Abstract
Partnerships to Encourage Actionable Cultures of Health (PEACH): An RWJF Systems for Action Study
Luke Sleiter, MPH1, Carl Letamendi, PhD, MBA1, Rachel Dannefer, MPH, MIA2 and Jennifer Pierre, DrPh, MPH1
(1)New York City Department of Health and Mental Hygiene, Long Island City, NY, (2)New York City Department of Health and Mental Hygiene, New York, NY
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Coordination among health and community services are critical to improving health outcomes in the most marginalized neighborhoods. Through generous support from the Robert Wood Johnson Foundation, our Partnerships to Encourage Actionable Cultures of Health (PEACH) study evaluates how aligning a city health department with community stakeholders under a place-based model can improve health, reduce inequities and address social determinants across neighborhoods.
PEACH investigates a co-located, cross-sectoral partnership and a shared decision-making governance structure between clinical and nonclinical partners, the city health department, frontline staff, and community-based organizations. Our electronic social needs referral and linkage system (NowPow) serves as a primary and novel mechanism to connect community members to clinical and social services that are tailored to their needs, which cultivates a cross-sector collaboration to improve health. We observe data on the impact that Action Center co-located partners and the NowPow system have on community health in East Harlem and the relative impact of this model in the community.
Through application of RWJ's culture of health framework, cities across the country can take steps towards fostering a culture of health. Co-location, active referral management and a collective governance structure among partners at the East Harlem Neighborhood Health Action Center help to address social determinants of health and foster a partnership which improves neighborhood health.
Working with neighborhood partners and including them in a collective structure where ideas are exchanged and decisions are made can help to identify and address health disparities, meet service gaps and take steps towards achieving health equity.
Conduct evaluation related to programs, research, and other areas of practice Public health or related organizational policy, standards, or other guidelines Public health or related public policy Public health or related research Social and behavioral sciences Systems thinking models (conceptual and theoretical models), applications related to public health
Abstract
Using appreciative inquiry as a technique in community-based participatory research action planning to improve maternal and child health
Abraham Salinas, MD, MPH, PhD1, Lindsey King, PhD, MPH, CHES, CCRP, CTTS2, Hamisu Salihu, MD, PhD3, Ronee Wilson, PhD, MPH, CPH4, Estrellita Lo Berry, MA5, Deborah Austin, PhD5, Kenneth Scarborough, MDiv., MPH6, Evangeline Best, BS, MA5, Lillian Cox, Georgette King, Carrie Hepburn, MS8, Conchita Burpee and Richard Briscoe
(1)University of South Florida, College of Public Health, Tampa, FL, (2)University of Florida, Jacksonville, FL, (3)Baylor College of Medicine, Houston, TX, (4)University of South Florida, Tampa, FL, (5)REACHUP, Inc., Tampa, FL, (6)Operation New Hope, (7)Tampa Bay Healthcare Collaborative, Dunedin, FL
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Traditionally public health utilizes a problem-based approach to program planning, instead of focusing and capitalizing on community strengths. Appreciative Inquiry (AI) is a technique that inspires community members to envision positive images of the future grounded in the best of the past, surpassing the weaknesses of problem-based planning. This study aimed to incorporate a community-based appreciative approach into community action planning to improve the health of mothers and babies in East Central Tampa. Using a community-based participatory research (CBPR) strategy, we engaged in community action planning using an adapted AI approach. A community advisory board (CAB) was created to serve as liaisons between academic researchers and the larger community. All CAB members participated in the AI process, which was implemented using e-nominal group technique, in order to identify strengths of the community and ideas for developing community-level empowering and sustaining strategies. The CAB adopted a strengths-based framework for community action planning as follows: (1) work to “undo racism” by instilling a sense of ownership, (2) promote positive community resilience and mental health, and (3) encourage individuals from the community to run for public office. They suggested a community wide campaign aimed at increasing neighborhood social capital. The AI process was successfully adapted for increasing community engagement in a constructive dialogue that incorporated and maximized community strengths into a long term action plan to bring about community and societal level change. AI has promising potential to not only produce sustaining change, but also inspire collective action.
