Northern Orange Latino community, Orange County, North Carolina : an action-oriented community diagnosis : findings and next steps of action

From September 2004 – April 2005, a six-member graduate student team from the Department of Health Behavior and Health Education at the University of North Carolina at Chapel Hill conducted an Action Oriented Community Diagnosis (AOCD) with the Latino Community (LC) of Northern Orange County (NOC). An AOCD examines the quality of life, community capacity, and strengths and needs of a community. Two preceptors from the Orange County Public Health Department mentored the student team throughout this process. The students interviewed 67 community members and service providers in both individual and group interview settings. Additional information was collected using secondary data sources and participant observations by the student team. The students presented the results at a community forum held in Hillsborough, North Carolina on April 9, 2005. Major topics that were discussed and addressed at the forum include transportation, adult education, linguistically and culturally competent service providers, a central location for information, and dental care. Below, a summary of the themes and the key action steps that were laid out at the community forum are listed (note Appendix F): There is a lack of public transportation in Northern Orange County. 1. Develop bilingual pamphlets about existing public transportation in Northern Orange County and distribute them to churches and social service agencies serving Latinos. 2. The Department of Transportation will hold a forum to inform Latinos of the extended bus routes that are scheduled to take effect in January 2006. 3. A bilingual community member will attend the Department of Transportation (DOT) board meetings. The Latino community needs more dental services that are affordable. 1. Hold dental screening and cleaning for preschoolers. 2. Publicize this and other events through a network of Promotores de Salud (community members who have received training in health education) as well as churches serving Latinos. 3. Latino community members will help the dental clinic to demonstrate the need for more dental services that are affordable. There is a need for a central location in Northern Orange County that provides the Latino community with information about existing social and health services. 1. Establish a planning committee. 2. Speak to libraries, schools, churches, and county commissioners about office space. 3. Coordinate a petition from the community and service providers. There is a need for more service providers in Northern Orange County with linguistic and cultural competency. 1. Invite the following agencies to learn how to recruit bilingual service providers: Orange County Health Department Medical Clinic in Hillsborough. Orange County Health Department Dental Clinic in Hillsborough. Orange County Department of Social Services. Day cares. Schools (parent/teacher conferences). Police. Courts. 2. Plan and hold job fairs. 3. Share resources and bilingual personnel between towns and counties. 4. Increase English as a Second Language (ESL) educational opportunities. 5. Offer free Spanish classes to personnel in agencies serving a large number of Latinos. There is a need for more adult education in Northern Orange County, such as ESL classes and job skills training. 1. Ask about possible locations for ESL classes. 2. Ask the following people and places for information and help: Teachers and schools. Social service agencies. Day cares. County politiciansMaster of Public Healt

Feasibility and Acceptability of Door-to-Door Rapid HIV Testing Among Latino Immigrants and Their HIV Risk Factors in North Carolina

Latino immigrants in the United States are disproportionally impacted by the HIV epidemic but face barriers to clinic-based testing. We assessed a community-based strategy for rapid HIV testing by conducting “door-to-door” outreaches in apartments with predominately Latino immigrants in Durham, North Carolina, that has experienced an exponential growth in its Latino population. Eligible persons were 18 years or older, not pregnant, and reported no HIV test in the previous month. Participants were asked to complete a survey and offered rapid HIV testing. Of the 228 Latino participants, 75.4% consented to HIV testing. There was a high prevalence of sexual risk behaviors among participants, with 42.5% acknowledging ever having sex with a commercial sex worker (CSW). Most (66.5%) had no history of prior HIV testing. In bivariate analysis, perceived HIV risk, no history of HIV testing, sex with a CSW, sex in exchange for drugs or money, living with a partner, and alcohol use were significantly associated with test acceptance. In the multivariate analysis, participants who had never been tested for HIV were more likely to consent to rapid HIV testing than those who had tested in the past (adjusted odds ratio 2.5; 95% confidence interval [CI], 1.1, 5.6). Most participants supported rapid HIV testing in the community (97%). Door-to-door rapid HIV testing is a feasible and acceptable strategy for screening high-risk Latino immigrants in the community. Factors associated with HIV risk among Latino migrants and immigrants in the United States should be considered along with novel testing strategies in HIV prevention programs

Process evaluation results from the HEALTHY physical education intervention

Process evaluation is an assessment of the implementation of an intervention. A process evaluation component was embedded in the HEALTHY study, a primary prevention trial for Type 2 diabetes implemented over 3 years in 21 middle schools across the United States. The HEALTHY physical education (PE) intervention aimed at maximizing student engagement in moderate-to-vigorous physical activity through delivery of structured lesson plans by PE teachers. Process evaluation data collected via class observations and interventionist interviews assessed fidelity, dose delivered, implementor participation, dose received and barriers. Process evaluation results indicate a high level of fidelity in implementing HEALTHY PE activities and offering 225 min of PE every 10 school days. Concerning dose delivered, students were active for approximately 33 min of class, representing an average of 61% of the class time. Results also indicate that PE teachers were generally engaged in implementing the HEALTHY PE curriculum. Data on dose received showed that students were highly engaged with the PE intervention; however, student misbehavior was the most common barrier observed during classes. Other barriers included teacher disengagement, large classes, limited gym space and poor classroom management. Findings suggest that the PE intervention was generally implemented and received as intended despite several barriers