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Lohr AM, Pratt R, Dirie H, Ahmed Y, Elmi H, Nur O, Osman A, Novotny P, Mohamed AA, Griffin JM, Sia IG, Wieland ML. The Association Between Perceived Discrimination, Age and Proportion of Lifetime in the United States Among Somali Immigrants: A Cross-Sectional Analysis. J Immigr Minor Health 2024:10.1007/s10903-024-01589-3. [PMID: 38578534 DOI: 10.1007/s10903-024-01589-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2024] [Indexed: 04/06/2024]
Abstract
Discrimination is detrimental to health. Little is known about perceived discrimination among Somali immigrants. We examined whether age or proportion of lifetime in the United States was associated with perceived discrimination among Somali immigrants. Guided by Intersectionality, we described a secondary analysis of Everyday Discrimination Scale (EDS) survey data from the Healthy Immigrant Community study. Younger participants ( ≤40 years) experienced more discrimination than older participants ( >40 years). Higher education, being male, and earning $20,000-$39,999 was associated with more perceived discrimination. These findings suggest that Somali immigrants who are younger, more formally educated, male, and/or earn $20,000-$39,000 report more discrimination than their counterparts. Possible explanations include exposure to discrimination outside the Somali community or more awareness about racism. Alternatively, the EDS may not capture the discrimination experienced by Somali women or older adults. Further research is needed to address the discrimination experienced by Somali immigrants. Clinical Trial Registration: NCT05136339, November 29,2021.
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Affiliation(s)
- Abby M Lohr
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA.
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, USA.
| | - Rebekah Pratt
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Hana Dirie
- Community Based Research, Mayo Clinic, Rochester, MN, USA
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA
| | - Yahye Ahmed
- Community Based Research, Mayo Clinic, Rochester, MN, USA
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA
| | - Hindi Elmi
- Intercultural Mutual Assistance Association, Rochester, MN, USA
| | - Omar Nur
- Somali American Social Service Association, Rochester, MN, USA
| | - Ahmed Osman
- Intercultural Mutual Assistance Association, Rochester, MN, USA
| | - Paul Novotny
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, 55902, USA
| | - Ahmed A Mohamed
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, USA
| | - Joan M Griffin
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
- Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA
| | - Irene G Sia
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA
| | - Mark L Wieland
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, USA
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Lohr AM, Capetillo GP, Molina L, Goodson M, Smith K, Griffin JM, Wieland ML, Sia IG. Development of a Digital Storytelling Intervention to Increase Breast, Cervical, and Colorectal Cancer Screening in the Hispanic/Latino Community: a Qualitative Evaluation. J Canc Educ 2024; 39:160-167. [PMID: 38044415 DOI: 10.1007/s13187-023-02389-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/18/2023] [Indexed: 12/05/2023]
Abstract
Digital storytelling (DST) interventions may be one way to address disparities in cancer screening experienced by the Hispanic/Latino population. Digital stories are short, first-person narratives that include voice-over narration and images. With storytellers' permission, researchers can screen digital stories as a health intervention. Digital stories can inspire viewers to adopt or change their behavior, such as completing cancer screening. Rochester Healthy Community Partnership (a 20-year community-based participatory research partnership) together with eight Hispanic/Latino, Spanish speaking cancer survivors, co-survivors, or recently screened individuals, developed digital stories about breast, cervical, and colorectal cancer screening. Here, we describe our qualitative evaluation of the DST workshop. To understand what the storytellers thought viewers would find relatable in their digital stories, we applied Narrative Theory. We also assessed workshop successes and opportunities for improvement. We used the constant comparative method for data analysis. We learned that the storytellers anticipated their stories would be engaging and that viewers would connect with Hispanic/Latino cultural values. During the workshop, the storytellers felt like they were making an important contribution. The storytellers highlighted specific opportunities for improvement including sharing the stories more quickly after the workshop. Future research is needed to test whether this intervention follows the Narrative Theory causal pathway by persuading viewers to complete recommended cancer screenings.
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Affiliation(s)
- Abby M Lohr
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA.
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, USA.
