Water Safety Education Programs in Culturally and Linguistically Diverse Seattle Communities: Program Design and Pilot Evaluation

Drowning is a public health concern that disproportionally affects children and minorities in Washington State. Community health educators from Seattle Children’s Hospital designed a Water Safety Education and Lifejacket Giveaway Program for low-income parents of preschool-aged children from culturally and linguistically diverse backgrounds. The program was interpreted into multiple languages and parents and children in attendance received free lifejackets. The mixed-methods pilot evaluation of this program found statistically significant relationships between language and self-reported parent swim skill level (English-speaker OR 4.6; 95%CI: 1.84 – 11.54); and confidence of keeping one’s child safe (English-speaker OR 3.34; 95%CI: 1.10 – 10.4). Additionally, parents who self-reported that they could swim had four times the odds of feeling confident in keeping their children safe around the water (95% CI: 1.21 - 13.28). Qualitative data from follow-up interviews identified that the program boosted parent knowledge and confidence in safe water practices. Multi-lingual delivery and the role of partner preschools was critical to this program’s success. Specific programmatic focus on adult parent/caregiver skills and knowledge that reduce risk around the water should be a priority for future efforts to reduce drowning.

1189 Recruiting, Training, And Implementing Sleep Health Educators In Community-based Research To Improve Sleep Health

Introduction Adherence to OSA assessment and treatment is low among racial/ethnic minorities, particularly among blacks. Navigating patients along the continuum of care from assessment to treatment adherence requires motivation, social support, and self-efficacy. Previous studies indicate that community health educators can provide motivation, social support, and skills to patients to better navigate the complex OSA care continuum. However, recruiting, training, and implementing sleep health educators in clinical or research settings is complex. For the current study, we describe how we recruit, train, and implement sleep health educators in research and clinical settings and assess what makes a sleep health educator successful. Methods We recruited and trained twenty-five self-identified black sleep health educators for a randomized clinical trial (R01MD007716) focused on increasing OSA assessment and treatment adherence among blacks. During recruitment, we assessed key personality attributes that translate to being an effective sleep health educator, via behavioral and personality surveys, focused groups, and process forms filled out by educators. Sleep health educators underwent an 8-week training program on sleep health and motivational interviewing. In order to be certified, sleep health educators had to pass a written and scenario-based assessment. During the implementation phase of the trial, we assessed how many interviews each health educator conducted and whether individual characteristics were related to how many interviews. Results Of the trained educators, 80% were female, ranging from 25 to 58 years old. They all completed at least high school. All educators rated the program highly and were very satisfied with dispensing tailored sleep health education. Educators who displayed the highest knowledge about sleep health, provided frequent emotional and strategic support, committed to helping their assigned participants, and who rated their rapport highly with their assigned participants were most effective in getting their participant to adhere to OSA assessment and treatment. Conclusion Sleep health educators can be vital to increasing OSA assessment and treatment adherence among blacks. In order to ensure success, sleep health educators must undergo a thorough recruitment, training, and implementation and dissemination process. Support K01HL135452, R01MD007716, R01HL142066, K01HL135452,and K07AG052685

Using Drawing as an Active Engagement Tool To Empower Learners and Promote Teaching of Health Topics

Community members in Lagos, Nigeria, are not able to correctly define blood pressure, its causes, and the impact certain values have upon health. Community Health Educators (CHEs) are volunteers trained through Northwestern University’s current Access to Health initiative to educate low-literacy community members, who do not have access to vital health information. Utilizing an active engagement method can improve learning and retention of information by the CHEs and similar audiences. An example of this is drawing, which can help educate and empower CHEs to teach health topics to low-literacy community members.

Southern New Mexico Dietary Practices and Impacts on Carotenoid Content of Traditional Mexican Meals (P06-115-19)

Objectives Identify and measure beta-carotene, lutein, zeaxanthin and total carotenoids within traditional Southern New Mexican meals. Methods Three traditional New Mexican meals, red chile enchiladas, squash calabacitas, and red chile posole were chosen based on their inclusion of carotenoid containing vegetables. Seven community health educators, promotoras, were recruited from the La Semilla Food Center (Anthony, NM, USA) to prepare each meal, as commonly consumed with traditional Mexican practices and ingredients, on two separate cooking days. The red chile enchilada meal included Spanish rice, pinto beans and a side salad with tomatoes and orange bell peppers. Calabacitas were served with panela cheese and a corn tortilla and the posole, a red chile pork stew with hominy, was topped with cabbage and avocado. Once prepared, one plate (approximately 240 g) of each meal was blended and frozen in liquid nitrogen for carotenoid analysis. Carotenoid extractions were performed with 10 g samples in duplicate for each meal and analyzed against beta-carotene, lutein and zeaxanthin standards via high-performance liquid chromatography (HPLC). Carotenoid content for the entire portion of each meal was calculated and remaining samples of the meals were saved for future in vitro digestions to determine carotenoid micellar efficiencies. Results Beta-carotene and zeaxanthin were found in all three meals from both cooking days, whereas lutein was predominately found in calabacitas. The enchilada plate prepared on the second cooking day contained the highest total carotenoid amount with approximately 6.11 ug/g (1.47 mg/plate) and the highest beta-carotene and zeaxanthin amounts with 1.68 ug/g (403.2 ug/plate) and 0.55 ug/g (132 ug/plate), respectively. Lutein content in calabacitas was approximately 0.47 ug/g or 112.8 ug/plate. Conclusions Carotenoid content within each complex food matrix varied between cooking days indicating that minor differences in preparation practices and ingredients impact nutrient content. Future work including in vitro digestions of the meals will provide a basis for determining bioavailability of health-promoting carotenoids from traditional Southern New Mexican meals. Funding Sources New Mexico State University Vice President for Research Grant.

