Applicant/s name; title; UCSF Mount Zion academic affiliation
Dr. Marta Kozinski, Mt. Zion Pediatrics, Director of Continuity Clinic, UCSF Pediatric Residnets
Community Partner affiliation, if partner: Rabbi Michael Lezak, GLIDE Center for Social Justice
Project dates: December 1, 2023 to December 1, 2026
Estimate of total budget requested: $7,478 x 3 years = $22,434
Goals:
GLIDE/CSJ clients gain proximity to medical professionals & gain trust and understanding by interacting outside the clinical setting
GLIDE/CSJ clients at the after-school program benefit from lessons on health-related topics
UCSF Mt. Zion pediatric residents deepen knowledge of the Tenderloin community, including impact of historical racism and assets
UCSF Mt. Zion pediatric residents critically reflect on power & privilege and the ways in which these factors influence their healing relationships and their role in engaging with communities to overcome oppression and promote social justice
UCSF Mt. Zion pediatric residents maintain hope for positive change and prevent burnout through a community of love and support
Summary of healthcare needs being addressed:
GLIDE/ Center for Social Justice (CSJ) is a nationally recognized center for social justice, dedicated to fighting systemic injustices, creating pathways out of poverty and crisis, and transforming lives. Through integrated comprehensive services, advocacy initiatives, and inclusive community, GLIDE/CSJ empowers individuals, families and children to achieve stability and thrive. UCSF and GLIDE have partnered in a myriad of ways, including direct clinical services and anti-racism training. The UCSF Pediatrics Residency has partnered with GLIDE for more than five years and we have grown the partnership to include three elements listed below. While the partnership activities involve all residents, 47 of the 91 UCSF pediatric residents are Mt. Zion primary care providers via their weekly continuity clinic. The ultimate aim is to train physicians who have a deep understanding of trauma-informed care informed by connection with community.
After-School/Summer Program Teaching
GLIDE's Afterschool Program is one of the many services offered through Glide’s Family Youth and Childcare Center (FYCC), which serves the children of very low-income households in San Francisco. The program is for youth in grades K–5 and provides homework help and tutoring, creative arts, nutrition, health & wellness, and physical recreation Monday through Friday throughout the school year and summer. UCSF Pediatric residents lead an age-appropriate lesson on a health-related topics that program leadership have identified as being relevant to their children and families. Each resident group leads a lesson for ~20 students, with the support of an Afterschool Program teacher. The lessons cover a variety of mental and physical health related topics from puberty to coping with loss.
Trauma-Informed Care Discussion with Rabbi Lezak
Drs. Joan Jueng, Kathryn Margolis, and Amy Whittle created a four-part novel trauma-informed care curriculum covering adverse childhood experiences, medical presentation of trauma in childhood, and protective childhood experiences. One of the unique aspects of this curriculum is a discussion with Rabbi Lezak and other GLIDE staff that allows residents to reflect on their work as healers, how to avoid compassion fatigue, and the meaning of their work. GLIDE staff are particularly well positioned to facilitate these discussions given their roles as spiritual leaders in an organization dedicated to addressing the impact of societal trauma.
Meal Service
GLIDE provides approximately 2,000 meals a day, 364 days a year, to the city’s poor, homeless and hungry. As GLIDE’s largest program, it serves as a gateway to GLIDE’s other programs and services. Residents participate in a breakfast service in their first year of residency in the DB/PIC block. They have a chance to interact informally with GLIDE clients and understand the vital role of these types of programs in addressing food insecurity.
This project captures multiple MZHF values:
Avodah (service): Residents will be serving the community by volunteering to serve meals as well as designing and delivering educational content for children at the after-school/summer program.
Limud u’Manhigut (Education and Leadership): Residents will bring health-related educational content to youth who might otherwise not have the opportunity to interact with physicians outside of the medical setting.
Tikkun Olam (Social Justice): GLIDE is a beacon for social justice work and residents will benefit from learning more about their community service offerings as well as their policy advocacy work.
Rahamim (Compassion): The partnership aims to have pediatric residents be proximal to residents of the Tenderloin to understand the stories of community members in a way they may not in the medical setting.
Specific Aims
To accomplish the goals above, we aim to:
Hold monthly sessions with the GLIDE after-school and summer program in which pediatric residents lead interactive sessions for K-5 students about health topics.
Hold monthly small-group teaching sessions between GLIDE staff and pediatric residents in which the focus is on compassion fatigue, building resilience as a healer, and reflection on power and privilege in medicine.
Hold twice-yearly sessions for pediatric residency as a whole to provide ritual and reflection space for healers and their relationship to trauma.
