Increasing the uptake of clinical preventive services among older adults in community settings to improve health and reduce disparities

Background. Aging adults are at increasing risk of a number of diseases that can be prevented or treated early through clinical preventive services (CPS) such as influenza vaccinations and colorectal cancer screening.

Objectives. To identify effective strategies that increase uptake of clinical preventive services among older adults in the community.

Methods. Data from the 2009 California Health Interview Survey (CHIS) were analyzed. More than 40 interviews were also conducted with community stakeholders representing aging services providers, community health centers, public health agencies, and other community settings such as pharmacies and YMCAs. These program administrators, planners, and front line staff were asked about their involvement in the engagement, delivery, and/or follow up components of CPS delivery.

Results. CHIS data revealed that among Californians aged 50 years and older, 50% had not received a flu shot within the past 12 months and 22% had never been screened for colorectal cancer. Furthermore, these utilization rates varied by race/ethnicity: 57% of African Americans and 53% of Latinos had not received the flu vaccine in the past year, as compared to 49% of Whites and 42% of Asians. Nearly twice as many Latinos (33%) than Whites (18%) reported they had never been screened for colon cancer. Community stakeholders identified 14 effective strategies for increasing CPS uptake, including cross-sector collaborations and expanded program efforts. Two case studies from California highlight promising practices.

Conclusions. Extending CPS delivery efforts to community settings has the potential to increase uptake among older adults and reduce health disparities.