David Shi-Ann Chang

All Publications

• A mixed methods evaluation of a six-year primary care community safety net-academic partnership model. Academic medicine : journal of the Association of American Medical Colleges Blacker, A., Shaw, J. G., Yu, A. C., Safaeinili, N., Chang, S. I., Seay-Morrison, T., Singh, B., Lee, H., Chang, D. S. 2026

  Abstract

  To expand the tripartite mission to advance health equity, academic medical centers (AMCs) need to look outside their walls. In 2018, Stanford's primary care division launched the Community Partnership Program (CPP) between their AMC and local safety-net community health centers (CHCs) to support the goals of meaningful community engagement and addressing local clinic capacity needs. The CPP embeds Stanford physician faculty in local CHCs through service agreements. This study aimed to characterize the experiences of CHC leaders and faculty involved in the CPP to better understand barriers and facilitators to program implementation and assess its success as a community-responsive partnership. Stanford's CPP faculty (n = 9/15) and representative CHC leadership (n = 9/11) from five partner CHCs participated in the study. The National Academy of Medicine's Assessing Community Engagement Conceptual Model guided an explanatory mixed methods study: cross-sectional survey followed by semi-structured interviews. A modified Enage for Equity Community Engagement Survey identified high- and low-scoring variables (Likert scale:1-strongly disagree/never to 5-strongly agree/always). Qualitative assessment explored facilitators and barriers to program implementation and success. Overwhelmingly, both CHC leaders and faculty (n = 18) highlighted the CPP's positive role in making their work meaningful (4.78 (0.5)) and trusting the partners they work with (4.50 (0.5)). Sufficient time (3.61 (1.0)) and financial support (3.33 (1.4)) to engage in the CPP were the lowest scoring variables. Qualitative results highlighted the importance of communication, trust, and institutional buy-in, the value of community-academic bridges, increased access to clinical care, development of community-aligned solutions, and the partnership's positive impact on well-being. A model of community-academic partnership with primary care faculty embedded in safety-net CHCs can be successful from both AMC and CHC perspectives. These findings offer pragmatic lessons that can support other AMCs in building their own capacity for equity-focused collaboration grounded in community-engaged principles.

  View details for DOI 10.1093/acamed/wvag181

  View details for PubMedID 42301909

• STANFORD HOMELESSNESS OUTREACH INITIATIVE: A STUDENT-LED MEDICAL EDUCATION PROJECT Mayer, M. D., Quint, M., Chang, D. SPRINGER. 2025: S532

  View details for Web of Science ID 001671085903291

• Perceptions of providers and unhoused patients on access to eye care in Santa Clara County: A qualitative study. Optometry and vision science : official publication of the American Academy of Optometry Liu, J. M., Chang, M., Liu, F. M., Patel, B., Chang, D. S. 2025

  Abstract

  Perspectives on eye care barriers differ between low-income patients and vision care providers. Comparing these views provides valuable insight into strategies for addressing disparities in underserved communities, especially in regions with significant income inequality and opportunity gaps.The aim is to identify obstacles that prevent individuals who are unhoused, have low income, or are publicly insured in Santa Clara County from accessing basic refractive eye exams and corrective glasses.Patients aged ≥18 years with low income presenting to a free vision care clinic in Northern California (n = 15) and vision care providers who primarily work with underserved patients in Santa Clara County, California (n = 11) participated in one-on-one phone interviews. Interviews were transcribed and analyzed.Most participants (87% patients and 82% providers) say that basic vision care (refractive eye exam and eyeglasses) in Santa Clara County is unaffordable and that in-person eye exams can be physically inaccessible (67% patients and 91% providers) due to busy work schedules or limited access to transportation. However, patient and provider perspectives on intrinsic barriers to accessing eye care diverge. In total, 73% of providers stated that limited health literacy contributed to lower utilization of routine vision care, while 47% of patients cited limited empathy from providers as responsible for their negative experiences and dissatisfaction with care.In Santa Clara County, patients with low income and their providers both identify similar external barriers to basic vision care: high costs, inadequate insurance coverage, and limited services. However, patients and providers may disagree on intrinsic barriers to accessing care. Suggestions for improving access to vision care include more help from healthcare coordinators, better information about affordable services, improved vision insurance, and mobile healthcare options.

  View details for DOI 10.1097/OPX.0000000000002250

  View details for PubMedID 40261685