Nonprofit Community Organizations Research Articles

Evaluating the Feasibility of a Novel Firearm Injury Prevention Program for Pre-adolescent Children Through Health Care and Community-Based Partnerships: The Future Healers Program Pilot Study.

Firearm violence is an American public health crisis that negatively impacts children and disproportionately affects Black youth. Few firearm injury prevention programs have been described in pre-adolescent children. The Future Healers Program is a novel collaboration constructed via partnership between the medical school, trauma center, academic surgery department, and local non-profit community organization. Our study sought to evaluate if (1) partnering with community organizations facilitated recruitment of children with prior exposure to firearm violence and (2) the health care community was a potential trusted partner appropriate for program delivery. Children aged 4-13 were recruited to join the program via news outlets and social media and in partnership with a local non-profit organization. Of the children and parents participating in the program, 48% (44/92) and 59% (38/64), respectively, completed an IRB-approved survey study. Pearson's chi-square, percentages, and 95% confidence intervals evaluated differences between children and caregivers on sociodemographic characteristics, firearm exposure (FE), firearm violence exposure (FVE), and perception of health care. Participant's residence was geocoded in relationship to incidents of firearm injury (2008-2021) in the same region. Caregivers (95%) and children (84%) reported substantial exposure to firearm violence and resided in areas with frequent firearm injury incidents. Notably, 82% of caregivers and 66% of children reported having a family member injured by gunfire. A high percentage of caregivers (79%) and children (91%) self-reported trust in the health care system. Partnerships between community organizations and health care systems can develop prevention programs that effectively recruit and engage pre-adolescent children impacted by firearm violence.

38 ¿Gustaría participar? - Recruitment of Spanish-speaking families for a pediatric neuropsychology study in North Texas

Objective:Hispanics account for approximately 19% of the US population and are the second largest ethnic group in the United States, yet they remain underrepresented in neuropsychology research. Common recruitment barriers include language, fear/mistrust, and unfamiliarity with neuropsychology. These recruitment challenges then interfere with the development of measures normed on Spanish-speaking Hispanics. The research team for a Spanish-based neuropsychological study at a pediatric medical setting in North Texas utilized several methods to maximize recruitment of Hispanics and identify the most successful strategies. It was hypothesized that internal recruitment efforts would have the best outcome.Participants and Methods:Recruitment of healthy Spanish-speaking children between 6.0 and 17.11 years old began in October 2021 and continues to date. Participants have been recruited within the Dallas Fort-Worth (DFW) metroplex using internal efforts within the pediatric medical center and external efforts in the community-at-large. Internal recruitment efforts have included: 1) setting up flyers at 19 different ambulatory clinics, 2) emailing study flyer to several internal groups, and 3) sharing information during a Hispanic workgroup meeting. Community-based efforts have included collaborating with: 1) a Spanishimmersion private elementary school (i.e., shared information with parents via email and sent flyers home with students), 2) three mental health colleagues (i.e., displayed study flyers within their clinic space and promoted study through word-of-mouth), 3) a local city council (i.e., featured flyer in electronic newsletter), and 4) a non-profit community organization (i.e., shared information and flyer through mass-text messages, social media post, and mass email to subscribers).Results:To date, 74 parent-child pairs have made one-time contact with the research team to inquire about the study and 55 have completed a second contact with initial screener by phone (19 lost to follow up). Of the screened families, 58% heard of the study through the non-profit organization, 31% through the Spanish-immersion private school, and 11% from internal recruitment efforts.Conclusions:Although we hypothesized that internal -based recruitment within the medical institution would be most fruitful, our findings did not support this hypothesis. A possible explanation could be that children recruited from medical clinics may not meet criteria for participation in our study (i.e., healthy children). Another possible reason may be that flyer-based recruitment in a medical clinic is too passive or impersonal. Recruitment through community organizations with sources known and trusted by participants was found to be the most successful method to recruit potential participants. Considering these findings, our approach to recruitment will move away from passive and indirect methods of recruitment (i.e., flyers in clinics) and emphasize alliance with community-based organizations to promote trust building and collaborative relationships between researchers, community organizations, and Hispanic research participants.

