scholarly journals Establishing a SARS-CoV-2 (COVID-19) Drive-Through Collection Site: A Community-Based Participatory Research Partnership With a Federally Qualified Health Center

2021 ◽  
Vol 111 (4) ◽  
pp. 658-662
Author(s):  
LaPrincess C. Brewer ◽  
Cynthia Woods ◽  
Aarti Patel ◽  
Jennifer Weis ◽  
Clarence Jones ◽  
...  
Keyword(s):  
Health Center ◽  
Low Income ◽  
Diagnostic Testing ◽  
Community Based Participatory Research ◽  
The United States ◽  
Academic Community ◽  
Collection Site ◽  
Disadvantaged Population ◽  
Federally Qualified Health Center ◽  
Structural Inequities

The COVID-19 pandemic has disproportionately affected underserved and minority populations in the United States. This is partially attributable to limited access to diagnostic testing from deeply rooted structural inequities precipitating higher infection and mortality rates. We describe the process of establishing a drive-through collection site by leveraging an academic–community partnership between a medical institution and a federally qualified health center in Minnesota. Over 10 weeks, 2006 COVID-19 tests were provided to a socioeconomically disadvantaged population of racial/ethnic minorities and low-income essential workers.

scholarly journals A PRESCRIPTION FOR WELLNESS: EXERCISE REFERRALS FOR PATIENTS AT A FEDERALLY QUALIFIED HEALTH CENTER

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S519-S519
Author(s):  
Gabriel Benavidez ◽  
Kelly Ylitalo
Keyword(s):  
Physical Activity ◽  
Chronic Disease ◽  
Health Center ◽  
Exercise Prescription ◽  
Patient Characteristics ◽  
The United States ◽  
Health Coaching ◽  
Adult Patients ◽  
Federally Qualified Health Center ◽  
Personalized Health

Abstract Physical activity improves quality of life and prevents or delays chronic disease, but most adults in the United States are inactive. Consultation and planning with a health care provider, specifically with an exercise “prescription,” may increase physical activity, but utilization patterns and success of such programs are not well understood. This study assessed the initial 6 months of an exercise prescription program at a large, federally-qualified health center during 2018 whereby adult patients were referred via prescription to personalized health coaching by a fitness advisor. A census of all adults (n=512) who received an exercise prescription was combined with attendance data from the on-site exercise facility to classify patients as never attended, 1 to 3 visits, and ≥4 visits. Ordinal logistic regression was used to examine patient characteristics from the electronic health record that influenced exercise facility attendance. Only 30.2% of adults (mean age 44.7 years (SD 14.4)) completed ≥1 visit and 21.7% completed ≥4 visits. We identified no significant utilization differences by sex, race/ethnicity, body mass index, diabetes, hypertension, or coronary artery disease, but adults aged ≥60 years had almost twice the odds of ≥4 visits (OR=1.97; 95% CI: 1.18, 3.33; p=0.01) compared to younger patients. Many adult patients did not participate in the exercise prescription program, but older adults were more likely to participate. Exercise prescription programs with personalized health coaching may be useful for older adult patients receiving care at a federally-qualified health center. Future work will examine if or how exercise prescriptions impact chronic disease self-management.

scholarly journals Outreach and Inreach Strategies for Colorectal Cancer Screening Among Latinos at a Federally Qualified Health Center: A Randomized Controlled Trial, 2015–2018

2020 ◽  
Vol 110 (4) ◽  
pp. 587-594
Author(s):  
Sheila F. Castañeda ◽  
Balambal Bharti ◽  
Marielena Rojas ◽  
Silvia Mercado ◽  
Adriana M. Bearse ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Randomized Controlled Trial ◽  
Usual Care ◽  
Health Center ◽  
Low Income ◽  
Controlled Trial ◽  
Crc Screening ◽  
Randomized Controlled ◽  
Federally Qualified Health Center ◽  
Mexico Border