Advocacy for health and health education Conduct evaluation related to programs, research, and other areas of practice Planning of health education strategies, interventions, and programs Program planning Public health or related education Social and behavioral sciences
Abstract
Qualitative assessment of barriers and facilitators to participation in a community-based fitness and healthy-lifestyle program in Sonora, Mexico
Quetzalín Domínguez-Quesney1, María Isabel Grijalva-Haro1, Noe C. Crespo, PhD, MPH2, Sonia Vega-López, PhD3, Graciela Caire-Juvera, PhD, MPH4 and María Isabel Ortega-Vélez1
(1)Centro de Invstigación en Alimentación y Desarrollo A. C., Hermosillo, Sonora., Mexico, (2)San Diego State University, Graduate School of Public Health, San Diego, CA, (3)Arizona State University, Phoenix, AZ, (4)Centro de Investigación en Alimentación y Desarrollo A. C., Hermosillo, Sonora., Mexico
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: The aim of this study was to identify barriers and facilitators to participation in a community-based program that promotes fitness and healthy eating among families with school-aged children from Hermosillo, Sonora (Mexico). The program was adapted from Athletes for life (AFL), an ongoing program targeting Hispanic families living in Phoenix, Arizona.
Methods: School-age children and one of their parents (Twenty-one dyads) attended 90 minutes nutrition and fitness workshops, 2 times a week for 12 weeks, at a community park close to the children’s schools. There was a reference group of twenty dyads. Qualitative data were collected using personal interviews (n=47) and two focus group discussions with participating parents (n=14). Barriers and facilitators were identified using a thematic analysis, with identification of categories regarding enrollment and attendance, and program content.
Results: During program implementation, 71.4% dyads attended more than 75% of the sessions. Concerning recruitment and attendance, participants mentioned health and work issues as main barriers. Regarding physical activity, parents’ lack of time for recreational activities, neighborhood insecurity and general environmental conditions of community parks (inadequate facilities and equipment) were the main obstacles. Regarding healthy eating, the main barriers were lack of family support and low income. Among the main facilitators for program compliance were the perceived benefits of exercise and acquired knowledge about healthy eating.
Conclusion: Program content, as adapted for implementation in a Mexican community, seemed valuable to study participants; however, barriers such as lack of time, neighborhood insecurity and lack of family support need to be addressed.
Advocacy for health and health education Assessment of individual and community needs for health education Planning of health education strategies, interventions, and programs
Abstract
Using Participatory Research Methods to Enhance Community Capacity to Address Disparities in Perinatal Mental Health
Dayna Campbell, MS, PhD(c)1, Nora Oppenheimer2, April Albrecht2 and Anuradha Sahu2
(1)American International College, Springfield, MA, (2)MotherWoman, Holyoke, MA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Perinatal mood and anxiety disorders are linked to poor birth outcomes. Women of color with perinatal mental health complications experience long term adversities and encounter barriers to treatment. The Community-based Perinatal Support Model (CPSM) achieves optimal mental health outcomes for mothers and families, through multi-sector collaboration in education, training, resource development, screening and policy. Feedback from local Perinatal Support Coalitions the CPSM was expanded into the enhanced Community-based Participatory Perinatal Support Model (CPPSM) to more effectively address disparities in perinatal mental health. Anchored to the philosophy of cultural humility, trainings were provided to promote authentic participation of communities at all levels of planning and action. This study’s purpose is to evaluate the ability of the CPPSM to increase engagement of community stakeholders from diverse sectors. Community members and partners from the four Perinatal Support Coalitions within western Massachusetts were selected to participate in one-on-one interviews to assess levels of community engagement and participation and perceptions of the future success of the Coalition in transforming support services for perinatal mothers. Preliminary data from twenty interviews suggested increased community engagement and participation with feelings of “true” and equitable partnerships. Participants recognized the value in making the model participatory. To our knowledge this is the first study looking at empowerment, collaboration and engagement by coalitions seeking to affect comprehensive, culturally appropriate, and sustainable interventions for perinatal mental health. This preliminary research informs future research, contribute to efforts to demonstrate CPPSM intervention effectiveness, and develop evidence to support expansion of CPPSM to other communities.
