scholarly journals 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

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.

scholarly journals Community Health Workers as a Strategy to Tackle Psychosocial Suffering Due to Physical Distancing: A Randomized Controlled Trial

2021 ◽  
Vol 18 (6) ◽  
pp. 3097
Author(s):  
Dorien Vanden Bossche ◽  
Susan Lagaert ◽  
Sara Willems ◽  
Peter Decat
Keyword(s):  
Randomized Controlled Trial ◽  
Community Health ◽  
Health Workers ◽  
Psychosocial Support ◽  
Controlled Trial ◽  
Intervention Group ◽  
Psychosocial Health ◽  
Control Group ◽  
Randomized Controlled ◽  
The Impact

Background: During the COVID-19 pandemic, many primary care professionals were overburdened and experienced difficulties reaching vulnerable patients and meeting the increased need for psychosocial support. This randomized controlled trial (RCT) tested whether a primary healthcare (PHC) based community health worker (CHW) intervention could tackle psychosocial suffering due to physical distancing measures in patients with limited social networks. Methods: CHWs provided 8 weeks of tailored psychosocial support to the intervention group. Control group patients received ‘care as usual’. The impact on feelings of emotional support, social isolation, social participation, anxiety and fear of COVID-19 were measured longitudinally using a face-to-face survey to determine their mean change from baseline. Self-rated change in psychosocial health at 8 weeks was determined. Results: We failed to find a significant effect of the intervention on the prespecified psychosocial health measures. However, the intervention did lead to significant improvement in self-rated change in psychosocial health. Conclusions: This study confirms partially the existing evidence on the effectiveness of CHW interventions as a strategy to address mental health in PHC in a COVID context. Further research is needed to elaborate the implementation of CHWs in PHC to reach vulnerable populations during and after health crises.

Syphilis epidemiology and public health interventions in Western Australia from 1991 to 2009

Sexual Health ◽  
2012 ◽  
Vol 9 (3) ◽  
pp. 272 ◽  
Author(s):  
Kellie S. H. Kwan ◽  
Carolien M. Giele ◽  
Heath S. Greville ◽  
Carole A. Reeve ◽  
P. Heather Lyttle ◽  
...  
Keyword(s):  
Public Health ◽  
Western Australia ◽  
Aboriginal People ◽  
Congenital Syphilis ◽  
The United States ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Sex With Men ◽  
Notification Data ◽  
The Impact

Objectives To describe the epidemiology of congenital and infectious syphilis during 1991–2009, examine the impact of public health interventions and discuss the feasibility of syphilis elimination among Aboriginal people in Western Australia (WA). Methods: WA congenital and infectious syphilis notification data in 1991–2009 and national infectious syphilis notification data in 2005–2009 were analysed by Aboriginality, region of residence, and demographic and behavioural characteristics. Syphilis public health interventions in WA from 1991–2009 were also reviewed. Results: During 1991–2009, there were six notifications of congenital syphilis (50% Aboriginal) and 1441 infectious syphilis notifications (61% Aboriginal). During 1991–2005, 88% of notifications were Aboriginal, with several outbreaks identified in remote WA. During 2006–2009, 62% of notifications were non-Aboriginal, with an outbreak in metropolitan men who have sex with men. The Aboriginal : non-Aboriginal rate ratio decreased from 173 : 1 (1991–2005) to 15 : 1 (2006–2009). Conclusions: These data demonstrate that although the epidemiology of syphilis in WA has changed over time, the infection has remained endemic among Aboriginal people in non-metropolitan areas. Given the continued public health interventions targeted at this population, the limited success in eliminating syphilis in the United States and the unique geographical and socioeconomic features of WA, the elimination of syphilis seems unlikely in this state.

scholarly journals Community Health Workers as a Strategy to Tackle Psychosocial Suffering due to Physical Distancing: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Dorien Vanden Bossche ◽  
Susan Lagaert ◽  
Sara Willems ◽  
Peter Decat
Keyword(s):  
Randomized Controlled Trial ◽  
Community Health ◽  
Health Workers ◽  
Psychosocial Support ◽  
Controlled Trial ◽  
Intervention Group ◽  
Psychosocial Health ◽  
Control Group ◽  
Randomized Controlled ◽  
The Impact

Background: During the COVID-19 pandemic some family physicians were overburdened and experienced difficulties reaching vulnerable patients and meeting the increased need for psycho-social support. This randomized controlled trial (RCT) tested whether a primary healthcare (PHC) based community health worker (CHW) intervention could tackle psychosocial suffering due to physical distancing measures in patients with limited social networks. Methods: CHWs provided 8 weeks of tailored psychosocial support to the intervention group. Control group patients received ‘care as usual’. The impact on feelings of emotional support, social isolation, social participation, anxiety and fear of COVID-19 were measured longitudinally using a face-to-face survey to determine their mean change from baseline. Self-rated change in psychosocial health at 8 weeks was determined. Results: We failed to find a significant effect of the intervention on the prespecified psychosocial health measures. However, the intervention did lead to significant improvement in self-rated change in psychosocial health. Conclusions: This study confirms partially the existing evidence on the effectiveness of CHW in-terventions as a strategy to address mental health in PHC in a COVID context. Further research is needed to elaborate the implementation of CHWs in PHC to reach vulnerable populations during and after health crises.

