Community-Based Participatory Research in Communities With Low Health Literacy

Abstract

A multidisciplinary team addressed a crisis in a community overwhelmed with diabetes. Studies in the region showed that 30.7% of the population have diabetes and a similar percentage has prediabetes, resulting in an urgent need for upstream prevention. Doctors at community clinics were diagnosing diabetes so late in the course of the disease that many patients had few years left to live. The team developed the POD2ER project to provide screening and education in a large, permanent flea market visited by thousands of people weekly. The project developed multidimensional communication methods guided by principles of community-based participatory research. Team members included a community health worker/medical assistant with extensive experience in health care services and research in communities with limited incomes. She brought crucial communication skills to the project team, which also included a physician, four master’s students in public health, and an anthropologist/public health faculty member; additional volunteers came from various biomedical disciplines, including medicine, nursing, pharmacy, biomedical science, physician’s assistants, and others. The project team developed culturally and economically appropriate methods of communication including evidence-based educational materials. The community health worker was invited to take the lead in orienting team members to routines at the flea market, to reassure flea market visitors, and to coordinate the flow at the booth. Public health students designed health education materials minimizing the number of words and emphasizing images for communication with a low-health-literacy audience. The project has continued for 4 years, screened about 1,000 people annually and provided health education to about 12,000.

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