Social Medicine

The Prevention and Access to Care and Treatment (PACT) Project 

An Elective in Community-Based Provision of Care to the Underserved

Sponsor:  The PACT Project is a project of Partners In Health (PIH), a non-profit organization committed to a preferential health care option for the poor, and the Division of Social Medicine and Health Inequalities at the Brigham and Women’s Hospital.   PACT participants live primarily in the Roxbury, Dorchester, and Mattapan communities and receive services from community health promoters trained in social and medical advocacy.

Project Description: With the help of physicians, medical students, medical residents, and social scientists, PACT health promoters:

1. provide harm reduction training and materials and prevention case management to high-risk and HIV-positive individuals;
2. increase access to and utilization of culturally-relevant and quality health care and social services for those infected with HIV; and
3. mobilize the affected community to advocate for its health and to address the underlying conditions and inequalities that create such vulnerability.

1. Health promoter program: in which health promoters provide lay case management, health promotion/adherence counseling services, and accompaniment as participants negotiate the complex health and social service systems.
2. Directly Observed Therapy (DOT) program: in which health promoters provide daily DOT of antiretroviral medications to high-risk HIV-positive patients in the Boston and greater Boston area.
3. Fuerza Latina program: in which a group of Latino men in early recovery from substance abuse explore a new harm reduction and social recovery initiative to become peer prevention leaders.

General Elective Description and Overall Responsibilities:  Through participation in the PACT Project, the resident will be further exposed to the needs of underserved community residents and the strengths and weaknesses of existing resource networks.  The resident will also participate in community project development and implementation, explore harm reduction, and pursue physician advocacy.  During the elective month, the resident will become a member of the PACT team and participate in health promotion and harm reduction activities.  These activities include assisting the health promoters in obtaining necessary medical and social services for patients; possibly accompanying participants to the housing court, immigration offices, or physician appointments; providing adherence counseling and education to patients; training health promoters; possibly performing DOT and other home visits with the PACT physicians and health promoters; and providing support and training to the peer prevention leaders.  Residents can also participate in longitudinal projects such as the creation of the DOT health promoter training manual and the Fuerza Latina harm reduction and social recovery curriculum. Residents can also participate in quantitative and qualitative data collection and analysis, grant writing, and networking with other community providers and agencies in the creation of resource algorithms for the project.  Residents can also attend weekly health and social justice conferences at Partners In Health and the Department of Social Medicine.

Qualifications:

1. Enthusiasm in interacting with HIV-positive clients and substance abusers.
2. Creativity, flexibility, sound judgment, and ability to take initiative.
3. Demonstrated ability to work as an effective team member in a complex and fast-paced environment.
4. Excellent interpersonal skills and demonstrated ability to interact professionally with culturally and educationally diverse staff and patients.
5. Spanish or Creole fluency preferred but not required.