Blog Archives
By Jamie Cetrone | Categories: | Comments Off on Cure Violence
Cure Violence was launched in Chicago and has since expanded to numerous sites across the United States. Cure Violence uses strategies and methods similar to disease control and prevention to prevent violence. The program aims to shift the thinking, policy, and practice of violence prevention so that violence is recognized and treated as a health issue. Cure Violence was founded by Dr. Gary Slutkin, former head of the World Health Organization’s Interventions Development Unit, and professor of Epidemiology and International Health from the University of Illinois-Chicago.
Cure Violence uses methods and strategies associated with disease control to stop the spread of violence. This model is centered on three essential elements, detecting and interrupting potentially violent conflicts, identifying and working with those at highest risk for involvement, and mobilizing communities to change existing norms. This work is conducted by trained health workers who engage those at highest risk in the community, schools, and hospitals. The community-based interventions are supported through partnerships with local organizations and city agencies, which provide financial and operational support. The hospital-based interventions, while connected to the community-based projects, are implemented in partnership with the trauma team, and social work and chaplaincy staff.
Beyond being integrated into the trauma team and providing direct assistance to patients, program staff collaborate with all departments engaged in treatment plan development and follow-up to reduce likelihood of reinjury. In collaboration with the community-level intervention, the model partners with all sectors, including community organizations, city agencies, faith and community leaders, and schools, to provide comprehensive prevention programming and support for those at highest risk of involvement in violence. Services provided may include counseling, crime victim compensation, employment, housing, education assistance, and case management.
The Cure Violence model has been replicated in 60 communities across the United States and has been independently evaluated numerous times. These evaluations have demonstrated large statistically significant reductions in shootings and killings of up to 73%. In addition to reductions in violence, the model has been shown changes in behavior and norms, such as reduced support for the use of violence within the target areas.
By Jamie Cetrone | Categories: | Comments Off on Henry’s Groceries for Health
Gleaners and Henry Ford Health System recognized an opportunity to improve the health of patients who are already high-risk clinically (multiple chronic conditions) and are screened positive for food insecurity. Case managers in three high-risk clinics screen patients for food insecurity and eligibility, and patients who accept enrollment in the program are offered a package of food (including fresh produce and frozen meats) every two weeks for six months. The pilot will enroll 300 patients total, with expansion based on success. Measures include ED visits, admissions, and readmissions experienced by the enrolled population.
The program scope includes the patients currently being seen in three Henry Ford Medical Group clinics across Southeast Michigan, including two in the City of Detroit. Case managers already support these clinics, so no new staff resources were required. Gleaners receives lists of patients to receive food deliveries (for patients at two of the clinics) or food pick-up (for patients in the third clinic). Funding is handled through existing Patient Needs Fund, covering the cost of the food and delivery for the patients.
HFHS Public Health Sciences assisted with the software to send patient information in a de-identified way to Gleaners. HFHS legal team assisted with ensuring a Business Associate Agreement. The Gleaners senior team meets with the HFHS program team weekly to track progress in the pilot.
The program launched in the three clinics on 11/15/17. As of 1/8/18, 575 patients have been assessed, of which 118 (20.5%) have been identified as food insecure. Some of these patients proved ineligible for the program due to extensive dietary restrictions, in-home cooking limitations, or family size, bringing the total eligible to 100 (17.5%). Of these, 100% have accepted the program, and only three have subsequently dis-enrolled for various reasons.
By Jamie Cetrone | Categories: | Comments Off on Worcester ACTs
The HOPE Coalition (Healthy Options for Prevention and Education), funded by UMass Memorial Medical Center, is launching a new initiative, Worcester Addresses Childhood Trauma (Worcester ACTs) for children who have witnessed violence. This program is a response to research conducted by the coalition’s director Laurie Ross, PhD in partnership with the Worcester Youth Violence Prevention Initiative (WYVPI).
For over a decade, the Worcester Police Department (WPD) has actively worked to reduce gang-related violence, and progress has been made in lowering the occurrence of violent incidents involving city youth. But young men of color — particularly Latinos — are still highly involved in serious incidents. In 2012, as the research partner with the Safe and Successful Youth Initiative (SSYI), a state program, Dr. Ross read case histories of young men who are a proven risk for gun or knife violence. Thirty percent had their first violent experience (as a victim or witness) before age 12, and 30 percent were parents, creating the potential for an ongoing cycle of violence. Analysis of WPD data encompassing 24,000 men (younger than 27) and 98,000 incidents showed that if they had been a victim or witness to violence before age 12, they were 49 percent more likely to have a violent incident later and participate in three more recorded incidents than those not involved with police at an early age.
Even more surprising was that if they had been a witness only, they were more likely to experience violence later in life than those who were victims only. While most social services support victims, Worcester ACTs will introduce timely trauma-informed family support for children under 10 and their families who have witnessed an incident. Within 72 hours of a call to the police, a culturally competent Community Health Worker (CHW) will help the family with emergent and longer term needs.
