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CP32 - The Role of Community Health Centers in Removing Barriers for Latinx Patients to Mobilize for Health Equity During the Pandemic
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CP32 - The Role of Community Health Centers in Removing Barriers for Latinx Patients to Mobilize for Health Equity During the Pandemic

Poster Type: Innovation

Category: Patient and Community Engagement

Issue or Challenge: Latinx communities are continuously among the least civically engaged communities throughout the U.S.. Limited economic opportunity and exclusion of low-income residents of color in decision-making exacerbate inequity in these neighborhoods, resulting in the growth of health and social disparities. AltaMed believes that Civic engagement is the vehicle through which working-class residents of color can be partners in changing the conditions that create health disparities in our communities. The COVID-19 pandemic brought additional challenges to sustaining civic engagement among hard-to-reach communities and simultaneously increased the need for them to be equitably represented in mobilization efforts (Montiel et al., 2020).

Description of Innovation: In January 2021, amidst the pandemic, AltaMed launched the Community Organizing Institute (COI) in an effort to build community power and tackle the lack of civic engagement amongst the populations that we serve. AltaMed believes that in order to truly address health disparities, the community must be at the center of all initiatives and be valued as partners at every step of design and implementation. This project leveraged popular education (Friere, 1996) and community participatory action strategies (Wallerstein & Duran, 2006) to engage patients in the co-development of a health equity agenda, advocacy planning, and development of community roundtables to express and address their concerns during the COVID-19 pandemic. In the summer of 2020, AltaMed surveyed a group of patients to assess their experiences and priorities during the COVID-19 pandemic. Patients were subsequently invited to discuss the results of the assessment and provide input on the design of a community education series. To further build capacity amongst patients and community members, AltaMed also launched the Advocacy and Leadership Academy(ALA) which was a 5-week curriculum designed to train participants in skills related to local, state and federal advocacy. In response to the engagement in these 2 opportunities, we launched the Community Organizing Institute(COI) with the intention of forming a community organizing group to mobilize around policy, systems, and environmental change campaigns to advance health equity during the COVID-19 pandemic. The COI serves as an opportunity for continued engagement of community members, patients and ALA graduates in direct advocacy.

Impact or Result: 35 residents improved their capacity to advocate locally and engage in long-term policy, systems, and environmental change. AltaMed improved its capacity to partner with community members and patients on community-led solutions to social determinants of health. AltaMed built infrastructure of a Community Organizing Institute composed of the Academy graduates and other community members.

Replicating this Innovation: Create concrete opportunities for patients to engage with and within the health system to advance health equity. AltaMed has a training curriculum for its advocacy and leadership academy. Launching a Develop a process for patient-led agenda-setting around priority issues. Invest time in preparing patients to improve their readiness to engage, and provide a dedicated staff member whose role is to sustain this engagement.

Author(s):

Noemi Mendez, Community Health Impact Project Coordinator, AltaMed Health Services Corporation

Corina Martinez, MS, Community Health Impact Manager, AltaMed Health Services Corporation


Speaker(s):
  • Noemi Mendez, B.A in Sociology
  • Corina Martinez, B.A, M.S
COVID-19 Vaccine Confidence Among Federally Qualified Health Center (FQHC) EmployeesCOVID-19 Vaccine Confidence Among Federally Qualified Health Center (FQHC) Employees
CP33 - COVID-19 Vaccine Confidence Among Federally Qualified Health Center (FQHC) Employees
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CP33 - COVID-19 Vaccine Confidence Among Federally Qualified Health Center (FQHC) Employees

Poster Type: Research

Track/Topic: Public Health Crises; Workforce

Research Objectives: The objectives of the cross-sectional online survey are to (1) understand what influences COVID-19 vaccine hesitancy amongst FQHC employees, (2) explore associations between vaccine hesitancy, demographic variables, and patient-facing employment; and (3) improve COVID-19 vaccine confidence among FQHC employees.

