RHA on the Move

Core Research Project- 2007-2008 Resident Health Advocates on the Move (RHAM):

Motivating Public Housing Residents to Use Health Van Screening Services

In the absence of new and innovative strategies, many standard preventive services measures for vulnerable opulations will fall short of the Healthy People 2010 objectives. Community-based research indicates that interventions are most likely to succeed when they are designed with communities as respected partners, address problems in the context of community strengths, respect cultural diversity, and rely on outreach workers in addition to health professionals for information dissemination and referrals (Two Feathers, 2005). Community intervention strategies are needed to increase the number of individuals who receive preventive services and reduce the morbidity and mortality associated with racial and ethnic health disparities. Increasing screening for diabetes and hypertension is a key strategy for achieving the objectives of Healthy People 2010 (5-4., 12-9-12-15). This is particularly true in high-risk areas such as public housing.

Residents of Boston-area public housing developments have received health screenings through the use of a mobile van designed to remove major barriers (eg. financial and transportation) to access preventive services. However, health screenings have been underutilized and new motivational and recruitment strategies are needed to improve screening for major chronic diseases. Therefore, we will conduct a trial to augment screening for three significant chronic diseases: hypertension, diabetes, and dental disease. Two housing developments in Boston have been chosen as intervention sites and they will be paired against comparable ‘control’ sites. The Partners in Health and Housing PRC partnership: BUSPH, Boston Housing Authority (BHA), Boston Public Health Commission (BPHC) and the Community Committee for Health Promotion (CCHP) participated in the planning, discussion, and decision-making in choosing the new core research project described below.

The RHAM research project will:

demonstrate the effectiveness of Resident Health Advocates (RHAs) and peer leaders in increasing the participation of public housing residents in health screening for diabetes, hypertension and dental disease by increased utilization of “Healthy Connection” , Boston’s Public Health Mobile Van, and
demonstrate the effectiveness of Resident Health Advocates in increasing the clinical follow-up of housing residents screened for diabetes, hypertension and dental disease who are referred for such follow-up.

The hypothesis being:

increased participation rates in which screening is promoted by a trained development resident and peer leaders, compared to residents in developments where screening is not promoted by a trained resident and;
residents referred for clinical follow-up after screening will have increased rates of follow-up when follow-up is encouraged and facilitated by a trained development resident compared to residents in developments where follow-up is not encouraged and facilitated by a trained resident.

At the same time that residence in public housing is an indication of need and health disparity, it also provides important potential strengths that can facilitate the success of programs designed to address these problems. In particular, the geographic cohesion and community identification characteristic of many public housing developments, when combined with the organizational capability (as manifested by the PHH/PRC alliance) to give voice and shape to residents’ concerns, suggests that public housing developments are an advantageous venue in which to address major health concerns of lower-income residents.

The primary evaluation will be a comparison of the proportion of persons (all residents 18 years and above) screened in the two intervention sites versus the two control sites. The project investigators will collect van screening attendance at the research sites as well as utilize a tracking form to record all screening activity and follow-up. The RHAs and peer leaders will play no role in administration or collection of surveys.

Core Research Investigators
Jo-Anna Rorie, MSN, MPH, DSc
Phone: (617) 638-5058
jrorie@bu.edu

Alan Geller, RN, MPH
Phone: (617) 638-7126
ageller@bu.edu

The Partners in Health and Housing Prevention Research Center (PHH-PRC) at Boston University School of Public Health is a member of the Prevention Research Centers Program, supported by Cooperative Agreement Number RFA-DP-09-001from the Centers for Disease Control and Prevention (CDC). Its contents are those of the PHH-PRC and do not necessarily represent the official position of the Centers for Disease Control and Prevention.