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Our Healthy Jackson County Presentation - HIT Jan 2023

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Our Healthy Jackson County Presentation - HIT Jan 2023

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In our first presentation, Jannette Berkley-Patton, PhD., of University of Missouri - Kansa City's School of Medicine will describe Our Healthy Kansas City Eastside, a set of projects organized by Dr. Berkley-Patton and UMKC and funded by Jackson County (MO) to improve health status in some of the most challenging neighborhoods in Kansas City. An initial round of funding was dedicated to improving the coverage of vaccinations in these same neighborhoods. Based on the success of that effort, this current round of funding expands into key health screenings, initiatives in maternal health, chronic disease prevention, and digital inclusion. A number of research projects are included in the program. The County grant is for $5 million and is expected to be followed up with another $5 million to expand further.
The success of the program is based on strong sector-led support (health care, education, faith communities, business) directly in the community through networking and events, as well as participation by multiple relevant community entities, like KC Digital Drive. KCDD will be active in both the chronic disease prevention and digital inclusion aspects of the program.
Dr. Berkley-Patton is a professor in the departments of Biomedical and Health Informatics at the School of Medicine. A fuller biography is available here.

In our first presentation, Jannette Berkley-Patton, PhD., of University of Missouri - Kansa City's School of Medicine will describe Our Healthy Kansas City Eastside, a set of projects organized by Dr. Berkley-Patton and UMKC and funded by Jackson County (MO) to improve health status in some of the most challenging neighborhoods in Kansas City. An initial round of funding was dedicated to improving the coverage of vaccinations in these same neighborhoods. Based on the success of that effort, this current round of funding expands into key health screenings, initiatives in maternal health, chronic disease prevention, and digital inclusion. A number of research projects are included in the program. The County grant is for $5 million and is expected to be followed up with another $5 million to expand further.
The success of the program is based on strong sector-led support (health care, education, faith communities, business) directly in the community through networking and events, as well as participation by multiple relevant community entities, like KC Digital Drive. KCDD will be active in both the chronic disease prevention and digital inclusion aspects of the program.
Dr. Berkley-Patton is a professor in the departments of Biomedical and Health Informatics at the School of Medicine. A fuller biography is available here.

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Our Healthy Jackson County Presentation - HIT Jan 2023

