Screening children for type 1 diabetes-associated antibodies at community health fairs.

OBJECTIVE: The incidence of type 1 diabetes (T1D) is increasing, most notably in young children and in racial and ethnic minorities. Historically, screening for risk with T1D-associated antibodies has been limited to those with a family history, while up to 90% of newly diagnosed patients lack such a family history. To address the needs to screen diverse ethnic groups in the general population, we screened children for T1D-associated antibodies in the Denver, Colorado metro area at community health fairs. METHODS: Children attending health fairs from 2015 to 2018 were offered free T1D screening by measuring the four prototypical T1D-associated antibodies. A finger stick capillary puncture was performed to collect blood spots on filter paper. Dried blood spots (DBSs) were eluted and antibodies were measured using fluid-phase radio-binding assays. RESULTS: At 39 health fairs, children were educated on the signs and symptoms of diabetes, and screened for T1D-associated antibodies (n = 478), which represented 90% of those that attended. Median age was 9.0 years (range of 1-18) with diverse ethnic backgrounds: 37% Hispanic, 31% Caucasian, 20% African American, and 12% other. Nine children screened positive for antibodies, single n = 8 and multiple n = 1, and confirmation with serum samples showed excellent correlation to the measurements from DBSs for antibodies directed against GAD, IA-2, and ZnT8 (P < .01 for each). CONCLUSIONS: Screening for T1D risk at community health fairs using DBSs on filter paper is feasible and provides an avenue to screen children from ethnically diverse backgrounds.

Mechanical falls: are patients willing to discuss their risk with a health care provider?

BACKGROUND: Falls in the elderly cause serious injury. OBJECTIVE: We aimed to determine subjects' comfort in discussing fall risk and home safety evaluations. METHODS: This prospective study surveyed a convenience sample of subjects (≥50 years old) in an emergency department (ED), health fair (HF), and family practice (FP). The survey included the Falls Efficacy Scale and Vulnerable Elders Survey-validated surveys measuring fall concern and functional decline. Other data-environmental living conditions, participant behaviors, fall frequency-were collected. The associations between perceived fall risk and participant characteristics were assessed using descriptive statistics and random-effects logistic regression. RESULTS: Participants (n = 416, 38% males, 62% females) had a mean age of 67.6 years; 35% were high fall risk. Previous year falls (p = 0.002), use of assistive device (p < 0.001), having at least one alcoholic drink/week (p = 0.043), and poor or fair perceived health status (p < 0.001) were associated with perceived fall risk. HF respondents were more willing than FP respondents to discuss falls (84.9% vs. 73.1%, p = 0.025). The difference was not significant between the HF and ED respondents (84.9% vs. 76.9, p = 0.11). HF subjects were more willing than FP to have a home safety inspection (68.9% vs. 45.9%, p < 0.001). The difference was not significant between the HF and ED respondents (68.9% vs 58.5, p = 0.09). CONCLUSIONS: Perceived and actual fall risks are highly associated. Most participants are willing to discuss their fall risk and a home safety evaluation. HF subjects were most willing to have these discussions; ED subjects were less willing than HF, but not significantly different from health fair participants. FP participants were significantly less willing to have these discussions than HF participants. This may suggest a meaningful opportunity for fall risk prevention in outpatient settings such as health fairs and the ED.

The reach and rationale for community health fairs.

Latinos living in the USA account for one third of the uninsured population and face numerous cultural, linguistic, and financial barriers to accessing healthcare services. Community health fairs have developed to address the unmet need for no- and low-cost services that target prevention and education among underserved communities. The current research describes an ongoing effort in a community in Southern California and examines the barriers to health care among participants registering to receive free breast health screenings, one of the major services offered at a 2010 health fair. A total of 186 adult Latina women completed a brief questionnaire assessing their healthcare utilization and self-reported barriers to engaging in preventive and screening services. Approximately two thirds of the participants reported never receiving or having more than 2 years passing since receiving a preventive health check-up. Participants identified cost (64.5%) and knowledge of locations for services (52.3%) as the primary barriers to engaging in routine healthcare services. Engaging with health professionals represents a leading way in which adults obtain health information; health fairs offering cancer health screenings represent a culturally appropriate venue for increased cancer health equity. Implications of the current research for future health fairs and their role in community cancer education are discussed.

Tobacco use and interest in smoking cessation among Latinos attending community health fairs.

