Community Organizations Research Articles

Social network analysis of key stakeholders in Brucellosis prevention in Western Iran

Abstract Background Brucellosis remains a persistent public health challenge in Iran, particularly in rural regions such as Lorestan province, due to systemic, economic, and cultural barriers. Effective disease control requires multisectoral collaboration among stakeholders. This study aimed to map the stakeholder network involved in brucellosis prevention in Lorestan province, identify gaps in coordination, and provide actionable recommendations for improving control strategies. Methods This cross-sectional study employed social network analysis (SNA) to explore the relationships among key stakeholders in brucellosis prevention. Data were collected through a structured questionnaire administered to 75 experts from various sectors, including health, veterinary, agriculture, and non-governmental organizations. The SNA evaluated network density, clustering coefficient, and centrality metrics to determine the levels of collaboration and influence among stakeholders. Results The analysis revealed a moderately dense network (density: 0.2745; clustering coefficient: 0.2839) with central roles played by the Veterinary Organization of Lorestan Province, Lorestan University of Medical Sciences, and the Ministry of Agriculture. These organizations exhibited high levels of influence, support, and interest in brucellosis prevention. However, limited involvement of community-based organizations and environmental agencies was identified, highlighting a critical gap in grassroots engagement. Fragmented coordination was particularly evident in rural areas, where traditional livestock practices, inadequate veterinary services, and the consumption of unpasteurized dairy products perpetuate disease transmission. Economic constraints, such as the high cost of vaccines, along with limited public awareness, further hinder effective control efforts. Conclusions Brucellosis prevention in Lorestan province requires a comprehensive, multisectoral approach. The adoption of a One Health framework can improve collaboration among stakeholders, enhance resource allocation, and address systemic barriers. Community engagement and intersectoral coordination are essential for improving public awareness and compliance with preventive measures. These findings provide a foundation for developing a National Brucellosis Control Program and inform strategies to mitigate zoonotic diseases in similar high-risk regions.

The Absence of Durable Solutions, The Presence of Local Solutions in Protracted Refugee Situations. The Case Study of Uganda’s Approach to Hosting Refugees

The numbers of refugees have been increasing annually, engendering protracted refugee situations in the developing countries hosting refugees, yet with very minimal implementation of durable solutions. This intrigues the question of whether the approach of local solutions that empower protracted refugees to become resilient and self-reliant, can become a viable option to durable solutions especially in poor African countries such as Uganda? We use secondary literature and primary data collected from South Sudanese refugees in Uganda to answer this question. We argue that in the absence of granting or minimally granting refugees any of the three conventional durable solutions of repatriation, local integration and resettlement; the approach of local solutions can become an important but temporary (although long term) alternative for refugees to live relatively comfortable lives. However, this approach has to be holistically embraced and supported by various stakeholders, including the national government, local governments, international community, donors, and various nongovernmental organizations, to overcome the accompanying challenges and for the approach to succeed in empowering refugees to become resilient and self-reliant for a long time in their first asylum country and live a life outside camps or designated settlements, as they wait for any of the conventional durable solutions.

South-North Learning in Mapuche Territory- Report back from the 10th Escuela Abierta de Salud Pública in Temuco, Araucania, Chile

This article summarizes the proceedings of the 10th Escuela Abierta de Salud Pública (Public Health Open School), held in the Mapuche territory, Temuco, Araucania, Chile in the spring of 2024. The free school brought together more than one hundred Indigenous and community leaders and organizers, students, clinicians, academics, educators, workers, and organizers to build collective analysis and action about health under capitalism. The conference focused on the emancipatory praxis of social determination of health and critical interculturality, which put forward transformative, meta-critical agendas for public and collective health research and practice. The article is submitted as a contribution to the growing and necessary movement for genuine South-North learning and collaboration to build a public and collective health praxis that is up to the challenge of intervening in the deepening crises of the global capitalist order.

