EVALUATING CLINIC TO COMMUNITY REFERRAL SYSTEMS TO ADDRESS OBESITY RELATED HEALTH DISPARITIES

To evaluate referral systems between clinic and community organizations in order to identify gaps for future implementation efforts in a primarily low-income and ethnic minority community. Purpose (a): The prevalence of obesity among high-socioeconomic status youth has decreased in recent years, whereas the prevalence of obesity among their low-socioeconomic status peers has continued to increase. Several programs and resources exist to provide obesity treatment, prevention and reductions in obesity related chronic diseases in youth. However, referral systems between these entities are often lacking. Thus, the goal of this project was to evaluate referral systems between clinic and community organizations in order to identify gaps for future implementation efforts in a primarily low-income, ethnic minority community. Methods (b): Assessment interviews were conducted with nineteen community organization members ranging from community and school-based organizational directors to clinical physicians. (Community-Based Organizations =5; Clinics =11; School-Based Organizations = 3). Four individuals were trained to administer surveys that assessed (1) access to healthcare facilities & preventative screenings (2) healthy eating (3) physical activity, (4) referral systems, and (5) chronic disease care. Results (c): Scores for each component were averaged per site, along with summing scores to create an overall indicator of clinic to community practices related to obesity-related health behaviors. The clinic to community assessments found an overall score of 62% (out of 100%) with PA screening, nutrition screening, chronic disease referral systems, and stroke care all falling below 60%. Tobacco screening (62%), chronic disease screening (68%), chronic disease education and counseling (67%), and pre-diabetes (71%) were all above 60%. Community-based organizations that provided outreach services (N=2) had very low levels of screening (0 – 1%), however both had high ratings related to chronic disease referrals (67% – 75%). Conclusions (d): To be successful in promoting health equity, we must close gaps between groups by offering better access through community organizations. Research is needed to determine how to improve the referral infrastructure between clinics, community-based, and school-based organizations to address obesity-related health disparities.