Instead, they’re learning how to BLAST through the code of life, backcross zebra fish genetics based on phenotypic traits, stain samples for immunohistochemistry, and even how to perform procedures on mouse models to explore the immune system.

This is the FIRM program: Future Innovators in Research and Medicine, and it just wrapped up its second year. It didn’t begin with a mandate or a five-year strategic plan. Instead, two Einstein trainees noticed something missing and decided to build it themselves.

Origins

In 2023, the Einstein Office of Community Engagement (OCE) issued a request for proposals for grants to build community among trainees. This planted a seed for Luis Ovando, PhD, G5, who “wanted to build community and reduce fragmentation amongst MD, PhD, and MD/PhD students at Einstein.”

One way Luis thought about this was to build something that would highlight the value of combining the skills each program focuses on developing, e.g., biomedical research and clinical medicine. Breaking down barriers between degree programs at Einstein is not always trivial, but doing so can pave the way for serving the Bronx community in unique ways.

With this goal in mind, Luis got to work on the grant. On Wednesday evenings, the OCE would host “community diners,” which created spaces for trainees to come together and discuss their ideas for the grant. This is where Luis connected with Justin Nwafor, MD/PhD, G1.

At the time, Justin had been heavily involved with the Einstein Enrichment Program (EEP), where he served as a tutor for high school students on Thursday evenings. Luis pitched Justin the idea for the grant: a workshop/hands-on series that brings MDs, PhD, and MD/PhDs together around a shared mission of helping to inspire the next generation of physicians and scientists.

Over the course of 3 months, the two translated that idea into a successful community grant proposal: funding came through. At this point, the “business plan” was complete, on paper at least.

The grant secured resources, but it didn’t answer the next set of questions: Who exactly are the users? What do they need? How do you recruit them? How do you design something that fits into already crowded schedules, both for Einstein trainees and for high school students finishing long days in class?

In startup terms, the minimum viable product (MVP) had been funded. What came next was stakeholder discovery and turning a prototype into a product. In practice, that meant identifying people across Einstein, finding trainee instructors willing to teach after hours, integrating with an existing pipeline of Bronx high school students, and figuring out how to align all of these pieces.

Only then could FIRM begin to take shape.

Einstein Enrichment Program: Don’t build a bridge if a great one already exists

FIRM did not emerge in a vacuum—it latched onto a program that had already been implemented at the institution.

Fortunately for Luis and Justin, Einstein had already built an on-ramp: the Einstein Enrichment Program (EEP). EEP is a long-running initiative designed to support economically and educationally disadvantaged high school students, many from the Bronx, by exposing them early to careers in science and medicine.

Luckily, Justin was intimately familiar with the program. Before FIRM existed, he had spent over a year tutoring EEP students in chemistry.

“The students are already in school for six, seven, eight hours a day,” Justin said. “They don’t want to come here and hear another lecture. That’s a lost cause.”

EEP was already offering mentoring, tutoring, lab opportunities over the summer, and physician talks, but Justin and Luis thought something was missing.

“What we were really trying to fill,” Justin explained, “was the gap between hearing about science and medicine and actually doing it.”

FIRM would become that missing middle: not another lecture series, not more tutoring, but a hands-on experience that treated high school students like early trainees rather than passive listeners.

Finding teachers: how to build a classroom without a professor

One of FIRM's innovations is that it relies almost entirely on social capital. There is no central office assigning instructors, no formal teaching requirement, no protected time, and no monetary compensation.

Instead, Luis and Justin build each year’s curriculum the way startups assemble early teams: by asking people they trust.

“We choose people who are specialized in that topic,” Luis said. “People we see in the halls, people we know from rotations, from labs, from departmental Works In Progress (WIPs).”

Each workshop is taught by Einstein trainees: MD, PhD, and MD/PhD students, paired intentionally across programs. The result is teaching that feels alive and fueled by a genuine desire to convey the love of a subject.

“The students can feel that passion,” Luis said. “They’re learning from someone who actually loves what they’re doing.”

Faculty still play a critical role: opening lab doors, sharing reagents, and offering space when budgets fall short.

“Funding is low,” Luis admitted. “But faculty are usually happy to help when they know it’s for high school students.”

What does FIRM look like?

FIRM runs for six to seven weeks each fall, pulling a small, selective cohort from the larger EEP program. Students “earn the right,” as Justin put it, to participate.

Each week follows the same basic structure: half lecture, half hands-on.

However, the content is anything but basic. Students begin by learning lab safety and pipetting before moving into microbiology (Gram staining and streak plating), genetics (zebrafish phenotyping and Punnett squares), immunology (live mouse imaging), neuroscience (immunohistochemistry and brain anatomy), oncology, and bioinformatics.

In one session, Justin and Luis crowdsourced laptops from the Einstein library and ran BLAST searches to build evolutionary trees.

“They’re figuring out how the whole tree of life comes to be,” Justin said. “They’re coding. They’re doing real work.”