Research Study Design/Methods: Using self-reported data from a cross-sectional online survey, 462 FQHC employees completed questions on demographics, FQHC employment, COVID-19 vaccine hesitancy, and vaccine hesitancy influence(s). COVID-19 vaccine hesitancy was defined as answering, “No,” or “Unsure,” on willingness to be vaccinated. COVID-19 vaccine confidence was defined as willingness to receive the COVID-19 vaccine or already being vaccinated. Descriptive statistics and a contingency analysis using Fisher’s Exact Test and unadjusted Odds Ratios were used to determine the association between COVID-19 vaccine hesitancy and gender, age, race, educational attainment, or being employed in a patient-facing role.

Research Principal Findings and Quantitative/Qualitative Results: Female employees were more likely to be vaccine hesitant than males [OR=3.09; 95% CI: 1.75-5.66, p35-years old were more likely to be vaccine hesitant than employees =35-years old [OR=2.89; 95% CI: 1.91-4.40, p0.0001]. Blacks were more likely to be vaccine hesitant than Whites [OR=3.04; 95% CI: 1.70-5.60, pxtagstartz0.0001]. Non-patient-facing employees were more likely to be vaccine hesitant than patient-facing employees [OR=1.74; 95% CI: 1.15-2.64, p=0.008]. Educational level had the largest effect size.


Speaker(s):
  • Jena Wallander Gemkow, MPH, BSN, RN
  • Daniel Parras, MPH
  • Katherine Chung-Bridges, MD, MPH
  • Shelly Sital, MPH
  • Stephanie Smith, BHSA
  • Andrew Hamilton, RN, BSN, MS
  • Timothy Long, MD
Adapting Dental Care Facilities to SARS-CoV-2: Reports from National Dental Practice-Based Research Network PractitionersAdapting Dental Care Facilities to SARS-CoV-2: Reports from National Dental Practice-Based Research Network Practitioners
CP34 - Adapting Dental Care Facilities to SARS-CoV-2: Reports from National Dental Practice-Based Research Network Practitioners
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CP34 - Adapting Dental Care Facilities to SARS-CoV-2: Reports from National Dental Practice-Based Research Network Practitioners

Poster Type: Research

Track/Topic: Public Health Crises

Research Objectives: The SARS-CoV-2 pandemic prompted dental practitioners to reduce potential risks of virus transmission at dental facilities. This study identified approaches used by National Dental Practice-Based Research Network (Network) practitioners to reduce the risks of SARS-CoV-2 transmission at dental facilities, information sources, and comfort levels with infection control and their costs.

Research Study Design/Methods: We invited participation from 5,450 active U.S. dentists, hygienists, and therapists who were enrolled in the Network on January 4, 2021. The protocol was approved by the Central and Regional Node IRBs. Practitioners were recruited via email and telephone from January 1 to February 14, 2021. We collected data SARS-CoV-2-related facility modification, patient flow and screening changes, procedure modification and PPE use, and information sources. We use chi-square and t-tests to compare results by practice setting, including federal and public health, and practice type. Regression and forest-plot analyses of practice and practitioner characteristics will be reported.

Research Principal Findings and Quantitative/Qualitative Results: 1529 respondents met study inclusion criteria. Respondents were representative of the Network members. We found most (75%-98%) practices reduced exposed surfaces and enhance social distancing; 40% closed wait areas. High-velocity evacuators were the most common change to operatories. Staff spent a median extra 40 minutes/day disinfecting dental office space. Overall, only 14% were concerned about providing care safety while 27% of community health/publicly supported dentists had similar concerns. Overall, 50% of practitioners (44% of publicly supported dentists) reported being somewhat to not-at-all confident their practice could maintain current patient volume, revenues, and SARS-CoV-2-related costs over the next 24 months.

Research Conclusions on Impact on Health Centers: National Dental PBRN practitioners, including dentists from community-based and publicly supported settings, reported multiple changes to dental office facilities, equipment, and disinfectant practices aimed at reducing the risks of SARS-CoV-2 virus transmission. Most practitioners had low levels of concern that they could safely care for patients, but community and publicly funded dentists had the highest levels of concern about safety among dentists in different settings. Overall, there was a notable lack of confidence in the financial sustainability of clinical practice over the next 2 years. Data cleaning and regression modeling are underway and will be reported at the presentation.

