Challenges and Successes in Reducing Health Disparities Workshop Summary (2008) / Chapter Skim
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4 Successful Clinical and Community-Development Strategies
4 Successful Clinical and Community-Development Strategies
Pages 69-90
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From page 69... ...
Ms. Charmaine Ruddock, the project director from Bronx Health Reach, and Dr.
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From page 70... ...
A Year of Planning During the initial planning year, Bronx Health REACH conducted a l iterature review and held a series of 10 focus groups to help create and mold the coalition action plan. Very early it was determined that the community initiative would focus specifically on diabetes care and prevention, and the project would benefit the entire community, not simply one racial group.
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These health concerns became the focus of the Bronx Health REACH initiative. According to the findings of the focus groups, stress was rampant in the community because of pressures exacerbated by living in a depressed socioeconomic area and a belief that racism was pervasive in the community.
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Moving Forward The Bronx Health Reach initiative was announced with fanfare at an event featuring elected officials, pastors, congregational members, and over 700 community residents. The key objectives of the Bronx Health REACH initiative were to develop and implement model community programs; institute sustainable health improvements through policy, system, and institutional changes; develop a health policy agenda; and mobilize community residents around that agenda.
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In 2007, a new Youth and Nutrition Program began, and Bronx Health REACH participated in a national initiative called the 50 Million Pound Weight Loss Challenge. With funding provided by the National Institutes of Health, another new program called Health Disparities: Navigating the Health Care System Workshop Series, was started.
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From page 74... ...
They also c ollaborated with the Bronx District Public Health Office and the New York City Department of Health on a bodegas initiative to have them supply more low-fat or no-fat milk. Bronx Health REACH has also recruited 11 restaurants in the Bronx to highlight their healthy menu options.
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Oklahoma REACH 2010 is a coalition made up of the Absentee–Shawnee and Cheyenne–Arapaho Tribes, the Cherokee, Chickasaw, Choctaw, Pawnee, and Seminole Nations, the Indian Health Care Resource Center in Tulsa, the Oklahoma State Department of Health, and the Wichita and affiliated tribes. The coalition is focused on reducing health disparities in cardiovascular disease, diabetes, and any associated risk factors through increased availability and promotion of physical activity at a community level.
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Every participating community has started a new physical activity program or expanded an existing one and several communities have created programs with objectives that move beyond the initial goal of increasing physical activity. Although physical activity remains the primary focus, programs have been developed
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Nearly 75 community tribal members have been trained to lead different physical activity programs, and approximately 200 certified training sessions have been held for American Indian community members. Community involvement and participation have been phenomenal.
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American Indians in Oklahoma are now just as likely to be physically active as the rest of the population. Successful fundraising has taken place through such programs as the Cheyenne–Arapaho partnership mentioned previously and through programs started by the Cherokee Nation, a group that receives substantial support for programs started under the REACH project.
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From page 79... ...
There is interest in taking the Oklahoma REACH model and applying it to other health initiatives, such as nutrition education or tobacco cessation training, among others. Another project coordinated by a local university, called the Community Networks Project, has been initiated to work with tribes and historically black towns in Oklahoma.
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From page 80... ...
They have community health workers with access to community resources who help match individuals to appropriate diabetes education or physical activity programs. They have also been able to obtain Medicaid funding for some of their community wellness advocates who work with asthmatics and diabetics.
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School health coordinators have been instrumental in developing and implementing wellness policies in the school districts and throughout the Steps communities. Steps programs have also been instrumental in instituting changes in the built environment, improving disease registries, and increasing access to quality health care.
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Combined, the four Steps communities serve about 700,000 New York State residents. Broome County is a rural residential county in New York, about 10 miles north of the Pennsylvania border.
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In addition to running the program, community peer leaders are also responsible for recording and tracking participant's weight, blood pressure, BMI, and physical measurement on a weekly basis. Each organization that partners with the Broome County Steps Mission Meltaway signs a memorandum of agreement stating that they will create policy systems and institute environmental changes related to physical activity and nutrition, so their employees and community members will have more opportunities to stay fit.
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From page 84... ...
Through targeted physical activity and nutrition interventions such as Mission Meltaway, Broome County has taken positive steps to achieve a healthier New York State. CHEROKEE NATION I was born and raised in Adair County, which is the most heavily populated native county in Oklahoma, and I have been with the Cherokee Nation This section is an edited transcript of Ms.
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From page 85... ...
All of the community health programs are open to tribal members as well as members of the larger community. The mission statement is that the Healthy Nation Program promotes healthy communities through increasing physical activity, improving nutrition, and preventing tobacco abuse.
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The Healthy Nation Program is a REACH 2010 and a Steps to a Healthier Cherokee Nation site -- one of only three tribes funded nationally as a Steps site. The Steps program was originally funded in 2004 with a 5-year Steps cooperative agreement.
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, referrals from health care providers, the Oklahoma State Health Policy Review, the School Health Inventory, OK Quit Line Data, the YRBS, and follow-up on smoking cessation programs. Another evaluation tool called the Knowledge, Attitudes, and Practice analyzes BRFSS information and tries to evaluate why people provide certain responses to questions.
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From page 88... ...
The Cherokee Nation has initiated a new program called Eat Better, Move More, which is focused on increasing physical activity, improving nutrition for elders, and providing nutrition centers. It is a 12-week program that includes functional testing and a variety of activities.
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From page 89... ...
Local community members stated that they would like more individual exercise instruction, in-depth nutritional programs, additional group activities, and activities for special populations. Prioritizing policy adoption for health promotion programs in the Cherokee Nation has been challenging, as has strategizing implementation procedures and methods for reaching program goals and objectives.
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