The relationship between social deprivation and a frailty index of cumulative deficits in French middle-aged caregivers

Abstract Background The Institut Pasteur de Lille, in the north of France, has implemented a large, multidisciplinary health check, which aims to identify frailty in middle-aged caregivers. We aimed to construct an adapted frailty index of cumulative deficit (FI-CD) and study the associated factors, in particular socioeconomic factors. Methods The cross-sectional study included caregivers aged 45 to 65. A 34-item FI-CD including deficits adapted to a middle-aged population (related to cognition and autonomy, dietetics, physical activity, comorbidities, functional signs, lab values and paraclinical examinations) was constructed in accordance with standard procedures. It was calculated as a ratio of deficits present out of the total number of possible deficits, giving a continuous score between 0 and 1. Scores &gt; 0.25 and &gt;  0.4 were classified as frailty and severe frailty, respectively. Univariate and multivariate associations were studied using linear regressions. Results One hundred and seventeen caregivers were included; among them, 111 were analyzed due to missing values. The mean FI-CD was 0.22 ± 0.08. Forty (36%) individuals were classified as frailty and three (2.7%) as severe frailty. In multivariate analysis, FI-CD was significantly associated with age (beta [95% confidence interval] = 0.005 [0.002; 0.009] per 1-year increase, p = 0.005) and social deprivation (beta = 0.054 [0.007; 0.102], p = 0.025). A significant interaction was observed between and age and social deprivation (p = 0.036). The adjusted relationship between FI-CD and age was beta = 0.010 [0.002; 0.019], p = 0.017 in precarious caregivers, and beta = 0.003 [− 0.001; 0.007], p = 0.19 in non-precarious caregivers. Conclusions The study suggested that the 34-item FI-CD could have clinical utility in the management of middle-aged caregivers. Social deprivation appeared as an important factor associated with frailty, highlighting the importance of early care and social support for precarious caregivers. </jats:sec

Additional file 1 of The relationship between social deprivation and a frailty index of cumulative deficits in French middle-aged caregivers

Additional file 1: Supplemental Table 1. Description of variables included in the Frailty Index

Screen to Save: Results from NCI's Colorectal Cancer Outreach and Screening Initiative to Promote Awareness and Knowledge of Colorectal Cancer in Racial/Ethnic and Rural Populations

Abstract Background: The Center to Reduce Cancer Health Disparities (CRCHD), National Cancer Institute (NCI), launched Screen to Save, NCI's Colorectal Cancer Outreach and Screening Initiative to promote awareness and knowledge of colorectal cancer in racial/ethnic and rural populations. Methods: The initiative was implemented through CRCHD's National Outreach Network (NON) and Comprehensive Partnerships to Advance Cancer Health Equity (CPACHE) programs. NON is a national network of Community Health Educators (CHEs), aligned with NCI-designated Cancer Centers (CCs). CPACHE are partnerships between a CC and a minority-serving institution with, among other components, an Outreach Core and a CHE. In phases I and II, the CHEs disseminated cancer-related information and implemented evidence-based educational outreach. Results: In total, 3,183 pre/post surveys were obtained from participants, ages 50 to 74 years, during 347 educational events held in phase I. Results demonstrated all racial/ethnic groups had an increase in colorectal cancer-related knowledge, and each group agreed that the educational event increased the likelihood they would engage in colorectal cancer-related healthful behaviors. For phase II, Connections to Care, participants were linked to screening. Eighty-two percent of participants who were screened during the follow-up period obtained their results. Conclusions: These results suggest that culturally tailored, standardized educational messaging and data collection tools are key elements that can serve to inform the effectiveness of educational outreach to advance awareness and knowledge of colorectal cancer. Impact: Future initiatives should focus on large-scale national efforts to elucidate effective models of connections to care related to colorectal cancer screening, follow-up, and treatments that are modifiable to meet community needs. </jats:sec