Community Health Needs Assessment€¦ · outreach site separately. Categorical variables are...

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Community Health Needs Assessment

Prepared by: Department of Epidemiology

College of Public Health and Health Professions & College of Medicine

University of Florida

Linda B. Cottler, PhD, MPH Email: [email protected] Phone: (352) 273-5468

Through September 2017

mailto:[email protected]

2

Table of Contents

Abbreviations and Definitions................................................................................................................... 3

About HealthStreet ................................................................................................................................... 4

Methodology ............................................................................................................................................. 5

Figure 1: County of residence among HealthStreet members, from October 2011 through September

2017 .......................................................................................................................................................... 8

Table 1: Demographics of HealthStreet members by major community outreach areas and insurance 9

Table 2: Access to care by major community outreach areas and insurance ........................................ 11

Table 3: Overall health conditions by major community outreach areas and insurance ....................... 12

Table 4: Top 8 health concerns† by major community outreach areas and insurance .......................... 16

Table 5: Substance use by major community outreach areas and insurance ........................................ 17

Table 6: Research perceptions by major community outreach areas and insurance............................. 21

Table 7: Top 3 neighborhood concerns† by major community outreach areas and insurance .............. 22

Contact Us ............................................................................................................................................... 23

References .............................................................................................................................................. 24

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Abbreviations and Definitions

Alachua County Area - The community outreach and recruitment site headquartered in Gainesville, Florida, opened in October 2011. This includes members who reside in Alachua, Baker, Bradford, Clay, Gilchrist, Levy, Marion, Putnam, and Union counties.

Duval County Area - The community outreach and recruitment site headquartered in

Jacksonville, Florida, opened in October 2013.

CHW - Community Health Worker. CHWs are lay community members who

share a common language and culture with the people they serve.1

CTSA - Clinical and Translational Science Award, supported by the National Center for Translational Sciences of the National Institutes of Health under University of Florida Clinical and Translational Science Award UL1TR001427.

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About HealthStreet HealthStreet is a community engagement model that seeks to reduce disparities in health

research and access to care; the backbone of the model is the Community Health Worker (CHW).

Founded and developed in 1989 at Washington University in St. Louis (Cottler PI), HealthStreet was

initiated at University of Florida (UF) in 2011 with the creation of the Department of Epidemiology.

CHWs engage community members in discussions at barbershops, beauty shops, parks, bus

stops, community agencies, churches, neighborhood associations, health care facilities, sports venues,

grocery stores, laundromats, nail salons, fitness centers, colleges, health fairs, and other places people

congregate.1 Community members are invited by CHWs to join the HealthStreet Registry which requires

a 30-minute, IRB approved, health assessment and blood pressure reading2 including social

determinants of health, health conditions and concerns, including mental health and substance use, and

research perceptions. Members are followed at 60 days post-assessment and continuously as relevant

research becomes available. They continue to be offered linkages to medical and social services and

opportunities to participate in health research. HealthStreet Gainesville (opened in 2011) and

HealthStreet Jacksonville (opened in 2013) have a growing population of community members who are

in the HealthStreet Registry.

As a national model for community engagement and translational research, HealthStreet data

can be utilized for Community Health Needs Assessments, hot-spotting analyses,3 preliminary data for

grants and cohort identification. The Registry includes people primarily in the Northeast Florida Corridor

from Gainesville to Jacksonville, including rural areas.

This effort is funded through the UF NIH CTSA, the College of Medicine, College of Public Health

and Health Professions, and NIDA.

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Methodology Data in this report are stratified by community outreach site and insurance. Community sites are

divided into the Alachua County Area and Duval County Area based on which outreach team was

involved in recruiting the member. Each community outreach site is separated into three categories:

“Private Insurance,” “Medicaid/Medicare,” and “No Insurance.” Those coded “No Insurance” responded

“No” to the question “Do you have any type of medical insurance?”

