Understanding a Patient Population and their Access to Current Health Care Services at a Community Health Fair in Omaha: A Mixed-Methods Study

Understanding a Patient Population and their Access to Current Health Care Services at a Community Health Fair in Omaha: A Mixed-Methods Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Understanding a Patient Population and their Access to Current Health Care Services at a Community Health Fair in Omaha: A Mixed-Methods Study Olivia Foley, Alexandra Van Cleave, Shannon Blee, Shalika Devireddy, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9087977/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Background Health fairs represent outreach events that facilitates healthcare information delivery to populations who may not otherwise have access to community health resources. Countless barriers to healthcare exist, including lack of transportation, restricted finances, low education level, language differences, and lack of insurance. Unique barriers and problems exist among a variety of communities, and proper communication of available resources is crucial to improve the overall health of a community. This study evaluates demographic characteristics and healthcare access needs amongst community members who attend a community health fair in Omaha, Nebraska. Methods This study utilized a 30-question cross-sectional survey to gather information from participants at the community health fair. This survey gathered information regarding attendees’ demographics, healthcare access, and suggestions for improvement in future. Results Roughly 500 participants attended the community health fair in 2025. Out of 500 participants, 92 filled out this study’s survey (18%). Participants reported speaking a variety of languages, including English, Spanish, Dutch, German, and Arabic. For employment status, 68% of respondents reported that they were unemployed. Beyond this, 30.7% of respondents reported that they did not have a primary health concern, while 11.3% reported mental health as their primary health concern. The top barrier to healthcare was transportation difficulties, reported by 22.5% of respondents. After participating in the fair, 80% of respondents stated that they were more aware of diseases that could affect them, and 97.7% of study participants reported they would recommend the health fair to others in the future. Conclusions Gathering information regarding demographics and healthcare access from attendees at a community health air allows for improved understanding of the community it serves. This will not only improve the success of future health fair events but also will provide information for other communities nationwide to offer a suggestion of possible primary health concerns and barriers to healthcare access. Health fair vulnerable population unhoused social determinants of health transportation language services Figures Figure 1 Figure 2 Figure 3 Background A health fair is defined as an “outreach event focused on community health education intervention, that is tailored to a specific community, and a way to provide accurate information about specific health problems and to trigger health behavior change in target audiences” ( 1 ). Many barriers limit access to healthcare in vulnerable populations, including lack of transportation, finances, education, language and insurance ( 2 – 5 ). Health fairs often bring numerous community organizations together in one place to provide abundant resources regarding education, free or reduced-cost screening materials funded by public health grants, or direct connections to healthcare providers. Community organizations often have pre-made educational materials regarding the resources they provide that are available for attendees to take and utilize. Overall, health fairs can be a beneficial avenue for providing access to free healthcare for a large portion of the population ( 6 ). Community health fair events often target specific communities typically lacking access to care, such as unhoused, low-income, uninsured, and other marginalized populations. Understanding why these are often the intended populations aids in deciding what services to provide at the fair. For example, a study examining the prevalence of hypertension in an unhoused population of Long Beach, California found that this population had increased rates of hypertension when compared to other communities ( 7 ). Those with hypertension are exposed to long-term health risks, regardless of if they are aware of their disease status, such as increased risk of cardiovascular or stroke events. Concerningly, across the United States, the mortality rate among those with hypertension is 3-4x higher in the unhoused population compared to those who are housed ( 7 ). Therefore, it is imperative that health fairs exist to not only screen for hypertension, but also to provide education and counseling to those patients. Additionally, at one health fair, approximately two thirds of the attendees cited not attending a preventative health checkup in over 2 years ( 4 ). Knowledge of prevalent ailments in underserved populations can help tailor future health fairs to more appropriately suit the needs of their attendees and affect significant change in their lives. While health fairs are undoubtedly beneficial, to understand the true impact of a fair, researchers must further analyze whether the event provided useful information and services to attendees, and whether the benefits of attending the event outweighed any potential harm. A study investigating follow-up after a health fair where high-risk participants were screened for cardiovascular events found that at 1 month, 30% had made an appointment with a physician and 65% planned to make an appointment, a majority of whom requested assistance making the appointment ( 8 ). This suggests that referrals and appointment scheduling available at a health fair may increase the likelihood of formal medical follow-up. Additionally, another study gave attendees an exit-survey in which they had overall rated the event as “highly favorable” ( 9 ). This signals that attendees not only find health fairs useful but feel invested in their own health and follow up care after the event. As past literature has illustrated, health fairs can play a vital role in working towards alleviating barriers in healthcare for specific populations. However, understanding attendees’ perceptions towards their own health and access to resources remains understudied. Therefore, the goal of this project is to gather information directly from health fair attendees about their own health perceptions and about specific healthcare resources that are most important to them. Through better understanding of attendees’ thoughts and attitudes about healthcare resources, researchers aim to highlight crucial aspects that can help improve the effectiveness of this health fair as well as guide the creation of similar events serving other underserved communities across the nation. Methods This