| | | | - Luz Molina
- Community Based Research, Mayo Clinic, Rochester, MN, USA
| | - Miriam Goodson
- Community Based Research, Mayo Clinic, Rochester, MN, USA
| | - Kaitlyn Smith
- Community Based Research, Mayo Clinic, Rochester, MN, USA
| | - Joan M Griffin
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Mark L Wieland
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, USA
| | - Irene G Sia
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA
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Tranby BN, Sia IG, Clark MM, Novotny PJ, Lohr AM, Pardo LS, Patten CA, Iteghete SO, Zeratsky KA, Rieck TM, Molina L, Capetillo GP, Ahmed Y, Drie H, Wieland ML. Negative Mood is Associated with Sociobehavioral Factors Contributing to Cardiovascular Risk in an Immigrant Population. Res Sq 2024:rs.3.rs-3934645. [PMID: 38559259 PMCID: PMC10980105 DOI: 10.21203/rs.3.rs-3934645/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Background Immigrants to the United States, on average, accumulate cardiovascular risk after resettlement, including obesity. There is a need to co-create interventions to address these disparities, and mood may be an important mediating factor. Methods The Healthy Immigrant Community (HIC) study, set in southeast Minnesota, enrolled 475 adult participants in a weight loss intervention to reduce cardiovascular risk. Baseline questionnaires assessed mood, nutrition, physical activity, self-efficacy for healthy eating and physical activity, social support, and cohesion. A single-item mood rating of poor or fair was considered "negative", while ratings of good, very good, or excellent were considered "positive". Results A total of 449 HIC participants (268 Hispanic/Latino and 181 Somali) with complete baseline measures and were included in this analysis. Participants endorsing negative mood compared to those endorsing positive mood had lower scores for healthy eating (p = 0.02) and physical activity levels (p = 0.03), lower confidence in eating a healthy diet (p = 0.001), and felt less of a sense of belonging to their community (p = 0.01). Those endorsing negative mood also reported receiving less social support from their family and friends to eat healthy (p = < 0.001) and be physically active (p = 0.01), and less often accessed community resources for healthy eating (p = 0.001) and physical activity (p = < 0.01) compared to participants reporting positive mood. Conclusions Negative mood was associated with less healthy nutrition, lower confidence in eating healthy, sedentary lifestyle, and perceived lack of belonging to the community. Integrating mood management and self-efficacy strategies may enhance the effectiveness of lifestyle interventions among immigrants who report negative mood. ClinicalTrialsgov registration NCT05136339; April 23, 2022.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Hana Drie
- Rochester Healthy Community Partnership
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Wieland ML, Molina L, Goodson M, Capetillo GP, Osman A, Ahmed Y, Elmi H, Nur O, Iteghete SO, Torres-Herbeck G, Dirie H, Clark MM, Lohr AM, Smith K, Zeratsky K, Rieck T, Herrin J, Valente TW, Sia IG. Healthy immigrant community study protocol: A randomized controlled trial of a social network intervention for cardiovascular risk reduction among Hispanic and Somali adults. Contemp Clin Trials 2024; 138:107465. [PMID: 38309526 PMCID: PMC10923143 DOI: 10.1016/j.cct.2024.107465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/18/2023] [Accepted: 01/28/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Immigrants to the United States face structural barriers that contribute to rising cardiovascular risk factors and obesity after immigration. This manuscript describes the development of the Healthy Immigrant Community protocol and baseline measures for a stepped wedge cluster randomized trial to test the effectiveness of a social network intervention for cardiovascular risk reduction among two immigrant populations. METHODS We developed a social network-informed, community-based, participatory research-derived health promotion intervention with Hispanic and Somali immigrant communities in Minnesota consisting of mentoring, educational and motivational sessions, group activities, and a community toolkit for healthy weight loss delivered by culturally concordant health promoters (HPs) to their social networks. Using a stepped wedge cluster randomized design, social network-based groups were randomly assigned to receive the intervention either immediately or after a delay of one year. Outcomes, measured at baseline, 6 months, 12 months, and 24 months, were derived from the American Heart Association's "Life's Simple 7": BMI and waist circumference, blood pressure, fasting blood glucose, total cholesterol, physical activity level, and dietary quality. RESULTS A total of 51 HPs were enrolled and randomized (29 Hispanic; 22 Somali). There were 475 participants enrolled in the study, representing a mean social network group size of 8 (range, 5-12). The mean BMI of the sample (32.2) was in the "obese" range. CONCLUSION Processes and products from this Healthy Immigrant Community protocol are relevant to other communities seeking to reduce cardiovascular risk factors and negative health behaviors among immigrant populations by leveraging the influence of their social networks.
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Affiliation(s)
- Mark L Wieland
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, USA; Rochester Healthy Community Partnership.
| | | | - Miriam Goodson
- Rochester Healthy Community Partnership; Alliance for Chicanos, Hispanics, and Latin Americans, Rochester, MN, USA
| | - Graciela Porraz Capetillo
- Rochester Healthy Community Partnership; Department of Language Services, Mayo Clinic, Rochester, MN, USA
| | - Ahmed Osman
- Rochester Healthy Community Partnership; Intercultural Mutual Assistance Association, Rochester, MN, USA
| | - Yahye Ahmed
- Rochester Healthy Community Partnership; Somali American Social Service Association, Rochester, MN, USA
| | - Hindi Elmi
- Rochester Healthy Community Partnership; Intercultural Mutual Assistance Association, Rochester, MN, USA
| | - Omar Nur
- Rochester Healthy Community Partnership; Somali American Social Service Association, Rochester, MN, USA
| | | | - Gloria Torres-Herbeck
- Rochester Healthy Community Partnership; Alliance for Chicanos, Hispanics, and Latin Americans, Rochester, MN, USA
| | | | - Matthew M Clark
- Rochester Healthy Community Partnership; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Abby M Lohr
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, USA; Rochester Healthy Community Partnership
| | | | - Katherine Zeratsky
- Rochester Healthy Community Partnership; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Thomas Rieck
- Rochester Healthy Community Partnership; Department of Integrative Medicine and Health, Mayo Clinic, Rochester, MN, USA
| | - Jeph Herrin
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Thomas W Valente
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Irene G Sia
- Rochester Healthy Community Partnership; Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA
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Lohr AM, Bell ML, Coulter K, Marston S, Thompson M, Carvajal SC, Wilkinson-Lee AM, Gerald LB, Korchmaros J. The Association Between Duration of School Garden Exposure and Self-Reported Learning and School Connectedness. Health Educ Behav 2023; 50:637-646. [PMID: 35311372 DOI: 10.1177/10901981221084266] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
When students feel connected to their school, they experience positive health and academic outcomes. In contrast, school disengagement is a predictor of dropout, delinquency, and substance use. School garden programming has the potential to help children achieve academic outcomes and feel connected to their school. Unfortunately, most school garden research has been conducted with white, affluent study participants. We describe the results of a secondary analysis utilizing data from an evaluation of a university-supported community school garden program (CSGP). Using a cross-sectional survey study design, we examined the impact of school garden programming in Title I schools on primarily Latino/a (Hispanic) elementary student self-reported learning and feelings of school connectedness by comparing students with ≤1 year exposure to those with >1 year. Social cognitive theory formed the conceptual basis for the analysis. Duration of school garden exposure did not have a significant association with self-reported learning or feelings of school connectedness. Regardless of past exposure, fifth-grade students, females, and those who identify as Latino/a (Hispanic) felt that school garden programming improved their learning. Latino/a (Hispanic) students who participate in school garden programming may also feel a greater sense of connection to their teachers and peers at school. Qualitative results demonstrated that most students enjoyed spending time in the garden and indicated that participating in the program helped them learn new things and feel connected to their school. If individuals who may be disadvantaged because of systemic racism, such as Latino/a (Hispanic) students, can benefit from school garden programming, such interventions should be further investigated and prioritized.
