Community-based Education Program Research Articles

A qualitative exploration of the sexual and reproductive health knowledge of adolescent mothers from indigenous populations in Ratanak Kiri Province, Cambodia.

Adolescents from indigenous populations in Ratanak Kiri Province in Cambodia experience worse sexual and reproductive health (SRH) outcomes when compared to their urban counterparts. However, few qualitative studies have been conducted to identify factors that may explain the poor SRH outcomes experienced by this population group. The socioecological model was used as the analytical lens to explore the SRH knowledge and sources of SRH information of adolescent mothers (aged 15-19 years) from indigenous populations in north-eastern Cambodia. Adolescent mothers from the Tompoun and Jarai indigenous population groups (n=22) were purposively recruited from seven villages in two districts of Ratanak Kiri Province. All adolescent mothers engaged in a combined body mapping exercise and semi-structured interview; this approach was considered the most appropriate qualitative data collection method to use in this context as it reduced language, cultural and social barriers that have previously restricted qualitative exploration of sensitive issues among this population group. The body maps and semi-structured interview transcripts were analysed using thematic analysis. Adolescent mothers demonstrated limited SRH knowledge including that pertaining to the anatomy of the female reproductive body, the physiology of human reproduction, fertility and pregnancy. Adolescents' primary source of SRH information was interaction with female family members and friends within their community. Adolescents' limited SRH knowledge was influenced by factors on individual (eg educational attainment, child marriage), relationship (eg social interaction with female family members and friends), community (eg access to educational and healthcare services) and societal (eg barriers to accessing national SRH programs and initiatives) levels. The%u202Ffindings support the need for SRH education in the primary and secondary school curriculum. In 2018 the Cambodia Ministry of Education, Youth and Sports introduced a Comprehensive Sexuality Education (CSE) program into the government primary and secondary school curriculum. The CSE, which is delivered in the Khmer language, provides Cambodian youth with an avenue to access accurate SRH information that will aid their SRH decision-making. However, indigenous girls face numerous social, cultural, economic and language barriers that restrict or prevent their access to formal education. Therefore, additional SRH materials and resources that are culturally and linguistically appropriate need to be developed for indigenous students attending primary and secondary schools in Ratanak Kiri Province and for young people who have ceased formal education. Educating village chiefs to deliver non-formal, community-based education programs is proposed as a means of increasing SRH knowledge and reducing health inequalities faced by this population group while ensuring that accurate information is delivered in a culturally appropriate manner.

The Effect of a Community Based Educational Intervention on Oral Health Knowledge Levels of Adult Caregivers of Young Children in the Rural Upper Peninsula of Michigan

ABSTRACTLow levels of oral health literacy in parents and caregivers may place a child at risk for poor oral health (Miller, Lee, DeWalt, & Vann, 2010). The purpose of this project was to determine baseline oral health literacy levels for a sample of adult caregivers of young children living in rural communities and to determine the effectiveness of a community-based education program on increasing these baseline levels of knowledge. A convenience sample of sixty-four participants who attended educational programs aimed at adult caregivers of young children comprised the sample. The Upper Peninsula Oral Health Literacy Assessment Survey was administered prior to and after participants attended the educational programming. A paired sample t-test was utilized to analyze the data. There was a statistically significant increase in oral health literacy levels after the implementation of a community-based educational program. Scores reflecting oral health literacy rose from 68.8% on the pre-test to 92.6% on the post-test. This study confirms a need for further oral health education. Increasing oral health literacy levels in adult caregivers of young children may lead to an increase in oral health seeking behaviors and a decrease in preventable dental caries in the pediatric population.

Exploring Strategies to Improve the Performance of Community Health Volunteers for Tuberculosis Care and Prevention: A Qualitative Study.

