Assessing the Unmet Clinical and Social Needs of a Community
Preliminary Data from a Community in South LA
Community-Academic Partnership
Dennishia Banner
Rachelle Bross, RD,PhD
Arleen Brown, MD, PhD
Nell Forge, MPH, PhD
Astrea Flowers, MSW
Gabriella Gomez, BA
Felica Jones
Loretta Jones, MA
Katherine Kahn, MD
Keyonna King, DrPH (c)
Aziza Lucas-Wright, Med
Karina Madrigal, BA
D’Ann Morris, MPA
Orwilda L. Pitts, LVN
Ibrahima Sankare, MHA
Linda Thompson, MSW Intern
Roberto Vargas, MD, MSHS
Lujia Zhang
Background
• Behavioral, clinical, and public health efforts to improve
awareness and management of cardiometabolic disease and its
risk factors have had limited success in reducing disparities.
• The Healthy Community Neighborhood Initiative (HCNI) is a
multifaceted community partnered study that aims to improve
health and health care in a predominantly African American
and Latino community in South Los Angeles (LA)
• HCNI is a community-academic collaborative of the Los Angeles
Urban League, Healthy African American Families, and the UCLA
CTSI (including Charles Drew University, Harbor /LA Biomed,
and UCLA)
4
70 Block Project
Rationale/Approaches
• >95% African American or Latino
• Community characterized by significant but modifiable needs:
• Chronic Disease
• Unemployment
• Foreclosure
• Low high school graduation rates
• HNCI Approaches: • Household surveys • Neighborhood observations • Community asset mapping
Crenshaw Senior High School
LAUL Headquarters
W. Vernon
W. Slauson
S. Van N
ess C
renshaw
Hillc
rest
2
1
2
1
Objectives
To 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 the
health of residents of this community
Methods • All study protocols, forms, and instruments documents were
developed and revised iteratively during:
• Weekly meetings of the community-academic partnership 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 all phases of the project
• Interview: Demographics, health behaviors, clinical characteristics and care, unmet household social needs, neighborhood problems/assets
• Physical data collection: BMI, waist circ., BP, biomarkers
• Participants received a gift bag containing community resource guide and were reimbursed with gift cards
Results: Recruitment to Date
Interviews and Clinical Examinations
Screened for eligibility 54
Eligible 51
Completed interviews 51
Completed physical examinations 51
Completed laboratory exams (finger stick)
51
Functional Status Tests for Participants > 50 years (N=28)
Chair stand & Grip strength completed
25
Unable to perform chair stand 3
Results: Participation Rates for Study Components
72% 68%
64%
24%
0%
10%
20%
30%
40%
50%
60%
70%
80%
Allow analysis ofde-identified data
after 2 years
Share samples withother researchers
Allow futureanalysis of DNA
Send lab reports toPMD
Results: Participant Characteristics
N 51
Demographic Characteristics
Age, Median (Range) 51 years (18 to 79)
African American 51 (100%)
Female 32 (63%)
Graduated from high school 44 (86%)
Chronic Conditions (Self-Report)
High Blood Pressure 24 (47%)
Diabetes 3 (6%)
Health Behaviors
Current Smoker 12 (24%)
Results: Physical Examination
N 51
Physical Examination
Body 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 (SBP: 140-209 mm Hg or DBP: 90-99 mm Hg*)
17 (27%)
Results: Laboratory Examination
N 51
Laboratory 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)
Conclusions
• The HCNI community-academic partnership has developed a baseline assessment to understand health disparities in this community
• Preliminary results suggest that residents are at high risk for cardiometabolic 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 underrepresented communities
• 6 Students participated in the research project (1 medical, 3 social work, 2 public health)
• 1 Application for intramural funding
• Community Resource Guide modified for use in this community
Added Value of CTSI funding
Support for community partners and their staff to participate 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 and community residents in the research process.
Next Steps
• Spanish language interviews are scheduled to start in December
• Goal: 125 household interviews by March 2013
• Data from these analyses will be linked to data from neighborhood observations and community asset mapping to inform future strategies
• These findings will be used to work with local residents to develop community based interventions
