Effective Recruitment Strategies for Community-Dwelling Persons Living With Dementia and Their Caregivers

Recruitment of diverse community-dwelling persons living with dementia (PLWD) and their caregivers (dyads) into randomized controlled trials (RCT) is challenging, time consuming and expensive. This presentation will describe community outreach efforts used over a one-year period to recruit dyads of PLWD and their caregivers in Healthy Patterns RCT. Community outreach yielded 296 inquiries, such that people expressed interest in joining the study. Of the 296 inquiries, almost all (95.6%) identified as African American, and 91(30.7%) consented to join the study. Presentations at senior centers yielded the highest number of inquiries (n=148), followed by staff presence at various community events such as health fairs and senior galas (n=145) and referrals (n=3). We found that community outreach was an effective recruitment strategy to generate inquiries among diverse PLWD and their caregivers to enroll in Healthy Patterns. We will discuss these strategies and provide suggestions for recruiting diverse dyads into clinical trials.

Knowledge is Power: Pathology Activity Booths in Community Health Fairs

Introduction/Objective Our pilot project “Pathology Activity Booths” is an innovative approach to investigating whether pathology activity exhibits at health fairs could increase access and promote learning and understanding of health topics and pathology of diseases. Health fairs are an effective form of community-based health promotion conducted in many underserved communities. Methods/Case Report Booth #1 (Colorectal Cancer Awareness Fair): Microscopes with histology slides of colon biopsies, with enlarged corresponding colonoscopy images, were displayed showing the histology of normal colon, abnormal colon and cancer (colon adenocarcinoma). Booth #2 (Children’s Back-To-School Fair): Microscopes with histology slides of normal skin, lung, kidney, liver, intestine, and brain tissue were shown. Post participation surveys assessed whether participants knew anyone with the diseases presented, had previous experience with microscopes, and/or felt they understood and learned from their experience at the booth. Results (if a Case Study enter NA) There were 71 total participants. At Booth #1, 100% (42/42) of participants stated they understood what they saw under the microscope and 95% (40/42) felt they learned something new. At Booth #2, 86% (25/29) of participants stated they understood what they saw under the microscope and 76% (22/29) stated they learned something new. One participant exclaimed she would now make her husband get the colonoscopy he had been avoiding. Conclusion The overwhelmingly positive responses indicate that pathology booths could be promising in promoting health knowledge in our patient population. Greater understanding of health topics may lead to increased use of screening tests that can ultimately improve health outcomes. Pathologists are well suited to be direct resources of accurate information for patients. As physicians who closely evaluate human disease, we can effectively provide access to a new, different and engaging perspective to community health education. Pathology activity booths may be a valuable resource for patients, an innovative method of teaching the community and a creative tool to enhance trainees’ experience and teaching ability.

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.

Asian-Americans Remain Low Utilizers of County Mental Health Services

The National Latino and Asian American Study (NLAAS, 2002–2003, n =2095) indicated that Asian-Americans (AA) use mental health services less frequently than the general population (8.6% vs. 17.95%). Even AA who have been diagnosed with mental health disorders use mental health services less frequently than their non-AA counterparts (34.1% versus 41.1%)2. AA in Riverside County count for 7.4% of the population, or about 181,356 individuals, according to the 2018 census estimates. The objective of the study is to examine and compare rates of utilization of mental health services by AA specifically in the Riverside County setting. This study utilizes data on patients’ ethnicity, age, gender, and diagnosis as collected annually by the Riverside County Department of Mental Health from the fiscal year of 2017–2018. It compares the prevalence of psychiatric disorders and the rate of utilization of mental health services by AA in the county to the data collected by the NLAAS. The total number of AA using mental health services in Riverside County is 669, which totals 1.73% of all individuals accessing the same services. The number of AA using mental health services represented 0.45% of the total AA population in Riverside County. AA in Riverside County are utilizing MH services even less than the national rates (0.45% vs 8.6% nationally from NLAAS data). The gap in care illustrated by these results exemplifies not only the disparity in utilization of MH services seen in this particular ethnic group, but portrays the stagnant results from Riverside County s attempts to address this issue. Possible reasons for the disparity include lack of access, stigma, recovery, migration, and a lack of culturally-competent care. A reimagined outreach initiative may help to better address this issue. Riverside County already has implemented an AA Task Force, holds health fairs at local churches in the communities, supports a UCR School of Medicine student-run free clinic, and is active in NAMI events.