ABSTRACTBackground:Community health volunteers contributed to the total Tuberculosis (TB) case findings; however, the attrition rate of these volunteers was high which reduces their optimal performance. Hence, sustainability of efforts should be explored to retain the community health volunteers in the TB program. Improvement of community health volunteers to perform community-based health education and prevent TB has not been examined consistently around the globe, including Indonesia. This study aimed to explore the strategies to improve performance of community health volunteers for TB care and prevention to reduce the incidence and stop the spread of TB in the community. Methods:A qualitative design was adopted and we used two focus group discussions in 2017 to collect the data. The participants included village health workers as volunteers in two regencies of Bandung City, West Java Indonesia. A thematic analysis was used to analyze the data. Results:Four major themes should be considered in developing a community-based TB health education program: (1) informing community health volunteers about the benefits and difficulties of being a TB volunteer; (2) recognizing the activities and feelings of volunteers; (3) emphasizing the Willingness to Help Others; and (4) having access to TB training. Conclusion:To develop a community-based health education program for TB care and prevention, community nurses need to listen to the opinions of community health volunteers, and TB patients and their family members to ensure that the health education program is tailored to meet community needs.

A community-based survey on massage therapy in Saudi Arabia

Massage therapy (MT) is the physical manipulation of the soft tissues. It primarily consists of manual or hands-on techniques such as applying fixed or movable pressure, holding, and moving muscles and body tissues. MT is beneficial for pain relief, sport-related injury rehabilitation, stress reduction, and to address psychological disorders. MT is the most prevalent form of complementary and alternative (CAM) therapy worldwide. The aim of this study was to evaluate the knowledge, attitudes, and perceptions regarding MT among the Saudi community. A cross-sectional online survey using WhatsApp©, Google Forms©, Facebook©, and Twitter© was conducted among the general community of the Kingdom of Saudi Arabia (KSA) to assess the knowledge, attitudes, and perceptions regarding MT. Data was collected using a 20-item, self-administered questionnaire consisting of a series of both closed-ended and Likert-type questions. A total of 436 respondents completed the survey. Most of the respondents were female 84.2% (n = 367). Approximately 65% resided in the central region of KSA. The majority of the respondents, 81.4%, believed that MT is effective, 27.7% thought that MT leads to complications, and more than half of the residents, 55.7%, believed that patients should consult with their physicians prior to MT. The most common reasons for MT were to treat muscle pain, for relaxation purposes, to treat bone and joint pain, and backache relief, which were reported by 49%, 20%, 19%, and 16% of the participants, respectively. The knowledge, attitudes, and perceptions of the Saudi population towards MT are insufficient in some aspects. The establishment of community-based health education programs to improve knowledge of MT is recommended.

The Effect of Community-Based Parent Education Program on Parenting Stress According to Adult Attachment Styles.

Objectives:The aim of this study was to measure the effect of a group-based parent education program on parenting stress and attitude and comparing the same according to adult attachment styles.Methods:Twenty-two mothers who enrolled in the parent education program participated in our study. The participants filled in the Korean version of the Experience in Close Relationship Revised (ECR-R), Korean-Parenting Stress Index-Short Form (K-PSI-SF), Maternal Behavior Research Instrument (MBRI), and Symptom Checklist-90-Revised (SCL-90-R) before and after the program. We compared the pre-and post-scores of the groups and compared the differences in effect according to adult attachment styles.Results:For all study participants, the Parent Distress (p=0.023) and Total Parenting Stress (p=0.018) significantly declined after the parent education program. There were no differences in other variables. Within the secure attachment group, the Total Parenting Stress (p= 0.008), Parent Distress (p=0.015), and Difficult Child (p=0.011) scores in the K-PSI-SF significantly decreased after participating in the program. The Difficult Child scores (p=0.040) significantly dropped in the K-PSI-SF post program within the secure attachment group, compared to the insecure attachment group.Conclusion:The group-based parent education program impacted parenting stress. Depending on the adult attachment styles, the effect of the program varied.

Benefits and Challenges of Partner Site Engagement with Community-Based Dental Education Programs: The Partner Sites' Perspectives.

