Blog Archives
By Amanda Jepson | Categories: | Comments Off on Mobile Medicine Program
Atrium Health launched two Mobile Medicine programs to improve access to care for their patient populations. Three Care Everywhere primary care units, along with Drive to Thrive, a mobile OB-GYN unit, aim to increase access to care by tackling transportation challenges, language barriers, and lack of insurance. Specifically, Care Everywhere brings clinical care to areas where traditional clinics may not be convenient or accessible, provides resources that help meet acute social needs, and connects patients to a primary care medical home. Drive to Thrive works to decrease unintended pregnancies via increased access to education and contraception and to connect patients in underserved communities to prenatal care earlier in their pregnancies to improve overall health outcomes.
The Mobile Medicine units park at different locations each weekday based on patient need. Atrium Health strategically chose locations using a data-informed approach that paired internal patient data with publicly available U.S. census data to target communities with the greatest health needs and social risk factors. Care Everywhere unit services include short-term and long-lasting health concerns, and Drive to Thrive primarily focuses on obstetrics and education. Neither program requires appointments, enabling patients to visit at their convenience. Both programs offer additional wellness services, such as referrals to other Atrium Health facilities and connections to resources for non–health care needs.
The Care Everywhere units were primarily funded by The Tepper Foundation and Truist Foundation, among other community funders. The Drive to Thrive unit received funding from a retired OB-GYN and other community donors. Both units required collaboration with nonprofits, faith-based organizations, and other community organizations to understand patient needs fully.
As a vertically integrated health care system, Atrium Health maintains an extensive inpatient and outpatient database of electronic health records that enables in-depth analysis of health care utilization and health outcomes across the system’s footprint. The Care Everywhere units launched in fall 2022, and the Drive to Thrive unit launched in January 2023. The Mobile Medicine program is expected to serve more than 480 patients by the end of 2023. Key program outcomes include increasing the establishment of ongoing support through placement with a primary medical home and connecting patients to care and social needs support through screening, diagnosis, and referrals to specialty care.
By Amanda Jepson | Categories: | Comments Off on Healthy Harvest Mobile Market
The Community Health Strategies and Innovation team at University Health created the Healthy Harvest Mobile Market program to mitigate the number of community members residing in food deserts. The goal is to provide the community with healthy and fresh food, as well as nutrition education, healthy recipes, and infographics.
The mobile market goes to local ZIP codes that are considered food deserts to serve the community members in that area. The program works closely with community members to provide health education and high-quality produce.
The program collaborates with multiple community stakeholders, including faith-based organizations, schools, and community clinics. Through these partnerships, the Healthy Harvest Mobile Market ensures that community members understand the important relationship between diet and health.
The mobile market delivers fresh produce and nutrition education to many who otherwise would not have access. Specifically, during the COVID-19 pandemic, the market delivered enough food to nourish more than 100,000 people. Since 2021, the mobile market has served around 159,000 people.
By aoguagha | Categories: | Comments Off on Diabetes Prevention Program
More than one-third of Rhode Islanders are prediabetic. In 2017, the Lifespan Community Health Institute, as part of Rhode Island Hospital, partnered with the City of Providence’s Healthy Communities Office to deliver the Diabetes Prevention Program to Providence residents. Since then, the program has grown and targets all eligible Rhode Island residents. The Diabetes Prevention Program, an evidence-based program, teaches people at risk for developing diabetes how to implement a healthy lifestyle with the goal of preventing or delaying the onset of type 2 diabetes. The program is available in English and Spanish and offered to participants at no cost.
Currently, the Lifespan Community Health Institute (LCHI) contracts with the Rhode Island Department of Health to deliver the Diabetes Prevention Program to all eligible Rhode Island residents. Free to participants, the program offers weekly one-hour sessions with a trained lifestyle coach to learn and maintain healthy lifestyle behaviors, peer support, healthy at-home meal recipes, and childcare and transportation assistance. Additionally, LCHI currently contracts with the Blue Cross Blue Shield of Rhode Island to offer the program to eligible State of Rhode employees and their beneficiaries. Learn if you qualify here.
The Lifespan Community Health Institute is one of only two CDC Recognized Organizations offering the Diabetes Prevention Program in Rhode Island that has achieved Full Plus recognition. Full Plus recognition means that a program has demonstrated effectiveness by achieving all of the performance criteria related to the Diabetes Prevention Recognition Program Standards and Operating procedures.
By aoguagha | Categories: | Comments Off on Feed1st Food Pantry Toolkit
By aoguagha | Categories: | Comments Off on ZSFG Health Advocates Program
The health care professionals of Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG), in San Francisco, understand health care alone does not necessarily mean good health. Social factors, such as access to food, safe housing, and education impact overall health, as well. ZSFG launched its Health Advocates program in 2013 to improve community health by connecting families with community resources that address their social needs. These needs might otherwise not have been met outside their typical hospital visits. The ZSFG Health Advocates program aims to change how people think about health.
