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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)
70 Block Project Rationale/Approaches W. Vernon 2 • >95% African American or Latino Crenshaw • Community characterized by significant but modifiable needs: S. Van Ness 1 • Chronic Disease • Unemployment • ForeclosureHillcrest • Low high school graduation rates W. Slauson • HNCI Approaches: 1 Crenshaw Senior High School • Household surveys 2 LAUL Headquarters • Neighborhood observations • Community asset mapping 4
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 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 DateInterviews and Clinical ExaminationsScreened for eligibility 54Eligible 51Completed interviews 51Completed physical examinations 51Completed laboratory exams 51(finger stick)Functional Status Tests for Participants > 50 years (N=28)Chair stand & Grip strength 25completedUnable to perform chair stand 3
Results: Participation Rates for Study Components80% 72%70% 68% 64%60%50%40%30% 24%20%10%0% Allow analysis of Share samples with Allow future Send lab reports to de-identified data other researchers analysis of DNA PMD after 2 years
Results: Participant CharacteristicsN 51Demographic CharacteristicsAge, 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 BehaviorsCurrent Smoker 12 (24%)
Results: Physical ExaminationN 51Physical 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*)
Results: Laboratory ExaminationN 51Laboratory 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