Private Insurance

28.4%

Medicaid/Medicare

35.4%

No Insurance

36.2%

Insurance Type Among Alachua County Area (n=6,536)

Private Insurance

25.5%

Medicaid/Medicare

27.0%

No Insurance

47.5%

Insurance Type Among Duval County Area(n=2,536)

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The private insurance category includes those who are on VA/Military Insurance. The following

chart shows the types of insurance coded “Private Insurance” among members from the community

outreach sites combined.

Blue Cross Blue Shield of Florida

48.7%

VA/Military13.5%

United Healthcare

8.9%

Avmed Inc.6.2%

Aetna/AARP5.5%

Humana4.3%

Cigna2.0%

Other10.9%

Insurance Type Among Private Insurance(n=2,506)

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The Medicare/Medicaid category includes those on Medicaid, Medicare, Medicare Supplement,

as well as those receiving assistance through programs such as Shands Charity Care, We Care, and

CHOICES, which are coded as “Other Assistance.” The following chart shows the types of insurance

coded “Medicare/Medicaid” among members from the community outreach sites combined.

The p-values are derived from tests for statistical between insurance groups for each community

outreach site separately. Categorical variables are analyzed using the Chi-square test and continuous

variables are analyzed using Analysis of Variance (ANOVA). All statistical analyses were conducted using

SAS 9.4.

Medicaid59.7%

Medicare19.0%

Medicare Supplement

13.3%

Other Assistance

8.0%

Insurance Type Among Medicare/Medicaid(n=2,999)

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Figure 1: County of residence among HealthStreet members,

from October 2011 through September 2017 (n=9,157)

Figure 1 shows the reach of HealthStreet in Florida. The following tables do not show members who

reside in Miami-Dade County or Panhandle area.

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Table 1: Demographics of HealthStreet members by major community outreach areas and insurance (October 2011 – June 2017)

Characteristic

Alachua County Area (n=6,536)

Duval County Area (n=2,536)

Total

Private Insurance (n=1,858,

28.4%)

Medicaid/ Medicare (n=2,314,

35.4%)

No Insurance (n=2,364,

36.2%)

p-value

Private Insurance

(n=647, 25.5%)

Medicaid/ Medicare (n=685, 27.0%)


47.5%) p-value

n=9,072 (%)

Gender

Female 61.8% 72.9% 48.3%

<.0001

57.8% 67.3% 49.8%

<.0001

5,411 (59.7)

Male 37.9% 27.0% 51.6% 42.2% 32.7% 49.9% 3,646 (40.2)

Transgender/Other 0.2% 0.2% 0.1% 0.0% 0.0% 0.3% 15

(0.2)

Average Age (years)

Female 44.6 45.8 41.1 <.0001 44.1 45.3 43.0 0.0694 44.1

Male 44.5 51.0 40.7 <.0001 42.6 50.7 42.7 <.0001 44.3

Race

Asian 2.8% 0.5% 0.8%

<.0001

0.6% 0.4% 1.1%

<.0001

101 (1.1)

African-American 45.3% 57.3 % 53.5% 85.0% 83.7% 74.3% 5,443 (60.1)

Caucasian 46.0% 36.2% 38.5% 11.5% 13.9% 20.4% 3,013 (33.3)

Other 5.9% 6.0% 7.2% 3.0% 2.0% 4.2% 503 (5.6)

Latino/Hispanic* 6.9% 5.3% 6.7% 0.0661 3.1% 3.4% 3.6% 0.8623 492 (5.5)

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Characteristic



Total


28.4%)


35.4%)


36.2%)

p-value

Private Insurance

(n=647, 25.5%)



47.5%) p-value

n=9,072 (%)

Marital Status

Never Married 40.0% 42.2% 53.2%

<.0001

46.7% 50.8% 56.4%

<.0001

4,295 (47.5)

Married 34.6% 20.5% 15.6% 25.3% 13.0% 12.2% 1,881 (20.8)

Divorced/Separated/Widowed 25.4% 37.3% 31.3% 28.0% 36.2% 31.4% 2,873 (31.8)

