Let’s Talk about TB
More than half of active tuberculosis (TB) cases in the United States occur in foreign-born individuals; the majority of these cases are attributable to reactivation of latent TB infection (LTBI). Reactivation of LBTI may be prevented with appropriate screening and treatment of those at risk.
More than half of active tuberculosis (TB) cases in the United States occur in foreign-born individuals; the majority of these cases are attributable to reactivation of latent TB infection (LTBI). Reactivation of LBTI may be prevented with appropriate screening and treatment of those at risk. Hawthorne Education Center (HEC) serves up to 2,500 adult learners each year; approximately 85% are foreign-born, of whom about three quarters are from high TB burden countries. HEC experienced frequent cases of active TB among its adult learners, which caused worry about health and disruption to the school. Past attempts to address TB at HEC through traditional ways had been ineffective. Hence, in 2004, HEC staff approached researchers at Mayo Clinic for help to address this issue over the long-term. A CBPR partnership was formed.
Let’s Talk about TB is a tuberculosis prevention and control program at HEC, and was the first CBPR project for RHCP. The community-academic research team provided orientation to CBPR. HEC staff and Mayo Clinic researchers developed the research strategy. Training workshops in focus group moderation enhanced community capacity to participate in the research process. Focus groups were conducted to understand HEC learners’ perception of TB and barriers and facilitators to screening and treatment. Together, HEC staff, learners and researchers developed educational tools to help answer and explain the most common TB questions and concerns in the Rochester community. Socio-culturally sensitive and linguistically appropriate educational tools (posters, leaflets, videos), and a series of innovative educational interventions including classroom discussions, interactive learning experiences, and demonstration of TB testing were shown around World TB Day each year for three years. Learners were given the opportunity to sign up for and get the test on-site. Those found to have positive test results were referred to the local health department for further evaluation and management.
TB education and screening continues at HEC annually. A streamlined procedure for follow-up care at the Olmsted County TB Clinic is in place.
Funding
National Institutes of Health: National Institute of Allergy and Infectious Diseases (R03 AI82703)
Mayo Clinic: Department of Medicine, and Center for Clinical and Translational Science
Let’s Talk
Healthy literacy influences health behaviors and health outcomes. It is estimated that close to half of the adult United States population is functionally illiterate when it comes to health.
Healthy literacy influences health behaviors and health outcomes. It is estimated that close to half of the adult United States population is functionally illiterate when it comes to health. Adults with low literacy levels are disproportionately racial and ethnic minorities. Let’s Talk was a pilot project to test the feasibility and sustainability of a community-based health literacy curriculum aimed at improving knowledge and healthy behaviors on topics identified by the community.
The project consisted of a series of information sessions where students of Winona State University Graduate Programs in Nursing, who are registered nurses, discuss health-care system navigation, health prevention, health promotion, and chronic disease management with members of African American, Cambodian, Hispanic, Somali and Sudanese communities who participated in the program. Nurses worked closely with community leaders or liaisons on refining the program to meet community needs. These information and learning sessions took place in various locations around Rochester, such as schools, community centers, homes, and religious gathering places. Sessions varied for different community groups, based on the recommendations of the respective community leaders or liaisons. For example, sessions were incorporated once a week during Cambodian Cultural School, and after church services with Sudanese families and those belonging to the African American community. Nurses met with elderly Somalis at the common room of their apartment building, and with Hispanic families at home. In many instances, the sessions followed the curriculum contained in a book called Staying Healthy from the Florida Literacy Coalition, Inc., which was adapted to provide Minnesota specific health resource information, and expanded to focus on topics of interest identified by Rochester communities. Click for PDF.
Funding
Winona State University Foundation
Mayo Clinic: Center for Clinical and Translational Science
Club Fit
Club Fit was an initiative aimed at promoting healthy habits and preventing excess weight gain among children members at the Boys and Girls Club of Rochester, Minnesota (BGCR). Obesity is associated with increased risk for cardiovascular, metabolic, and other health conditions and for psychosocial concerns such as bullying, stigma, and emotional difficulties.
Club Fit was an initiative aimed at promoting healthy habits and preventing excess weight gain among children members at the Boys and Girls Club of Rochester, Minnesota (BGCR). Obesity is associated with increased risk for cardiovascular, metabolic, and other health conditions and for psychosocial concerns such as bullying, stigma, and emotional difficulties. Approximately one-third of children and adolescents in the U.S. are obese or overweight. Childhood obesity disproportionately affects children of ethnic minorities and low-income populations. BGCR serves over 1,600 children each year. Close to two-thirds are from racial/ethnic minority groups, and a majority live in low-income homes. BGCR offers youth development programs and services in several core areas including Health and Life Skills, which focus on physical activity and nutrition.
The initial formative phase of Club Fit was to review existing physical activity and nutrition programming, and to define opportunities to enhance these programs at BGCR. During this phase, researchers conducted focus groups, surveys, and physical measures to assess perceived barriers, facilitators, and opportunities for improvement to sustaining healthful physical activity and nutrition behaviors among BGCR members.
BGCR leaders and staff worked with health promotion experts from Mayo Clinic and RHCP to develop a physical activity and nutrition intervention administered as part of regular programming at BGCR.
In the second phase, BGCR staff administered the intervention, while researchers conducted pre-post assessments among Club members, to evaluate the effectiveness of the intervention. Assessments demonstrated an improvement in members’ motivation and self-efficacy for engaging in regular physical activity. The evaluation also showed a dose-response relationship between participation in Club Fit activities and healthier body mass index. Following the formal evaluation, BGCR continued to utilize the Club Fit intervention elements as part of its Health and Life Skills curriculum.
Funding
Mayo Clinic: Center for Clinical and Translational Science and Office of Health Disparities Research
Positive Loser
Immigrants and refugees to the United States have physical activity levels and dietary behaviors that are less healthy than the non-immigrant majority. Low levels of physical activity and poor dietary behaviors are associated with greater risks for obesity, diabetes and cardiovascular diseases.
Immigrants and refugees to the United States have physical activity levels and dietary behaviors that are less healthy than the non-immigrant majority. Low levels of physical activity and poor dietary behaviors are associated with greater risks for obesity, diabetes and cardiovascular diseases. Interventions aimed at increasing physical activity and improving dietary quality among immigrants and refugees may promote healthier lifestyles and prevent chronic diseases.
Positive Loser was a pilot fitness program for exercise and nutrition for women with little experience with exercise, aimed at improving confidence in being physically active and eating a healthy diet. Positive loser was a six-week program with classes that met two times a week at the Rochester Area Family YMCA. Each class had two parts: 60 minutes of physical activity and 30 minutes of nutrition education. This socio-culturally appropriate wellness program for women was co-created by community leaders and researchers based on feedback obtained during a half-day fitness retreat, along with data from focus groups. About 50 Somali, Cambodian, Hispanic, and African American women in Rochester participated in the program. Pre and post measurements showed that participants had lower weight, lower blood pressure, lower waist-hip ratios, and reported improved self-confidence about exercise and diet, along with improved quality of life. The experience and results from this project led to the Healthy Immigrant Families project.
Funding
Mayo Clinic: Center for Clinical and Translational Science and Department of Medicine