Phillips County (Arkansas) Courthouse (Getty Images)
A UAMS project aimed at improving the health of medically underserved people in the Arkansas Delta is expanding its outreach in partnership with UCLA and Howard University researchers.
Both the Arkansas project and the UCLA/Howard project seek to gather data on health needs and outcomes as well as provide information and resources to “historically marginalized and disadvantaged populations,” according to a UAMS press release.
With help from a $1.7 million CDC Foundation grant, UCLA and Howard researchers began Project REFOCUS (Racial Ethnic Framing of Community-Informed and Unifying Surveillance) in October 2020 to study COVID-19-related stigma and discrimination in underserved communities and provide related real-time information through an electronic dashboard, the press release said.
The UAMS Heart Health Communities project is the sixth project in the nation to be selected to work with Project Refocus.
But the Arkansas project had already been at work in Phillips County, in an area of the state known as the Delta and known for high levels of poor health and low income. Over the past two years, Heart Healthy Communities developed a network of local providers and other community partners to connect people with resources to improve health and wellness.
“We have community health workers going door to door. Once we gain the trust of residents, our system can be modified to gather data or dispense information,” said Irion “Chip” Pursell Jr., a UAMS public health specialist and principal investigator for the project.
“Our goal initially was to gather data to determine how to rebalance health outcome disparity,” he said.
“Poor health outcomes tend to cluster in low-wealth neighborhoods, and the HHC community-centric approach facilitates the collection of actionable data that can be integrated into the Project Refocus dashboard,” Pursell said.
“Refocus gives us another tool,” he said. “What I like about its dashboard is a nearly unlimited ability to enter data” down to the community level. The dashboard already has national, state and some county level data available.
“The other benefit (of the dashboard) is letting clients know about the availability of this data, which can be very granular,” Pursell said. “If clients, say, want to advocate for a new park or if county government wants to know where a new ambulance is needed, they’ll have the data to help them decide.”
Heart Healthy Communities is funded by a $70,000 grant from the U.S. Office of the Assistant Secretary of Health and Human Services. The project initially had four part-time community health workers. Participation in Project Refocus will allow HHC to add two full-time workers.
Chandra L. Ford, who leads the UCLA research team, said Project Refocus aims to determine what types of information needs to be included on the dashboard. That determination will be “guided by input from the community,” she said.
One of the project’s goals is to reduce mistrust in disadvantaged communities, said Ford, who is the founding director of the UCLA Fielding School of Public Health’s Center for the Study of Racism, Social Justice & Health, and a professor in the UCLA Department of Community Health Sciences.
“Public health practitioners face challenges in effectively monitoring the presence, spread and impacts of COVID-19 among these disadvantaged populations,” said Ford.
“Lessons learned from prior epidemics, such as HIV/AIDS, make it clear that stigma and mistrust slow disease mitigation efforts among the most disadvantaged populations, contribute to mistrust of public health messages, delay access to services and reduce adherence to treatment,” she added.
“This mistrust is rooted not in science denialism, but in legitimate concerns about the unequal treatment African American and other communities have received in health care.”
Monica Ponder, an epidemiologist and assistant professor of health communication at Howard University, noted that “during crises, fear can have a counter effect on access and adherence to community-level mitigation efforts.”
“Chronic stress is an important pathway by which stigma influences physical and mental health,” she said. “That can become a vicious cycle, fueled by racism and bias. Public health crisis communications must recognize the historical trauma, lived experiences and political climate in which people reside.”
The CDC Foundation is an independent, nonprofit organization created by Congress to mobilize philanthropic and private-sector resources to support the work of the Centers for Disease Control and Prevention and the public health community.
The University of Arkansas for Medical Sciences is the state’s only health sciences university.
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