Body Mass Index

Female 29.3 31.4 30.4 <.0001 30.0 30.4 31.1 0.1410 30.5

Male 28.5 28.0 27.3 0.0007 28.3 27.7 27.0 0.0160 27.7

12+ Years of Education 93.5% 76.5% 74.9% <.0001 86.1% 66.3% 74.5% <.0001

7,171 (79.2)

Currently Employed 59.4% 20.8% 32.8% <.0001 52.7% 13.3% 26.9% <.0001 3,098 (34.3)

Veteran Status 16.9% 6.8% 8.5% <.0001 15.8% 8.5% 5.7% <.0001 899

(10.0)

Household size (including participant)

3.0 3.2 3.2 0.0299 2.9 3.1 2.7 <.0001 3.1

Food Insecure (not enough money to buy food)

25.5% 48.5% 59.0% <.0001 32.7% 53.3% 60.6% <.0001 4,276 (47.4)

Pets (cat or dog) 45.8% 43.1% 38.1% 0.0047 24.9% 22.2% 16.5% 0.0023 1,455 (34.4)

Uses social media or text messaging

84.0% 68.8% 72.9% <.0001 86.5% 72.6% 81.3% <.0001 6,897 (76.2)

*Latino/Hispanic is not mutually exclusive with other races

Table 1 shows demographic information of HealthStreet members. Data is collected from individual questions asked of all members.

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Table 2: Access to care by major community outreach areas and insurance (October 2011 - June 2017)

Characteristic



Total


28.4%)


35.4%)


36.2%)

p-value

Private Insurance

(n=647, 25.5%)



47.5%)

p-value n=9,072

(%)

No doctor visit within past 6 months 24.2% 20.8% 47.2% <.0001 25.0% 20.0% 47.4% <.0001

2,915

(32.1)

No physical exam within past 12 months 21.3% 22.4% 50.7% <.0001 19.9% 17.5% 54.1% <.0001

3,010

(33.2)

Been to ER within past 6 months

23.6% 40.5% 36.5% <.0001 19.9% 31.3% 34.9% <.0001 2,864 (33.0)

Receives health care or health services at UF Health/Shands 37.9% 48.5% 22.5% <.0001 30.7% 48.4% 39.2% <.0001

1,598 (37.9)

Ever had a colonoscopy (over 50 years) 69.7% 65.4% 36.1% <.0001 50.2% 54.1% 33.1% <.0001

2,087 (54.5)

Ever had a mammogram (women over 40 years)

93.7% 91.3% 76.7% <.0001 90.9% 89.9% 73.2% <.0001 2,719 (86.6)

Ever screened for prostate cancer (men over 45 years)

70.2% 62.6% 39.0% <.0001 64.0% 61.5% 39.3% <.0001 507

(54.9)

Table 2 shows access to care among HealthStreet members. Data is collected from questions asked of each member.

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Table 3: Overall health conditions by major community outreach areas and insurance (October 2011 - June 2017)

Characteristic



Total


28.4%)


35.4%)


36.2%)

p-value

Private Insurance

(n=647, 25.5%)



47.5%)

p-value n=9,072

(%)

ADD/ADHD 6.9% 7.7% 11.0% <.0001 4.8% 6.3% 5.3% 0.4698 669 (7.8)

Allergies (Animal, Drug, Food, Seasonal, Other)

52.0% 50.4% 44.1% <.0001 37.2% 34.6% 32.1% 0.0877 4,024 (44.5)

Anemia 13.4% 18.3% 11.4% <.0001 10.4% 11.2% 12.4% 0.4127 1,232 (13.6)

Antibiotic Resistant Infection 2.7% 3.9% 2.9% 0.0644 1.1% 1.5% 1.4% 0.7996 241 (2.7)

Arthritis (Gout, Osteoarthritis, Other)

23.9% 33.4% 21.3% <.0001 13.6% 22.1% 15.1% <.0001 2,097 (23.5)