A Hybrid Grey Decision Methodology in Social Sustainable Supplier Selection

In the past decade, sustainable supply chain management has received much attention from practitioners and academics due to the heightened emphasis on environmental, economic, and social sustainability by customers, for-profit and non-profit institutions, community organizations, legislation, and government oversight. Evaluating and selecting a suitable supplier is considered a critical choice, crucial in supply chain management. Social sustainability in the supplier selection process is an important factor that has not received sufficient attention from academicians. Social and societal challenges are increasingly impacting supply chains. To tackle this challenge in the agricultural section of nations with emerging economies, this study proposed a new methodology using Grey FUCOM (Full Consistency Method) and Gray PROMTHEE (Preference Ranking Organization Method for Enrichment Evaluation) methods for evaluating the social sustainability of wheat and barley seed production companies. This study assists seed users in identifying the most significant supplier selection criteria and one of the most effective suppliers for ecological sustainability throughout the supply chain while maintaining market competitiveness. The results demonstrated a consistent and dependable rating behavior about the weight coefficients of the criteria. Improving the procedures used to evaluate wheat and barley seed suppliers results in a healthier society. So, the proposed model can efficiently evaluate a critical component of the food supply chain in the early stages.

Exploring the value of pro bono evaluation work as a method to build evaluator competencies and strengthen organizational capacity

The Cultivating Evaluation Education and Development (CEED) program engages early career evaluators in an experiential learning experience by supporting them as they lead a pro bono evaluation for a local nonprofit community organization. We explored the value of this professional development to the early career evaluators, to the sponsor organization, and to the nonprofit organizations receiving CEED services by examining findings from six CEED projects. We found that early career evaluators self-reported gains in confidence and competence especially in four American Evaluation Association Evaluator Competencies (2018) domains - professional practice, methodology, planning and management, and interpersonal skills. The initiative allowed the sponsor organization to expand connections with community organizations, implement work consistent with the mission, and provide new mentoring opportunities. Representatives from the recipient nonprofit organizations reported they gained a deeper understanding of evaluation, improved their dissemination efforts, and built organizational evaluation capacity.

Factors supporting settlement among Syrian refugee women: A longitudinal participatory action research study

Introduction: Over 13 million Syrians have been forcibly displaced since the start of the Syrian civil war in 2011. In response to this humanitarian crisis, several high-income countries have settled thousands of Syrian refugees. In Canada, over 50,000 Syrian refugees have resettled through varying resettlement programs. Half of the refugees are women who are mothers or of child-bearing age, and who experience numerous health disparities. This article reports findings from a larger, Canadian-based study inquiring into the factors supporting and shaping the settlement and integration experiences among women who are Syrian refugees and mothering. Methods: A longitudinal intersectionality-framed participatory action approach was initiated through multiple meetings with a diverse range of non-profit community organizations focused on refugee health and settlement. Through these meetings, sustainable relationships were formed, and trust was built toward further engaging with the Syrian refugee mothering women population. A core group of 4 women were employed as peer research assistants and were integrated across research processes. Results: In total, 40 Syrian refugee mothering women participated in this study. Six themes emerged from data analysis of their lived experiences of resettlement. Four of these themes are published elsewhere. We focus this article on two of the six key findings: harnessing strength-based capabilities, and peer research assistant experiences. Conclusions: The two findings described in this article convey facilitators that add to understanding influences on the mental well-being of Syrian refugee mothering women. Unique to this study is the novel integration of peer research assistants and a model of support which contributes to an ethical and inclusive approach to understanding lived experiences among refugee women. This article highlights how this model benefits the peer research assistant and promotes community engagement among women.

Abstract B042: Understanding unmet needs of adult survivors of childhood cancer in California’s Salinas Valley: A community-academic partnership to develop programs for families after cancer treatment

