A nationwide study by the UCLA Center for Health Policy Research shows providing health services in unorthodox settings helps underserved adults get preventive care.

With support from the Centers for Disease Control and Prevention, the study’s authors reviewed 142 outreach programs nationwide and identified 20 that successfully used non-traditional settings, such as churches and parks, to promote or deliver preventive services (such as bone density and cancer screenings) to older underserved populations.

“The research shows that health providers might need to think outside the box on how and where to deliver health services,” said Janet Frank, lead author of the study and an adjunct associate professor at the UCLA Fielding School of Public Health. “The programs that fared the best did not wait for patients to come to them--they went to where the patients were.”

Being in a culturally familiar place increases a person’s comfort level and encourages him or her to ask questions, Frank noted.

“For many older adults, it’s more inviting to have coffee and chat with a small group about health issues than go to a hospital or doctor’s office,” she said. “Once they’re engaged in discussion, they’re more likely to get the blood pressure reading or flu shot.”

The authors noted that adults age 50 and older from various racial and ethnic groups have rates far below the targeted national goals for many preventive services. African Americans had the lowest rate of flu vaccinations at 52 percent, which is well under the target of 90 percent. Asian women had the lowest participation rate for mammograms, 64 percent, compared to a target of 81 percent.

To reach these at-risk groups, providers offered services in community settings, including churches, neighborhood homes, offices, parks, and YWCA facilities.

To strengthen delivery and expansion of preventive health services to diverse, underserved, older adults, the authors have four policy recommendations: ensure funding to establish and integrate a program into a host organization for continuity; create written materials that could be “culturally tailored” to fit more than one group; offer financial incentives to community-based programs and clinical providers to encourage them to partner together; and have health service providers bring services to where people live, work and gather.

Creation and dissemination of program data is one key element, the authors wrote: "Funders need to support published work (and access to it) that includes manuals of procedures, implementation guidelines, and other materials so program planners will have the road maps they need to assure successful replication. These types of materials should routinely be components of final progress reports to funding agencies and should be made available in the public domain."

The study is available here.

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