Results From a Pilot Video Intervention to Increase Cervical Cancer Screening in Refugee Women

Many refugee women emigrate from countries with high cervical cancer incidence rates and have low rates of cervical cancer screening both before and after resettlement. Refugee women face many barriers to cervical cancer screening, including limited knowledge of cervical cancer and screening recommendations and cultural and linguistic barriers to being screened. Our pilot study aimed to develop and evaluate educational videos to promote cervical cancer screening among Karen-Burmese and Nepali-Bhutanese refugees, two of the largest groups of refugees arriving to the United States in recent years. We developed culturally tailored narrative videos for each ethnic group. Karen-Burmese and Nepali-Bhutanese women ( N = 40) were recruited through community health educators to participate in a pre- and posttest study. We assessed changes in cervical cancer knowledge and intentions to be screened, and satisfaction with the videos. We found that women were significantly more likely to report having heard of a test for cervical cancer and indicated significantly greater intentions to be screened after watching the video. Their knowledge about cervical cancer and screening also improved significantly, and they reported high levels of acceptability with the video. Our results suggest that culturally tailored narrative educational videos were acceptable to the target audiences and may be effective in increasing cervical cancer screening among refugee women. Further research should assess how health care and social service providers could implement video-based interventions to encourage women to be screened for cervical cancer during early resettlement.

Native Voices: Native Peoples’ Concepts of Health and Illness in New Mexico: opening a local conversation by hosting a national traveling exhibit

Background: The University of New Mexico Health Sciences Library and Informatics Center hosted the National Library of Medicine’s Native Voices: Native Peoples’ Concepts of Health and Illness traveling exhibit. The authors’ goal was to promote local interest in the Native Voices exhibit, with an emphasis on making the exhibit content and materials available to American Indian communities throughout rural New Mexico.Case Presentation: We convened a daylong summit to highlight the exhibit and encourage discussion among 30 American Indian community health educators. The summit prompted the compilation and distribution of descriptions of 23 community projects that promote health and wellness. We also took a scaled-down version of the exhibit to 4 rural college campuses around the state that serve significant Native American student populations. Approximately 140 students and faculty interacted with the exhibit materials, and all 4 sites incorporated the exhibit into curriculum activities.Conclusions: A hosted national exhibit developed into a multifaceted, funded project that engaged with Native American communities. We demonstrated successful field deployment of a downsized, portable version of the full traveling exhibit to make meaningful connections with members of our outreach population.

Abstract 216: Effectiveness of Telehealth on Hypertension Management Among Disparate Populations: a Systematic Review

Introduction: Telehealth (TH) uses telecommunication technology (e.g. internet, telephone, mobile or smart phone) as a cost-effective way to provide healthcare delivery for hypertension (HTN) control. However, effectiveness of TH on HTN control among disparate populations is unclear. Methods: We conducted a systematic review using the Cochrane methods to assess effectiveness of TH for HTN control in disparate people diagnosed with HTN. Participants were considered disparate based on Healthy People 2020 definitions. Outcomes included: 1) HTN control; 2) blood pressure change; 3) medication adherence; and 4) utilization of care. Multiple databases were searched for published articles from 2000-July 2016 without restrictions on study design, language, location, or outcomes. The search garnered 1766 titles. Following screening, 18 primary studies were included that noted at least one outcome from TH use in disparate people with HTN. Results: Thirteen randomized control trials, 4 pre-post, and 1 cross-sectional studies were included. Most studies (61%) were conducted in USA. Follow-up varied from 28-730 days and total sample included 14,136 adults. Studies reported disparate populations by social and community context (89%), education (28%), income (33%), health and healthcare (39%), neighborhood and built environment (6%). TH was utilized in primary care including federally qualified health centers, community clinics, rural and urban small practices, homes, or in mixed settings. Most TH interventions were multi-component, included disease monitoring (83.3%), and/or self-management education (55.5%) implemented by nurses, pharmacists, or community health educators. TH used internet (55.5%) and/or phone (61.1%) or text message (22.2%) to deliver healthcare securely. Physicians reviewed reports as needed. Compared to usual care (UC), 14 of 18 studies found improvement in HTN control or reduced blood pressure. Of these, 9 of the 14 reported on HTN control and 3 of the 9 found improved control (p< 0.05). Of the 12 studies reporting on change in blood pressure, 9 found a significant reduction in either SBP or DBP (p<0.05). Eight of the 18 studies reported on hypertension medication adherence and 2 of the 8 studies found a significant improvement in adherence (p<0.05). Frequency of HTN assessment was reported and significantly improved for TH in 2 of 18 studies (p<0.05). Conclusion: In conclusion, TH showed promise to improve blood pressure control, and other health outcomes in disparate people with HTN. These results may inform healthcare providers, health plans, and decision makers of the potential for TH to improve HTN control among disparate populations.