Cambodians in Lowell, Massachusetts, experience significant health disparities. Understanding the trauma they have experienced in Cambodia and as refugees has been the starting point for Lowell Community Health Center's whole community approach to developing community-based interventions. This approach places physical-psychosocial-spiritual needs at the center of focus and is attentive to individual and institutional barriers to care. Interventions are multilevel. The effect of the overall program comes from the results of each smaller program, the collaborations and coordination with the Cambodian community and community-based organizations, and the range and levels of services available through the health center.

Literature and practice are limited on strategies to reach elder Southeast Asian refugees by using their strengths and resilience. This article presents the Centers for Disease Control and Prevention-funded Cambodian Community Health 2010 Program in Lowell, Massachusetts, as a case example and provides refugee history, project background, community survey results about strengths and risks, literature on strengths-based approaches, outreach activities, and evaluation. The focus is elimination of health disparities in cardiovascular disease and diabetes. "Community conversations" and a daylong forum with community leaders were used to develop plans for outreach. A Cambodian Elders Council provided information and guidance used to refine the program. Key findings highlight involving elders in organizing events, avoiding reliance on literacy, integrating health promotion with socialization, using ties with Buddhist temples, developing transportation alternatives, and utilizing local Khmer-language media. Implications include applicability to other refugee communities with low literacy, high levels of trauma, limited English, and strong religious involvement.

Refugees in the United States have high rates of chronic disease. Both long-term effects of the refugee experience and adjustment to the U.S. health environment may contribute. While there is significant research on health outcomes of newly resettled refugees and long-term mental health experiences of established refugees, there is currently little information about how the combined effects of the refugee experience and the U.S. health environment are related to health practices of refugees in the years and decades after resettlement. We examined cross-sectional survey data for Cambodian refugee and immigrant women 35 to 60 years old (n = 160) from an established refugee community in Lowell, Massachusetts, to examine the potential contributors to health behaviors and outcomes among refugees and immigrants postresettlement. In our representative sample, we found that smoking and betel nut use were very low (4% each). Fewer than 50% of respondents walked for at least 10 minutes on 2 or more days/week. Using World Health Organization standards for overweight/obese for Asians, 73% of respondents were overweight/obese and 56% were obese, indicating increased risk of chronic disease. Depression was also high in this sample (41%). In multivariate models, higher acculturation and age were associated with walking more often; lower education and higher acculturation were related to higher weight; and being divorced/separated or widowed and being older were related to higher risk of depression. The interrelated complex of characteristics, health behaviors, and health outcomes of refugees merits a multifaceted approach to health education and health promotion for long-term refugee health.

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A challenge that community-university partnerships everywhere will face is how to maintain continuity in the face of change. The problems besetting communities continually shift and the goals of the university partners often fluctuate. This article describes a decade-long strategy one university has successfully used to address this problem. Over the past ten years, a community-university partnership at the University of Massachusetts Lowell has used summer content funding to respond creativity to shifting priorities. Each summer a research-action project is developed that targets a different content issue that has emerged with unexpected urgency. Teams of graduate students and high school students are charged with investigating this issue under the auspices of the partnership. These highly varied topics have included immigrant businesses, youth asset mapping, women owned businesses, the housing crisis, social program cutbacks, sustainability, and economic development and the arts. Despite their obvious differences, these topics share underlying features that further partnership commitment and continuity. Each has an urgency: the information is needed quickly, often because some immediate policy change is under consideration. Each topic has the advantage of drawing on multiple domains: the topics are inherently interdisciplinary and because they do not “belong” to any single field, they lend themselves to disciplines pooling their efforts to achieve greater understanding. Each also has high visibility: their salience has meant that people were often willing to devote scarce resources to the issues and also that media attention could easily be gained to highlight the advantages of students, partners, and the university working together. And the topics themselves are generative: they have the potential to contribute in many different ways to teaching, research, and outreach. This paper ends with a broader consideration of how partnerships can implement this model for establishing continuity in the face of rapidly shifting priorities and needs.