Community engagement and linkage to care efforts by peer community‐health workers to increase PrEP uptake among sexual minority men

Background: Cardiovascular disease is the leading cause of mortality among Haitian adults, and hypertension (HTN) is the most important CVD risk factor, as in other resource-poor countries. The majority of Haitians have never been screened for hypertension and access to clinic-based services is limited. Methods: Twenty-eight Haitian community health workers (CHW) conducted household-based HTN screening within a population-based longitudinal cohort study of 3,000 adults in metropolitan Port-au-Prince. Randomly selected GPS locations across census blocks were selected in proportion to the estimated population of each block. One household at each waypoint was selected systematically and CHW collected household information and conducted three blood pressure measurements the same day on all adult household members (≥ 18 years) present at the time of the survey using AHA guidelines. Adults with HTN were referred to the GHESKIO clinic for repeat BP measurement and treatment. Results: Between March and September 2019, 585 households provided verbal consent for surveys and BP screening (97% response rate). These households had a total of 2542 people (1777 adults) with the median number of adults per household being 3 (IQR 2-4; range 1-9). A total of 913 adults (51%) were present at the time of survey, and all agreed to blood pressure screening. The majority were women (70%) with a median age of 36 years (IQR 27-52). Hypertension prevalence (SBP > 140 and/or DBP > 90) was 25.3% (15.5% Stage I, 9.8% Stage II). Figure 1 reports HTN prevalence by age group (18-30, 31-45, 46-60, >60) and by sex, with HTN increasing by age group but without significant variation by sex. Conclusion: Community blood pressure screening is feasible and highly acceptable in Port-au-Prince, Haiti. Preliminary results show high rates of HTN among a population with limited access to screening, diagnosis and treatment. Further research is urgently needed to design linkage to care strategies and effective treatment interventions to curb the HTN epidemic in Haiti.

Download Full-text

Community Health Warriors: Marshallese Community Health Workers’ Perceptions and Experiences with CBPR and Community Engagement

Progress in Community Health Partnerships Research Education and Action ◽

10.1353/cpr.2017.0037 ◽

2017 ◽

Vol 11 (3) ◽

pp. 315-320 ◽

Cited By ~ 3

Author(s):

Rachel S. Purvis ◽

Williamina Ioanna Bing ◽

Christopher J. Jacob ◽

Sharlynn Lang ◽

Sammie Mamis ◽

...

Keyword(s):

Community Engagement ◽

Community Health ◽

Community Health Workers ◽

Health Workers

Download Full-text

The role of community health workers in the surgical cascade: a scoping review

Human Resources for Health ◽

10.1186/s12960-021-00659-z ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Helen W. Li ◽

Michael L. Scanlon ◽

Nicholas Kisilu ◽

Debra K. Litzelman

Keyword(s):

Community Health ◽

Community Health Workers ◽

Scoping Review ◽

Health Workers ◽

Surgical Care ◽

Linkage To Care ◽

Surgical Site Infections ◽

Healthcare Services ◽

Operative Care

Abstract Background Community health workers (CHWs) can increase access to various primary healthcare services; however, their potential for improving surgical care is under-explored. We sought to assess the role of CHWs in the surgical cascade, defined as disease screening, linkage to operative care, and post-operative care. Given the well-described literature on CHWs and screening, we focused on the latter two steps of the surgical cascade. Methods We conducted a scoping review of the peer-reviewed literature. We searched for studies published in any language from January 1, 2000 to May 1, 2020 using electronic literature databases including Pubmed/MEDLINE, Web of Science, SCOPUS, and Google Scholar. We included articles on CHW involvement in linkage to operative care and/or post-operative surgical care. Narrative and descriptive methods were used to analyze the data. Results The initial search identified 145 articles relevant to steps in the surgical cascade. Ten studies met our inclusion criteria and were included for review. In linkage to care, CHWs helped increase surgical enrollment, provide resources for vulnerable patients, and build trust in healthcare services. Post-operatively, CHWs acted as effective monitors for surgical-site infections and provided socially isolated patients with support and linkage to additional services. The complex and wide-ranging needs of surgical patients illustrated the need to view surgical care as a continuum rather than a singular operative event. Conclusion While the current literature is limited, CHWs were able to maneuver complex medical, cultural, and social barriers to surgical care by linking patients to counseling, education, and community resources, as well as post-operative infection prevention services. Future studies would benefit from more rigorous study designs and larger sample sizes to further elucidate the role CHWs can serve in the surgical cascade.