Authors:

Jeffrey Fellows, Senior Investigator, Kaiser Permanente Center for Health Research


Speaker(s):
  • Jeffrey Fellows
Team-Based Home Blood Pressure Monitoring to Improve Hypertension Control Among Uninsured PatientsTeam-Based Home Blood Pressure Monitoring to Improve Hypertension Control Among Uninsured Patients
CP35 - Team-Based Home Blood Pressure Monitoring to Improve Hypertension Control Among Uninsured Patients
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CP35 - Team-Based Home Blood Pressure Monitoring to Improve Hypertension Control Among Uninsured Patients

Poster Type: Innovation

Primary Funding Source: American Medical Association, American Health Association, West Side United, Centene Corporation, NACHC and CDC Million Hearts® Innovation Award

Category: Quality of Care and Quality Improvement

Issue or Challenge: Esperanza Health Centers is a FQHC that serves a primarily Latinx population on Chicago’s southwest side. In 2018, Esperanza achieved a hypertension control of 80%, and we were selected as one of the Million Hearts® Hypertension Control Champions in 2019. However, amidst the COVID-19 pandemic, our hypertension control dropped to 58% in 2020. With the shift to telemedicine, we found an increase in the number of visits with no documented BP measurement and discovered uninsured patients were less likely to own a blood pressure monitor compared to insured patients.

Description of Innovation: We distributed blood pressure devices to uninsured and under-insured patients with hypertension through phone outreach and at our COVID19 vaccination sites, provided home blood pressure monitoring education and support to patients over the phone, and ensured patients followed-up appointments with their primary care provider. Strong evidence shows that home blood pressure monitoring plus clinical support helps people with hypertension lower their blood pressure. Home blood pressure monitoring enables providers to better manage hypertension and helps patients take an active role in the process. Furthermore, home blood pressure monitoring enhances the telehealth experience for patients and care teams. We utilized data from our EHR to help identify patients eligible for BP cuffs and leveraged Esperanza’s existing team-based care model. At Esperanza, care teams consist of a provider, a medical assistant, and a care coordinator who work closely together during the visit and in-between visits to provide high-quality care for patients. Every care team member plays a role in improving hypertension control. We developed a workflow that aligns with the care coordinators’ existing role in providing education, connecting patients to internal and community resources, and providing population health outreach to address patient care gaps.

Impact or Result: As of 04/08/2021, we sent BP monitors to 471 uninsured and underinsured patients with hypertension. Prior to our program, 17% of uninsured patients with hypertension had a BP monitor order. Now, 28% of uninsured patients with hypertension have a BP monitor order, which is an 11% increase. Of the patients in our program, 56% have a BP reading entered into their chart during the program measurement period. Since the program is currently underway, patients without a BP reading this year will have additional calls with their care coordinators and the majority have upcoming appointments with their primary care providers. We will continue to monitor the number of BP monitors sent to patients, the percent of patients with a BP reading in their chart, and the hypertension control rate for those patients. Additionally, we will monitor the number of care coordinator calls and telemedicine appointments with a BP reading entered.

Replicating this Innovation: For community health centers interested in adopting this model, we recommend establishing partnerships with organizations with technical expertise (e.g., AMA, AHA) for SMBP training and support, forging relationships with existing community-based organizations and coalitions, and collaborating with different departments within your organization to review baseline data on hypertension patients, create a workflow that includes EHR documentation, incorporate current roles involved with hypertension improvement efforts, and identify measures to track progress of new processes.