  1. 1. A Jackson County COVID-19 Vaccination and Health Services Initiative in KC’s Eastside JANNETTE BERKLEY-PATTON, PHD UMKC HEALTH EQUITY INSTITUTE UMKC COMMUNITY HEALTH RESEARCH GROUP
  2. 2. Funded amount: $5 million Funding period: 6/1/2021-12/31/2021 Primary Goals: 1. Increase reach of COVID-19 vaccinations and access to health services 2. Build a community-health-academic infrastructure to address health disparities across 4 sectors in the Eastside (business, faith, youth, neighborhoods)
  3. 3. WHERE? SOCIAL VULNERABILITY & LOW COVID-19 VACCINATION RATES • Vulnerable Zip Codes • 64106 • 64109 • 64127 • 64128 • 64129 • 64130 64030
  4. 4. Churches Neighborhood Associations Youth Organizations Businesses Tapping community influence, access, and capacity Equipping Community Influencers to Encourage COVID-19 Vaccinations and Use of Health Services
  5. 5. Community Engagement Approach Engaging the Eastside Community Across All Phases of the Work Impact & Sustainability!
  6. 6. How? A Community-Engaged Infrastructure UMKC Health Equity Institute Community/UMKC Sector Leads Neighborhood Associations Businesses Faith based Youth Organizations Health Services Vaccinations & Health Services Communications & Marketing Website, Scheduling System, Dashboard, Materials, PR, Local Vendors Research Studies Over 60 community partners across 4 sectors!
  7. 7. Neighborhood Sector Minister Gregg Wilson, Community Engagement Outreach Liaison LaMonica Upton, Center for Neighborhoods Dina Newman, Center for Neighborhoods Cash Wilson, Community Engagement Outreach Liaison
  8. 8. Youth Sector Denise Dean, UMKC School of Nursing and Health Studies Amanda Grimes, UMKC School of Nursing and Health Studies Monique Johnston, Youth Ambassadors of KC
  9. 9. Business Sector Maria Myers, Source Link UMKC Innovation Center Daniel Smith, The Porter House KC
  10. 10. Faith Sector Carole Bowe Thompson, UMKC Community Health Research Group Rev. Eric Williams, Calvary Temple Baptist Church Leah Banks, Calvary Community Outreach Network
  11. 11. 160 Community Health Liaisons! -Handed out flyers -Attended community meetings -Talked to friends and family -Hung door hangers -Did call blasts -Posted on social media -Coordinated OHKCE events -Showed up and showed out!
  12. 12. Sample of OHKCE Materials
  13. 13. Engaged Community Partners and Community Health Liaisons Completed thousands of entries on their implementation activities in online database system
  14. 14. Vaccinations Given 12,942 “A friend told me they were having this event. I’d been on the fence for 6 months, but I have a new grandbaby. I care about myself, but this wasn’t all about me. It’s about keeping my [grandbaby] safe.” $50 for 1st shot
  15. 15. Individuals Vaccinated by Zip Code Persons Vaccinated 57% Females 43% Black/African American 13% Hispanic, Latino, Spanish Origin
  16. 16. Data presented by the KCMO Health Department at the OHKCE Community Forum, 2/2022
  17. 17. Top 3 events 1. KC Daiquiri Shop at Happy Foods: 61 people vaccinated 2. Guadeloupe High School: 59 people vaccinated 3. Morning Star Missionary Baptist Church: 57 vaccinated
  18. 18. Health Services Provided 4,152 Blood pressures, blood glucose screening, mental health screenings, dental assessments, linkage to care “I just need to get my sugar checked. I’m doing good but glad I can get this done here.”
  19. 19. Highlights on Health Screening Services Dental Services 358 Dental referrals 242 Dental appointments completed “Holy crap!!! I want to freaking cry!!! You have no idea how much this means to me!!! I’m so excited to start over, you have no idea!! Thank you!!!” -OHKCE dental patient Sexually Transmitted Infections Testing 328 Tests completed 375 STI educational talks So far, 18% of tests are positive “One of my favorite moments was a real discussion with a newly divorced 60 something woman about safe sex practices and ways to reduce her risk. She expressed she hasn't this talk with her doctor, and she felt empowered to ask questions and take charge of her health.” -Dr. Stefanie Ellison, UMKC School of Medicine
  20. 20. How Services Delivered? Many Volunteers!!! Health Providers Faculty Students Nearly 300 student volunteers!
  21. 21. Survey on Health Beliefs and Behaviors 3,496 Surveys Completed
  22. 22. Survey Participant Characteristics (N=3,496) -81% African American -59% Females -16% Hospitalized due to COVID-19 -77% Would use health services at the community-based vaccination location Why Vaccinated? -78% Wanted to keep family safe -60% Wanted to keep self safe -51% Wanted to keep community safe Health -24% postponed medical care since pandemic -49% Saw dentist in past year -30% Hypertension -21% Depression -13% Diabetes
  23. 23. Participants and Social Determinants of Health Social Determinants: -40% Did not have enough food in past year -32% Lost income since pandemic started -24% Challenges with transportation -9% Had challenges getting to vaccination site -77% Believed people should wear masks as mandated by government
  24. 24. OHKCE Community Forum 121 Attendees (Community health liaisons, community partners, health, and researchers) -OHKCE successes, findings, Eastside vaccination rates -12 Focus groups -Health priorities ◦ Diabetes, high blood pressure, and mental health -Needed strategies and programs ◦ Health education and literacy including support in finding doctors and resources to cover costs ◦ Nutrition and exercise ◦ Access to/trust with healthcare systems and reduction of healthcare costs
  25. 25. Lessons Learned ◦ The Community Engagement matters! ◦ Increasing capacity to co-locate health services in community settings is critical. ◦ Ex. Young man vaccinated after talking to pharmacist ◦ People will use health services provided in community-clinics. ◦ Double benefit – uptake of services and data collection on health behaviors. ◦ Community partners need to get paid – and fed! ◦ Celebrate progress!!
  26. 26. What Comes Next? Preventive Health Services: -COVID-19 and chronic diseases ◦ Vaccinations and health screenings -Cancer ◦ Cancer screenings and referrals -Diabetes ◦ Evidence-based Lifestyle change programs -Infant mortality ◦ Evidence-based Early reproductive services
  27. 27. Vaccinations, Health Screenings, and Other Healthcare Services Vaccinations -COVID-19 -Flu Health Screenings -Blood pressure -Blood glucose -Mental health -Dental assessments and treatment -STIs/HIV -Broadband Internet Services -Cancer screenings ◦ Colon ◦ Oral ◦ HPV ◦ Mammograms Goal: 2,000 units of health services Goal: 5,000 vaccinations
  28. 28. Infant Mortality Reproductive age women: -Early prevention -Early decision-making -Support -Access to Care Asking 1 Question: DO YOU WANT TO BE PREGNANT IN THE NEXT YEAR?
  29. 29. Infant Mortality Program: We CARE-KC Understand Needs -Focus groups -Surveys -Engage women in program design -Interview health providers -Address health system barriers Pilot program -Pilot test in University Health ER -Train medical assistants to provide counseling -Get OB/GYN appointments scheduled -Address medical needs Expand to Community -Expand to community- clinic settings -Provide initial contact onsite with counseling follow-up -Get OB/GYN appointments scheduled -Address medical needs Goal: 2,000 women overall
  30. 30. Diabetes Prevention Program Need for Diabetes Prevention Programs -High rates of prediabetes -Early screening with at-risk persons -Access to free diabetes prevention programs in trusted clinic and community spaces -Tailored for special populations -Support from community health workers Screening in Community Settings Screening in Health Centers Community Health Workers DPP in Community and Clinic Settings Goal: 1,500 prediabetic persons
  31. 31. Expand and Sustain the Project Geographic and Organization Expansion -Go beyond initial zip codes -Include more community organizations ◦ Especially youth organizations -Include more special populations ◦ Spanish speaking ◦ Refugee Additional Funding and Resource Expansion -Grant funding -Systems changes -Infrastructure support
  32. 32. Thank You!!

