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Health Screening Events as a Community-Clinical Linkages Strategy for Addressing Chronic Illnesses in Black Communities

Christian-Afflu, Stephanie N. (2024) Health Screening Events as a Community-Clinical Linkages Strategy for Addressing Chronic Illnesses in Black Communities. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Disparities in the prevalence, incidence, and mortality rates of various chronic illnesses in the US have been persistent between White and Black populations. One method to aid in alleviating this disparity is through the community-clinical linkages (CCL) strategy of providing free health screenings in community settings that identify risk factors and refer participants to clinical resources. I explored community-based health screening events as a CCL strategy in Black populations through three papers.
The first paper explores data from sixty-three articles about addressing risk factors for heart disease and stroke, breast or prostate cancer, asthma, or diabetes through screening in community-based settings with Black adults throughout the US. The second analyzes transcripts from four focus groups regarding perceived barriers to accessing clinical resources and strategies to promote engagement with resources. Results from those two papers provide programmatic suggestions for the third paper, a process evaluation of a pharmacist-led health screening intervention held throughout Allegheny County, Pennsylvania.
Key findings of this dissertation are: (1) There is a lack of literature on studies that conduct health screening events focused specifically on risk factors for chronic illnesses in Black communities. There is a dearth of information regarding referrals, follow-ups, and demographics. (2) Barriers to access include lack of knowledge, lack of trust in healthcare professionals, transportation, and wait times. Strategies for engagement include using liaisons, creating a central location for resources, and advertising in local spaces. (3) The activities in the program are being carried out with fidelity. Programmatic opportunities include using multiple methods for follow-up to increase success rate, promoting events, centralizing resources, using community liaisons, and utilizing an electronic consenting method and internal database.
Health screening events are a long-standing detection intervention to address chronic illnesses. The lack of evidence regarding linking participants to clinical resources is a detriment in this CCL strategy. However, addressing barriers to access and improvements with following up and documentation processes may address these concerns. These significant findings contribute to chronic disease prevention by providing insight into the breadth of the literature, information on barriers, and an example of an intervention dedicated to alleviating these health disparities.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Christian-Afflu, Stephanie N.snc47@pitt.edusnc470000-0001-5678-8376
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairGary-webb, Tiffany L.tgary@pitt.eduTgary
Committee MemberCole, Evan S.evancole@pitt.eduEvancole
Committee MemberDocumet, Patricia I.documetp@pitt.eduDocumetp
Committee MemberElias, Thistle I.Elias@pitt.eduElias
Committee MemberElliott, Jennifer
Date: 3 January 2024
Date Type: Publication
Defense Date: 17 November 2023
Approval Date: 3 January 2024
Submission Date: 14 December 2023
Access Restriction: 1 year -- Restrict access to University of Pittsburgh for a period of 1 year.
Number of Pages: 175
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Behavioral and Community Health Sciences
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Health Screening, Chronic Illness, Community-Based Screening, Black, African-American, Community-Clinical Linkages
Date Deposited: 03 Jan 2024 18:57
Last Modified: 03 Jan 2024 18:57


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