Worcester ACTs includes the below partners, who work together to address an identified gap in the connection of young children who have witnessed violence to needed social and mental health services:
- Center for Health Impact
- Central Massachusetts Area Health Education Center, Inc.
- Clark University
- Community Healthlink
- Fairlawn Foundation Fund at Greater
- Worcester Community Foundation
- Straight Ahead Ministries
- UMASS Medical School Child Trauma Training Center
- Worcester Division of Public Health
- Worcester Police Department
- YWCA of Central Massachusetts
All 400 WPD officers have already received training on how trauma affects a child’s brain development and hiring of CHWs is underway. The program launches in January, 2018.
By Jamie Cetrone | Categories: | Comments Off on Youth Mental Health Model
UMass Memorial Medical Center provides funding to support the coordinator role of the Healthy Options for Prevention and Education (HOPE) Coalition, a youth-adult partnership created to reduce youth violence and substance use, and promote adolescent mental health. HOPE addresses public health concerns affecting at-risk youth, including tobacco and alcohol use, violence, and access to mental health. Several programs initiated through this effort include; HOPE Peer Leaders, a program that works closely with the City of Worcester Health & Planning departments to change local policies that regulate outdoor signage of tobacco products; HOPE Mental Health model, provides on-site mental health services at youth-serving organizations; and Youth Worker Training Institute, a thirteen-week program that trains Youth Workers on protective factors in order to work better with adolescents.
HOPE peer leaders co-chair the Youth Substance Abuse Prevention Task Force with the Worcester Division of Public Health (WDPH). In fiscal year 2016, peer leaders focused on changing the city’s tobacco purchase policy and, by working with the WDPH, successfully raised the minimum age for tobacco purchases in the city to 21.
In 2016, the program served approximately 631 youth through one-on-one counseling, therapeutic groups and crisis intervention delivered by You, Inc. Since its launch, the model has served over 5,000 youth who otherwise would not have had access to mental health support.
By Jamie Cetrone | Categories: | Comments Off on Veggie Mobile
The Regional Environmental Council (REC) developed the Grant Square Community Garden in 2010 with support from UMass Memorial Medical Center and the City of Worcester. It has 30 raised beds maintained by the REC YouthGROW program and neighborhood residents. The youth tended garden generates between 500-800 pounds of produce for the neighborhood and 15 stops in food-insecure areas across the city through REC’s “Veggie Mobile” mobile farmers market, including three stops in Bell Hill. Medical Center funding doubles the value of food stamps for purchase at the Veggie Mobile.
UMass Memorial Medical Center partners with the Worcester Regional Environmental Council (REC) to bring fresh produce to low-income/food-insecure neighborhoods through the Veggie Mobile program. Funding provided by UMass Memorial Medical Center to the Worcester Regional Environmental Council doubled SNAP purchases on the Veggie Mobile. REC’s Food Justice Program works to increase access to nutritious, healthy, and locally grown food in Worcester’s food-insecure neighborhoods, including Bell Hill where the UMass Memorial campus is located. REC programs encompass a community garden, three school gardens, a YouthGROW urban farm, and the Veggie Mobile which makes 15 weekly stops in all five of the Neighborhood Revitalization Strategy Areas identified in the city.
Since 2012, SNAP and EBT purchases on the Veggie Mobile have increased from 30% of sales, to 90% currently. Total purchases have increased by 300 percent.
By Jamie Cetrone | Categories: | Comments Off on Fresh Foodies
A significant proportion of Harris Health System’s primary care patient population is obese (BMI > 30); and nearly one third of patients with a diabetes diagnosis are considered to have poor control of their blood glucose levels (A1c >9). This data highlighted the need for more comprehensive, patient-centered education and support and led to the development of the Fresh Foodies program. The goal of the program is to help patients with diabetes and obesity manage their health with nutrition through grocery store tours and food vouchers. These tours reinforce the lessons from group nutrition classes and individual appointments that participants have with a registered dietitian.
Patients have to attend two appointments with a registered dietitian or one appointment with the dietitian (RD), and one nutrition class. Once completed, the RD sends the patient list to the health educator who then invites the patient to participate in the tour. The health educator works with grocery store management to schedule the tour and order the $30 gift cards. Health educators and community health workers provide reminder calls, grocery store tours, and follow-up phone calls. The tour guide focuses on the perimeter of store and selected inner aisles (i.e. bread, beans, and frozen food aisles). Upon completion of the grocery store tour, the patient is provided with a $30 grocery store gift card to practice planning and purchasing healthy foods for family meals on a budget.
Funding for the program was provided by the Harris County Hospital District Foundation. Harris Health Nutrition Services and Harris Health Community Outreach Services work collaboratively to provide nutrition education to patients in individual and group settings and lead patients on the tour. The grocery store tour takes place at an a H-E-B Grocery Store located near the participating community health centers.
