Session
Voices of Faith: Critical Stakeholders in Ensuring the Diversification of Research and Strengthening Policies That Lead Toward Healthier Communities
APHA 2022 Annual Meeting and Expo
Abstract
Effect of 12-Week Educational Intervention & Health Coaching on Diabetes and Hypertension Outcomes: Results from a Randomized Controlled Trial
APHA 2022 Annual Meeting and Expo
Background: Type 2 Diabetes (T2DM) and hypertension (HTN) are prevalent comorbid chronic conditions in West Virginia (WV) with patients lacking access to self-management education and support in rural and medically underserved communities. Consequently, individuals with comorbid T2DM and HTN are often unable to receive much-needed self-management support from their healthcare providers, have low self-efficacy, and lack healthy lifestyle practices.
Objective: The Diabetes and Hypertension Self-Management program (DHSMP) offered a holistic approach to improving T2DM and HTN self-management.
Intervention & Results: Sixty-two adults with comorbid T2DM and HTN were assigned to a 3-arm, parallel-group, randomized controlled trial comparing 12-week DHSMP core lifestyle (Group A; N=21), 12-week DHSMP core plus medication adherence with medication therapy management (MTM, Group B; n=21) and enhanced usual care (EUC; 3-hour educational session; N=20) in two geographically-separated WV churches. The intervention groups were provided weekly health coaching plus 75-minute educational sessions. Participants completed assessments at baseline, 3- and 6-months. The primary outcomes included A1c, blood pressure, lipids, and medication adherence (MMAS8 scale), compared between assessment points and between groups. Mean age and BMI were 61.9 ±12 years and 37.4 ±7.6, respectively. Participants’ A1c, blood pressure, triglyceride, and HDL improved between baseline and 6-months for the intervention group (A & B) but not in the EUC control group participants. Medication adherence was generally low at baseline. MTM improved adherence in Group B compared to Group A participants.
Discussion/Conclusion: Results demonstrate the efficacy of a health coach-assisted non-pharmacological intervention in improving medication adherence and T2DM and HTN health outcomes.
Abstract
Sacred Spaces and Trusted Messengers: A faith driven COVID-19 response strategy
APHA 2022 Annual Meeting and Expo
The Latinx community was disproportionately impacted by the COVID-19 pandemic in Riverside County, accounting for 71% of COVID-19 cases in 2020. Forty-seven percent of the Latinx community in California, identify as Roman Catholic. Lack of access to vaccine, religious limitations due to allowable vaccine type, linguistic and technological barriers, living and working conditions, work related migration, lack of transportation, misinformation and hesitancy lead to increased case rates, death rates and decreased testing and vaccine uptake rates.
Inclusion of an Equity Officer in the Incident Command Structure and the formation of the Vaccine Equity Task-force were initial steps to address inequities. Through these efforts a strong partnership was formed with the Diocese of San Bernardino. Media campaigns, outreach, education, translation, testing and vaccine clinics were held at various parishes county wide. The Diocese provided support, resources, a channel for open communication, accurate information to debunk myths and reduce hesitancy for the community as trusted messengers. The focus of this partnership was to provide effective, equitable, culturally, linguistically appropriate resources and safe spaces for vaccination and testing.
In January 2021, 3.0% of the Latinx community was fully vaccinated. As of March 2022, 56.3% of Latinx community 5+ was fully vaccinated. One hundred and twenty-three vaccine clinics and over 12,000 doses were administered at Catholic parishes as of April 2022.
Ongoing collaboration with the San Bernardino Diocese to support with community education, recovery and wrap around services. Leveraging faith and community leaders as trusted messengers to address inequities beyond the COVID-19 pandemic.
Abstract
Engaging faith communities in improving blood pressure through self-management and medication adherence tools: An implementation study from Barbados
APHA 2022 Annual Meeting and Expo
ISSUE: Barbados is a small island developing state (SIDS) where 40% of persons over 25 have hypertension. Of those treated, over one-third continue to have raised blood pressure (BP). Community-based interventions emphasizing medication adherence are rare.
DESCRIPTION: We partnered with faith-based organizations (FBOs) to pilot a modified chronic disease self-management program, that includes medication adherence tools and phone text reminders, in people with hypertension that is poorly controlled (BP>130/90mmHg). Controls received standard care with no intervention. COVID-19 necessitated virtual workshop delivery. We based our evaluation on the RE-AIM framework.
LESSONS LEARNED: REACH: Of 345 persons screened in 20 FBOs, 99 (29%) were eligible, 78 consented and completed interviews. In the first wave, 48 were invited to participate and 12 (25%) declined, reasons being workshop timings or unfamiliarity with the virtual platform. EFFECTIVENESS: Of those in intervention arm, 36 have started the workshop series; 22 (61%) attended at least 3 of 6 sessions. Systolic BP will be compared between intervention and control groups. ADOPTION: Of 24 FBOs invited, 20 agreed. Reasons for FBO non-participation included COVID-19 restrictions or lack of permissions from National FBO-leaders. IMPLEMENTATION: Virtual workshops were led by trained FBO members and were cost-saving compared to in-person delivery; fidelity checks found high leader performance. MAINTENANCE: future work.
RECOMMENDATIONS: Navigating bureaucratic structures is critical to gaining access to FBOs. Planned focus groups will explain barriers and facilitators to workshop attendance. This work will inform scale-up and scale-out of future FBO-based interventions to address hypertension in Barbados and other SIDS.
Abstract
Leading Causes of Life in Public Health Strategy
APHA 2022 Annual Meeting and Expo
ISSUE: Leading Causes of Life (LCL) offer a strong alternative framework for public health analysis, strategy and program development compared to currently accepted logic based on leading causes of death and social determinants.
DESCRIPTION: The Leading Causes of Life Initiative is a global group of Fellows that began at The Carter Center, Memphis and South Africa seeking to align “religious health assets with public health challenges of HIV/AIDS and other health inequities. LCL augments the fundamental logic of pathology-oriented public health with a more robust framework that integrates the positive social determinants demonstrated in peer studies into violence, mental health and socioeconomic inequities.
LESSONS LEARNED: The Leading Causes of Life are especially valuable for public health partnerships involving faith-based health assets because of its bridging language aligning social connections, values, coherence, hope and generative relationships.
and RECOMMENDATIONS: Traditional leading causes of mortality, morbidity, and negative social determinants are helpful in setting priorities but less in identifying the social and intangible assets needed for sustained response and realigning institutional partnerships. LCL should be systematically integrated into community assessment research, participatory program design, and actions that build capacity to change conditions at the individual, family and community level. Those changes necessarily include changing institutional practices and public policies.