INTERVIEW WITH THE PRINCIPAL INVESTIGATOR

What is the Lincoln Project?

The Lincoln Project is a multi-disciplinary research effort focused on reducing the impact of Out of Hospital Premature Natural Death (OHPND) in 29 North Carolina counties.

Why focus on OHPND?

An individual’s health and well-being are influenced by multiple factors over the course of a lifetime. Whether someone suffers from diabetes or an undiagnosed heart condition, an outcome of OHPND can be devastating for families and communities. We believe that by designating OHPND as the focus of our project, we can identify the foundation of population health. We can evaluate and understand the complex interplay among disease states and health determinants, such as the environment, cultural issues, access to medical care and others to design interventions that address all risk factors in the community.

How you do this?

By looking back through a patient’s history and retrospectively understanding their progression from well-being to OHPND we can identify the modifiable, and nonmodifiable, determinants of health. Most importantly, not only can we identify health determinants at the individual level, but also at the community level, which will lead to multifaceted interventions that foster a community-centered approach to health.

How do social determinants influence community health?

Social determinants may account for up to 80% of factors that influence health. Socioeconomic status, the availability of affordable housing, access to proper nutrition and transportation, social isolation, etc. all influence productivity, community wellbeing, and yes, health. Medical professionals can only address a small portion of health determinants, so it is imperative that communities build a culture of health that goes beyond medicine. We must recognize that in order to build healthy communities, there must be a local and national change that gives people access to educational and preventative resources.

How do you reduce the incidence and impact of OHPND?

One of the goals of the Lincoln Project is to contribute to a growing movement that targets community change and recognizes the need for local, regional and national policy decisions. Our hope is that our findings support meaningful change in local areas and on a national scale. Our research will inform federal, state and local policy decisions and define clinical best practices related to OHPND prevention. Our primary focus is the design and evaluation of innovative community-level prevention and intervention programs. The foundation of our intervention and prevention techniques is based on The American Red Cross Home Fire Prevention Campaign, which targets neighborhoods with a high risk of home fires. Volunteers “blanket” the target neighborhood, install smoke detectors in homes where indicated and educate individuals on fire safety. Our approach features a similar door-to-door strategy that is targeted to specific regions.

How does the community intervention work?

The unifying concept of the research team is community as the primary building block of health, and if properly nurtured, cultural change that prioritizes and sustains healthy behaviors will come from within the community. A mainstay of the intervention is layperson community health workers that engage the at-risk population to address individual needs and advocate for the community. Volunteer Community Health Works (VCHWs) play an integral role in implementing a community-centered intervention. As trusted members of the community, they are ideally suited to transcend barriers to engagement.