Journal of Health Care for the Poor and Underserved最新文献

The Pre to 3 Program in Vanderburgh County, Indiana (United States) was designed to affect maternal-infant health in medically underserved populations through community health worker (CHW) led initiatives. This program provides free, hands-on support for infants, parents, and families from the first trimester of pregnancy until the child's third birthday. The CHW-driven Pre to 3 Program demonstrates improved outcomes in breastfeeding initiation, safe sleep practices, adequate prenatal care, child vaccination rates, food security, housing stability, and employment status. The Vanderburgh County Health Department Pre to 3 Program presents the state of Indiana, and similarly medically underserved counties, the opportunity to improve maternal-infant health through expanded implementation. With increased financial resources, and subsequently more program personnel, there is significant potential for positive impact on the health outcomes of high-risk communities.

This report describes the transformation of a San Diego County collective impact initiative to center community voices through the co-creation of a community council to address childhood obesity. We present seven suggested recommendations for others interested in forming a community council within a collective impact effort and highlight challenges and future directions.

Youth-centered policy approaches are needed to address Black youth mental health and amplify their voices in policy change. This paper describes the implementation of a policy assessment framework, focusing on how it was adapted to meaningfully incorporate youth voices, and highlights successes and lessons learned for future use.

Mobile health clinics (MHC) have emerged as vital resources to enhance health care access for historically marginalized populations. Using the Arksey and O'Malley framework, this scoping review explores MHC programs, focusing on target populations, settings, services, professionals, and outcomes. The review was conducted through a comprehensive search of PubMed, CINAHL Complete, and EBSCO's Business Source Complete databases from 2017 to 2024. Thirty-eight relevant articles were identified. The review underscores the significance of setting, professional roles, and services offered by MHC programs, alongside highlighting key themes such as populations served, measured outcomes, and barriers/facilitators. It advocates for interprofessional collaboration beyond traditional clinics to provide inclusive care and bridge health care disparities. Beyond health care delivery, the review underscores the importance of interprofessional collaboration in addressing health inequities. The findings of this scoping review provide insights for designing and implementing effective mobile health services in underserved communities.

A needs-assessment at a federally qualified health center in the Bay Area found that over 40% of patients faced diaper need, with cost as the major barrier and few local diaper banks available to address this need. This report describes a clinic-based diaper distribution program that helps fill this gap.

We investigate the health impacts of a community health worker (CHW) program in an urban clinic serving uninsured and underinsured patients, the vast majority of whom are non-English speaking and/or have recently immigrated to the United States. Over a three-year period between January 2019 and March 2022, 1,139 clinic patients were invited to participate in a CHW program based on evidence of chronic disease including obesity, hypertension, and diabetes. During a 90-day program, enrollees demonstrated statistically significant improvement in clinical values including weight (mean reduction of 2.8 pounds), hemoglobin A1c (mean reduction of 0.49), and blood pressure (mean systolic pressure reduction of 3.1 points). We offer initial evidence on the cost-effectiveness of this intervention relative to other means of achieving similar outcomes and suggest that CHW programs are a high-value intervention within immigrant and minority communities.

Pre-health pathway programs provide an important learning environment for students seeking careers in health care. We aim to assess how the Bronx Community Health Leaders (BxCHL), a longitudinal and learner-driven mentorship program for socioeconomically disadvantaged students and students belonging to groups underrepresented in medicine (URiM), affects the students' personal and professional development. We conducted a survey and analyzed the responses from 61 students who participated in the program for various lengths of time. Quantitative assessment shows measurable changes in the students' knowledge, skills, and attitudes toward health care careers. The qualitative assessment identified six themes that highlight perceived changes in students' confidence, personal/professional growth, mentorship, leadership skills, agents of change, and community service. The BxCHL's program student-driven design positively affects the students' readiness to enter health care professions.

The unmet health care needs of people with pre-existing disabilities who have long COVID are understudied. During the COVID-19 pandemic, people with disabilities experienced barriers to accessing care and supplies needed to prevent and treat COVID-19. Once they had contracted COVID-19, people with disabilities were more likely to develop long COVID compared with people without disabilities. Using the 2022 National Survey on Health and Disability, this study aimed to compare how unmet health care needs differ among people with pre-existing disabilities with and without long COVID. We examined bivariate associations between unmet health care needs and respondents' demographic characteristics and responses to open-ended survey questions. About 73% of respondents with long COVID reported unmet health care needs compared with 62.6% of respondents without long COVID. Four key themes emerge from open-ended responses: exacerbation of existing disability, navigating the health care system, gaslighting by health care providers, and financial burdens.

Tailored technical assistance enhances patient and provider engagement and hypertension control in community health centers. Addressing each center's particular needs, the approach described here focused on self-measured blood pressure monitoring, training, and skills-building, and strengthening community-clinic linkages. Systematic approaches to stakeholder engagement can enhance health care delivery and improve hypertension control rates.