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Creating musculoskeletal programs for culturally diverse, underserved communities: a community-based participatory research survey.

ABSTRACT: BACKGROUND: Arthritis and other musculoskeletal diseases are the most prevalent health conditions in the USA, causing enormous financial and social burdens, especially in underserved communities. Targeted care and prevention programs are urgently needed. QUESTIONS/PURPOSES: Within an overall goal of revealing health disparities, the questionnaire explored (1) the use of and access to healthcare, (2) the factors affecting quality of life, and (3) the levels of provider-patient communication. METHODS: A New York City musculoskeletal hospital conducted a community health needs survey among its diverse ethnic/racial communities. A 39-item questionnaire was administered online, by mail, and in person (in English, Spanish, and Chinese). Answers were analyzed in terms of sociodemographics, to define health disparities within a total sample and two subsamples. RESULTS: In the total sample, respondents were 60% White, 16% Black, 14% Hispanic/Latino, and 11% Asian, mostly female, and aged 50 to 79. More than 17% of the total sample indicated they could not access a healthcare provider when needed. Poor nutrition and lack of physical activity were large areas of concern, as were falls and poor self-reported health status. Nearly all respondents said they took steps to communicate with their healthcare providers. Dramatic health disparities were found between Whites and non-Whites (e.g., non-Whites were most likely to rate their health poorly, consider their diet fair or poor, lack health insurance, and be unable to access a healthcare provider). CONCLUSION: The findings are being used to further refine, develop, and expand the hospital's community programs, especially for culturally diverse and underserved communities.

SUBMITTER: Goldsmith S

PROVIDER: S-EPMC4171440 | biostudies-literature | 2014 Oct

REPOSITORIES: biostudies-literature

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Creating musculoskeletal programs for culturally diverse, underserved communities: a community-based participatory research survey.

Goldsmith Sandra S Friedman Dana D Horton Roberta R Seehaus Mavis M Robbins Laura L

HSS journal : the musculoskeletal journal of Hospital for Special Surgery 20140904 3

<h4>Background</h4>Arthritis and other musculoskeletal diseases are the most prevalent health conditions in the USA, causing enormous financial and social burdens, especially in underserved communities. Targeted care and prevention programs are urgently needed.<h4>Questions/purposes</h4>Within an overall goal of revealing health disparities, the questionnaire explored (1) the use of and access to healthcare, (2) the factors affecting quality of life, and (3) the levels of provider-patient commun ...[more]

PMID: 25264445

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Project description:BACKGROUND:Breast cancer screening continues to be underutilized by the population in general, but is particularly underutilized by traditionally underserved minority populations. Two of the most at risk female minority groups are American Indians/Alaska Natives (AI/AN) and Latinas. American Indian women have the poorest recorded 5-year cancer survival rates of any ethnic group while breast cancer is the number one cause of cancer mortality among Latina women. Breast cancer screening rates for both minority groups are near or at the lowest among all racial/ethnic groups. As with other health screening behaviors, women may intend to get a mammogram but their intentions may not result in initiation or follow through of the examination process. An accumulating body of research, however, demonstrates the efficacy of developing 'implementation intentions' that define when, where, and how a specific behavior will be performed. The formulation of intended steps in addition to addressing potential barriers to test completion can increase a person's self-efficacy, operationalize and strengthen their intention to act, and close gaps between behavioral intention and completion. To date, an evaluation of the formulation of implementation intentions for breast cancer screening has not been conducted with minority populations. METHODS/DESIGN:In the proposed program, community health workers will meet with rural-dwelling Latina and American Indian women one-on-one to educate them about breast cancer and screening and guide them through a computerized and culturally tailored "implementation intentions" program, called Healthy Living Kansas-Breast Health, to promote breast cancer screening utilization. We will target Latina and AI/AN women from two distinct rural Kansas communities. Women attending community events will be invited by CHWs to participate and be randomized to either a mammography "implementation intentions" (MI2) intervention or a comparison general breast cancer prevention informational intervention (C). CHWs will be armed with notebook computers loaded with our Healthy Living Kansas-Breast Health program and guide their peers through the program. Women in the MI2 condition will receive assistance with operationalizing their screening intentions and identifying and addressing their stated screening barriers with the goal of guiding them toward accessing screening services near their community. Outcomes will be evaluated at 120-days post randomization via self-report and will include mammography utilization status, barriers, and movement along a behavioral stages of readiness to screen model. DISCUSSION:This highly innovative project will be guided and initiated by AI/AN and Latina community members and will test the practical application of emerging behavioral theory among minority persons living in rural communities.

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Creating musculoskeletal programs for culturally diverse, underserved communities: a community-based participatory research survey.

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Creating musculoskeletal programs for culturally diverse, underserved communities: a community-based participatory research survey.

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