Abstract Childhood cancer survivors are at elevated risk of poor health outcomes as they age due to late effects from past cancer treatments. Lifelong risk-based survivorship care is recommended; however, those who lack insurance, have lower income and education, or live in a socioeconomically disadvantaged area are less likely to receive this care, contributing to health disparities. Working toward the goal of improving equitable access to care for cancer survivors, the Stanford Cancer Survivorship Program has partnered with Jacob’s Heart, a nonprofit community organization that supports families of children with cancer in California’s Salinas Valley, a socioeconomically disadvantaged region with a large Latinx farmworker population and high rates of limited English proficiency. Jacob’s Heart provides material resources (financial, food, transportation) and psychosocial support (1:1 and group counseling, social activities) to families during treatment. Together with Jacob’s Heart, we are conducting a needs assessment in accordance with community-based participatory research principles. We present preliminary findings of a qualitative study designed to identify post-treatment concerns, needs, and barriers to cancer survivorship care in the Salinas Valley communities. Semi-structured interviews were conducted with Jacob’s Heart staff, adolescent/young adult (AYA) cancer survivors, and parents of cancer survivors. Eligible participants were ≥5 years post cancer diagnosis, ≥15 years of age, spoke English or Spanish, and received services from Jacob’s Heart during their treatment. The Jacob’s Heart team led recruitment using purposive sampling; 7 staff members, 19 AYA cancer survivors and 13 parents of cancer survivors were recruited. Interviews were conducted in-person or by video or telephone, in English or Spanish with professional interpreters if needed, and transcribed verbatim. Interview topics included demographics, post-treatment healthcare experiences, challenges and concerns related to prior treatment, sources of support, and suggestions for resources. Data were analyzed qualitatively using reflexive thematic analysis based on grounded theory and the constant comparative method. Preliminary findings indicate concerns among the staff around helping families adjust to life post-treatment and helping AYAs transition to independence as young adults. AYAs voiced communication challenges around survivorship topics (overwhelmed by too much information, worried about future health problems, yet hesitant to discuss with healthcare teams) and expressed the need for age-specific social connections and peer support. Further analysis of AYA and parent interviews is ongoing and will be presented at the time of the meeting. This study highlights the strength of a community-academic partnership to understand the lived experiences of AYA cancer survivors and their families and to identify opportunities to improve care. Findings will inform future collaborative interventions and projects that can be implemented in the community to address the unmet needs. Citation Format: Stephanie M. Smith, Caroline Pecos-Duarte, Evelyn Tolamatl Ariceaga, Elle Billman, Anmol Teer, Catherine Benedict, Mary Smith, Sandy Montes, Esmeralda Rivera, Daniela Ramirez, Heidi Boynton, Lidia Schapira. Understanding unmet needs of adult survivors of childhood cancer in California’s Salinas Valley: A community-academic partnership to develop programs for families after cancer treatment [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B042.

Integrating Community Health Workers and Nurse Midwives on the Health-Care Team to Improve Birth and Breastfeeding Outcomes.

A plethora of international research has consistently demonstrated the efficacy of both the nurse-midwifery model and the community health worker (CHW) model in improving birth and breastfeeding outcomes, particularly among low-income women. However, these two professional groups rarely work as a team in the U.S. health-care system. Typically, certified nurse midwives are on staff at clinics and hospitals; conversely, CHWs tend to work at non-profit community organizations. Although the Community Preventive Services Task Force concluded that integrating CHWs on clinical care teams is effective, these paraprofessionals remain nearly excluded from the healthcare organization because they are not licensed healthcare professionals, hence, non reimbursable. We integrated these two health professional groups within a small, community-based, nonprofit, and charitable women's clinic in Jackson, Mississippi, serving a predominantly Medicaid population to determine if their combined health services would significantly improve birth and breastfeeding outcomes among an intervention group compared with a control group that received usual standard care from an obstetrician.

Teach-Back Method in Presenting Health Promotion Topics Program: Nursing Collaboration with the Micronesian Islander Community Organization and Micronesian Islander Parent Leaders

Background A Micronesian Islander-based nonprofit community organization and academic nursing partnership in the United States Pacific Northwest identified the need to use the Teach-Back method with the Micronesian Islander Parent Leaders (MIPLs) to address prevention of non-communicable diseases for health promotion outreach. MIPLs are well-respected community leaders and elders from diverse Island communities. The Teach-Back method verifies a person’s understanding of the health messages, reteaching or modifying messages if knowledge is not met, and is a strategy for health literacy. A health message communicator or presenter uses caring, plain, and respectful language and asks participants to repeat the health messages that they receive in their own words. The RE-AIM framework guided this community participatory scholarly project. The community participatory scholarly project aimed to implement and evaluate the Teach-Back method in presenting health promotion topics with MIPLs as a program. Project questions were: 1) How effective is the Teach-Back method in presenting health promotion topics as a program using a distance learning format? and 2) Is the Teach-Back method as a program acceptable for communicating health messages for MIPLs? Approach The project was implemented in 4 virtual sessions using the Teach-Back method in presenting health promotion topics. We used the Teach-Back Confidence and Commitment Scale, distance learning and open-ended items, and field notes and observations journal for evaluation. Participants used the Teach-Back Observation Tool to practice observing the presenter leveraging essential elements of the Teach-Back method. Findings MIPLs reported increased adoption and acceptance of the Teach-Back method to communicate health messages to their community and family members. Conclusion Health promotion topics identified by the group were presented using caring, respectful, plain language, and in a non-threatening manner as a vehicle to illustrate and evaluate using the established Teach-Back method tools

