Description of the Organization, including Services Provided and Service Region

Community outreach can be described as a practice of organizing a local public awareness activity through the community-wide (targeted) and countrywide (broad) interaction. Community engagement is considered as a relationship building process that includes fostering partnerships between all parties involved and along with the targeted community. The prime goal is to cultivate a sense of pride and it includes the participation of the community members, the study team members and the participants of the study. The engagement and the outreach strategies are broad and the main intent is to reach a large proportion of the community (Riesch et al., 2013). The study is based on implementing an outreach campaign to target a particular group that is not accessing the healthcare services. The entire study will be done from the perspective of a mid-level manager.

Brigham and Women’s Hospital (BWH) is the largest hospital in the Boston, Massachusetts, US. Brigham is the global leader and this is composed of Brigham and Women’s Physicians, Brigham and Women’s Faulkner Hospital, Brigham and Women’s Hospital. Boston’s Brigham is an international leader in the field of medicine and the has achieved several pioneering breakthroughs that have improved lives all over the world. The BWH includes the 150 outpatient practices and has more than 1200 physicians. BWH serves the patients that are located in United States, New England and also patients from 120 countries. BW is widely known as a referral centre for the complex cases in all the areas of medicine. The U.S News and the world report has ranked BWH as a top hospital and it is even the best in the speciality areas which include rheumatology, orthopaedics, neurosurgery, neurology, gynaecology, heart surgery, cardiology and cancer (Brighamandwomens.org, 2018d).

The various services rendered by BWH can be majorly segregated in 3 different types:

• Centres of excellence- women’s health centre, primary care centre, orthopaedic & arthritis centre, neuroscience centre, heart & vascular centre, a cancer centre.  
• Clinical departments- Surgery, radiology, radiation oncology, psychiatry, physical medicine and rehabilitation, paediatric new-born medicine, pathology, orthopaedic surgery, obstetrics and gynaecology, neurosurgery, neurology, medicine, emergency medicine, dermatology, pain management, perioperative and anesthesiology.
• Patient support- spiritual care services, social work, security, pharmacy, family and patient relations, nutrition, nursing, Kessler library, interpreter services, ethics consultation service, care coordination (Brighamandwomens.org, 2018c).

The BWH also has a centre for community health and health equity (CCHE) that is committed to providing the community programs, advanced systems of research and care in order to raise the status of health served by BWH. The programs implemented by the hospital address the real-life issues and thus affecting the health outcomes of the residents of Boston. The commitment of the CCHE is to go beyond the premises of the hospital and serve those people that need the most. BWH is committed to working with the neighbours like the Dorchester, Mattapan, Jamaica Plain, Roxbury, Mission Hill. BWH working along with the other departments of the BWH, community-based organizations, community health centres have been able to implement the various programs which are aimed towards reducing the advancing the educational opportunities for the young people, increasing the rates of colorectal cancer screening, improving birth outcomes and reduction of violence (Brighamandwomens.org. (2018a). The major commitments of the CCHE are as follows:

• Supporting the individuals that are suffering from partner abuse.
• Enhancing the career and the educational opportunities.
• Improving knowledge of healthy behaviours and habits.
• Fostering the family support and the social support systems.
• Expanding the school-based and the community-based programs.
• Increasing the access to care for the vulnerable populations.
• Addressing and along with it reducing the healthcare disparities (Brighamandwomens.org, 2018b).

Healthcare Services for a Targeted Group

The region where the BWH operates and renders the services is the Boston area in Massachusetts. The figure below shows the map of the Hospital and the neighbouring areas.

                               

                                             Figure 1: Location of the Brigham and Women’s Hospital and the adjacent areas.

The healthcare services include the healthcare organizations, professionals and the other healthcare workers. While the main aim of the healthcare services is to provide the medical care to the people in need or the ones that are unable to access the healthcare. The Healthcare services are meant for providing the health care to the populations, communities, families and the patients. The healthcare services also include the homecare, palliative, primary, diagnostic, hospital, long terms, rehabilitative, preventive and emergency care. It is important to note that the healthcare services are meant to provide care to a targeted population which will be patient centred, high quality. In order to provide successful healthcare service, different types of the care are required to be provided (Barello, Graffigna & Vegni, 2012).