Administer health education strategies, interventions and programs Advocacy for health and health education Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Public health or related organizational policy, standards, or other guidelines
Abstract
Community-Driven Lupus Health Equity Projects: Lessons Learned from a Community Lupus Health Education Program
Thometta Cozart, MS, MPH, CPH, CHES1, Steve Owens, MD, MPH2 and Elizabeth Traore, MPH3
(1)Directors of Health Promotion and Education, Tuscaloosa, AL, (2)Epilepsy Foundation, Landover, MD, (3)Directors of Health Promotion and Education, Washington, DC
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: Lupus is a chronic disease that is under discussed. Research shows that at least 1.5 million Americans have lupus, an autoimmune disease without a cure that damages any part of the human body. Lupus has disproportionally affected the lives of women of color. Lupus health disparities in rural areas contribute to mortality rates and health complications. Purpose and Methods: The Lupus Education and Awareness for Patients, Professionals and Providers (LEAP) Program was launched through the Directors of Health Promotion and Education and funded by the HHS Office of Minority Health. By awarding 10 mini-grants to community- and faith-based agencies with some being in rural areas, a community lupus health education program was established to reduce lupus related health disparities among racial and ethnic minority groups. Results: These agencies provided lupus awareness and educational materials to nearly 6,000 individuals at 82 community events, such as health fairs, church gatherings, walk-a-thons, lupus luncheons. All agencies identified collaboration, partnership development and integrating lupus health education as keys to their successful community health programs. Examples of culturally tailored health education approaches, along with activity results and program challenges, will be further discussed during this session. Conclusion: With guidance from the LEAP Program, lupus awareness was offered through new partnerships within rural, minority and underserved communities. By continuing to implement community-led interventions, health disparities may be addressed, even under discussed chronic health disparities such as lupus.
Administer health education strategies, interventions and programs Chronic disease management and prevention Diversity and culture Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs
Abstract
Improving Transportation Access in Underserved Areas: A Community Collaboration
Katherine Pope, RN, MPH
Live Young Sky Lakes Wellness Center, Klamath Falls, OR
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Health initiatives within the built environment are often not data driven and do not take community opinion into account. The Protected Bike Lane Project, launched in a rural and conservative community, aimed to do both by working with our local healthcare system, university, government officials, engineers, students, insurance providers, and community members. We created GIS maps in collaboration with our local university, using health outcomes from our medical system to identify neighborhoods with health disparities (such as obesity, diabetes, hypertension, etc alongside neighborhood walkability). Using these results, a protected bike lane was proposed to improve connectivity, transportation, health outcomes, and the economy in underserved areas. Our local health coalition, Healthy Klamath, helped inform this initiative. We allied with a local city councilor and an engineering firm to design the project. Throughout the process, we sought community buy-in via virtual and public open houses that we heavily advertised. We also went door to door in the affected area to ensure that community members were supportive. Community feedback informed the type and route of the protected bike lane. By working with our local insurance company, we were able to identify funding to construct the project. In addition, we were able to get community support and advocacy within our local government to ensure that this project was approved. This presentation will discuss how community involvement has made this project a reality and how we are taking steps to analyze health and economic improvements before and after bike lane construction.