Adolescent well-being during the COVID-19 pandemic in India

Background:It is without question that gender attitudes/norms, voice and agency, self-efficacy, and locus of control are important determinants of health and well-being, particularly for adolescent girls and boys in low to middle income countries. And, while prior to the COVID-19 pandemic, there were trends suggesting social inequities would be on the decline, these trends have since reversed due to abrupt long-term school closures as a result of the pandemic. This study examines adolescents’ perceptions of gender norms/attributes, voice/agency, self-efficacy, locus of control, and gender-based violence norms pre-COVID and one year later during the COVID-19 pandemic and subsequent lockdown in India, a country with one of the largest adolescent populations worldwide.Methods: The data for this study were derived from a larger study via two cross-sectional self-reported survey of adolescents ages 10-15 years old in public schools located in Delhi, India (urban), and Uttar Pradesh, India (rural) pre-COVID and one year later. The adolescent participants were part of local existing after-school programs and interventions implemented by non-profit community organizations, and a convenience sample (n=547) was recruited.Results: The present study found that positive gender attributes, positive gender norms, GBV norms, voice, and locus of control all worsened between the two time periods-pre-COVID-19 and one year later during the height of the COVID-19 pandemic.Conclusions: As India looks ahead to rebuilding after the pandemic, it will be imperative that attention is paid to gender perceptions and attitudes, empowerment, and family/gender violence as a result of the short and longer impact of COVID-19.

“I’m aging faster”: social participation as experienced by individuals aging with a traumatic brain injury

ABSTRACT Objectives 1) To get an insight into the experience of aging with traumatic brain injury (TBI), and 2) explore intervention avenues perceived as promising for the social participation of this population. Method Through an exploratory descriptive study, in-depth semi-structured interviews were conducted with aging TBI survivors recruited in a nonprofit community organization whose mission is to support the social participation of people living with TBI. Thematic analysis was done on qualitative data, using a hybrid approach of deductive and inductive analysis. Results Ten aging TBI survivors with an average age of 64.9 years were interviewed. Participants expressed the perception of declining faster and with greater limitations than their fellow seniors unchallenged by TBI but also of having social participation opportunities due to their condition. A list of ten facilitators (e.g., doing activities in synch with life story) and five barriers (e.g., unequal levels of disability) to their social participation emerged. Conclusion Social participation is crucial to TBI-affected individuals’ healthy aging. Nonprofit community organizations should offer opportunities for participation, mobilize environmental resources, foster self-confidence, and support the achievement of meaningful personal projects to enable the social participation of people aging with TBI.

Multispecies Families: Pets, Community, and Social Action

In this essay, I reflect on what I learned about human–animal relationships, families, and community through volunteering at an animal shelter, and how I translated these insights into founding a nonprofit community organization, Animal Advocates of Greater Lafayette (AAGL). I first discuss the increasing research and scholarship in the social work field that examines the role of pets in human lives. I describe my methodological frame, drawing on the fields of autoethnography and personal narrative in qualitative research. I then relate both animal and human stories from the field (in this case, an animal shelter), and tell the story of the founding and current activities of AAGL. In conclusion, I suggest that AAGL, as a community organization, models how to rethink families through a multispecies lens.

Dynamics between fragmentation and unity: Identity and nonprofit relationship management in the Asian American Community

Focusing on community-based nonprofits with specific missions of serving the Asian American community, this study examined the dynamics between various layers of identity, including ethnicity and panethnicity, and identified how intercultural relationship management contributed to a sense of community and empowerment among minority communities. Interviews from both nonprofit community organizations and community members revealed the following major findings. First, Asian American community nonprofits needed to manage a myriad of identities within their community, particularly the interplay between diverse ethnic identities and the pan-Asian ethnic identity. To help manage these identities, these nonprofits adopted a dual approach using both segmented outreach and coherent advocacy. Second, these community nonprofits used intercultural relationship management to build a sense of community and efficacy, promoting outcomes such as health awareness, communicative activeness, cultural shift, political engagement, and community alliances. This study contributes to relationship management literature through introducing identity-based relationship building strategies.