Asthma 16.8% 23.6% 18.2% <.0001 16.2% 20.5% 15.0% 0.0080 1,706 (18.9)

Autism 0.1% 0.9% 0.5% 0.0020 0.5% 0.6% 0.2% 0.2954 44

(0.5)

Autoimmune (Lupus, Scleroderma, Rheumatoid Arthritis)

5.4% 9.8% 4.5% <.0001 11.3% 17.8% 12.8% 0.0010 771 (8.7)

Back Pain, Bone Pain 40.6% 54.1% 49.0% <.0001 38.9% 50.2% 48.6% <.0001 4,341 (47.9)

Brain/Spinal/Nervous System (Cerebral Palsy, Down Syndrome, Paralysis)

1.1% 1.6% 0.9% 0.0028 0.2% 0.6% 0.3% 0.4122 84

(1.0)

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Characteristic



Total


28.4%)

Medicaid/ Medicare (n=2,314 35.4%)


36.2%)

p-value

Private Insurance

(n=647, 25.5%)



47.5%)

p-value n=9,072

(%)

Breathing/Lung (Chronic Bronchitis, Chronic Sinus Infections, Pneumonia)

15.5% 21.5% 17.5% <.0001 11.9% 17.4% 12.6% 0.0047 1,544 (17.1)

Cancer (type and treatment recorded but not reported here)

10.8% 13.2% 5.8% <.0001 5.4% 7.3% 3.0% <.0001 760 (8.4)

COPD/Emphysema 3.7% 9.5% 4.2% <.0001 5.4% 6.1% 4.2% 0.1457 514 (5.7)

Dementia 1.3% 2.5% 1.4 % 0.0043 0.5% 2.1% 0.8% 0.0069 140 (1.5)

Diabetes (Type 1 & Type 2) 12.2% 18.2% 8.9% <.0001 14.4% 21.7% 10.9% <.0001 1,219 (13.6)

Digestive Health (Acid Reflux, Crohn's Disease, Diverticulitis, Esophagitis, Gallstones, Irritable Bowel Syndrome, Pancreatitis, Ulcer, Ulcerative Colitis)

31.9% 41.5% 31.8% <.0001 22.6% 31.0% 27.2% 0.0025 2,973 (33.0)

Headaches 33.0% 38.5% 35.9% 0.0012 27.1% 31.5% 31.7% 0.0890 3,123 (34.4)

Hearing (Hearing Loss, Tinnitus, Vertigo)

22.9% 28.7% 24.9% <.0001 12.0% 16.8% 18.0% 0.0028 2,079 (23.0)

Heart/Circulation (Arrhythmias, Clots, Coronary Artery Disease, Heart Attack, Heart Murmur, Mitral Valve Prolapse, Deep Vein Thrombosis)

14.8% 20.8% 14.2% <.0001 7.0% 13.4% 9.9% 0.0005 1,338 (14.9)

Hepatitis C 2.0% 3.0% 3.1% 0.0473 1.7% 2.6% 3.5% 0.0802 249 (2.7)

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Characteristic



Total


28.4%)


35.4%)


36.2%)

p-value

Private Insurance

(n=647, 25.5%)



47.5%)

p-value n=9,072

(%)

Hypertension 31.4% 43.9% 31.4% <.0001 34.8% 45.1% 31.8% <.0001 3,245 (35.9)

High Cholesterol 21.9% 26.0% 13.7% <.0001 17.3% 27.6% 13.8% <.0001 1,785 (19.9)

HIV/AIDS 0.4% 2.9% 1.0% <.0001 2.0% 4.5% 2.8% 0.0230 175 (1.9)

HPV 3.2% 3.0% 2.4% 0.2877 1.7% 1.6% 1.4% 0.8783 224 (2.5)

Infectious Diseases (Meningitis, Rheumatic Fever, Shingles, Tuberculosis)

6.6% 7.8% 5.0% 0.0006 2.5% 3.7% 4.5% 0.0920 515 (5.7)

Kidney/Urinary (Incontinence, Kidney Failure, Kidney Stones, Urinary Tract Infections)