scholarly journals The Burden of COVID-19 Infection in a Rural Tamil Nadu Community

2021 ◽  
Author(s):  
Rita Isaac ◽  
Biswajit Paul ◽  
Madelon Finkel ◽  
Mahesh Moorthy ◽  
Seshasailam Venkateswaran ◽  
...  
Keyword(s):  
Community Health ◽  
Tamil Nadu ◽  
Health Workers ◽  
Extended Family ◽  
Community Health Center ◽  
Vulnerable Groups ◽  
Severe Illness ◽  
Suspected Case ◽  
Antibody Testing ◽  
The Impact

Abstract Background: There are almost 11 million cases of COVID-19 in India. Transmission rates vary from region to region, and are influenced by many factors including population susceptibility, travel and uptake of preventive measures. To date there have been relatively few studies examining the impact of the pandemic in poor, rural regions of India. We report on a study examining COVID-19 burden in a rural community in Tamil Nadu.Methods: The study was undertaken in a population of approximately 130000 people, served by the Rural Unit of Health and Social Affairs (RUHSA), a community health center of CMC, Vellore. We established and evaluated a COVID-19 PCR-testing programme for symptomatic patients – testing was offered to 350 individuals, and household members of test-positive cases were offered antibody testing. We also undertook two COVID-19 seroprevalence surveys in the same community, amongst 701 randomly-selected individuals. Results: There were 182 positive tests in the symptomatic population (52.0%). Factors associated with test-positivity were older age, male gender, higher socioeconomic status (SES, as determined by occupation, education and housing), a history of diabetes, contact with a confirmed/suspected case and attending a gathering (such as a religious ceremony, festival or extended family gathering). Amongst test-positive cases, 3 (1.6%) died and 16 (8.8%) suffered a severe illness. Amongst 129 household contacts 40 (31.0 %) tested positive. The two seroprevalence surveys showed positivity rates of 2.2% (July/Aug 2020) and 22.0% (Nov 2020). 40 tested positive (31.0%, 95% CI: 23.02 -38.98). Our estimated infection-to-case ratio was 31.7.Conclusions: A simple approach using community health workers and a community-based testing clinic can readily identify significant numbers of COVID-19 infections in Indian rural population. There appear, however, to be low rates of death and severe illness, although vulnerable groups may be under-represented in our sample. It’s vital these poor, rural populations aren’t overlooked in ongoing pandemic monitoring and vaccine roll-out in India.

Abstract P303: Use of Community Health Workers for Community-based Hypertension Screening in Urban Haiti

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Caleigh Smith ◽  
Vanessa Rivera ◽  
Jean Joscar Victor ◽  
Lookens Pierre ◽  
Fabyola Preval ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Linkage To Care ◽  
Median Number ◽  
Population Based ◽  
Age Group ◽  
Cvd Risk ◽  
Blood Pressure Screening

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.

Thinking Transnationally

2019 ◽  
pp. 165-185
Author(s):  
Margarita María Sánchez
Keyword(s):  
Educational Opportunity ◽  
Forced Migration ◽  
Opportunity To Learn ◽  
The United States ◽  
Great Opportunity ◽  
Migrant Families ◽  
History Of ◽  
The Individual ◽  
The Impact

Wagner College is participating in a ground-breaking project that brings migrant families together after years of separation. This project has been not only inspirational for both faculty members and students, but is also a great opportunity to learn about forced migration and alternatives to keep families together. The “Transnational Project: San Jerónimo Xayacatlán-Port Richmond” was created to connect communities in both the United States and Mexico and to preserve their cultural identities that have been threatened by forced migration. In this chapter, I would like to present the project focusing on three aspects: the history of the project, the individual stories of members who migrated and of those who stayed in their homeland, and the impact of this educational opportunity in the classroom. I will use a series of interviews with the members of Ñani Migrante (the group formed by the members of both the San Jerónimo and the Port Richmond communities), the presentations of both panels that took place at Wagner College, and the reflections of students who attended them.

Thinking Transnationally

2016 ◽  
pp. 230-250 ◽  
Author(s):  
Margarita María Sánchez
Keyword(s):  
Educational Opportunity ◽  
Forced Migration ◽  
Opportunity To Learn ◽  
The United States ◽  
Great Opportunity ◽  
Migrant Families ◽  
History Of ◽  
The Individual ◽  
The Impact

Wagner College is participating in a ground-breaking project that brings migrant families together after years of separation. This project has been not only inspirational for both faculty members and students, but is also a great opportunity to learn about forced migration and alternatives to keep families together. The “Transnational Project: San Jerónimo Xayacatlán-Port Richmond” was created to connect communities in both the United States and Mexico and to preserve their cultural identities that have been threatened by forced migration. In this chapter, I would like to present the project focusing on three aspects: the history of the project, the individual stories of members who migrated and of those who stayed in their homeland, and the impact of this educational opportunity in the classroom. I will use a series of interviews with the members of Ñani Migrante (the group formed by the members of both the San Jerónimo and the Port Richmond communities), the presentations of both panels that took place at Wagner College, and the reflections of students who attended them.

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