study was a cross-sectional survey assessing healthcare access and health fair satisfaction among adult attendees at a community health fair in Omaha, Nebraska held in August 2025. The primary objective was to evaluate current access to healthcare services among attendees, and the secondary objective was to assess attendee satisfaction with the health fair. The protocol was reviewed and approved by the Creighton University Institutional Review Board prior to data collection. All health fair attendees aged ≥ 18 years were eligible to participate; individuals < 18 years were excluded. Participants were recruited in person at a designated research booth during the event. Trained medical student volunteers provided standardized verbal explanations describing the study purpose, institutional affiliation, and voluntary nature of participation, and obtained written informed consent before survey administration. Participants were given adequate time to review the consent document and ask questions. For participants who did not speak English, telephone-based interpreter services (InterpretManage) and in-person Spanish interpretation were used to support both the consent process and survey completion. After consent, volunteers administered the survey during the health fair; completion time was typically under 10 minutes. Surveys were completed on paper, collected by designated investigators, and secured during the event. The research team developed a 30-item survey that consisted of structured and open-ended questions designed to assess demographic characteristics, healthcare access, perceived barriers to care, and satisfaction with the health fair. Survey content covered demographic characteristics including age, race/ethnicity, language(s) spoken, gender identity, sex assigned at birth, employment status, insurance status/type, highest education level achieved, veteran status, current residence, and length of stay, as well as current access to technology. Health-related questions assessed self-rated health level, prior community resource use, healthcare utilization within 6 months, presence of a primary care physician, trust in physicians, and likelihood of following up with health organizations. Open-ended items asked participants to describe their primary health concern and their main barrier to obtaining care. The health fair satisfaction section included questions on how attendees learned about the event, whether participation increased their health awareness, likelihood of recommending the health fair to others, and anticipated follow up with participating organizations. Participants also identified their favorite and least favorite stations and provided open-ended explanations to clarify perceived strengths and areas for improvement. After the event, responses were entered into an electronic database available only to authorized student investigators and the supervising faculty advisor. No protected health information or directly identifying information was collected. Following data entry, responses were systematically coded for analysis. Closed-ended items were assigned predefined numerical values corresponding to each response category. Open-ended responses were reviewed and categorized into thematic groups, after which numerical codes were assigned to each category to facilitate quantitative and qualitative analysis. Discrepancies between coders were resolved through discussion and consensus. Descriptive statistics were used to summarize demographic variables and measures of healthcare access and satisfaction. Continuous variables were reported as means with standard deviations or medians with interquartile ranges, as appropriate, and included minimum and maximum values. Categorical variables were summarized using frequencies and percentages. Results Demographics Of approximately 500 health fair attendees, 92 participated in this research project, ~ 18% response rate. The median age of participants was 51 years old, ranging from 22–81 years old. Respondents self-identified gender, race, languages spoken, and veteran status. Self-reported gender rates were reported as 31.9% female, 65.9% male, and 2.2% non-binary. Forty percent of participants identified as White/Caucasian, 37% as African American/Black, and 8% as Hispanic/Latino. Remaining race identification demonstrated in Fig. 1 . Most respondents stated that they spoke English, with 82.7% only speaking English and 6.2% speaking English and Spanish, 3.7% of respondents only spoke Spanish, and the remaining 7.4% spoke multiple other languages including Dutch, German, and Arabic. Of respondents, 8.7% identified as veterans. For employment status, most respondents described themselves as unemployed (68%). Fourteen percent of participants identified as employed, 11% on disability, and 7% as retired (Fig. 2 ). Most respondents, 49% report some high school as the highest education level achieved, 45% as some undergraduate/college, 3% graduate-level, 2% some elementary/middle school, and 1% no formal education (Fig. 3 ). Primary Health Concerns and Barriers for their Current Health Care Access The respondents had the opportunity to report their primary health concern at time of survey administration. The top four primary health concerns were: no health concern/not applicable (30.7%), mental health concerns (11.3%), social determinant of health concerns (11.3%), and cardiology concerns (8.1%). Along with their primary health concern, respondents reported their top barrier to healthcare access, with the top five listed as no barriers (22.5%), transportation difficulties (22.5%), financial difficulties (10.2%), lack of time (8.2%), and negative personal experiences in healthcare (8.2%). Most participants self-described their health as average or good with 44.9% for each category. The majority reported seeing a doctor within the last 6 months, 65.9%, and 53.6% report seeing a doctor regularly. Of those who regularly see a doctor, 45 people, 92.3% report trusting their primary doctor (Table 1 ). Table 1 Health Care Access of Study Participants at a Community Health Fair in Omaha, NE. Current Health Care Access n (%) Self-Identified Health Status Poor Health 9 (10.1) Average Health 40 (44.9) Good Health 40 (44.9) Have you seen a doctor… In the last 6 months? No 30 (34.1) Yes 58 (65.9) Regularly? No 39 (46.4) Yes 45 (53.6) Do you trust your primary doctor? No 3 (7.7) Yes 36 (92.3) Health Fair Outcomes After attending the health fair, 80% of respondents stated that they were more aware of diseases that could affect them. 97.7% reported that they would recommend the health fair to others in the future. 