The aim of this qualitative study was to examine the perspectives of key personnel at partner sites providing community learning experiences to dental students to gain more understanding of the effects that community-based programs have on the sites themselves. Fourteen semi-structured interviews were conducted in 2015 with individuals from nine extramural sites. Interviewees had a range of roles from clinicians to CEOs, with six also reporting they were faculty preceptors. Three of the researchers developed a coding scheme focused on the benefits and challenges that community sites experience from participating in a community-based dental education (CBDE) program. Each coder then reviewed the interview transcripts independently before final group discussions and recoding to agreement. The main themes related to benefits were recruiting future dentists, staying current with clinical developments, sites' indirectly improving their missions by exposing students to broader roles of oral health providers, raising awareness regarding the need for dentistry in community settings, and nurturing a positive workplace environment. The main themes related to challenges were balancing education and training for students with clinical demands, communication with the university, and managing distinctive clinical and professional characteristics of students. This study's participants reported that the main benefit of CBDE for partner sites was dentist recruitment. The study also provided insights for both partner sites and dental schools to consider when developing and maintaining these partnerships.

Polysubstance Use among Patients Enrolling in Methadone Maintenance Treatment Program in a Vietnam Province with Drug-Driven HIV Epidemic.

Methadone maintenance treatment (MMT) has been scaled up significantly in recent years. This study aimed to investigate the pattern of polysubstance use in 395 MMT patients and its contextualized associated factors. A cross-sectional study was performed in three outpatient MMT clinics in Nam Dinh Province. Multivariate Poisson regression was used to identify factors associated with polysubstance use status. The mean MMT duration and the current MMT dose was 3.3 years and 69.2 mg, respectively. Among participants, 24.8% reported daily alcohol use, 68.6% smoked regularly, and 6% used illicit drugs. Peer pressure and MMT suboptimal adherence were found to associate with continual usage of drugs (47.8%). Participants who lived with a spouse/partner, were self-employed, and smoked were more likely to drink alcohol. Those who drink were also more likely to smoke, and vice versa. Recommendations for policymakers include community-based education and promotional programs aiming to decrease substance usage in the community as well as encouraging and supporting the private health sector in establishing private MMT services and clinics. Further longitudinal studies on polysubstance usage among MMT patients should also be conducted.

Connecting Primary Care to Community-Based Education: Michigan Physicians' Familiarity With Extension Programs.

Clinical-community linkages enhance health care delivery and enable physician-patient partnerships to achieve better health. The Michigan State University (MSU) Model of Health Extension includes a strategy for forming these linkages by focusing on increasing primary care patient referrals and enrollment in health programs. This article shares the results of a survey of Michigan internal medicine and family medicine physicians (n = 323) to better understand attitudes toward and familiarity with community-based education (CBE) programs and to assess the logistical requirements to make CBE referrals efficient and sustainable. Survey results showed that at most, 55% of respondents were aware of at least one CBE program implemented by Cooperative Extension. Of those who were aware, over 85% agreed that the programs have positive benefits for patients. Thirty-five percent reported at least one referral barrier, and familiarity with the CBE programs was a significant predictor for reporting all referral barriers. The results suggest that increasing physicians' familiarity of CBE health programs is a key first step in identifying ideal strategies to overcome referral barriers. Data from this study may help determine scalable state level models for increasing awareness of chronic disease prevention and other CBE programs in efforts to improve the health of the nation.

LB1100 Healthy Skin for Everyone: One-year data from a community-based skin cancer education program in an underserved population

LB1100 Healthy Skin for Everyone: One-year data from a community-based skin cancer education program in an underserved population

Factors associated with the intention to use adult preventive health services in Taiwan.

This research aimed to examine the factors associated with the intention to use adult preventive health services in Taiwan. Using Andersen's behavioral model, we employed a cross-sectional descriptive design to investigate 500 samples from four communities in southern Taiwan. We used a self-reported survey to assess participants' intention to use adult preventive health services, and the predisposing, enabling, and need factors influencing their intention. Intention to use adult preventive health services was more significantly explained by predisposing and enabling factors than by need factors. In addition, a lack of fixed medical facilities (enabling factor) and Taiwanese origin (predisposing factor) were associated with decreased odds of intention to use adult preventive health services. An educational level of high school or below (predisposing factor), higher amounts of exercise (predisposing factor), and lower barriers to use preventive health services (predisposing factor) were associated with increased odds of intention to use adult preventive health services. The findings can assist public health nurses in identifying high-risk groups with lower intentions of using adult preventive health services. Additionally, community-based health education program can be developed to increase people's intention to use adult preventive health services.