The Health Advocate program is a student and community volunteer–based service group that conducts standardized social and legal needs screenings for patients at the ZSFG health centers for children, women, and families.
The Health Advocates program extends the care of patients and connects them directly to resources that help overcome systemic societal barriers and legal obstacles that impact health and well-being. Through the Health Advocates program, ZSFG improves the quality of life and health outcomes for families.
The ZSFG Health Advocates program connects families with existing benefits programs and external community organizations based on their level of need. The program collaborates with Bay Area Legal Aid as part of the San Francisco Medical-Legal Partnership (MLP) to provide legal advice and support to families. Families screened for more complex issues by the health advocates — family mental health issues or complicated legal challenges, for example — are connected with clinical social workers and/or lawyers from the MLP network who can provide professional support and case management.
By Amanda Jepson | Categories: | Comments Off on Health Equity Accelerator
The Health Equity Accelerator at Boston Medical Center (BMC) originated from research and development after COVID-19 highlighted multiple health inequities that would not have been uncovered in normal conditions. These discoveries, paired with BMC’s historical interest in closing the health equity gap, fuel the Health Equity Accelerator. The program’s goal is to drive racial health equity in the areas of pregnancy, infectious diseases, behavioral health, chronic conditions, and oncology and end-stage renal disease, with a vision to transform health care to deliver health justice and well-being.
The Health Equity Accelerator incorporates three foundations of health care: research, clinical care, and community, including social determinants of health (SDOH). The Accelerator team consists of executive leadership, project managers and analysts, community navigators, and research experts. This team breaks problems down into core elements and, through research and evaluation, identifies and implements innovations to combat the problem. The team will partner with community leaders to seek insight on how well those solutions and interventions affect the target issues. The program aims to serve patients and their communities, specifically those of color, that face immense health inequities.
The Health Equity Accelerator’s strategy aims to promote four pillars to collaborate and complement each other in the mission. These groups include clinical operations, community and SDOH, research and evaluation, and policy and advocacy. The Accelerator team also identifies external partners interested in participating in interventions to help communities BMC and other health institutions share.
The Accelerator’s Equity in Pregnancy program focuses on improving the rate of severe maternal morbidity for mothers of color and the rate of babies of color born small for gestational age. Through research, the program identified gaps and developed recommendations that will help close those gaps. Another project focused on empowering people of color, who were at a higher risk for disease transmission, to make informed decisions regarding COVID-19 vaccinations.
By Amanda Jepson | Categories: | Comments Off on Fresh for You Market
Eskenazi Health has a strong belief in the concept of food as medicine, a pillar of the health system’s Beyond Barriers campaign. In Indianapolis, 41 percent of children younger than age 5 suffer from malnutrition, and in Marion County, 21 percent of residents live in a food desert. Prior to the COVID-19 pandemic, nearly 200,000 county residents identified as food insecure. Through the Fresh for You Market and the Fresh for You Market on Wheels, Eskenazi Health is combating food insecurity in the community and providing residents with access to nutritional and affordable food.
The Fresh for You Market, a grocery store and food pantry, is located on the Eskenazi Health downtown campus on a bus route easily accessible to the community. The self-sustaining Market is open to the public, and proceeds from sales directly fund the Fresh for You Market voucher program. This program provides patients who screen positive for food insecurity during clinic visits with free food vouchers to shop at the market. The Fresh for You Market on Wheels is a mobile version of the market that parks at a different location throughout Indianapolis each weekday. A nutrition navigator on board helps patients pick foods for specific diets and conditions, and a chef prepares hot meals and hosts cooking demonstrations.
The Fresh for You Market and Market on Wheels would not be possible without community partners. The downtown market partners with a local food bank, and the market on wheels partners with local produce vendors, public transportation, the Indiana Department of Health, and other government agencies.
Since opening in June 2017, the Fresh for You Market has been a key food resource for patients, residents, and health system staff. In the first full year of operation, the Market served 6,200 people. During the COVID-19 pandemic, the market opened to health system employees working long hours who were unable to make it to the grocery store. The Fresh for You Market on Wheels, launched in July 2023, is making its way to for access to food in a social needs screening.
By Amanda Jepson | Categories: | Comments Off on Beyond Barriers
After discovering significant disparities in age expectancy from zip codes only 16 miles apart in Marion County, Ind., Eskenazi Health acted to find solutions to enhance the health of the community it serves. Thus, the $60 million campaign titled, Beyond Barriers, takes a multidisciplinary approach to three main areas: health care, mental health care, and food as medicine. The goal of the campaign is to create life expectancy equity for everyone in the city of Indianapolis through an integrated and sustainable model of community infrastructure improvement.