77.1% of participants believe they will be able to follow up with organizations that they interacted with during the health fair, 18.6% were unsure and 4.3% did not believe they would be able to follow up. The top three favorite stations present at the health fair were described as the following: all stations, food stations, and the haircut station. Discussion This study examined both demographic characteristics and health access needs of participants at a local community health fair with the primary goal of identifying key services needed at health fairs to improve its success and efficacy. Upon analysis of the gathered data, several key trends emerged. Firstly, 86 participants (93.5%) listed English as at least one of their spoken languages and 6 participants (6.5%) did not list English as a language they spoke. Among respondents who reported speaking a language other than English (either along with an ability to speak English or not), numerous languages were listed, including Spanish, Dutch, German, and Arabic. Second, 68% of all respondents were unemployed. Along with this, study participants identified mental health concerns as a primary health concern for the community, as well as reported that transportation difficulties were their top barrier to healthcare access. Like many other areas across the nation, Omaha, Nebraska has a large immigrant population. As of 2023, the overall population of Omaha was 488,000 people, 93% of whom are United States (US) citizens, and 10.5% of whom were born outside of the US (51,400 people) ( 10 ). The three largest ethnic groups in Omaha are Non-Hispanic (NH) White, NH Black or African American, and two races including other (Hispanic) ( 10 ). Beyond this, between 1980 and 2020, the Latino population in Nebraska grew more than double the national rate overall, and 67 out of 93 counties in Nebraska gained population from international migrants ( 11 , 12 ). This demographic diversity found in Omaha and Nebraska overall contributes to the wide array of languages reportedly spoken at the community health fair, including English, Spanish, Dutch, German, and Arabic, and highlights the importance of having translation services available. Language barriers have long been identified as a hindrance of healthcare access, as it “prevents the establishment of essential doctor-patient communication, leading to inequity and negatively impacting the healthcare” of migrant and vulnerable patients ( 13 ). Language barriers prevent patients from properly understanding medical instructions, make it nearly impossible to navigate healthcare systems on their own, and make it difficult to build trust with providers ( 14 ). The use of a patient’s native language during the delivery of healthcare services improves patient satisfaction, medical compliance, and health improvement ( 15 ). This highlights the importance of having language translation services available in clinical settings, including at events such as community health fairs, despite their national underutilization ( 14 ). Over half of all study participants reported unemployment, highlighting a major issue faced by many vulnerable communities. Although employment opportunities and resources are not traditionally thought of as a health care asset, unemployment has been shown to have a significant negative impact on health ( 16 ). Adverse health outcomes found to be associated with unemployment include poor general/physical health, poor mental health, obesity, depression, hypertension, high cholesterol, diabetes, cardiovascular disease, stroke, chronic obstructive pulmonary disease, current/ever asthma, and cancer ( 16 ). Conversely, employment has been found to have positive social, psychological, and financial benefits that improve overall health as well as decrease excessive utilization of insurance and health services ( 17 , 18 ). This highlights the importance of including employment opportunities and job search resources at events such as community health fairs. This will provide a long-term investment that will help improve the health of vulnerable populations and individuals overall. Participants at this community health fair highlighted mental health issues as their primary medical concern. Many participants at the health fair were residents of a local shelter for those experiencing homelessness. Reported prevalence of mental health disorders among unhoused individuals is around 67% currently experiencing mental illness, and 77% reporting ever lifetime mental health issues ( 19 ). It has been found that males experiencing homelessness are more likely to experience a mental health issue than unhoused females, and substance use disorder and antisocial personality disorder are among the most prevalent mental health issues ( 19 ). Mental illness can be both a cause and a consequence of homelessness, due to the stress and uncertainty of unstable housing and the role that trauma plays in the relationship between the two ( 20 ). Lack of reliable or consistent housing can cause extreme stress on individuals, creating a vulnerable environment that can trigger or exacerbate mental illness ( 21 ). The overall prevalence as well as the exacerbating conditions vulnerable populations face make it crucial to provide mental health resources at community health events, such as information regarding residential treatment, coping strategy building resources, and access to trained psychiatrists and therapists. Finally, transportation barriers were also cited as the primary barrier to health care access among the studied population. Nationally, between 1997 and 2017, 5.8 million Americans (1.8%) reported delays in medical care due to a lack of transportation ( 22 ). It was also found that “Hispanic people, those living below the poverty threshold, Medicaid recipients, and people with a functional limitation had greater odds of reporting a transportation barrier” than others ( 22 ). Transportation issues frequently result in delay of or missing healthcare appointments as well as increases declination of key health services, such as vaccinations ( 23 ). Thus, when organizing a health fair event designed to attract and assist disadvantaged and vulnerable populations, it is crucial to include screening methods to identify and resources to address barriers to healthcare access, such as lack of transportation ( 24 ). Limitations: Despite all efforts to minimize bias and create a sound design, this study still faces some limitations. The first limitation this study faces was a low response rate. Out of 500 health fair attendees, only 92 participated in the survey, representing an 18% response rate. This could impact results if a particular subset of attendees was more drawn to participate in the survey and could alter trends in resources crucial to a health fair’s success and reduce the power of the study’s results overall. Beyond this, there was a possible miscommunication of questions by researchers or misunderstanding of questions by participants. In response to questioning regarding primary health concern, 30.7% reported having no health concerns, and in response to questioning about primary barriers to health care access, 22.5% reported having no barriers to access. Although these might represent respondents’ true situations, this might also highlight a disconnect between the intent of a question and participant’s understanding. Conclusions Overall, participants at