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PURPOSE: To identify, through a qualitative study, community perspectives on the critical factors that facilitate the development, effectiveness, and sustainability of community-academic partnerships. METHOD: Between June 1998 and April 1999, 25 semistructured interviews were conducted with community members who represented eight partnerships at five academic health centers. Content analysis and open coding were performed on the data, and patterns of ideas and concepts were categorized. RESULTS: After review of the data, responses from three partnerships were excluded. Nine major themes that community respondents thought strongly influenced the effectiveness of community-academic partnerships emerged from respondents from the remaining five partnerships: (1) creation and nurturing of trust; (2) respect for a community's knowledge; (3) community-defined and prioritized needs and goals; (4) mutual division of roles and responsibilities; (5) continuous flexibility, compromise, and feedback; (6) strengthening of community capacity; (7) joint and equitable allocation of resources; (8) sustainability and community ownership; and (9) insufficient funding periods. CONCLUSION: The themes that emerged from this study of the perceptions and experiences of the community partners in community-academic partnerships can be critical to further developing and evolving these partnerships.

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CONTEXT: As faculty at health professionals schools have become increasingly engaged with their communities in partnerships to improve health, new questions have arisen about faculty rewards for such activities. To sustain the community work of their faculty, institutions need to reconceptualize faculty rewards, promotion, and tenure that are relevant to community activities. HISTORICAL PERSPECTIVE: Scholarship has evolved since the 17th century from a focus on character-building to the practical needs of the nation to an emphasis on research. In 1990, Boyer proposed four interrelated dimensions of scholarship: (1) discovery; (2) integration;(3) application; and (4) teaching. The challenge became the development of criteria and innovative and creative ways to assess community scholarship. CURRENT MODELS FOR COMMUNITY SCHOLARSHIP: This paper reviews four evidence-based models to document and evaluate scholarly activities that are applicable to community scholarship. PROPOSED MODEL FOR COMMUNITY SCHOLARSHIP: We propose a new model for community scholarship that focuses on both processes and outcomes, crosses the boundaries of teaching, research, and service, and reshapes and integrates them through community partnership. We hope this model will generate national discussion about community scholarship and provide thought-provoking information that will move the idea of community scholarship to its next stage of development.

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This article is based on a program that was developed by the Center for Healthy Communities (CHC), a community-academic partnership in Dayton, Ohio, that continues to act as a force for change in health professions' education and health delivery, stressing the philosophy of "doing with" instead of "doing for" or "doing to." The Health Action Fund is a grassroots health communications and social marketing program that targets community groups who are involved often in health promotion activities developed by large agencies. However, rather than taking the traditional approach to health promotion and prevention where program development and implementation is left to professionals, a different approach was taken that encourages members of neighborhoods, a community group, or a church to identify a problem and then develop a way to address that problem for their group. The program focuses on neighbors helping neighbors where communities take the lead in health promotion and prevention activities. We discuss in detail the project's innovation, challenges and how they have been addressed, qualitative and quantitative improvements made to the program, and how the program serves as a model for other communities.

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This article explains a partnership-based community education model, which uses as an example a partnership between the Center for Healthy Communities in the Department of Family and Community Medicine at the Medical College of Wisconsin (MCW) and the rural Marion area of central Wisconsin. MCW is similar to other medical schools in that it has a strong history and philosophy of placing students in communities for educational purposes. This article describes how the Center for Healthy Communities is moving beyond student placement to true partnership building. The center followed four stages of development as it built a partnership with this rural Wisconsin community: (1) establish and build relationships, (2) develop common goals, (3) develop and implement programs and (4) maintain and expand progress. The center also applied a set of principles in developing the partnership. By following the stages and applying the principles, the center found that two elements were key to building a partnership for medical student education and community health improvement: long-term commitment and ability and willingness to spend time in the community. As a result, a meaningful, ongoing partnership developed that benefits both the community and MCW.

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BACKGROUND AND OBJECTIVES: Determining authorship for publications is often a difficult process, even more so when individuals from several disciplines collaborate with community organizations to conduct projects. Although multidisciplinary and community-academic partnerships provide fertile ground for publication efforts, disputes about authorship and ownership of data may hinder efforts to disseminate information. This article describes a process for dealing with authorship in multi-professional collaborations. It provides an authorship scale, similar to a neonatal Apgar scale, to determine order of authorship in multi-professional projects. Key components or activities in the process of authorship are identified, and points are assigned to each component in proportion to an investigator's level of activity in each component/activity. Scores are summed and can range from 1 to 35 for each author. The order of authorship is then determined by the relative score of each participant.

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As academic health center seek to address the changes in the health care system and in medical education, several approaches have been tried, some successfully, others not. The authors describe a successful approach that involves a close partnership between the health professions schools at two academic institutions, and agencies from the surrounding community. Specifically, the Center for Healthy Communities, begun in 1991 and formally institutionalized in 1994 in Dayton, Ohio, is a partnership among the schools of medicine, nursing, and professional psychology at Wright State University (WSU); the department of social work at WSU; the Allied Health Division of Sinclair Community College; more than 200 individuals (from grassroots neighborhood people to civic leaders); and 50 health and human services organizations in the Dayton area. The Center is recognized as a force for change in health professions education and health care delivery both in the community and in the academic settings. The authors explain how the Center was formed, list its goals (such as establishing strong partnerships among community educators and providers and educating students in the delivery of primary health care in the community), explain three principles that have been followed and that were crucial to the success of the Center (for example, individuals in the community must become empowered to capitalize on their strengths), and discuss the major difficulties that the community and the academic institutions encountered and strategies for meeting them (such as the importance of building trust and the importance of learning the needs identified by the community partners, not just those identified by the academic partners). The authors maintain that a successful community-academic partnership must be built on the foundation of community health development, a concept analogous to economic development, and that such a partnership can be a powerful tool for making a difference in the community's health.

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Three hundred thirty-one Indiana physicians practicing general-family medicine (GP-FP), obstetrics-gynecology (OB-GYN), pediatrics (PED), internal medicine (IM), and psychiatry (PSYCH) were surveyed as to their perceptions about adolescent health and their perceived need for specific adolescent services and Continuing Medical Education (CME). Significant differences were noted in all specialty areas that were not accounted for by the sex or age of the physician. The majority of GP-FP and PED reported that adolescents (aged 11-19 years) made up at least 10% of their practice compared to fewer than 5% of IM practices. Fewer than 7% of the respondents had had no training about adolescent medicine; most (47.5%) had received some CME in adolescent medicine. Family planning was the service least likely to be: provided by PED, IM, and PSYCH, (p less than 0.0001); considered serious for these physicians' adolescent patients (p less than 0.0001); and of interest for CME by all physicians (p less than 0.0001). All specialities believed their adolescent patients to be minimally troubled by the most common problems of youth (p less than 0.0001), but did accurately perceive youth as having psychosocial and medical problems. Training about substance abuse, counseling, learning problems, and eating disorders were most desired. Few respondents wanted individualized, in-person training. The implications of these results are discussed.

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