Community Interventions to Address Health Disparities in the Care of Normal Pressure Hydrocephalus (NPH) in Maryland
Johns Hopkins Bloomberg School of Public Health
Summary
The study aims to estimate Normal Pressure Hydrocephalus (NPH) prevalence and evaluate health equity gaps in Baltimore and Maryland based on zip codes and race, with a focus on the Black community. Interventions will include educational elements about NPH and three layers targeting patients, Primary Care Providers, and community health workers to enhance care access. Short-term outcomes will measure referrals to specialists, while long-term outcomes will assess healthcare utilization. The study aims to identify and reduce racial disparities in NPH care access, informing intervention strategies for NPH and other surgical areas.
Description
This proposal responds to an established need for developing an evidence-based and community-informed approach to address health disparities in specialty surgical clinics where barriers to accessing care are multiplied along each level of the referral pathway. The study will focus on Normal Pressure Hydrocephalus (NPH) related care - a clinical syndrome characterized excess cerebrospinal fluid (CSF) in the brain resulting in symptoms of falls, dementia, and urinary incontinence, that is treated surgically by shunting to remove excess fluid from the brain. This disorder afflicts an estimated ab…
Eligibility
- Age range
- 65+ years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: * People over 65 years old who have completed the Annual Wellness Survey (AWV) survey * have a clinical profile in the Hopkins Epic data sets * live in Maryland Exclusion Criteria: * People under 65 years old will be excluded if they have not completed the AWV survey * do not live in Maryland Community Health Worker (CHW) Inclusion Criteria: * certified Community Health Workers from Maryland * completed accredited training by the Maryland Department of Health Primary Care Physician inclusion criteria: * must have patients in Johns Hopkins University AWV
Interventions
- Otherpatients will receive NPH education
Patients will benefit from the Hydrocephalus Association's (HA) educational strategy for idiopathic normal pressure hydrocephalus (iNPH) emphasizes patient collaboration in the development of educational materials specifically for this condition. HA has a library of assets that include PowerPoint presentations, videos, and online and print educational materials. There will be also in-person outreach resulting recruitment, website (the study website and HA website), webform (with a symptom of gait, dementia, and bladder symptoms), YouTube videos. The investigators will also go to the communities like senior centers, health fair, and churches, then we will give a talk about iNPH. These resources will be carefully adjusted to suit low-income demographics, guided by feedback from Baltimore audiences and HA's iNPH volunteers.
- Otherprimary care physicians (PCPs) will receive professional NPH education
A comprehensive professional development program for PCPs and CHWs, featuring presentations, educational videos, webinars, and tools on iNPH diagnosis, treatment, and care management. Provider Continuing Medical Education (CME) credits will be offered for in-person lectures, aiming to equip PCPs with the skills needed to address iNPH in low-income settings effectively
- OtherA community health worker will assist PCP
A community health worker will assist PCP to identify barriers and help overcome these barriers in order for patient to access iNPH care.
Locations (2)
- Johns Hopkins University and HospitalBaltimore, Maryland
- Johns Hopkins UniversityBaltimore, Maryland