Anticipated benefit for underserved or vulnerable communities in San Francisco
Through the above-described activities, we aim to grow connections between young people of the Tenderloin and pediatric providers, both to engender more understanding and trust in the medical system and to inspire interest in healthcare professions. The sessions are meant to increase knowledge in certain topic areas but also motivate youth to want to learn more around science and health topics. We also aim to benefit vulnerable communities by encouraging proximity between pediatric trainees and GLIDE clients and staff, and by doing so deepen providers’ understanding of trauma-informed care. These experiences cultivate compassion, enhance the sense of meaning in service to others, and help trainees reflect on issues of systemic and historical racism.
How the project addresses UCSF Mount Zion priorities and compelling San Francisco healthcare needs
One of the most compelling challenges facing San Francisco is the fentanyl crisis, and the Tenderloin has been the epicenter. In the last five years, the number of fatal overdoses has nearly tripled and approximately ¼ of these overdoses occur in the Tenderloin. The Tenderloin also has one of the highest concentrations of children and youth in San Francisco, a large portion of whom are recent immigrants. Considering the growing science around “adverse childhood experiences,” children who are living in the Tenderloin are at risk for physical and mental health consequences of chronic exposure to neighborhood-level challenges. For decades, GLIDE has served this neighborhood by balancing the needs of all residents, including youth/family programming that provides protective experiences and builds resilience as well as providing services aimed at those experiencing homelessness and using substances.
This project fits with UCSF Mt. Zion values by emphasizing PRIDE values: professionalism, respect, integrity, diversity and excellence. Mt. Zion pediatric residents will bring back to their primary care practice a greater understanding of their role in mitigating childhood trauma. They will understand better the way in which chronic socioeconomic disparities rooted in historical racism impact child and family health.
Description of partnership (or the intentions to build toward meaningful engagement with community partner), including type, history and duration
The UCSF Pediatrics Residency has partnered with GLIDE for more than five years, both via the general residency and via the PLUS (Pediatric Leaders Advancing Health Equity) program. The work has been guided by dozens of meetings between GLIDE leadership, UCSF residency leadership, and the UCSF Center for Community Engagement. Engagement of learners at GLIDE has taken many forms, including meal service volunteering, co-developing curriculum for youth and adult programs, small group discussions, volunteering at health events, and large group teaching sessions. While the partnership activities involve the residency as a whole, 47 of the 91 UCSF pediatric residents are Mt. Zion primary care providers via their weekly continuity clinic. The ultimate aim is to train physicians to develop a deep understanding of trauma-informed care that is informed by connection with an experienced community partner.
How the community partner's experience and expertise was integrated into proposal development
This proposal was informed by years of relationship building via meetings and in-person engagement between GLIDE and UCSF Pediatrics. GLIDE is a national leader around social justice advocacy, from direct services to policy change. They have taken a leadership role in educating UCSF providers and staff around trauma-informed care via Healers at the Gate, an experiential learning experience at GLIDE followed by reflection sessions over the course of many weeks. This experience informs the teaching sessions that Rabbi Michael will be having with the residents. The after-school curriculum staff guide the content for the teaching sessions for youth; topics reflect the priorities of the community.
Roles and responsibilities of each partner (Please note: we are not seeking to fund partnerships that are based on a transactional [e.g., vendor] relationship.)
GLIDE Partners
Maritza Estrada-Esquivel, Program Manager, GLIDE After School Program
Ms. Estrada-Esquivel provides guidance to the UCSF pediatrics team on the content and logistics of the after-school/summer teaching programming.
Rabbi Michael Lezak, Center for Social Justice
Rabbi Lezak will lead monthly discussions with the residents around their roles as healers and Rabbi Michael has led dozens of teaching sessions for UCSF staff, faculty, and trainees on the topics of anti-racism and trauma-informed care. His justice pilgrimages to Alabama and into the Tenderloin empower leaders to see the through-line from slavery to mass incarceration and mass poverty, ultimately summoning these leaders to moral responsibility and righteous action. He spearheads groundbreaking work with law enforcement and district attorneys from around the country to help them understand the challenges faced by people living in extreme poverty.
UCSF Contacts:
Marta Kozinski, Director, Mt. Zion Continuity Clinic, UCSF Pediatric Residency
Dr. Kozinski leads the teaching experience for pediatric residents practicing primary care at the Mt. Zion Pediatrics clinic. Dr. Kozinski and Dr. Whittle will collaborate on how the continuity clinic teaching curriculum can reinforce the learning objectives of the GLIDE partnership around professionalism and cultural humility.
Amy Whittle, MD, Director, Physicians in Community, UCSF Pediatric Residency
Dr. Whittle coordinates the partnership with GLIDE, including qualitative and quantitative evaluations of the activities. Dr. Whittle will lead meetings with GLIDE staff, guide the development of teaching sessions, and present data back to the group about the progress of the partnership.
Requested grant period (e.g., start date of December 1, 2023 or later and duration of project): December 1, 2023 to December 1, 2026
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