Conexion: A localized information resource for a low-income Hispanic community

在全国范围内，拉美裔在获取健康信息方面存在许多障碍，并受到重大健康问题的影响 差距，包括不成比例的糖尿病和精神病负担。拉美裔美国人的比例是美国的1.7倍 可能已经被诊断出患有糖尿病，报告严重心理困扰的可能性是普通人的1.4倍。 与非西班牙裔白人相比。无法获得有用和可理解的健康信息意味着 拉美裔美国人的健康差距很大。从文化和地理角度定制信息，并使用 值得信赖的社区网站传播信息是有效的方法，可以改善获得卫生保健的机会 信息和减少拉美裔健康差距。我们项目的目标是开发、传播和 为低收入西班牙裔评估两种新颖的、情境化的“Conexion”健康信息资源 人口。Conexion资源的基本概念是结合高质量的健康信息 已经公开提供的资源(例如，到Medline Plus的链接)，具有本地资源、本地风味和 当地已知的可信实体的背书。为了传播Conexion资源，我们将利用 现有平台GetHealth Heights.org(GHH)，我们的团队将其开发为在线社区 华盛顿高地-因伍德社区的人们分享关于健康的资源。额外的初步报告 该项目的工作包括社区组织(CBO)之间建立的伙伴关系，以及 由24名国会预算办公室成员组成的温室气体排放指导委员会。具体目标是(1)开发Conexion 现有GHH平台关于糖尿病和抑郁症的本地化健康信息资源，通过 参与式、以用户为中心的设计过程：(A)吸引消费者、服务提供商、医疗专家、 以及(B)展示最终设计产品的可用性和可理解性；(2) 向华盛顿高地的低收入拉美裔目标人群传播Conexion-Inwood 通过两个CBO、一个初级保健机构和通过GHH直接进入，并应用RE-AIM框架 评估传播战略的覆盖范围、采用、实施和维护；以及(3)开展 对200名消费者进行的随机对照试验，以检查Conexion对：(A)抑郁或糖尿病的影响 知识，(B)使用抑郁症/糖尿病信息的自我效能(例如，与提供者沟通或 寻求专业帮助和服务，或参与治疗决定)；和(C) 病人激活。AIM 3试验的主要终点是患者激活，这将在以下一点进行评估- 一个月的随访。我们还将在试验结束后审查执行和可持续性方面的障碍。这 提案，涉及CBO、一名医学图书馆员和一名护士之间的积极合作 初级保健提供者网站，寻求在低收入人群中克服获取卫生信息的障碍 收入拉美裔美国人。Conexion为健康信息资源提供了一个可概括的模型，该模型可以 一旦进行了测试，并记录了经验教训，就可以在其他社区推广。

Nationwide, Hispanics have many barriers to accessing health information, and are subject to significant health disparities, including disproportionate burden of diabetes and mental illness. Hispanics are 1.7 times more likely to have been diagnosed with diabetes and 1.4 times more likely to report serious psychological distress, compared to non-Hispanics whites. Lack of access to useful and understandable health information represents a significant health disparity for Hispanics. Tailoring information culturally and geographically, and use of trusted community sites to disseminate information are effective approaches that can improve access to health information and reduce Hispanic health disparities. The goal of our project is to develop, disseminate, and evaluate two novel, contextualized “Conexion” health information resources for a low-income Hispanic population. The essential concept of a Conexion resource is to combine high quality health information resources that are already publicly available (e.g., links to Medline Plus) with local resources, local flavor, and endorsement from locally known trusted entities. To disseminate Conexion resources, we will leverage an existing platform, GetHealthyHeights.org (GHH), which our team developed as an online community to engage people in the Washington Heights-Inwood community to share resources about health. Additional preliminary work for this project includes established partnerships among community based organizations (CBOs), and the GHH Steering Committee, which consists of 24 CBO members. Specific aims are to (1) develop Conexion localized health information resources on diabetes and depression for the existing GHH platform through a participatory, user-centered design process that: (a) engages consumers, service providers, medical experts, and medical librarians, and (b) demonstrates usability and understandability of the final design products; (2) disseminate Conexion to the targeted population of low-income Hispanics in Washington Heights-Inwood through two CBOs, a primary care setting, and direct access through GHH, and apply the RE-AIM framework to assess reach, adoption, implementation, and maintenance of the dissemination strategies; and (3) conduct a randomized controlled trial of 200 consumers to examine impact of Conexion on: (a) depression or diabetes knowledge, (b) self-efficacy to use depression/diabetes information (e.g., to communicate with providers or family members, to seek professional help and services, or to participate in treatment decisions), and (c) patient activation. The primary endpoint for the Aim 3 trial is patient activation, which will be assessed at one- month follow up. We will also examine barriers to implementation and sustainability after the trial ends. This proposal, which involves an active collaboration between CBOs, a medical librarian, and a nurse practitioner primary care provider site, seeks to overcome barriers to health information access in a population of low- income Hispanics. Conexion provides a generalizable model for a health information resource that can be replicated in other communities once it is tested and lessons learned are documented.