21.1% 30.5% 21.4% <.0001 11.4% 13.6% 12.1% 0.4626 1,911 (21.1)

Liver Cirrhosis 0.7% 1.3% 0.8% 0.0757 0.9% 1.9% 0.9% 0.1289 91

(1.0)

Mental Health Disorder, Other (Eating Disorder, Personality Disorder, Schizophrenia)

5.4% 11.0% 9.5% <.0001 3.4% 8.9% 7.7% 0.0001 750 (8.3)

Mood Disorders/Anxiety (Anxiety, Bipolar Disorder, Depression, Mania)

30.9% 43.9% 41.5% <.0001 24.1% 34.2% 36.3% <.0001 3,382 (37.4)

Movement Disorder (Parkinson’s Disease, Restless Leg Syndrome, Tourette Syndrome)

5.7% 7.9% 6.9% 0.0196 2.5% 4.5% 4.5% 0.0747 551 (6.1)

Multiple Sclerosis 0.5% 0.9% 0.3% 0.0484 0.6% 0.4% 1.2% 0.1960 58

(0.6)

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Characteristic



Total


28.4%)



36.2%)

p-value

Private Insurance

(n=647, 25.5%)



47.5%)

p-value n=9,072

(%)

Muscle/Bone (Fibromyalgia, Osteomyelitis, Osteoporosis, Scoliosis)

10.6% 16.8% 8.0% <.0001 4.6% 9.1% 5.6% 0.0016 926

(10.3)

Reproductive Health (Infertility) 4.2% 4.7% 4.0% 0.4443 4.1% 4.1% 3.9% 0.9845 377 (4.2)

Seizures 2.7% 6.2% 4.9% <.0001 2.2% 5.4% 4.0% 0.0092 408 (4.5)

Serious Head Injury 4.1% 5.8% 6.9% 0.0006 2.6% 5.8% 5.2% 0.0128 492 (5.4)

Sickle Cell Disease 0.5% 1.0% 0.8% 0.1722 1.2% 1.2% 0.5% 0.1611 74

(0.8)

Skin (Acne, Athlete's Foot, Cold Sores, Eczema, Psoriasis, Rash, Rosacea, Skin Ulcers)

35.8% 31.0% 31.8% 0.0023 27.7% 27.6% 25.2% 0.3632 2,796 (30.9)

Sleep (Insomnia, Narcolepsy, Sleep Apnea, Sleep Walking)

31.0% 37.3% 35.2% 0.0001 20.3% 26.3% 26.7% 0.0062 2886 (32.0)

STIs (Chlamydia, Genital Warts, Gonorrhea, Herpes, Syphilis)

9.6% 11.5% 10.5% 0.1380 5.0% 7.3% 7.8% 0.0623 863 (9.6)

Stroke/TIA 3.3% 7.9% 3.1% <.0001 2.2% 4.8% 3.2% 0.0236 404 (4.5)

Thyroid (Hyperthyroidism, Hypothyroidism)

7.1% 7.1% 4.7% 0.0006 5.0% 3.5% 3.1% 0.1229 496 (5.5)

Vision (Cataracts, Glaucoma, Retinopathy)

12.0% 18.6% 5.8% <.0001 7.9% 15.9% 5.1% <.0001 1004 (11.2)

Weight Control 19.3% 21.4% 16.7% 0.0003 10.8% 11.0% 9.6% 0.5457 1,506 (16.6)

Table 3 shows health conditions among HealthStreet members. The respondent self-reports a history of health conditions based on responses to

the question “Have you ever been told you had, or have you ever had a problem with (CONDITION).”