a local community health fair in Omaha, Nebraska found that the event improved their health literacy and reported that they would recommend the event to others. Crucial to the efficacy of a health promotion event such as this is understanding the needs of vulnerable populations. This study found that language barriers, mental health issues, and transportation barriers are key issues affecting overall health and access in the studied population. Moving forward, future health fairs must include resources and services addressing these issues to ensure a positive impact on this population’s health and healthcare access overall. Declarations Ethics approval and consent to participate: This project received Institutional Review Board approval from the Creighton University School of Medicine on April 24, 2025 (determination: EXEMPT 2ii). The protocol number for the study is 2005439-01. Participants were provided with information sheets regarding the survey’s content and study purpose and then were asked to provide verbal consent if they wished to proceed. This study was conducted in accordance with the Declaration of Helsinki. Consent for publication: As all information in this study is deidentified, this is not applicable. Funding: Not applicable. Author Contribution Authors Olivia Foley (OF), Alexandra Van Cleave (AV), Shannon Blee (SB), Shalika Devireddy (SHD), Samantha Draves (SD), and Bruce Houghton (BH) contributed to the development of the study design and methods. Author OF functioned as principal investigator, organizing procedure for collecting surveys and keeping results secure. Author AV helped gather data as well as contributed to the analysis of results. Authors OF, AV, and SHD contributed to the writing of the final manuscript, while authors OF, AV, SB, SD, Abubakar Tauseef (AB), and BH contributed to editing and overall approval of final manuscript. Acknowledgement Authors would like to acknowledge and thank the staff at the Sienna Francis House for providing the space necessary for hosting this annual Health Fair event as well as assisting with data collection as needs arose. 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Opening doors to health equity: Screening for social determinants of health at community health fairs. Volume 8. JACCP: JOURNAL OF; 2025. pp. 579–86. 7 https://doi.org/10.1002/jac5.70058 . Additional Declarations No competing interests reported. Supplementary Files Table1.jpg Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 29 Apr, 2026 Reviews received at journal 14 Apr, 2026 Reviewers agreed at journal 10 Apr, 2026 Reviewers agreed at journal 09 Apr, 2026 Reviewers agreed at journal 08 Apr, 2026 Reviewers invited by journal 08 Apr, 2026 Editor invited by journal 12 Mar, 2026 Editor assigned by journal 12 Mar, 2026 Submission checks completed at journal 12 Mar, 2026 First submitted to journal 10 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Medicine","correspondingAuthor":false,"prefix":"","firstName":"Samantha","middleName":"","lastName":"Draves","suffix":""},{"id":623154052,"identity":"8767ebd6-4df9-47ec-9456-9927e9c5b10e","order_by":5,"name":"Abubakar Tauseef","email":"","orcid":"","institution":"Creighton University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Abubakar","middleName":"","lastName":"Tauseef","suffix":""},{"id":623154055,"identity":"585d7563-f067-48c1-9173-d5bb5f5fe443","order_by":6,"name":"Bruce Houghton","email":"","orcid":"","institution":"Creighton University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Bruce","middleName":"","lastName":"Houghton","suffix":""}],"badges":[],"createdAt":"2026-03-10 22:23:24","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9087977/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9087977/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107245650,"identity":"ea448693-7801-44fd-813f-33d3006253b5","added_by":"auto","created_at":"2026-04-19 08:06:13","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":194802,"visible":true,"origin":"","legend":"\u003cp\u003eRacial Breakdown of Study Participants at a Community Health Fair in Omaha, NE.\u003c/p\u003e","description":"","filename":"Figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9087977/v1/d33033b9c2dca6463fbe7a2e.jpg"},{"id":107245651,"identity":"2b565d09-e5e1-4a9c-8ccc-527ba2b1b840","added_by":"auto","created_at":"2026-04-19 08:06:13","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":119542,"visible":true,"origin":"","legend":"\u003cp\u003eEmployment Status of Study Participants at a Community Health Fair in Omaha, NE.\u003c/p\u003e","description":"","filename":"Figure2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9087977/v1/9449587414e19fb01767f14d.jpg"},{"id":107484399,"identity":"de0cbe39-b76f-4373-81fe-8d7a79231d21","added_by":"auto","created_at":"2026-04-22 02:31:52","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":127308,"visible":true,"origin":"","legend":"\u003cp\u003eEducation Level of Study Participants at a Community Health Fair in Omaha, NE.\u003c/p\u003e","description":"","filename":"Figure3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9087977/v1/42bac01c7a8a0f887012378a.jpg"},{"id":107487011,"identity":"693cc63e-7235-453d-becc-945ca6529a71","added_by":"auto","created_at":"2026-04-22 02:39:34","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":665503,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9087977/v1/56de54ae-5eb7-40d9-bbcf-2be42bcb2ad5.pdf"},{"id":107484254,"identity":"67e358b8-a449-4127-afbc-544b7f5152d4","added_by":"auto","created_at":"2026-04-22 02:31:14","extension":"jpg","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":146447,"visible":true,"origin":"","legend":"","description":"","filename":"Table1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9087977/v1/ea564e4ab9ee3841ddbfdc30.jpg"}],"financialInterests":"No competing interests reported.","formattedTitle":"Understanding a Patient Population and their Access to Current Health Care Services at a Community Health Fair in Omaha: A Mixed-Methods Study","fulltext":[{"header":"Background","content":"\u003cp\u003eA health fair is defined as an \u0026ldquo;outreach event focused on community health education intervention, that is tailored to a specific community, and a way to provide accurate information about specific health problems and to trigger health behavior change in target audiences\u0026rdquo; (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Many barriers limit access to healthcare in vulnerable populations, including lack of transportation, finances, education, language and insurance (\u003cspan additionalcitationids=\"CR3 CR4\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Health fairs often bring numerous community organizations together in one place to provide abundant resources regarding education, free or reduced-cost screening materials funded by public health grants, or direct connections to healthcare providers. Community organizations often have pre-made educational materials regarding the resources they