Author(s):

Sonia Ayala, MA, LCSW, Manager of Health Equity, Esperanza Health Centers

Rachel Cheung, Practice Transformation Associate, Esperanza Health Centers

Andrew Van Wieren, MD, Medical Director, Esperanza Health Centers

Carrie Kindleberger, APN, FNP-BC, Family Medicine Lead Provider, Esperanza Health Centers

Ted Hufstader, MPH, Director of Quality and Practice Transformation, Esperanza Health Centers

Paola Seguil, MS, RD, LDN, Quality Manager, Esperanza Health Centers


Speaker(s):
  • Paola Seguil, MS, RD, LDN
  • Andrew Van Wieren, MD
  • Carrie Kindleberger, APN, FNP-BC
  • Ted Hufstader, MPH
  • Sonia Ayala, MA, LCSW
  • Rachel Cheung
ACCESS Westside Healthy Start: Impact of Integrated Support Systems for Maternal Child HealthACCESS Westside Healthy Start: Impact of Integrated Support Systems for Maternal Child Health
CP36 - ACCESS Westside Healthy Start: Impact of Integrated Support Systems for Maternal Child Health
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CP36 - ACCESS Westside Healthy Start: Impact of Integrated Support Systems for Maternal Child Health

Poster Type: Innovation

Primary Funding Source: Health Resources and Services Administration Maternal Child Health Bureau

Category: Quality of Care and Quality Improvement

Issue or Challenge: Infant mortality (IM) serves as a proxy for community health and access to quality health services and while the U.S. 2018 infant mortality rate (IMR) was 5.7 deaths per 1,000 live births , significant disparities persist by geography, race, and ethnicity. Chicago is no exception. The average IMR (2013-2017) for Chicago is 6.6 deaths per 1,000 live births while on the westside of Chicago in the community areas of Austin, East Garfield Park, West Garfield Park, North Lawndale, and Humboldt Park the average IMR is 11 deaths per 1,000 live births, 1.67 times the Chicago rate.

Description of Innovation: Access Community Health Network (ACCESS) provides community-based health care and serves the target community areas of Austin, East Garfield Park, West Garfield Park, North Lawndale, and Humboldt Park. To reduce infant health disparities, ACCESS obtained federal funding to establish its Westside Healthy Start (WHS) program and partnered with another local FQHC to provide targeted family-centered and comprehensive case management services utilizing a life course approach from preconception to 18 months postpartum. To seamlessly provide services, WHS instituted a care team approach to support participants and coordinate services. WHS’ primary focus is to promote adequate prenatal care and provide education and resources on topics such as safe sleep to reduce chances of premature or low birth weight babies, Sudden Infant Death Syndrome (SIDS) or other leading causes of infant mortality. To meet participant needs, WHS devotes efforts to community education to drive collective impact and developing and maintaining strong community relationships. Through this innovative infrastructure, case managers connect participants with resources and education at the health center, telephonically, and at home to ensure pregnancy and overall health and wellness goals are met. This approach helped to reduce health disparities affecting mothers and babies on Chicago’s West side.

Impact or Result: The average IMR (2013-2017) on the Westside of Chicago in the community areas of Austin, East Garfield Park, West Garfield Park, North Lawndale, and Humboldt Park is 11 deaths per 1,000 live births while for WHS participants, the average (2014-2019) IMR is 6.6 deaths per 1,000 live births. Several factors contribute to the reduced IMR. ACCESS WHS’ safe sleep education and community partnerships connect participants with safe sleep resources (Ex: Pack 'N Play™) and contributes to an increase in participants reporting safe sleeping practices from 72% in 2017 to 80% in 2020. Breastfeeding can also reduce the incidence of SIDS. Therefore, WHS focuses on initiation and duration. WHS’ partner LCHC reported increased rates from 58% in 2017 to 64% in 2020. While exchanging lessons learned, LCHC stated their success is due to a strong breastfeeding culture and specifically named the influence of midwives and breastfeeding educator on breastfeeding.

Replicating this Innovation: Replication of this model can be done by investing in the maternal and child heath workforce including a non-clinical support system that can connect participants with social services and community resources. Keys to replications include (1) developing strong relationships with the community and organization, (2) utilizing a care team approach, (3) customizing workflow development, and (4) incorporating evaluation activities to monitor progress and program effectiveness.

