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Published in final edited form as: Radiographics. 2025 Aug;45(8):e240185. doi: 10.1148/rg.240185

The Role of Radiology in Community Engagement

Somiah E Almeky 1, Franklin Iheanacho 1, Priscilla J Slanetz 1, Anand K Narayan 1, Lucy B Spalluto 1, Arun Krishnaraj 1, Carla Brathwaite 1, Farouk Dako 1, Randy C Miles 1, Daniel B Chonde 1, Gwendolyn M Bryant-Smith 1, Christina Alexandra LeBedis 1, Efrén J Flores 1
PMCID: PMC12312759  NIHMSID: NIHMS2100344  PMID: 40705687

Abstract

Health disparities represent a significant and growing concern in the United States, largely due to recent recognition of worse outcomes experienced by historically underserved groups. Radiologists have an opportunity to address these disparities by using community engagement (CE) to deepen their knowledge about patient and community-level barriers and inform the development of programs focused on improving patient access to timely radiology care. Various established frameworks, such as the socioecologic model and the National Institute on Minority Health and Health Disparities research framework, can be adapted and leveraged by radiology practices to promote CE and advance health equity. These models emphasize multilevel interactions among individual factors to broader societal influences, enabling tailored approaches to addressing disparities in access to radiologic services. Providing practical ways of applying these models will increase the presence and impact of radiology in the community. In this article, case-based practical examples of current CE efforts in radiology are presented, with the aim of empowering radiologists to engage in and lead community-focused initiatives. For each case study, specific disparities and access to radiologic services, as well as intervention strategies, are described. Finally, the authors present adaptations to existing models and frameworks to inform a radiology-centric CE model that can be used to sustainably address health disparities by enhancing educational efforts, building coalitions, and developing comprehensive outreach strategies. This proposed model is intended to not only alleviate disparities but also mitigate radiologist burnout, thereby enhancing both community health outcomes and radiologist well-being.

Introduction

Health disparities, which are preventable differences in morbidity and health outcomes, are of growing concern, particularly for underrepresented groups (1,2). It is predicted that 57% of the American population will belong to an underrepresented or medically underserved group by the year 2060, heightening the need to address health care disparities (3). An important goal for health systems is the realization of health equity, defined as attainment of the highest level of health care for all individuals. Achieving health equity demands a concentrated and sustained societal commitment to address avoidable inequalities and eliminate health care disparities. Community outreach and clinical workflows tailored to serve the needs of the increasingly diverse patient populations served by radiology practices are strategies to reach this goal (4).

The root causes of health disparities vary and are often multifactorial. Social determinants of health play an important role, given their direct impact on access to transportation, insurance, and technology, which ultimately contributes to differences in health outcomes (1). Disparities can be found in nearly all areas of radiology, as diagnostic imaging plays a central role in patient care in both routine and acute clinical settings. Thus, radiologists are in a unique position to identify and address health disparities.

An underrecognized cornerstone in addressing health care disparities in radiology is community engagement (CE). According to the U.S. Centers for Disease Control and Prevention, CE is the process of working collaboratively with and through groups of people affiliated by geographic proximity, special interest, or similar situations to address issues affecting their well-being (1). This CE process can have many forms, ranging from outreach initiatives to the forming of strong bidirectional community partnerships whereby final decision making takes place at a community level. Community collaborators can be members of organized groups or institutions or simply individuals coming together to address various topics related to health promotion, research, or policy making.

While CE can be achieved during a time-limited project, it is more often a dynamic process that evolves into long-term collaborations and shifts the traditional focus on a single health issue to a broader focus of addressing the range of social, economic, political, and environmental factors that affect health. This involves building a foundation of trust with community stakeholders and enlisting them as allies in this process. Community partnerships can be leveraged to identify previously unappreciated causal links to inequities and develop practical solutions built on the partners’ knowledge of the local community’s circumstances. These partnerships formed by means of CE can serve as vehicles for positive change through the development of effective, culturally appropriate programs and robust research results (1). By way of enduring relationships and collaborations with the community, health interventions can be systematically implemented to mitigate health disparities and advance health equity (2–4).

