healthy people 2020 - Society for Public Health Education

✯ Conference Abstracts ✯
friday | november 5
current sessions b3
Room: Colorado E-F
community & population health: challenges
for a new decade
Changing Expectations: Advancing the Community Role
in Translational Research.
Alexandra Lightfoot, EdM, EdD, UNC Center for Health
Promotion and Disease Prevention; Christina Hardy, MPH, UNC Center
for Health Promotion and Disease Prevention
background: Despite strides in medical advances and treatment, few
of the Healthy People 2010 objectives have been realized. To address
2020’s goals of achieving health equity, eliminating disparities, and improving
the health of all population groups calls for innovative multi sector
strategies. This session highlights an initiative to enhance equity and
effectiveness in translational research and transform the way communities
and academic investigators work together to investigate persistent
health challenges and design and evaluate effective solutions.
theoretical basis There is a growing recognition that translational
research benefits from community involvement at the outset. Community-based
participatory research (CBPR) has shown substantial promise
for building new and creative partnership approaches to tackle some of
the most intractable public health problems at all levels of the socioecologic
model. The last decade has seen growing support for CBPR and increased
demand for skills, knowledge, training and strategies to enhance
community members’ equitable participation in research addressing
the needs of their communities. Objectives The NC Translational and
Clinical Sciences Institute (TraCS) and the UNC Center for Health
Promotion and Disease Prevention (HPDP) received ARRA funding to
launch Community Leadership and Reciprocal Development (CLRD):
Advancing Community-Engaged Research at Two CTSA Institutions in
collaboration with Vanderbilt’s Institute for Clinical and Translational
Research (VICTR). The goal of the pilot is to expand and accelerate both
institutions’ capacity to advance translational research, by 1) drawing on
the expertise of community partners working with our respective institutions,
and, 2) initiating a cross-institution partnership to share expertise,
develop resources, and disseminate new knowledge and approaches.
intervention This session will examine three aspects of UNC’s CLRD
model: 1) creation of a new position at the university for a community
partner experienced in CBPR, a “Community Research Fellow,” who coleads
project activities; 2) recruitment of a pool of “community experts,”
seasoned community leaders with CBPR expertise, who provide training
and technical assistance to advance the adoption and implementation of
CBPR among community-academic partnership teams; and 3) facilitated
guidance sessions, or charrettes, for partnerships who express interest in
using CBPR approaches.
evaluation measures/results: We are using Glasgow’s RE-AIM
framework to evaluate the translatability and potential impact of our
efforts to build capacity for CBPR while developing robust and fairlycompensated
consultancies for community partners. Early indications
suggest that our model provides a valuable resource in the development
of effective, rigorous and mutually beneficial research approaches for
communities and academic investigators.
Social Determinants of Health.
Sally Lin, PhD; Dana Brimmer, PhD, Centers for Disease
Control and Prevention; Kerri Timmerman, MPH, Senior Research
Assistant at the Chronic Diseases Branch, Centers for Disease Control
and Prevention; William Reeves, MD, Senior Advisor in the Public Health
Surveillance Program Office at CDC
Abstract: background: Social determinants of health are increasingly
recognized as important factors in public health research; particularly
sense of community (SOC) in community-based participatory research.
However, few studies have examined the associations between SOC and
barriers to healthcare utilization (HU), which is pivotal in communitybased
unwellness prevention. Theoretical Framework: Healthcare access
and utilization are functions of the need for good health and health-related
socio-demographic factors. We used the conceptual framework of
McMillan & Chavis to measure sense of community regarding its impact
on how communities function.
hypothesis: We hypothesized that people with lower SOC will be
more likely to report barriers to HU.
methods: The sample consisted of 750 participants in a populationbased
study on unwellness in Georgia between November 2007 and
August 2009. A self-administered questionnaire included healthcare and
SOC measures: Membership, Influence, Reinforcement of Needs, and
Shared Emotional Connection. Multiple logistic analysis was used to
estimate the relationship between SOC and barriers to HU, controlling
for other socio-demographic influences, including insurance coverage
and self-reported health status. The significance level was set at 0.05.
results: Most of the 750 participants were women (75%), White (75%),
married (67%), urban/rural residents (83%) and their mean age was
47.6. Thirty-four percent reported barriers to HU. Participants who had
barriers to HU had significantly lower SOC scores than those who did
not. Higher SOC scores were associated with increased age and marriage,
but were not statistically significantly associated with sex, race,
and residential area. All SOC domains but Reinforcement of Needs were
positively associated with years of residence. When examining the association
with unhealthy days, Influence and Reinforcement of Needs were
negatively associated with physically unhealthy and poor or fair health.
In addition to these two SOC subscales, Membership was also associated
with mentally unhealthy days and days for limited usual activities. After
adjusting age, marital status, insurance coverage and unhealthy days,
Membership remained a significant protective factor for having barriers
to healthcare utilization (OR= 0.79, 95% CI= 0.66 – 0.92).
conclusions: Higher Membership reduces the risk of having barriers to
HU. Activities to increase sense of community in younger, non-married,
and new residents are potential interventions in promoting a healthier
community. Implications for Practice: Community quality needs to be
considered in public health efforts to reduce barriers to healthcare utilization
and preventive healthcare in unwell community-dwellings.
Health Disparities Curriculum: Involving Students in Public
Health Advocacy (High School Students).
Nell Curran, BA, Stanford University, Youth Science Program/San Jose
State University
Healthy People 2010 includes the elimination of health disparities as
one of two major goals for the decade. In response to this public health
priority, the needs of the local community, and requests from teachers
and students, the Stanford Medical Youth Science Program partnered
with Overfelt High School in East San Jose, CA to develop an innovative
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sophe conference ✯ november 4-6, 2010