Community-based educational design for undergraduate medical education: a grounded theory study

BackgroundCommunity-based education (CBE) is strategically important to provide contextual learning for medical students. CBE is a priority for countries striving for better primary health care. However, the CBE literature provides little curriculum guidance to enhance undergraduate medical education with the primary health care context. We aim to develop a CBE framework for undergraduate medical education (from macro, meso, and micro curriculum levels) to engage students and teachers with better, more meaningful learning, within primary health care settings.MethodsWe used a grounded theory methodology by interviewing eight medical educationalists and ten CBE teachers, followed with the coding process by sensitizing the concepts of ‘medical education’ and ‘primary care’, to explore any new concepts. The primary data originated from a developing country where the paradigm of high-quality primary health care is mostly unfamiliar. Three senior researchers from international associations of general practices from different countries provided validation to the results.ResultsWe identified a new framework for a community-based educational program. The micro-curriculum should offer opportunities for small group activities, ranging from simple to complex learning, emphasizing clinical skills, leadership, and teamwork to improve self-directed and collaborative practice. Sufficient role models and constructive feedback within primary care contexts are robust facilitators. For the meso-curriculum, comprehensive coordination on teacher-training and CBE program is needed. To ensure the sustainability of the program, faculty leaders and managers should include the macro-curriculum with a national postgraduate general practice curriculum and provide strong commitment.ConclusionsWe designed a ‘CBE-tree’ model for the undergraduate medical curriculum. By using the CBE framework developed in this study, students and teachers may better comprehend the essential of primary health care.

The Impact of a Community-Based Food Education Program on Nutrition-Related Knowledge in Middle-Aged and Older Patients with Type 2 Diabetes: Results of a Pilot Randomized Controlled Trial.

The purpose of this study was to evaluate the impact of a community-based food education program on nutrition-related knowledge in middle-aged and older patients with type 2 diabetes (T2D). Participants (n = 36; 65.9 ± 6.0 years old) were recruited in primary health care to a 9-month community-based lifestyle intervention program for patients with T2D and randomly assigned to an exercise program (control group; n = 16) or an exercise program plus a food education program (experimental group; n = 20). Nutrition-related knowledge was assessed through a modified version of the General Nutrition Knowledge Questionnaire. The increase in total nutrition-related knowledge score and sources of nutrients area score was significantly higher in the experimental group compared to the control group. No significant changes in nutrition-related knowledge were found between groups in dietary recommendations and diet-disease relationship areas, although improvements were observed. This community-based food education program, with the use of easy to implement strategies (short-duration lectures and dual-task problem solving activities during exercise), had a positive and encouraging impact on nutrition-related knowledge in middle-aged and older patients with T2D.

A Systematic Review on Epidemiology and Promotion of Motorcycle Helmet Use in Thailand.

Background. Road traffic accidents are the fourth leading cause of death in the entire population, and the first among the youth (ages 15-19 years) in Thailand. The situation in Thailand is worse than in neighboring low- to middle-income countries in the Southeast Asia region. Seventy-three percent of the deaths in the country are motorcycle drivers or passengers. Although motorcyclists (both drivers and passengers) have been obligated to wear helmets by law, the prevalence of helmet use nationwide is not high (43.7% in 2010). Methods. We performed a systematic review to examine potential social determinants of helmet use behavior (observational studies) and to summarize previous intervention studies to promote helmet use (interventional studies) in the country. Studies were identified in PubMed and Web of Science, and by additional review of Thai-written literature. Results. We identified 16 relevant studies for social determinants of helmet use and 5 relevant studies for promoting helmet use in Thailand. Our review shows that several factors such as teens and children (age), women (gender), rural areas (geography), and alcohol drinking (interaction with another behavior) are associated with non-helmet use. We also identified 4 interventional studies implemented in Thailand: 1 law enforcement program and 4 community-based educational programs. Although all the studies improved the prevalence of helmet use after the interventions, only 2 studies exceeded 50%. Conclusion. There is consistent evidence that being younger, being a woman, living in non-Bangkok areas, and drinking alcohol are associated with non-helmet use among motorcycle users in Thailand. We also observed that the effect of past intervention programs is limited.

