Involving Communities in Multicultural Network: From Screening to Access to Care

描述（由申请人提供）：拟议的社区参与式研究（CBPR）项目将促进社区成员的参与和投入，以改善已建立的多元文化网络/护理系统。具体而言，该项目将侧重于改善心血管风险因素领域的外展和获得护理的机会，使用社区通过CBPR过程建议的文化适当方法。该项目支持NIH和NHLBI的使命，致力于开发一种创新的、以社区为基础的模式，以提高低收入、无保险的少数群体获得医疗保健的机会。该项目将作为一个试点，将社区重建纳入一个大型多元文化社区的发展中护理网络，整合基线和进程后执行评估组成部分，以不断加强已制定的外联战略，增加获得护理的机会。由马里兰州蒙哥马利县初级保健联盟（PCC）协调的非营利组织合作提供的多元文化护理网络/系统目前提供多个护理站点，已成功实施共享电子医疗记录，并包括针对非裔美国人、亚裔美国人和拉丁裔人口的少数族裔健康计划。该项目将建立在这些举措以及县支持的蒙哥马利关怀计划的基础上，并将纳入社区不同层面的参与，以确定最适当的外展和获得每种代表文化的护理战略。该项目的实施将以PRECEDE-PROCEED模式为指导，由社区成员做出关键决定。对表现出心血管疾病风险因素的参与者的预期干预措施包括：在网络诊所提供进一步评估的预约，提供翻译服务，为参与者提供有关健康保护和医疗保健服务费用/资格的预防方法的咨询，并提供有关社区支持团体的信息。预计将为广大社区作出更多努力，包括开展教育和外联活动，让社区成员了解筛查的机会。此外，该项目预计将建立一个基线和监测数据库，以支持项目评估和未来的项目扩展。该项目与公共卫生相关，因为CBPR有可能解决医疗保健系统中与每个种族/族裔群体相关的社会和文化问题相关的挑战性差距，并且如果得到解决，可以促进外展，健康意识，最危险人群的筛查参与，并最终获得护理。在社区伙伴和当地卫生诊所的支持下，项目小组计划减少差异，改善多元文化社区的健康状况。

DESCRIPTION (provided by applicant): The proposed community based participatory research (CBPR) project will promote the involvement and input of community members to improve an established multicultural network/system of care. Specifically, this project will focus on improving outreach and access to care in the area of cardiovascular risk factors, using culturally-appropriate approaches suggested by the community via the CBPR process. This project supports the missions of both the NIH and the NHLBI by working to develop an innovative, community-based model for enhancing access to medical care for low-income, uninsured, minority populations. This project will serve as a pilot to embed CBPR into the developing care network of a large multicultural community, integrating baseline and post-process implementation evaluation components to permit continuous enhancement to the developed strategies for outreach and increased access to care. The multicultural network/system of care, provided by a collaboration of nonprofit organizations coordinated by Primary Care Coalition (PCC) of Montgomery County, MD, currently offers multiple care sites, has successfully implemented shared electronic medical records, and includes minority health initiatives for African American, Asian American, and Latino populations. This project will build on these initiatives, as well as the county-supported Montgomery Cares program, and will incorporate participation from different levels of the community to determine the most appropriate outreach and access to care strategies for each of the represented cultures. Implementation of the project will be guided by the PRECEDE-PROCEED model, with community members making key decisions. Anticipated interventions for participants who exhibit risk factors for cardiovascular disease include: providing an appointment for further evaluation at the network clinics, offering translation services, counseling participants about preventive approaches to health preservation and costs/eligibility for health care services, and supplying information about community support groups. Anticipated additional efforts for the community-at-large will include education and outreach campaigns to inform community members of opportunities for screening. Further, this project anticipates establishing a baseline and surveillance database to support program evaluation and future expansion of the project. This project is relevant to public health because CBPR has the potential to address challenging gaps in the health care system related to social and cultural issues pertinent to each racial/ethnic group represented, and, that if addressed, can facilitate outreach, health awareness, screening participation of those most at risk, and ultimately access to care. With community buy-in and support from community partners and local health clinics, the project team plans to reduce disparities and improve health in a multicultural community.