In five months, 67 patients were provided with semi-personal (one staff per two patients) guided grocery store tours and 40 of the 67 participated in the two-week follow-up phone call. Patients have reported learning how to purchase more food for less money, select fresh produce, read labels, shop for fresh and not processed food. Patients also report learning that fresh vegetables and fruits are better than canned food. All patients believe the grocery store tour enhanced what was taught during the nutrition class and during their appointment with the dietitian, and all patients report that they would recommend the tour to friends and family.
By Jamie Cetrone | Categories: | Comments Off on Caught in the Crossfire
In 1993, Sherman Spears, a paraplegic former gunshot victim working at local CBO Youth ALIVE!, began visiting young gunshot wound (GSW) victims at the Oakland hospital where he had been treated. This became Caught in the Crossfire, the first hospital-based violence intervention program – now a national model.
The program serves youth and adult survivors of intentional injury (gunshot, stab wound, and physical assault) with immediate response upon hospital treatment in the golden moment when the patient is open to long-term support. Continuing post-discharge for 6-12 months, trained intervention specialists from the peer community of the patients will provide case management, mentoring, linkage to mental health and services, safety assessment/retaliation prevention, and other services in the field/community in order to prevent retaliation and reinjury and to promote physical, social, and emotional healing from trauma.
This program coordinates with hospital Administration, Social Services, and Trauma to access patient records, coordinate hospital access to visit patients, and to communicate about follow-up care. Community partners include Youth ALIVE!, Eden Medical Center, Children’s Hospital Oakland, Alameda County Emergency Medical Services, and the City of Oakland.
Program measures include positive outcomes such as attachment to mental health services, education/employment and housing, and reduction in negative outcomes such as arrests and injury recidivism. Without intervention, nationally, up to 44% of patients recidivate within 5 years. In the program, it is less than 3%.
By Jamie Cetrone | Categories: | Comments Off on Nice Ride Community Partnership
The program started in 2016 as a collaboration between the mental health and cardiology teams at Hennepin County Medical Center, in an effort to implement a holistic approach to treating patients. Through this program, patients can make therapeutic lifestyle changes that reduce their risk of a heart attack or stroke — while simultaneously improving their mental health. Patients are given “prescriptions” to ride a bicycle as a form of treatment. With support from the Nice Ride MN bike share program, patients can rent a bicycle free of charge.
The Nice Ride Community Partnership serves adults with Serious and Persistent Mental Illness (SPMI) who participate in the program. The program is guided by the notion that better physical health equals better mental health. The program combines clinical goals from the William W. Jepson Day Treatment Program with the Comprehensive Cardiovascular Prevention Program (C2P2) to address multiple health concerns in their populations and track results over time. Nice Ride MN and U.S. Bank provide bicycles and funding for the program.
In its first year (2016), the program had 31 participants who logged a total of 957 hours. A cardiologist form Hennepin County Medical Center tracks participant progress over time.
By Jamie Cetrone | Categories: | Comments Off on Rx for Change
The Rx for Change program was created with funding and support from Regional One Health’s Foundation, and a partnership with the Office of the Mayor of the City of Memphis. The purpose of Rx for Change is to “intervene and offer support and guidance to victims of violence” by connecting clients with community resource partners which may 1) reduce retaliation levels, 2) allow clients to achieve personal goals, and 3) reduce recidivism rates.
The program serves clients ages 14-24 who are victims of intentional violence and residing in Shelby County, Tennessee. The program is funded and staffed by the hospital, but involves a number of internal and external partners that help assist clients with navigating on-going care, as well as completing personal goals outlined by the client once they are discharged. Partners include: Blue Cross/Blue Shield, Regional One Health Foundation, the City of Memphis Mayor’s Office, GRASSY, 901 BLOC, Workforce Investment Network, HopeWorks, and Hospitality Hub.
Clients are reviewed at the end of a six-month period of time to assess progress. At that time the client is marked graduated, or not. Through-out the process clients are marked active, deferred, inactive or referred. These categories allow us to monitor progress toward success. To-date, approximately 200 clients have been on-boarded. Repeat Intentional Injury rates are low, and this past fiscal year three clients were successfully graduated.
By Jamie Cetrone | Categories: | Comments Off on Food for Health
In partnership with a health clinic, UNM screened diabetic patients who had a HGA1c over 7 (indicating that their diabetes is not under control) for food insecurity. Patients who screened positive were considered to be food insecure, and were referred to a healthy food center. The goal was to educate patients on healthy eating to see if diabetes can be better controlled.
Hospital resources used for this program included a community health worker who did the screenings during clinical visits. The hospital also worked with Roadrunner Food Bank and Healthy Foods Center, who provided patients and their families with food on a weekly basis.
The program resulted in consistent access to fresh fruits and vegetables for patients and families, allowing for increased intake of healthy food. Program surveys saw a 33% increase in reports of eating fruits/vegetables “more than once a day”. Surveys also showed increased self-reported health outcomes (from 78% poor/terrible to 80% very good/good), and improved quality of life indicators (27% increase in reports of “never” being kept from usual activities due to poor mental of physical health).