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Lohr AM, Neumbo KC, Njeru JW, Molina L, Hasley R, Ahmed Y, Quirindongo-Cedeno O, Torres-Herbeck GA, Goodson ML, Osman A, Weis JA, Wieland ML, Sia IG. Addressing COVID-19 inequities using bidirectional crisis and emergency risk communication and vaccine clinic interventions: a descriptive study. BMC Public Health 2023; 23:1517. [PMID: 37558981 PMCID: PMC10413496 DOI: 10.1186/s12889-023-16410-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 07/27/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Im/migrants (immigrants and migrants, including refugees, asylum seekers, and individuals without legal documentation) experience unique assets and needs in relation to coronavirus disease 2019 (COVID-19). Community-based participatory research (CBPR) is one way to engage im/migrant communities. Rochester Healthy Community Partnership (RHCP) is a CBPR partnership in Rochester, Minnesota. RHCP partners noted that credible COVID-19 information was not available to their communities. In response, RHCP formed a COVID-19 Task Force and adapted the Centers for Disease Control and Prevention's Crisis and Emergency Risk Communication (CERC) framework to create an intervention that prioritized im/migrant groups experiencing health disparities. In the CERC intervention, communication leaders delivered COVID-19 health messages to their social networks and documented related concerns. RHCP relayed these concerns to regional leaders to ensure that im/migrant experiences were included in decision making. Once vaccines were available, RHCP continued to deploy the CERC intervention to promote vaccination equity. The aims of this paper are to (1) describe the implementation of a bidirectional CERC intervention for vaccination equity, and (2) describe a community-engaged and community-based vaccine clinic intervention. METHODS First, we surveyed participants (n = 37) to assess COVID-19 experiences, acceptability of the CERC intervention, and motivation to receive a COVID-19 vaccination. Second, we collaborated with community partners to hold vaccine clinics. We report descriptive statistics from each intervention. RESULTS When asked about the acceptability of the CERC intervention for vaccine equity, most participants either reported that they 'really liked it' or 'thought it was just ok'. Most participants stated that they would recommend the program to family or friends who have not yet received the COVID-19 vaccine. Almost all participants reported that they felt 'much more' or 'somewhat more' motivated to receive a COVID-19 vaccine after the intervention. We administered 1158 vaccines at the vaccination clinics. CONCLUSIONS We found that participants viewed the CERC intervention for vaccination equity as an acceptable way to disseminate COVID-19-related information. Nearly all participants reported that the intervention convinced them to receive a COVID-19 vaccine. In our experience, community-engaged and community-based clinics are a successful way to administer vaccines to im/migrant communities during a pandemic.
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Affiliation(s)
- Abby M Lohr
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, USA.
