Correlates of attendance at community engagement meetings held in advance of bio-behavioral research studies: A longitudinal, sociocentric social network study in rural Uganda

Background Community engagement is central to the conduct of health-related research studies as a way to determine priorities, inform study design and implementation, increase recruitment and retention, build relationships, and ensure that research meets the goals of the community. Community sensitization meetings, a form of community engagement, are often held prior to the initiation of research studies to provide information about upcoming study activities and resolve concerns in consultation with potential participants. This study estimated demographic, health, economic, and social network correlates of attendance at community sensitization meetings held in advance of a whole-population, combined behavioral, and biomedical research study in rural Uganda. Methods and findings Research assistants collected survey data from 1,630 adults participating in an ongoing sociocentric social network cohort study conducted in a rural region of southwestern Uganda. These community survey data, collected between 2016 and 2018, were linked to attendance logs from community sensitization meetings held in 2018 and 2019 before the subsequent community survey and community health fair. Of all participants, 264 (16%) attended a community sensitization meeting before the community survey, 464 (28%) attended a meeting before the community health fair, 558 (34%) attended a meeting before either study activity (survey or health fair), and 170 (10%) attended a meeting before both study activities (survey and health fair). Using multivariable Poisson regression models, we estimated correlates of attendance at community sensitization meetings. Attendance was more likely among study participants who were women (adjusted relative risk [ARR]health fair = 1.71, 95% confidence interval [CI], 1.32 to 2.21, p < 0.001), older age (ARRsurvey = 1.02 per year, 95% CI, 1.01 to 1.02, p < 0.001; ARRhealth fair = 1.02 per year, 95% CI, 1.01 to 1.02, p < 0.001), married (ARRsurvey = 1.74, 95% CI, 1.29 to 2.35, p < 0.001; ARRhealth fair = 1.41, 95% CI, 1.13 to 1.76, p = 0.002), and members of more community groups (ARRsurvey = 1.26 per group, 95% CI, 1.10 to 1.44, p = 0.001; ARRhealth fair = 1.26 per group, 95% CI, 1.12 to 1.43, p < 0.001). Attendance was less likely among study participants who lived farther from meeting locations (ARRsurvey = 0.54 per kilometer, 95% CI, 0.30 to 0.97, p = 0.041; ARRhealth fair = 0.57 per kilometer, 95% CI, 0.38 to 0.86, p = 0.007). Leveraging the cohort’s sociocentric design, social network analyses suggested that information conveyed during community sensitization meetings could reach a broader group of potential study participants through attendees’ social network and household connections. Study limitations include lack of detailed data on reasons for attendance/nonattendance at community sensitization meetings; achieving a representative sample of community members was not an explicit aim of the study; and generalizability may not extend beyond this study setting. Conclusions In this longitudinal, sociocentric social network study conducted in rural Uganda, we observed that older age, female sex, being married, membership in more community groups, and geographical proximity to meeting locations were correlated with attendance at community sensitization meetings held in advance of bio-behavioral research activities. Information conveyed during meetings could have reached a broader portion of the population through attendees’ social network and household connections. To ensure broader input and potentially increase participation in health-related research studies, the dissemination of research-related information through community sensitization meetings may need to target members of underrepresented groups.

Prevalence and incidence of frailty among community-dwelling older adults in Slovenia

