Hypertension and diabetes mellitus are leading health concerns in the United States. Despite a disproportionate burden of both conditions among African Americans, it is estimated that 44% of diabetes cases and one quarter of hypertension cases within this population are undiagnosed. Lack of awareness of the risk of these conditions may hinder preventive efforts and the adoption of positive lifestyle changes. Based on the findings from a pilot study to develop and standardize uniform screening forms for hypertension and diabetes, this article reports on the perceived risk versus actual risk of developing these conditions among primarily African American participants using a community-based screening tool. Each form assessed both perceived and actual risk of diabetes and hypertension, respectively. A total of 265 hypertension and 225 diabetes screening forms were randomly selected from eight sites across the country. The risk perception of the overall study sample was similar to its actual risk for developing either condition. However, a significant proportion of individuals who scored at high risk for diabetes or hypertension were unaware of their risk for these conditions. These results suggest the need for developing culturally relevant interventions, public health education, and policies that address the risk misperceptions among this group.
The article highlights the Telehealth EcoSystem™ model, a holistic
cross-sector approach for socioeconomic revitalization, connectivity,
interoperability and technology infrastructure development to address health
equity for rural underserved communities. Two guiding frameworks, Community
& Economic Development (CED) and Collective Impact, provided the foundation
for the Telehealth EcoSystem™ model. Public and private organizational
capacities are addressed by comprehensive healthcare and social service delivery
through stakeholder engagement and collaborative decision-making processes. A
focus is maintained on economic recovery and policy reforms that enhance
population health outcomes for individuals and families who have economic
challenges.The Telehealth EcoSystem™ utilizes an intranet mechanism that enables a
range of technologies and electronic devices for health informatics and
telemedicine initiatives. The relevance of the intranet to the advancement of
health informatics is highlighted. Best practices in digital connectivity, HIPAA
requirements, electronic health records (EHRs), and eHealth applications, such
as patient portals and mobile devices, are emphasized. Collateral considerations
include technology applications that expand public health services.The ongoing collaboration between a social science research corporation, a
regional community foundation and an open access telecommunications carrier is a
pivotal element in the sequential development and implementation of the
Telehealth EcoSystem™ model in the rural southeastern region
community.
Adaptation, adoption, and implementation of HELP and MyRx demonstrated important postintervention changes among racial/ethnic participants in Chicago and Houston. The communities faced similar implementation challenges across settings, targets of change, and cities. Available resources were insufficient to sustain benefits with measurable impact on racial/ethnic disparities beyond the study period. Results suggest the need for implementation studies of longer duration, greater power, and salience to policies and programs that can sustain longterm interventions on a community-wide scale.
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