In another, they watched blood cells move through living tissue under a microscope.

Key Performance Indicators + Outcomes

As a program led by trainees representing every Einstein degree program, FIRM does track outcomes. Students take quizzes, fill out surveys, and at the end of the program, they give presentations reflecting on what they learned and how their thinking has changed. Not only have they had exposure to what a career in STEM looks like, but they also get the chance to learn how to communicate what they’ve done.

But the moments that matter most rarely show up on a Google Form.

I personally saw this firsthand while helping lead the oncology workshop this past November. On one of my slides was the cover of The Emperor of All Maladies by Siddhartha Mukherjee. I mentioned, almost offhandedly, that I had read the book in high school and that it was one of the reasons I decided to pursue a career in healthcare.

Within seconds, every student’s phone was out. Screens lit up across the room as they took pictures of the slide.

That was the moment I realized something important was happening here. Justin had described this phenomenon earlier in our conversation:

“You don’t know what’s going to spark it,” he said. “You really don’t.”

Sometimes it’s a pipette. Sometimes it’s a zebrafish. Sometimes it’s watching blood cells move through living tissue in real time. And other times it’s a book, one that someone a few years ahead of you once read and decided to follow.

In that moment, it became clear that FIRM’s real return on investment (ROI) isn’t immediate or linear, but that it compounds in the background. Exposure leads to curiosity. Curiosity leads to confidence. Confidence, given enough time, becomes a trajectory.

You can’t measure that in six weeks. But you can feel it when it starts.

One student entered the program focused on electrical engineering and left thinking seriously about biomedical engineering. Another discovered an interest in immunology he hadn’t expected.

Others simply kept showing up.

“They come from a full day of school,” Justin said. “It’s four to six in the evening, and they’re taking notes. Asking questions. They want to be there.”

For both founders, that alone feels like a win.

“We’re not losing students because they’re not interested,” Justin said. “They just weren’t exposed early enough.”

Challenges and Detours

FIRM is not easy to run. Both founders are full-time trainees, with planning meetings taking place at night, in between experiments, exams, and clinic.

“The admin work cooks you,” Justin admitted. “You want to do the fun stuff, but someone still has to schedule rooms and chase emails.”

Luis described a more unexpected and subtle pressure: responsibility.

“If an instructor can’t show up, Justin and I step in,” he said. “If there are no resources, we find them.”

The program evolves by trial and error. One year, they formalized instructor roles; the next, they dropped them (only to realize they were essential).

“That was a lesson,” Luis said. “You need structure to keep people engaged.”

Nothing about FIRM is static, but that’s the point.

Future of FIRM

FIRM is still small by design. The goal isn’t scale for scale’s sake; it’s sustainability. It would be a shame if the program ceased to run when Justin and Luis graduate.

Short-term, the team plans to deepen content, add new workshops (including drug development and structural biology), and expand leadership to ensure the program survives beyond any single cohort.

Both founders hope for the same long-term outcome:

“Hopefully,” Justin said, “we’ll see some of them come back to Einstein one day.”

So what is Innovation, anyway?

It wouldn’t be an EIG Einstein Innovators profile if we didn’t end by asking a deceptively simple question: What does innovation actually mean?

For Justin, innovation begins with curiosity, but doesn’t stop there.

“In science, innovation is the peak of curiosity,” he said. “It’s wanting to understand something we already know, or creating something completely new that we’ve never seen before, and then seeing what it allows us to do.”

He pointed to protein design and chemistry as examples of a field finally breaking free from what already exists in nature.

“You’re never going to see an airplane made out of sticks and leaves,” he said. “This is completely new stuff. And that’s where innovation lives.”

Luis framed innovation as:

“For me, innovation sits between discovery and novelty,” he said. “It’s not just finding something new, it’s learning how to apply it. And then using that application to make more discoveries.”

CRISPR, he explained, didn’t begin as a tool. It began as curiosity about bacteria. Innovation happened when someone realized what else it could become.

Seen through that lens, FIRM itself starts to look less like a program and more like a prototype.

It didn’t begin with a strategic plan or institutional directive. It began with two trainees noticing a gap in the Einstein community between students’ training in science and medicine, between exposure and access, and deciding to build something that didn’t yet exist.

FIRM is innovative not because it teaches BLAST, zebrafish genetics, or immunology. It’s innovative because it turns proximity into possibility. It treats exposure as a mechanism rather than an afterthought. It assumes that talent is already there and that the real work is creating the conditions for it to surface.

Innovation, in this case, isn’t a breakthrough discovery or a successful startup launch. It’s the compounding of small moments like a pipette in a student’s hand for the first time, a Punnett square that suddenly explains a Zebrafish’s stripes, and a shift from a mechanical to a biomedical engineer.

You can’t always measure when innovation works.

But sometimes, you can see it: in the flash of twelve phones rising at once to capture a book cover projected at the front of a classroom.

