256691 Improving follow-up among low-income urban populations

Monday, October 29, 2012 : 8:50 AM - 9:10 AM

Yohanna Barth-Rogers, MD , Department of Family Medicine, University of California Los Angeles, Los Angeles, CA
Lea Heller, BS , Family Medicine, UCLA, Los Angeles, CA
Jinsol Lee , Department of Family Medicine, UCLA, Los Angeles, CA
Benjamin Chadwick , Department of Family Medicine, UCLA, Los Angeles, CA
Lisa Arangua, MPP , Department of Family Medicine, UCLA, Los Angeles, CA
Yu Ming Ni, MS , Department of Family Medicine, UCLA, Los Angeles, CA
Mani Vahidi , Department of Family Medicine, UCLA, Los Angeles, CA
Steve Shoptaw, PhD , Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA
Ronald M. Andersen, PhD , Department of Health Services, UCLA School of Public Health, Los Angeles, CA
Lillian Gelberg, MD, MSPH , Family Medicine, University of California, Los Angeles, Los Angeles, CA
     
Background. Follow-up of substance-using, homeless populations in urban areas poses a great challenge. NIDA/UCLA Quit Using Drugs Intervention Trial (QUIT) conducted an RCT of a brief intervention for reducing risky drug use and harm in low-income, diverse primary care patients in FQHCs. We learned many lessons about study design and methods and hypothesize that the methodological changes we implemented increased follow-up rates. Methods. Our initial study method required that each patient complete a “Re-contact Form” that included email address and contact number(s). With the initial data testing it became apparent that we faced tremendous challenges following study participants. As part of our study protocol, a working group met weekly to discuss follow-up. This group generated a list of lessons learned and implemented methodological changes to improve follow-up. We then compared follow-up rates before and after each protocol change was made. Results. Protocol changes that resulted from the working group discussions: 1. Research assistants to assist study participants in completing re-contact forms 2. Schedule all three follow-up appointments at enrollment 3. Give laminated schedules to study participants with staff contact numbers 4. Have an identifiable and long-term presence in the clinics 5. Include more detailed contact information on re-contact form. With each protocol change that was implemented the proportion of patients re-contacted increased. Conclusions. Among substance-using, low-income populations it is difficult to perform follow-up. However, we found many simple ways to improve longitudinal follow-up. We hope that our experience will benefit future studies to improve research methods in homeless populations.

Learning Areas:
Administer health education strategies, interventions and programs
Implementation of health education strategies, interventions and programs
Provision of health care to the public

Learning Objectives:
To list the challenges of performing follow-up of substance-using, homeless populations in urban areas. To describe simple ways to improve longitudinal follow-up among low-income and homeless populations.

Keywords: Substance Abuse, Homeless

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a core team member on the study. I wrote the abstract and will do the data analysis and write the presentation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3020.0: Health care delivery strategies and coordination of care for individuals experiencing homelessness