Understanding FinTech and Decentralized Finance (DeFi) for Financial Inclusion

For a very long period of time, financial inclusion researchers have been addressing the barriers that prevent unprivileged people from accessing and using financial services. Financial exclusion is an underlying social problem that dates from the creation of the first financial system. Without the access to the banking and financial infrastructures, the unbanked are perpetuating a vicious cycle of poverty. Blockchain is leading this transformation of allowing unbanked and underbanked people to have access and interact with the finance industry. The promise of a digital economy is starting to take shape, as financial technology (FinTech) companies are evolving the concept of democratization of access. Decentralized finance (DeFi) is expanding the possibilities of financial technology by creating an ecosystem based on transparency, accessibility, and efficiency. We are witnessing a paradigm shift for most of the financial services which are remodeling the accessibility and usability of these services, addressing the excluded and underserved population.

973. Utilization of Project ECHO for COVID-19 Medical Knowledge and Best Practices for Health Professionals serving an Underserved Population

Background During the global COVID-19 pandemic, the release of research and data particularly to guide clinical care evolved rapidly and highlights the critical need for timely, and equitable access to medical knowledge and best practices. Specialized medical knowledge has historically been confined to specialists in academic medical centers and disconnected from healthcare professionals in underserved areas. It is important to bridge this gap and democratize knowledge through a model that supports rapid dissemination of best practices to build capacity in areas of need. Methods A Project ECHO partnership was implemented between academic infectious diseases specialists and local healthcare professionals involved in COVID-19 screening, diagnosis and management serving an underserved population. BCM COVID-19 ECHO supported the Access2Health SmartPod COVID-19 clinical operations staffed by a charitable community organization. The SmartPod clinical team were engaged in weekly one-hour ECHO sessions with didactic presentations and case discussions on diverse COVID-19 topics. The program was evaluated at 6 months. COVID 19 ECHO Model BCM COVID-19 ECHO Telementoring Program with the United Health Partners in the community BCM COVID-19 ECHO Telementoring Session Topics Curriculum developed for the health professionals seeing patients in the SmartPOD and clinics in underserved communities. Results In Fall 2020, BCM COVID-19 ECHO facilitated 10 sessions with an average attendance of 8 healthcare professionals per session. Evaluation results indicated high levels of satisfaction with session content and telementoring partnerships, with 80% expressing intent to apply the knowledge and skills acquired from the sessions to their clinical practice. Conclusion The Project ECHO model successfully engaged healthcare professionals in a continuous learning loop. With the rapid and vast amount of information during the COVID-19 pandemic, it is important to ensure health professionals have equitable access to medical knowledge and feel empowered to implement best practice changes. Disclosures All Authors: No reported disclosures

The Opportunities and Challenges of Integrating Population Histories Into Genetic Studies for Diverse Populations: A Motivating Example From Native Hawaiians

There is a well-recognized need to include diverse populations in genetic studies, but several obstacles continue to be prohibitive, including (but are not limited to) the difficulty of recruiting individuals from diverse populations in large numbers and the lack of representation in available genomic references. These obstacles notwithstanding, studying multiple diverse populations would provide informative, population-specific insights. Using Native Hawaiians as an example of an understudied population with a unique evolutionary history, I will argue that by developing key genomic resources and integrating evolutionary thinking into genetic epidemiology, we will have the opportunity to efficiently advance our knowledge of the genetic risk factors, ameliorate health disparity, and improve healthcare in this underserved population.

A web-based intervention is feasible for supporting weight loss and increased activity in rural women with arthritis

Rural women have well documented health disparities, with higher prevalence of obesity and chronic conditions, including arthritis. Change in weight and actigraph-recorded data were examined in a subset of 63 of 82 women with physician-diagnosed arthritis who completed a 30-month web-based clinical trial. Repeated measures analyses showed women lost weight from baseline to six months, slowly regained at 18 and 30 months, ending with a lower weight than baseline F(1,62)=40.89, p < .001, η2p =.40. Of 53 women with complete data, activity increased at six months, decreased at 18 months, and increased at 30 months F(1,52)=4.14, p =.04, η2p=.07. Women showed improved change in weight and activity from baseline at six, 18 and 30 months. This study adds support that web-based programs may promote weight loss and activity in a hard-to-reach, underserved population of midlife and older rural women with arthritis.