To learn more and get involved with FIRM, please reach out to Justin or Luis (justin.nwafor@einsteinmed.edu and luis.ovando@einsteinmed.edu)

If you have ideas for future Einstein Innovators pieces or would like to help write one, please reach out to us using the button below.

And yet, even as clinicians and scientists in 2025 are rewriting human genomes, some states are moving to undermine childhood vaccine mandates, the very policies that have spared millions of lives from preventable and dangerous diseases like hepatitis B and measles (Shattock et al. 2024) (Mazzei 2025/09/03). The juxtaposition between breathtaking innovation on one side and eroding trust and growing vulnerability on the other is stark.

Yet despite these contradictions, people are engaging with their health in new ways. From the rise of wearable and digital health tracking to the omnipresence of health advice on social media and large language models that “personalize” the internet’s understanding of health and science, physicians and scientists are no longer the sole interpreters and translators of medical knowledge.

In this landscape, how clinicians and scientists communicate is as important as what they discover. This can be perfectly summarized by Dr. Tal Zaks, the former Chief Medical Officer at Moderna during the COVID-19 pandemic, when asked to reflect on his tenure, “But where did we fail? […] I think it’s a question of probably scientists, myself included, overstepping our boundary, in a sense. And it goes back to the point I started with, of the misguided philosophical framework that we operate under, which assumes that because it is science, it is good. Science per se is not an ethical framework of a force for good. People who deploy it for good have the obligation to explain why their moral framework is what it is” (Colossus, Investing, and Business Podcasts 2025).

The “explaining why” is precisely where Dr. Damara Gutnick and the BRAID initiative at Montefiore/Einstein come in. BRAID, or “Bridging Research, Accurate Information & Dialogue,” creates spaces where clinicians, scientists, trainees, patients, and communities can engage in honest conversations, wrestle with uncertainty, and rebuild trust. At a time when mis- and disinformation can spread faster than any virus, BRAID is showing that dialogue itself can be a form of healing.

Fortunately, EIG sat down with Dr. Gutnick to learn more about her path and the work that BRAID is doing to achieve its mission of addressing pressing issues with innovative, community-centered solutions.

1. Origins:

a. Can you tell us about the foundations of BRAID?

BRAID’s foundations include: 1) Best Practices in Trust-Building and Community Engagement, 2) Asking, Listening, and Doing What Matters and 3) Motivational Interviewing.

I trained at Montefiore many years ago as one of the primary care residents. During my residency, communication was very important. There was a strong emphasis on person-centered care and person-centered communication. As a resident, I had an opportunity to participate in the Hazelden program, an inpatient drug and alcohol rehab center. That’s where I first heard the term motivational interviewing.

After residency, I worked at the Bellevue Hospital outpatient primary care clinic where I served as the physician champion for a behavioral health integration program. There was a huge shortage of psychiatrists at the time, people would wait months for an appointment. The goal of our program was to teach primary care providers how to handle general psychiatry (depression and anxiety screening and treatment) and only refer more complicated cases.

It turned out to be really effective. It opened up access to psychiatry for those who truly needed it. Through that work, I learned a lot about communication. We had a psychiatrist supervising our care managers, and that’s where I started hearing more about motivational interviewing again.

There was a citywide collaborative for these programs, so every few months teams from across New York City would come together to share what they were learning. At one of those meetings, there was a lecture on motivational interviewing, taught by someone who would later become one of my mentors, Dr. Steve Cole.

After the session, I went up to him and said, “This was really cool. I’ve been trying to apply it with my patients, and I’d love to learn more.” And he said to me, “This is the future of medicine.” At the time, only psychiatrists and psychologists were trained in motivational interviewing, but he believed it could be applied everywhere. He encouraged me to pursue further training.

So I did. I started applying what I learned with my patients, and immediately I noticed a difference. The conversations just felt different.

In motivational interviewing, there’s something called the spirit of MI, which describes the way you are with your patients. You can remember it with the word CAPE. When you put a cape on a child, you empower them to feel like a superhero, and that’s what CAPE represents in this context:

• C stands for compassion: doing everything in the best interest of the person you’re working with.

• A stands for acceptance: respecting a person’s autonomy and their right to change or not to change. If someone isn’t ready, you meet them where they are instead of pushing.

• P is partnership: you’re not the doctor telling the patient what to do, you’re working alongside them, trying to understand their perspective.

• E is evocation: drawing out a person’s own reasons for change. When people articulate their own motivations, they’re far more likely to follow through.

So I started using motivational interviewing with my patients and began seeing tangible results. At that time, our clinic had just implemented report cards for doctors, tracking things like what percentage of your patients had good control of their diabetes or blood pressure. After I started applying MI, my numbers went green across the board.

Patients noticed too. One patient said to me, “I don’t know why, Dr. Gutnick, but it feels different today.” It was because I had stopped telling her what to do. Instead, I was listening and meeting her where she was.