While numerous evidence-based models for community-centered research and engagement exist, their direct application to radiology remains relatively uncharted (1,5–10). Therefore, the purpose of this article is to provide a practical case-based review of current CE practices in radiology with the aim of acquainting radiologists at all levels with CE principles and to emphasize the pivotal role of radiology in advancing health equity and population health through CE.

Current Models Related to CE

Various models have been established to guide health equity and CE efforts, and each offers a unique approach to addressing health disparities and improving access to resources (1,5,7). Fundamental principles guide these models and their potential applications in radiology.

Two models that are used to understand existing health disparities and guide research, clinical care, and community outreach efforts in radiology are the socioecologic model (SEM) and the National Institute on Minority Health and Health Disparities (NIMHD) research framework. The SEM provides a comprehensive framework for conceptualizing public health issues. Understanding the interactions among various factors at multiple levels is crucial when instituting CE projects to impact population health (1). At the individual level, the SEM is focused on biologic and personal history elements, such as age, education, and income, that shape an individual’s experiences and actions. The second level delves into relationships, examining the influence of close social networks, including those among peers, partners, and family members. At the third level, the focus is shifted to the community, exploring the impact of settings such as schools, work-places, and neighborhoods. The fourth level addresses broad societal factors, encompassing norms, and the influences of health care, economic, educational, and social policies.

The NIMHD research framework provides a comprehensive multilevel conceptualization of factors that influence the health of minority populations, which is particularly relevant in addressing disparities related to imaging access, image quality, transportation, and language barriers in radiology (Fig 1) (5). Although the NIMHD research framework is not exclusively focused on CE, considering it is crucial for ensuring equitable implementation of programs (11). The SEM offers broader applicability, while the NIMHD framework mainly addresses minority populations.

Figure 1.

Figure 1.

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Diagram illustrates components of the adapted NIMHD research framework.

There are other models and approaches that more directly incorporate the community into these efforts, including the CE continuum and community-based participatory research models. The CE continuum depicts a range of interventions from outreach to strong community collaborations with shared leadership (1). This continuum is proven to be effective for implementing outreach programs such as cancer screening education and mobile radiology resources, ensuring maximal collaboration and community empowerment (Fig 2). The community-based participatory research approach is a collaborative research process that involves all partners equitably, with research questions informed by the community (Fig 3) (6). This model is instrumental in investigating community-based issues such as cancer screening equity, identification of barriers to technology, and engagement and recruitment of participants for clinical trials. This investigation is achieved by actively involving community members in the research process, enhancing relevance and acceptance while empowering participants by giving them a voice in matters that affect them directly. This engagement fosters a sense of ownership and responsibility among participants from the community toward the outcomes, potentially leading to more effective and sustainable community changes (12,13). When implementing or investigating CE programs, the ultimate goal should be that the interventions developed in collaboration with the community are tailored to the specific needs and sociocultural contexts relevant to the community members.

Figure 2.

Figure 2.

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Diagram illustrates components of the CE continuum.

Figure 3.

Figure 3.

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Diagram illustrates components of a community-based participatory research cycle.

As collaborations among health care systems, radiology practices, patients, and their communities evolve and become sustainable and bidirectional, another model that has been used in these efforts is the reciprocal innovation model. This model fosters bidirectional, mutually beneficial research and translational efforts within long-term partnerships (7). The reciprocal innovation model has been found to have the greatest utility in global health initiatives, where developing collaborations with community members is essential to advancing patient care and ensuring favorable health outcomes. This model promotes CE mutual learning and equity, moving away from the traditional one-way knowledge and resource flow from high-income countries (HICs) to low- and middle-income countries (LMICs) toward a balanced exchange. It acknowledges the value of innovations from LMICs as equally applicable in HICs, fostering culturally appropriate and sustainable health interventions tailored to local needs. By establishing long-term, genuinely reciprocal partnerships, the model transforms global health relationships, building trust, respect, and mutual benefits. These stronger partnerships are crucial for addressing historical imbalances and neocolonial tendencies in international health research and aid.

