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Individual Level: Provide education and outreach to raise awareness about the importance of breast cancer screening, debunk myths and misconceptions, and empower individuals to prioritize their health through regular screenings.

- Interpersonal Level: Engaging with healthcare providers, caregivers, and support networks to deliver culturally competent, patient-centered screening services that meet their unique needs and preferences.

- Community Level: Collaborating with community organizations, local clinics, and advocacy groups to increase access to screening resources, reduce barriers to screening (SDOH), and promote a supportive environment for individuals seeking screening services.

- Societal Level: Work with State Reps in the area where disparities are the greatest to advocate for policy changes, funding initiatives, and structural interventions that address systemic inequities in screening access, improve healthcare infrastructure, and prioritize health equity in breast cancer screening programs.

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Environmental outcomes - Food Is Medicine for Pregnant Hispanic/Latinas with Gestational Diabetes 18 - 45

Specific Aim 1

Engage the priority population (Hispanics/Latinas with GDM) to discover healthy eating barriers.

Specific Aim 2

Explore awareness amongst clinicians in FQHCs and WIC clinics about Food Is Medicine prescription programs.

Specific Aim 3

Determine a feasible process for to implement FIM for pregnant Hispanic/Latinas in local FQHC and WIC clinics.

By the end of 1 year of program implementation, healthcare providers will provide a Food Is Medicine prescription to 50% of pregnant Hispanic/Latinas with gestational diabetes.

By the end of 1 year of program implementation, the proportion of Hispanic/Latina women with a history of GDM that have adequate fruit and vegetable intake based on recommended dietary guidelines will increase by 30%

Typology of Community-Based Interventions

1. All participating FQHCs & WIC clinics identify and administer FIM produce Rx (setting)

2. Clinical providers confident in knowledge base about FIM (target of change/agent)

3. Pregnant Hispanic/Latina mothers with GDM (resource)

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Applying the SEM to the example of access to prenatal facilities, at different levels:

Environmental outcomes that can affect the health and health behavior for the priority population are access to prenatal facilities, access to skilled health workforce, and transportation.

•Environmental level: Factors such as the distance to the nearest healthcare/prenatal facilities, the availability of public transportation, and the maternity care desert.

•Individual level: In the case of access to healthcare facilities, factors such as an individual’s health literacy, transportation options, and financial resources may influence their ability to access care or access skilled health workforce.

•Social level: In the case of access to healthcare facilities, the social level may include the influence of family and friends on an individual’s decision to seek care, as well as the social norms around healthcare utilization and prenatal care.

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Lung Cancer Screening_Viola B. Leal_2024.02.27

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Roldyne Dolce | Community Health - Environmental Outcome/Change

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Roldyne Dolce | Community Health - Environmental Outcome/Change

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Model/Framework: Ecological Levels

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1. Early detection/treatment initiation of active HCV infection among jail incarcerated populations.

2. Jail based opt-out testing policy for HCV, HCV treatment planning and linkage to care as a healthcare priority like drug treatment programs, increased awareness around HCV prevention and treatment. Organizational (policy for testing, treatment), and awareness/risk perception (lowered barriers, increased risk perception) changes.

3. Political/healthcare leaders (funding priority), healthcare professionals, clinic administrators