Search

Launched in 2012, the Claremont Healthy Village Initiative (CHVI) is a partnership focused on fostering community collaboration, addressing the social determinants of health, and reducing health disparities. Partners include local community centers, schools, after-school programs, health care providers, a health insurer, city agencies, tenant associations, resident leaders, elected officials, and other stakeholders.To understand the development and value of collaboration within the CHVI from the perspective of multiple partners.Using a community-based participatory research approach, we worked collaboratively with the CHVI leaders, we used paper-and web-based surveys grounded in social network theory were administered in 2017 and 2018. Questions focused on relationships between organizations that are part of the coalition. Our analysis included responses from organizations that participated in the survey at both points in time. Network measures such as density, degree centrality, and node characteristics were used to understand information sharing, referral, and collaboration among the participating organizations. Additional data included stake-holder interviews.Coalition partners increased connectedness with one another over the course of the study, with significantly greater density of relationship and bi-directional partnerships in the follow-up survey. Of the three types of interactions, referrals showed a trend for highest density change. Trust levels were highest among organizations with a local physical presence.Social network analysis provided visual and quantitative information that helped reinforce relationships and identify opportunities to improve connectedness and collaboration among diverse community partners, helping to support the coalition's goals and objectives.

Purpose: Hispanic women are less likely to be screened for breast cancer than non-Hispanic women, which contributes to the disproportionate prevalence of advanced-stage breast cancer in this population group. Patient navigation may be a promising approach to help women overcome the complexity of accessing multiple health care services related to breast cancer screening and treatment. The goal of this study is to assess patient perception and cost-effectiveness of a multilevel, community-based patient navigation program to improve breast cancer screening among Hispanic women in South Texas. Methods: We used mixed methods—including focus groups of program participants and a microsimulation model of breast cancer—to evaluate the effectiveness and cost-effectiveness of the program on the target population. Program data from 2013 to 2016 were collected and used to conduct the analyses. Results: Focus groups showed that the patient navigation program improved patient knowledge, attitudes, and behaviors regarding breast health and increased the mammography screening rate from 60% to 80%. Cost-effectiveness analysis showed that the program could increase life expectancy by 0.71 years and yield an incremental cost-effectiveness ratio of $3120 per quality-adjusted life year compared to no intervention. Conclusion: The 3-year multilevel, community-based patient navigation program effectively increased mammography screening uptake and adherence and improved knowledge and behaviors on breast health among program participants. Future research is needed to translate and disseminate the program to other socioeconomic and demographic groups to test its robustness and design.

OBJECTIVE: To estimate the average incremental health care expenditures associated with habitual long and short duration of sleep as compared to healthy/average sleep duration. DATA SOURCE: Medical Expenditure Panel Survey (MEPS) data (2012; N=6,476) linked to the 2010–2011 National Health Interview Survey (NHIS). STUDY DESIGN: Annual differences in health care expenditures are estimated for habitual long and short duration sleepers as compared to average duration sleepers using two-part logit generalized linear regression models. PRINCIPAL FINDINGS: Habitual short duration sleepers reported an additional $1,400 in total unadjusted health care expenditures compared to people with average sleep duration (p

Most residents in New York City (NYC) do not consume sufficient fruits and vegetables every day. Difficulties with access and high prices of fruits and vegetables in some neighborhoods contribute to different consumption patterns across NYC neighborhoods. We developed an agent-based model (ABM) to predict dietary behaviors of individuals at the borough and neighborhood levels. Model parameters were estimated from the 2014 NYC Community Health Survey, United States Census data, and the literature. We simulated six hypothetical interventions designed to improve access and reduce the price of fruits and vegetables. We found that all interventions would lead to increases in fruit and vegetable consumption but the results vary substantially across boroughs and neighborhoods. For example, a 10% increase in the number of fruit/vegetable vendors combined with a 10% decrease in the prices of fruits and vegetables would lead to a median increase of 2.28% (range: 0.65%-4.92%) in the consumption of fruits and vegetables, depending on neighborhood. We also found that the impact of increasing the number of vendors on fruit/vegetable consumption is more pronounced in unhealthier local food environments while the impact of reducing prices on fruits/vegetable consumption is more pronounced in neighborhoods with low levels of education. An agent-based model of dietary behaviors that takes into account neighborhood context has the potential to inform how fruit/vegetable access and pricing strategies may specifically work in tandem to increase the consumption of fruits and vegetables at the local level.

Traditional sources of information for small and rural communities have been disappearing over the past decade. A lot of the information and discussion related to such local geographic areas is now scattered across websites of numerous local organizations, individual blogs, social media and other user-generated media (YouTube, Flickr). It is important to capture this information and make it easily accessible to local citizens to facilitate citizen engagement and social interaction. Furthermore, a system that has location-based support can provide local citizens with an engaging way to interact with this information and identify the local issues most relevant to them. A location-based interface for a local geographic area enables people to identify and discuss local issues related to specific locations such as a particular street or a road construction site. We created an information aggregator, called the Virtual Town Square (VTS), to support and facilitate local discussion and interaction. We created a location-based interface for users to access the information collected by VTS. In this paper, we discuss focus group interviews with local citizens that motivated our design of a local news and information aggregator to facilitate civic participation. We then discuss the unique design challenges in creating such a local news aggregator and our design approach to create a local information ecosystem. We describe VTS and the initial evaluation and feedback we received from local users and through weekly meetings with community partners.