Islamophobia di Kanada

Islamophobia, as a global phenomenon, has seen significant impacts in various countries, including Canada. This research aims to investigate the dynamics of Islamophobia in Canada, explore the factors that influence public perceptions, and analyse its impact on Muslims. Using media content analysis, community surveys, and case study methods, this research identifies a number of cases of discrimination, negative rhetoric, and violence faced by Muslim communities in Canada. The study also examines how the mass media plays a key role in shaping public perceptions of Islam, as well as the extent to which government policies and regulations reflect the protection of Muslim rights. Findings highlight trends of inequality in everyday life, including in the workplace, education, and social interactions. In addition, the research discusses the efforts that have been taken by the government, Muslim community organisations to address Islamophobia. In particular, focus is given to educational initiatives and interfaith dialogue as a way to promote mutual respect in Canada's multicultural society. The study concludes by highlighting the challenges still faced by the Muslim community in Canada and emphasising the importance of cross-sectoral cooperation to create an inclusive and equitable environment for all its citizens, regardless of religious or cultural identity.

Community stakeholder perspectives for empowering EJ initiatives through Public Participation Geographic Information Systems (PPGIS)

Abstract This study explores the use of Public Participation Geographic Information Systems (PPGIS) to support environmental justice (EJ) efforts in Charlotte, North Carolina by incorporating community knowledge and engagement. Through a workshop with representatives from community-based organizations (CBOs), participants learned about PPGIS, NASA remote sensing data, and environmental screening tools. A hands-on web-Geographic Information Science (GIS) demonstration allowed them to identify how PPGIS might address challenges in their EJ efforts. Using a mixed-methods approach, both surveys and focus group discussions were conducted to collect community and individual perspectives on the strategic implications of incorporating PPGIS into current EJ efforts. Thematic analysis of the focus groups revealed key themes of community engagement and representation, challenges with coordination, the power of GIS and data, political and policy advocacy, and holistic and intersectional approaches. Descriptive statistics and comparative insights from survey data revealed nuances in individual CBO representative’s perceived strengths, weaknesses, opportunities and threats, complementing focus group narratives. Assessment of the strengths, weaknesses, opportunities, and threats of current efforts showed that coalition building, community involvement, and local knowledge were key strengths. In contrast, weaknesses included a perceived lack of influence over decision-makers and difficulty securing funding. The study concludes that PPGIS could strategically enhance community mobilization, facilitate collaboration, and advocate for policy change.

Teachers’ experiences of school-based mental health literacy programmes: a qualitative study of tackling the blues

ABSTRACT Concern about school pupils' mental health has increased globally. Mental health programmes in state schools, including those provided by external partners, have also expanded. However, little research exists which explores the views and experiences of teachers and other school staff on the development of coproduced, contextually tailored, mental health literacy (MHL) programmes delivered with external partners (including academic researchers and community organisations) to support pupil mental health. This paper reports new interview data from 14 teachers and 1 teaching assistant based in 8 primary schools in north-west England who were involved with a sport- and art-based MHL programme (Tackling the Blues, TtB) during the school year 2022/23. Three themes were identifiable in the interviewees' comments: (i) Externality and navigating the constraints of the national curriculum; (ii) “It's opened my eyes”: developing and enhancing mental health literacy; and (iii) Supporting inclusive and proactive mentally healthy schools. Our findings suggest that TtB provided schools and teachers the opportunity to work with external organisations committed to working with, rather than on or for, them over the school year. This collaborative approach helped align TtB to the values, ethos, and strategic priorities of the school, including existing whole-school approaches to mental health within and beyond the curriculum. External partners' complementary expertise helped build capacity for delivering MHL work flexibly in schools, strengthened teachers' confidence, and expanded their understanding of pupils' diverse mental health needs. This further strengthened programme acceptability by fostering more pupil-to-pupil conversations which were perceived to positively contribute to stigma reduction and help-seeking efficacy.

Effectiveness of the Colorectal Cancer Alliance's digital screening quiz and navigation model for promoting CRC screening.