provide that are available for attendees to take and utilize. Overall, health fairs can be a beneficial avenue for providing access to free healthcare for a large portion of the population (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eCommunity health fair events often target specific communities typically lacking access to care, such as unhoused, low-income, uninsured, and other marginalized populations. Understanding why these are often the intended populations aids in deciding what services to provide at the fair. For example, a study examining the prevalence of hypertension in an unhoused population of Long Beach, California found that this population had increased rates of hypertension when compared to other communities (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Those with hypertension are exposed to long-term health risks, regardless of if they are aware of their disease status, such as increased risk of cardiovascular or stroke events. Concerningly, across the United States, the mortality rate among those with hypertension is 3-4x higher in the unhoused population compared to those who are housed (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Therefore, it is imperative that health fairs exist to not only screen for hypertension, but also to provide education and counseling to those patients. Additionally, at one health fair, approximately two thirds of the attendees cited not attending a preventative health checkup in over 2 years (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Knowledge of prevalent ailments in underserved populations can help tailor future health fairs to more appropriately suit the needs of their attendees and affect significant change in their lives.\u003c/p\u003e \u003cp\u003eWhile health fairs are undoubtedly beneficial, to understand the true impact of a fair, researchers must further analyze whether the event provided useful information and services to attendees, and whether the benefits of attending the event outweighed any potential harm. A study investigating follow-up after a health fair where high-risk participants were screened for cardiovascular events found that at 1 month, 30% had made an appointment with a physician and 65% planned to make an appointment, a majority of whom requested assistance making the appointment (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). This suggests that referrals and appointment scheduling available at a health fair may increase the likelihood of formal medical follow-up. Additionally, another study gave attendees an exit-survey in which they had overall rated the event as \u0026ldquo;highly favorable\u0026rdquo; (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). This signals that attendees not only find health fairs useful but feel invested in their own health and follow up care after the event.\u003c/p\u003e \u003cp\u003eAs past literature has illustrated, health fairs can play a vital role in working towards alleviating barriers in healthcare for specific populations. However, understanding attendees\u0026rsquo; perceptions towards their own health and access to resources remains understudied. Therefore, the goal of this project is to gather information directly from health fair attendees about their own health perceptions and about specific healthcare resources that are most important to them. Through better understanding of attendees\u0026rsquo; thoughts and attitudes about healthcare resources, researchers aim to highlight crucial aspects that can help improve the effectiveness of this health fair as well as guide the creation of similar events serving other underserved communities across the nation.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis study was a cross-sectional survey assessing healthcare access and health fair satisfaction among adult attendees at a community health fair in Omaha, Nebraska held in August 2025. The primary objective was to evaluate current access to healthcare services among attendees, and the secondary objective was to assess attendee satisfaction with the health fair. The protocol was reviewed and approved by the Creighton University Institutional Review Board prior to data collection.\u003c/p\u003e \u003cp\u003eAll health fair attendees aged\u0026thinsp;\u0026ge;\u0026thinsp;18 years were eligible to participate; individuals\u0026thinsp;\u0026lt;\u0026thinsp;18 years were excluded. Participants were recruited in person at a designated research booth during the event. Trained medical student volunteers provided standardized verbal explanations describing the study purpose, institutional affiliation, and voluntary nature of participation, and obtained written informed consent before survey administration. Participants were given adequate time to review the consent document and ask questions. For participants who did not speak English, telephone-based interpreter services (InterpretManage) and in-person Spanish interpretation were used to support both the consent process and survey completion.\u003c/p\u003e \u003cp\u003eAfter consent, volunteers administered the survey during the health fair; completion time was typically under 10 minutes. Surveys were completed on paper, collected by designated investigators, and secured during the event.\u003c/p\u003e \u003cp\u003eThe research team developed a 30-item survey that consisted of structured and open-ended questions designed to assess demographic characteristics, healthcare access, perceived barriers to care, and satisfaction with the health fair. Survey content covered demographic characteristics including age, race/ethnicity, language(s) spoken, gender identity, sex assigned at birth, employment status, insurance status/type, highest education level achieved, veteran status, current residence, and length of stay, as well as current access to technology. Health-related questions assessed self-rated health level, prior community resource use, healthcare utilization within 6 months, presence of a primary care physician, trust in physicians, and likelihood of following up with health organizations. Open-ended items asked participants to describe their primary health concern and their main barrier to obtaining care. The health fair satisfaction section included questions on how attendees learned about the event, whether participation increased their health awareness, likelihood of recommending the health fair to others, and anticipated follow up with participating organizations. Participants also identified their favorite and least favorite stations and provided open-ended explanations to clarify perceived strengths and areas for improvement.\u003c/p\u003e \u003cp\u003eAfter the event, responses were entered into an electronic database available only to authorized student investigators and the supervising faculty advisor. No protected health information or directly identifying information was collected. Following data entry, responses were systematically coded for analysis. Closed-ended items were assigned predefined numerical values corresponding to each response category. Open-ended responses were reviewed and categorized into thematic groups, after which numerical codes were assigned to each category to facilitate quantitative and qualitative analysis. Discrepancies between coders were resolved through discussion and consensus.