Notes de l'éditeur

  • What do we mean by taking something to “Scale” in research?

    To identify intervention and research design factors perceived to increase the potential for interventions to be implemented on a more widespread basis or 'scaled up‘.
  • Leverage knowledge, expertise, reach, and resources, benefiting from their combined and varied strengths 
    Community Settings--Community Partners
    Trusted spaces; Community influencers as messengers; Multi-sectoral outlets; Accessible places
    SCALABLE AND SUSTAINABLE IMPACT
  • In using a Community-based Participatory Research Approach the CAB or Community Action Boards play many different roles across the continuum.

    There is a growing recognition that “traditional” research approaches have failed to solve complex health disparities. 

    Community members themselves, weary of being “guinea pigs” are increasingly demanding that research address their locally identified needs.  Traditional researchers often complain about challenges in trying to recruit “research subjects.”  These challenges are often a result of community members feeling that researchers have used them and taken findings away for the researchers benefit (e.g., scholarly papers) but the community is left with no direct benefit.

    Significant community involvement can lead to scientifically sound research. Researchers using participatory methods have found community input invaluable in the design and adaptation of research instruments to make the tools user friendly, applicable and culturally appropriate.

    Research findings can be applied directly to develop interventions specific for communities. The specific outcome of CBPR research is not simply to find answers to complex social questions but to have those results provide information that can be used by the community to develop its own solutions.

    This approach to research has the potential to build greater trust and respect between researchers and com
    munities.  Trust and respect are two common reasons why individuals do not participate in research. If the research design and methods actively engage community members in an equitable manner, trust is likely to build.

    Agenda Setters: Agreeing on research question. What is it we want to learn?


  • Built a robust infrastructure to provide systems that will:
    Reach our target populations
    Provide vaccinations and other health services (Blood Pressure, Dental Referrals, A1C/glucose, Mental Health Screenings)
    Promote events
    Share data with community members and key UMKC and Community stakeholders
    Schedule events
    Recruit participants to other research projects

    Neighborhoods: n= 13
    Business: n= 15
    Faith based: n=17
    Youth: n= 14
    Average: 14.75 (15 per sector was our target number)

    Researchers: about
  • 31% White
    zip n
    64030 179
    64106 285
    64109 418
    64127 732
    64128 573
    64129 189
    64130 786
    64137 83
    Sex n
    Female 6,384
    Male 4,786
    Unknown 19
    Race n
    American Indian or Alaska Native 21
    Asian 387
    Black or African American 4,865
    Multiple 245
    Native Hawaiian or Pacific Islander 10
    Other 1,853
    Patient Declined 119
    Unavailable 229
    White 3,460
    Ethnicity n
    Hispanic, Latino, or Spanish Origin 1,434
    Multiple 127
    Not Hispanic, Latino, or Spanish Origin 8,937
    Patient Declined 240
    Unavailable 451
  • Neisseria gonorrhea, Chlamydia trachomatis, Mycoplasma genitalium and Trichomonas vaginalis
  • 667 instances of student volunteering
    Hundreds of hours of faculty volunteers
  • In understanding infrastructure – technology is important even for church-based intervention delivery.

    Building up of Church liaisons is key to increasing reach – very important role.

    Balance Church empowerment/flexible-controlled research: Be prepared for things to take longer, be flexible, will never have control.

    More time consuming but better adaptation, buy-in, and sustainability

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