Intermediate and behavioral health outcomes of community education events: Evidence from interventions to increase reproductive healthcare seeking among small town, low income African American women

Background/significance: African American women suffer significant disparities in relation to reproductive health (HIV/AIDS, STIs, breast and cervical cancer). In smaller towns and cities, they encounter barriers in obtaining healthcare that are specific to their social environments: limited providers, transportation difficulties, and privacy concerns; in addition to the health knowledge deficits often faced by low income African American women more generally. Community-based interventions have been identified as holding the most promise for achieving improvements. Objective/purpose: Identify effective community-based strategies for encouraging low income African American women in a small town setting to seek reproductive healthcare services. Methods: Community health education events (n=10) and a transportation program were conducted over 18 months in a racially diverse town in the northeastern U.S., in partnership with local health and human service organizations. Impact was assessed through ethnographic observations, qualitative interview accounts (n=61) from health education event participants, and pre- and post-event questionnaires. Results: Five intermediate and two behavioral health outcomes were identified: (1) gains in reproductive health knowledge; (2) heightened intentions to seek healthcare services; (3) increased health awareness; (4) intention to communicate health information to others within the participants' social network; (5) renewal of ties with local providers; (6) signing up to receive reproductive health services the local publicly funded provider; (7) receiving health on-site screenings. Discussion/conclusions: While behavior change in the form of seeking reproductive health services is the ultimate goal of this project, intermediate health outcomes are also important indicators of the interventions' success as precursors to this goal.