\u003c/p\u003e \u003cp\u003eDescriptive statistics were used to summarize demographic variables and measures of healthcare access and satisfaction. Continuous variables were reported as means with standard deviations or medians with interquartile ranges, as appropriate, and included minimum and maximum values. Categorical variables were summarized using frequencies and percentages.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eDemographics\u003c/h2\u003e \u003cp\u003eOf approximately 500 health fair attendees, 92 participated in this research project, ~\u0026thinsp;18% response rate. The median age of participants was 51 years old, ranging from 22\u0026ndash;81 years old. Respondents self-identified gender, race, languages spoken, and veteran status. Self-reported gender rates were reported as 31.9% female, 65.9% male, and 2.2% non-binary. Forty percent of participants identified as White/Caucasian, 37% as African American/Black, and 8% as Hispanic/Latino. Remaining race identification demonstrated in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Most respondents stated that they spoke English, with 82.7% only speaking English and 6.2% speaking English and Spanish, 3.7% of respondents only spoke Spanish, and the remaining 7.4% spoke multiple other languages including Dutch, German, and Arabic. Of respondents, 8.7% identified as veterans.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFor employment status, most respondents described themselves as unemployed (68%). Fourteen percent of participants identified as employed, 11% on disability, and 7% as retired (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Most respondents, 49% report some high school as the highest education level achieved, 45% as some undergraduate/college, 3% graduate-level, 2% some elementary/middle school, and 1% no formal education (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003ePrimary Health Concerns and Barriers for their Current Health Care Access\u003c/h3\u003e\n\u003cp\u003eThe respondents had the opportunity to report their primary health concern at time of survey administration. The top four primary health concerns were: no health concern/not applicable (30.7%), mental health concerns (11.3%), social determinant of health concerns (11.3%), and cardiology concerns (8.1%). Along with their primary health concern, respondents reported their top barrier to healthcare access, with the top five listed as no barriers (22.5%), transportation difficulties (22.5%), financial difficulties (10.2%), lack of time (8.2%), and negative personal experiences in healthcare (8.2%).\u003c/p\u003e \u003cp\u003eMost participants self-described their health as average or good with 44.9% for each category. The majority reported seeing a doctor within the last 6 months, 65.9%, and 53.6% report seeing a doctor regularly. Of those who regularly see a doctor, 45 people, 92.3% report trusting their primary doctor (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eHealth Care Access of Study Participants at a Community Health Fair in Omaha, NE.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCurrent Health Care Access\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-Identified Health Status\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoor Health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9 (10.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAverage Health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e40 (44.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGood Health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e40 (44.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHave you seen a doctor\u0026hellip;\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eIn the last 6 months?\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e30 (34.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e58 (65.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eRegularly?\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e39 (46.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e45 (53.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eDo you trust your primary doctor?\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (7.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36 (92.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003eHealth Fair Outcomes\u003c/h3\u003e\n\u003cp\u003eAfter attending the health fair, 80% of respondents stated that they were more aware of diseases that could affect them. 97.7% reported that they would recommend the health fair to others in the future. 77.1% of participants believe they will be able to follow up with organizations that they interacted with during the health fair, 18.6% were unsure and 4.3% did not believe they would be able to follow up. The top three favorite stations present at the health fair were described as the following: all stations, food stations, and the haircut station.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003e This study examined both demographic characteristics and health access needs of participants at a local community health fair with the primary goal of identifying key services needed at health fairs to improve its success and efficacy. Upon analysis of the gathered data, several key trends emerged. Firstly, 86 participants (93.5%) listed English as at least one of their spoken languages and 6 participants (6.5%) did not list English as a language they spoke. Among respondents who reported speaking a language other than English (either along with an ability to speak English or not), numerous languages were listed, including Spanish, Dutch, German, and Arabic. Second, 68% of all respondents were unemployed. Along with this, study participants identified mental health concerns as a primary health concern for the community, as well as reported that transportation difficulties were their top barrier to healthcare access.\u003c/p\u003e \u003cp\u003eLike many other areas across the nation, Omaha, Nebraska has a large immigrant population. As of 2023, the overall population of Omaha was 488,000 people, 93% of whom are United States (US) citizens, and 10.5% of whom were born outside of the US (51,400 people) (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). The three largest ethnic groups in Omaha are Non-Hispanic (NH) White, NH Black or African American, and two races including other (Hispanic) (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Beyond this, between 1980 and 2020, the Latino population in Nebraska grew more than double the national rate overall, and 67 out of 93 counties in Nebraska gained population from international migrants (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). This demographic diversity found in Omaha and Nebraska overall contributes to the wide array of languages reportedly spoken at the community health fair, including English, Spanish, Dutch, German, and Arabic, and highlights the importance of having translation services available.