Latino Health Riverside

Greer Sullivan & Mary Figueroa

Latino Health Riverside Project was funded through a Patient-Centered Outcomes Research Institute (PCORI) Eugene Washington PCORI Engagement Award (1289)

Latino Health RiversideGoals• Engage 3 predominantly Latino neighborhoods in

Riverside • Identify communities' health priorities• Build capacity for community engaged research

• Community members• CBO’s • Academics

Situation• No minority owned CBO focusing on health• Very little prior community discussion about health

Riverside, California

Latino Health Riverside Steering Committee

In Home Meetings• Community representatives identified host

families

• We supplied invitations and meals

• We prepared a series of questions as facilitation

• Anthropologist took notes

Four Priority Areas

• Access to care

• Management of chronic health condition

• Neighborhood safety

• MENTAL HEALTH

Modified Deliberative DemocracyKettering Model

Which is more important?• Preventing mental illness or improving treatment for

those who already have a mental health problem?• Addressing mental health among children (young

adults) or adults (and seniors)?• Encouraging service use by providing community

education about mental health and stigma or linking to services?

• Improving existing services or offer more services in community?

Thank you!• Patient Centered Outcomes Research Institute (PCORI)• Mike Pazzani, Vice Chancellor for Research and Economic

Development, UC Riverside• In- Home Meetings host families• UC Riverside Participants: Christina Reaves, Ann Cheney,

Juliet McMullin, Rita Rodriguez, Michelle Jaramillo• MPH Student (University of Washington): Alejandra Cabral • Parkview Community Hospital and neighborhood community

centers• Community Based Organization Partners:

• Casa Blanca Home of Neighborly Services• Arlington Temporary Assistance• Community Settlement Association

Steering Committee• Patricia Cano• Carmen Martinez• Darlene DeBayona • Morris Mendoza• Suzanna Medina • Andrea Nieto• William Leon• Hurnan Vongsachang• Katherine Tsai• Araceli Damian • Jocelyn Guerrero-

Cardenas

• Joey Abadilla• Gloria Perez• Mary Alvarez• Michelle Anguiano • Eldaa Rivera • LuAnna Jauergui• Diana Alvarez• Marci Aguirre• Lily Gallegos• Sylvia Aguirre-Aguilar• Carlos Fernandez

• Greer Sullivan• Ann Cheney• Christina Reaves• Mary Figueroa• Alejandra Cabral

Deliberative Democracy Kettering Model

• Name the issue

• Frame the issue

• Prepare issue book

• Facilitate deliberation

• Find common ground

• Invite participants to be part of the solution

Comparing Focus Groups and Deliberative Forums

• Inductive analysis: similar themes

• Deductive analysis:− Forum participants more tuned to

o Structural inequalitieso Structural solutionso Community initiated solutions

− Forum participants expressed more hopelessness − Activation

Comparing Public Deliberation Methods Sites: Chicago, Sacramento, Durham, Silver SpringParticipants: 1774 recruited (about 75% show rate)

55% women, 45% college, 90% white, 12% >65y/oDesign: Five arm RCT comparing

• Four Deliberative methods • Reading materials only

Topic: “Should individual patients or their doctors be able to make any health decisions no matter what the evidence of medical effectiveness shows, or should society specify some boundaries for these decisions?”Outcomes: Knowledge about medical evidence

Attitudes about using evidence in medical decision-making

Comparing Deliberative Methods: Results

• Deliberation increased knowledge and shifted attitudes (deliberation vs. RMO)

• All methods changed either knowledge or one attitude measure

• Citizens Panel and Brief Citizens Deliberation were superior in increasing knowledge

• Citizens Panel most effective in changing attitudes • “”Public deliberation may be particularly useful for

healthcare issues where members have limited knowledge yet hold strong beliefs.”

• Participant activation??