Opening Doors with CommunityBased Outreach

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Opening Doors with Community-Based Outreach

• National Nursing Centers Consortium
• 260 South Broad Street, 18th Floor
• Philadelphia, PA 19102
• [phone]
• Leaders for Healthy Neighborhoods!

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PANEL AGENDA

• Overview of the NNCC and best-practice programs
  Lead Safe Babies, Asthma Safe Kids, RADICAL Youth
• Tine Hansen-Turton, Executive Director, National
  Nursing Centers Consortium
• Evaluation of programs
• Dr. Nancy Rothman, Director, Temple Health
  Connection
• Community perspective
• Lorraine Thomas, Outreach Specialist, The Health
  Annex
• Nakia Brunson, AmeriCorpsVISTA Member, National
  Nursing Centers Consortium and Temple Health
  Connection
• Discussion

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QUESTIONS TO CONSIDER

• What does a best practice health promotion
  program look like?
• How do you implement a best practice program
  within a community?
• What are the challenges faced in program design,
  implementation, and/or evaluation?

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Overview of NNCC

• Established in Philadelphia in 1996
• The only national association of nurse-managed
  health centers in the U.S.
• 65 member health centers across 30 states
• 35,000 people served annually
• 300,000 health related encounters annually
• Rural and urban locations

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What is a Nurse-managed Health Center?
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Member Center Outcomes

• High patient satisfaction
• ER use 15 less than the aggregate
• Non-maternity hospital days 35-40 less
• Specialty cost 25 less than the aggregate
• Prescription cost 25 less than the aggregate
• Preventive health care for children performance
  of 94
• Information obtained from HMO Reports from
  select nurse-managed centers

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To What Do We Attribute Outcomes?

• Accessible
• Affordable
• Friendly
• Culturally appropriate services
• Intensive case management services
• Enabling services
• Health promotion and disease prevention focus

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NNCC Vision and Mission

• The vision of the NNCC is to improve the health
  of our communities through neighborhood-based
  health care services that are accessible,
  acceptable, and affordable.
• The mission is to strengthen the capacity,
  growth, and development of the nurse-managed
  health centers to provide quality health care
  services to vulnerable populations and to
  eliminate health disparities in underserved
  communities.

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NNCC Health Promotion Programs

• Lead Safe Babies, Asthma Safe Kids, RADICAL Youth
• Community-based and community-driven
• Culturally compatible care
• Persistence and commitment of Outreach Workers
  from target neighborhoods
• Incentives

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Lead Safe Babies Background

• Kicked off in December 2000
• Funding from the Philadelphia City Childhood Lead
  Poisoning Prevention Program, the U.S. EPA,
  Region III, and the Center for Disease Control
• Currently operates in 5 Philadelphia-based
  nurse-managed health centers and 3 centers
  located throughout rural Pennsylvania

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Lead Safe Babies, contd.

• Primary Prevention Program
• Community input on design
• To date, over 600 mothers have been reached
  throughout Philadelphia
• Recent expansion to rural Pennsylvania
• National expansion expected shortly
• Programs success has led to 6 expansion grants
  over 3 years

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Lead Safe Babies Goals

• Giving new mothers the knowledge and tools to
  prevent their children from becoming lead
  poisoned through home visits
• Ensuring that children at high risk for lead
  poisoning are screened at nine months of age, as
  per Philadelphia Department of Public Health
  recommendations

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Content of Home Visit

• Individualized, one-on-one education
• Cleaning methods to keep lead dust down in the
  home
• Provide cleaning supplies
• Nutrition education - Lead Safe Cookbooks

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Asthma Safe Kids

• Kicked off in October 2002
• Funded by the U.S. EPA, Region III
• To date, over 200 families of asthmatic children
  have been reached
• Program has expanded to western PA and West
  Virginia

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Asthma Safe Kids, contd

• In-home visitation program, similar to Lead Safe
  Babies
• Education focuses on the prevention and control
  of asthma by reducing exposure to environmental
  asthma triggers
• Incentives to reduce triggers include pillow and
  mattress covers, cockroach bait, and laundry
  detergent

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Content of Home Visit

• Household assessment of environmental asthma
  triggers
• Education on reducing exposure to asthma triggers
  and management of asthma
• Materials provided to assist in the reduction and
  prevention of exposure to triggers

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R.A.D.I.C.A.L. Youth

• Real Actions Directed to Improving Childrens
  Health And Lifestyle
• Goal of empowering youth to be agents of change
  in their community by teaching them about
  relevant environmental health issues
• Focus on lead poisoning prevention, asthma,
  environmental tobacco smoke

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R.A.D.I.C.A.L Youth Beginnings

• Originated at Temple University Service Learning
  Center at Norris Homes in North Philadelphia,
  2000
• Core group of children between the ages of 9 14
• Funded by the U.S. EPA, Region III, through a
  grant with the NNCC

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Step by Step Education

• Step 1 Once the children are educated and
  understand the curriculum, they write skits,
  raps, songs, and poems that will later be used to
  spread messages regarding environmental health
  issues.
• Step 2 Participating children receive support
  while perfecting their presentations.
• Step 3 When the presentations are complete, and
  costumes and music are set, the children perform
  in front of audiences. Their work can then be
  used and adapted by others.

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Thats RADICAL, dude!

• Bi-monthly performances began in August, 2002
• To date, over 200 individuals have been reached
  by the youth performers
• Although funding has ended, RADICAL children
  continue to perform throughout Philadelphia

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EVALUATIONS
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Why Our Method is Successful

• Community driven
• Based on relationships
• Culturally compatible care
• Persistence and commitment of Outreach Workers
• Incentives

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Lessons Learned

• Collaboration at every level is essential to
  success
• Relationships are the key to education
• Involve target audience in every step
• Be flexible and accommodating

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Nurse-Managed Health CentersA Grassroots
Approach

• Community Advisory Board
• Relationship based on trust
• Health care for all insured and uninsured
• Care where people live, learn, and play
• Centers are here to stay
• Holistic approach
• All patient concerns treated equally
• Helpful, caring, and trustworthy

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Discussion Questions
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What does a best practice health promotion
program look like?

• Organization is trusted by community
• Outreach workers are from community
• Health education is presented at an appropriate
  level
• Materials and incentives are provided to
  participants
• Follow-up
• Evaluation of changes in knowledge, behavior, and
  health outcomes

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How do you implement a best practice program
within a community?

• Partnerships
• Cultural and Linguistic Awareness
• Resources
• Funding

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Challenges in program design, implementation,
and/or evaluation

• Transient population
• Distrust of external organizations
• Lack of knowledge

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THE END- THANK YOU!