| | | | - Jane W Njeru
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, USA
| | - Luz Molina
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, USA
- Community Based Research, Mayo Clinic, Rochester, USA
| | | | - Yahye Ahmed
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, USA
- Community Based Research, Mayo Clinic, Rochester, USA
| | - Onelis Quirindongo-Cedeno
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, USA
| | - Gloria A Torres-Herbeck
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, USA
- Community Based Research, Mayo Clinic, Rochester, USA
- Alliance of Chicanos, Hispanics, and Latin Americans, Rochester, USA
| | - Miriam L Goodson
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, USA
- Community Based Research, Mayo Clinic, Rochester, USA
- Alliance of Chicanos, Hispanics, and Latin Americans, Rochester, USA
| | - Ahmed Osman
- Intercultural Mutual Assistance Association, Rochester, USA
| | - Jenny A Weis
- Research Administrative Services, Mayo Clinic, Rochester, USA
| | - Mark L Wieland
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, USA
| | - Irene G Sia
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, USA
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Lohr AM, Vickery KD, Hernandez V, Ford BR, Gonzalez C, Kavistan S, Patten CA, Njeru JW, Novotny PJ, Larkey LK, Singh D, Wieland ML, Sia IG. Stories for change protocol: A randomized controlled trial of a digital storytelling intervention for Hispanic/Latino individuals with type 2 diabetes. Contemp Clin Trials 2023; 126:107093. [PMID: 36682492 PMCID: PMC9998363 DOI: 10.1016/j.cct.2023.107093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/21/2023]
Abstract
BACKGROUND Hispanic/Latino adults are disproportionately impacted by type 2 diabetes mellitus (T2D). The Stories for Change (S4C) Diabetes digital storytelling intervention promotes T2D self-management among Hispanic/Latino people. We describe the S4C protocol and participant baseline characteristics. METHODS Study eligibility criteria: Hispanic or Latino, age 18-70 years, ≥1 office visit within a year at a participating clinic, T2D diagnosis for ≥6 months, HbA1c ≥ 8%, and intention to continue care at the recruitment clinic. We used a two-group, parallel randomized controlled trial design and an intervention derived through a community-based participatory research approach. All participants received usual diabetes care and two cards describing how to engage healthcare teams and access diabetes-related resources. At baseline, the intervention group additionally viewed the 12-min, intervention video (four stories about diabetes self-management). To encourage subsequent video viewing, participants received five monthly text messages. The messages prompted them to self-rate their motivation and self-efficacy for T2D management. The control group received no additional intervention. Bilingual (English/Spanish) staff collected data at baseline, six weeks, three months, and six months including biometric measurements and a survey on diabetes self-management outcomes, theory-based measures, and the number of video views. We reviewed the number of diabetes-related appointments attended using electronic medical record data. RESULTS Participants (n = 451; 70% women, mean age = 53 years) had an average HbA1C ≥9%. Intervention participants reported identifying with the storytellers and engaging with the stories. CONCLUSION We present a digital storytelling intervention protocol that provides a template for future health promotion interventions prioritizing health disparity populations. CLINICALTRIAL gov#NCT03766438.
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Affiliation(s)
- Abby M Lohr
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA; Center for Clinical and Translational Science, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA.
| | - Katherine Diaz Vickery
- Health, Homelessness & Criminal Justice Lab, Hennepin Healthcare Research Institute, 730 S 8th St, Minneapolis, MN 55415, USA
| | | | - Becky R Ford
- Health, Homelessness & Criminal Justice Lab, Hennepin Healthcare Research Institute, 730 S 8th St, Minneapolis, MN 55415, USA
| | - Crystal Gonzalez
- Mountain Park Health Center, 635 E Baseline Rd, Phoenix, AZ 85042, USA
| | - Silvio Kavistan
- Health, Homelessness & Criminal Justice Lab, Hennepin Healthcare Research Institute, 730 S 8th St, Minneapolis, MN 55415, USA
| | - Christi A Patten
- Center for Clinical and Translational Science, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA; Department of Psychiatry and Psychology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Jane W Njeru
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Paul J Novotny
- Division of Biomedical Statistics and Informatics, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Linda K Larkey
- Edson College of Nursing and Health Innovation, Arizona State University, 550 N 3rd Street Ac, Phoenix, AZ 85004, USA
| | - Davinder Singh
- Mountain Park Health Center, 635 E Baseline Rd, Phoenix, AZ 85042, USA
| | - Mark L Wieland
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA; Center for Clinical and Translational Science, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Irene G Sia
- Center for Clinical and Translational Science, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA; Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
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Lohr AM, Raygoza Tapia JP, Valdez ES, Hassett LC, Gubrium AC, Fiddian-Green A, Larkey L, Sia IG, Wieland ML. The use of digital stories as a health promotion intervention: a scoping review. BMC Public Health 2022; 22:1180. [PMID: 35698097 PMCID: PMC9192132 DOI: 10.1186/s12889-022-13595-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/31/2022] [Indexed: 11/12/2022] Open
Abstract
Background It is challenging to develop health promotion interventions created in collaboration with communities affected by inequities that focus beyond individual behavior change. One potential solution is interventions that use digital stories (DS). Digital storytelling (DST) is an opportunity for reflection, connection with others, and the elevation of voices often absent from daily discourse. Consequently, public health researchers and practitioners frequently employ the DST workshop process to develop messaging that promotes health and highlights concerns in partnership with historically marginalized communities. With participants’ permission, DS can reach beyond the storytellers through behavior or attitude change interventions for health promotion among communities who share the targeted health concern. Our goal was to synthesize the literature describing interventions that use DS for health promotion to identify gaps. Methods We conducted a scoping review. Our inclusion criteria were articles that: 1) described empirical research; 2) used DS that were developed using the StoryCenter DST method; 3) assessed an intervention that used DS to address the health promotion of viewers (individuals, families, community, and/or society) impacted by the targeted health issue 4) were written in English or Spanish. To synthesize the results of the included studies, we mapped them to the health determinants in the National Institute of Minority Health and Health Disparities (NIMHD) research framework. We assessed the number of occurrences of each determinant described in the results of each article. Results Ten articles met the eligibility criteria. All the included articles highlighted health equity issues. Our mapping of the articles with definitive results to the NIMHD research framework indicates that interventions that use DS addressed 17 out of 20 health determinants. All mapped interventions influenced intentions to change health behaviors (NIMHD level/domain: Individual/Behavioral), increased health literacy (Individual/Health Care System), and/or stimulated conversations that addressed community norms (Community/Sociocultural Environment). Conclusions Interventions that use DS appear to positively affect the health promotion of participants across a range of health issues and determinants. Future research is needed in the Interpersonal, Community, and Societal levels and within the Biological, Physical/Built Environment, and Sociocultural Environment domains.
Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13595-x.
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Affiliation(s)
- Abby M Lohr
- Department of Community Internal Medicine, Mayo Clinic, Rochester, USA.
| | | | - Elizabeth Salerno Valdez
- Department of Community Health Education, School of Public Health and Health Sciences, University of Massachusetts, Amherst, USA
| | | | - Aline C Gubrium
- Department of Community Health Education, School of Public Health and Health Sciences, University of Massachusetts, Amherst, USA
| | - Alice Fiddian-Green
- School of Nursing and Health Professions, University of San Francisco, San Francisco, USA
| | - Linda Larkey
- College of Nursing and Health Innovation, Arizona State University, Tempe, USA
| | - Irene G Sia
- Department of Infectious Diseases, Mayo Clinic, Rochester, USA
| | - Mark L Wieland
- Department of Community Internal Medicine, Mayo Clinic, Rochester, USA
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Lohr AM, Alves SS, Coulter K, Redondo-Martinez F, Coronado G, David C, Espinoza C, Ingram M, Carvajal SC, Wilkinson-Lee A. Community Health Worker-Led Community Clinical on the U.S. / Mexico Border: Lessons Learned. Prog Community Health Partnersh 2022; 16:93-103. [PMID: 35342114 PMCID: PMC9359453 DOI: 10.1353/cpr.2022.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Community-clinical linkages (CCLs) connect public health organizations and health care providers to better support patients. Community health workers (CHWs), representatives from priority populations with special connections to their community, can lead CCLs. OBJECTIVES Our objective was to learn about how to conduct a CHW-led CCL from the perspectives of those implementing the intervention. METHODS We conducted focus groups with CHWs and their supervisors and regularly consulted community partners while coding and analyzing data. RESULTS We learned that CHWs thrive when supported by peers, supervisors, institutions, and researchers. Supervisors- who are new to the CHW role-should consider seeking training in CHW professional development and performance evaluation. Focus group participants agreed that by balancing the strengths and weaknesses of their organization, CHW-led CCLs benefit patients because the collaboration helps them to better manage their health. CONCLUSIONS Future CHW-led CCL practitioners should consider how to best institutionally support CHWs to maximize benefits for patients.
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Affiliation(s)
- Abby M Lohr
- University of Arizona, Mel and Enid Zuckerman College of Public Health, Health Promotion Sciences Department,Corresponding Author, Abby Lohr, current affiliation: Postdoctoral Research Fellow, Mayo Clinic in Rochester, ; Affiliation during the research: University of Arizona, Mel and Enid Zuckerman College of Public Health, Health Promotion Sciences Department
| | - Sophie S. Alves
- University of Arizona, College of Social and Behavioral Sciences, Mexican American Studies Department
| | - Kiera Coulter
- University of Arizona, Mel and Enid Zuckerman College of Public Health, Health Promotion Sciences Department
| | | | | | | | | | - Maia Ingram
- University of Arizona, Mel and Enid Zuckerman College of Public Health, Health Promotion Sciences Department
| | - Scott C. Carvajal
- University of Arizona, Mel and Enid Zuckerman College of Public Health, Health Promotion Sciences Department
| | - Ada Wilkinson-Lee
- University of Arizona, College of Social and Behavioral Sciences, Mexican American Studies Department
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Ingram M, Coulter K, Doubleday K, Espinoza C, Redondo F, Wilkinson-Lee AM, Lohr AM, Carvajal SC. An integrated mixed methods approach to clarifying delivery, receipt and potential benefits of CHW-facilitated social support in a health promotion intervention. BMC Health Serv Res 2021; 21:793. [PMID: 34380482 PMCID: PMC8359608 DOI: 10.1186/s12913-021-06778-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 07/05/2021] [Indexed: 11/17/2022] Open
Abstract
Background Social support plays a critical role in physical and emotional health, making it an important component of community health worker (CHW) health promotion interventions. Different types of support operate in different ways, however, and the relationship between the nature of CHW support and the subsequent health benefit for their clients is not well understood. Methods This paper describes an integrated mixed methods study of the emotional, informational, appraisal and tangible support CHWs provided to Latinx community members residing in three US-Mexico border communities. Using a cohort (n = 159) from a CHW community-based intervention, we identify and describe four clusters of social support in which participants are characterized by life situations that informed the types of social support provided by the CHW. We examine the association between each cluster and client perceptions of social support over the 6-month intervention. Results CHWs provided emotional, appraisal, informational and tangible support depending on the needs of participants. Participants who received higher levels of emotional support from the CHW experienced the greatest post intervention increase in perceived social support. Conclusions Study findings suggest that CHWs may be adept at providing non-directive social support based on their interaction with a client rather than a health outcome objective. Health promotion interventions should allow CHWs the flexibility to tailor provision of social support based on their assessment of client needs. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06778-6.
