assessing the unmet clinical and social needs of a community

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featured project for the UCLA CTSI Community Engagement and Research Program


  • 1. Assessing the Unmet Clinical and Social Needs of a CommunityPreliminary Data from a Community in South LA

2. Community-Academic Partnership Dennishia Banner Keyonna King, DrPH (c) Rachelle Bross, RD,PhD Aziza Lucas-Wright, Med Arleen Brown, MD, PhD Karina Madrigal, BA Nell Forge, MPH, PhD DAnn Morris, MPA Astrea Flowers, MSW Orwilda L. Pitts, LVN Gabriella Gomez, BA Ibrahima Sankare, MHA Felica Jones Linda Thompson, MSW Loretta Jones, MAIntern Katherine Kahn, MD Roberto Vargas, MD, MSHS Lujia Zhang 3. Background Behavioral, clinical, and public health efforts to improveawareness and management of cardiometabolic disease and itsrisk factors have had limited success in reducing disparities. The Healthy Community Neighborhood Initiative (HCNI) is amultifaceted community partnered study that aims to improvehealth and health care in a predominantly African Americanand Latino community in South Los Angeles (LA) HCNI is a community-academic collaborative of the Los AngelesUrban League, Healthy African American Families, and the UCLACTSI (including Charles Drew University, Harbor /LA Biomed,and UCLA) 4. 70 Block Project Rationale/ApproachesW. Vernon2 >95% African American or LatinoCrenshaw Community characterized bysignificant but modifiable needs:S. Van Ness1 Chronic Disease Unemployment ForeclosureHillcrest Low high school graduation rates W. Slauson HNCI Approaches:1 Crenshaw Senior High School Household surveys2 LAUL Headquarters Neighborhood observations Community asset mapping4 5. ObjectivesTo use community-partnered participatory research (CPPR)methods in a neighborhood in South LA to: Assess household needs and community resources Collaboratively develop interventions to improve thehealth of residents of this community 6. Methods All study protocols, forms, and instruments documents weredeveloped and revised iteratively during: Weekly meetings of the community-academicpartnership team and ad hoc working group meetings Community and academic events Sessions with invited community / academic experts Mentoring of staff, community members, and students in allphases of the project Interview: Demographics, health behaviors, clinical characteristicsand care, unmet household social needs, neighborhoodproblems/assets Physical data collection: BMI, waist circ., BP, biomarkers Participants received a gift bag containing community resourceguide and were reimbursed with gift cards 7. Results: Recruitment to DateInterviews and Clinical ExaminationsScreened for eligibility54Eligible51Completed interviews 51Completed physical examinations51Completed laboratory exams 51(finger stick)Functional Status Tests for Participants > 50 years (N=28)Chair stand & Grip strength 25completedUnable to perform chair stand3 8. Results: Participation Rates for Study Components80% 72%70% 68%64%60%50%40%30%24%20%10%0%Allow analysis of Share samples withAllow future Send lab reports tode-identified data other researchers analysis of DNAPMDafter 2 years 9. Results: Participant CharacteristicsN51Demographic CharacteristicsAge, Median (Range)51 years (18 to 79)African American 51 (100%)Female32 (63%)Graduated from high school44 (86%)Chronic Conditions (Self-Report)High Blood Pressure 24 (47%)Diabetes 3 (6%)Health BehaviorsCurrent Smoker12 (24%) 10. Results: Physical ExaminationN51Physical ExaminationBody Mass Index (BMI) Women, Mean (SD) 32 kg/m2 (8.0) Men, Mean (SD) 31 kg/m2 (7.4)Waist Circumference Women, Mean (SD) 110.7 cm (35.5) Men, Mean (SD) 110.1 cm (35.9)Blood Pressure Systolic Blood Pressure, Mean (SD)131 mm Hg (22.8) Diastolic Blood Pressure, Mean (SD) 80 mm Hg (13.3) Uncontrolled Blood Pressure 17 (27%)(SBP: 140-209 mm Hg or DBP: 90-99 mm Hg*) 11. Results: Laboratory ExaminationN51Laboratory Examination Total Cholesterol, Mean (SD) 166 mg/dL (39.8) HDL Cholesterol, Mean (SD) 57 mg/dL (20.4) LDL Cholesterol, Mean (SD) 85 mg/dL (34.3) 12. Conclusions The HCNI community-academic partnership has developed abaseline assessment to understand health disparities in thiscommunity Preliminary results suggest that residents are at high risk forcardiometabolic disease / poor outcomes from these conditions Products: 3 Community research training sessions (Informed consent;Assessing depression; Survey administration; Clinical exams) 5 Lay health workers trained to work in underrepresentedcommunities 6 Students participated in the research project (1 medical, 3social work, 2 public health) 1 Application for intramural funding Community Resource Guide modified for use in this community 13. Added Value of CTSI funding Support for community partners and their staff toparticipate in research that was of importance to them Supplies and equipment for physical data collection Support for applications for other intramural funding Infrastructure to support participation of students andcommunity residents in the research process. 14. Next Steps Spanish language interviews are scheduled to start inDecember Goal: 125 household interviews by March 2013 Data from these analyses will be linked to data fromneighborhood observations and community assetmapping to inform future strategies These findings will be used to work with localresidents to develop community based interventions


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