In the next section, a practical approach to CE is described, with a discussion of current ways in which these models have been adapted in radiology CE efforts by using a case-based approach.

A Case-based Practical Approach to CE in Radiology

Opportunities to foster CE in radiology exist at multiple levels, including health equity efforts with a focus on cancer screening, creating inclusive patient care spaces, resident-driven community initiatives, global health programs, and improving access to technologic advances. This section offers a case-based review of current CE efforts in radiology across multiple institutions serving a variety of patient populations. Each case review highlights the relevant models applied, as well as the disparity being addressed by these initiatives.

Case 1: Lung Cancer Screening

For lung cancer screening (LCS) initiatives, the CE models being applied are the CE continuum and the NIMHD research framework. The disparity being addressed is that related to barriers to LCS participation.

The National Lung Screening Trial and subsequent trials have revealed a decrease in lung cancer mortality among patients who are eligible for screening and have high risk, leading the U.S. Preventive Services Task Force to recommend annual LCS with low-dose CT for individuals aged 50–80 years who meet the eligibility criteria, and the Centers for Medicare and Medicaid Services (CMS) to offer coverage for this service (14,15). Despite the proven benefits, disparities persist in access and health outcomes, especially among those with serious mental illness, historically underserved racial and ethnic minority groups, and urban and rural populations, with LCS rates remaining low (2%–16% of eligible individuals) due to a complex, multilevel combination of barriers at the health care system, provider, and patient levels (13,14). These barriers result in disparities in LCS access and implementation, including adherence to recommended follow-up, across different socio-demographic groups, with less than half of patients returning for annual screenings after the initial examination (16).

Outreach Intervention: Coordination of Screening Care.—

With coordination of care, radiology encounters can be used as teachable moments to provide patients with additional information and connect them with available resources (17–19). This care coordination in radiology is particularly important for maximizing services offered at the point of care for patients who have to overcome multiple social barriers to receiving radiologic services. For example, at Boston Medical Center, a safety-net hospital that serves many patients who are experiencing socioeconomic barriers to care, lung cancer questionnaires were developed and distributed in radiology waiting rooms to identify patients who were eligible for LCS (20) (Fig 4). On the CE continuum, this intervention qualifies as a form of community outreach, serving as a new channel by which eligible community members can be reached and offered potentially life-saving services. This initiative specifically addresses language barriers through the implementation of surveys translated in various languages. In addition, connecting with patients in radiology waiting rooms while they are in the hospital for other visits serves to reduce transportation barriers related to multiple separate visits. Using this comprehensive multilevel approach to address factors that influence the health of minority populations closely aligns with the foundations set forth by the NIMHD framework.

Figure 4.

Figure 4.

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Example of care coordination in radiology: maximizing LCS efforts in radiology waiting rooms through the implementation of an LCS questionnaire.

Case 2: Breast Cancer Screening

Disparities in breast cancer outcomes persist despite the well-known benefits in breast cancer morbidity and mortality due to early detection resulting from screening mammography (20). Women living in rural areas, those with disabilities, and U.S. immigrants are some of the patient populations with decreased access to screening mammography, which is often influenced by factors such as distance from medical facilities, disability-related challenges, and insurance status (9,16,21). Disparities in access extend beyond screening mammography and also involve advanced breast imaging services, the use of which remains lower among historically underserved patient populations, despite their availability in given locations, due to geographic inaccessibility and proportionally higher out-of-pocket expenses (22).

The lower use of imaging resources and lower screening rates in these communities is also influenced by cultural beliefs and perceptions, an underrecognized barrier to equitable care. Therefore, the value of community-based and culturally sensitive education and outreach efforts by radiologists and health care professionals is insurmountable in addressing these disparities.