The program serves Eskenazi Health’s patient population and surrounding community. At the heart of Beyond Barriers are Health Equity Zones identified to improve access to health care, mental health care, and nutritional foods. Each zone is home to an Eskenazi Health Center where community health care workers work one-on-one with patients at appointments and home visits. During this time, they screen patients for social determinants of health and help with self-management goals to promote positive health behaviors. The campaign also sustains mental health professional recruitment, upgrades mental health facilities, and expands the John & Kathy Ackerman Mental Health Professional Development Center. Another important aspect of Beyond Barriers is the Fresh for You Market, which provides fresh and affordable foods to patients and families who lack access to affordable food options.
Eskenazi Health engages with education, transportation, public health, housing, food pantries, and other industries to expand existing programs and create and support new programming and services. By working with these entities, Eskenazi Health can focus on long-term social determinants of health and improving quality of life for all Central Indiana residents.
Launched in 2017, the Fresh for You Market, located at Eskenazi Health’s downtown campus, has helped patients and families access affordable and healthy groceries. In its first full year of operation, the market fed 6,200 people from under-resourced and underserved communities and improved the quality of life of those served. In summer 2023, the Fresh for You Market launched a mobile food pantry, Fresh for You Market on Wheels, which is parked in various locations around Indianapolis each weekday based on patient needs indicated in social needs screenings.
By Hannah Lambalot | Categories: | Comments Off on Food Rx: A Cross-Sector Approach to Improving Health and Health Equity
High Harris County, Texas, has America’s highest number of uninsured residents, and one in five patients at Harris Health System screen positive for food insecurity. The health system partnered with Houston Food Bank (HFB), the University of Texas School of Public Health, and grocery store H-E-B for a Food Rx program based at two family practice clinics.
“Our food ‘farmacies’ are unique in that we go beyond a food insecurity model. Our patients are able to select the healthy foods they want as they walk and learn with a dietitian,” said Chief Integration Officer Karen Tseng. “We also provide them with the skills and confidence to translate those raw ingredients into healthy, cost-effective, culturally appropriate meals through our culinary medicine programming.”
Patients enroll with a community health worker, work with a dietitian to select healthy food; connect with an HFB navigator to enroll in the Supplemental Nutrition Assistance Program and Temporary Assistance for Needy Families program, and are linked to community food resources.
Patients with uncontrolled diabetes are invited to join a nine-month program, in which they participate in biweekly “walk and learn” sessions with a diabetes educator while redeeming 30 pounds of fresh food from the food farmacy. During the COVID-19 pandemic, Harris Health System adapted the walk-and-learn education model with curbside delivery, biweekly tele-education, and virtual culinary education initiatives.
Food Rx served more than 650 patients in its first year. Participants improved their nutrition knowledge scores, increased daily fruit and vegetable consumption, and reported increased confidence in basic cooking techniques. Program graduates decreased HbA1c levels by an average of 0.72 percentage points.
By Hannah Lambalot | Categories: | Comments Off on Mothers Overcoming Maternal Stress (MOMS)
Postpartum Support Helps Improve Mental Health, Family Connection
High levels of parenting stress can cause poor birth outcomes, slow child development, lack of child-parent bond, and child maltreatment. Memorial Healthcare System started Mothers Overcoming Maternal Stress (MOMS) in 2008 to help mothers improve mental health and keep children healthy.
MOMS serves women who exhibit symptoms of depression or anxiety affecting daily functioning for more than two weeks, as well as mothers with additional risk factors, including low-income status, single-parent households, early or unplanned pregnancy, medical complications, and traumatic life events. Customized participant plans include in-home cognitive behavioral therapy, parenting classes, community resources, and case management services.
MOMS offers flexible hours for counseling and case management, transportation to appointments and program activities, and help applying for government assistance programs. Other benefits include:
- connections to the local food pantry and housing authority to mitigate food and housing insecurity;
- cooking classes;
- dollar store and supermarket tours to teach label reading and healthy shopping skills;
- warm handoffs to Memorial Primary Care to develop a medical home;
- financial assistance;
- employment opportunities; and
- quarterly family retreats to provide bonding opportunities within and among program families.
Amid the COVID-19 pandemic, MOMS provided participants smartphones with six months of prepaid service to use for telehealth services and delivered masks, diapers, gloves, cleaning supplies, and food to participants’ homes. MOMS has served 1,532 participants since 2008. Among participants, 97 percent report improved overall family functioning and parenting skills, 96 percent report feeling more connected to the community, 94 percent report fewer depression or anxiety symptoms, 93 percent demonstrate an acceptable level or improvement of attachment and bonding with their child, and 86 percent have children that score within range of developmental milestones.
