INCREASING COMMUNITY BASED HEALTH PROMOTION THROUGH THE FAMILY - PowerPoint PPT Presentation

Paula Winkler, M.Ed., Center Director South Central AHEC INCREASING COMMUNITY BASED HEALTH PROMOTION THROUGH THE FAMILY HEALTH HISTORY TO ENHANCE COMMUNICATION BETWEEN PATIENT AND PROVIDER IN A PRIMARY CARE SETTING

SETTING THE STAGE

CLINICAL TRANSLATION SCIENCE AWARD (CTSA)  Community Engagement Core Function –  2008 - 2013  3 Legged Stool  PBRN – School of Public Health – Translational Advisory Board (AHEC)  Community Based Participatory Research (CBPR)

TRANSLATIONAL ADVISORY BOARD (TAB) SOUTH CENTRAL AHEC

TAB MISSION  The mission of the Translational Advisory Board (TAB) is to serve as a representative body which aims to improve community health through the facilitation of community-based participatory research and educational outreach activities in partnership with the UT Health Science Center at San Antonio. 

GOALS OF THE TAB Setting the health research agenda in the community Partnering with researchers to develop and refine health research protocols in the community Participating in data collection and analysis Reporting health research findings to community members Seeking sustainable resources for community health research initiatives and programs Facilitating community health research partnerships

HEALTH DEMOGRAPHICS OF TABS Diabe Diabetes Prev Preval alence in TAB Cou in TAB Counties 200 2009 Statewide Prevalence of Diabetes  8.2% Guadalupe 8.2% Gillespie County 8.5% Frio Cou 8.3% Comal 8.7% Bexar 7.5% 8.0% 8.5% 9.0% Percen Percent Deaths C aths Caused b used by D Diabetes abetes in in TAB C Counties 2 unties 2009 1.5% Guadalupe 1.2% Gillespie 3.9% Frio Source: CDC National Diabetes Surveillance System 2.8% Comal 3.3% Bexar 0.0% 1.0% 2.0% 3.0% 4.0% Percent Percen Source: Texas Health Data

HEALTH DEMOGRAPHICS OF TABS Heart Disease Mor Hear t Disease Mortality in ality in TAB Counties 2009 B Counties 2009 26.0% 25.4% 25.2% 25.0% 24.0% 24.0% Percent Percen 22.6% 23.0% 22.5% 22.0% 21.0% Bexar Comal Frio Gillespie Guadalupe Source: Texas Health Data

HEALTH DEMOGRAPHICS OF TABS Stroke Mor Str ality Rat Rates in s in TAB Counties B Counties 2009 2009 Breast Breast Canc Cancer (F (Femal emale) Mor Mortal ality ity Rat Rates in s in TAB B Mortality Coun Counties 2009 ties 2009 60.0 120.0 51.7 103.4 50.0 100.0 93.4 40.0 36.9 100k 80.0 Rate per 100 100k Rate per Rate per 100 Rate per 30.0 54.3 60.0 53.1 22.7 22.5 40.3 18.5 40.0 20.0 20.0 10.0 0.0 0.0 Bexar Comal Frio Gillespie Guadalupe Source: DHHS Community Health Status Indicator Report 2009

GENOMIC-BASED RESEAR GENOMIC-BASED RESEARCH APPLICA CH APPLICATIONS IONS FOR COMMUNIT R COMMUNITY ENGA Y ENGAGEMENT GEMENT: : GRA GRACE Detai De tailed F ed Family Healt Health Hist Histor ory as a Genom y as a Genomic and Clin and Clinica ical T Tool ool Nedal Arar., MS., MA., PhD. Associat Associate Pr e Prof ofessor essor Department of Medicine/UTHSCSA. Health Research Scientist, South Texas Veterans Health Care System San Antonio, TX Email: ararn@uthscsa.edu.

CTSA PILOT GRANT 2011-2012  Expand GRACE to Community - $50K  Dr. Nedal Arar - PI  TABs recruit 20 participants per community  TABs assist to identify facility/technology for study  AHEC housed Project Coordinator  AHEC staff assisted Project Coordinator

FAMILY HEALTH HISTORY

FHH PURPOSE  To enhance participants' awareness/knowledge regarding the importance of FHH information.  To collect FHH and establish extended three generations pedigree using SG online FHH tool.  To encourage participants sharing their FHH information with relatives and providers.  To document individuals actual behaviors regarding the use of their FHH information by conducting a follow up visit after 6 months.  To assess consumers’ satisfaction regarding the utilizations of their FHH information, assessed by the American Customer Satisfaction Index (ACSI),

WHAT RUNS IN YOUR FAMILY? Talk Health History Campaign Public Service Announcement (PSA) Video

MY FAMILY HEALTH PORTRAIT

MY FAMILY HEALTH PORTRAIT  Protects personal  Because of information information by not saving security measures, it after the end of the requires users to print or session save on desktop/other external devices  Lets the user know exactly whose information to fill in and doesn’t require names  Keep the history to share with family and/or your doctor/other provider

REMEMBER…  Any information you fill in is good information!  Don’t get frustrated if you don’t know everything about everyone!

GRACE: PARTICIPANT NUMBERS Total of 75 participants between 5 counties Bexar 17 Comal 20 Frio 9 Gillespie 12 Guadalupe 17

SUMMARY OF DEMOGRAPHICS Summary of Demographics Median Age|| 53.4 Age Range || 24.5 ‐ 57 % Non ‐ Hispanic White: Com, Gua, Gil || 88.9% % Non ‐ Hispanic White: Bex, Fri || 17% Marital Status || 49.8% Married Average Income || 37% ‐ $30k/yr, 33% ‐ $50+/yr Average Educational Level || 38% ‐ 4yr+ degree, 34% ‐ some college

PARTICIPANTS COMMENTS ON FACILITATION AND BARRIERS OF THE SURGEON GENERAL TOOL Facilitation/Motiv cilitation/Motivation tion Barrier Barriers Having a mobile application available Lack of computer knowledge Family helping to add to the family Lack of computer/internet access health history Being an online tool for the public to Time Constraints access Encouragement from family/doctor’s Lack of knowledge of family history office -Not knowing their family -adoption

RESULTS KAP Assessment Averages Family health history refers to diseases and conditions that run in my family 90.3% Strongly Agreed Knowing my Family Health History will help me to identify my risk for diseases 93.9% Strongly Agreed Being aware of my FHH and making the right healthcare and lifestyle choices can reduce my risks 80.4% Strongly Agreed My familial risk may increase if I have multiple family members with the same or related conditions 76.4% Strongly Agreed I fell I have little control over risks to my health 21.5% Strongly Disagreed There are things I can do to prevent or minimize my risks of developing common chronic diseases 67.6% Strongly Agreed There is not much use in trying to knkow my family health history because the disease will develop 52.5% Strongly Disagreed anyway Health care providers should help patients make informed choices about their health care plans based 77.3% Strongly Agreed on their family health history

WHERE DO USERS GO FROM HERE?  Finding health information online isn’t always easy

MEDLINEPLUS

MEDLINEPLUS  Reliable health  Not easy to browse to information in lay family health history language health topic page – opportunity for education  Available in English, Spanish, and other languages  Provides links to other trusted health information sources

FUTURE DIRECTION  National Library of  Expand to Science Medicine Grant Teachers in Classrooms application – awaiting results  Residency Training – Community Medicine  PCORI Grant Blocks Opportunities  PBRNs  NIH Grants

THANK YOU!