Author(s):

Lindsay Zeman, Evaluation Specialist, Access Community Health Network

Timika Anderson-Reeves, Director of Maternal Child Health & Women's Health Community Integration, Access Community Health Network

Dara Gray Basley, Manager of Health Equity, Access Community Health Network


Speaker(s):
  • Lindsay Zeman
  • Timika Anderson-Reeves
  • Dara Gray Basley
Diabetes Care Program: A Nurse-Led, Team-Based Approach to Chronic Disease ManagementDiabetes Care Program: A Nurse-Led, Team-Based Approach to Chronic Disease Management
CP37 - Diabetes Care Program: A Nurse-Led, Team-Based Approach to Chronic Disease Management
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CP37 - Diabetes Care Program: A Nurse-Led, Team-Based Approach to Chronic Disease Management

Poster Type: Innovation

Category: Quality of Care and Quality Improvement

Issue or Challenge: Diabetes is a complex chronic illness that has significant medical, social, and financial impacts when the disease is not controlled. The percentage of poorly controlled diabetic patients at Community Health Care (CHC), a Federally Qualified Health Center, in April 2019 was 32%. This percentage included patients whose Hemoglobin A1c (HgbA1c) was greater than 9% or untested. Each patient with a poorly controlled A1c is at risk for serious complications. The problem needed to be addressed in an innovative way to improve patient outcomes, reduce total cost of care for these patients, and improve both the patient and provider experience.

Description of Innovation: The creation of the Diabetes Care Program (DCP) was an exciting initiative to improve patient engagement, disease management, and clinical outcomes for patients with uncontrolled diabetes. The development of a formalized DCP shifted diabetes management from a primarily individual provider and patient model, with limited provider access and time, to a team-based model led by nurses with a focus on patient education and engagement. The new care model consists of a nurse visit with the patient immediately before the provider visit and routine follow-up phone calls with the nurse and patient. The nurse uses motivational interviewing and patient education to engage patient in disease self-management with consideration of social determinants of health. Another component of the project was establishment of workflows to outreach to patients that needed diabetes care but had not had a diabetes visit in the last year or were overdue for follow-up based on their last visit. Clinical workflows include specific patient outreach and point of care diabetes management, regardless of initial reason for visit. These workflows help ensure patients’ chronic disease needs are consistently considered, evaluated, and managed.

Impact or Result: The impact of the DCP was significant. Our baseline data revealed that 32% of diabetic patients had an uncontrolled or untested Hgb A1c. After 9 months of program utilization, the uncontrolled percentage decreased to 25.9%. There were 345 patients enrolled in the DCP and 83% percent of those patients showed improvement in their A1c scores during their enrollment in the program. Furthermore, 57% of those patients ended with a level less than 9%. The average A1c decreased from 11.5% to 8.9% in the enrolled patients. Additionally, the clinical care teams enjoyed this work which may have contributed to improvement in overall staff satisfaction survey results.

Replicating this Innovation: The DCP is a program that has an ability to easily be replicated at other organizations providing care to patients with diabetes. We were able to use existing staffing models with an RN on every care team to shift the schedules to accommodate the new workflows and RN patient support. The RN staff enjoyed this level of patient interaction. Additionally, the development of outreach and mechanisms to evaluate diabetes in patients regardless of the initial reason for the visit provided an opportunity to better manage chronic disease and provided an opportunity to truly function as a Patient Centered Medical Home.

Author(s):

Theresa Jennings, DNP, ARNP, FNP-c, Family Nurse Practitioner, Clinical Assistant Professor, Community Health Care, Inc; University of Iowa College of Nursing

Rebecca Hayes, MD, MEHP, CMO - Pediatric and Internal Medicine Physician, Community Health Care


Speaker(s):
  • Theresa Jennings, DNP, ARNP, FNP-c
  • Rebecca Hayes, MD, MEHP
Author(s):
  • Rebecca Hayes, MD, MEHP
Addressing Social Determinants of Health Through Mobile Medical Van in Miami-Dade, CountyAddressing Social Determinants of Health Through Mobile Medical Van in Miami-Dade, County
CP39 - Addressing Social Determinants of Health Through Mobile Medical Van in Miami-Dade, County
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CP39 - Addressing Social Determinants of Health Through Mobile Medical Van in Miami-Dade, County