Introduction Frailty is recognized as one of the most important global health challenges as the population is aging. The aim of this study was to evaluate prevalence and incidence of frailty, and associated factors, among the population of older adults in Slovenia compared to other European countries. Methods The prevalence and 4-year incidence of frailty among older adults (≥65 years) were evaluated using data from the Survey of Health, Ageing and Retirement in Europe (SHARE). Frailty was defined by the SHARE operationalization of Frailty phenotype. Multiple logistic regression model was used to explore factors associated with frailty. Results Age-standardized prevalence (95% CI) of frailty and pre-frailty in Slovenia were 14.9% (13.3-16.5) and 42.5% (39.8-45.2), respectively. Factors (OR, 95% CI) associated with increased frailty in Slovenia included age (7584 years: 5.03 (3.08-8.22); ≥85 years 21.7 (10.6-44.7) vs. 65-74 years), self-rated health (fair: 4.58 (2.75-7.61), poor: 54.6 (28.1-105.9) vs. excellent/very good/good), number of chronic diseases (1.20 (1.03-1.40)), and polypharmacy (yes: 3.25 (1.93-5.48) vs. no). Female gender and lower education were significantly associated with pre-frailty, but not frailty, in the adjusted model. Independently of these characteristics, age-standardized prevalence of frailty varied among geographical regions. Age-standardized 4-year incidence of frailty and pre-frailty in Slovenia were 6.6% (3.0-10.1) and 40.2% (32.7-47.6), respectively. Conclusion Among the Slovenian population of older adults aged 65 years and older, the age-standardized prevalence of frailty is 15% and 4-year incidence of frailty is 7%. Regional differences in Slovenia show the lowest prevalence in central Slovenian regions and the highest in northeastern Slovenian regions.

Mom Expo: Bridging the Gap Between Local Women and Perinatal Resources

The purpose of this project was to describe the implementation of a perinatal health fair intended to connect local women to holistic resources. Researchers used participatory strategies to develop the health fair with local women and perinatal educators. Researchers evaluated the health fair using pragmatic measures based on the (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Forty-two attendees were reached and 23 educators hosted booths and educational sessions. Feedback indicated strong enthusiasm for future similar events. Nearly three quarters of the time spent implementing the health fair was devoted to building relationships within the community. Overall, this project provides practical and empirical information to inform the planning, implementation, and evaluation of perinatal health fairs that establish meaningful connection between local women, perinatal educators, and health researchers.

The Impact of and Interaction between Diabetes and Frailty on Psychosocial Wellbeing and Mortality in Ireland

Frailty in middle-aged and older adults is associated with diabetes-related complications. The impact of and interaction between diabetes and frailty on psychosocial wellbeing and mortality in Ireland for adults aged ≥50 years were assessed using data from the Survey of Health, Ageing and Retirement in Europe. Measures included diabetes status (self-reported), frailty phenotype (≥3/5 criteria), low self-rated health (“fair” or “poor”), depression screening (EURO-D index score ≥4), and low quality of life (QoL) (CASP-12 index score < 35). Among the 970 participants, those with diabetes (n = 87) were more likely to be frail (23% vs. 8%; p < 0.001), have low self-rated health (46% vs. 19%; p < 0.001), depression (25% vs. 17%; p = 0.070), and low QoL (25% vs. 18%, p = 0.085). Adjusting for diabetes, age and sex, frailty independently predicted low self-rated health (OR: 9.79 (5.85–16.36)), depression (9.82 (5.93–16.25)), and low QoL (8.52 (5.19–13.97)). Adjusting for frailty, age and sex, diabetes independently predicted low self-rated health (2.70 (1.63–4.47)). The age-sex adjusted mortality hazard ratio was highest for frailty with diabetes (4.67 (1.08–20.15)), followed by frailty without diabetes (2.86 (1.17–6.99)) and being non-frail with diabetes (1.76 (0.59–5.22)). Frailty independently predicts lower self-reported wellbeing and is associated with reduced survival, underpinning its role as an integral part of holistic diabetes care.

Productive Aging in India: Pre-Retirement Perceptions, Priorities, and Gendered Perspectives