Nomadic Tibetan women’s reproductive health: findings from cross-sectional surveys with a hard-to-reach population

Background Western China has undergone substantial sociodemographic change, yet little is known about the health status of ethnic minority populations living in these areas. Methods We report findings from two cross-sectional surveys conducted with female Tibetan nomads living in rural areas of Western China/Eastern Tibet. We present results of descriptive analyses of data collected from reproductive-aged females who attended community health fairs in 2014 (n = 193) and 2016 (n = 298). Results On average, sexual debut preceded marriage among study participants, with fertility near replacement levels (2.7 and 2.1 in 2014 and 2016, respectively). Contraceptive use was common, and dominated by use of IUDs and female sterilization. Although over three-quarters (76%) of 2016 survey participants reported ever having at least one sexually transmitted infection (STI) symptom, there was low awareness of STIs (59%) and action to prevent STIs (21%). Younger women (< 40) were more likely to report having had had an STI symptom, as compared to older women (84% versus 71%; p < 0.05). Conclusions We demonstrate feasibility of collecting data with this hard-to-reach population. Reporting of STI symptoms warrants further investigation to identify and address health conditions in this population of Tibetan nomadic women, especially amidst broader social and contextual changes that may affect the Tibetan population.

The Experiences of Caregivers of Persons Living with Dementia in Jamaica during COVID-19

This article provides descriptive insights of the experiences of family caregivers of persons living with dementia during the COVID-19 pandemic. Data were generated as part of a qualitative cross-national project to explore the costs and consequences of providing unpaid dementia care. Participants in Jamaica, who were recruited using community gatekeepers, information booths at health fairs, conferences, and other outreach events, were contacted by telephone to discuss their experiences of the pandemic. When face-to-face in-depth interview data collection was suspended due to the pandemic, ethical approval was received to contact all research participants who were informal unpaid family caregivers, both those whose care recipients had died and those who were active caregivers ( N = 19). Participants in this study were the 10 active family caregivers ( n F = 8; aged 45+; 60% from high socio-economic status). Their updates and reflections during these calls were documented in fieldnotes and analyzed for key themes. Data showed that the pandemic has illustrated the direct costs, both financial and otherwise, that informal dementia carers bear in Jamaica. It also intensified pre-existing challenges faced by family carers. We provide recommendations for sustainable support for family carers.

Community Engagement and Outreach Programs for Lead Prevention in Mississippi

The objective of the project was to encourage health promotion through education, outreach, and community-based training. The people attending health fairs (n = 467), community events (n = 469), and Kindergarten classes (n = 241) were the study participants. Hands-on training was offered at homebuilding retail stores (n = 25). U.S. Department of Housing and Urban Development (HUD)’s online visual training was given to realtors (n = 220), and inspectors, contractors, and Do-It-Yourself (DIY) workers (n = 75). Training workshops were attended by home-buyers and rental home owners at the Neighborhood Association Meetings (n = 91). The impact of training was evaluated by pre- and posttests. Nearly, 90% of the participants (n = 25) reported the hands-on training was useful. At posttest after the HUD online training, 59.4%, 67.9%, 65.1% of the participants (n = 220) identified soil, car batteries, and paint as sources of lead in the environment, respectively. Nearly 70% identified lead as a poison in the environment while 77.5% and 47.2% demonstrated two behaviors which help prevent lead poisoning. A total of 62.3%, 48.1%, and 58.5%, at posttest identified three complications or illnesses—behavioral, physical, and psychological, respectively. The home owners are required to get permission from the City for housing repair. In coordination with the federally funded housing repair or lead abatement programs, the trained inspectors are authorized to certify the renovation or repair works. These outreach activities were successful in improving the knowledge of the community people on lead poisoning prevention.

Food Insecurity Among Older Adults: A Transprofessional, Community-Based Collaboration

To address inequities related to food insecurity among older adults, a better understanding of the phenomenon was needed. An innovative screening tool to distinguish among high, medium and low risk and that considers cultural preferences related to food acquisition and related behaviors was developed and piloted. Screenings and healthy eating education were offered at health fairs and other community events. Information about food insecurity and healthy eating as well as resources, such as food maps, guidelines, and food preparation materials were disseminated. Preliminary findings suggest that over half of those screened have high levels of food insecurity. Approximately 37% have five or more comorbidities that combined with food insecurity, represent a significant threat to health and well-being. Elected officials and community leaders soon learned about this initiative and sought education and screening for their constituencies. The research and project evaluation will be used in collaboration with these leaders to identify polices at the local, state and federal level to promote health equity and reduce food insecurity disparities. Efforts are under development to integrate the new screening and referral mechanisms in community-based primary care practices.