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Affiliation(s)
- Maia Ingram
- Health Promotion Sciences College of Public Health, University of Arizona, 1295 N. Martin Ave, Tucson, AZ, 85724, USA.
| | - Kiera Coulter
- Health Promotion Sciences College of Public Health, University of Arizona, 1295 N. Martin Ave, Tucson, AZ, 85724, USA
| | - Kevin Doubleday
- Health Promotion Sciences College of Public Health, University of Arizona, 1295 N. Martin Ave, Tucson, AZ, 85724, USA
| | - Cynthia Espinoza
- Yuma County Health Services District, 2200 W 28th St #137, Yuma, AZ, 85364, USA
| | - Floribella Redondo
- Arizona Community Health Workers Association, 424 N Christine Ave, Douglas, AZ, 85607-354, USA
| | - Ada M Wilkinson-Lee
- Mexican American Studies, University of Arizona, 1110 James E. Rogers Way, Tucson, AZ, 85721, USA
| | - Abby M Lohr
- Health Promotion Sciences College of Public Health, University of Arizona, 1295 N. Martin Ave, Tucson, AZ, 85724, USA
| | - Scott C Carvajal
- Health Promotion Sciences College of Public Health, University of Arizona, 1295 N. Martin Ave, Tucson, AZ, 85724, USA
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11
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Lohr AM, Doubleday K, Ingram M, Wilkinson-Lee AM, Coulter K, Krupp K, Espinoza C, Redondo-Martinez F, David C, Carvajal SC. A Community Health Worker-Led Community-Clinical Linkage Model to Address Emotional Well-Being Outcomes Among Latino/a People on the US-Mexico Border. Prev Chronic Dis 2021; 18:E76. [PMID: 34351845 PMCID: PMC8388205 DOI: 10.5888/pcd18.210080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Compared with their non-Hispanic White counterparts, Latino/a people have limited access to health resources that might improve their emotional well-being. Interventions that prioritize the Latino/a population, address social determinants of health, and decrease health disparities are needed. The objective of this study was to describe a community-clinical linkage intervention led by community health workers (CHWs) in 3 Latino/a populations along the US-Mexico border. METHODS Researchers at the Arizona Prevention Research Center conducted the Linking Individual Needs to Community and Clinical Services (LINKS) study during 2017-2018. Clinic-based CHWs referred participants to community-based CHWs who met with participants monthly for 6 months to assess participant needs, provide support for emotional well-being, and link them to resources. Two community-based CHWs collaborated to maximize participant care; they also administered an emotional well-being questionnaire at baseline and at 3-month and 6-month follow-up. We estimated changes in emotional well-being outcomes. RESULTS Scores for social support, perceived hopefulness, and quality-of-life measures among 189 LINKS participants increased significantly during the study period, especially among men and participants with low baseline scores. For each of the 3 outcomes, the standardized change was approximately 0.28 per 3 months of intervention, a decrease of more than half an SD (0.56) during 6 months of follow-up. CONCLUSION A CHW-led community-clinical linkage intervention can result in positive emotional well-being outcomes. We encourage policy makers, funders, and public health practitioners to further investigate such interventions as a solution to reduce disparities in emotional well-being.
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Affiliation(s)
- Abby M Lohr
- Arizona Prevention Research Center at the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ 85724.
| | - Kevin Doubleday
- Arizona Prevention Research Center at the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Maia Ingram
- Arizona Prevention Research Center at the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Ada M Wilkinson-Lee
- Mexican American Studies Department, College of Social and Behavioral Sciences, University of Arizona, Tucson, Arizona
| | - Kiera Coulter
- Arizona Prevention Research Center at the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Karl Krupp
- Arizona Prevention Research Center at the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | | | | | | | - Scott C Carvajal
- Arizona Prevention Research Center at the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
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12
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Lohr AM, Van Gorden N, McClelland DJ, Dubinsky E, Gerald LB, Wilkinson-Lee A, Carvajal SC. Updating search strategies for literature reviews with OUR2D2: an open-source computer application. J Med Libr Assoc 2021; 109:317-322. [PMID: 34285675 PMCID: PMC8270383 DOI: 10.5195/jmla.2021.1105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: While writing a scoping review, we needed to update our search strategy. We wanted to capture articles generated by our additional search terms and articles published since our original search. Simultaneously, we strove to optimize project resources by not rescreening articles that had been captured in our original results. Case presentation: In response, we created Open Update Re-run Deduplicate (OUR2D2), a computer application that allows the user to compare search results from a variety of library databases. OUR2D2 supports extensible markup language (XML) files from EndNote and comma-separated values (CSV) files using article titles for comparisons. We conducted unit tests to ensure appropriate functionality as well as accurate data extraction and analysis. We tested OUR2D2 by comparing original and updated search results from PubMed, Embase, Clarivate Web of Science, CINAHL, Scopus, ProQuest Dissertation and Theses, and Lens and estimate that this application saved twenty-one hours of work during the screening process. Conclusions: OUR2D2 could be useful for individuals seeking to update literature review strategies across fields without rescreening articles from previous searches. Because the OUR2D2 source code is freely available with a permissive license, we recommend this application for researchers conducting literature reviews who need to update their search results over time, want a powerful and flexible analysis framework, and may not have access to paid subscription tools.
