Browsing by Author "Weathers, Tess D."

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    Design and Implementation of the Diabetes Impact Project: A Multisector Partnership to Reduce Diabetes Burden in Indianapolis Communities
    (Wolters Kluwer, 2023) Staten, Lisa K.; Weathers, Tess D.; Nicholas, Celeste; Grain, Tedd; Haut, Dawn P.; Duckett-Brown, Patrice; Halverson, Paul K.; Caine, Virginia; Community and Global Health, School of Public Health
    Context: Community-level health disparities have not arisen suddenly but are the result of long-term systemic inequities. This article describes the design and implementation of a community-engaged multisector partnership to address health disparities by reducing the diabetes burden in 3 Indianapolis communities through the implementation of evidence-based strategies across the prevention continuum. Program: The project has 5 foundational design principles: engage partners from multiple sectors to address community health, focus on geographic communities most affected by the health disparity, practice authentic community engagement, commit for the long term, and utilize a holistic approach spanning the prevention continuum. Implementation: The design principles are incorporated into the following project components in each community: (1) health system community health workers (hCHWs), (2) neighborhood CHWs (nCHWs), (3) community health promotion initiatives, and (4) resident steering committees, as well as a backbone organization responsible for overall coordination, project communication, evaluation, and partnership coordination. Evaluation: This complex multilevel intervention is being evaluated using data sources and methodologies suited to each project component and its purpose overall. Each component is being evaluated independently and included holistically to measure the impact of the project on the health and culture of health in the communities. Key Performance Indicators were established upon project initiation as our common metrics for the partnership. Because complex interventions aiming at population-level change take time, we evaluate Diabetes Impact Project-Indianapolis Neighborhoods (DIP-IN), assuming its impact will take many years to achieve. Discussion: Health disparities such as the diabetes prevalence in project communities have not arisen suddenly but are the result of long-term systemic inequities. This complex issue requires a complex holistic solution with long-term commitment, trusted partnerships, and investment from diverse sectors as seen in this project. Implications for policy and practice include the need to identify stable funding mechanisms to support these types of holistic approaches.
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    Impact of community health workers on diabetes management in an urban United States Community with high diabetes burden through the COVID pandemic
    (Elsevier, 2024-02-09) Hansotte, Elinor; Andrea, Sarah B.; Weathers, Tess D.; Stone, Cynthia; Jessup, Alisha; Staten, Lisa K.; Community and Global Health, Richard M. Fairbanks School of Public Health
    Objective: Community Health Worker (CHW) interventions are promising approaches to increasing access to health care, garnering better health outcomes, and decreasing health inequities for historically marginalized populations. This study examines the impact of a health system-based CHW program embedded in the Diabetes Impact Project - Indianapolis Neighborhoods (DIP-IN), a large, place-based, multi-year intervention to reduce diabetes burden. We assessed the CHW program's effectiveness in managing glucose control and reducing diabetes-associated complications across the COVID timeline. Methods: We examined the association between the CHW intervention and diabetes management in 454 CHW patients and 1,020 propensity score-matched comparison patients. Using electronic medical records for encounters between January 1, 2017, and March 31, 2022, we estimated the CHW program effect using a difference-in-difference approach through generalized linear mixed models. Results: Participation was associated with a significant reduction (-0.54-unit (95 % CI: -0.73, -0.35) in glycosylated hemoglobin (A1C) on average over time that was beyond the change observed among comparison patients, higher odds of having ≥ 2 A1C measures in a year (OR = 2.32, 95 % CI: 1.79, 3.00), lower odds of ED visits (OR: 0.88; 95 % CI: 0.73, 1.05), and lower odds of hospital admission (OR: 0.81; 95 % CI: 0.60,1.09). When analyses were restricted to a pre-pandemic timeframe, the pattern of results were similar. Conclusion: This program was effective in improving diabetes management among patients living in diabetes-burdened communities, and the effects were persistent throughout the pandemic timeline. CHW programs offer crucial reinforcement for diabetes management during periods when routine healthcare access is constrained.
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    A Mixed-Methods, Community-Based Study To Identify Predictors Of Depression In Latino Adolescents By Gender
    (2019) Bigatti, Silvia M.; Diaz, Virna; Conrad, Katrina K.; Ramirez, Michelle; Weathers, Tess D.; Social and Behavioral Sciences, School of Public Health
    Latino adolescent depressive symptoms are a growing problem, of interest to both the community and academic partner who are reporting the present study. In this mixed-method, community-based participatory research study we quantitatively examined predictors of depression known to impact adolescent mental health that are amenable to interventions. Concurrently, we qualitatively assessed parents’ perceptions of mental health problems in children, their causes and potential solutions. The data from parents (n = 108) was obtained in focus groups led in Spanish, and the data from adolescents (n = 86) was obtained in English language surveys. Among the adolescents there was an even representation of males (47.7%) and females (52.3%), Mage = 15.24 (SD = 1.97). Nearly half (47.7%) of the adolescents were experiencing minor depression and one in ten (10.5%) were experiencing major depression according to their scores on the PHQ-9. Adolescent participants reported low acculturative stress, average social support, and high mastery, as well as highly functional families. Males reported higher self-mastery than females and lower acculturative stress. Predictors of depression differed by gender. For males, self-mastery predicted depressive symptoms; for females acculturative stress predicted depressive symptoms. The focus groups with parents supported and expanded quantitative findings. The parents demonstrated a keen awareness of depression in teens and their own contributions to the problem, including their efforts to maintain their culture of origin which prevents integration of their children into the majority culture. Parents also reported difficulties knowing what steps to take and finding resources. The additional dimension of parental voice is often missing from studies of adolescents, and here it clarified many of the issues identified in the teens. These findings suggest the need to focus on mental health in this population, potentially developing differential interventions by gender and taking a family systems approach.
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    Your Life. Your Story. Latino Youth Summit: Building Latino Adolescent Resilience Through a Successful Community-Academic Partnership
    (Ball State University, 2016) Conrad, Katrina K.; Bigatti, Silvia M.; Diaz, Virna; Medina, Monica A.; Mirabal, Magdy; Weathers, Tess D.; Social and Behavioral Sciences, School of Public Health
    Developing successful relationships between academia and community can be difficult. Investigators who want to work with community organizations often do not know where to start, or how to carry them out well. However, successful collaborations can speed up the transition from research to practice, and bring interventions to communities more effectively. We present the development of a successful partnership and the consequent intervention program, Your Life. Your Story., a yearlong resiliency-building intervention for Latino youth at risk for depression. We present the exploratory study where our relationship began, as well as the preliminary findings that led to the design of our intervention. We then present the detailed components of the resiliency-building, emotional expression, coping and social support intervention. We also present preliminary qualitative and quantitative results and show the yearlong intervention plan. Throughout, we show, in sections in italics, how the partnership guaranteed that the study and intervention would succeed.