Innovative Community-Based Health Screening Initiative Prepared for Launch

Sylvester Comprehensive Cancer Center and other units of the University of Miami Miller School of Medicine are collaborating in the launch of an innovative health initiative to screen hard-to-reach populations in Miami-Dade County for multiple conditions and help them connect with appropriate care. The collaborative population health management program involves a variety of community partners and is supported by a five-year, $2.5 million grant from the National Institutes of Health.

“To our knowledge, this will be the first multi-pronged screening strategy that tests for four distinct diseases in a community-based setting,” said Olveen Carrasquillo, M.D., M.P.H., professor of medicine and public health sciences, and Chief of the Division of General Internal Medicine. “By engaging community health workers (CHWs) we can deliver state-of-the-art, point-of-care screening services in non-clinical settings, including the privacy of one’s home, allowing us to connect with even the hardest-to-reach minority populations.”

Carrasquillo and Erin Kobetz, Ph.D., M.P.H., Senior Associate Dean for Health Disparities and Associate Director for Disparities and Community Outreach at Sylvester’s Jay Weiss Institute for Health Equity, are co-principal investigators for “Increasing Uptake of Evidence Based Screening Services though a CHW-led Multi-Modality Program,” the NIH-funded study. “This project continues to build on the Miller School of Medicine’s unique position to advance the science of health disparities and generate interdisciplinary solutions to address it,” said Kobetz, who is also an associate professor of medicine, public health sciences and obstetrics/gynecology. She and Carrasquillo are also Directors of the Miami CTSI Community Engagement and Cultural Diversity Program.

A team of Miller school specialists including Emmanuel Thomas, M.D., Ph.D., assistant professor of cell biology at the Schiff Center for Liver Diseases and Miami CTSI KL2 Scholar, Daniel Sussman, associate professor of clinical medicine in the Division of Gastroenterology, and Sonjia Kenya, Ed.D., M.S., M.A., assistant research professor of medicine, Director of Community Health Programs at Sylvester’s Jay Weiss Institute for Health Equity, and Education and Research Officer at the Miller School’s Office of Diversity and Multiculturalism, have developed the multi-modal strategy for the early detection and prevention of four health priority conditions: Hepatitis C Virus (HCV), colorectal cancer, Human Immunodeficiency Virus (HIV) and cervical cancer.

For nearly a decade, the University of Miami’s South Florida Center for Reducing Health Disparities (SUCCESS) has led interventions to improve health and reduce health disparities among the most vulnerable and medically underserved individuals throughout the Miami metropolitan area.

“Now, our partners will be going out and finding individuals who face multiple barriers to care, such as lack of health insurance, language and health literacy, distrust of formalized health care systems and even lack of convenient transportation,” Carrasquillo said.

The Miller School’s partners include the Health Choice Network, a consortium of federally qualified health centers, and the Center for Haitian Studies, a health care and social advocacy organization predominantly serving Haitians. Each health center will determine the most appropriate outreach strategies, such as offering screenings at community-based venues such as pharmacies, supermarkets, churches or health fairs.

“We are pleased to strengthen our longstanding partnership with the University of Miami,” said Alejandro Romillo, President and CEO of Health Choice Network. “By developing new programs that raise the quality and accessibility of heath care, our member centers can better serve their communities.”

Geographically, the study will focus on three Miami-Dade communities with active Community Advisory Boards: Little Haiti (Haitians), Hialeah (Hispanics) and the South Dade U.S. 1 corridor from West Perrine to Florida City (Hispanic, Haitian and non-Haitian blacks).

The study involves a trial of 900 people aged 50-65 who have not been appropriately screened for one or more of the four chronic conditions.

“In each of the three communities, we plan to recruit 300 residents using strategies and approaches guided by our community partners,” said Carrasquillo, noting that participants will be randomly assigned to one of two active CHW-led intervention approaches.

“Our specific aim is to determine if a strategy in which CHWs conduct these multi-modality screenings results in an increase in the proportion of participants who have been screened for all four conditions, compared with a strategy in which patients are actively linked to primary care at one of our participating health centers,” Carrasquillo said. “We hope that our study will provide important information for health systems undertaking population health management approaches to improving the health of minority communities.”

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