Outreach Intervention 1: Increasing Access with Use of Mobile Mammography Services.—

For breast cancer screening, the use of mobile mammography has led to a reduction in mortality by increasing access to early detection (20). Specifically, in breast cancer, factors such as longer travel distances to mammography facilities negatively impacts mammography screening rates, underscoring the importance of easy access (23,24). This issue is critical, as patients who live farther from health care facilities experience additional barriers to treatment and often have more advanced disease stages and a worse cancer prognosis (25). Mobile units play a crucial role in addressing these disparities by making breast cancer screening more accessible to women who might otherwise miss these screening examinations due to social determinants of health such as transportation barriers (Fig 5).

Figure 5.

Figure 5.

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Photograph of a mobile mammography unit illustrates CE in practice.

Mobile mammography embodies the definition of CE, with active engagement with community members in a certain geographic location with the goal of increasing screening in that specific population. Actively going to communities of historically underserved patient populations helps to build a sense of partnership and trust with that community, thereby alleviating previously existing barriers to care. This intervention recognizes the role of the interplay between community and society in individual health outcomes and therefore addresses access to screening on a broader level, as described with the SEM and NIMHD framework.

Outreach Intervention 2: Increasing Breast Imaging Health Literacy with Infographics.—

Effective communication with patients is essential for transforming patient-centered care and supporting shared decision making (26). This approach requires that breast imaging radiologists work closely with patients, engaging them in decisions about their care to enhance both outcomes and satisfaction. Radiologists specializing in breast imaging must use skill when communicating with patients, especially when confronted with the challenges associated with addressing breast biopsy recommendations, supporting patients undergoing these procedures, and delivering the difficult news of a new breast cancer diagnosis. To aid in these communications, the Society of Breast Imaging has developed infographics with simple text to promote breast cancer screening and address commonly encountered questions; this is a valuable resource for both radiologists and patients (27). This intervention is based on the principles of CE, as the creation of these infographics was based on feedback from community members regarding commonly asked questions. The model most applicable to this intervention would be the NIMHD framework, highlighting the interplay of various levels of influence at individual, interpersonal, and community levels on overall outcomes.

Fostering Inclusive Care in Radiology with Community-based Art

The presence of visual art in clinical spaces has been shown to reduce hospital lengths of stay, increase pain tolerance, decrease anxiety, and improve the patient’s experience and satisfaction (28–33). Art, both its creation and its inclusion in health care spaces, is an often underappreciated and overlooked intervention that has immense potential in reducing health care disparities and improving general health. One such example that can be applied to radiology care spaces is the positive impact that certain colors have on influencing emotions, contributing to the overall well-being of individuals during medical procedures and screenings (34). In addition, art can serve as a positive distraction for patients undergoing stressful examinations such as mammography (35,36).

Beyond the medical healing component, a significant part of the importance of art in health care spaces is its role as a means of building trust and connection with patients and community members (37). Despite the role that culturally competent and community-based art has in addressing long-standing misconceptions among historically underserved populations and fostering a sense of community and understanding among patients, data suggest that these forms of art are underrepresented in health care spaces (29,38–41). Therefore, there is a need for radiology practices to leverage CE to form new partnerships and co-create inclusive health care spaces that are representative of the communities served, foster trust, and advance health equity.

Case 3: Community-based Art in Radiology

The disparity being addressed with community-based art is that due to radiology care spaces that are not reflective of the diverse communities being served. The CE model being applied is the CE continuum.

Outreach Intervention: Partnering with Local Artists to Build Inclusive Spaces and Exploring Health Equity through Art.—

Community-based art has intrinsic connections to the social determinants of health in local communities, and investments in local artists can create economic opportunities for artists in the communities served by health care systems (42). For example, the Women Helping Women Art Initiative at the University of Arkansas for Medical Sciences Winthrop P. Rockefeller Cancer Institute commissioned works of art from female artists in their catchment area. They then auctioned the art pieces, allowing purchasers the opportunity to have the works dedicated to them when they were installed in their new breast center (36). Facilitating collaborations between health care systems and local artists can serve to enhance the dissemination of relevant information and increase engagement with health care systems (43–45).