FNEE2 The Warehouse: Delivering a Multi-Pronged, Community-Based Nutrition Assistance and Education Program to a Rural City in Arkansas

Objective Reducing barriers to healthy food access is difficult in rural parts of Arkansas. Community-based education and behavior change programs that employ multiple strategies to affect change across multiple levels of influence have a greater impact than any single strategy alone. Use of Theory or Research The Warehouse impacts residents across the socio-ecological model through community-based strategies to address barriers to healthy food access. Target Audience McCrory area residents seeking increased access to healthy foods between August and October of 2018. Program Description The Warehouse is a community facility supported by the Woodruff County Extension Service, ARcare, and the City of McCrory, Arkansas. These organizations collaborate to provide a resource for participants to attend meal-planning workshops to increase their food preparation skills, while nutrition education provides the necessary knowledge for understanding the importance of a healthy diet. Health screening services provide participants with knowledge about how diet impacts overall health. Evaluation Methods Program evaluation assessed changes in food-related participant behavior, post-utilization of services at The Warehouse. Descriptive data was collected via self-reported survey. Results A majority of participants (83%) attended multiple sessions at the Warehouse, with several attending primarily for food distribution (42%) and nutrition education (27%). Few participants (26%) reported that they would have enough food to last through the month without the food distribution services of the Warehouse, and 60% of participants indicated that they have prepared Warehouse recipes at home. Further, 94% of participants indicated that they are eating ‘Somewhat’ (64%) or ‘Definitely’ (30%) healthier than before attending. Conclusion The Warehouse, with its multi-layered strategy to provide knowledge and skill-building opportunities to its patrons, has been successful in creating and maintaining a local culture of health. Community-based programming can benefit from the collaboration of several organizations employing multiple strategies to reduce barriers to healthy food access in Arkansas. Funding Center for Disease Control and Prevention, Supplemental Nutrition Assistance Program – Education.

Community-Based Environmental Education Program Using Photovoice for Physically Challenged Individuals

「환경교육법」제정(2008년)과 「평생교육법」개정(2016년) 이후 환경교육과 장애인 교육에 대한 관심은 많아졌지만, 장애인 환경교육에 대한 실천적, 이론적 관심은 매우 부족하다. 연구진은 최근 환경위기가 고조되고 있는 제주 지역에서 지체장애인, 장애인 교육자와 활동가, 교육공학 전문가 등의 검토 과정을 거친 뒤, 제주의 자연환경을 소재로 ‘포토보이스를 활용한 지체장애인 환경교육 프로그램’을 개발했다. 포토보이스는 본래 참여적 실천 연구방법의 하나이나, 사람들은 포토보이스 활동에 참여하며 자신과 세상의 삶을 성찰하고 사회변화를 꾀하는 등 의식화 교육의 성과를 보일 수 있다. 9명의 지체 장애인을 모집하여 ‘지체장애인에게 자연은 00이다.’ ‘지체장애 인이 자연과 함께 살아가는 것을 방해하는 것은 00이다.’ ‘지체장애인이 자연과 함께 살아가는 것을 돕는 것은 00이다.’라는 주제를 가지고 김영갑 갤러리 방문 및 촬영, 텃밭가꾸기 활동 및 촬영, 그리고 상호토론과 전시회 등을 실시했다. 일련의 프로그램을 시범 운영한 결과, 지체 장애인은 자연환경의 가치를 새롭게 인식했고, 자연과의 관계에서 자신의 삶을 성찰했을 뿐 아니라, 장애인과 비장애인 동행의 중요성, 장애인 환경교육의 과제와 대안 등을 탐색했다. 이후 사진 전시 회를 통해 자신의 목소리를 정책 당국에 전달하는 성과를 보였다. 끝으로 연구진은 이 프로그램의 강점과 개선점 분석을 통해 포토보이스 활용 지체장애인 환경교육의 이론적 의의와 실천적 시사점을 도출할 수 있었다.There have been few theoretical and practical interests in environmental education for physically challenged individuals even though the 「Environmental Education Act」 was established in 2008 and the 「Lifelong Education Act」 was revised in 2016. We developed an environmental education program using photovoice for physically challenged individuals based on the natural environment of Jeju Island. Photovoice is an educational method as well as a participatory action research, involving photograph, talking with peers and exhibiting activities. We recruited 9 physically challenged individuals and gave them a workbook with three questions, namely: (1) what nature means to them, (2) what prevents them from living with nature, and (3) what helps them live with nature. We proceeded to bring them to Kim Young-Gap Gallery and a home garden where they planted some vegetables, while letting them take some pictures in both places. We also facilitated to discuss the above three questions using photos taken at the gallery tour and garden activities. An exhibition of the results of their discussion with their photos was displayed. As results of implementing the program, we were able to help them recognize the value of the natural environment, understand the relationship between nature and themselves as well as between them and non-disabled people. They were also able to express their views on environmental education policies. In conclusion, we discussed the theoretical and practical implications of the environmental education program using photovoice for physically challenged individuals.