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Table 4: Top 8 health concerns† by major community outreach areas and insurance (October 2011 - June 2017)

Characteristic



Total


28.3%)



36.2%)

p-value

Private Insurance

(n=601, 25.4%)



47.7%)

p-value n=8,382 (%)

Hypertension 28.9% 29.9% 27.0% 0.0971 39.3% 38.3% 32.8% 0.0095 2,569 (30.7)

Diabetes 24.0% 22.0% 18.4% <.0001 26.8% 27.1% 17.8% <.0001 1,812 (21.6)

Muscle and Bone Problems 17.7% 20.4% 21.9% 0.0058 14.3% 19.2% 21.2% 0.0024 1,660 (19.8)

Weight Problems 24.5% 16.9% 12.9% <.0001 22.6% 11.8% 7.8% <.0001 1,357 (16.2)

Oral Health 6.3% 12.1% 19.3% <.0001 13.6% 18.3% 26.6% <.0001 1,285 (15.3)

Cancer 18.5% 11.8% 13.7% <.0001 20.0% 14.8% 14.8% 0.0119 1,245 (14.9)

Heart Problems 16.7% 14.2% 13.1% 0.0064 13.3% 15.0% 12.8% 0.4515 1,194 (14.2)

Mental Health 13.5% 13.2% 13.2% 0.9690 9.7% 10.6% 11.0% 0.6908 1,049 (12.5)

†Among those with at least one health concern

Table 4 shows the top health concerns among HealthStreet members. The CHW asks the respondent “What are your top three health

concerns?” Of the 9,072 members with completed intakes during this time span in Alachua and Duval County areas, 8,382 (92.4%) had at least

one health concern. The health concerns are ordered by prevalence and are in members’ own words.

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Table 5: Substance use by major community outreach areas and insurance (October 2011 - June 2017)

Characteristic



Total


28.4%)



36.2%)

p-value

Private Insurance

(n=647, 25.5%)



47.5%)

p-value n=9,072 (%)

Alcohol: More than (men: 4, women: 3) alcoholic drinks in a single day, in the last 30 days

22.6% 17.7% 29.3% <.0001 23.7% 17.8% 27.3% <.0001

2,121 (23.4)

Club Drugs

Never 94.6% 94.6% 88.5%

<.0001

98.2% 97.1% 94.1%

0.0002

8,458 (93.4)

Past user 5.0% 5.0% 10.6% 1.7% 2.9% 5.5%

555 (6.1)

Current user (past 30 days) 0.4% 0.4% 0.9% 0.2% 0.0% 0.4%

42 (0.5)

Cocaine or crack

Never 85.9% 82.6% 72.3%

<.0001

92.6% 85.3% 80.0%

<.0001

7,352 (81.2)

Past user 13.4% 16.0% 24.8 % 6.3% 12.9% 16.8%

1,535 (16.9)


173 (1.9)

Marijuana

Never 54.7% 51.8% 37.7%

<.0001

62.4% 63.9% 53.1%

<.0001

4,576 (50.6)

Past user 34.4% 33.5% 37.1% 27.4% 23.4% 30.4%

2,988 (33.0)


1,488 (16.4)

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Characteristic



Total


28.4%)



36.2%)

p-value

Private Insurance

(n=647, 25.5%)



47.5%)

p-value n=9,072 (%)

Heroin

Never 97.0% 97.3% 96.0%

0.0855

98.0% 98.3% 97.1%

0.4287

8,788 (97.0)

Past user 3.0% 2.7% 4.0% 2.0% 1.6% 2.7% 268 (3.0)

Current user (past 30 days) 0.1% 0.1% 0.1% 0.0% 0.2% 0.2% 8

(0.1) Speed or amphetamines

Never 91.1% 92.7% 88.3%

<.0001

96.3% 97.1% 94.9%

0.1274

8,343 (92.1)

Past user 8.3% 7.1% 11.3% 3.4% 2.9% 4.6% 680 (7.5)


(0.4)

Prescription pain medication

Never 45.1% 41.7% 52.0%

<.0001

58.2% 48.5% 61.0%

<.0001

4,456 (49.3)

Past user 44.7% 39.6% 38.1% 27.7% 28.5% 26.7% 3,326 (36.8)

Current user (past 30 days) 10.2% 18.7% 9.9% 14.1% 23.0% 12.4% 1,249 (13.8)