At that point in my career, I was pretty burnt out. But letting go of that pressure to push patients, just meeting them where they were, was transformative. It brought joy back into my work. Patients could feel that, and I did too.

I became enamored with MI. I realized MI didn’t just impact my patients; it changed me as a clinician. I then went through advanced training with the founders of MI, Bill Miller, Terry Moyers, and Stephen Rollnick, and eventually became a member of the Motivational Interviewing Network of Trainers (MINT).

b. So once you saw how motivational interviewing changed things for you and your patients, how did that lead to your broader work, training others, and shaping programs?

I loved it so much that I wanted to share it. Around that time, NYC Health + Hospitals was running a citywide behavioral-health-integration collaborative, and I told them, “I think I could help other sites do this.” After some back-and-forth, they actually bought out part of my time and I became an implementation coach for hospitals and FQHCs across the system.

So I started visiting sites across the city and teaching doctors, nurses, and social workers how to integrate MI into their everyday patient encounters.

What I loved about that was realizing scale. When I used MI myself, I was reaching my own panel of maybe 200 to 300 patients. But by training other clinicians, I was indirectly reaching thousands more. It was this incredible downstream impact, because each clinician I trained could apply MI to their own patient panel.

Then came the DSRIP Program (Delivery System Reform Incentive Payment Program).
It was an $8-billion Medicaid waiver to New York State aimed at redesigning care delivery and reducing avoidable hospitalizations. The state was divided into 25 performing-provider systems (PPSs); Montefiore was part of two PPSs- one in the Bronx and one in the Hudson Valley.

Under my leadership as the Medical Director of the Montefiore Hudson Valley Collaborative (MHVC), we implemented an MI train-the-trainer model that helped build capacity within our partner organizations, including hospitals, FQHCs, Behavioral Health and Substance Use provider organizations and even CBOs to train their staff in MI sustainably.

What I loved about DSRIP was that it let me operate at yet another level, not just coaching front-line staff, but influencing policy and organizational culture. The DSRIP program had funding to incentivize change and to support training programs. So it was incredible to see hospitals and CBOs training their staff in communication skills and integrating best practices in trust-building and cultural competence.

Through that work, I started to see that motivational interviewing wasn’t just a technique, it was foundational to everything I was doing. It shaped how I thought about patient partnership, trust, and empathy.

Around the same time, I was introduced to the “What Matters to You” movement. It began with a 2012 New England Journal of Medicine article by Michael Barry and Susan Edgman-Levitan, which argued that healthcare needs to shift from asking “What’s the matter?” to “What matters to you?”

That single question changes everything. “What’s the matter?” focuses on a chief complaint: chest pain, fatigue, a purple toe, but “What matters to you?” goes much deeper. It gets at a person’s priorities, stressors, relationships, fears, and joys. When you ask it, you uncover the social determinants behind a person’s health and their motivation for change (D. Gutnick and McNeilly 2025).

When care plans are built around what matters most to people, they’re more practical, sustainable, and meaningful and people are more likely to follow them.

The movement took off internationally in 2014 through the Institute for Healthcare Improvement (IHI). Maureen Bisognano, the former IHI president, gave a keynote where she said, “We need to shift healthcare from ‘What’s the matter?’ to ‘What matters to you.’” Audiences around the world adopted it.

I was in one of those audiences and thought, Let me try this with my patients at Bellevue. And it was transformative (just as powerful as motivational interviewing).

Now, “What Matters to You” has its own global network. It’s aligned with the Beryl Institute for Patient Experience, has a public website, and hosts monthly meetings that anyone can join.

That’s really the foundation that later shaped BRAID: combining the principles of motivational interviewing and “What Matters to You” into a community-based, trust-building model.

2. Building the model

a. That’s a great background. Can you talk a bit about the “why” behind BRAID?

The idea for BRAID really grew out of a few earlier projects. One was led by Dr. Bruce Rapkin, a professor at Einstein, who had done remarkable work in public libraries across Queens. He partnered with community members to co-design creative programs that increased cancer-screening rates, everything from performances to quilting clubs. Even after the grant ended, the libraries kept the work going because it was theirs (Rapkin et al. 2017).

Bruce and I had worked closely together and thought, “How do we take this kind of co-design model to the next level?” We sat down with a diverse team to brainstorm and realized we needed a name that captured what we were trying to do. That’s how BRAID was born: short for Bridging Research, Accurate Information, and Dialogue with the community.

At first, we planned to focus on cancer education, building on Bruce’s work at the library. Around the same time, our colleague Dr. Rosy Chhabra, who directs the School Health Program at Montefiore, had created a cervical-cancer education program (CHIC - Cervical Health in the Community) that trained women to teach their peers about screening (Chhabra et al. 2018). That peer-to-peer model was powerful, and we wanted to weave that idea in as well.

Around then, COVID started. Suddenly, trust in vaccines was collapsing everywhere. We decided to pivot to use the BRAID model not for cancer, but for vaccine confidence. Funding was available, and we launched a pilot.

