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Partnering with patients can improve clinical services, research, and advocacy. Community engagement frameworks such as community-based participatory research (CBPR) recommend incorporating patient views into decision-making as much as possible to foster deep and collaborative partnerships.1 In 2020, the authors started the DC Network for Expectant and Parenting Teens (DC NEXT), a coalition of service providers and advocates who care for pregnant and parenting teens, including health care providers, social workers, and public health and policy professionals.2 DC NEXT used the collective impact model for social change, which emphasizes collaboration with people most impacted by an issue.3 To create meaningful engagement, we recruited a group of young parents to participate in DC NEXT, known as the context team.4 Context experts are people with lived experience of a situation who experientially know an issue.5 Working alongside coalition members, the context team improved services, conducted research, and advocated to increase support for pregnant teens and young parents.DC NEXT advertised a job description for 10 paid context team members through community organizations, social media, and directly to eligible patients. We sought participants who were passionate about improving systems for young parents and had capacity for the role. Ninety applicants submitted an interest form describing their experiences as young parents and recommendations to improve resources. All applicants were invited to have a 1:1 informational interview; 44 applicants scheduled and 20 completed the informational interview. These 20 applicants were invited to interview with a larger group of DC NEXT leaders. Ten applicants completed the group interview and were selected as context team members because of their capacity to complete the application process and passion for the opportunity.Tatiyana Bell, Context Team Member—“I joined the context team because my social worker Christiana told me about the opportunity. I was excited to have the chance to advocate for young parents, because I was one myself. If you really want to know how to fix organizations, you need teen parents to tell you how. They know a lot having experienced it themselves.”La’Tia Taylor, Context Team Member—“I heard about the chance to join DC NEXT from a friend who was already on the context team. She told me about how DC NEXT was working to improve things for young parents—I wanted to be part of that too so decided to apply.”As the goal was for the context team to co-lead DC NEXT, they met regularly with the various health care, education, and nonprofit leaders to build relationships. At monthly network meetings context team members shared “team spotlights” to update the rest of the coalition about their activities. A staff member with preious youth engagement experience was hired to supervise the context team and support their involvement in DC NEXT. She held weekly meetings to create community and to facilitate a youth-only space for the context team to prepare for and debrief all network-wide activities. Even with this intentional approach, the first 2 years of working together moved slowly. Meetings were virtual because of the COVID-19 pandemic, and this impacted engagement because it was harder to focus on meeting content, and it was challenging to build community virtually. Engagement improved once we determined it was safe to hold in-person meetings and events.Patricia Quinn, former director of DC NEXT—“It was important for the context team to be deeply involved in every aspect of DC NEXT. They co-developed the mission statement and program goals. We didn’t want them to be a separate advisory board that was consulted periodically; we wanted them to be empowered to guide the work of DC NEXT.”Tatiyana Bell, Context Team Member—“Being on the context team, it feels like we have an equal seat at the table. Even though all of us have different backgrounds we are genuinely included and listened to.”Christiana Jolda, Social Worker—“We want the context team to feel comfortable sharing their perspectives. Everyone uses their first names—even the doctors, social workers, and teachers—to show that everyone’s voice matters.”The context team worked with partner organizations from DC NEXT, giving feedback through focus groups to educators, childcare providers, and health care organizations on how to improve their programs.La’Tia Taylor, Context Team Member—“I learned about so many helpful programs by being on the context team and have been able to share them with other young people. I also educated staff based on my lived experience. For example, a school social worker didn’t know that you can apply for benefits online now. I gave her the website so she can share it with her students.”Yael Smiley, Pediatrician—“We’ve modified our teen-tot program based on the context team’s input. They told us how important it is to prioritize the mental health of young parents, and to try to intervene before mental health becomes a crisis. In response we’ve added integrated telehealth mental health support which has led to over 100 young parents in our program receiving mental health services.”Compiling materials from the Patient-Centered Outcomes Research Institute (PCORI) and the Collaborative Institutional Training Initiative (CITI), we created a curriculum to teach the context team about patient-centered outcomes research. We led workshops on research methodology, research ethics, health disparities, and communicating research findings (Table 1). Along with this training, the context team co-developed research projects for DC NEXT.La’Tia Taylor, Context Team Member—“After these sessions, I felt more interested in being involved in research studies. We had the chance to help create a well-being survey for pregnant and parenting teens across Washington, DC.6 The context team gave our input on what questions should be on the survey, and we recruited over 300 young people to take it. When the results came back, we were able to explain why certain findings made sense based on our own experiences.”Tatiyana Bell, Context Team Member—“When we went to events to advertise the survey, teens were way more likely to come over to our table than to other tables. We were more successful at attracting