Residents of public housing in Boston have low incomes and insufficient health insurance, which decreases the likelihood that they receive regular medical care. Residents may lack knowledge about risk factors for and symptoms of chronic disease. Promoting residents’ use of preventive care requires new strategies.
Researchers train Resident Health Advocates (RHA) to motivate fellow residents to seek recommended medical care and to enroll in health promoting programs. Participants, 540 mostly Hispanic and African-American residents, are screened for diabetes, high cholesterol, hypertension, and dental disease. All participants with positive screening results receive printed materials about where to get a diagnosis and treatment, and how to enroll in citywide prevention programs. Then some participants are assigned to an intervention group in which an RHA helps them navigate the health system. RHAs also help residents enroll in well-established citywide prevention services such as the state-sponsored Smoker’s Quitline, Strategic Alliance for Health, or the Family Weight Management program. The other participants are assigned to delayed intervention groups.
RHAs are also working with community clinics, hospitals, and dental clinics to make appointments for residents. RHAs attend follow-up appointments with residents in the intervention group and work to remove logistical barriers to primary care appointments. At 4 and 6 months after screening, researchers ask RHA-assisted residents if they kept appointments for treatment prevention programs. Results for the intervention group are compared with those of residents who received only the printed materials. Health care centers may benefit from increased understanding of referral and communication processes for reaching underserved clients.