Everything was co-designed with the community from day one. We constantly asked, “Does this make sense to you? How should we adjust it?” and built measures of trustworthiness into the model itself.

We pulled from the literature on institutional trust and from the AAMC’s Principles of Trustworthiness Toolkit. At the heart of it is a simple principle: the community knows best. You have to be transparent, share information openly, and earn trust over time.

A lot of traditional community programs come in with pre-packaged solutions: “Here are two options; pick one.” BRAID does the opposite. It starts with listening, understanding what matters to people, and evoking their own ideas through motivational interviewing. Then we co-design solutions together.

So in essence, BRAID is built on partnership and trust. The name also carries symbolism: when someone braids your hair, it happens through closeness and trust. You’re sitting together, talking, connected. That’s what BRAID is meant to represent: a process of weaving together research, accurate information, and real dialogue.

b. That’s a thoughtful foundation. Could you break down what BRAID actually looks like in practice? What are the conversation circles, the parking lot, and how do the community messengers fit in?

The BRAID model has two main phases (D. N. Gutnick, Stephenson-Hunter, et al. 2024; D. N. Gutnick, Lozano, et al. 2024). The first is trust-building and co-design, and the second is dissemination: spreading accurate information through trusted community members.

We always start by partnering with community-based organizations because they already have the trust of the neighborhoods they serve. They help us identify trusted messengers (people others naturally turn to for advice). These could be faith leaders, librarians, people working at food pantries, anyone known and respected in the community.

We invite those individuals to join a series of BRAID conversation circles. Aligned with the best practices in trust building, each participant is compensated for their time and expertise. It’s important not to “use” the community; they’re paid consultants, just like any professional expert.

In these circles, we talk about topics relevant to the project: vaccines, clinical-trial diversity, genomics, dementia prevention, and more. The environment is intentionally open and conversational. We also look for people who are comfortable discussing sensitive or complex issues, as those individuals often make the best “BRAIDers” later on.

We train some participants in motivational interviewing before they start sharing information more widely. That way, when they talk with others, they’re not debating or pushing; they’re drawing out what matters to people and having genuine conversations. Two Einstein students, Marie Ivantechenko (M4) and Shubarna Akhter (M4), recently published a paper about this (Ivantechenko, Akhter, and Gutnick 2025).

Inside each session, there’s a facilitator, who is MI-trained, and a parking lot attendant, often a medical student. The facilitator guides the discussion, while the parking lot attendant listens carefully and takes note of key themes and questions that arise.

If someone brings up a question during the conversation, we don’t interrupt the flow to answer it right away. Instead, we “park” it, write it down in the parking lot. At the end of the session, we go back to the list and say:

“These are the questions and ideas we heard. Which of these would you like us to explore next time?”

That way, the community sets the agenda for the next discussion. It’s their priorities that shape the work, not ours. This process also teaches students a critical clinical skill: active listening. Many community members have told us how meaningful that feels. Comments like, “Wow, you really heard us,” or “I can’t believe you captured everything we said,” come up all the time.

Sometimes we miss something, and they’ll correct us, which is great: it keeps it collaborative. That practice of reflecting back and confirming understanding is exactly what physicians should be doing with their patients, too.

I often tell students this role mirrors a clinical skill called “surveying,” in which we gather all the patients’ concerns up front before diving into the details by continually asking, “Anything else?” “Anything else?” Then, after all the concerns are collected, you ask the patient to help prioritize the most important ones for them. For example, if someone comes in with 10 issues, you might say, “We have 20 minutes today, let’s focus on the ones that matter most to you.” That simple act of naming everything first makes people feel heard. The parking lot serves that same purpose at a community level.

So in BRAID, listening and reflecting aren’t just courtesies; they’re part of how we build trust. The community decides what matters most, and we respond to that.

3. Measuring Impact + Stories of success

a. What are some applications of BRAID?

BRAID is a highly adaptable model, and we have used it to address multiple public health concerns. We’ve done this with vaccines during COVID-19 (Stephenson-Hunter et al. 2023; Bell et al. 2025). Then we did it around clinical-trial diversity (McNeilly et al. 2025), and we’ve also used the model to share the results of a research study back with the community.

The study was part of the SOL Study, which showed that prolonged exposure to poverty in Latinos actually increased their risk of developing Alzheimer’s dementia at an earlier age. So, we shared that information, as well as things you could do to keep yourself from developing dementia like, what are the best practices in brain health? Keeping yourself active, socializing, eating healthy, exercising, playing puzzles or dominoes. Sharing what you can do, because this is what the research showed, so let’s be proactive.

We’ve also used it around genomics. Dr. Sri Raj, who’s a geneticist and anthropologist in our system, did work on the All of Us database and found that in the Bronx there’s a community called the Garifuna (there are about 100,000 to 200,000 living here) who have a very high rate of carrying an autosomal dominant variant for hypertrophic cardiomyopathy (Isshiki et al. 2025).