\u003c/p\u003e \u003cp\u003eLanguage barriers have long been identified as a hindrance of healthcare access, as it \u0026ldquo;prevents the establishment of essential doctor-patient communication, leading to inequity and negatively impacting the healthcare\u0026rdquo; of migrant and vulnerable patients (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Language barriers prevent patients from properly understanding medical instructions, make it nearly impossible to navigate healthcare systems on their own, and make it difficult to build trust with providers (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). The use of a patient\u0026rsquo;s native language during the delivery of healthcare services improves patient satisfaction, medical compliance, and health improvement (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). This highlights the importance of having language translation services available in clinical settings, including at events such as community health fairs, despite their national underutilization (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOver half of all study participants reported unemployment, highlighting a major issue faced by many vulnerable communities. Although employment opportunities and resources are not traditionally thought of as a health care asset, unemployment has been shown to have a significant negative impact on health (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Adverse health outcomes found to be associated with unemployment include poor general/physical health, poor mental health, obesity, depression, hypertension, high cholesterol, diabetes, cardiovascular disease, stroke, chronic obstructive pulmonary disease, current/ever asthma, and cancer (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Conversely, employment has been found to have positive social, psychological, and financial benefits that improve overall health as well as decrease excessive utilization of insurance and health services (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). This highlights the importance of including employment opportunities and job search resources at events such as community health fairs. This will provide a long-term investment that will help improve the health of vulnerable populations and individuals overall.\u003c/p\u003e \u003cp\u003eParticipants at this community health fair highlighted mental health issues as their primary medical concern. Many participants at the health fair were residents of a local shelter for those experiencing homelessness. Reported prevalence of mental health disorders among unhoused individuals is around 67% currently experiencing mental illness, and 77% reporting ever lifetime mental health issues (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). It has been found that males experiencing homelessness are more likely to experience a mental health issue than unhoused females, and substance use disorder and antisocial personality disorder are among the most prevalent mental health issues (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Mental illness can be both a cause and a consequence of homelessness, due to the stress and uncertainty of unstable housing and the role that trauma plays in the relationship between the two (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Lack of reliable or consistent housing can cause extreme stress on individuals, creating a vulnerable environment that can trigger or exacerbate mental illness (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). The overall prevalence as well as the exacerbating conditions vulnerable populations face make it crucial to provide mental health resources at community health events, such as information regarding residential treatment, coping strategy building resources, and access to trained psychiatrists and therapists.\u003c/p\u003e \u003cp\u003eFinally, transportation barriers were also cited as the primary barrier to health care access among the studied population. Nationally, between 1997 and 2017, 5.8\u0026nbsp;million Americans (1.8%) reported delays in medical care due to a lack of transportation (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). It was also found that \u0026ldquo;Hispanic people, those living below the poverty threshold, Medicaid recipients, and people with a functional limitation had greater odds of reporting a transportation barrier\u0026rdquo; than others (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). Transportation issues frequently result in delay of or missing healthcare appointments as well as increases declination of key health services, such as vaccinations (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Thus, when organizing a health fair event designed to attract and assist disadvantaged and vulnerable populations, it is crucial to include screening methods to identify and resources to address barriers to healthcare access, such as lack of transportation (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e).\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eLimitations:\u003c/h2\u003e \u003cp\u003eDespite all efforts to minimize bias and create a sound design, this study still faces some limitations. The first limitation this study faces was a low response rate. Out of 500 health fair attendees, only 92 participated in the survey, representing an 18% response rate. This could impact results if a particular subset of attendees was more drawn to participate in the survey and could alter trends in resources crucial to a health fair\u0026rsquo;s success and reduce the power of the study\u0026rsquo;s results overall. Beyond this, there was a possible miscommunication of questions by researchers or misunderstanding of questions by participants. In response to questioning regarding primary health concern, 30.7% reported having no health concerns, and in response to questioning about primary barriers to health care access, 22.5% reported having no barriers to access. Although these might represent respondents\u0026rsquo; true situations, this might also highlight a disconnect between the intent of a question and participant\u0026rsquo;s understanding.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eOverall, participants at a local community health fair in Omaha, Nebraska found that the event improved their health literacy and reported that they would recommend the event to others. Crucial to the efficacy of a health promotion event such as this is understanding the needs of vulnerable populations. This study found that language barriers, mental health issues, and transportation barriers are key issues affecting overall health and access in the studied population. Moving forward, future health fairs must include resources and services addressing these issues to ensure a positive impact on this population\u0026rsquo;s health and healthcare access overall.