The Health Disparities Strategic Plan of the National Institute of Health recommends translating scientific discoveries to reach disparity populations. Translating and adapting evidence-based behavioral interventions (EBIs) (usually developed in mainstream populations) into community and clinical settings to reach disparity populations can help reduce disparities. The CADC faculty has collaborated on several independently-funded behavioral interventions that involved translating, adapting, and implementing interventions to reach disparity populations. We provide resources and information on these interventions, organized by those conducted in community settings and clinical settings. By featuring the methods of translation in detail, with resources such as project manuals available, our goal is to make these methods available as a guide to others designing interventions to reduce disparities.
Interventions in Community Settings
We describe and provide links to several behavioral interventions (programs) conducted in community settings to reach diverse older adults. All were evaluated using a randomized, controlled trial design. A variety of downloadable resources include implementation manuals, participant program manuals, training manuals, and process evaluation forms. These materials can be used “as is” or as a methodological guide to others conducting such interventions. Each intervention’s web pages include information on the program, resources, community partners, research, and publications. Downloadable resources vary by intervention.
Increasing Colorectal Cancer Screening in Asian Americans Using Lay Health Workers
Series of programs delivered by trained bilingual/bicultural lay health workers, to increase screening for colorectal cancer (CRC). Programs included lectures, phone calls, and CRC health education materials. Each program addressed cultural issues for several ethnic groups. Resources available from each program include several types of patient health education materials, lay health worker training materials, and study design and publications.
The Chinese Healthy Nutrition and Physical Activity project (+Chinese)
Program to increase nutrition and physical activity knowledge and behaviors in older Chinese Americans. The program, delivered by lay health workers in a community setting, comprised lectures and printed materials in participants’ preferred language (Chinese or English).
- Lay health worker nutrition lecture (Chinese, English)
- Lay health worker exercises and tips (Chinese)
Community of Voices - Comunidad de Voces
Community choir program for diverse older adults to improve psychosocial well-being, delivered by professional choir directors. The weekly choir practices involved learning and singing culturally-relevant songs, physical movement, and socializing, all of which are pathways to improved well-being.
- Program manual
- Evaluation forms
- Research (outreach and recruitment, study design and results)
Nuevo Amanecer – A New Dawn (+Spanish)
Stress management program for Spanish-speaking Latinas with breast cancer. Delivered by peers (compañeras). Designed and evaluated for urban and rural Latinas at all phases of treatment for breast cancer.
- Implementation manual
- Participant program manual
- Compañera training manual
- Implementation evaluation forms
Lifestyle program to reduce diabetes risk factors for culturally diverse adults, delivered by public health department staff. Diabetes risk assessments in community settings identified persons at risk; those at risk were invited to enroll.
- Diabetes Risk Appraisal (+Spanish)
- Participant program manual (+Spanish)
- Curriculum, interventionist manual
- Staffing and training
Community Healthy Activities Model Program for Seniors (CHAMPS)
Program encouraging seniors to increase physical activity by participating in activities available in their community, delivered by health educators and tailored to their preferences and abilities. Also adapted for three community settings to reach minority and underserved seniors.
- CHAMPS program manual
- Adapted programs
- Resources for physical activity in older adults
Interventions in Clinical Settings
Our clinic- and hospital-based research includes (i) implementation science RCTs of interventions designed to promote efficient delivery of guideline-concordant care within busy primary care visits, (ii) quasi experiments testing the effects of policy changes to translational services within primary care and hospital settings, and (iii) patient-centered work to make video clinic visits more accessible to diverse elder patients.
The goal of this project was to video-enable older patients scheduled for office visit appointments in UCSF General Medicine in the early days of the pandemic so that they were able to keep their appointments as video visits, or for those who were unable to be video-enabled, to convert their visits to telephone visits.
- Patient Script
- Tip Sheet
Language Access Systems Improvement (LASI) Initiative
The overarching goal of this proposal was to evaluate the impact of a systems intervention to certify the proficiency of clinicians’ non-English language skills and simultaneously create easy access to professional interpreters through videoconferencing – the LASI initiative.
- Study design
- Patient-oriented results infographics (Spanish-English and Chinese-English)
Implementation science RCT of intervention to increase discussion of breast cancer risk reduction between patients and primary care physicians.
- Study design
- Patient surveys (English, Chinese, and Spanish)
- Patient and physician individualized risk reports