Characteristics of Households of People With Diabetes Accessing US Food Pantries: Implications for Diabetes Self-Management Education and Support.

The purpose of this study is to explore the associations between food insecurity (FI) and coping strategies of relevance to diabetes self-management among households of people with diabetes (HHDM) who access US food pantry programs. The authors conducted a secondary data analysis of HHDM accessing US food pantry programs from the Hunger in America 2014 study (n = 16 826). Weighted analyses included descriptive statistics for household sociodemographics, food pantry service utilization, FI, and coping behaviors. The authors used chi-square and logistic regression to estimate the relationship between FI and coping behaviors. Nearly one-half of HHDM reported visiting food pantries at least 6 times in the past year. Most HHDM were FI, with the majority experiencing the most severe form of FI. Over one-fifth of households reported lacking health insurance. The majority of HHDM reported purchasing inexpensive unhealthy foods to ensure household food adequacy, and many reported watering down food and beverages. The odds of reporting these behaviors significantly increased as FI worsened. Food pantries represent an opportunity for the delivery of community-based diabetes self-management education and support programs. These programs should be adapted to address population barriers to self-management and to support access to healthful foods and medical care.

A community-based education programme to reduce insecticide exposure from indoor residual spraying in Limpopo, South Africa

BackgroundIndoor residual spraying (IRS), the coating of interior walls of houses with insecticides, is common in malaria-endemic areas. While important in malaria control, IRS potentially exposes residents to harmful insecticides. The World Health Organization recommends steps to minimize exposure; however, no programme has focused on educating populations.MethodsA dramatic presentation and song were developed by study personnel and performed by lay performers in order to spread awareness of the importance of IRS and to minimize insecticide exposure. Performances were staged at 16 sprayed villages in the Vhembe District of Limpopo, South Africa, at which 592 attendees completed short questionnaires before and after the performance about behaviors that might limit insecticide exposure. Overall indices of the attendees’ change in knowledge of precautions to take prior to and after spraying to prevent insecticide exposure were analyzed using hierarchical mixed models to assess the effect of the performance on change in participants’ knowledge.ResultsApproximately half of attendees lived in homes that had been sprayed for malaria and 62% were female. Over 90% thought it better to allow IRS prior to the presentation, but knowledge of proper precautions to prevent exposure was low. The proportion answering correctly about proper distance from home during spraying increased from 49.4% pre-performance to 62.0% post-performance (RR = 1.26, 95% CI = 1.13, 1.41), and the proportion reporting correctly about home re-entry interval after spraying increased from 58.5 to 91.1% (RR = 1.54, 95% CI 1.35, 1.77). Attendees improved in their knowledge about precautions to take prior to and after spraying from mean of 57.9% correct to a mean of 69.7% (β = 12.1%, 95% CI 10.9, 13.4). Specifically, increased knowledge in closing cupboards, removing food and bedding from the home, covering immoveable items with plastic, and leading animals away from the home prior to spraying were observed, as was increased knowledge in sweeping the floors, proper disposal of dead insects, and discarding dirty washrags after spraying.ConclusionsA dramatic presentation and song were able to increase the attendees’ knowledge of precautions to take prior to and after spraying in order to limit their insecticide exposure resulting from IRS. This approach to community education is promising and deserves additional study.

