The 130th Annual Meeting of APHA

Abstract #42269

John A. Dougherty, PhD, Program Design and Evaluation Services, Multnomah County Health Department, Oregon, 426 SW Stark Street, 6th Floor, Portland, OR 97204, 503-988-3663 x22290, John.X.Dougherty@co.multnomah.or.us

Abstract Text: Background: An AmeriCorps lead reduction team (CLEARCorps) that primarily did small repairs to reduce home lead paint hazards in Portland Oregon was taught a simplified motivational enhancement intervention. The standardized information-giving model used by the team was replaced by a relationship-based approach that was tailored to resident concerns and more likely to engage residents in sustained lead dust management. A more rapid decrease in the numbers of children exposed to hazardous levels of lead dust in the home was the primary goal. Methods: The Motivational Enhancement approach of Miller and Rollnick was simplified to a core set of skills. The Transtheoretical model was reconceptualized into three stages of relationship between the team member and the resident, keeping the team's focus on the interaction rather than on assessing the resident. Results: CLEARCorps team members were able to learn and apply the simplified model to assist residents to engage in dust control activities. Regular review sessions with the team uncovered natural feelings and judgments about residents that if ignored could result in service inequities. The concept of "bracketing" feelings was an important component of the team process. Conclusion: AmeriCorps volunteers with widely differing educational backgrounds can be taught to employ a motivational intervention to assist residents to engage in lead dust reduction activities. One unexpected result of the approach was the identification and reduction of personal barriers to more equitable service delivery. The model was subsequently adapted by CLEARCorps/USA for its nationwide program.

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