Furthermore, the goal of leveraging community-based art is to develop and maintain longitudinal relationships with local community artists in historically underserved communities (43–45). In this way, these artists become trusted messengers for hospitals, and through them, hospitals learn how to effectively serve their local communities. Involving and collaborating with members of the local community in their efforts exemplifies an application of the CE continuum model in radiology. An example of such an initiative in radiology is the Peoples’ heART (Health Equity × Art) founded at Massachusetts General Hospital. The Peoples’ heART program serves to engage and connect with patients by rotating art displays specially curated by health care workers, local community artists, and community advocates. These art installations are centered around different key topics in health equity, allowing each topic a space to be engaged with in a meaningful way and exploring the vast landscape that makes up health equity (43,46).

Radiology Resident–driven Initiatives

Resident-driven initiatives emphasize the importance of CE in radiology training and shed light on the impact of CE on resident wellness and sense of purpose. While CE has not historically been integrated into radiology training, there is a need for trainee involvement in this space. Several barriers to implementing CE in training exist and include time limitations while in training, as well as a lack of readily available opportunities. Creating and promoting opportunities in which CE concepts are incorporated into radiology training can help address some of these barriers and allow trainees to gain a new appreciation for the roles that radiologists can have in the community. The secondary impact of CE on factors such as well-being and sense of meaning has been demonstrated throughout various settings within and outside of medicine (47–50). New resident-led programs such as the Communities Crushing Cancer initiative (discussed below) show early promise of the impact that these initiatives can have in the field of radiology (51).

Case 4: Empowering the Next Generation in Radiology

Outreach Intervention 1: Improving Patient Education through the Communities Crushing Cancer Program.—

Communities Crushing Cancer is a radiology resident–led initiative aimed at raising cancer awareness and increasing rates of cancer screening with use of patient education efforts. Through this initiative, residents across various institutions were able to educate patients, families, and hospital employees regarding the importance of breast, lung, and colorectal cancer screening in a series of table-display events (51). Standardized materials such as informational posters and translated patient brochures were curated and distributed to residents for use during these events. With local and statewide initiatives, radiology residents united in a collaborative effort to spearhead community outreach programs within their respective institutions (Fig 6). By promoting active engagement with patients and community members, as well as addressing the need for improved rates of cancer screening among underserved patient populations, Communities Crushing Cancer embodies the core principles of CE. This intervention closely aligns with the CE continuum model, providing community members with informational resources and establishing a channel for further outreach.

Figure 6.

Figure 6.

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Photograph illustrates the patient educational materials and setup used during a Communities Crushing Cancer table-display event led by radiology residents.

Outreach Intervention 2: Radiologists Improving Access to Care at the Shade Tree Clinic.—

The Shade Tree Clinic at Vanderbilt University Medical Center offers care to under-insured and uninsured individuals (52). A team of radiologists, radiology trainees, medical students, and technologists volunteer their time one Saturday each month at the Shade Tree Clinic, where they provide high-quality point-of-care US to underserved patient populations to minimize the need for additional travel or medical appointments for these patients. The Shade Tree Clinic represents a collaboration of various health care professionals at an institution, with the goal of addressing a need or disparity in their local community, exemplifying the practice of CE. This intervention is based on the NIMHD framework, promoting the health of minority populations by addressing disparities in imaging access, adequate image quality, and transportation to and from facilities.

Global Health Initiatives

The underutilization of imaging in low- and middle-income countries is attributed to insufficient investment, high costs of equipment and maintenance, and a short-age of adequately trained personnel to operate radiology equipment (16). Although numerous solutions have been proposed to address this multifaceted issue, CE stands out as a viable model for implementing these solutions effectively. Several important CE approaches have been derived from countries outside of Western and high-income nations. These approaches include the concept of community health workers (CHWs). CHWs are frontline public health care workers who are trusted members of the community and work outside fixed health facilities to provide health services and education in their communities (53). CHWs are slowly being introduced into the field of radiology in the United States, positively impacting access to cancer screening and facilitating reduced medical comorbidities among low-income and racial and ethnic minority populations (54–56).