97 Background: Evaluating the effectiveness of a Colorectal Cancer screening navigation model delivered in a digital platform offered by a patient advocacy organization. Designed as a digital screening quiz tool and live navigation to promote CRC screening, the Colorectal Cancer Alliance’s Screening Quiz is a risk stratification tool that connects respondents to live certified cancer care navigators delivering evidence-based interventions to increase CRC screening, education and patient and family support. The framework utilizes small and mass media, one-on-one education and patient navigation services to help address and reduce barriers to care. Research on these critical interventions shows that on-time screening for CRC leads to better outcomes. Methods: The Screening Quiz has been promoted through social sharing, community outreach, and media, including influencer campaigns to increase outreach to at-risk communities. Questions assess personal and family history, hereditary syndromes, and demographics to provide a CRC screening recommendation based on current USPSTF guidelines. Respondents overdue for screening are triaged to the Alliance’s patient navigation team. This interaction includes phone calls and emails for symptomatic individuals/high risk for CRC, telephone and email for average-risk uninsured, and emails for average-risk insured. At-risk individuals are connected to resources, such as financial assistance, free at-home screening tests, and colonoscopy scheduling services. Results: July 2022 to July 2024, the Screening Quiz provided over 50,000 screening recommendations. The median age of respondents was 46; 32% of respondents were between the ages of 45 to 64. Of the respondents, 29% were male and 71% were female. Most were White (79.2%), but nearly half of those who opted into navigation identified as BIPOC, including 16.7% Black/AA, 6.6% Asian, and 2.1% AI/AN. Additionally, 8.4% of respondents identified as ethnically Hispanic/Latino with another race. Most respondents were symptomatic (66.6%) but 6.5% were asymptomatic high-risk. These two groups represented 88% of 1,869 respondents triaged to patient navigation. Conclusions: The digital Screening Quiz, combined with live navigation, represents a promising approach for increasing CRC screening rates and addressing care gaps compared to traditional methods. The Alliance’s ability to engage at-risk communities through its national network of volunteers and partners, combined with evidence-based interventions, positions it well to continue closing screening gaps. Going forward, the Alliance aims to leverage its relationships with healthcare providers and community organizations further to expand the reach of its CRC screening efforts.

Fostering Trust in Public Health Messaging: Tailoring Communication for Rural Parents.

As pandemic-related mistrust of public health recommendations in rural communities may compound gaps in pediatric immunizations, our team explored parents' perceptions of trustworthiness in messaging. Qualitative study using 4 virtual focus groups. Rural Wisconsin. Participants (n = 25) were parents or guardians of children recruited through our contacts with community-based organizations serving rural communities. Researchers used task-oriented elicitation techniques to initiate discussion on the trustworthiness of messengers and messages providing health recommendations. Participants were asked to (1) review existing public health messaging on a range of topics and from a range of sponsors; and (2) rank a list of potential messengers in terms of trustworthiness (eg, local health department, Centers for Disease Control). Discussions were recorded, and audio files transcribed, to facilitate a team-based, thematic analysis. Competency in medical knowledge and parenting experience contributed to estimations of trustworthiness. Participants also responded well to messages and messengers that were able to project recognition of their children's uniqueness and their experience as parents. Participants distrusted messengers who were seen as biased or "one-sided" in their perspectives. For successful health promotion for rural-living parents, messengers must be recognized as "competent" to provide pediatric health advice and to avoid blanket recommendations that may undermine parents' experience and feelings of being "understood" and affect perceptions of trustworthiness.

Stakeholder engagement strategies to build resilience to compound hazards: Engaging community-based organizations in research

Stakeholder engagement strategies to build resilience to compound hazards: Engaging community-based organizations in research

Ageing Healthy: Perceptions of Older Persons, Community Members, and Other Stakeholders in Uganda.