Adderall or Ritalin

Never 92.9% 94.2% 90.3%

<.0001

96.8% 96.3% 94.8%

0.0306

8,433 (93.4)

Past user 5.8% 5.0% 9.0% 2.2% 3.2% 4.7% 526 (5.8)


(0.8)

19

Characteristic



Total


28.4%)



36.2%)

p-value

Private Insurance

(n=647, 25.5%)



47.5%)

p-value n=9,072 (%)

Prescription medication for anxiety and sleep

Never 75.7% 70.6% 76.1%

<.0001

87.0% 80.1% 84.3%

0.0003

6,946 (76.8)

Past user 13.8% 15.3% 15.6% 6.5% 8.6% 9.9% 1,193 (13.2)


(10.0)

Inhalants

Never 98.6% 98.6% 97.6%

0.0325

99.4% 99.0% 98.7%

0.2997

8,923 (98.4)

Past user 1.4% 1.3% 2.3% 0.6% 0.7% 1.3% 135 (1.5)


(0.1)

Hallucinogens

Never 90.5% 93.6% 88.1%

<.0001

98.2% 98.1% 96.8%

0.1045

8,390 (92.6)

Past user 9.3% 6.3% 11.4% 1.2% 1.5% 2.8% 638 (7.0)


(0.3)

Smoked cigarettes

Never 57.4% 43.0% 34.6%

<.0001

72.6% 61.6% 52.3%

<.0001

4,396 (48.5)

Past user 24.6% 22.5% 17.4% 10.7% 12.7% 9.9% 1,661 (18.3)


3,004 (33.2)

20

Characteristic



Total


28.4%)



36.2%) p-value

Private Insurance

(n=647, 25.5%)



47.5%) p-value n=9,072 (%)

Smoked cigars or cigarillos

Never 75.7% 69.2% 56.0%

<.0001

86.5% 86.7% 77.5%

<.0001

3,080 (72.9)

Past user 17.5% 19.3% 19.8% 7.7% 5.0% 8.1%

615 (14.6)


531 (12.6)

Tobacco through hookah, bong, pipe

Never 82.8% 88.8% 77.7%

<.0001

93.2% 95.0% 90.8%

0.0889

3,666 (86.8)

Past user 15.0% 8.9% 18.3% 4.6% 3.9% 7.1%

456 (10.8)


104 (2.5)

E-cigarettes

Never 88.0% 84.4% 78.2%

<.0001

94.9% 95.6% 92.3%

0.1553

3,695 (87.4)

Past user 8.6% 12.9% 16.9% 2.9% 3.1% 4.7%

398 (9.4)


133 (3.2)

Table 5 shows substance use among HealthStreet members. Substance use status is measured from the health assessment by asking questions

such as “Have you ever used (SUBSTANCE)?” Respondents answering “No” are coded “Never.” Respondents answering “Yes” would then be

asked the follow-up question “Have you used (SUBSTANCE) in the last 30 days?” Those answering “Yes” are coded “Current user,” while those

answering “No” are coded “Past Users.”

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Table 6: Research perceptions by major community outreach areas and insurance (October 2011 - June 2017)

Characteristic



Total


28.4%)



36.2%)

p-value

Private Insurance

(n=647, 25.5%)



47.5%)

p-value n=9,072 (%)

Ever been in a health research study

25.6% 22.2% 13.6% <.0001 18.7% 15.9% 10.7% <.0001 1,659 (18.4)

Interested in participating in research

89.3% 94.5% 94.7% <.0001 93.7% 94.6% 94.3% 0.7540 8,458 (93.4)

Would you volunteer for a health research study:

That only asked questions about your health

92.8% 94.4% 94.7% 0.0313 92.6% 93.7% 92.9% 0.7057 8,500 (93.8)

If researchers wanted to see your medical records

80.4% 87.3% 90.3% <.0001 83.1% 88.0% 88.4% 0.0039 7,835 (86.6)