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003e \u003cp\u003e This project received Institutional Review Board approval from the Creighton University School of Medicine on April 24, 2025 (determination: EXEMPT 2ii). The protocol number for the study is 2005439-01. Participants were provided with information sheets regarding the survey\u0026rsquo;s content and study purpose and then were asked to provide verbal consent if they wished to proceed. This study was conducted in accordance with the Declaration of Helsinki.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eConsent for publication:\u003c/strong\u003e \u003cp\u003eAs all information in this study is deidentified, this is not applicable.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding:\u003c/h2\u003e \u003cp\u003eNot applicable.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eAuthors Olivia Foley (OF), Alexandra Van Cleave (AV), Shannon Blee (SB), Shalika Devireddy (SHD), Samantha Draves (SD), and Bruce Houghton (BH) contributed to the development of the study design and methods. Author OF functioned as principal investigator, organizing procedure for collecting surveys and keeping results secure. Author AV helped gather data as well as contributed to the analysis of results. Authors OF, AV, and SHD contributed to the writing of the final manuscript, while authors OF, AV, SB, SD, Abubakar Tauseef (AB), and BH contributed to editing and overall approval of final manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eAuthors would like to acknowledge and thank the staff at the Sienna Francis House for providing the space necessary for hosting this annual Health Fair event as well as assisting with data collection as needs arose.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eGoldman KD, Schmalz KJ. Top Grade Health Fair: An A Fair to Remember. 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Transportation Barriers to Health Care in the United States: Findings From the National Health Interview Survey, 1997\u0026ndash;2017. Am J Public Health. 2020;110(6):815\u0026ndash;22. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2105/AJPH.2020.305579\u003c/span\u003e\u003cspan address=\"10.2105/AJPH.2020.305579\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLyeo JS, Tiznado-Aitken I, Farber S, Brown HK, Spence N. Predictors of transportation-related barriers to healthcare access in a North American suburb. 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JACCP: JOURNAL OF; 2025. pp. 579\u0026ndash;86. 7\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1002/jac5.70058\u003c/span\u003e\u003cspan address=\"10.1002/jac5.70058\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Health fair, vulnerable population, unhoused, social determinants of health, transportation, language services","lastPublishedDoi":"10.21203/rs.3.rs-9087977/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9087977/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eHealth fairs represent outreach events that facilitates healthcare information delivery to populations who may not otherwise have access to community health resources. Countless barriers to healthcare exist, including lack of transportation, restricted finances, low education level, language differences, and lack of insurance. Unique barriers and problems exist among a variety of communities, and proper communication of available resources is crucial to improve the overall health of a community. This study evaluates demographic characteristics and healthcare access needs amongst community members who attend a community health fair in Omaha, Nebraska.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis study utilized a 30-question cross-sectional survey to gather information from participants at the community health fair. This survey gathered information regarding attendees\u0026rsquo; demographics, healthcare access, and suggestions for improvement in future.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eRoughly 500 participants attended the community health fair in 2025. Out of 500 participants, 92 filled out this study\u0026rsquo;s survey (18%). Participants reported speaking a variety of languages, including English, Spanish, Dutch, German, and Arabic. For employment status, 68% of respondents reported that they were unemployed. Beyond this, 30.7% of respondents reported that they did not have a primary health concern, while 11.3% reported mental health as their primary health concern. The top barrier to healthcare was transportation difficulties, reported by 22.5% of respondents. After participating in the fair, 80% of respondents stated that they were more aware of diseases that could affect them, and 97.7% of study participants reported they would recommend the health fair to others in the future.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eGathering information regarding demographics and healthcare access from attendees at a community health air allows for improved understanding of the community it serves. This will not only improve the success of future health fair events but also will provide information for other communities nationwide to offer a suggestion of possible primary health concerns and barriers to healthcare access.\u003c/p\u003e","manuscriptTitle":"Understanding a Patient Population and their Access to Current Health Care Services at a Community Health Fair in Omaha: A Mixed-Methods Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-19 08:06:09","doi":"10.21203/rs.3.rs-9087977/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-04-29T21:49:34+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-14T18:09:27+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"133525732037393118694336960786974306535","date":"2026-04-10T18:55:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"45494649126228072764372449930672138659","date":"2026-04-09T12:22:22+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"140310187896247903575727345118139844022","date":"2026-04-08T20:58:57+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-08T18:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-12T11:56:53+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-12T07:04:17+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-12T07:04:01+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2026-03-10T22:19:26+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"067c4d61-6455-49e0-ac31-cb310f440629","owner":[],"postedDate":"April 19th, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-04-29T21:49:34+00:00","index":77,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-19T08:06:09+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-19 08:06:09","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9087977","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9087977","identity":"rs-9087977","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}