Health fairs are vital for reaching underserved Latinos providing access to health services including smoking cessation. The purpose of this study is to describe tobacco use and interest in smoking cessation among Latino smokers attending community health fairs. We surveyed 262 self-identified Latinos attending health fairs; we assessed smoking behavior and attitudes of 53 (20.2%) current smokers. Smokers were mostly uninsured (98.1%), male (54.7%), recent immigrants (96.2%) with limited English proficiency (60.4% spoke Spanish at home), and were mainly light (86.3%) and nondaily (58.7%) smokers. Although most participants attempted to quit smoking at least once in the past year, only 5.0% of current smokers reported ever using cessation medication and 94.3% were unaware of free-telephone counseling. The majority of smokers were ready to quit within 30 days and were interested in participating in cessation programs. Health fairs provide a unique opportunity to address smoking cessation among underserved Latinos with limited knowledge of access to, and use of effective cessation services.

Competing hypotheses of missing data among older adults.

To explain missing data in a study of 83 older adults, hypotheses regarding fatigue and age were proposed, the former (fatigue) appearing more likely.

Recomendaciones para una presentación oral / Recommendations for oral presentations

Los profesionales de la salud deben ser competentes en el desarrollo de su disciplina, pero además deberán ser hábiles en el manejo de las herramientas destinadas a la comunicación, cuyo uso será necesario en algún momento de su carrera profesional. El presente artículo describe algunos de los elementos que intervienen antes, durante y después de la comunicación oral y que pueden ser útiles para mejorar las habilidades personales para realizar una exposición oral. Enfrentarse a una audiencia puede producir cierta angustia y nerviosismo que es necesario controlar, la preparación de la intervención oral y de los medios audiovisuales, así como el uso de los elementos paralingüísticos y el lenguaje del cuerpo, pueden disminuir la tensión nerviosa y aumentar el rendimiento de la exposición oral, condiciones indispensables para una exposición efectiva (AU)

Older, hypertensive, and hypercholesterolemic fairgoers visit more booths and differ in their health concerns at a community health fair.

The purpose of this study was to determine whether persons attending a community health fair had different health concerns and booth visitation patterns based on their risk factor profiles. All fairgoers were encouraged to complete an anonymous survey of demographic information, top 4 health concerns, and selected cardiac risk factors. Over the five-hour duration of the fair, 329 surveys were collected from about 450 fairgoers. There were no exclusion criteria for the survey. The fair was sponsored by the Maryland Chapter of the American College of Physicians, organized by medical students from the University of Maryland and Johns Hopkins University, and included 23 booths on a variety of health topics. Older fairgoers and fairgoers with a self-reported history of high blood pressure or elevated cholesterol showed an increased interest in hypertension and heart disease (p < 0.05). Older fairgoers also showed an increased interest in health topics related to aging, such as estrogen replacement therapy and geriatric medicine. Older, hypertensive and hypercholesterolemic fairgoers visited an increased mean number of total booths when compared to other respondents (p < 0.05). Most booths reported a higher percentage of older, hypertensive, and hypercholesterolemic visitors than the overall percentage of fairgoers who reported these risk factors. These results suggest that booth visitation patterns of health fair participants may be viewed as a deliberate attempt by at risk populations to access health information particular to their needs.

The health beliefs of health fair participants.

The motivations and health beliefs of adults who participate in community-based health promotion were studied through a survey of 303 adults attending five community health fairs. Subjects were predominately female (69.9%), over age 60 (66.8%), and had at least yearly contact with a family physician (85.3%). Obtaining laboratory testing services was the sole reason for attendance for 47% of participants, was thought to be of much greater importance than health educational materials also offered at the health fair, and identified as providing a sense of control over personal health care. Receiving their own normal test results was perceived as assuring a "healthy" future for 86% of participants and few used these results to support erroneous health beliefs. A theme of "positive health feedback", identified through factor analysis of survey responses, may prove useful for family physicians to incorporate into more directed and useful health promotion efforts for enhanced patient participation and satisfaction.

The purpose of health fairs as perceived by university-based health educators.

The purpose of this study was to assess the attitudes of university-based health educators on the role of health fairs. Ninety-nine health educators from throughout the country completed a three-part survey requesting information regarding local health fairs, demographics of the respondent, and a series of Likert-type questions regarding the role and function of health fairs. Results indicate that one's level of training and level of involvement played a significant role in determining attitudes regarding the purpose of health fairs. Health educators with doctoral training, when compared to individuals with master's-level training, were less likely to approve of health fairs.

Screening for ischaemic heart disease risk factors at a health fair: low attendance by those at highest risk.

Among people attending a heart disease screening project at a Health Fair in Sheffield, only 22 of 425 (5.2%) lived in areas with more than 25% of the population belonging to social classes IV or V. The incidence of heart disease is known to be particularly high in these areas, where 15.1% of the total population live. By analysis of the attendance rates from districts other than those immediately adjacent to the site of the Health Fair, we found that the strength of this inverse correlation increased, suggesting that the problems of access are probably greater for people living in deprived areas than for others.