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.

Testing for Turkeys Faith-Based Community HIV Testing Initiative: An Update.

Testing for Turkeys (TFT) HIV/hepatitis C virus (HCV) and sexually transmitted infection (STI) testing initiative is a joint effort between Older Women Embracing Life (OWEL), Inc., a nonprofit faith-based community HIV support and advocacy organization; the Johns Hopkins University Regional Partner MidAtlantic AIDS Education and Training Center (MAAETC); and the University of Maryland, Baltimore JACQUES Initiative (JI), and is now in its 11th year of providing HIV outreach, testing, and linkage to care. Since 2008, the annual TFT daylong community HIV testing and linkage to care initiative has been held 2 weeks before Thanksgiving at a faith-based center in Baltimore, Maryland, in a zip code where one in 26 adults and adolescents ages 13 years and older are living with HIV (Maryland Department of Health, Center for HIV Surveillance, Epidemiology, and Evaluation, 2017). TFT includes a health fair with vendors that supply an abundance of education information (handouts, videos, one-on-one counseling) and safer sex necessities, including male and female condoms, dental dams, and lube. Nutritious boxed lunches and beverages are provided to all attendees and volunteers. Everyone tested for HIV who stays to obtain their results is given a free frozen turkey as they exit. The Baltimore City Health Department is on hand with a confidential no-test list (persons in the state already known to have HIV) to diminish retesting of individuals previously diagnosed with HIV. However, linkage to care is available to everyone: newly diagnosed individuals and those previously diagnosed and currently out of care.

Evaluation of a nursing student health fair program: Meeting curricular standards and improving community members' health.

BACKGROUND: Public health nursing (PHN) is an essential component of baccalaureate nursing education. In order to build PHN competencies, universities must design and operationalize meaningful clinical activities addressing community and population health. Currently, there is a paucity of literature delineating best practices for promoting competency in PHN. AIMS: The purpose of this manuscript is to describe a PHN-student health fair program as a means for meeting undergraduate PHN curricular standards, and to report results of an evaluation conducted examining its effectiveness in improving community member's health knowledge. METHODS: Health fairs were held at community agencies that served the homeless or victims of intimate partner violence. A total of 113 community members that attended a health fair were assessed at baseline and immediate posttest using open-ended questionnaires. The design of the health fairs included a community assessment, intervention, and evaluation flow that followed the nursing process. RESULTS: We report that results from participants surveyed indicated that PHN-student delivered health fairs improved health knowledge among community members in this sample (p = .000). CONCLUSION: Health fairs conducted by PHN students appear to be promising community health promotion and disease prevention interventions that can serve as an effective strategy for teaching PHN student competencies and facilitating engagement with the community.

A bi-level intervention to improve oral hygiene of older and disabled adults in low-income housing: results of a pilot study.

OBJECTIVE: This paper describes the results of a bi-level intervention, using a cognitive-behavioral theoretical approach, to improve the oral hygiene of older adults and the disabled in community-based low income senior housing. METHODS: The bi-level pilot intervention consisted of an on-site tailored adapted motivational interviewing (AMI) session and two oral health fairs, supported by a resident campaign committee, to change community norms. All materials were available in English and Spanish. Participants completed a survey consisting of 12 domains that provided the basis for tailoring the AMI and shaping the campaigns. The domains were activities of daily living (ADLs), access to oral health information, oral hygiene status, dental knowledge, hygiene behaviors, importance of oral hygiene, self-efficacy/locus of control, diet, intentions, self-management worries/fears, perceived risk and dry mouth. MAIN OUTCOME MEASURES: Each participant received clinical assessments consisting of full-mouth plaque score (PS) and gingival index (GI) before the intervention and at three months. RESULTS: Twenty-seven residents with at least one tooth completed all phases of the study. The mean number of domains requiring attention was 4.5 (SD 1.6) with a range of one to seven. Mean baseline PS was 83% (SD 16%) which improved significantly to 58% (SD 31%); mean baseline GI was 1.15 (SD 0.61) and improved significantly to 0.49 (SD 0.46). CONCLUSIONS: This pilot study supports the feasibility and acceptability of a tailored oral hygiene intervention among older and disabled adults living in low income senior housing. Although a small sample, the study demonstrated significant improvements in both plaque and gingival scores three months after the bi-level intervention.

The community comes to campus: the Patient and Community Fair.