teens because we actually had young people on our team.”Haley Bliss, Pediatrician—“After our trainings, I helped the context team create the “Young Families Thriving Research Agenda” (Table 2). We held brainstorming sessions and then narrowed the priorities into 5 areas for future research: 1) supporting fathers; 2) perinatal support; 3) parenting and child development; 4) mental and physical health; and 5) social drivers of health.Yael Smiley, Pediatrician—“We’ve shared the research agenda locally and nationally with decision makers who focus on services, research, and advocacy for pregnant and parenting teens. Tatiyana and La’Tia joined us at a national meeting of adolescent health providers to share the research agenda.”We are committed to translating the context team’s knowledge from their lived experiences into policy changes. Policy experts from DC NEXT taught them about the local legislative and budget processes. The context team has spoken on panels before legislators and their staff and given testimony on bills that impact young parents. For example, they testified in support of a bill to expand virtual instruction to pregnant and postpartum students in high schools, which was passed into law in 2024.7Shaune Smith, Context Team Member—“An issue I really care about is housing. I remember all the obstacles that came with attempting to sustain affordable and long-term housing for myself and my children. The process of getting into a family shelter was unreasonably difficult. I want to make things better for other young parents. I submitted testimony to the Department of Human Services advocating that they expand access to resources like housing that are designed specifically to meet the needs of young parents.”La’Tia Taylor, Context Team Member—“Being on the context team put me in rooms I never expected to be in. One of the most impactful experiences so far was working with the city to develop a ‘warm line’—a social services network that provides residents with centralized access to resources and referrals. The point of the line is to help families get resources they need to stay out of the child welfare system. I saw how policy making can change because we shared our experiences.”Nandi Mjenga, Community Engagement Specialist and Context Team Manager—“Everyone on the context team wants to leverage this opportunity to find meaningful full-time employment. I help them update their resumes to showcase all the skills they’ve gained during this experience and connect them to other paid opportunities.”La’Tia Taylor, Context Team Member—“This experience has confirmed my career ambitions, and now I am even more interested in advocacy. With every meeting and opportunity to network I come across somebody who is relevant for my long-term goals.”Shaune Smith, Context Team Member—“I’ve challenged myself and grown. For example, I used to avoid public speaking. But I know it’s important to speak up to make things better for others. Being on the context team I’ve spoken in front of large groups and on panels. I still don’t love public speaking, but it’s gotten a bit easier.”Tatiyana Bell, Context Team Member—“This partnership has led me to other career opportunities. Because of this experience I was selected to review grant applications about teen health and recommended which projects I thought should get funding. I also conducted interviews for another research project and am preparing to lead a focus group of young parents.”We experienced some attrition and low engagement. Of the 10 initial context team members, 5 left the project after 2 years because of lack of time to devote to the project. Two new members were recruited, including 1 young father. After another year, 4 context team members remained regularly engaged. As we adjusted our meeting structure and timing, we found that during in-person meetings the context team members were more focused and gave deeper feedback. Eventually we settled on a monthly, in-person, 3-hour session that provided time for education, project work, and relationship building.“The context team has changed a lot. People had varied levels of engagement and length of time with the context team. Now we have just Tatiyana, La’Tia, and Shaune. Even though the group is smaller it works well because they are all extremely committed and engaged.”“A bigger team is not necessarily better. You need to decide how much work there actually is to do and decide how many people should be involved. And it’s important to choose people who are dedicated and make sure expectations are met by everyone on the team.”“Our experience with engagement reflects the unique circumstances of parenting teens. As context team members balanced school, work, and parenting, some couldn’t participate fully in the project because of these competing demands.”Paying context experts for their time and expertise is crucial. Using funding from multiple grants we have supported the context team continuously for 5 years, paying a rate of $50 to 75 per hour in line with institutional consultant rates.Tatiyana Bell, Context Team Member—“The amount of pay should be meaningful and should be related to how involved we are. And make sure the pay comes consistently on time. But even though pay is important, it’s not everything. I stayed involved because I’m passionate about the issues.”Christiana Jolda, Social Worker—“It takes time to build trust, and our relationships have evolved. Over time, context team members have asked me for help managing relationship issues, navigating health care systems, and getting referrals for community programs. The trust we’ve built has extended beyond just working together.”La’Tia Taylor, Context Team Member—“I like that we get to know each other as people, and I can show up as my whole self on the context team. There’s a social worker I can go to if I need help with something. We can bring our kids to see the doctor who works with us.”Partnerships are most impactful when they are truly collaborative and empower participants. The context team model prioritizes deep engagement with people with lived experience of an issue. During this long-term partnership, the context team improved services, led research, and advocated to improve systems of care for young parents. Their perspectives offer helpful strategies for establishing meaningful community partnerships.