Low-income families and the positive outcomes associated with participation in a community-based leisure education program

ABSTRACTLeisure is promoted as critical to enhancing both individual and community wellbeing; however, for individuals living in poverty, access to and participation in leisure is often difficult, which makes experiencing the positive outcomes associated with leisure and recreation even more difficult. The purpose of this paper is to describe the positive outcomes low-income families experienced through participation in a community-based leisure education program. Through semi-structured interviews with ten mothers living in poverty and two staff members that delivered the leisure education program to low-income families, this study highlights the positive outcomes associated with participating in a community-based leisure education program.

705-P: Health Extension: A Better Way to Manage Diabetes?

Background: Given the increasing number of individuals with diabetes who live in settings with limited access to care, new models of care delivery for management of diabetes are critical. Health Extension for Diabetes (HED), a community-based non-clinical diabetes education program delivered by a Health Extension Agent, is based on the AADE7 Self-Care Behaviors for Managing Diabetes. Methods: This intervention is a mixed-methods research study with a primary outcome to reduce/prevent complications associated with diabetes. Goal assessment metrics were selected by clinical, non-clinical and evaluation staff, and resulted in 3 categories: health behaviors, health outcomes, and healthcare utilization. Pre/post analysis of graduates in HED cohorts 1-3 focuses on health behaviors and health outcomes with emphasis on 2 crucial measures, diet and exercise. Pre/post data were compared using Stata 15. Results: Table 1 shows client demographics and the pre/post analysis of several variables collected during evaluation process. Conclusion: Overall, this novel educational diabetes self-management support intervention was found to be effective shown through the short-term outcome measures. This new method increased client physical activity and confidence (self-efficacy) in regard to diabetes management while lowering consumption of sugary beverages. Disclosure C.J. Dietz: None. P. Tilkemeier: None. W.W. Sherrill: None. D.E. McFall: None. M.D. Stancil: None. M.A. Parisi: None. C. Beauchamp: None. H.N. White: None. Funding Greenville Health Authority

Aboriginal community understandings of dementia and responses to dementia care

ObjectiveAboriginal people and Torres Strait Islanders are impacted by dementia at higher rates and at a younger age of onset than the broader Australia population. Public health strategies to support this population require a thorough understanding of how Aboriginal people perceive dementia and dementia care support needs. The aim of this study was to investigate Aboriginal community understandings of dementia and their responses to dementia care. Study designThis study is a community participatory action research partnership. MethodsThe mixed method study was undertaken in 2017 with members of a discrete Aboriginal community from rural Tasmania, Australia. Participants were older than 18 years, self-identified as an Aboriginal person and were living or had lived in the community studied. Data were derived from 50 participants who completed the 27-item Dementia Knowledge Assessment Scale (DKAS). Twelve of these participants also shared their dementia care experiences in individual interviews. ResultsThe DKAS results showed a low overall level of dementia knowledge, with a total mean score of 27.73 (scoring 51% on average) of a possible score of 54. The salient interview theme was the cultural obligation to care for family members living with dementia. Dementia care metaphors represented ways to protect family members living with dementia and maintain their ongoing connections to home and community. However, limited understandings of dementia affected their capacity to provide quality care. ConclusionThe findings contribute to public health scholarship involving Aboriginal community responses to dementia care. The study has resulted in important initiatives including a community-based dementia education program to ensure Aboriginal people impacted by dementia are provided with effective and culturally appropriate care.