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Research ArticleOriginal Research

Exploring the Relationship Between Community Program Location and Community Needs

Hannah Shadowen, Kristen O'Loughlin, Kelly Cheung, William Thornton, Alicia Richards, Roy Sabo, Jennifer Hinesley and Alex H. Krist
The Journal of the American Board of Family Medicine January 2022, 35 (1) 55-72; DOI: https://doi.org/10.3122/jabfm.2022.01.210310
Hannah Shadowen
From the Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA (HS); Department of Psychology, Virginia Commonwealth University, Richmond, VA (KO); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (AR, RTS); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JH, KC, AHK); YMCA of Greater Richmond, Richmond, VA (WT).
MPH
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Kristen O'Loughlin
From the Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA (HS); Department of Psychology, Virginia Commonwealth University, Richmond, VA (KO); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (AR, RTS); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JH, KC, AHK); YMCA of Greater Richmond, Richmond, VA (WT).
MS, MA
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Kelly Cheung
From the Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA (HS); Department of Psychology, Virginia Commonwealth University, Richmond, VA (KO); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (AR, RTS); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JH, KC, AHK); YMCA of Greater Richmond, Richmond, VA (WT).
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William Thornton
From the Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA (HS); Department of Psychology, Virginia Commonwealth University, Richmond, VA (KO); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (AR, RTS); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JH, KC, AHK); YMCA of Greater Richmond, Richmond, VA (WT).
MS, MBA
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Alicia Richards
From the Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA (HS); Department of Psychology, Virginia Commonwealth University, Richmond, VA (KO); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (AR, RTS); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JH, KC, AHK); YMCA of Greater Richmond, Richmond, VA (WT).
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Roy Sabo
From the Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA (HS); Department of Psychology, Virginia Commonwealth University, Richmond, VA (KO); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (AR, RTS); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JH, KC, AHK); YMCA of Greater Richmond, Richmond, VA (WT).
PhD
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Jennifer Hinesley
From the Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA (HS); Department of Psychology, Virginia Commonwealth University, Richmond, VA (KO); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (AR, RTS); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JH, KC, AHK); YMCA of Greater Richmond, Richmond, VA (WT).
PsyD
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Alex H. Krist
From the Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA (HS); Department of Psychology, Virginia Commonwealth University, Richmond, VA (KO); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (AR, RTS); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JH, KC, AHK); YMCA of Greater Richmond, Richmond, VA (WT).
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Article Figures & Data

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  • Figure 1.
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    Figure 1.

    Hotspots of community program density and needs in Richmond, Virginia, by domain in the summer and fall of 2019.

  • Appendix Figure 1.
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    Appendix Figure 1.

    Thematic maps of community need and community program location. Each black dot represents a community program that assists with the relevant domain. The lighter color represents a lower rate or prevalence of the particular measure of community need. The darker color represents a higher rate or prevalence of the particular measure of community need. The specific scale and the specific community need is noted within the box for each.

  • Appendix Figure 2.
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    Appendix Figure 2.

    Sensitivity analysis of mental health.

  • Appendix Figure 3.
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    Appendix Figure 3.

    Sensitivity analysis of unhealthy alcohol use.

  • Appendix Figure 4.
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    Appendix Figure 4.

    Sensitivity analysis of nutrition.

  • Appendix Figure 5.
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    Appendix Figure 5.

    Sensitivity analysis of physical activity.

  • Appendix Figure 6.
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    Appendix Figure 6.

    Sensitivity analysis of finance.

  • Appendix Figure 7.
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    Appendix Figure 7.

    Sensitivity analysis of housing.

  • Appendix Figure 8.
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    Appendix Figure 8.

    Sensitivity analysis of food insecurity.

Tables

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    Table 1.