Chronic disease management and prevention Conduct evaluation related to programs, research, and other areas of practice Implementation of health education strategies, interventions and programs Other professions or practice related to public health Planning of health education strategies, interventions, and programs Public health or related public policy
Abstract
University, the Health Department, and the Community partnering to address Lead Exposure and Lead Awareness in Lincoln-Lemington
Dennis Jones, PhD1, Marcus Poindexter, PhD Student2 and Denise Jones, MA3
(1)West Virginia University, Morgantown, WV, (2)University of Pittsburgh, Pittsburgh, PA, (3)Youth Enrichment Services, Pittsburgh, PA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: In 2016, Allegheny Front highlighted Pittsburgh as a city with higher than normal concentrations of lead in its public drinking water. They attributed this to the city’s aging infrastructure, similar to other cities along the rustic belt. While water is not the primary source of lead exposure, this concern gained significant attention from local and governmental agencies and communities about the potential risk on disenfranchised individuals and families and on children 0-6 years, who are most vulnerable to the effects of lead. Methods: A partnership with West Virginia University, the Allegheny County Health Department, Youth Enrichment Services, and the Lincoln-Lemington Community Consensus Group was forged to examine pathways to (1) lessen children's exposure to lead; (2) improve the community's awareness of lead, (3) understand the community's sanitary practices, and (4) improve the community's access to free county resources. Results: The partnering of the university, a governmental health agency, a community group, and the nonprofit sector is not an innovative practice. However, the collaboration of these institutions to address this systematic problem is, and has shown effectiveness in meeting the project's objectives. Partners observed an increased understanding of the community’s sanitary practices and a greater awareness of lead and lead exposure prevention. Preliminary data on lessening childhood lead exposure and increased access to county resources suggests positive improvements. Conclusion: We found that the partnership between the university, the county's health department, YES, and the community was effective at producing a community action plan to lessen Lincoln-Lemington residents' lead exposure.
Administer health education strategies, interventions and programs Advocacy for health and health education Implementation of health education strategies, interventions and programs
Abstract
Economical, User-Friendly Disease Surveillance and Mapping System to Allow Participatory Research in Resource-Poor Settings: A Pilot in Managua, Nicaragua
Chelsea Schmitt, M.S. and Jaime Corvin, PhD, MSPH, CPH
University of South Florida, Tampa, FL
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Mapping data is an important component of public health research. While current efforts focus on GIS as the primary tool for mapping, its complexity, the significant training necessary to become proficient and software costs are barriers to use. For those in resource-poor settings, a need exists for a mapping procedure that is both economically feasible and user-friendly. Epicollect5, a free web-based application, is one such option. Epicollect5 displays the geographic location of data, uses an intuitive interface, and requires little training. The goal of this project was to test the use of Epicollect5 for disease surveillance in a resource-poor community clinic setting. Specifically mosquito-borne diseases were tracked within two communities near Managua, Nicaragua. An Epicollect5 survey, Google Earth map, and GPS coordinate keys were provided to each clinic. Physicians completed the survey with patients whose symptoms suggested mosquito-borne illness. Surveys were uploaded via Wi-Fi. Mapped results were immediately available.
Results suggest the automatic location tool in Epicollect5 which uses GPS location of the device is problematic if data is acquired from a centralized location (clinic) that differs from the location of interest (patient's home). Manual entry requires known GPS coordinates. Supplementation with Google Earth addresses this hurdle.
This project demonstrates the utility of combining two freely-available tools for infectious disease surveillance, and is promising for a variety of applications. This system can make incredible strides in bringing mapping capabilities into the hands of the local community and NGOs for real-time outbreak mapping, while fostering the development of community-driven targeted inventions.
