Empowering Underserved Communities in Southern Puerto Rico: A Formal Training Program in Community Health Promotion.

Community health promotion offers a potential solution to persistent healthcare challenges, with community health workers playing a pivotal role. The Community Training Institute for Health Disparities (CTIHD) implemented a problem-solving curriculum in Community Health Promotion, integrating a competency-based learning model through two courses: Introduction to Community Health Promotion and Design of an Action Plan for the Promotion of Community Health. Each course comprised ten three-hour sessions, featuring pre/post-tests, evaluations, and a cognitive debriefing. Knowledge change was assessed using pre/post-test scores among 27 community leaders from southern Puerto Rico. Cohort 1 and Cohort 2 demonstrated an overall retention rate of 62.6% and 96.7%, respectively. Although differences in knowledge gained between cohorts and courses weren't statistically significant, a trend toward increased knowledge was noted. Cohort 1 experienced a 22% knowledge increase in Course 1 and a 24% increase in Course 2. Cohort 2 demonstrated a 41% knowledge increase in Course 1 and a 25% increase in Course 2. The CTIHD's Community Health Promotion Program has made significant strides in elevating awareness and knowledge, marking a positive step toward reducing health disparities and fostering healthier, empowered communities in southern Puerto Rico.

A Qualitative Approach to Explore Perceptions, Opinions and Beliefs of Communities who Experienced Health Disparities towards Chronic Health Conditions.

The prevalence of chronic medical conditions is associated with biological, behavioral, and social factors. In Puerto Rico (PR), events such as budget cuts to essential services in recent years have contributed to deepening health disparities. This study aimed to explore community perceptions, opinions, and beliefs about chronic health conditions in the southern region of Puerto Rico. Framed by a Community-Based Participatory Research (CBPR) approach, this qualitative study developed eight focus groups (n = 59) with adults (age of 21 or older) from southern Puerto Rico, in person and remotely, during 2020 and 2021. Eight open-ended questions were used for discussions, which were recorded, transcribed, and analyzed via computer analysis. Content analysis revealed four main dimensions: knowledge, vulnerabilities, barriers, and identified resources. Relevant topics included: concerns about mental health-depression, anxiety, substance use, and suicide; individual vulnerabilities-risk behaviors, and unhealthy habits; economic factors-health access and commercialization of health. Resource identification was also explored, and participants discussed the importance of alliances between public and private sectors. These topics were addressed across all focus groups, with various recommendations. The results highlight the importance of prioritizing identified community needs, evaluating available resources, and promoting tailored-made interventions to reduce risk factors for chronic health conditions.

Evaluation of the Pink Luminous Breast LED-Based Technology Device as a Screening Tool for the Early Detection of Breast Abnormalities.

Breast cancer is the leading cause of sex-specific female cancer deaths in the United States. Detection at earlier stages contributes to decreasing the mortality rate. The mammogram is the "Gold Standard" for breast cancer screening with an estimated sensitivity of 86.9% and a specificity of 88.9%. However, these values are negatively affected by the breast density considered a risk factor for developing breast cancer. Herein, we validate the novel LED-based medical device Pink Luminous Breast (PLB) by comparison with the mammogram using a double blinded approach. The PLB works by emitting a LED red light with a harmless spectrum of 640-800 nanometers. This allows the observation of abnormalities represented by dark or shadow areas. In this study, we evaluated the sensitivity and specificity of the PLB device as a screening tool for the early detection of breast abnormalities. Our results show that the PLB device has a high sensitivity (89.6%) and specificity (96.4%) for detecting breast abnormalities comparable to the adjusted mammogram values: 86.3 and 68.9%, respectively. The percentage of presence of breast density was 78.2% using PLB vs. 72.9% with the mammogram. Even with higher findings of breast density, the PLB is still capable of detecting 9.4% of calcifications compared to 6.2% in mammogram results and the reported findings for cysts, masses, or tumor-like abnormalities was higher using the PLB (6.5%) than the mammogram (5.6%). A 100% of the participants felt comfortable using the device without feeling pain or discomfort during the examination with 100% acceptability. The PLB positive validation shows its potential for routine breast screening at non-clinical settings. The PLB provides a rapid, non-invasive, portable, and easy-to-use tool for breast screening that can complement the home-based breast self-examination technique or the clinical breast examination. In addition, the PLB can be conveniently used for screening breasts with surgical implants. PLB provides an accessible and painless breast cancer screening tool. The PLB use is not intended to replace the mammogram for breast screening but rather to use it as an adjunct or complemental tool as part of more efficient earlier detection strategies contributing to decrease mortality rates.

Outcome of Decolonization Therapy in a Hospital in Southern Puerto Rico.

OBJECTIVE: Methicillin resistant Staphylococcus aureus (MRSA) is a resistant bacteria responsible for hard-to-treat infections. To understand the primary impact of this infection in healthcare settings, a retrospective study was performed at a hospital in southern Puerto Rico. Our objectives were to classify the types of MRSA infection, identify factors associated with the infection, and evaluate the outcome of decolonization therapy after its having been implemented at the hospital. METHODS: Medical records of cases encompassing October 2009 through October 2011 were reviewed. A total of 761 MRSA-positive patients were identified and their infections classified as community-acquired MRSA (CA-MRSA), hospital-acquired MRSA (HA-MRSA), or healthcare-associated community-onset MRSA (HACO-MRSA). Basic demographics, reason for hospitalization, medical history, and culture sites, along with other information, were obtained for each case. SPSS v17 was used for statistical analysis. Fisher's exact test was used to measure the statistical significance of the crude OR, using the patients with CA-MRSA as the comparison group. HA-MRSA cases were compared before and after the intervention, using Epidat v4.0 to calculate the cumulative incidence of HA-MRSA before and after the implementation of decolonization therapy at the hospital. RESULTS: In our study, 5.0% of the patients were found to be infected with HA-MRSA, 72.8%, with CA-MRSA, and 22.2%, with HACO-MRSA. After the intervention, we found a decrease of 10.35% (p = 0.704) in HA-MRSA, of 2.6% (p = 0.791) in CA-MRSA, and of 7.0% in HACO-MRSA (p = 0.650). CONCLUSION: Our findings suggest that CA-MRSA could be responsible for the majority of the infections caused by MRSA within the hospital at which the study took place. Decolonization of MRSA is a useful tool in helping to control the spread of infection, although future studies are needed to confirm our study's findings.