Teacher, Center, and Neighborhood Characteristics Associated with Variations in Preschool Quality in Childcare Centers.

Childcare programs serving preschool children are generally of poorer quality than publicly-funded preschools both in terms of their classroom processes and structural features. Research on childcare programs has typically collapsed them into a single group, yet these programs vary greatly in neighborhood disadvantage and organization as they are managed by for-profit chains, non-profit community organizations, faith-based organizations, or individual owners. Little is known about variations in childcare program quality and what factors are associated with quality. The current study utilized latent profile analysis (LPA) with classroom process, structural features, and neighborhood disadvantage indicators to identify patterns of quality and neighborhood disadvantage within a diverse sample of childcare programs serving preschool children. Classroom processes (instructional support, emotional support, classroom management, positive discipline) and structural features (teacher age, experience, education, and satisfaction) data was collected from preschool teachers (N = 127) from 76 childcare programs. Neighborhood disadvantage (median income; rates of unemployment, single parents, and education) was measured using census tract data. LPA indicated two profiles of childcare programs with high-quality classroom processes and two with poorer processes. Both of the high-quality profiles were in low-to-moderate income neighborhoods and the two low-quality profiles were in more affluent neighborhoods. Subsequent analyses suggested quality covaried with management type with the lowest quality centers often run by for-profit chains. Connections between classroom processes, structural features, and neighborhood disadvantage are complex making it extremely challenging for parents to identify high-quality care for their children.

Undergraduate Medical School Health Fair Hepatitis Screenings: Utilizing Non-Profit Community Organizations.

Background:Undergraduate medical schools serve a critical role in providing screenings to medically underserved populations through the use of health fairs. Non-profit community organizations (NPCO) often participate by providing local credibility, administrative resources, and technical knowledge. Here we present a three-year narrative of hepatitis B and C screening efforts to highlight the challenges and benefits of undergraduate medical school and NPCO partnerships.Methods:Hepatitis screenings were conducted at biannual health fairs in Harlem, New York from 2017 to 2019. Meeting minutes from post-event debriefings were analyzed to identify any overarching themes with NPCOs.Results:NPCOs share a common goal in working with the community to advance their access to medical care and treatment. Communication and prompt follow-up are critical to maintaining expectations between NPCOs and health fair organizers.Conclusions:NPCOs can play an important role in encouraging, outreaching, and even managing hepatitis screening initiatives in conjunction with medical school health fairs.

Health Café Series: a Potential Platform to Reduce Health Disparities.

To help bridge the increasing gap between health scientists/physicians and the community, we have developed a new seminar program—Health Café series. Health Café takes place in causal settings, is open to everyone, and features a keynote speaker regarding prevalent healthcare-related topics. Health Café topics are usually generated via community feedback and are coordinated in partnership with local nonprofit community organizations. The Health Café series is completely free, and no prior knowledge is required to attend seminars. We have been collaborating with a web of community organizations in the Hartford areas of Connecticut, especially among populations with health disparities. We believe our new Health Café series program would serve as a forum to reduce health disparities in the region.

Documentary Resistance: The Stories of “We Tell” as Collective Political Agency

Angela Aguayo reports on “We Tell: Fifty Years of Participatory Community Media,” a touring retrospective of documentary media projects coprogrammed by Louis Massiah and Patricia R. Zimmermann, with archival assistance from the XFR Collective, and featuring forty projects produced by thirty-six nonprofit community organizations and cultural centers. “We Tell” dives into more than fifty years of media as developed by embattled communities with a shared political vision and a focus on advocacy and addressing problems more often excluded from larger public concern. In her review of the exhibition, Aguayo argues that participatory community media presents a critique of representational politics within the larger documentary field and offers a corrective to the tourism tendencies of contemporary documentary-production culture by foregrounding collaborative authorship and collective agency.

SUPPORT AND EDUCATION NEED FULFILLMENT IN INFORMAL DEMENTIA CAREGIVERS

Caregivers vary widely in their need for and utilization of support services, and there are many reasons for this (e.g., time or financial cost, distance, perception of need). This study explored the disparity between services that are desired and those that are utilized, and examined the hypothesis that unmet needs are a determinant of caregiver burden. An online sample of informal caregivers (N=151) responded to a questionnaire containing a list of common caregiver support services: sharing duties, professional transportation, respite care, non-profit community organizations, financial counseling, caregiver education programs, support groups. Participants were presented with a list of support services and information and asked to indicate A) which they desired and B) which they had received while providing care. Respite care and financial counseling were identified as support that caregivers were unable to obtain, while caregiving education and family/friend support were most commonly fulfilled. A linear regression model controlling for demographic variables was constructed. Unfulfilled support needs accounted for 40.6% of variance in caregiver burden, however the final model included only total ratio of unfulfilled services, transportation services, stress management skills, professional treatment for the caregiver, and behavioral management skills. Results highlight the unique contribution of certain support services in burden reduction. These findings imply a need to improve accessibility to caregiver support, especially those which require payment (e.g., transportation aids and mental healthcare). Further implications and actionable changes related to caregiver support services are discussed.