Promoting healthy ageing would benefit from an understanding of what this means to stakeholders. We explored healthy ageing perceptions in rural and peri-urban Ugandan communities. Community dialogues, focus group discussions with older persons, community members, community-based organization leaders, key informant interviews with Ministries of Gender (2), Health (1), non-governmental organizations (3) and elderly representatives (5) were held. Thematic content analysis framework was used. Physical perceptions of ageing healthy included physical fitness, absence of health challenges, good physical appearance and looking younger. Emotional perceptions were a stress-free life with children's care, a balanced diet, basic needs and activity involvement. Socio-economic included financial stability, medical accessibility, future planning and network engagement. Spirituality, ageing with dignity and knowledge of body changes were others. The study provides insight into physical, emotional, and socio-economic perceptions of healthy ageing. Additional research in other settings would inform the UN Decade of Healthy Ageing.

Integrating MOUD in Non-Medical Community Organizations: Better Together MOUD (BT-MOUD)

Integrating MOUD in Non-Medical Community Organizations: Better Together MOUD (BT-MOUD)

The neighborhood walk: introducing first-year medical students to social determinants of health in underserved neighborhoods

BackgroundSocial determinants of health (SDoH) contribute to up to 80% of an individual’s health, underscoring its importance in medical education. Research has shown that community exposure and engagement during undergraduate medical education increases the likelihood of students working in underserved areas in the future. Given the limited research on the feasibility and educational effects of SDoH experiences implemented at the early stages of medical education, this study presents a unique perspective on an interactive learning opportunity during the preclinical curriculum. The purpose of this study is to evaluate the educational impact of an immersive social determinants of health learning intervention for first-year medical students.MethodsFirst year medical students visited one of five underserved neighborhoods in Pittsburgh during Orientation Week. Students received materials about neighborhoods and community engagement etiquette prior to their visit. Visits spanned four hours with two groups of approximately 15 students for each neighborhood, led by at least one faculty member and two student facilitators. Students visited two to four community organizations in each neighborhood and participated in a debrief session. Students completed a feedback survey, and results were analyzed with Chi-square Test of Independence (p < 0.05).ResultsThe survey response rate was 58.2%. Students ranked the intervention as “Excellent” (77%), “Above Average” (14%), and “Good” (7%). When asked to rate the comfortability of helping patients obtain community resources on a scale of 1–5, 64.3% of students rated 4 or above. Similarly, 91.6% of students rated 4 or above when asked about knowledge of available resources in their neighborhood. The major learning outcomes from students were richness of community resources/history (35.7%), food insecurity (26.2%), and dissipation of previous stigma (23.8%). There was a significant association between growing up in Pittsburgh and self-rating of comfortableness with helping patients obtain community resources (p = 0.02). Students who completed pre-visit materials were more likely to rate the materials (p < 0.01) and debrief session as helpful (p < 0.01).ConclusionsPrior exposure to and information about communities was found to enhance the neighborhood learning experience. This initiative demonstrates the benefit of early engagement with community resources and neighborhood-based health disparities in undergraduate medical education.

Repair work in raced welfare capitalism: community health workers in the United States

ABSTRACT In modern capitalism, the costs of care and social reproduction are widely externalised to women in households, but also to (women in) community organisations. This article analyses the role of community medicine in the US, and in particular the labour and struggles of community health workers (CHWs). Highlighting the gendered and raced inequalities of US welfare capitalism, I explore how CHWs sustain individuals and communities through three main forms of repair work: Safety net plugging is the often-invisible work of addressing unmet community needs; bridging is the work of intermediating between (punitive) state authorities and oppressed communities; and transforming lived experience is the devalued personal work of turning discrimination into care. Drawing on qualitative fieldwork in the US with a focus on California, my findings stress the laboriousness of caring in a punitive welfare state, and the devaluation of doing so in a ‘meritocratic', credentials-centred social order. I argue that CHWs' repair work might be a cost effective ‘fix’ for the health system, but that their struggle for professional recognition also challenges ingrained, racialised concepts of merit and professionalism. Their struggles connect with broader debates about reparative justice, repair, and labour value in our current socio-ecological crises.

Cognitive impairment and self-reported health outcomes among older adults: Longitudinal evidence from Australia.