This study explores the perceptions of urban, middle class, white collar employees in India approaching retirement, to unpack ‘productive aging’ through a specific sociocultural lens. India, is aging fast with limited social security. Projected growth in the 60+ age group is 326% (2000 -2050) and 700% for the 80+. Prior studies largely focused on rural and blue collar adults. This study involves a sample of 76 people’s (41 men, 35 women of relatively high SES) attitudes to aging. Key findings show, self-perceived health status was different between men and women (ordinal regression analysis showed p value 0.034 at 95% CI). 51.22% men rated their health excellent/very good compared with 28.57% women. 12.2% men rated their health fair/poor compared with 25.72% women. Despite this, results of men and women’s perceptions of aging were remarkably similar though living in a country with entrenched gender inequality. Cultural influence was apparent from the gendered difference (p value 0.036, 95% CI) in response to the question “our society frowns upon paid work after retirement” (20% women agreed compared with 4.77% men). Interestingly, despite social constraints 68.58% women agreed that they prefer a paid alternate career after retirement compared with 53.66% men. Another difference (p value 0.006, 95% CI) on the question “I need to be gainfully occupied for my own personal satisfaction” had 100% women reporting they agree or strongly agree as compared with 85.37% men. Findings will be discussed in the context of gender and changing family structures among adults in late middle age.

40. The Role of Health Literacy in Vaccination Disparities: Do Patients Understand the Health Messages?

Background Numerous public health campaigns are organized with the goal of improving immunization rates. However, vaccination uptake remains low among certain racial/ethnic minority groups including Hispanic patients. The level of health literacy (HL), ability to recognize the words used, may impact patients’ understanding of health-related messages and consequently health behavior and vaccination. Methods We conducted a HL survey among adult female attendees of a health fair in an underserved area of Los Angeles. Attendees visiting a youth education booth were surveyed using an electronic tool. Respondents were surveyed on their familiarity with and recognition of specific words including: measles, shingles, pertussis, hepatitis, meningitis, stroke, diabetes, pneumonia, and human papilloma virus (HPV). Comparisons were analyzed using chi-squared tests. Results Forty-three women (n=28 Hispanic; n=15 Non-Hispanic) completed the survey. The mean ages of Hispanic and non-Hispanic (predominantly Caucasian and Asian) respondents were 35.4 ±14 years and 29.9 ±12 years, respectively. A significantly lower percentage of Hispanic vs. Non-Hispanic women reported recognition of words associated with vaccine-preventable diseases: “meningitis” (15% vs. 60%, p&lt; .01), “hepatitis” (18% vs. 69%, p&lt; .01), and “HPV” (33% vs 67%, p&lt; .05). Substantially lower recognition was also reported for “pneumonia”, although this did not reach statistical significance (46% vs 77%, p=.06). The percentage reporting recognition of “diabetes” did not differ significantly between groups (68% vs 60%, p=0.43). Conclusion Immunization campaigns often use words that patients may not understand, potentially impacting patients’ relationship with the healthcare system and health behavior change. We found a lower level of recognition (health literacy) of words associated with vaccine-preventable diseases among Hispanic vs. Non-Hispanic women attending a community health fair. These findings have implications for developing culturally-tailored communication tools and educational strategies using a language easily recognized by a specific community to help reduce racial disparities in vaccination uptake. Disclosures All Authors: No reported disclosures

Building a foundation for utilizing evidence based practice in conjunction with research in baccalaureate nursing program

Less is known about the undergraduate nursing students’ ability to conduct beginning research. This study aims to explore and describe nursing students' experiences in planning and implementation of community health fairs; and utilizing evidence based practice integrated with research as a learning outcome. The study using a quantitative and descriptive design was conducted by senior nursing students during diverse community health events as a part of Gerontological nursing clinical. The students utilized three fall assessment tools: Balance and Gait test, Timed Up and Go test, and 10-year Fracture Risk Calculation. A total of 74 students participated in seven community health fair events focused on Fall Prevention. This health fair event was in conjunction with the National Fall Prevention Awareness week. A total of 201 older adults were served during the event by nursing students who provided screening process and related health education. Data were gathered and a group of students volunteered to complete the research process. The students participated in oral presentation in the Annual University Research Student Symposium and had poster presentation in the professional academic conference. Early systematic organized planning of the clinical experience gives students opportunity to integrate evidence based practice into research. Application of varied evidence based assessment tools focused on older adults enables students to understand the health issue in depth and the need for additional services. Health fair experiences improve students’ communication and education skills, reality of health issues of the target population in a community, and evidence based research.