Analysis of a Community Health Screening Program and the Factors Affecting Access to Care

Abstract

Introduction Free community health fairs and screening initiatives can be effective in broadening access to care and improving health outcomes in historically marginalized communities. UTHealthCares is a community health-focused organization developed at the University of Texas Health Science Center in Houston. At the beginning of 2023, UTHealthCares oversaw a free community health fair in the Eastex-Jensen Area - a medically underserved area in Northeast Houston. The health fair consisted of four stations - vitals and body mass index collection, vision screening, blood glucose screening, and dental screening. Participants also received coronavirus disease 2019 vaccinations, referrals, and health education. The purpose of this study is to evaluate the effectiveness of the UTHealthCares community health fair while assessing the factors that influence participants' access to medical care. Methods After completing the health fair, participants filled out an optional questionnaire. The questionnaire contained items that assessed satisfaction with the health fair, improvements in managing health, and access to resources. We calculated descriptive statistics, including mean response and 95% confidence intervals for rating scale questions. We used the chi-squared test to evaluate the independence of categorical variables and the Mann-Whitney U test to evaluate differences in means between distributions. Results A total of 111 people participated in the health fair, 91 of which completed a questionnaire. When participants rated their satisfaction with the health fair, the average response was 4.62 out of five. Participants also reported that they were more comfortable managing areas of health related to the stations offered at the fair. Many participants reported limited access to fresh food and long travel times to the physician. Participants that traveled further to reach one resource also tended to have significantly higher travel times for the other: X2 (4, N=78)=28.04, p<0.0001. However, 77.8% of respondents reported that the lack of insurance or cost was their greatest barrier to seeing a medical provider, while only 2.47% reported the lack of transportation as their greatest barrier. Participants who reported having health insurance also had a significantly higher probability of visiting a medical provider when they had a health issue: U=928.5, p=0.0006. Conclusion Overall, participants reported high satisfaction with the health fair. Participants also gave valuable feedback for improving future community health initiatives. Although many participants reported travel times greater than 30 minutes to reach community resources, very few participants indicated that transportation was their largest barrier to accessing medical care. Instead, the lack of insurance and high costs seem to be participants' most significant hindrances. Therefore, interventions in the Eastex-Jensen area focused on expanding access to care should also include components that improve access to insurance.