Actually, about one in twenty-five carry it, and it has a very high penetrance. So we engaged the Garifuna community to inform them about this risk and to co-design messaging strategies for their peers to let them know about this in a way that would resonate with them (click here to see an example of a codesigned video).

We’ve used BRAID in many different ways, but the idea is always the same: you bring people together to talk about what matters to them related to that topic. It’s not like a focus group where you come in with a fixed list of questions. You might have them in the background, but it’s not about where you want the conversation to go, it’s about where the community wants it to go.

You evoke their questions, their concerns, and then say, “I understand these are big concerns of yours. Would you like us to bring in a scientist or clinician to talk about that next time we meet?” So you’re empowering the community to decide where the conversation goes.

b. How does the second phase of BRAID work (the dissemination part)? And how do you measure impact?

All right, so the first phase is about trust building, first of all, and then there’s also space for co-designing. So, the scientists could come and talk about X, Y, and Z, and then we say to the community, “What do you think about that?”

And they might say, “Okay, I trust what you just told me, but the way you’re messaging it would not resonate with my peers.” So we have space for co-design. You’re coming out of phase one with a co-designed, accurate message—trust.

Now those community experts from the first phase—we call them community experts—can transition, if they’d like to, into a BRAIDer. A BRAIDer is somebody who shares the codesigned accurate information downstream. BRAIDing is the act of sharing that information downstream.

And here’s the key part, the BRAIDers come back. We don’t just send them off and call it done. They go out, have those conversations in their community, and then they come back to the next circle and tell us what they heard: the questions, the resistance, the new worries.

That’s what makes BRAID different, it’s iterative. Every round of dissemination feeds the next round of dialogue.

The next piece is how we measure it.

Together with two Einstein students, Julia Zimmerman (M4) and Roula Kouvatas (M4), we did a network analysis to understand how information moves, asking people, “Who did you talk to?” and then following up later to see how those conversations went. But that’s really time-consuming. So, one of our former BRAID team medical students who is now a Montefiore resident, Dr. Phillip Chen, built a BRAID website, where each BRAIDer has a unique webpage with their co-designed materials and their own QR code or link. When someone shares it or scans it, we can see how far the message travels.

That’s one way of measuring impact: tracking dissemination digitally, but the focus is still on relationships. It’s about whether people trust the message, whether they feel seen, and whether they want to pass it along.

c. Are there any stories that stand out to you, moments when you really felt BRAID was working?

Yeah, so actually, Saba Saidi (Einstein M3) did a survey and interviews of participants in the BRAID model (the medical students, my team, the scientists, and clinicians that came), and she’s studying how it affects us as clinicians and as healthcare providers participating in the BRAID circles.

Because when you come as a scientist, you’re not coming to lecture; you’re coming to listen, to understand what matters to the community, and to address their concerns. So it becomes a dialogue where you’re equal with the community, too.

The community loved that. In their evaluations, they said having access to a scientist or a clinician was really valuable.

And what was most humbling to me was a comment by a young man who said, “You know, what I loved about this is it’s the first time in healthcare that anybody’s ever listened to me — that a doctor ever listened to me.”

And I was like, wow. I said, “Tell me more.” He said, “It’s like healthcare’s transactional. People come in and say, what’s your problem? Okay, here’s what you should do. But nobody really listens to what matters to me.”

That made me think back to some of my earlier patient interactions when I was a young attending working at Bellevue, and there was this one woman, an older woman, who I was having a vaccine conversation with, about the flu vaccine. And in retrospect I realize that it was obvious that she didn’t trust the vaccine, and I missed that.

I was saying, “But it’s really important,” and giving her all the reasons, rather than listening to why. You know, at that moment, I might have learned about Tuskegee from her, I might have learned, if I had opened it up and left that space. But I was just giving the reasons, giving the reasons, and I keep thinking about that one interaction.

And then I had another patient it made me think about, too. Her grandson was involved in an altercation (he was in the wrong place at the wrong time) and he ended up getting picked up by the police, even though he was completely innocent. She was an African-American woman, and this was maybe fifteen or twenty years ago.

I really missed the opportunity to understand what was going through her mind and how this was her everyday. I thought it was just a one-time thing that happened. I didn’t understand the daily experiences of the patients I was working with.

And I think it’s really important for us to think about that, Why is there distrust? It’s because there are structural reasons that people feel the way they feel and have the experiences they have. We have to be more aware of that.

That, to me, is the biggest thing, and other doctors and staff who’ve gone through BRAID have said the same. It’s an opportunity to really put ourselves in other people’s shoes.

4. Innovation

a. That’s awesome. I think we can transition now to the discussion of innovation. What we’re trying to do with EIG is to make innovation something that’s accessible: something students can actually practice. What does innovation mean to you, especially in healthcare?

When I think of innovation, I go back to DSRIP.