Poster Type: Innovation

Category: Social Determinants of Health

Issue or Challenge: The purpose of the Mobile Medical Van (MMV) is to improve access to early, comprehensive primary care services among South Florida’s most vulnerable populations by addressing social determinants of health (SDOH) including transportation, food insecurity, housing, insurance coverage and other barriers that contribute to health inequities. Though Miami-Dade County has nearly 20% of all individuals below the federal poverty line, people experiencing homelessness and those living in public housing have even greater needs. Community Health of South Florida’s (CHI) MMV initiative was designed to serve these populations through comprehensive primary and behavioral health care and by addressing SDOH.

Description of Innovation: The mobile medical van (MMV) is the only comprehensive full-service mobile clinic in the area serving the population (public housing, early childcare centers and homeless encampments) through a lens of addressing social determinants of health through a care management model. The MMV provides full-service primary care and behavioral health services, an SDOH assessment integrating the PRAPARE Assessment tool, laboratory services, immunizations, cancer and STD screening, EKG, telehealth (to link with other providers), support with insurance, linkages to community resources and support with accessing public benefits. The van operates in close partnership with community organizations and the public housing authority. MMV patients become part of the CHI network and have access to all CHI support services, as appropriate, including referrals for ongoing care, comprehensive disease management and care reminders. Comprehensive evaluation of the MMV supports a deeper understanding of SDOH among this population and how addressing SDOH at the point-of-care can lead to improvement in core clinical measures. The MMV population is regularly assessed for SDOH, support follow-through and UDS clinical quality measures.

Impact or Result: We assessed results from the first eight months of MMV implementation, which took place at the height of COVID-19 cases in South Florida (July to February, 2021.) Overall, 178 people received care at MMV and were assessed for SDOH. In terms of SDOH, 48% of our patients indicated they had one or more barriers to care including transportation (21%), housing stability (19%) and food insecurity (15%). Over 49% of clients reported that if the MMV was not available, they would have gone to an urgent care or emergency department, and 25% said they would have remained sick and not received healthcare. In terms of clinical measures, data suggests that MMV clients have poorer diabetes control (48%) and cervical cancer screening (50%), but higher 1st trimester entry into prenatal care (100%), screening for depression (79%) and statin therapy for prevention of CVD (85%), compared to the 2030 HRSA target.

Replicating this Innovation: MMVs can be adapted by other Health Centers and clinical settings, provided they have community need and sufficient funding for staffing and sustainability. It is important to recognize the role of building trust within the communities and to use the skills of trained outreach workers to reinforce linkages within, and across, clinical and social service settings. MMVs can reach the vulnerable populations by delivering health services curbside in communities of need and addressing not just medical and behavioral health conditions but also SDOH at the community level.

Author(s):

Tony Amofah, MD, MBA, FACP, Chief Medical Officer, Community Health of South Florida, Inc.

Peter Wood, VP Planning and Government Affairs, Community Health of South Florida, Inc

Eunice Hines, MPH, CCHW, CHC, Director for Migrant Health & Outreach Services, Community Health of South Florida, Inc

Rachna Patel, OMS_IV, MPH candidate, Nova Southeastern University - KPCOM MPH program

Nicole Cook, PhD, MPA, Associate Professor, OCHIN


Speaker(s):
  • Nicole Cook, PhD, MPA
  • Tony Amofah, MD, MBA, FACP
  • Peter Wood
  • Eunice Hines, MPH, CCHW, CHC
  • Rachna Patel
Bite of HOPEBite of HOPE
CP40 - Bite of HOPE
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CP40 - Bite of HOPE

Poster Type: Innovation

Primary Funding Source: Novo Nordisk and Harris County

Category: Social Determinants of Health

Issue or Challenge: The Bite of HOPE culinary program is a upstream model designed to change the food environment in Houston. It is the first low cost culinary institute, accredited by the Texas Workforce Commission, focusing on integrating the medical and culinary resources in the community to change perceptions about food and change the way Houston eats. The goal with this program is to educate the different communities on the benefits of healthy eating, create next generation of healthy cooking chefs and food businesses, and integrate health care and eating in seamless transition.