Australia's population is ageing, with forecasts indicating that individuals aged 65years and over will account for >20% of the total population by 2066. Ageing is strongly linked with a significant decrease in cognitive capabilities. This study aimed to explore the association between cognitive impairment and four types of health outcomes among older Australians. Data used for this study was collected from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. The final analysis consisted of 11,146 person-year observations from 7035 unique individuals from Wave 2012 and Wave 2016, respectively. A longitudinal random-effects generalised least squares, and ordered logistic regression were used to analyse the association between cognitive impairment and health outcomes. The study results suggest that cognitive impairment was negatively associated with general health, mental health, self-assessed health and health satisfaction. Older Australians with cognitive impairment scored lower on general health (β=-2.82, SE=0.56), mental health (β=-2.93, SE=0.53), self-assessed health (β=- 0.75, SE=0.10), and health satisfaction (β=-0.19, SE=0.09) compared to the counterparts without cognitive impairment. The heterogeneous results also showed cognitive impairment was associated with poor health outcomes across age groups. This study found evidence that cognitive impairment is associated with poor health outcomes. To enhance the physical and mental health and well-being of older adults, the community, government and non-government organizations, and other stakeholders should prioritize routine healthcare prevention, targeted interventions, and treatment practices, particularly for individuals with or at risk of cognitive impairment.

Exploring community stakeholder perspectives of partnership development in community-engaged undergraduate Global Health Education in the UK: a qualitative study

ObjectivesTraditionally, patients have had passive roles in medical education; however, there have been increasing efforts to partner with communities to create authentic representation of laypeople in medical education. Communities’ perspectives...

P-524. Comparative Costs of Implementing an Evidence-Based Online HIV Prevention Program: Direct-to-Consumer Marketing vs. Community-Based Organization Recruitment

Abstract Background Black/African American and Hispanic/Latino men who have sex with men face a disproportionate burden of new HIV diagnoses. The Keep It Up! (KIU) program, an evidence-based online intervention, is effective in reducing risk behaviors. The KIU 3.0 study, conducted between 2019-2022, compared two delivery strategies: centralized, national direct-to-consumer (DTC) recruitment, and decentralized recruitment via community-based organizations (CBO). Here, we report strategy costs. Methods We conducted interviews to identify and quantify start-up (e.g. equipment, training), time-dependent (e.g. advertisements, payroll), and variable (e.g. incentives, medical materials) costs for both delivery models. We report costs in 2021 USD. We analyzed cost variation among CBOs and present a hypothetical scenario where all CBOs match the efficiency of the two with the lowest cost per participant. Results The DTC arm enrolled 1,468 participants. Start-up costs totaled $398,384 of which $376,393 was content design and development. Ongoing costs per participant totaled $501 (66.8% variable, 29.8% time-dependent, and 3.4% overhead, Table 1). The CBO arm enrolled 656 participants across 22 sites. Start-up costs totaled $511,528 of which $401,141 was content design and development. Ongoing costs per participant totaled $4,239 (9.2% variable, 69.3% time-dependent, and 21.4% overhead, Table 1). Site-specific costs ranged from $467 - $26,950 per participant with no correlation to the number of participants (Table 2, Figure 1, Spearman’s Rho = 0.007). In a hypothetical optimized CBO scenario, we estimated that 1,991 participants would enroll, start-up costs would be $470,653 and ongoing costs per participant would be $573, demonstrating that CBO delivery has the potential for similar costs to DTC delivery. Conclusion DTC implementation demonstrated lower costs per participant than CBO distribution. CBO costs were highly variable with no correlation to enrollment. It is important to note the challenges related to the COVID-19 pandemic (clinic closures and restrictions, material shortages, and price increases) when contextualizing these costing outcomes. Efficient implementation models are crucial for scaling evidence-based interventions. Disclosures Brian Mustanski, PhD, Hologic: Grant/Research Support

P-509. Impact of an Innovative Educational Initiative Using Community-Based Organization Partnerships to Reach Young Adults at Risk for HIV

