Resident Health Advocates on the Move: Community-based approach to promoting health screening in public housing developments

Community intervention strategies are needed to increase the number of individuals who receive preventive services and reduce the morbidity and mortality associated with racial and ethnic health disparities. Promoting screening for diabetes and hypertension is a key strategy for achieving the objectives of Healthy People 2010.This is particularly true in high-risk areas such as public housing. Objectives: This study tests a Resident Health Advocate (RHA) intervention in public housing developments to increase health screening visits on the Boston Public Health Van and to measure the number of appointments with primary care physicians kept by participants with positive screening results. Methods: This trial involved four housing developments with paired characteristics. At two intervention sites, RHAs recruited residents with fliers and personal contact. At the control sites, fliers were left with the development manager as this was the standard procedure. The Health Van measured blood pressure, cholesterol levels, diabetes risk, and oral health. We calculated the number of people at intervention and control sites who used the van, their presumptive diagnoses, and referral-seeking practices with PCPs and dentists. Results: RHA outreach strategies led to increased use of the van among residents at intervention sites; 100 residents came from intervention sites compared to 47 residents from the control sites (RR=1.37, CI=0.98, 1.92). We also discovered problems residents encountered when making appointments with community health centers and keeping their appointments. The results of this research will be used to improve the RHA training process and inform other projects that enlist community health workers.