM model is particularly noteworthy and has tremendous potential for application in our future efforts.”
About the Community Engagement Awards
UNLV established four university-wide awards in 2016 to recognize campus individuals for their exceptional community engagement in the areas of service learning, community-based research, faculty/staff community outreach activity, and student service. These annual awards are administered by the office of government and community engagement.