BACKGROUND: Community-based learning connects students with local communities so that they learn about the broad context in which health and social care is provided; however, students usually interact with only one or a few organisations that serve a particular population. One example of a community-based learning activity is the health fair in which students provide health promotion and screening for local communities. CONTEXT: We adapted the health fair concept to develop a multi-professional educational event at which, instead of providing service, students learn from and about the expertise and resources of not-for-profit organisations. INNOVATION: The fair is an annual 1-day event that students can attend between, or in place of, classes. Each community organisation has a booth to display information. One-hour 'patient panels' are held on a variety of topics throughout the day. Evaluation methods include questionnaires, exit interviews and visitor tracking sheets. Over 5 years (2009-2013), the fair increased in size with respect to estimated attendance, number of participating organisations, number of patient panels and number of students for whom the fair is a required curriculum component. Students learn about a range of patient experiences and community resources, and information about specific diseases or conditions. IMPLICATIONS: The fair is an efficient way for students to learn about a range of community organisations. It fosters university-community engagement through continuing connections between students, faculty members and community organisations. Lessons learned include the need for community organisations to have techniques to engage students, and ways to overcome challenges of evaluating an informal 'drop-in' event. The fair is an efficient way for students to learn about a range of community organisations.

A collaborative communitywide health fair: the process and impacts on the community.

The purpose of this article is to describe the process of conducting a collaborative communitywide health fair, and the impacts of such health intervention programs on community members. A community health fair addresses the health access needs of underserved populations. The success or effectiveness of such community-based programs requires systematic approach to assessment, planning, implementation, and evaluation. The PRECEDE˜PROCEED model was used as the guiding framework. The health fair described in this article was coordinated by nurses and drew resources from multiple health providers and organizations. The fair provided opportunities for vulnerable populations to access and utilize appropriate and comprehensive health services, resources and education.

Student-led rural health fairs: attempting to improve medical education and access to health care.

OBJECTIVES: Residents of rural communities, especially in the Southeast, have decreased access to health care. Ensuring medical students receive adequate exposure to their issues is complicated by the urban location of most schools. We describe health fairs conducted in rural communities to suggest how having medical students use screening tools can identify patients with risk factors for disease which can offer students the opportunity to learn about rural health issues through patient counseling. METHODS: The Mitchell Wolfson Sr. Department of Community Service, a University of Miami Miller School of Medicine student-led organization, conducts fairs at four sites throughout the rural Florida Keys. Medical students, under the supervision of attending physicians, offer screening and preventive health services including risk factor screening for cardiovascular disease, ophthalmological exams, dermatologic exams, osteoporosis screening, and female exams with pap smears. These fairs were reviewed. RESULTS: In the past three years, 1694 unique patients were seen. Many lacked a primary care provider (46%) or health insurance (43%) and were provided screening for several disorders including cardiovascular disease risk factors (hypertension, diabetes, dyslipidemia, and obesity). Screening revealed that many patients (41%) had multiple markers of elevated cardiovascular disease risk. This provided experiences to more than 200 students each year. CONCLUSION: Fairs provide medical students exposure to rural health issues through the valuable opportunity of using risk factor screening tools and counseling. This provides valuable information to patients of rural communities. Future research should examine how fairs influence student knowledge and attitudes toward rural health and affect health outcomes.

Blood pressure screenings through community nursing health fairs: motivating individuals to seek health care follow-up.

PURPOSE: To evaluate the effectiveness of blood pressure [BP] screenings through community-based health fairs. Effectiveness was measured by those with high BP readings who either made an appointment with or actually followed up with their primary care provider [PCP] in person following post-screening referral. DATA SOURCES: Anonymized data were provided for 958 individuals who obtained BP screening through a three-day health fair provided by the Ceres Police Department Nurse Program. CONCLUSIONS: Of 958 screened, 170 (17.8%) were identified with high BP readings and provided with PCP referral. Data were analyzed on 124 individuals with high BP recordings. Of the 124 PCP referrals, 116 (93%) either made an appointment with or followed up in person with their PCP following BP screening. Of the 98 who visited with their PCP, 29 (30%) were either placed on BP medication, had their current BP medication dose increased, or were changed to another BP medication by their PCP. IMPLICATIONS FOR PRACTICE: Hypertension remains a leading cause of morbidity and mortality. Nurse-operated health fairs, crafted to identify those with high BP readings, are promising as a simple and effective means in motivating individuals to seek follow-up care.

A community intervention to prevent traffic accidents among bicycle commuters.

OBJECTIVE: To evaluate an educational intervention designed to prevent traffic accidents among workers that use the bicycle for commuting. METHODS: A longitudinal intervention study with a stepped wedge implementation was carried out between January 2006 and May 2007. Five neighborhoods with distinct geographic characteristics were selected in the city of Pelotas, Brazil, and 42 census tracts were randomly selected from these neighborhoods. All households were screened for male bicycle commuters, resulting in a sample of 1,133 individuals. The outcomes analyzed were "traffic accidents" and "near accidents". The cyclists were interviewed monthly by phone to record traffic accidents and "near accidents". Every 15 days, from the second month of study, a group of about 60 cyclists was invited to attend the intervention meeting that included an educational component (a talk and a video presentation), distribution of a safety kit (reflective belt & sash, reflective tape and an educational booklet) and a bicycle breaks check-up (maintenance performed if necessary). Poisson regression adjusted for time effect was used to assess the intervention effect. RESULTS: Nearly 45% of the cyclists did not attend the intervention. During the study period, 9% of the study individuals reported a traffic accident and 88% reported a "near accident". In total there were 106 accidents and 1,091 near accidents. There was no effect observed from the intervention on either of the outcomes. CONCLUSIONS: The intervention tested was not capable of reducing traffic accidents among bicycle commuters. Lack of interest in safety by commuters and external factors, such as road design and motorist behavior, may have together influenced this result.