Objectives. To compare usual care, inreach consisting of one-on-one education, mailed outreach offering a fecal immunochemical test (FIT), and a combination of outreach and inreach for promoting colorectal cancer (CRC) screening. Methods. We conducted a 4-arm randomized controlled trial from 2015 to 2018 at a US federally qualified health center near the California–Mexico border primarily serving low-income Hispanics/Latinos. A total of 673 individuals aged 50 to 75 years not up to date with screening were assigned to 1 of the 4 intervention groups. The primary outcome was CRC screening through 6 months follow-up. Results. A total of 671 patients were included in intention-to-screen analyses. Their mean age was 59.9 years, 48.9% were male, and 86.3% were primarily Spanish-speaking. Screening was 27.5% for usual care (95% confidence interval [CI] = 0.21, 0.34), 52.7% for inreach (95% CI = 0.45, 0.60), 77.2% for outreach (95% CI = 0.71, 0.83), and 78.9% for combination of inreach and outreach (95% CI = 0.73, 0.85; P < .001 for all comparisons except P = .793 for outreach vs combination). Conclusions. Among individuals at high risk for noncompletion, inreach with one-on-one education nearly doubled, and outreach offering mailed FIT alone or in combination with inreach nearly tripled screening compared with usual care. Mailed FIT outreach was superior to inreach for promoting screening.

Outcomes from birth to 6 months of publicly insured infants born to mothers with severe acute respiratory syndrome coronavirus 2 infection in the United States

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Tina L. Schuh ◽  
Leena B. Mithal ◽  
Sara Naureckas ◽  
Emily S. Miller ◽  
Craig F. Garfield ◽  
...  
Keyword(s):  
Health Center ◽  
Low Income ◽  
Growth Parameters ◽  
Clinical Status ◽  
Genetic Diagnosis ◽  
The United States ◽  
Growth Patterns ◽  
Publicly Insured ◽  
In Pregnancy

Abstract Objectives We evaluated inpatient management, transition to home, breastfeeding, growth, and clinical outcomes of infants born to mothers diagnosed with SARS-CoV-2 infection in pregnancy and followed in a Federally Qualified Health Center (FQHC), that serves a diverse and low-income patient population, from birth through 6 months of life. Methods Infants born between 4/3/20 and 7/26/20 at Prentice Women’s Hospital with mothers who received prenatal care at Erie Family Health Center (Erie), the second largest FQHC in Illinois, and had confirmed SARS-CoV-2 during pregnancy were included. Data were abstracted from delivery hospital admission and outpatient follow-up appointments between 4/8/20 and 2/4/21. Results Thirty-three infants met inclusion criteria. Average gestational age was 38.9 weeks (IQR 37.6–40.4), 3 (10%) were premature and 5 (15%) required NICU admission. Nearly all (97%) mothers expressed intent to breastfeed. Outpatient follow-up rates were similar to historical cohorts and 82% (23/28) of infants were vaccination compliant. Growth parameters showed normal distributions at all time points. At 6 months, any and exclusive breast milk feeding rates were lower compared to historic cohorts (18 vs. 36%, p<0.05, 0 vs. 21%, p<0.01). Three infants (10%) received development-related referrals, one carried an underlying genetic diagnosis. Outpatient visits were predominantly face-to-face with telemedicine use comprising only 6% of visits (11/182). Conclusions Longitudinal follow-up of 33 publicly insured infants born to mothers with SARS-CoV-2 infection in pregnancy followed in an FQHC showed high rates of follow-up and vaccination compliance, normal growth patterns and reassuring clinical status, and lower than expected rates of breastfeeding.