Description of Innovation: HOPE Clinic believes that it can change the way Houston eats by empowering food stakeholders and community members with the knowledge food has over our health and bodies along with the power and responsibility business have with their patrons. HOPE Clinic’s Bite of HOPE program has the mission to improve communities through knowledge of healthy food and healthy culinary practices. Since its conception, this program has:1) Filled an existing gap in the elementary school curriculum which does not incorporate health food education. The program pioneered a food and nutrition afterschool education program with Alief ISD to empower children to make healthy choices throughout their lives, foster food literacy and teach culinary skills. 2) worked closely with over 180 school counselors and nurses providing them nutrition education and cooking demonstrations with the goal of providing them with a more comprehensive and complex approach to nutrition education and change taking into account the psychological and social dimensions, which are more appropriate to address the growing prevalence of diet-related chronic diseases in Houston.3) During COVID-19, Bite of HOPE established a Youtube channel (A Bite of HOPE) as a platform for home bound families to share and discover healthy recipes and delivered food supplies needed to prepare the recipes. It also partnered with United Health care to reach home bound Seniors.4) Implemented a successful small food business leadership program with to transform the way Houston eats, buy helping restaurant owners become healthy food outlets and champions of healthy practices.

Impact or Result: Bite of HOPE is working on a evaluation strategy that would measure changes in the menu of small business, as well as changes in eating practices of Alief ISD families. The program has been successful in helping recruiting small food business to embrace healthy menu changes.

Replicating this Innovation: Bite of HOPE is currently being partially replicated in Philadelphia.

Author(s):

Andrea Caracostis, MD, MPH, CEO, Asian American Health Coalition dba HOPE Clinic


Speaker(s):
  • Andrea Caracostis, MD, MPH
Transforming Oral Health Care Through the Use of Teledentistry Before, During, and After COVID-19: FQHCs’ PerspectiveTransforming Oral Health Care Through the Use of Teledentistry Before, During, and After COVID-19: FQHCs’ Perspective
CP41 - Transforming Oral Health Care Through the Use of Teledentistry Before, During, and After COVID-19: FQHCs’ Perspective
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CP41 - Transforming Oral Health Care Through the Use of Teledentistry Before, During, and After COVID-19: FQHCs’ Perspective

Poster Type: Research

Track/Topic: Technological Solutions and Tools to Improve Care and Population Health Management

Research Objectives: The objectives of this research were to identify and explain trends in how safety net clinics used teledentistry during the first year of the COVID-19 pandemic, to triage care for patients with dental emergencies, deliver preventive services, and manage progressive disease using minimally invasive dentistry.

Research Study Design/Methods: We conducted a community engaged mixed methods study with Health Choice Network (HCN). We extracted data including procedures, encounters, and patient information from the dental records of patients at twenty clinics (n=488,024). We conducted semi-structured individual interviews with representatives from these clinics (n=21). We analyzed interview transcripts, and member checked findings with community partners. Qualitative results guided the quantitative analysis, which we conducted by examining patterns and factors associated with teledentistry utilization. We then compared the results of the statistical analysis with those of the qualitative analysis to identify and seek to explain areas of concordance and discordance.

Research Principal Findings and Quantitative/Qualitative Results: Health centers that had used teledentistry before the pandemic; that had strong medical-dental integration in which telehealth was established on the medical side; whose states provided clear and early assurance of reimbursement; and that approached teledentistry as a “team effort” requiring ongoing training and commitment were more successful in utilizing teledentistry as a resource for serving dental patients during the pandemic. Conversely, health centers whose staff were skeptical of telehealth; who experienced reopening pressures from various stakeholders; or whose patient population faced intervening social determinants of health were less successful in optimizing teledentistry to address patients’ dental needs.