The program selected for the Hispanic population in the Boston area is of the prevention, health screening and direct service type. The program will prioritize on the chronic disease management among the disadvantaged groups for the promotion of wellness among the vulnerable populations and also for the purpose of reducing the health disparity. The main objective is to open the doors towards the initiative of health colorectal cancer screening. The initiative will be launched in order to address the barriers that exist in the screening of colonoscopy among the targeted population. The main goals of the program are: 1) increasing awareness among the targeted population that will need the colorectal cancer screening at the two healthcare centres like the Southern Jamaica Plain Health centre and Brookside Community Healthcare Centre, 2) increase the recommendation of the physicians among the patients that are aged 50 years and old, these patients will seek the help of the BWH licensed community health centres, 3) to decrease the no-show rates of screening colonoscopy and also increase the test preparation, 4) to address the barriers that exist in the screening procedures and this includes the patient education, resource referral, patient navigation (brighamandwomens.org, 2018a).

The program will target the Hispanic population living in the regions like the Boston-Roxbury, Boston-Mattapan, Boston-Jamaica Plain, Boston-Dorchester. The several health indicators are colorectal cancer and other types of cancer. The service will include both male and the female patients belonging to the age group of an adult. The language spoken by such targeted population is Spanish and English.

Demographic Data of the Target Population

The target group selected for the delivery of the healthcare are the Hispanics and the Latinos. The population of the Hispanics in Massachusetts according to the census of 2010 is 9.6 percent of the State’s entire population. The Hispanic residents in Massachusetts are 627,654. According to the demographics, Massachusetts is one of the countries which has contributed to the growth of the Hispanic population from the year 2000 to 2010. Massachusetts is the first state in which the Hispanic population is of non-Mexican origin. 41 percent of the Hispanics youths live in poverty in comparison to the non-Hispanic black and white youths (Worldpopulationreview.com, 2018). The Hispanic population in the neighbourhood of Boston are as follows:

• Mattapan- the non-white Hispanic population is 95.3 percent
• South Dorchester- the non-white Hispanic population is 73.9 percent
• Roxbury- the non-white Hispanic population is 91.6 percent
• North Dorchester- the non-white Hispanic population is 64.7 percent
• Jamaican Plain- the non-white Hispanic population is 44.4 percent (Statisticalatlas.com, 2018).

Comparing the Hispanic population in the with respect to the relative race and ethnicity are as follows:

• The Mattapan region has 55.9 percent fewer Hispanics in comparison to Boston.
• The Roxbury region has 44.9 percent fewer Hispanics in comparison to Boston.
• The South Dorchester region has 25.6 percent of fewer Hispanics in comparison to Boston.
• The North Dorchester region has 14.8 percent of fewer Hispanics in comparison to Boston.
• The Jamaica plain region has 10.8 percent less Hispanics in comparison to Boston (census.gov, 2018).

While it is important to note that the majority of the Hispanics belong to the age group of 25 to 29 years of age and the percentage is 0.69 percent (Statisticalatlas.com, 2018).

The Hispanics in the Boston region include the persons from the Central or South America, Puerto Rican, Mexican, Cuban. The culture of the Hispanics is generally patriarchal and where that male member has the greater dominance and authority. Hispanics come from where there is a presence of activities related to shared dominance and the accountability is taken to be collective. Demographically the Hispanics are younger in comparison to the other non-Hispanics. The median age group is considered to be 27.5 years whereas in comparison to other US population it is 36.9 years. The income levels are found to be rising among the Hispanics, although the income is less in comparison to the U.S average. Even if the Hispanics are earning less in comparison to the average white Americans, the Hispanics live longer. The Hispanics also have issues with getting diseases and they are of greatest concern. The majority of the diseases occur due to the not accessing the healthcare services, polluted water, unclean air, exposure to pesticides, environmental factors. The average household size is found to be about 3.47 people in comparison to the US average population. The children are the big part of the household with 62 percent were below the age of 18 years (Perez-Rodriguez et al., 2014).