Case 5: Increasing Global Access to Radiology

Outreach Intervention: Development of Accessible and Affordable MRI Technologies in Uganda.—

The reciprocal innovation model has provided the framework for many global health initiatives in radiology, including the development of affordable, low-field-strength MRI units in Uganda (57). Modern MRI systems are trending toward higher field strengths to maximize signal intensity and spatial resolution while minimizing imaging time, yet high-field-strength devices are expensive to install and operate, making them scarce outside of high-income countries and major population centers (58). The aim in using low-field-strength MRI machines is to minimize imaging distortions without depending heavily on processing technologies such as machine learning.

Inspired by the need to improve the detection of pediatric hydrocephalus, a prevalent condition in Uganda, researchers at the Delft University of Technology in the Netherlands developed a low-field-strength MRI unit and made the technology open source, allowing anyone to design and locally manufacture these systems. In addition, kits and tools for assembling these low-field-strength MRI units were manufactured and provided to biomedical engineers in the country (57). The development of low-field-strength MRI systems exemplifies frugal innovation, which involves creating effective, affordable, and portable products by using fewer resources to perform imaging in underserved communities (59). Radiology-centric frugal innovations include low-field-strength MRI, ultraportable radiography, and handheld US units that have been adapted and used in a wide variety of health care settings beyond low- and middle-income countries (60). By addressing a health disparity through the engineering of a new technology, this bidirectional collaboration with researchers in the Netherlands and community members in Uganda exemplifies an application of the reciprocal innovation model in radiology.

Technology

Patient portals and telehealth are central to the digital health care transformation, significantly enhancing access to preventive care services such as cancer screening. Despite the potential of digital tools, the development of this technology has the risk of widening health care disparities, as underserved populations lack access to many newly developed digital health tools (1,61,62).

Case 6: Addressing Telehealth Barriers in Radiology

Outreach Intervention: Using Telehealth to Address Disparities in LCS.—

In regions such as Southwest Virginia, where disparities in lung cancer care are exacerbated by high smoking rates and geographic isolation from screening centers, the radiologists and researchers at the University of Virginia have used telehealth networks and collaborations with local hospitals to enhance LCS accessibility in underserved areas. The leaders of this initiative established partnerships emphasizing the importance of CE, educational efforts, and logistical planning to align with regulatory standards and streamline LCS service delivery. To engage with the rural community, lunch talks and in-person appearances were conducted to outline program goals, emphasize the importance of screening, and address questions about service logistics. These visits also provided updated medical education on LCS evidence.

Marketing was achieved in specific rural areas by collaborating with local providers and gaining understanding from patients of where they receive health care information, such as local radio, newspapers, and social media. Strategies included using telehealth for shared decision-making visits, enlisting local health care providers, and tailoring technology for the unique demands of remote LCS programs, an innovative example of the correlation of technology and CE (63). This intervention leverages the SEM, with recognition that there were factors coming into play at community and societal levels that needed to be addressed to improve LCS in the given patient population.

Practicing CE: Future Directions

The Radiology-Centric CE Model

When envisioning the future of CE in radiology, a proposed centralized model, the radiology-centric CE model, emerges. This model integrates the key principles of existing models to effectively streamline efforts. At its foundation are coalitions, uniting individual researchers and organizations to maximize collective influence, minimize duplication of efforts, and create new shared resources. The next step after building coalitions is constituency development, which involves fostering relationships with community members invested in public health. This is followed by outreach, which is meeting communities where they are and working with them to advance health promotion efforts. Capacity building follows, with the aim of enhancing health by developing sustainable skills, resources, and organizational structures within communities. At the apex of the radiology-centric CE model is education, addressing gaps in health disparity education within radiologic training (Fig 7).