Frederick F.Wherry, Kristin S.Seefeldt, and AnthonyAlvarezCredit Where It's DueNew York: Russell Sage, 2019. 159 p.

It is hard to imagine life in the contemporary United States without a credit score. Renting an apartment, buying a car on installment, and often even finding a job requires a credit score. A higher credit score results in credit at more favorable terms; a borrower with poor credit score may pay as much as extra $70,000 over the life of a home mortgage of $100,000. We assume that most people have a credit score and individuals who have a low credit score have made some poor decisions in their life by not paying their credit card bills or other loans on time. Wherry and his colleagues present startling statistics. They show that an estimated 45 million adults in the United States lacked a credit score in 2010—either because they had no credit history or they had too few credit lines to be scored. The burden of being credit invisible fell most harshly on Blacks and Latinx adults (28 percent in both cases) compared to whites and Asians (16–17 percent). “Giving Credit Where Credit is due,” a mantra of modern credit justice activists, requires consensus on who deserves it and why. Should credit, like political freedom, be a fundamental right for all adults? Or is credit a privilege best granted to those who have demonstrated themselves fit to use it, or at least disciplined enough not to abuse it? Authors of Credit Where It's Due, Frederick Wherry, Professor of Sociology at Princeton; Kristin Seefeldt, Associate Professor of Social Work and Social Policy at University of Michigan; and Anthony Alvarez, Assistant Professor of Sociology at California State University, Fullerton, argue that low credit score is part and parcel of a life lived on the margins of the organized financial world and not a function of conscious individual choices. The book is based on fieldwork conducted at Mission Asset Fund (MAF) which began as a nonprofit community organization in 2007 in the Mission District of San Francisco and seeks to enhance financial inclusion for minorities, immigrants, and low-income households and to create a fair credit marketplace for everyone. It documents financial trajectories that land individuals in a credit invisible situation where they are unable to obtain credit on fair terms and traces their struggle to get out of this predicament. While the authors’ diagnosis of what lands individuals in a credit bind is fascinating, highlighting poor starting points, diverse family and life demands, and student debt as prime culprits, it is the focus on solutions that is most interesting. Authors suggest several solutions for addressing the credit conundrum. They argue that Blacks and Latinx will never be able to catch up to their white counterparts simply by working at the same jobs, engaging in the same saving and investment practices, or getting the same education. Historical evidence shows that whites inherit over ten times as much wealth as their minority counterparts which allows them to build a credit history. The only way to bridge this gap is to consciously establish an investment account for every child born to a family with less than median income. This account will provide seed capital for their future financial security. They also propose short-term loans for every family that would protect families from getting into exorbitantly priced emergency or “payday” loans. This is to be supplemented by extending safety regulations and financial education to students taking college loans to ensure they do not fall into default. Although the focus is on low income Americans, some of the ideas in the book and solutions have interesting synergies with recent discussions on financial inclusion in the economic development literature. The premise of the book is challenging and pulls it in two different directions. On the one hand, it seeks to be an academic manuscript, trying to find a niche in the broader discourse on credit and financial stability. On the other hand, its value and impact come from its close link with one specific NGO focusing on equalizing the credit landscape. It is a challenging task to blend the two in creating a cohesive narrative and at times the authors struggle with it. However, the compelling storyline of the book allows readers to ignore this tension and remain engaged throughout the reading.