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Affiliation(s)
- Abby M Lohr
- , Health Promotion Sciences Department, PhD Candidate, University of Arizona Mel and Enid Zuckerman College of Public Health
| | - Noah Van Gorden
- , MCS Student, Arizona State University, School of Computing, Informatics, and Decision Systems Engineering
| | - D Jean McClelland
- , Health Promotion Sciences Department, Program Director for Community Based Health Information Resources, University of Arizona, Mel and Enid Zuckerman College of Public Health
| | - Ellen Dubinsky
- , Office of Digital Innovation and Stewardship, Scholarly Communication Librarian, University of Arizona Libraries
| | - Lynn B Gerald
- , Health Promotion Sciences Department, Professor, University of Arizona, Mel and Enid Zuckerman College of Public Health
| | - Ada Wilkinson-Lee
- , Department of Mexican American Studies, Associate Professor, University of Arizona, College of Social and Behavioral Sciences
| | - Scott C Carvajal
- , Health Promotion Sciences Department, Professor, University of Arizona, Mel and Enid Zuckerman College of Public Health
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Coulter K, Ingram M, Lohr AM, Bell ML, Carvajal S. Examining Associations between Community Health Worker-Rated Health and Mental Health among Latino Adults with Chronic Disease. Int J Environ Res Public Health 2020; 18:ijerph18010100. [PMID: 33375663 PMCID: PMC7795006 DOI: 10.3390/ijerph18010100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 12/16/2020] [Accepted: 12/22/2020] [Indexed: 01/02/2023]
Abstract
Latinos with chronic disease often experience comorbid depression, but confront barriers to mental health treatment. Community health workers (CHWs) develop trusting relationships with the communities they serve, and may be uniquely positioned to identify Latinos with mental health care needs. Research has not examined whether their rating of clients’ health is indicative of their mental health. This mixed-methods study examines CHWs’ appraisals of Latino adults’ health and their relation to mental health outcomes, and explores factors informing CHWs’ rating of health status. The current study utilized baseline data from the Linking Individual Needs to Community and Clinical Services (LINKS) study. We assessed associations between CHW-rated health (CHWRH), or rating of health status as poor–excellent, and mental health outcomes with multilevel linear regression modelling. We qualitatively analyzed CHWs’ written perceptions of participants’ health status to understand what influenced their health rating. The quantitative results showed that CWHRH was significantly related to depressive symptoms and emotional problems severity. The qualitative results showed that CHWs took a holistic and ecological approach in rating health. The findings suggest that CHWRH could be indicative of mental health among Latino adults. Further studies investigating CHWRH as an independent indicator of mental health are warranted.
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Affiliation(s)
- Kiera Coulter
- Department of Health Promotion Sciences, University of Arizona, Tucson, AZ 85724, USA; (M.I.); (A.M.L.); (S.C.)
- Correspondence:
| | - Maia Ingram
- Department of Health Promotion Sciences, University of Arizona, Tucson, AZ 85724, USA; (M.I.); (A.M.L.); (S.C.)
| | - Abby M. Lohr
- Department of Health Promotion Sciences, University of Arizona, Tucson, AZ 85724, USA; (M.I.); (A.M.L.); (S.C.)
| | - Melanie L. Bell
- Department of Epidemiology & Biostatistics, University of Arizona, Tucson, AZ 85724, USA;
| | - Scott Carvajal
- Department of Health Promotion Sciences, University of Arizona, Tucson, AZ 85724, USA; (M.I.); (A.M.L.); (S.C.)
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Lohr AM, Henry N, Roe D, Rodriguez C, Romero R, Ingram M. Evaluation of the Impact of School Garden Exposure on Youth Outlook and Behaviors toward Vegetables in Southern Arizona. J Sch Health 2020; 90:572-581. [PMID: 32378189 DOI: 10.1111/josh.12905] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 08/27/2019] [Accepted: 10/22/2019] [Indexed: 06/11/2023]
Abstract
BACKGROUND Our objective was to evaluate the effect of garden-based learning on outlook and behaviors toward vegetables among primarily Latinx students. An educational strategy, garden-based learning is a teaching tool that complements other disciplines. METHODS Third- and fourth-grade students at 4 elementary schools with different garden programs completed a bingo survey and participated in class discussions to measure outlook and behaviors toward vegetables. RESULTS Students in schools with more garden exposure were more likely to answer "Yes" to survey questions reflecting a positive attitude and behaviors toward vegetables. In class discussions, students most often mentioned vegetables grown in the school garden as their favorite vegetables. CONCLUSION For third- and fourth-grade students, the length of exposure to a school garden appears to have a positive impact on both perceptions of and desire to consume vegetables. Other studies have shown that positive outlook and behaviors toward vegetables can change vegetable consumption habits in children. Integrating garden-based learning into the school curriculum may positively influence eating behaviors over the long-term future.