Figure 7.

Figure 7.

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Graph illustrates the radiology-centric CE model, leveraging existing CE models and frameworks to address health care disparities in radiology.

Coalitions in Radiology

To enhance community involvement in radiology and nurture future trainees, the creation of a collaborative network with a focus on these objectives is advocated. Defined by the U.S. Centers for Disease Control and Prevention in 2011, a coalition is an alliance of individuals and organizations united to address a particular issue (1). The foremost goal of a CE coalition is to capitalize on existing initiatives and create a centralized repository for ongoing opportunities, thereby simplifying the distribution of resources and tool kits for CE. This endeavor aims to mitigate the hurdles of launching new projects and prevent duplicative efforts, fostering synergistic partnerships for outreach to underserved and resource-limited communities.

Incorporating a central database will not only facilitate seamless collaboration but also encourage innovation by offering leaders a comprehensive view of ongoing CE efforts and adaptable strategies for local requisites. The Radiology Health Equity Coalition (RHEC) (64) serves as a pertinent model, with a commitment to sharing resources and best practices, advocating for communities, and collaborating on programs that enhance access to preventive and diagnostic imaging services. By aligning with such established frameworks, notably the RHEC, the proposed coalition could leverage volunteer opportunities across various levels and thereby amplify the potential for nationwide implementation and impact of CE initiatives.

CE in Radiology Curriculum

There is an overall lack of streamlined educational content and resources on CE available to trainees. Educating the next generation of radiologists on their role in minimizing health care disparities and providing them with practical and effective tools are vital to achieving health equity (16). With recognition of the need to empower the next generation of radiologists, a Community Engagement in Radiology curriculum could guide future efforts in this area. This curriculum, grounded in the radiology-centric model, would be aimed at equipping trainees with the knowledge, skills, and resources needed for meaningful CE. The core elements of this curriculum encompass didactics to increase cultural competency, cultural humility, cultural dexterity, foundational skill building emphasizing capacity building, and service learning to foster long-lasting community collaborations (65,66). Aligned with the Radiology Accreditation Council for Graduate Medical Education competencies, the aim of the curriculum would be to instill compassion, integrity, and respect for diverse patient populations; effective communication; and patient education (67). To realize this vision and inspire the next generation, a coalition formed by a CE committee would serve as a central hub for collaboration and innovation. It would also serve as a database and important resource for trainees interested in CE and health equity, thereby driving progress and encouraging synergistic partnerships. This integration would enrich the training experience and contribute positively to the broader radiology community.

Conclusion

CE offers an opportunity for radiologists at all levels to form meaningful connections with the communities they serve and reconnect with their sense of meaning and purpose in daily work. Radiologists play a central role in patient care and are in a unique position to transform every stage of the patient’s journey through the radiology department and to bridge existing barriers to care. The implications of CE are multifold, and the benefits extend not only to the patient populations being served but also to every radiologist taking part in these efforts. Numerous opportunities for CE in radiology exist and include cancer screening efforts, creating inclusive patient care spaces, resident-driven community initiatives, global health programs, and improving access to telehealth in radiology.

Developing a radiology-centric model for CE can address health care disparities by leveraging existing CE models and frameworks. The proposed radiology-centric CE model emphasizes education, capacity building, outreach, and coalition formation and aims to enhance engagement and equity efforts in radiology while also providing a new sense of purpose that can mitigate professional burnout. This unified approach can empower the next generation of radiologists and reinforce meaningful and impactful practice in the field, driving progress toward both professional fulfillment and enhanced patient care.

TEACHING POINTS.

  • While CE can be achieved during a time-limited project, it is more often a dynamic process that evolves into long-term collaborations and shifts the traditional focus on a single health issue to a broader focus of addressing the range of social, economic, political, and environmental factors that affect health.