Abstract Background Young adults (YA) are particularly vulnerable to acquiring HIV due to low self-perceived risk, low rates of HIV testing, and lack of knowledge/awareness about pre-exposure prophylaxis (PrEP). Methods Between 3/23 – 8/23, six education sessions for YAs were conducted in the Southeastern U.S. by local healthcare professionals (HCPs) along with community-based organizations (CBOs) in non-clinical settings (e.g. college campuses, breweries). Pre- and post-surveys were administered, with follow-up surveys 3 weeks later. A scale-up education toolkit was disseminated to HCPs nationwide. Results A total of 264 YAs participated in the education sessions (mean age: 24 years; 85% female; 54% Caucasian; 87% heterosexual) with 29% previously tested for HIV and 21% who previously discussed PrEP with a HCP. YA’s knowledge of different forms of PrEP improved significantly (38% pre- vs. 96% post-activity; p &amp;lt; 0.001) as did their confidence in protecting themselves from acquiring HIV (55% pre vs. 93% post; p &amp;lt; 0.001). In addition, awareness of local resources for HIV testing improved from 60% to 93% (p &amp;lt; 0.001) with a significant increase in YAs who stated they were likely to get tested for HIV (26% pre vs. 63% post, p &amp;lt; 0.001). Seventy-five HCPs and CBO leaders also participated. Interestingly, there was a disconnect between CBO/HCPs’ perceptions of barriers to HIV/STI testing compared to YAs’ reported challenges (Fig 1). All providers stated they were likely/very likely to organize another session. A follow-up survey of HCPs (N = 10) found they helped 58 YAs access HIV testing and 33 access PrEP since the education, with 70% of HCPs using the materials during 1:1 counseling with YAs, suggesting sustainability of the resources. HCPs (N = 867) who reviewed the toolkit had improvements in their confidence in differentiating between PrEP options and identifying who would benefit from each approach (p &amp;lt; 0.001) and counseling YAs about PrEP (p &amp;lt; 0.001). Conclusion Providing HIV prevention education to YAs in informal, community settings increases reach to those who may not have these discussions with their HCPs during regular visits. This type of educational initiative, which includes partnering with CBOs, is scalable and sustainable. Disclosures Meredith E. Clement, MD, Gilead Sciences: Grant/Research Support|Viiv Pharmaceuticals: Advisor/Consultant Kelly E. Pillinger, PharmD, AHFS: Contractor

P-1441. Demographic and Clinical Characteristics of New Migrant Patients with HIV in a New York City Open Access HIV Primary Care Clinic

Abstract Background Since 2022, New York City has seen an influx of migrants, many seeking asylum due to political strife or discrimination. This study assessed the clinical characteristics of new migrant patients with HIV who sought care at an academic, open access clinic. Methods This is a retrospective chart review study of new clinic patients January 2022–March 2023. Patients were included in the study if they were ≥18 years of age, living with HIV, and had migrated to the United States within one year of first clinic visit. Results From January 2022 through March 2023, we identified 58 patients who met study criteria. 53 patients (91.4%) identified as male, and the mean age was 33 years (SD 8.8), see Table 1. Most patients were from South America, with just over half from Venezuela alone. 48.3% of patients were walk-ins and 43.1% were connected through an open access line, with a majority referred from community-based organizations. 37 patients (63.8%) were on ART (antiretroviral therapy) at first visit, see Table 2. 67% of patients had an HIV viral load of 200 copies/ml or less. 29.8% of patients had a reactive RPR (rapid plasma reagin) consistent with a current diagnosis of syphilis. 11.8% of patients screened had a positive IGRA (interferon gamma release assay), none with active tuberculosis. 17.9% and 10% of eligible patients were screened for Strongyloides and Schistosoma antibodies, respectively. Only 4 of 56 eligible patients received empiric treatment for helminthic infection. 46.6% of patients reported history of STI (sexually transmitted infection), see Table 3. Nearly all patients (93.1%) were linked to a care coordinator prior to or at first visit. 25 patients were identified as having a possible mental health disorder or history of trauma, and 44% were seen by a licensed social worker same day, see Figure 1. Conclusion Most new migrant patients were from South America, identified as male, and had suppressed HIV. There were missed opportunities to screen for and treat helminthic infections. There was a high burden of STIs and mental health disorders. Many patients utilized our open access line or walked into clinic and nearly all were connected to a care coordinator at or prior to first visit. Continued research is needed to better understand the needs of this vulnerable and growing patient population. Disclosures All Authors: No reported disclosures