Increasing Colorectal Cancer Screening at an Urban FQHC Using iFOBT and Patient Navigation

2017 ◽  
Vol 18 (5) ◽  
pp. 741-750 ◽  
Author(s):  
Richard L. Martin ◽  
Madelaine Tully ◽  
Allison Kos ◽  
David Frazer ◽  
Amy Williamson ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Health Center ◽  
Colorectal Cancer Screening ◽  
Patient Navigation ◽  
Black Americans ◽  
The United States ◽  
Academic Community ◽  
Outreach Program ◽  
Fecal Occult Blood

Introduction. Colorectal cancer is the second leading cause of cancer death in the United States. Black Americans suffer even higher incidence and death rates than the general population. Genetics and patient perceptions explain some of this difference, however, modifiable health care system factors such as lack of access to colon cancer screening also contribute. Partnering an academic health center with local community groups, we piloted a colorectal cancer screening program at a Federally Qualified Health Center (FQHC) serving predominately low socioeconomic status Black Americans. The program was designed to identify and remove barriers to screening and improve screening rates. Method. At a single center FQHC, we developed an outreach program centered around (1) patient and provider education, (2) immunochemical fecal occult blood test (iFOBT) distribution, and (3) patient navigation. We identified 402 eligible patients, of which 228 (56.7%) completed screening. Results. Our 56.7% screening rate represented a twofold increase above prepilot levels at the clinic. Nine (4%) iFOBT returned positive. Three of these nine patients completed colonoscopy. Screening rates and follow through were higher under a single navigator model. Conclusions. Our academic–community partnership provided an effective, evidence based, and sustainable model for increasing colorectal cancer screening in a high risk, low resource community.

scholarly journals A Promotor-Led Pilot Study to Increase Colorectal Cancer Screening in Latinos: The Juntos Contra El Cáncer Program

2020 ◽  
pp. 152483992091224
Author(s):  
Elva M. Arredondo ◽  
Jill Dumbauld ◽  
Maria Milla ◽  
Hala Madanat ◽  
Gloria D. Coronado ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Center ◽  
Screening Test ◽  
The United States ◽  
Perceived Barriers ◽  
Program Outcomes ◽  
Crc Screening ◽  
Federally Qualified Health Center ◽  
Latino Adults ◽  
Crc Knowledge

Background. Latinos have lower colorectal cancer (CRC) screening rates compared to other racial/ethnic groups in the United States, despite an overall increase in CRC screening over the past 10 years. To address this disparity, we implemented a promotor-led intervention to increase CRC screening test adherence in community-based settings, connecting community members with a partnering federally qualified health center. Purpose. To evaluate the Juntos Contra el Cáncer/Together Against Cancer (JUNTOS) intervention, by assessing pre–post changes in (1) CRC screening test adherence and (2) CRC knowledge and perceived barriers to CRC screening. We also assessed the feasibility and acceptability of program activities. Method. JUNTOS was a group-based intervention, delivered by promotores (community health workers), to promote CRC screening test adherence among Latino adults. The intervention consisted of a culturally tailored 2½-hour interactive workshop followed by an appointment scheduling assistance from a promotor. Workshop participants were Latino adults (males and females) aged 50 to 75 years who were not up-to-date with CRC screening guidelines. We conducted interviews before and 6 to 9 months after the workshop to assess program outcomes. Results. Of the 177 participants included, 118 reported completing the CRC screening test (66.7%) by 6 to 9 months postintervention. We observed baseline to 6- to 9-month increase in CRC knowledge and lower perceived barriers to obtaining CRC screening. Furthermore, the intervention was found to be feasible and acceptable. Conclusion. Results suggest that JUNTOS can be feasibly implemented in partnership with a federally qualified health center. The current study supports group-based CRC interventions in community and clinic settings.

scholarly journals Multicomponent Informed Consent with Marshallese Participants

2021 ◽  
pp. 155626462110056
Author(s):  
Rachel S. Purvis ◽  
Britni L. Ayers ◽  
Cari A. Bogulski ◽  
Kyle F. Kaminicki ◽  
Lauren K. Haggard-Duff ◽  
...  
Keyword(s):  
Community Based Participatory Research ◽  
The United States ◽  
Academic Community ◽  
Pacific Islanders ◽  
Personal Health Information ◽  
Indigenous Populations ◽  
Community Research ◽  
Plain Language ◽  
Community Based ◽  
Study Participants