    Number of Community Programs Identified and Identified Community Needs in Richmond, Virginia, in the Summer and Fall of 2019

    DomainNumber of Programs Geolocated in RichmondMetric for Assessing Community Need by Census Tract*Mean Value (SD) of Need by Census Tract
    Mental health47Percent of adults reporting 14 days per month when mental health was not good13.7% (3.7%)
    Smoking11Percent of adults who are past or current smokers20.3% (6.7%)
    Unhealthy alcohol use35Percent of adults with ≥ 1 binge drinking episode in past month17.2% (4.62%)
    Nutrition56Percent of adults with body mass index ≥ 30 kg/m233.3% (8.98%)
    Physical activity32Percent of adults with no leisure time physical activity26.7% (9.99%)
    Transportation20Percent of households with no vehicle available10.6% (12.9%)
    Financial121Percent of residents below 100% poverty level24.9% (16.8%)
    Housing73Percent of renter-occupied units with an eviction judgement annually12.1% (8.33%)
    Food insecurity67Designated as a food desert11 of 66 census tracts
    • Abbreviation: SD, standard deviation. Notes: Some resources provided more than one service, so the total number of resources does not sum to 280.

    • ↵* Data sources for community metrics include the American Community Survey for 2018 (financial, transportation),28 500 Cities Project data for 2018 (mental health, alcohol use, physical activity, obesity, smoking),29 Food Access Research Atlas (food insecurity),30 and the Eviction Lab (housing).31

    • View popup
    Table 2.

    Percent of Census Tracts (n = 66) with a Community Program within One or One-Half Miles Radius from the Centroid in Richmond, Virginia, in the Summer and Fall of 2019

    Domain1-Mile Distance0.5-Mile Distance
    Mental health2318
    Smoking55
    Unhealthy alcohol use1714
    Nutrition2521
    Physical activity1613
    Transportation1310
    Financial3632
    Housing2920
    Food insecurity3329
    • View popup
    Table 3.

    Binomial Regression Model to Identify Relationship Between Levels of Community Need and Density of Service Programs in Richmond, Virginia, in the Summer and Fall of 2019

    Services Domain1-Mile Distance from Centroid Relative Risk (95% CI)0.5-Mile Distance from Centroid Relative Risk (95% CI)
    Mental health1.22 (0.94 – 1.57)1.17 (0.89 – 1.52)
    Smoking1.12 (0.70 – 1.80)1.08 (0.76 – 1.53)
    Unhealthy alcohol use1.45 (0.99 – 2.13)1.39 (0.94 – 2.06)
    Nutrition0.97 (0.84 – 1.12)0.91 (0.76 – 1.08)
    Physical Activity0.97 (0.84 – 1.13)0.95 (0.80 – 1.12)
    Transportation1.02 (0.95 – 1.09)1.03 (0.96 – 1.10)
    Financial1.05 (1.02 – 1.08)*1.06 (1.03 – 1.10)*
    Housing0.87 (0.77 – 0.98)*0.84 (0.70 – 1.00)
    Food insecurity0.54 (0.18 – 1.56)0.53 (0.16 – 1.71)
    • Abbreviation: CI, confidence interval. Notes: (1) Adjusted for percent Black residents and life expectancy of census tract. (2) In the binomial regression model, there were no significant relationships between location of community programs and percent Black residents or life expectancy of census tracts.

    • ↵* Bold shaded cells statistically significant (P value < 0.05).

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The Journal of the American Board of Family     Medicine: 35 (1)
The Journal of the American Board of Family Medicine
Vol. 35, Issue 1
January/February 2022
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Exploring the Relationship Between Community Program Location and Community Needs
Hannah Shadowen, Kristen O'Loughlin, Kelly Cheung, William Thornton, Alicia Richards, Roy Sabo, Jennifer Hinesley, Alex H. Krist
The Journal of the American Board of Family Medicine Jan 2022, 35 (1) 55-72; DOI: 10.3122/jabfm.2022.01.210310

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Exploring the Relationship Between Community Program Location and Community Needs
Hannah Shadowen, Kristen O'Loughlin, Kelly Cheung, William Thornton, Alicia Richards, Roy Sabo, Jennifer Hinesley, Alex H. Krist
The Journal of the American Board of Family Medicine Jan 2022, 35 (1) 55-72; DOI: 10.3122/jabfm.2022.01.210310
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