Abstract
Clinic community linkages: Provider perspectives in working with Community Health Representatives
Christian Brown, BS1, Sonya S. Shin, MD, MPH2, Cameron Curley3, Olivia Muskett3, Shine Salt4, Amber Lalla5, Kathy Ray6, Mae-Gilene Begay, MSW7 and Adrianne Katrina Nelson, MPH, MSc1
(1)Community Outreach and Patient Empowerment Program, Gallup, NM, (2)Brigham and Women's Hospital, Boston, MA, (3)Community Outreach & Patient Empowerment Program, Gallup, NM, (4)Community Outreach and Patient Empowerment (COPE) Program, Gallup, NM, (5)University of Norte Dame, Gallup, NM, (6)Indian Health Service, St. Michael, AZ, (7)Navajo Nation Department of Health, Window Rock, AZ
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
background: The Navajo Nation Community Health Representatives (CHRs) provide home health care and education to community members. COPE, a community-based organization, seeks to improve coordination between clinical teams and CHRs. Clinic-community linkages are strengthened through provider-led trainings of CHRs on health topics, CHR utilization of patient education materials (flipcharts that have been developed with local provider input to reflect regional and national best practices), and development of care processes, such as referrals to CHRs and CHR access to Electronic Health Records (EHR).
objective: Understand providers’ opinions about COPE and collaboration with Navajo CHRs.
methods: Qualitative interviews were conducted with 13 healthcare providers from five of the eight service units. Three study staff used open-coding to create a codebook. Coded material was summarized and patterns were identified and tied into a narrative using concept mapping.
results: Providers overwhelmingly supported CHRs’ access to EHR to record patient visits and streamline referrals. They were enthusiastic about COPE flipcharts mentioning they provided a consistent message to CHRs and community. Those that led COPE trainings with CHRs valued the face-to-face time and opportunity to build relationships. Among their requests were having designated clinic personnel to manage referrals with CHRs and a formal system to track CHR training on specific modules.
conclusion: Providers participating in COPE trainings highly valued the work of CHRs and requested COPE help to further streamline relationship-building and communication, such as referrals and updates, with the CHRs. Future resources should be focused on making communication easy and pleasant between CHRs and providers.
Administer health education strategies, interventions and programs Diversity and culture Implementation of health education strategies, interventions and programs Other professions or practice related to public health Planning of health education strategies, interventions, and programs Social and behavioral sciences
Abstract
Responses to a Culturally-Relevant Online Cancer Education Course: Alaska Tribal Health Workers Increased Cancer Knowledge, Increased Capacity to Share Cancer Information, and Reduced Cancer Risk Behaviors
Katie Cueva, ScD, MAT, MPH1, Laura Revels, BA2, Melany Cueva, RN, EdD2, Mark Dignan, PhD, MPH3 and Anne Lanier, MD, MPH2
(1)University of Alaska Anchorage, Anchorage, AK, (2)Alaska Native Tribal Health Consortium, Anchorage, AK, (3)University of Kentucky, Lexington, KY
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Introduction:
Alaska’s tribal primary care providers in rural Alaska - Community Health Aides and Practitioners (CHA/Ps) - requested online education about cancer for themselves and their communities. In response, a research team at the Alaska Native Tribal Health Consortium developed a culturally-respectful distance-delivered cancer education course designed with, and for, Alaska’s CHA/Ps.
Approach:
The online semester-long university course incorporated ten interactive online cancer education modules, with digital storytelling and synchronous virtual class meetings. All modules were community-based and collaboratively developed with input from a community advisory group of CHA/Ps, content experts, and interested partners. Course participants completed a pre-course assessment, and evaluations at the end of each module, at the end of the course, two-months post-course, and six-months post-course.
Results:
While evaluation is ongoing, as of January 2017 a total of 27 individuals participated in two course offerings and completed a total of 125 end-of-module surveys. All course participants reported that they intended to reduce their personal cancer risk and share cancer information as a result of the course. Comparison of pre and post-course survey responses showed increased knowledge about cancer and increased comfort with finding accurate cancer information online. Half reported increased weekly minutes of physical activity from pre to post course and all tobacco users moved from not trying to quit to “I am currently trying to quit.” Almost all course participants reported increased confidence, preparation, and comfort in talking about cancer with their patients, families, friends, and communities. Six-month follow-up results will also be shared.
Conduct evaluation related to programs, research, and other areas of practice Diversity and culture Implementation of health education strategies, interventions and programs Public health or related education Public health or related research Social and behavioral sciences
Abstract
Water is Life: Utilizing Photovoice to empower our American Indian youth to transfer knowledge
Deb LaVeaux, MS1, Vanessa Simonds, ScD1 and Velma Pickett, BS2
(1)Montana State University, Bozeman, MT, (2)Little Big Horn College, Crow Agency, MT
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Water has been a physical, spiritual and cultural life source for the Apsáalooke nation since their beginning. Respecting and protecting that life source for the next generations will be the task of the youth of today. Three years ago, a local tribal research team embarked on a community-based participatory research project with researchers from Montana State University to engage tribal community youth to; increase children’s appreciation and skills related to environmental health and science literacy; increase knowledge and understanding of the relationship between the water and human health; provide children with actionable steps to take to protect the water and their health. Through the Guardians of the Living Water summer camps and after school programs, various science and cultural activities were used to help children in the 4th -6th grade become active participants in learning and dissemination of information and knowledge about the importance of water. We will provide an overview of how Photovoice was adapted and utilized as a participatory activity to nurture these students as co-researchers, and to provide a venue to voice their understanding and concerns about water-related issues. Students were provided training in basic photography, photo-story presentation, safety and ethics of Photovoice, and basic thematic analysis methods. Students used digital cameras to take pictures representing water’s importance. Selected photographs were discussed and captioned, and analyzed for emerging themes. Students selected several important issues, and developed action plans, which became activities for the following summer camp.
Public health or related education
Abstract
Adolescent reproductive health among urban American Indian & Alaska Native youth
Adrian Dominguez, MS, Abigail Echo-Hawk, MA and Kelsey Liu, MPH
Urban Indian Health Institute, Seattle, WA
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Sexually transmitted diseases (STDs) are an essential component of reproductive health and well-being and impose a significant burden on our health care system. Furthermore, STDs do not affect the population equally, with poorer, women of color being the most adversely affected. To erase these inequities, we sought to analyze disparities between American Indian/ Alaska Native (AI/AN) youth, under 25 years old, and non-Hispanic white (NHW) youth to support program planning and grant writing focused on combatting STDs in urban AI/AN communities.
Prevalence or incidence was calculated for indicators comparing the AI/AN population in Urban Indian Health Program (UIHP) service areas across multiple data sources including the National Notifiable Disease Surveillance System. Infection rates were analyzed by gender, race and age groups.
Our results showed that chlamydia infection rates were three times higher for AI/AN youth in UIHP areas when compared to NHW youths (1,269.3/ 100,000 v. 436.3/ 100,000). Gonorrhea was more than three times higher for AI/AN youths compared to NHW youths (200.8/ 100,000 v. 60.9/ 100,000). Lastly syphilis infection rates were almost twice as high for AI/AN youths compared to NHW youths (5.7/ 100,000 v. 1.9/100,000).
Our analysis found that there is an urgent need among urban AI/AN youths for improved and comprehensive sexual health education and access to preventative care. Increased sharing of information around STDs and reduced barriers to preventative care is critical to eliminating existing disparities in health outcomes for urban AI/AN youths and improving health throughout their life course.
Administer health education strategies, interventions and programs Assessment of individual and community needs for health education Epidemiology Public health or related education Public health or related research Social and behavioral sciences