Download Full-text

Recommendations From Black Sexual Minority Men: Building Trust to Improve Engagement and Impact of HIV/STI Research

Health Promotion Practice ◽

10.1177/1524839920947679 ◽

2020 ◽

pp. 152483992094767

Author(s):

Suzanne M. Grieb ◽

Kevon-Mark Jackman ◽

Carla Tilchin ◽

Charles Clark ◽

Simone Sawyer ◽

...

Keyword(s):

Community Engagement ◽

Sexual Minority ◽

Research Process ◽

Research Literature ◽

Trust Building ◽

Policy Makers ◽

Sexual Minority Men ◽

Sexually Transmitted ◽

Action Strategies ◽

Minority Men

As demonstrated by the consistently documented disproportionately high rates of HIV and STIs (sexually transmitted infections) among Black sexual minority men (BSMM), current efforts to develop responsive interventions to reduce HIV and other STIs within this population have not been sufficient. It is therefore critical that public health researchers reflect meaningfully on the ways in which they investigate HIV and STIs. Engagement with BSMM is crucial in addressing the disproportionately high rates of HIV and STIs experienced, and thus the goal of the current research was to identify community-developed strategies that may enhance community engagement in research with BSMM. Seven focus groups ( N = 38) were held with cisgender BSMM ages 18 to 45 years in Baltimore, Maryland to explore how to better engage this population and improve HIV and STI research. Data analysis of the text was conducted using an iterative, thematic constant comparison process informed by grounded theory. Four distinct themes related to trust-building within the broader community emerged: (1) authentic engagement with the community, (2) increased transparency of the research process, (3) capacity building of research staff from the community, and (4) a balance of research and action. Strategies for researchers to build community trust were identified that are related to, but slightly distinct from, common discussions in the community engaged research literature that are centered more specifically on trust-building within community–academic partnerships. Engagement with BSMM is crucial in addressing HIV and STI health disparities. It is critical that community engagement also be a priority to policy makers, research institutions, and funding institutions.

Download Full-text

Community Health Workers as Accelerators of Community Engagement and Structural Competency in Health

Structural Competency in Mental Health and Medicine ◽

10.1007/978-3-030-10525-9_14 ◽

2019 ◽

pp. 167-177 ◽

Cited By ~ 1

Author(s):

Chau Trinh-Shevrin ◽

MD Taher ◽

Nadia Islam

Keyword(s):

Community Engagement ◽

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Structural Competency

Download Full-text

Reminder use to improve service referral use among participants in a community engagement program (Preprint)

10.2196/preprints.11011 ◽

2018 ◽

Author(s):

Deepthi Satheesa Varma ◽

Mark W. Hart ◽

Denise S. McIntyre ◽

Evan K Kwiatkowski ◽

Linda B. Cottler

Keyword(s):

