Recruitment and Retention Framework for a Timed-Activity Intervention Among Older Latinos With ADRD

Latino participation in ADRD research is essential to advance cognitive health equity. We present results of an adapted framework to increase recruitment and retention of older Latinos with ADRD and caregivers (CGs) in a timed-activity intervention. Framework factors include 3 structures with strategies informed by a Latino Community Advisory Board. For Characteristics of Study Processes, we included linguistically equivalent data collection procedures/measures, scheduled at times most convenient for participants/CGs. Participants were called weekly for questions/guidance with procedures. Intervention sessions built-in additional time to embed Latino cultural values: familismo, personalismo, confianza and respeto. Study Team Infrastructure, included bilingual/bicultural members/students; and trusted community partners to assist with participant referrals. For Preferences and Beliefs Toward Research, we conducted a series of focus groups to understand beliefs about “memory health” and perceptions of ADRD risks. Strategies yielded effective results. We reached our recruitment goal; started a wait-list of interested participants; had zero (n=0) attrition.

Expanding Arizona’s Dementia Capable System

Currently, 5.8 million US adults live with Alzheimer’s disease (ADRD); the number is expected to double by 2050. Arizona will experience the greatest percent increase in ADRD by 2025. This project targeted three underserved groups in order to expand Arizona’s dementia capable system: people living alone with ADRD; people with Down Syndrome or another intellectual/developmental disability (DS/IDD) aging with ADRD and their family caregivers; and people with ADRD and their caregivers in the Latino community. This presentation describes the development and delivery of the project’s educational workshops, case management services, and evidence-based programs. Over 2,220 participants have participated in workshops to date with the largest percentage being case managers, care coordinators, and discharge planners. Evaluations have been extremely positive with 86.1% being “very likely” to recommend the project to others. The presentation concludes with findings and lessons learned regarding the delivery of the project’s evidence-based programs and case management services.

Illinois Unidos: A Community Demands Equity, Justice, and Inclusion

At the onset of the COVID-19 pandemic, neither government officials nor members of the news media fully grasped what was happening in the Latino community. Underreporting of COVID-19 cases led to a systematic neglect of the Latino population and resulted in disproportionately high rates of infection, hospitalization, and death. Illinois Unidos was formed to engage in community mobilization, health communication, advocacy, and policy work in response to inequalities exacerbated by COVID-19 in Latino communities in Illinois. (Am J Public Health. 2021;111(S3):S204–S207. https://doi.org/10.2105/AJPH.2021.306407 )

Who Was at Risk for COVID-19 Late in the US Pandemic? Insights From a Population Health Machine Learning Model

Background: Notable discrepancies in vulnerability to COVID-19 infection have been identified between specific population groups and regions in the United States. The purpose of this study was estimate likelihood of COVID-19 infection using a machine-learning algorithm that can be updated continuously based on health care data.Methods: Patient records were extracted for all COVID-19 nasal swab PCR tests performed within the Providence St. Joseph Health system from February to October of 2020. Several different machine learning models were tested to evaluate effects of sociodemographic, environmental, and medical history factors on risk of initial COVID-19 infection.Results: A total of 316,599 participants were included in this study and approximately 7.7% (n = 24,358) tested positive for COVID-19. A gradient boosting model, LightGBM (LGBM), predicted risk of initial infection with an area under the receiver operating characteristic curve of 0.819. Factors that predicted infection were cough, fever, being a member of the Hispanic or Latino community, being Spanish speaking, having a history of diabetes or dementia, and living in a neighborhood with housing insecurity. Conclusion: A model trained on sociodemographic, environmental, and medical history data performed well in predicting risk of a positive COVID-19 test. This model could be used to tailor education, public health policy, and resources for communities that are at the greatest risk of infection.

Latino Families’ Decisions to Accept Hospice Care

Objectives: The underrepresentation of Latinos in hospice care is well-documented. A gap remains, however, in the literature’s description of the factors that shape Latino families’ decisions to enroll in hospice care. The need for such understanding is dire considering the shifts in population and the research evidence that Latinos experience worse end-of-life outcomes compared to non-Latino whites. This study contributes to such understanding by exploring Latino older adults’ experiences with healthcare broadly and reasons for choosing hospice care specifically, including how they learned about hospice and their understanding of the service at the time of enrollment. Methods: Semi-structured interviews were conducted with 13 hospice-enrolled Latinos 65 or older, or their decision-making proxies. Qualitative data was analyzed using thematic analysis. Results: Findings show that hospice represents a way to access services, and not necessarily a philosophy of care that Latinos understand or seek at end of life. Conclusion: Healthcare providers such as hospital and hospice social workers must engage in efforts to enhance advance care planning discussions and hospice education with the Latino community.