Older women in this sample were sexually active, engaged in potentially risky sexual behavior, and believed that physicians should address issues of sexuality. Older African American women were significantly more likely than white women to report HIV-related changes in their behavior and to discuss sex with a physician. This community-based study corroborates clinical research and suggests both a gap and a disparity in older women's dialogue with physicians. It also indicates the need for more broadly generalizable data on issues pertinent to older women's sexual health.

This study reports on implementation of the CommunityRx system, a population health innovation that promoted clinic-community linkages via: a youth workforce (MAPSCorps) that conducted an annual community resource census; Community Health Information Specialists (CHIS) who supported cross-sector resource navigation; and a health information technology (HIT) for prescribing community resources. Between 2012–14, MAPSCorps identified 19,589 public-serving places in the 106mi2 implementation region. CHIS used these data to generate an inventory of nearly 15,000 health-promoting resources. The HIT platform was integrated with 3 electronic health record (EHR) systems at 33 clinical sites to map 37 prevalent health and wellness conditions to community resources; 253,479 personalized HealtheRx “prescriptions” were generated for approximately 113,000 participants. Participants found the HealtheRx very useful (83%); 19% went to a place they learned about from the HealtheRx. This study demonstrates the feasibility of using HIT and workforce innovation to bridge the gap between clinical and other health-promoting sectors.

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BackgroundAfrican American caregivers of community-residing persons with dementia are mostly unpaid and have high rates of unmet basic and health needs. The National Alzheimer’s Project Act (NAPA) mandates improved coordination of care for persons with dementia and calls for special attention to racial populations at higher risk for Alzheimer’s Disease or related dementias (ADRD) to decrease health disparities. The purpose of this study is to describe the perceptions of African American caregivers of people with dementia about community resources needed to support caregiving as well as their own self-care.MethodsUsing a qualitative study design, in-depth, semi-structured qualitative interviews were conducted with caregivers (N = 13) at an urban geriatric clinic to elicit community resource needs, barriers to and facilitators of resource use and how to optimize clinical referrals to community resources. Caregivers were shown a community resource referral list (“HealtheRx”) developed for people with dementia and were queried to elicit relevance, gaps and insights to inform delivery of this information in the healthcare setting. Data were iteratively coded and analyzed using directed content analysis. Results represent key themes.ResultsMost caregivers were women (n = 10, 77%) and offspring (n = 8, 62%) of the person with dementia. Community resource needs of these caregivers included social, entertainment, personal self-care and hospice services. Main barriers to resource use were the inability to leave the person with dementia unsupervised and the care recipient’s disinterest in participating in their own self-care. Facilitators of resource use included shared caregiving responsibility and learning about resources from trusted sources. To optimize clinical referrals to resources, caregivers wanted specific eligibility criteria and an indicator of dementia care capability.ConclusionsAfrican American caregivers in this study identified ways in which community resource referrals by clinicians can be improved to meet their caregiving and self-care needs.