Before coming across the communication technologies that will be used among the Hispanics in order to reach them will largely depend on the variety of media consumption of the different types of media by the Hispanics. The different types of media used by the Hispanics are as follows:

• Magazines (issued on a monthly basis)- the percentage of the Hispanics that use such a media is 12.70 percent.
• Newspapers (read on a 28-day basis)- the percentage of the Hispanics that use such a media is 17.20 percent.
• Radio (listened half an hour in a week)- the percentage of the Hispanics that use such a media is 38.40 percent.
• Television (Viewed half an hour in a week)- the percentage of the Hispanics that use such a media is 57.10 percent.
• Internet- the percentage of the Hispanics that use such a media is 69.30 percent (Cdc.gov, 2018).

Communication Technologies for the Target Group

Considering the above-mentioned data, it can be concluded that the best choice of the technologies would be radio, television, internet, e-magazines and e-newspapers. These communication technologies will be environmentally appropriate. Thus in order to highlight each of the communication technology, there is a need to emphasize each of the categories.

• Magazines- It has been found that the prime reason due to which the Hispanics read magazines is to stay up to date with the latest trends and styles.
• Newspapers- the main reason due to which the Hispanics go through the newspapers is to keep themselves up to date. It has been seen that the minority newspapers are a vital part of the community and newspapers delivers the data which other media cannot. The Hispanics are interested in the news that actually provides information about their needs and concerns. The proneness of reading newspapers is seen the most among the 34 to 54 age group (Lopez & Gonzalez-Barrera, 2018).
• Radio- the main reason for listening to the radio is that it makes the Hispanics have a good mood. The Hispanic families often listen to a single radio station for a whole day.
• Television- the top reason cited for viewing the television is for pure entertainment. Majority of the programmes watched by the Hispanics is the Spanish, English programs.
• Internet- the usage of the internet by the Hispanics is reported to be solely based on gaining a good source of knowledge. Studies have shown that the usage of internet has increased among the Hispanics. 45 percent of the Hispanic population has been found to be using Facebook. It has been reported that the English speaking Hispanics prefer to visit the social networking sites at least two to three times a day. The Hispanics that use the internet are reported to be affluent and young, these people have larger households and are interested to accrue benefits from internet than any other sophisticated media (Mark & Ganzach, 2014).

Even if the communication technologies are not used for the purpose of communication, then there are other options like the custom publications. Both the newspapers and the magazines which are the printed media can be beneficial for communication. They are actually effective considering the habit of the Hispanics regarding the usage of the printed for gaining knowledge of the happenings related to their community and the latest styles and trends. Both the Hispanics and the Latino communities are can be made to access the content via the publication in bilingual languages (Lee et al., 2014).

The BWH is one of the reputed and world-renowned hospitals in Boston that serves both the residents of the Boston and the neighbouring regions. Considering the fact that the Hispanics are not properly availing the screening services for colorectal cancer. It is necessary to properly disseminate the information of availing the health services that are exclusively available for the Hispanics in the region. The target population can be communicated via the 3 major ways, such as via radio, television and the internet. Although the Hispanics also love to read newspapers and magazines the communication technologies will help disseminate the information faster.

Radio- It is reported that the Hispanics love to hear a single channel all day along and the whole prefers it as well. Thus, the Hispanics channel can be explicitly brought in to contract to air the advertisement regarding the benefits of screening colorectal cancer.

Television- It has been reported that the Hispanics love to watch televisions for the sole purpose of entertainment. The channels that the Hispanics prefer are the English and the Spanish channels. Thus, this channel can provide advertisements in between the programs about availing the services that are rendered by BWH.  

Internet- the internet is one of the best places for the dissemination of information considering the fact that majority of the adults use internet for the purpose of gaining knowledge and accessing the social media (Slate Magazine, 2018). The Social networking sites like the Facebook and Myspace can be used by the show the advertisement of the BWH and the colorectal screening services rendered by the hospital. The social media will provide a platform for sharing and communication in a collective way.

