The Vietnamese American population is one of the fastest growing groups in the Asian ethnic community. They also have the highest rate of health uninsured with many barriers to access to care (Huang, 2013). Houston and its vicinity have the 3nd largest Vietnamese American population in the United States (Zong & Batalova, 2016) with many health care issues due to the lack of insurance and multiple barriers to access to care (Nguyen, 2015). The purpose of this study is to evaluate the effectiveness of a multi-service community –based health fair servicing the under-served Vietnamese American with barriers to access to care.
Methods:
Recognizing these deficits and challenges, the Vietnamese American Nurses Association (VANA), based in Houston, has established partnership with other organizations and disciplines to provide culturally sensitive multi-service annual health fair to the Vietnamese American living in Houston and its vicinity for the past several years. The participants were limited to the age of 18 and older. The program included diseases screenings, and disease early detection and prevention educational programs and flu vaccination. These services carried out by nurses, doctors, dentists, optometrists, nurse practitioners (NPs) and volunteers. The main language used was Vietnamese language. There were Vietnamese translators available for the non-Vietnamese speakers. Most of the educational materials were translated into Vietnamese. The general educational programs had 2 sessions, 50 minutes each with 3 different topics in each session, ranging from chronic health diseases like diabetes and cardio vascular diseases, to common cancer topics such as breast, cervical and colon cancers. These educational sessions are conducted by medical doctors, NPs, and community educational specialist. Other educations were incorporated in to the screening stations, thus the participants had opportunity to learn the information related to that particular screening activity with more one on one instruction. At the time of exit, an evaluation form which has 15 items, rated on a Likert scale, was distributed to the participants to measure the effectiveness of the program and participant satisfaction with the event. There was a comment section for the participant to fill in if they have additional comments or suggestions. Descriptive statistics was used.
Results:
There were 501 participants with average age of 49 years old and 62 % were male participated in this annual health fair activity. Services included bone density screening with 154 people attended the ankle bone density screening with about 10% with Z score >-2.6 indicating osteoporosis. They were referred out to their primarily physician for a formal osteoporosis evaluation. Blood pressure screening with 207 participants participated with 35% were identified with systolic blood pressure at 140 mm/Hg or higher. Diabetic screening with blood fasting glucose with 120 participants were screened with 25% > 100mg/dl, Cholesterol screening with 297 participants screened with 48%> 200 mg/dl. Flu vaccination with 250 shots was given to eligible participants. Their age ranges from 18 to 72 years old. For participants age 65 years old and older, pneumovax vaccine also offered. Hepatitis B and C screen with 113 people were screened, about 20% with positive antibodies/antigen for hepatitis B and C. These participants were referred to a GI specialist for follow up and treatment if needed. Vision screening with 228 screened with about 30% were referred out for further examination and treatment for vision problems. Dental health screening: 157 participants screened. About 15% were referred to community dentists for further evaluation and treatment of dental diseases. Breast cancer screening with clinical exam and mammogram: 123 females were screened with 100 mammogram ordered. Five participants were referred to breast specialists for abnormality found on exam and on mammograms.
Participant’s evaluation and satisfaction survey had 47% return rate with 80% reported very satisfied with the health fair over all. Some of the participants were indicating that they are using this annual health fairs as their annual health checkup since they don’t have health insurance, lack of access to care, and language barriers. Some comments were noted with the participants asking for more cancer educational topics and the educational sessions were too long.
Conclusion:
The effectiveness of the community health fairs have been evaluated in the poor and underserved populations in different countries globally. Some outreach programs have utilized the community lay health workers (CLHW) for the health education interventions (de Vries & Pool, 2017). The results from that research did not show that using the CLHW for the community health education was sustainable resources. In the contrary, this annual health fair utilized most of the health care professional thus it was evaluated as more effective as evidenced by more participants are satisfied with which the program and carried on with the educational teaching. This program has a very efficient follow up system which can be a benefit in improving the health of the community members (Bramante, & Song, 2012). One of the falls back of the general community health fair program is the false sense of security of the participants after attended the health fair. Careful referrals for follow up with abnormal findings as well as general annual health check up by their primary health care providers (PHP) were strongly encouraged by these annual health fair organizers. A specialist or a resource would be identified and the contact information was given to the participants who needed follow up. This health fair organizers were trying to avoid the trap of creating a false sense of security since the health fair professionals only see them once a year. As the health fair is getting more comprehensive with complex organizational details due to the raising demands and its popularity, the participation of the community organizations and resources are more ever needed. The welfare of the community members should always be up-held along with ethical conducts and thorough follow -up after the event.
As supported by other research in the different ethnic community (Murray, Liang, & Navarro, 2014), this annual health fair also had identified the needs and the benefits of the multi-disciplinary annual health fair to the under-served Vietnamese American. This annual comprehensive health fair has proven to be very effective and beneficial to the community members. The patterns and set up can be generalized for other cities or countries on the globe to replicate.
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