How public health issues affect the African community

Introduction

The Center for Promoting Health and Health Equity-Racial and Ethnic Approaches to Community Health (CPHHE-REACH) Initiative was created to reduce cardiovascular health disparities and risk factors among African Americans in Omaha, Nebraska. This initiative aimed to improve healthier lifestyle choices that reduce or alleviate chronic diseases through policy, systems, and environmental improvements. One of the main objectives of this initiative was to evaluate the impact of safety and security factors on physical activity among urban minority communities. In this article, we will analyze the evaluation of the CPHHE-REACH initiative and discuss its strengths and limitations. Furthermore, we will explore how this evaluation could inform a proposed evaluation of the Maryland Department of Housing and Community Development's Homeless Solutions Program.

Policy/Program Description

The Center for Promoting Health and Health Equity-Racial and Ethnic Approaches to Community Health (CPHHE-REACH) Initiative is the policy or program that the study focused on. Creighton University's Department of Health and Sciences Multicultural and Community Affairs (HS-MACA) created this initiative through its office of the Center for Promoting Health and Health Equity (CPHHE) in 2014. In the same year, the initiative was awarded a three-year cooperative agreement from the Centers for Disease Control and Prevention (CDC) as a segment of their Racial and Ethnic Approaches to Community Health (REACH) program. The initiative aims to develop a new model for African Americans in Omaha, Nebraska, to reduce cardiovascular health disparities and risk factors.

CPHHE-REACH is a collaborative agreement between community-based agencies in the African-American community of Omaha. It aims to educate, develop, and implement policies, systems, and environmental improvements that promote healthier lifestyles and reduce chronic diseases.

Purpose of the Evaluation

The evaluation aimed to assess the behavioral changes and benefits of participating in physical activity through the CPHHE-REACH initiative for North Omaha's African-American community members. The study specifically aimed to determine the impact of safety and security factors on physical activity behavior among urban minority communities. The evaluation also used the Health Belief Model (HBM) to predict physical activity behavior change (Kosoko-Lasaki et al., 2017).

Evaluation Method and Results

The evaluation method used in the study was a qualitative thematic analysis of focus group data collected from North Omaha African-American community members who participated in the CPHHE-REACH initiative. The focus group participants' recorded statements were analyzed using the HBM to determine relationships that may help predict further outcomes and interventions. The study found that safety and security factors, such as crime, street quality, and lighting, were significant barriers to physical activity in urban minority communities (Kosoko-Lasaki et al., 2017).

In a similar study conducted by Kneeshaw-Price et al. (2015), the researchers used a mixed-methods approach to evaluate the effectiveness of a community-based physical activity program among African-American and Latino residents in a low-income urban community. The study found that community-based interventions, such as providing resources and creating partnerships with community organizations, effectively increased physical activity levels among participants.

Another study by King et al. (2015) evaluated the effectiveness of a community-wide campaign to increase physical activity levels among African Americans. The study used a pre-test/post-test design and found that the campaign effectively increased physical activity levels among participants. The study also found that social support and community involvement were important factors in promoting physical activity behavior change.

In summary, through policy, systems, and environmental improvements, the CPHHE-REACH initiative aimed to reduce cardiovascular health disparities and risk factors among African Americans in Omaha, Nebraska. The evaluation method was a qualitative thematic analysis of focus group data collected from North Omaha African-American community members. The study found that safety and security were significant barriers to physical activity in urban minority communities. Other studies have also found that community-based interventions, social support, and community involvement effectively promote physical activity behavior change among African Americans.

Strengths and Limitations of the Evaluation

One of the strengths of the evaluation was the use of focus groups to collect qualitative data about physical activity, health status, and health-promoting behavior. Focus groups are an effective way of gathering data from participants in a relaxed and informal setting, allowing for a more in-depth understanding of participants' experiences, perspectives, and attitudes toward the intervention (Morgan, 1996). Additionally, the research design was based on the Health Belief Model (HBM), widely used in health behavior research to understand and predict health behaviors (Rosenstock et al., 1988). The HBM provides a framework for understanding how individuals perceive the threat of illness, the benefits and barriers of taking action, and the cues to action that influence behavior change.

A limitation of the evaluation is the convenience sampling method used to recruit participants. Convenience sampling can introduce bias into the study, as the sample may not be representative of the target population (Polit & Beck, 2017). A recruitment assignment protocol was used to reduce this bias to ensure appropriate sampling randomizations. However, no information is provided on how the protocol was implemented, making it difficult to assess its effectiveness. Additionally, the study only included African American participants, limiting the findings' generalizability to other racial and ethnic groups. Finally, the study did not include any quantitative data, which would have provided a complete picture of the impact of the intervention on physical activity levels.

Recommendations for What Could Have Been Done Differently

To address the limitations of the evaluation, the evaluator could have used a more representative sampling method, such as stratified random sampling, to recruit participants. This method would have ensured that the sample is representative of the target population and that the findings could be generalized to a broader population. Additionally, the evaluator could have collected quantitative data to complement the qualitative data from the focus groups. This would have provided a complete picture of the impact of the intervention on physical activity levels and health outcomes. Finally, the evaluator could have conducted a follow-up survey to assess the long-term impact of the intervention.

How the Evaluation Reviewed Can Inform the Proposed Evaluation of the "Maryland Department of Housing and Community Development's Homeless Solutions Program"

In terms of method, the evaluation reviewed can inform the proposed evaluation of the "Maryland Department of Housing and Community Development's Homeless Solutions Program" in several ways. First, using focus groups to collect qualitative data is an effective method for understanding program participants' experiences, perspectives, and attitudes. Focus groups can provide insights into how the program is perceived and experienced by participants and can identify areas for improvement.

Second, using the Health Belief Model as a theoretical framework is useful for understanding the factors that influence health behaviors. The model can be used to develop survey questions and interview guides that target the model's constructs, such as perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action. This can help to assess program effectiveness and identify ways to improve health outcomes for the homeless population served by the program.

Lastly, the reviewed evaluation highlights the importance of collecting quantitative and qualitative data. A mixed-methods approach can provide a more complete understanding of program outcomes and the factors contributing to those outcomes. By incorporating both types of data, the evaluation can better assess program effectiveness and provide a more nuanced understanding of the experiences and perspectives of program participants.