When Do Health Fairs Work: Perspectives from Wellness without Walls Participants

Introduction: Some communities in Memphis, TN face a lower life expectancy by as much as a decade compared to other communities (68.7 years vs 81.6 years). Residents of these communities with poorer health outcomes are predominately African American, face socioeconomic issues, and have few accessible health care options. A local non-profit hospital partners with residents in one community to provide information, screenings, and medical follow-up contacts through events called Wellness without Walls. In 2017, 572 participants attended seven events. However, little is known about why individuals attended or how they used the information provided to manage their health. Objective: A qualitative study examined participant perspectives on the events’ essential elements, use of the events as a source of primary healthcare, and the ability for these events to influence behaviors and health outcomes. Methods: Interviews were conducted at the first 2018 Wellness without Walls event by trained master’s students. Questions included: participant’s reasons for attending, past attendance, other places participants learn about their health, what would be missed most if removed, and what was learned through the event. Interviews were transcribed and thematic coding conducted by researchers trained in qualitative methods. Results: Thirty interviews were conducted with a mix of first time attendees (n=9), occasional attendees (n=8), and frequent attendees (n=11). Most interviewees participated in event screenings (i.e., blood pressure, blood sugar, cholesterol, weight; n=23). Few (n=9) reported not having a medical home, and most (n=18) used the event in tandem with physician visits: “Helps you know between visits.” Screenings (n=17), especially blood pressure (n=13), and socialization (n=7) would be missed most if removed. Knowing or monitoring numbers was the most common theme related to information gained (n=21). Some participants spoke of wanting to make lifestyle changes (n=7), or changes to their clinical care (e.g., doctor, medications; n=6): “Try to eat better, buy foods I need, but hard to do with food stamps.” Themes related to convenience (n=7), “I walked over,” and mutual respect (n=4), “…don’t have an attitude with the community,” were noted across questions. Conclusion: Events such as Wellness without Walls offer opportunities for residents of vulnerable neighborhoods to monitor their health and may prompt behavior change. Such events may best help reduce health disparities when coupled with lifestyle behavior change programs, but may be less successful if non-health factors such as socialization, convenience, and community respect are not present.