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Affiliation(s)
- Abby M Lohr
- Research Specialist Senior Arizona Prevention Research Center, , Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave., Tucson Arizona 85724
| | - Nick Henry
- Director, Community Lending and Impact, , Community Investment Corporation, 2033 E. Grant Rd., Tucson, AZ 85719
| | - Denise Roe
- Professor, , Mel and Enid Zuckerman College of Public Health, University of Arizona, 1515 N Campbell Ave, Levy Building 1933, Tucson, AZ 85724
| | - Claudio Rodriguez
- Farm and Garden Program Manager, , Community Food Bank of Southern Arizona, 3003 S Country Club Rd., Tucson, AZ 85713
| | - Rosalva Romero
- Farm to Child Outreach Coordinator, , Community Food Bank of Southern Arizona, 3003 S Country Club Rd, Tucson, AZ 85713
| | - Maia Ingram
- Co-Director of the Arizona Prevention Research Center, , Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave., Tucson, Arizona 85724
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Lohr AM, Ingram M, Carvajal SC, Doubleday K, Aceves B, Espinoza C, Redondo F, Coronado G, David C, Bell ML. Protocol for LINKS (linking individual needs to community and clinical services): a prospective matched observational study of a community health worker community clinical linkage intervention on the U.S.-Mexico border. BMC Public Health 2019; 19:399. [PMID: 30975126 PMCID: PMC6460798 DOI: 10.1186/s12889-019-6725-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 03/29/2019] [Indexed: 12/03/2022] Open
Abstract
Background Latinos are currently the largest and fastest growing racial/ethnic group in the United States and have the lowest rates nationally of regular sources of primary care. The changing demographics of Latino populations have significant implications for the future health of the nation, particularly with respect to chronic disease. Community-based agencies and clinics alike have a long history of engaging community health workers (CHWs) to provide a broad range of tangible and emotional support strategies for Latinos with chronic diseases. In this paper, we present the protocol for a community intervention designed to evaluate the impact of CHWs in a Community-Clinical Linkage model to address chronic disease through innovative utilization of electronic health records (EHRs) and application of mixed methodologies. Linking Individual Needs to Community and Clinical Services (LINKS) is a 3-year, prospective matched observational study designed to examine the feasibility and impact of CHW-led Community-Clinical Linkages in reducing chronic disease risk and promoting emotional well-being among Latinos living in three U.S.-Mexico border communities. Methods The primary aim of LINKS is to create Community-Clinical Linkages between three community health centers and their respective county health departments in southern Arizona. Our primary analysis is to examine the impact of the intervention 6 to 12-months post program entry. We will assess chronic disease risk factors documented in the EHRs of participants versus matched non-participants. By using a prospective matched observational study design with EHRs, we have access to numerous potential comparators to evaluate the intervention effects. Secondary analyses include modeling within-group changes of extended research-collected measures. This approach enhances the overall evaluation with rich data on physical and emotional well-being and health behaviors of study participants that EHR systems do not collect in routine clinical practice. Discussion The LINKS intervention has practical implications for the development of Community-Clinical Linkage models. The collaborative and participatory approach in LINKS illustrates an innovative evaluation framework utilizing EHRs and mixed methods research-generated data collection. Trial registration This study protocol was retrospectively registered, approved, and made available on Clinicaltrials.gov by NCT03787485 as of December 20, 2018. Electronic supplementary material The online version of this article (10.1186/s12889-019-6725-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Abby M Lohr
- Arizona Prevention Research Center, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ, 85724, USA.
| | - Maia Ingram
- Arizona Prevention Research Center, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ, 85724, USA
| | - Scott C Carvajal
- Arizona Prevention Research Center, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ, 85724, USA
| | - Kevin Doubleday
- Arizona Prevention Research Center, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ, 85724, USA
| | - Benjamin Aceves
- Arizona Prevention Research Center, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ, 85724, USA
| | - Cynthia Espinoza
- Yuma County Health District, 2200 W 28th St # 137, Yuma, AZ, 85364, USA
| | - Floribella Redondo
- Arizona Community Health Outreach Workers Association, 1171 W Target Range Road, Nogales, AZ, 85621, USA
| | - Gloria Coronado
- Yuma County Health District, 2200 W 28th St # 137, Yuma, AZ, 85364, USA
| | - Cassalyn David
- Mariposa Community Health Center, 1710 N. Mastick Way, Nogales, AZ, 85621, USA
| | - Melanie L Bell
- Arizona Prevention Research Center, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ, 85724, USA
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Lohr AM, Ingram M, Nuñez AV, Reinschmidt KM, Carvajal SC. Community-Clinical Linkages With Community Health Workers in the United States: A Scoping Review. Health Promot Pract 2018; 19:349-360. [PMID: 29363334 PMCID: PMC6690722 DOI: 10.1177/1524839918754868] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Despite the proliferation of community-clinical linkage (CCL) interventions with community health workers (CHWs), little is known about the components of these programs or how linkages are realized. In this scoping review, we synthesize evidence concerning the role of CHWs in creating and sustaining CCLs aimed at improving individual health outcomes. Our inclusion criteria included peer-reviewed articles that described a CHW intervention in the United States that used a CCL model. A total of 2,776 titles and/or abstracts were screened and 47 articles underwent full text review. Two independent reviewers rated the screened articles based on additional criteria including the CHW connection to community and evidence of linkage follow up rather than simple referral. For the 11 peer-reviewed articles included in the final review, we describe the CHW's relationship to the community, training, and role within the intervention, linkage, and outcomes. We used a standardized framework to determine commonalities in CHW roles across the interventions. CCLs with CHWs positively affect the delivery of both clinical care and community resources across a range of disease areas in a variety of contexts. To identify effective CCL models, additional information on CHW training, CCL follow-up methods, and the CHW role in CCLs is recommended.
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