|
Over the past year, I developed, implemented, and evaluated a culturally-appropriate pilot health education intervention at a community health clinic for an ethnically diverse low-income population of Prince George's County, MD. My methods included identifying potential clients with indicators of high cholesterol, hypertension, and/or diabetes, developing curricula and offering both individual counseling sessions and group workshops.
Through eliciting the clients’ explanatory models of their chronic diseases and their typical diet and physical activity behaviors, the individual counseling sessions and workshops aimed to improve participants’ dietary, physical activity, and cardiovascular and/or diabetes self-care behaviors.
A very small percentage of targeted clients attended the workshops, so the process evaluation aimed to assess clients’ actual and providers’ perceived barriers to accessing the workshops. Clients reported that structural barriers prevented them from attending, while providers reported that they perceived clients’ barriers as sociocultural.
The evaluation provides evidence supporting the continuation of the workshops, as well as several recommendations for removing barriers to accessing the workshops.
Papers
Donaldson-Lopez, Jackie
2008 The Anthropology of Health: Developing, Implementing, and Evaluating a Culturally-Appropriate Health Education Intervention. Master of Applied Anthropology thesis, Department of Anthropology, University of Maryland. 
---
2007 Evaluation Report on Barriers to Accessing Health Education Workshops: Client and Provider Perceptions. (Unpublished). College Park, MD: University of Maryland.
---
2007 Developing an Intervention at a Community Clinic: How Latinas View Their Gestational Diabetes Care and Treatment. (Unpublished). College Park, MD: University of Maryland.
Obesity often leads to subsequent health conditions such as hypertension, diabetes, heart disease, and stroke, as shown in several published studies and reports. Many health studies have also shown that prevalence of obesity and related conditions is higher in African Americans than in whites.
Although it is known that some of the most effective preventative measures for obesity include increased physical activity, reduced intake of sodium, fats, and sugar, and an increased intake of fiber, many reports on dietary interventions indicate a lack in awareness of the social and cultural determinants of diet and exercise beliefs and practices.
The focus of this study is to assess the complexity of these sociocultural beliefs and practices of diet and exercise, and to implement an appropriate intervention program through churches in the African American community in Seat Pleasant, MD, as these churches are able to reach large numbers of people and have historically played significant roles within African American communities.
Papers
Donaldson, Jackie, Doneby Smith, Caine Francis, Alyson Waite, and Priya D'Souza
2006 Capital Black Belt Project: An Intervention. (Unpublished). College Park, MD: University of Maryland.
I developed a health education intervention for Latinas with gestational diabetes in a culturally-diverse, low income area of Prince George's County, MD. The intervention not only focused on education the women, but also involved their families to strengthen support for the women, as well as provide prevention education, since children of Latina gestational diabetics are 50 to 70 percent more likely to develop diabetes themselves.
Papers
Donaldson, Jackie
2007 Health Education Intervention for Latinas with Gestational Diabetes and Their Families in Langley Park, Prince George's County, MD. (Unpublished). Washington, DC: George Washington University.
When I began this qualitative methods project in Fall 2006, I anticipated being able to speak directly to patients in community health clinics to understand whether or not patients’ cultural beliefs and behaviors influenced their care and treatment. From the literature and from personal experience overhearing patient-provider exchanges in an emergency waiting room, I had a preconceived notion that Latina/o patients and their providers experienced challenges in communicating with each other. Despite several attempts to strike up conversations in community health clinics with the women waiting to be taken to exam rooms, I was only able to informally interview one teen-aged patient who has only visited a community health clinic once since emigrating to the U.S. a year ago. Instead, I focused on learning more about community health clinic staff experiences.
Observing and interviewing patients without an introduction or common ground proved challenging. Conversely, speaking with and observing community health clinic staff, especially at the Spanish Catholic Center in Langley Park, MD, proved an eye-opening experience. From discussions in semi-structured and formal interviews, staff members find working at a community health clinic to be challenging but immensely fulfilling. They consider themselves to be dedicated and caring people who, despite funding issues, lack of resources, and low salaries, provide quality health care and treatment for their community members who are uninsured and underserved. For most people I interviewed, working at a community health clinic fulfilled their personal mission. They felt they provided quality health care, although two providers, including a physician assistant and nurse disagreed.
I’d like to conduct more semi-structured interviews with community health clinic staff. I have more questions about the challenges of working in and I’d like to learn more about working with and serving patients and their needs. And I’d like to observe patients in exam rooms and interview them about their health care experiences. Ultimately, I believe my research can be used to help develop “best practices" for community health educators. This is still very much a new idea for me, but one I plan on testing out through the next year and a half.
If I had the time and capability, or worked on a team project, I would be very interested in comparing the experience patients have in community health clinics and private practices or hospitals. I did get a taste of the differences two health professionals had in working at both levels, and from their discussion, it appeared as though the differences were striking, with quality of health care and treatment being a primary division, and funding and resources being contributing factors. Although ethnicity was not discussed, these two health professionals were white, middle-class educated women who do not live in the same community where they practiced at their community health clinics. I am interested in exploring this disparity more, as well as interviewing patients who have also had experiences in the community and private sectors.
|
