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By Carlitta Armour,
RN
African Americans constitute only 12 percent of the U.S. population, yet rank first in many of the leading causes of death and disease in the United States. The higher costs of the disproportionate disease rates among African Americans have sparked a rapid "hit and miss" influx of dollars into both the public and private sector in the form of new programs and grant-funded projects. Yet ill health and premature mortality rates for this population continue to rise. The very people targeted for outreach efforts remain highly underserved. There’s a great need for interventions, but as healthcare providers and project directors we should ask ourselves, Do we really want to see progress and improvement or are we simply interested in going through the motions? Many projects are poorly researched, and consequently they result in frustrated attempts at outreach efforts. As you search for solid solutions, consider the following suggestions. Hire and support knowledgeable, culturally competent nurses and outreach workers. They’re most likely to be people who look, feel, and sound like the clients they are serving. Employing an articulate, well-coifed individual with an impressive résumé may seem great. But it’s important for the person to be able to relate to a teen single mother who also has a history of substance abuse and financial problems and lacks motivation. And it’s important that your agency or institution support the recommendations this individual brings back and act quickly on them. Look at the overall picture of what clients need. Provide the materials and equipment that are needed, like instructional videos or demonstrations with live presentations. Brochures and pamphlets passed out at a health fair just won’t do. They might later be used to pick up trash when the dustpan can’t be found. Clients are not going to access the service or product unless they really feel it’s something they can easily use, and do so without a lot of intrusion into their private lives. Also, unless there is person-to-person intervention and follow-up (trust building) again, all you’ll have done is have gone through the motions. Respect faith communities. "Targeting the churches" is a phrase out on the street now. But here’s a bit of caution about using churches to try to change people’s health habits. Unless you plan to accomplish your goals with honest denominational insight and some genuine soul-searching, then don’t bother. Historically, the majority of African American churches are in the business of Christianity and the unchanging "outreach of saving souls." If you use a church as a health outreach site, you are probably one of many who have approached church members telling them what they need to do. Besides, the make-up of a congregation (in terms of age and specific health concerns) may differ from your agenda. Let congregations tell you what they need, how and when they need it, and then be willing to support that request in a timely manner. Also, if you are working with a congregation, remember that it’s likely that there are a lot of healthcare professionals who attend, and it’s important to work with them after getting the approval of the minister. Spend money where it counts. Spending funds on 1,000 brochures to be included in a church bulletin sounds good, but whom have you really educated? It’s unlikely that brochures will help someone make measurable lifestyle changes. This money would be better used to purchase blood pressure machines, weigh scales, or glucometers, or to pay for Alzheimer’s caregiver training—something tangible that will really make a difference long after you are gone and your funded project has ended. Combine projects creatively with area events. The Bakersfield African American Cultural Association combines a very successful mini-health fair with its annual, multifaceted Martin Luther King Jr. birthday celebration, which brings out all age groups. Healthcare vendors get up close and personal with participants. Couple this with some door-to-door marketing and highly visible outreach workers and your efforts will prosper. Healthcare outreach in the African American community is an awesome task, but not a medical mystery. Hiring culturally competent workers and supporting them with technical and monetary assistance, church collaboration, and creative projects will get you started toward improving health care for the very people who need it most. Carlitta Armour, RN, has 15 years of experience in a variety of settings, including community health. She is a free-lance writer and case management consultant. |