Health Care ◽

Mobile Phone ◽

Community Engagement ◽

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Baseline Assessment ◽

Significant Difference ◽

Service Referral

BACKGROUND Recent research on health care delivery has shown that mobile based interventions are effective in bringing behavior change among clinical populations. Mobile phone-based interventions are considered to be convenient and economical to the provider and non-invasive and hence acceptable to the receiver. Studies have also shown that personalized text message reminders are more acceptable and effective than automated mass messages. However, despite the increasing literature on mobile phone-based interventions (mHealth) contributing to improvement in health care, there is a dearth of information on the use of reminders for social and medical service referrals provided to nonclinical populations by community-engagement programs. OBJECTIVE This pilot study aimed to apply mobile phone-based interventions to improve the utilization rates of medical and social service referrals provided to community members by Community Health Workers (CHW’s) through HealthStreet – a community engagement initiative at the University of Florida (UF). METHODS 300 eligible HealthStreet members were randomly assigned to CALLSONLY, TEXTONLY, CALLS+TEXT reminder intervention groups. Reminders were sent based on their assignment on the 15th and 45th day after the baseline assessment reminding them to utilize the medical and/or social referrals that were provided by the community health workers based on their expressed need during the baseline assessment. A telephonic follow up was done on the 30th and 60th day to assess the rate of utilization of the referrals. Further, a telephone based brief satisfaction survey was also administered to all participants on the 60th day follow up call. RESULTS Out of 290 participants, 201 (69.3%) successfully completed the 30-day HealthStreet follow up and 149 (51.4%) participants successfully completed the 60-day HealthStreet follow up. At the 30-day follow up, 52 of the 201 respondents reported the use of at least one referral and there were no differences for utilization by contact status. At the 60-day follow up, 69 of the 149 participants reported utilizing at least one referral; there were no differences for this group either. CONCLUSIONS Findings from this study did not find any significant difference in the rate of service referral utilization between participants who received different types of reminders. The absence of a significant difference between the two groups may be because of the smaller sample size of the study.

Download Full-text

Community awareness, engagement and linkage to care efforts by peer community-health workers to increase PrEP uptake among men who have sex with men in Baltimore, Maryland

10.21203/rs.3.rs-15665/v1 ◽

2020 ◽

Author(s):

Jason E. Farley ◽

Derek T Dangerfield II ◽

Jessica LaRicci ◽

Paul Sacamano ◽

Omeid Heidari ◽

...

Keyword(s):

Community Health ◽

Health Workers ◽

Total Yield ◽

Linkage To Care ◽

The United States ◽

Mobile App ◽

Peer Community ◽

Sex With Men ◽

The Individual ◽

The Impact

Abstract Background: Despite clear evidence that pre-exposure prophylaxis (PrEP) prevents HIV, uptake remains suboptimal across the United States, particularly in populations at greatest risk of HIV infection, such as men who have sex with men (MSM) in Baltimore. This paper will evaluate awareness, engagement and linkage to care for PrEP activities through multiple outreach strategies. Methods: This is an observational evaluation of the impact of LGBTQ+ outreach on the PrEP cascade between March 1, 2016 to March 31, 2019. Descriptive statistics are used to characterize the data and the linkage cascade by outreach type. Results: Across all activities, our team had contact with 2,370 participants and scheduled a PrEP appointment for 84 (3.5%) with 58 (2.4%) who completed the intake visits. Among 54 venue-based activities, which focused on PrEP awareness messaging, 2,125 participants were reached with 11.4% (243/2125) interested in further discussion with a peer community-health worker (CHW). After 3 separate attempts to contact the individual, peer contact was successful in 66.2% (161/243); 11.2% (18/161) of those were interested in linkage to PrEP; 83.3% (15/18) had a PrEP appointment scheduled; and 53.3% (8/15) completed the PrEP visit. Online and telephone-based outreach resulted in 24 contacts through prepmaryland.org and 43 calls on the PrEP warm line, all of these indivduals reporting interest in further discussion with the peer CHW. Among prepmaryland.org users and warm line calls 54.2% (13/24) and 67.4% (29/43), respectively, were successfully contacted, while 100% (13/13) and 75.9% (22/29) of those reported interest in a PrEP referral. Among the referred, 61.5% (8/13) and 86.4% (19/22) had a PrEP appointment scheduled; and 50% (4/8) and 78.9% (15/19) completed the visit. The mobile app, PrEPme, yielded 178 unique downloads; 94.4% (168/178) had interest in further discussion with a peer CHW; follow-up contact was successful 64.3% (108/168); 41.6% (45/108) were interested in PrEP referral; 95.5% (43/45) had a PrEP appointment successfully scheduled; and 72.1% (31/43) completed the intake visit.Conclusions: Outreach efforts reached a large number of participants attending LGBTQ+ centric and health-based events, yet resulted in a relatively low total yield of engagement with peer CHWs and even lower documented PrEP initiations.

Download Full-text