Blogs

By DeJuan Patterson, MPA

Who I Am and Who I Represent

I am a Baltimore-based advocate and credible messenger. Credible messengers are trusted neighborhood leaders and experienced community advocates with relevant life experiences who help community members transform their attitudes and behaviors around a public policy issue.  I leverage my unique experience as a government affairs professional and grassroots leader with a history of frontline advocacy to address public issues in my city.

My personal journey following my experience with gun violence taught me the importance of having a voice and developing my own agency as it related to my medical treatment and recovery. As a credible messenger and advisor, I have demonstrated the importance of agency and capacity-building within communities.

For the last five years, I have brought my experiences and skills to the PATIENTS Program at the University of Maryland Baltimore. The PATIENTS Program is an interdisciplinary research team of community partners and researchers housed at the University of Maryland School of Pharmacy that works to change the way we think about research by creating a path for health equity in West Baltimore. I serve as a community partner (they call me a “PATIENTS Professor”) to assist my academic partners with empowering individual community members to be equal partners in patient-centered healthcare and research.

Why Use the Credible Messengers Approach?

Partnerships between credible messengers and institutions attempting to solve public issues is relatively new; however, we have seen positive outcomes in research, public health, and safety in just a few years. Credible messengers who live in the community come from similar circumstances and demonstrate integrity and transformation. Place-based initiatives are more successful when they are co-developed by those living in the “place.”

Credible messengers working in tandem with traditional institutions are critical for successful community engagement because residents are more inclined to feel safe, respected, included, and follow the credible messenger's guidance. This collaborative process (called Community-Based Participatory Research, CBPR) can strengthen the quality of data and empower residents to use that data to improve their communities. Building upon the CBPR model can lead to Community-Engaged Research, a process that empowers community members and recognizes their expertise via compensation.

Building and strengthening a relationship with credible messengers within this community-academic partnership can lead to:

• authentic conversations and data-gathering;
• increased agency and advocacy by community members;
• Enhanced institutional research effectiveness and reputation;
• Community health benefits; and
• Saved lives

This Time, It Must Be Different

The COVID-19 pandemic is not the first public health crisis we’ve faced, nor will it be the last, but this time it must be different. We must provide people with the right tools (information) to make informed decisions on their own behalf, instead of having institutions say what people should do. This leads to better decisions and personal commitment to follow through on the decision.

I am currently advising on a project that invites the community to join the conversation on how to craft language and communication about COVID-19 testing during this crisis. This project is funded by the United States Food and Drug Administration (FDA), and our approach to engaging the community in the conversation involves myself and two other credible messengers. Our success in recruiting participants from six underrepresented populations, using a virtual platform for research, underscores the benefit of the credible messenger approach. Instead of placing an academic spokesperson who “looks like the community” in front of the community and expecting that spokesperson to achieve instant trust and credibility because of their race, the PATIENTS Program with the FDA chose to collaborate with credible messengers. We don’t just look like our community; we are our community.

This Partnership is Different

As a credible messenger, I was willing to partner with the PATIENTS program and the FDA during the current COVID-19 crisis because of my personal experience with family members being affected by this crisis and my history of collaboration and partnership with the PATIENTS Program. I have maintained relationships with the program and its leader, Dr. Daniel Mullins, and I keep them informed about current issues in my community. Our consistent communication over the years has been bidirectional and mutually beneficial. As a result, we find alignment for relevant community health research that improves public health and are already poised to collaborate on our current project with the FDA on communication with Black and Brown Communities during this public health crisis.

• Greater trust by residents and community leaders of our community-academic partnership
• Better community understanding of the risk of undesirable health outcomes
• Equitable return on investment with direct benefits and funding for the community
• Respect for cultural differences and values
• Creating credible data even during a crisis

Lastly, but importantly, we learned that remaining flexible when talking about emerging public health and public policy issues that may be uncomfortable or require pivoting towards new approaches (e.g. meeting online instead of in-person) was vital throughout the process. As trusted members of the community, credible messengers must avoid eroding the community trust we’ve worked to build. We need to understand and remember that we are risking our reputation by aligning with institutions for the collective benefits. Moreover, we must accept that there will be questions of integrity and uncomfortable situations between us and our community while navigating difficult conversations unless we do the following call to action.

Call to Action

It cannot be emphasized enough: Putting someone who looks like the community but is not of the community forward as an alternative to using a credible messenger does not work. Throughout public health engagement history, we have consistently witnessed the hiring and promotion of celebrity spokespeople instead of relevant credible messengers. This approach can no longer be utilized because it is blatantly offensive and an insult to the community’s intelligence. We can see through the façade and appointment of celebrities as a for-hire carrot of credibility. For the sake of public health, we can longer afford to take these convenient shortcuts because:

• It’s offensive
• It results in erosion of public trust during a crisis
• It prolongs the public crisis and threatens public health
• It has negative future implications when more participatory research and action is needed

I acknowledge the past declarations of institutional diversity, equity, and inclusion; however, this time it must be different. The time is now to repair community and institutional partnerships that restore trust and increase health equity. To demonstrate that this time is different, I am requesting that institutions and practitioners establish more bidirectional learning with communities, especially communities of color. There should be intentional investment and actions that promote the collaboration of credible messengers that value communication before action is implemented on our behalf without us.


Disclaimer: The project for which I currently serve as a Consultant is supported by the Food and Drug Administration (FDA) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award [FAIN Univ. Maryland CERSI: U01FD005946] totaling $300,000 with 100 percent funded by FDA/HHS. The views expressed in this article are those of the author, Mr. DeJuan Patterson, and do not necessarily represent the official views of, nor an endorsement by, FDA/HHS, or the U.S. Government.