As medical director, one of the things I loved most was that we had funds to spark innovation and creativity - to incentivize change. We had an innovation fund, and community-based organizations and federally qualified health centers could submit proposals for projects that addressed what we called our “true north.”

The true north for DSRIP was reducing unnecessary healthcare utilization: things like preventable hospital readmissions and avoidable ED visits. So we said to the community, “Here’s the problem. We’ll give you startup funds to test an innovative idea that could reduce unnecessary use, but you have to show that it works.”

And the projects that came back were amazing. One of my favorite examples was putting a social worker in the Yonkers Public Library (Porteus et al. 2019). The librarians told us people came in asking for help with food stamps, housing, even how to get a MetroCard — and they didn’t know how to help. So we said, “Let’s put someone there who can.”

And another example that really stuck with me was from Highbridge, in the Bronx. We have a CDC grant called the New York City CONNECT Grant. This is a collaboration with the Food Bank of New York and NYU. NYU’s working in two neighborhoods in Brooklyn, and we’re working in two neighborhoods in the Bronx with the highest rates of cancer disparities.

And we asked the community, “What’s most important to you?” And in one community, Highbridge, it’s hilly.

And so, access to care is problematic because it turns out that the bus system changed the stop. And there used to be a stop at the bottom of a hill next to where all these seniors lived. And they got rid of that stop, and now the stop’s at the top of the hill, so the seniors can’t use the bus to get to their doctors’ appointments.

So the community said, “That’s important to us, and that’s what we would like to work on. That’s what the equity strategy would be.” Would it be a mechanism to—what does that mean? Is it advocating for MTA to put that bus stop there? Or maybe it’s about educating the community about Access-A-Ride and other ways that they could access rides to the hospital. So that’s what we’ve been working on with the community in that place.

And that’s very innovative. Now, it doesn’t fall into technology, per se.

These experiences really shaped how I think about innovation now. You can’t call something innovative if you haven’t integrated feedback from the community from the beginning.

I believe that every innovation project should have a community advisory board. You start by asking, “What’s your problem that you want help solving?” instead of “Here’s our solution, which one do you want?”

It’s that partnership that makes something truly innovative. Because the community is the expert on itself.

So, when I think about innovation, I think about relationships, systems, and trust: doing things differently so people can actually access what they need.

To learn more about BRAID, please visit www.BRAIDERS.org

Citations

Bell, Brett I., Sarah Hill, Justin Olivera, Valerie Fong, Michelle Schumacher, Madeline Friedman-DeLuca, Tiffany Cheng, et al. 2025. “Understanding Vaccine Disparities in the Bronx, New York, through a Mixed Methods Analysis of Community and Provider Perspectives.” AJPM Focus 4 (4): 100373.

Chhabra, R., A. Rivera, N. Sharma, S. N. Ghosh, and L. J. Bauman. 2018. “Engaging Community Members as Health Advocates in a Peer Driven Intervention - A Cervical Cancer Prevention Pilot in Punjab.” India. Global Journal of Health Education and Promotion 18 (1): 36–52.

Colossus, Investing, and Business Podcasts. 2025. “Tal Zaks - Bridging Science, Medicine, and Returns - [Invest like the Best, EP.406] - Invest like the Best with Patrick O’Shaughnessy.” Wave AI Note Taker: Podcast Notes with AI. January 14, 2025. https://pod.wave.co/podcast/invest-like-the-best-with-patrick-oshaughnessy-48a998b1-8bc3-4e91-9c00-6d2f4d646fdd/tal-zaks-bridging-science-medicine-and-returns-invest-like-the-best-ep406-5bd2f6bc.

Gutnick, Damara, and Sarah McNeilly. 2025. “Motivational Interviewing Is ‘Doing’ What Matters: Integrating Motivational Interviewing Spirit and Skills into What Matters to You? Conversations.” Journal of Patient Experience 12 (February): 23743735251317040.

Gutnick, Damara N., Patricia Lozano, Smeily Rodriguez Martinez, Katherine W. Wang, Debra A. Williams, Bruce D. Rapkin, and Nelly Gonzalez-Lepage. 2024. “Research Protocol for Bridging Research, Accurate Information and Dialogue (BRAID)-Clinical Trials: A Mixed-Methods Study of a Community-Based Intervention to Improve Trust and Diversify Participation in Clinical Trials.” Frontiers in Public Health 12 (September): 1407726.

Gutnick, Damara N., Cara Stephenson-Hunter, Elizabeth Spurrell-Huss, Moria Byrne-Zaaloff, Saskia Shuman, and Bruce Rapkin. 2024. “Bridging Research, Accurate Information and Dialogue (BRAID): A Novel Strategy to Build Community Trust.” Progress in Community Health Partnerships: Research, Education, and Action 18 (2): 247–58.