Administer health education strategies, interventions and programs Communication and informatics Protection of the public in relation to communicable diseases including prevention or control Public health or related research
Abstract
A Best Practice Assessment Model to Implement Trauma- and Grief- Informed Assessment for Culturally Diverse Youth in Underserved Communities
Karen Calhoun, MA1, Polly Gipson, PhD2, Ben Oosterhoff, PhD3, Timothy Brown, MPH4, Christopher Layne, PhD5 and Julie Kaplow, PhD, A.B.P.P.3
(1)Michigan Institute for Clinical and Health Research, Ann Arbor, MI, (2)Department of Psychiatry, Ann Arbor, MI, (3)Baylor University College of Medicine, Houston, TX, (4)Baylor University School of Medicine, Houston, TX, (5)University of California, Los Angeles, Los Angeles, CA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
An alarming number of children, particularly those living in underserved communities, experience a range of psychological and behavioral health issues in response to trauma and bereavement exposure such as Posttraumatic Stress Disorder (PTSD) and/or maladaptive grief reactions (Kaplow et al., 2012; Oosterhoff, Kaplow, & Layne, in press). These issues are often magnified from secondary exposure to accumulating traumatic events, including multiple deaths of family members and friends. Cultural issues play an important role in the mental health outcomes of diverse youth. For example, among Arab American youth, gender acculturation/identity stress, exposure to intergenerational trauma (e.g., emigration, war, terrorism), and media reporting of world conflict are potential traumatic stressors that may impact their well-being.
Although the overlapping fields of childhood grief and trauma are advancing, many healthcare providers do not have access to best practice guidelines, evidence-based assessment and treatment modalities to adequately identify maladaptive grief and/or PTSD, often leading to misdiagnosis and inappropriate treatment planning. This presentation will highlight findings from the Grief-Informed Foundations of Treatment (GIFT) Network, a national practice-research network that provides trauma and bereavement informed screening, assessment, case conceptualization and treatment planning to school systems; school-based and school linked health clinics; academic institutions; health systems/hospitals and mental health organizations serving children, youth and their families. Our community-engaged approach includes the voices of specific cultural groups to allow for cultural tailoring of assessment tools, ultimately helping stakeholders to identify and reduce PTSD and maladaptive grief reactions among children and adolescents of various backgrounds.
Administer health education strategies, interventions and programs Diversity and culture Planning of health education strategies, interventions, and programs Public health administration or related administration Public health or related organizational policy, standards, or other guidelines Systems thinking models (conceptual and theoretical models), applications related to public health
Abstract
Project PLACE (Population Level Approaches to Cancer Elimination): Using a Community Based Approach to Advance Health Equity
Kearston Ingraham, MPH1, Laura Fish, PhD1, Maritza Chirinos, MD2, Pao-Hwa Lin, PhD3, Xiaomei Gao, MS1 and Nadine Barrett, Ph.D, MA, MS1
(1)Duke Cancer Institute, Durham, NC, (2)El Centro Hispano, Durham, NC, (3)Duke University, Durham, NC
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: Previous studies have engaged the community in research with mixed approaches and outcomes. Few have developed a research plan that incorporates community partners in research design, data collection, and outcomes toward a co-developed research agenda that builds capacity and aligns priorities to advance health equity. The purpose of this study is to describe the processes and outcomes associated with engaging community partners in survey development and data collection to advance a partnered research agenda to reduce health disparities.
Methods: The study team worked with the Duke Cancer Institute's (DCI) Office of Health Equity and Disparities’ Community Advisory Council, and the Advisory Committee for the NCI funded program entitled, Project PLACE (Population Level Approaches to Cancer Elimination). These councils provide guidance throughout the project and work to engage DCI’s current and new partners interested in identifying and addressing community health needs via research and services.
Results: The process yielded 24 partner organizations conducting 47 events from April through December 2017, resulting in 2,315 surveys. We present data on existing and newly developed community partnerships that represent diverse populations located in strategically targeted counties in North Carolina.
Conclusion: Effective and authentic community engagement can yield meaningful partnerships to advance a co-developed research agenda with aligned priorities. Data from this study allows for next steps which include priority setting activities to increase access to cancer services and clinical trials, and advance a shared community engaged research portfolio.
Assessment of individual and community needs for health education Diversity and culture Public health or related research