Communication Campaign to the Board and Request for Approval

Table 1: Communication plan

Audience	Messages	Media or vehicle	Frequency	Timing
Male	Colorectal cancer screening available in BWH	Social media	Whole week	The many times a user will log into their social networking site.
Female	Colorectal cancer screening available in BWH	Radio	Morning, noon and the evenings	3 times a day and overall 21 times a week
Male and female	Benefits of colorectal cancer screening and its benefits	Radio and television	Whole week	10 times a day for television and 3 times in a day.

Conclusion

Thus from the above discussion, it can be concluded that there are several regions where the different communities and ethnic groups are unable to access the healthcare. Even situations arise where such groups often do not have the information regarding where to access the healthcare facilities. Thus, such situations demand appropriate action to disseminate the information regarding the healthcare delivery and the how to access the healthcare centres. The study has highlighted one such community called the Hispanics that have are unable to access the healthcare and thus a communication plan is developed to address the issue.

Reference

Barello, S., Graffigna, G., & Vegni, E. (2012). Patient engagement as an emerging challenge for healthcare services: mapping the literature. Nursing research and practice, 2012.

brighamandwomens.org. (2018a). Center for Community Health and Health Equity (CCHHE) – Brigham and Women’s. Retrieved from https://www.brighamandwomens.org/about-bwh/community-health-equity/center-for-community-health-and-health-equity

Brighamandwomens.org. (2018b). Community Health Needs Assessment – Brigham and Women’s Hospital. Retrieved from https://www.brighamandwomens.org/about-bwh/community-health-equity/community-health-needs-assessment

Brighamandwomens.org. (2018c). Clinical Departments & Services – Brigham and Women’s Hospital. Retrieved from https://www.brighamandwomens.org/services

Brighamandwomens.org. (2018d). About BWH – Brigham and Women’s Hospital. Retrieved from https://www.brighamandwomens.org/about-brigham-and-womens hospital?utm_content=hpherotop

Cdc.gov. (2018). Cultural Insights: Communicating with Hispanics/Latinos. Retrieved from https://www.cdc.gov/healthcommunication/pdf/audience/audienceinsight_culturalinsights.pdf

census.gov. (2018). U.S. Census Bureau QuickFacts: Boston city, Massachusetts. Retrieved from https://www.census.gov/quickfacts/fact/table/bostoncitymassachusetts/PST045217

Lee, Y. J., Boden-Albala, B., Larson, E., Wilcox, A., & Bakken, S. (2014). Online health information seeking behaviors of Hispanics in New York City: a community-based cross-sectional study. Journal of medical Internet research, 16(7).

Lopez, M., & Gonzalez-Barrera, A. (2018). IV. Watching, Reading and Listening to the News. Retrieved from https://www.pewhispanic.org/2013/07/23/iv-watching-reading-and-listening-to-the-news/

Mark, G., & Ganzach, Y. (2014). Personality and Internet usage: A large-scale representative study of young adults. Computers in Human Behavior, 36, 274-281.

Perez-Rodriguez, M. M., Baca-Garcia, E., Oquendo, M. A., Wang, S., Wall, M. M., Liu, S. M., & Blanco, C. (2014). Relationship between acculturation, discrimination, and suicidal ideation and attempts among US Hispanics in the National Epidemiologic Survey of Alcohol and Related Conditions. The Journal of clinical psychiatry.

Riesch, S. K., Ngui, E. M., Ehlert, C., Miller, M. K., Cronk, C. A., Leuthner, S., … & Durkin, M. S. (2013). Community outreach and engagement strategies from the Wisconsin study center of the national children’s study. Public Health Nursing, 30(3), 254-265.

Slate Magazine. (2018). Slate’s Use of Your Data. Retrieved from https://www.slate.com/blogs/future_tense/2017/06/22/study_hispanic_americans_use_the_internet_less_than_any_other_ethnic_group.html

Statisticalatlas.com. (2018). Race and Ethnicity in Boston, Massachusetts (City). Retrieved from https://statisticalatlas.com/place/Massachusetts/Boston/Race-and-Ethnicity

Worldpopulationreview.com. (2018). Boston, Massachusetts Population 2018. Retrieved from https://worldpopulationreview.com/us-cities/boston-population/