Isshiki, Mariko, Anthony J. Griffen, Paul Meissner, Paulette Spencer, Michael D. Cabana, Susan D. Klugman, Mirtha Colón, et al. 2025. “Genetic Disease Risks of Under-Represented Founder Populations in New York City.” PLoS Genetics 21 (6): e1011755.

Ivantechenko, Marie, Shubarna Akhter, and Damara Gutnick. 2025. “Empowering Trusted Messengers with Motivational Interviewing Skills: Improving Dissemination of Accurate Information to Communities.” Community Health Equity Research & Policy 46 (1): 41–51.

Mazzei, Patricia. 20205/09/03. “Florida Moves to End Vaccine Mandates for Schoolchildren.” The New York Times, 20205/09/03. https://www.nytimes.com/2025/09/03/us/florida-vaccine-mandates.html.

McNeilly, Sarah M., Katherine W. Wang, Sarah A. Jacobs, Nang S. Yone, Debra A. Williams, Bruce D. Rapkin, Caroline Davis Joseph, and Damara N. Gutnick. 2025. “Towards a Learning Healthcare Community in the Bronx: Evaluating the Bridging Research, Accurate Information and Dialogue (BRAID) Model.” Health Research Policy and Systems 23 (1): 20.

Musunuru, Kiran, Sarah A. Grandinette, Xiao Wang, Taylor R. Hudson, Kevin Briseno, Anne Marie Berry, Julia L. Hacker, et al. 2025. “Patient-Specific in Vivo Gene Editing to Treat a Rare Genetic Disease.” The New England Journal of Medicine 392 (22): 2235–43.

Porteus, S., E. Scott, J. Shenk, C. Williams, and D. N. Gutnick. 2019. “More Than Books at the Yonkers Public Library: Innovative Partnerhsips to Address Social Determinants of Health in the Community.” NYS DSRIP Annual Learning Symposium, February.

Rapkin, Bruce D., Elisa Weiss, David Lounsbury, Tamara Michel, Alexis Gordon, Jennifer Erb-Downward, Eilleen Sabino-Laughlin, et al. 2017. “Reducing Disparities in Cancer Screening and Prevention through Community-Based Participatory Research Partnerships with Local Libraries: A Comprehensive Dynamic Trial.” American Journal of Community Psychology 60 (1–2): 145–59.

Shattock, Andrew J., Helen C. Johnson, So Yoon Sim, Austin Carter, Philipp Lambach, Raymond C. W. Hutubessy, Kimberly M. Thompson, et al. 2024. “Contribution of Vaccination to Improved Survival and Health: Modelling 50 Years of the Expanded Programme on Immunization.” Lancet 403 (10441): 2307–16.

Stephenson-Hunter, Cara, Yousra Yusuf, Rita Larson, James Campanella, and Damara N. Gutnick. 2023. “What Matters to Us: Bridging Research and Accurate Information through Dialogue (BRAID) to Build Community Trust and Cultivate Vaccine Confidence.” Preventive Medicine Reports 34 (102253): 102253.

To learn more about recent BRAID work driven by Einstein students that will be delivered at the 2025 IHI Global Forum, please see below:

IHI 2025 Global Forum Posters on the Garifuna Cardiogenomics Project: Sanjana Boyapalli and Rachel Sklar (Einstein MS2s)

• Boyapalli S, Sklar R, Jacobs N, Raj SM, Franco N, Farris C, Caballero S, Campanella J, Weissler-Snir A, Colon M, Williams D, Greally JM, Gutnick D. Co-designed strategies for dissemination of genetic risk information in the Bronx Garifuna community [poster presentation]. Poster presented at: Institute for Healthcare Improvement; 2025; Anaheim, CA.

• Sklar, R.P., Boyapalli, S., Jacobs, N., Raj, S., Franco, N., Caballero, S., Farris, C., Colon, M., Williams, D., Campanella, J., Gutnick, D. (2025, December 7-10). BRAIDing Trust: Empowering the Garifuna Community and Clinicians around Cardiogenomic Risk. Institute for Healthcare Improvement Forum, Anaheim, CA, United States

IHI 2025 Global Forum Posters on the SOL Study: Patty Lozano (Einstein MS4)

• Lozano P, Jacobs, S, Isasi C, Isasi R, Filigrana Villegas P, Williams DA, Franco N, Davis-Joseph C, Gutierrez C, Gutnick DN. BRAID-Alz: Bridging Research, Accurate Information, & Dialogue on Alzheimer’s to the Bronx Community. Institute for Healthcare Improvement, Anaheim CA. Dec 2025

IHI 2025 Global Forum Posters on the Community Engagement Toolkit: Katherine Wang (Einstein MS2)

• Spurrell-Huss L, Wang K, Lechuga C, McNeilly S, Hernandez R, Davila J, Balaji A, Perez H, Gutnick D. From Silos to Synergy: Designing a Three-Pillar Toolkit for Health System-Wide Community Engagement, Institute for Healthcare Improvement, Anaheim CA. Dec 2025

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