If you had to give a blood sample 82.7% 86.9% 88.8% <.0001 81.0% 81.7% 83.9% 0.2144 7,732 (85.4)

If you were asked to give a sample for genetic studies

85.2% 88.2% 86.3% 0.0165 81.9% 83.8% 81.4% 0.4153 7,736 (85.4)

If you might have to take medicine

51.0% 62.8% 66.6% <.0001 58.2% 66.7% 66.3% 0.0009 5,584 (61.8)

If you were asked to stay overnight in a hospital or clinic

65.1% 74.7% 75.7% <.0001 66.3% 73.5% 77.0% <.0001 6,574 (72.6)

If you might have to use medical equipment

81.8% 86.3% 86.5% <.0001 76.2% 79.7% 81.9% 0.0128 7,570 (83.6)

If you didn’t get paid 81.4% 78.2% 77.9% 0.0120 78.6% 78.6% 77.9% 0.9143 7,123 (78.8)

Table 6 shows research perceptions among HealthStreet members. Data is collected from individual questions asked of all members.

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Table 7: Top 3 neighborhood concerns† by major community outreach areas and insurance (October 2011 - June 2017)

Characteristic



Total


28.7%)



35.9%)

p-value

Private Insurance

(n=457, 25.2%)


No Insurance

(n=846, 46.7%)

p-value n=6,585

(%)

Safety/Crime 31.9% 33.9% 28.9% 0.0072 42.2% 46.0% 40.8% 0.1705 2,276 (34.6)

Health 19.9% 10.1% 13.0% <.0001 8.3% 5.7% 5.7% 0.1364 781

(11.9)

Drugs 7.8% 12.5% 12.0% <.0001 6.1% 6.1% 8.0% 0.2755 651 (9.9)

†Among those with a neighborhood concern

Table 7 shows the top neighborhood concerns among HealthStreet members. The CHW asks the respondent “What do you think is the most

important concern for your neighborhood?” Of the 9,072 members with completed intakes during this time span in Alachua and Duval County

areas, 6,585 (72.6%) had a neighborhood concern.

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Contact Us

Customized reports are available for:

Community Health Needs Assessment

Preliminary data for grants

Cohort identification

Navigation of screened and eligible

participants in our database to your

research studies

Please let us know how we can help you.

Linda B. Cottler, PhD, MPH

Email: [email protected]

Phone: (352) 273-5468

mailto:[email protected]

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References 1. Cottler LB, McCloskey DJ, Aguilar-Gaxiola S, Bennett NM, Strelnick H, Dwyer-White M, Collyar

DE, Ajinkya S, Seifer SD, O'Leary CC, Striley CW, Evanoff B. Community needs, concerns, and

perceptions about health research: findings from the Clinical and Translational Science Award

Sentinel Network. Am J Public Health 2013; 103: 1685–1692.

2. Webb FJ, Striley CW, Cottler LB. Marijuana use and its association with participation, navigation,

and enrollment in health research among African Americans. J Ethn Subst Abuse 2015; 25: 1–15.

3. Ruktanonchai CW, Pindolia DK, Striley CW, Odedina FT, Cottler LB. Utilizing spatial statistics to

identify cancer hot spots: a surveillance strategy to inform community-engaged outreach

efforts. Int J Health Geogr 2014, 13: 39.

4. Cottler LB, Striley CW, O’Leary CC, Ruktanonchai CW, Wilhelm KA. Engaging the community in

research with the HealthStreet model: national and international perspectives. Translational

Medicine – What, Why and How: An International Perspective. Translational Research in

Biomedicine. Basel, Karger, 2013; 3: 98–109.

5. Cottler LB, Nagarajan R. Real-time assessment of community health needs and concerns. Sci

Transl Med 2012; 1: 4(119).

6. Cottler LB, Callahan C, Striley CW. HealthStreet: A community-based approach to include mental

health in public health research. Mental Health in Public Health: The Next 100 Years. New York,

NY: Oxford University Press; 2011: 247–273.

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