Preterm Birth Initiative Community Advisory Board Application

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1 Preterm Community Advisory Board Application Summary Each year across the world, one million preterm babies die within the first 28 days of life. Of the 14 million more preterm babies who survive, many are faced with a lifetime of serious health complications. Fortunately, you have an opportunity to be part of the solution. The UCSF California Preterm (PTBi-CA) is seeking applicants for membership in our Community Advisory Board (CAB). Applicants should be passionate about reducing the rate of preterm birth and work or live in San Francisco, Oakland, or Fresno. The CAB will play a key role by providing the community s perspective on potential research. This two-year commitment, beginning in September 2016, involves participation in several meetings per year. PTBi offers CAB members a monthly stipend, travel reimbursement, and childcare during Interviewing candidates on a rolling basis. Application Deadline: September 14 th by 5 pm meetings and events. Please read on for details about the position and application process. We hope you ll consider joining the movement to address the epidemic of preterm birth. Background PTBi-CA is multi-year, research program focused on reducing the burden of prematurity in California. Being born too early (before 37 weeks gestation) is the leading cause of death in infants and children under age five worldwide. In California, preterm birth disproportionately affects women of color and women in low-income communities. Our cell-to-society approach brings together UCSF researchers, government entities, community-based organizations, and families affected by or at risk for preterm birth to work towards solutions. Through the generous support of Marc and Lynne Benioff, the PTBi-CA is committed to conducting high impact research that will help us better understand what causes preterm birth in the most affected communities and what programs and policies can be established to prevent prematurity and/or improve the outcomes of babies born preterm. Purpose The Community Advisory Board (CAB) is a key partner in moving this work forward. The CAB will play an important role in guiding academic and community-based research in San Francisco, Oakland, and Fresno by helping to develop research priorities and design. The CAB will be comprised of diverse stakeholders from all three areas who are interested in reducing preterm birth-related disparities and improving health equity. Community members, providers, and study participants are encouraged to apply. The CAB will strengthen links to the communities most heavily affected by preterm birth, building trust and enabling high-impact research. The CAB will help ensure that the research produces results in the community, improving the lives of families in California and beyond. 1

2 Activities CAB members will participate in the following activities: Review discovery and interventions research sponsored by the PTBi to ensure the research promotes the interests and wellbeing of the affected communities in San Francisco, Oakland, and Fresno. Partner with the PTBi-CA leadership team at UCSF to ensure all research activities are culturally appropriate and relevant to the communities. The CAB will also contribute to the PTBi-CA strategic plan by articulating the important gaps in current knowledge and proposed research. Participate in a two-day orientation session to learn more about the role of CAB members and current research efforts to reduce the burden of prematurity. Members will also participate in five types of activities throughout the year: 1. Review research proposals submitted to the PTBi-CA twice a year (in the spring and fall) 2. Review the PTBi-CA research portfolio on an annual basis 3. Attend a local World Prematurity Day event (November 17 th ) to support greater community awareness of prematurity and our ongoing research efforts 4. Participate periodically in meetings to advise research teams from UCSF and other partner groups 5. Assist with community engagement and mobilization efforts CAB members who actively participate (attending the retreat and 80% of meetings) will be compensated $250 per month for the duration of their terms. PTBi-CA will provide refreshments and support with childcare and transportation costs to regional meetings. Meeting locations will rotate across our three geographies. PTBi-CA will also provide webbased teleconferencing to encourage active participation and support CAB members in using these technologies. Member Selection The CAB will be comprised of 18 individuals who live in or serve communities with high preterm birth rates in San Francisco, Oakland, or Fresno. Applicants should be passionate about working collaboratively on lowering the rates of preterm birth and ensuring that preterm babies have better long-term health (particularly among those communities disproportionately affected). We are seeking applicants who understand issues facing women of color, pregnant women who may be at risk for preterm birth, young mothers, and women without stable housing. A two-year commitment to the roles and responsibilities described above will be required. If you identify with one or more of the following groups, we encourage you to apply: Community members who have experienced preterm birth, those who are at-risk for preterm birth, or those who have family members affected by preterm birth Clinic- or hospital-based providers of women at risk for preterm birth or babies born preterm Community-based service providers in communities with high rates of preterm birth Current or former preterm birth-related research study participants 2

3 Application Timeline Call for applications and nominations (August 11 th 2016) Application deadline (September 14 th 2016) Candidate interviews on a rolling basis (August-September 2016) Selection notices sent to applicants (September 28 th 2016) First CAB meeting and retreat in Oakland (October 5 th and 6 th 2016) Application Checklist Review the selection criteria Commit to serving a two-year term Agree to attend the CAB retreat and each full CAB board meeting Complete the attached application Attach a resume or CV (required for all providers; suggested for community members) Provide a reference, including contact information, for an individual who can speak to your interest in community service Call Shanell Williams if you have questions at or mail your application by Wednesday, September 14 th, at 5 pm to shanell.williams@ucsf.edu or to the physical address below PTBi CA Contact Shanell Williams, Community Engagement Specialist California Preterm (PTBi-CA) Obstetrics, Gynecology & Reproductive Sciences University of California, San Francisco 3333 California Street, Suite 285 San Francisco, California shanell.williams@ucsf.edu

4 Application Please complete the following two pages. Date: Which of the following group(s) do you affiliate with: community member, clinic provider, hospital provider, community-based organization staff member or provider, current or former research study participant? First and Last Name: Name of Organization (if you are affiliated with one) Street Address or Organization (Line 1): Street Address (Line 2): City: State: Zi Zip Code: Daytime Phone: Evening Phone: Please describe the personal and professional experience that has prepared you to serve as a PTBi-CA Community Advisory Board member. If you need more space feel free to attach a separate sheet. Please note that a resume or CV is not required for community members, but if you have one, please attach it in addition to filling out this section. 4

5 Reference Name: Reference Company and Job Title: Reference Phone: Reference Please describe your relationship with the reference provided: I am have reviewed the requirements for participation in the PTBi-CA Community Advisory Board (CAB) and the application checklist. I am committed to attending the two-day retreat and the full CAB board meetings and participating in the activities outlined above. I will communicate with the PTBi-CA staff to make arrangements that will support my active participation on CAB. Print Name: Signature: Please attach a separate sheet with responses to the following questions: 1. Why are you interested in serving on the Community Advisory Board for the California Preterm? 2. What is your experience with preterm birth and disparities in birth outcomes? 3. How will your experience help you guide the PTBi-CA in its efforts to conduct preterm birth research? 5