Pacific Islanders are the second fastest-growing population in the United States; however, Pacific Islanders, and Marshallese specifically, are underrepresented in health research. A community-based participatory research (CBPR) approach was used to engage Marshallese stakeholders and build an academic-community research collaborative to conduct health disparities research. Our CBPR partnership pilot tested a multicomponent consent process that provides participants the option to control the use of their data. Consent forms used concise plain language to describe study information, including participant requirements, risks, and personal health information protections, and were available in both English and Marshallese. This study demonstrates that when provided a multicomponent consent, the vast majority of consenting study participants (89.6%) agreed to all additional options, and only five (10.4%) provided consent for some but not all options. Our description of the development and implementation of a multicomponent consent using a CBPR approach adds a specific example of community engagement and may be informative for other indigenous populations.

scholarly journals Adapting a Family-Focused Diabetes Prevention Program for a Federally Qualified Health Center: A Qualitative Report

2020 ◽  
Vol 46 (2) ◽  
pp. 161-168
Author(s):  
Patrick Rivers ◽  
Melanie Hingle ◽  
Griselda Ruiz-Braun ◽  
Robert Blew ◽  
Joy Mockbee ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Health Center ◽  
Low Income ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Family Members ◽  
Diabetes Prevention Program ◽  
Willingness To Participate ◽  
Federally Qualified Health Center ◽  
History Of

Purpose The purpose of the study was to explore the needs of high-risk Latinx/Hispanic women with a history of gestational diabetes who were patients at a Federally Qualified Health Center (FQHC) in anticipation of a future family-based program. Methods Six focus group studies were conducted in partnership with El Rio Community Health Center, an FQHC in Tucson, Arizona. Thirty-nine women participated, each identified as Latinx/Hispanic, self-reported a history of gestational diabetes or prediabetes, and had at least 1 child aged 8 to 13. Three investigators independently reviewed transcripts from the focus groups to identify themes that reflected thematic saturation from participants’ responses. Data coding and results were discussed as a group and any differences were collectively adjudicated. Results All participants had a family member with diabetes and worried about their and their immediate family members’ risk for developing the disease. The possible benefits of participating in a lifestyle prevention program were universally recognized, but multiple barriers to participation were described, including scheduling conflicts, access to childcare, transportation, and the need to involve additional family members to reinforce program objectives. Conclusions There is a strong willingness to participate in a diabetes prevention program among respondents, but to be successful, interventions must be tailored to specific needs and challenges. Trying to apply existing prevention curricula with low-income Latinx/Hispanic populations may not be successful without adaptations.

scholarly journals Location Matters: Geographic Disparities and Impact of Coronavirus Disease 2019

2020 ◽  
Vol 222 (12) ◽  
pp. 1951-1954
Author(s):  
Tina Q Tan ◽  
Ravina Kullar ◽  
Talia H Swartz ◽  
Trini A Mathew ◽  
Damani A Piggott ◽  
...  
Keyword(s):  
United States ◽  
Low Income ◽  
Rural Areas ◽  
Geographic Location ◽  
The United States ◽  
Geographic Disparities ◽  
Geographic Disparity ◽  
Communities Of Color ◽  
Structural Inequities ◽  
The Impact

Abstract The coronavirus disease 2019 (COVID-19) pandemic in the United States has revealed major disparities in the access to testing and messaging about the pandemic based on the geographic location of individuals, particularly in communities of color, rural areas, and areas of low income. This geographic disparity, in addition to deeply rooted structural inequities, have posed additional challenges to adequately diagnose and provide care for individuals of all ages living in these settings. We describe the impact that COVID-19 has had on geographically disparate populations in the United States and share our recommendations on what might be done to ameliorate the current situation.

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