  • With coordination of care, radiology encounters can be used as teachable moments to provide patients with additional information and connect them with available resources. This care coordination in radiology is particularly important for maximizing services offered at the point of care for patients who have to overcome multiple social barriers to receiving radiologic services.

  • The foremost goal of a CE coalition is to capitalize on existing initiatives and create a centralized repository for ongoing opportunities, thereby simplifying the distribution of resources and tool kits for CE. This endeavor aims to mitigate the hurdles of launching new projects and prevent duplicative efforts, fostering synergistic partnerships for outreach to underserved and resource-limited communities.

  • Educating the next generation of radiologists on their role in minimizing health care disparities and providing them with practical and effective tools are vital to achieving health equity. With recognition of the need to empower the next generation of radiologists, a Community Engagement in Radiology curriculum could guide future efforts in this area.

  • Radiologists play a central role in patient care and are in a unique position to transform every stage of the patient’s journey through the radiology department and bridge existing barriers to care.

Funding.—

G.M.B.S. Arkansas Cancer Coalition Grant in conjunction with the Arkansas Department of Health for Mobile Mammography at the University of Arkansas for Medical Sciences, and Arkansas Breast Care Grant from the Arkansas Department of Health to provide services to underserved women in Arkansas. E.J.F. Funding from the National Cancer Institute (5 K08CA270430-02) for research related to this article.

Disclosures of conflicts of interest.—

P.J.S. Site principal investigator for the Tomosynthesis Mammographic Imaging Screening Trial; royalties from Wolters-Kluwer for three breast imaging topics on UpToDate; editorial board member of Radiology, American Journal of Roentgenology, and Academic Radiology; second past president of the Association of Academic Radiology (AAR); board member of AAR Research and Education Fund; chair of American College of Radiology (ACR) Commission on Publications and Lifelong Learning; member of ACR Board of Chancellors and ACR Practice Parameter Committee for Breast Imaging; board member of ACR Radiology Advocacy Network; medical advisory board member of densebreast-info.org. A.K.N. Grants from Susan G. Komen Foundation and National Academy of Medicine. L.B.S. Institutional grants from ACR; Veterans Affairs Office of Research and Development, Office of Rural Health; Bristol Myers Squibb Foundation; National Institutes of Health; and U.S. Centers for Disease Control and Prevention; honoraria for grand rounds lectures at various academic institutions; payment for expert case review from Hare, Wynn, Newell and Newton; Co-chair of RSNA Health Equity Committee. A.K. Payment for expert testimony for various legal practices, member of the ACR Board of Chancellors. F.D. Grants from Radiological Society of North America, AAR, and National Cancer Institute; recipient of Robert A. Winn Excellence in Clinical Trials award; payment or honoraria for grand rounds from Massachusetts General Hospital and the University of Pittsburgh; support for attending meetings and/or travel from RSNA Health Equity Committee and the United Nations; member of RAD-AID International Board of Directors. R.C.M. Payment or honoraria for lectures from Hologic and GE HealthCare. D.C. Payment for lectures from Emory University; chair of the American Roentgen Ray Society Diversity, Equity, and Inclusion Subcommittee; executive director of The Peoples’ heART. E.J.F. Recipient of MGH Physician Scientist Development award; co-chair of Radiological Society of North America Health Equity Committee; Journal of the American College of Radiology Associate Editor for Health Equity; member of National Academies of Science, Engineering and Medicine (NASEM) Committee on the Use of Race and Ethnicity in Biomedical Research; honoraria for grand rounds presentations at multiple academic medical centers; travel support as member of the American Cancer Society National Lung Cancer Roundtable and NASEM Committee on the Use of Race and Ethnicity in Biomedical Research. All other authors, the editor, and the reviewers have disclosed no relevant relationships.

Abbreviations:

CE

community engagement

LCS

lung cancer screening

NIMHD

National Institute on Minority Health and Health Disparities

SEM

socioecologic model

Footnotes

Presented as an education exhibit at the 2023 RSNA Annual Meeting.

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