Examining Health Insurance and Non-Medical Challenges Among Vietnamese Americans in Texas During the COVID-19 Pandemic

When COVID-19 data on Asian Americans are available, they are frequently aggregated, concealing community-specific concerns. Consequently, there is limited COVID-19 literature on Vietnamese Americans. In this study, we investigated the association between health insurance coverage and non-medical challenges during the COVID-19 pandemic, in Vietnamese Americans in Texas. The NIH Community Engagement Alliance (CEAL) Common Survey 2 was administered electronically in English and Vietnamese and contained 23 questions about non-medical drivers of health, COVID-19 vaccination, and research participation. Vietnamese American adults in Texas were recruited between September 2021 and March 2022 via partnerships with community organizations. Responses were compared and analyzed using logistic regression. Of 217 respondents, 23 (11%) were uninsured. Of the uninsured participants, 43% lost health insurance coverage during the COVID-19 pandemic. Uninsured individuals had significantly higher odds of experiencing non-medical challenges, including obtaining housing (OR = 6.10, p &lt; 0.001), food (OR = 6.41, p &lt; 0.001), and medications (OR = 3.45, p &lt; 0.05) than insured individuals. Uninsured individuals had a significantly longer time-lapse since seeing a healthcare provider (ordinal OR = 0.20, p &lt; 0.05) than insured individuals. Thus, lack of insurance is strongly associated with non-medical challenges during the COVID-19 pandemic among Vietnamese Americans in Texas. Disaggregating data can address non-medical drivers of health, advancing equity for marginalized communities.

P-476. Pilot Implementation of HIV Self-Testing in Ghana: Analysis of the Community-Based Demand Generation Approach

Abstract Background Under the auspices of the Ministry of Health (MoH) and National AIDS/STI Control Programme (NACP), Ghana piloted an HIV Self-Testing (HIVST) project in 2023. The implementation took place in 50 HIV high burden districts and it was spearheaded by Ghana HIV and AIDS Network (GHANET), a grassroots civil society organization (CSO) with membership across the country. This paper examines the strategies and outcomes of the project which was sponsored by the Global Fund and currently being expanded as part of Grant Cycle Seven (GC7) implementation from 2024 to 2026. Methods One hundred and fifty (150) volunteers from 50 community-based organizations (CBOs) were trained to distribute ORAQUICK HIVST kits to local residents in the selected districts. Video instructions on the effective use of the test kits (produced in English and six different Ghanaian dialects) were made available to persons who voluntarily received the kits. Through an online portal (GHANET Information Management System (GIMS)) data about the distributions were recorded. Follow-ups were conducted to ascertain, among others, how the kits were used. The data was quantitatively analyzed and descriptive statistics was used to summarize the data using Statistical Package for Social Science (SPSS v.28). Results A total of 123,088 ORAQUICK HIVST kits were distributed (with follow-ups) to 73,853 (60%) females and 49,235 (40%) males. Young people aged 20 – 24 received the highest number of kits totaling 28,790 which is about 23%, followed by those aged 25 – 29 who received 25,006 which is about 20% and those aged 30 – 34 who received 17,460 which is about 14%. A total of 422 persons comprising 304 (72%) females and 118 (28%) males self-reported their results as reactive. Of this number, 329 persons comprising 72% of females and 28% of males were confirmed positive. And, out of that number, 202 persons comprising 73% females and 27% males were successfully initiated on antiretroviral therapy (ART) in health facilities. Conclusion Male participation of 40% in the testing exercise was encouraging as it above the national average of 20% . It is therefore recommended that in Ghana, HIVST should, particularly, be targeted men. Disclosures All Authors: No reported disclosures