Research Conclusions on Impact on Health Centers: Teledentistry was an important resource that many safety net clinics used during the first year of the pandemic to triage patients with suspected dental emergencies, deliver preventive services, and manage progressive disease using minimally invasive techniques. Contextual factors including policy climate, staffing characteristics, and confidence in the modality influenced clinics’ introduction and sustainment of teledental services. Acknowledging the likelihood of future pandemics, teledentistry preparedness is an essential activity in pandemic preparedness to manage population-level disease, maintain revenue, and reserve in-person resources for emergency or urgent dental needs.

Authors:

Sarah Raskin, Consultant/ Assistant Professor, Virginia Commonwealth University

Madhuli Samtani-Thakkar, Biostatistician, Analytics and Evaluation, CareQuest Institute for Oral Health

Vuong Diep, Health Science Specialist, Analytics and Evaluation, CareQuest Institute for Oral Health

Farren Hurwitz, Business Development Manager, Health Choice Network

Julie Frantsve-Hawley, Director, Analytics and Evaluation, CareQuest Institute for Oral Health

Katherine Chung-Bridges, MD, MPH, Director of Research, Health Choice Network

Eric Tranby, Data and Impact Manager, Analytics and Evaluation, CareQuest Institute for Oral Health

Deborah George, Clinician, Jessie Trice Community Health Center Inc

Michelle Fundora, BHSA, CPHRM, Operations Manager, Health Choice Network

Margarita Ollet, MBA, BSN, RN, Executive Vice President and COO, Health Choice Network


Speaker(s):
  • Vuong Diep
  • Katherine Chung-Bridges, MD, MPH
  • Farren Hurwitz
  • Sarah Raskin
  • Michelle Fundora, BHSA, CPHRM
  • Eric Tranby
  • Julie Frantsve-Hawley
  • Margarita Ollet, MBA, BSN, RN
  • Deborah George
  • Madhuli Samtani-Thakkar
Research Ready: Improving Clinic-Based Research by Engaging Clinic Support StaffResearch Ready: Improving Clinic-Based Research by Engaging Clinic Support Staff
CP42 - Research Ready: Improving Clinic-Based Research by Engaging Clinic Support Staff
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CP42 - Research Ready: Improving Clinic-Based Research by Engaging Clinic Support Staff

Poster Type: Innovation

Primary Funding Source: Patient Centered Outcomes Research Institute

Category: Workforce

Issue or Challenge: Through our experience implementing research studies in Community Health Centers (CHCs) and other outpatient settings, the Louisiana Public Health Institute (LPHI) recognized that the role of clinic support staff is often overlooked. We found that when these staff are not comfortable with research, it hinders the success of studies and leads to poor experiences for patients, staff, and researchers. As more research is being conducted in clinical settings, engaging and training support staff members as champions for research will help equitably engage participants in non-traditional study sites, such as CHCs.

Description of Innovation: The project team designed, implemented, and evaluated Research Ready, a training to improve clinic staff capacity to partner in research. The training was developed to inform clinic staff, such as medical assistants and nurses, about basic research principles and considerations for supporting the implementation of research in a clinical setting. Research Ready is available in three formats: e-learning, facilitated session, and self-guided workbook.Research Ready was informed by interviews conducted with clinic support staff and researchers who had implemented studies in outpatient settings. Clinic staff from a variety of settings were interviewed, including Federally Qualified Health Centers (FQHCs), private healthcare systems, and academic medical centers. To date the training has been implemented and evaluated at over a dozen sites, including six FQHCs.

Impact or Result: Survey results showed that participants thought the Research Ready training was easy to understand and increased their knowledge about research. Results also showed that participants felt the information from the training was applicable to their jobs and helped them feel more comfortable talking with their patients about research.

Replicating this Innovation: Research Ready materials are available for free on LPHI’s website. Any organization who is interested can access and use the resources to implement the training. The e-learning module is a self-study option that can be integrated into an organization’s learning management system.

Author(s):

Daniele Farrisi, Senior Program Manager, Louisiana Pubic Health Institute

Margaret Sanders, Clinic Engagement Manager, Louisiana Public Health Institute


Speaker(s):
  • Daniele Farrisi
  • Margaret Sanders
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