A randomized community-based intervention trial comparing faith community nurse referrals to telephone-assisted physician appointments for health fair participants with elevated blood pressure.

OBJECTIVE: To measure the effect of faith community nurse referrals versus telephone-assisted physician appointments on blood pressure control among persons with elevated blood pressure at health fairs. METHODS: Randomized community-based intervention trial conducted from October 2006 to October 2007 of 100 adults who had an average blood pressure reading equal to or above a systolic of 140 mm Hg or a diastolic of 90 mm Hg obtained at a faith community nurse-led church health event. Participants were randomized to either referral to a faith community nurse or to a telephone-assisted physician appointment. The average enrollment systolic blood pressure (SBP) was 149 +/- 14 mm Hg, diastolic blood pressure (DBP) was 87 +/- 11 mm Hg, 57% were uninsured and 25% were undiagnosed at the time of enrollment. RESULTS: The follow-up rate was 85% at 4 months. Patients in the faith community nurse referral arm had a 7 +/- 15 mm Hg drop in SBP versus a 14 +/- 15 mm Hg drop in the telephone-assisted physician appointment arm (p = 0.04). Twenty-seven percent of the patients in the faith community nurse referral arm had medication intensification compared to 32% in the telephone-assisted physician appointment arm (p = 0.98). CONCLUSIONS: Church health fairs conducted in low-income, multiethnic communities can identify many people with elevated blood pressure. Facilitating physician appointments for people with elevated blood pressure identified at health fairs confers a greater decrease in SBP than referral to a faith community nurse at four months.

Case-finding in the community: the results 2.

Improving the health and well-being of the population is at the centre of policy development, and the vision is to involve individuals, families and communities. The Case-finding in the Community Project was designed to build upon the established relationship between district nursing and the local community of East Belfast, working together to improve the health of adults in the community using a case-finding approach. The aims were to improve the early detection of long-term conditions, to increase access to primary care and the specialist nursing services, and to further develop the working partnership with East Belfast Community Health Information Project. Between September 2006 and March 2007, 351 people attended 17 health fairs in East Belfast at a range of venues. There were 115 people with identified risk factors for respiratory, cardiac, diabetes and hypertension. From the results of this project, there is a need for 'case-finding' patients with the potential to develop chronic disease management.

"Have you seen your aura lately?" examining boundary-work in holistic health pamphlets.

An increasing number of people in the United States are using holistic therapies. Both encouraging and informing this trend in growth, printed leaflets are a popular and important medium for holistic health practitioners. Using a discourse analytic approach, the author analyzed pamphlets and printed texts distributed at a holistic health fair. These texts reflect and construct specific understandings of holistic health and proper health care. Understood through the notion of boundary-work, pamphlets demarcated holism as the proper way of conceptualizing health and health care. However, holistic medicine's boundaries are quite porous, as these practices are also legitimized through the use of scientific conventions and the practice of integration, both commonly associated with biomedicine.

Combining health promotion classroom lessons with health fair activities.

This article focuses on the important role of the school nurse in promoting healthy lifestyle choices through networking, resource identification, and working with community partners. "Everyone Is Healthy at Northeast" was a health promotion program designed and presented in two ways: classroom lessons and a health fair. There were interactive health promotion classroom lessons on topics such as proper hand washing, the effects of tobacco, and keeping one's heart healthy. These lessons were enhanced by community partners in delivering the healthy lifestyle message through a variety of teaching methods: music, interactive games, and hands-on visuals. The health promotion education program culminated in a schoolwide health fair that showcased the healthy lifestyle choice information at various stations. "Everyone Is Healthy at Northeast" was a success and promoted healthy lifestyle choices through creativity, collaboration, and support from the entire school community.

Health fairs: An avenue for colon health promotion in the community.

Colon cancer is the number two cause of cancer deaths in both men and women in the United States. Colon cancer is 90% treatable if diagnosed early, yet only 41% of Americans over age 50 who should be screened have been. Two of the reasons why so many people are not screened include the lack of public awareness about colorectal cancer and the need for regular screening, and the lack of social support for discussion of the "disease down there." GI nurses can use hospital, community, and university health fairs as an opportunity to educate their communities on the prevention of and screening for colon cancer. Suggestions are given on how to: be included in a health fair, set up the booth, obtain information to distribute, develop a display of educational materials, "hook" the audience, and educate attendees on a cancer prevention diet and exercise program. The American Cancer Society Screening Guidelines and factors that increase colon cancer risk are listed. A colon cancer screening questionnaire is included for attendees to take home, complete, and discuss with their private physicians. A health fair is presented as a fun way to promote the prevention of and screening for colon cancer.