UCLA

Chronic diseases are the leading cause of poor health, disability, and death in the U.S. Efficient delivery of recommended preventive health services may significantly impact chronic disease burden, yet only a fraction of eligible adults receive preventive care. Therefore, innovative strategies are needed that extend the reach of the health care system into community venues, particularly for those with limited access to traditional health care settings. This dissertation examines how community health fairs organized through clinical-community partnerships can supplement the health care system in delivering preventive health services. Health fairs organized through the Faith Community Health Partnership (FCHP), a community benefit program of Providence Health and Services, were studied.

The first study utilized administrative data from FCHP health fairs to construct a profile of participants (n=5,274), and the preventive health services they received including referrals for those with positive findings. Overall, screening rates for a standard battery of tests were high. FHCP health fairs served an at-risk population as evidenced by the large proportion of participants who screened positive on multiple tests.� Also reached were large numbers of uninsured and racial/ethnic minorities.

The second study conducted a survey of 315 FCHP health fair participants to identify barriers to health care access, motivations for attending the health fairs, services received, and preferences for additional services. Common barriers to access included cost, lack of timely appointments, and long wait times in the doctor’s office. Free and convenient health fairs may address most identified barriers to care. Fewer than 33% of participants with positive screenings reported receiving referrals to follow-up care.

The third study conducted qualitative interviews with FCHP partners (Providence, health ministries, and vendors), to identify the factors that underlie successful and sustainable collaboration in clinical-community partnerships. Perceived value, leadership buy-in, trust, and collaborative learning were key factors in promoting collaboration.

The FCHP clinical-community partnership provided preventive health services to substantial numbers of health fair participants from populations of interest. However, for health fairs to serve as effective extenders of traditional primary care, the partners must also commit to providing linkages to primary care and adequate follow-up for participants with positive screenings.