Connecting Boston's Public Housing Developments to Community Health Centers: Who's ready for change?

Background: Residents of public housing are at increased risk of living with uncontrolled chronic disease, including heart disease, stroke, and diabetes. Despite close proximity to community health centers and comprehensive academic medical centers, public housing residents face many barriers to engaging in primary care. We conducted this research to compare the readiness of housing developments versus community health centers addressing heart health through a community-based intervention.

Methods: Key informant interviews were conducted across 8 public housing developments and 7 nearby community health centers. Each organization received a composite readiness score, which ranged from 1-9, corresponding with their readiness to engage in heart health prevention activities across 6 dimensions of readiness.

Results: Preliminary findings indicate that health centers have significantly higher levels of readiness to engage in heart health prevention activities compared with housing developments. Both health centers and housing developments scored highest in existing programs and policies to address heart health and the resources available to address the issue. Both health centers and housing developments scored lowest in community knowledge of heart health programs Conclusions: Our findings confirm a mismatch in community readiness to address heart health between housing developments and community health centers. We will focus on stage-specific goals in our intervention in order to better align housing development readiness with community health center readiness. Eliciting perspectives of key stakeholders (residents of each housing development and staff of each corresponding health center) when developing an intervention around a community-identified health priority ensures community buy-in and support for program implementation.