MON-018 Effectiveness of the National Diabetes Prevention Program in Latino Men

Introduction The United States Latino population has disproportionately high rates of type 2 diabetes, with a 11.8% prevalence, which is among the highest for all ethnic groups nationwide. Additionally, 43% of Latino adults are obese (vs 36% for Caucasian) making Latinos 50% more likely to suffer from obesity and DM2. The National Diabetes Prevention Program (NDPP) is an evidence-based group lifestyle intervention program with demonstrated efficacy among diverse populations. However, due to generally low enrollment rates among Latino men, its applicability to this group remains in question. The VUELA DPP is a community-based NDPP for Latinos, run by the non-profit community organization VUELA for Health in partnership with a regional medical center. Classes are primarily taught in Spanish at sites already frequented by the local Latino community, allowing for high recruitment and retention rates of Latino men and women. Here we report on the effectiveness of the VUELA DPP among Latino men participants. Methods Data were analyzed from 147 male participants aged 17 to 83 years enrolled in the NDPP from January 2014 to July 2018. Variables included: age, race/ethnicity, number of sessions attended, weight, and physical activity. The number of sessions attended was categorized by quartiles representing a fourth of the distributed population (1-10, 11-16, 17-22, and 23-25 sessions). Weight loss was determined from the first and last weight. Averages and odds ratios were calculated with 95% confidence intervals to evaluate male participation in the program and weight loss. Results The majority of participants were between 35 and 50 years old (x̅=48.2) and identified as Hispanic White (n=119). Additionally, 8 participants identified as Non-Hispanic (NH) White, 2 as NH Black, and 1 as NH American Indian/Alaskan Native. Overall, males attended an average of 15.7 of 24 sessions (SD=6.4), with the fewest sessions attended being 1 and the most being 25 sessions. On average, males lost a total of 6.94 pounds (SD=8.7) and exercised a total of 115.2 minutes weekly (SD=72.7). Logistic regression analysis revealed that greater participation was associated with more weight loss, with participants who attended 17-22 sessions being 1.6 times more likely to lose weight (CI=0.31-3.31; p=0.4) and participants who attended 23-25 sessions being 3.2 times more likely to lose weight (CI=0.37-28.0; p=0.3). Participants who attended 19-25 classes were 2.97 times more likely to lose weight (CI=0.73-12.07; p=0.13). Discussion Our culturally-tailored NDPP program was successful in engaging Latino males. Greater participation of Latino men was correlated with greater weight loss and physical activity. More research is needed to evaluate the factors such as education, awareness, and social support that may increase Latino male participation in DPP and similar lifestyle intervention programs.

Improving community support for older people's needs through commissioning third sector services: a qualitative study.

This exploratory study of commissioning third sector services for older people aimed to explore whether service data was fed back to commissioners and whether this could improve intelligence about the population and hence inform future commissioning decisions. Third sector services are provided through charities and non-profit community organizations, and over recent years services have developed that assess and advise people for self-management or provide wellbeing support in the community. Third sector services have an opportunity to reach vulnerable populations and to provide intelligence about them. Some third sector services are state funded (commissioned) in the United Kingdom. While evidence is available about the commissioning of statutory health and social care, as well as private providers, there is limited evidence about how third sector health services are funded. Participants were recruited from commissioner organizations and third sector organizations, both with an interest in supporting the independence, self-management and wellbeing of older people. Organizations were recruited from five purposively selected sites within one region of England (East Midlands). Semi-structured interviews explored the relationships between commissioners and providers and the nature of funding arrangements, including co-production. Interviews also explored collection of data within the service and how data were fed back to commissioners. Focus groups were held with older people with the potential to benefit from wellbeing services. Commissioning arrangements were varied, sometimes complex, and often involved co-production with the third sector. Commissioners valued third sector organizations for their engagement with the local community, value for money, outreach services and ability to provide information about the community. Assessing the needs and outcomes of individuals was integral to delivery of support and advice to older people. Diverse approaches were used to assess an individual's needs and outcomes, although there were concerns that some assessment questionnaires may be too complex for this vulnerable group. Assessment and outcomes data were also used to monitor the service contract and there was potential for the data to be summarized to inform commissioning strategies, but commissioners did not report using assessment data in this way, in practice. While the policy context encouraged partnerships with third sector organizations and their involvement in decision making, the relationship with third sector organizations was not valued within contract arrangements, and may have been made more difficult by the tendering process and the lack of analysis of service data. This exploratory study has demonstrated a diversity of commissioning arrangements for third sector services across one region of England. Most commissioners invited co-production; that is, the commissioners sought input from the third sector while specifying details of the service. Service data, including assessments of needs and outcomes, were reported to commissioners, however commissioners did not appear to use this to full advantage to inform future commissioning decisions. This may indicate a need to improve measurement of needs and outcomes in order to improve the credibility of the commissioning process.