Addressing Barriers to Colorectal Cancer Screening
Colorectal cancer (CRC) is a leading cause of cancer-related deaths in the United States, despite the availability of high-quality screening options. Multiple barriers to CRC screening have been identified, including cost for the uninsured, younger age, racial or ethnic minorities, recent immigration to the United States (non-English speakers), fear or distrust of the health care system, and rural residence. This learning collaborative will explore barriers to CRC screening and identify interventions that can be implemented by health center programs serving at-risk populations.
Association of Health Literacy With Poor Diabetes Outcomes
The purpose of this learning collaborative is to review the relationship between health literacy and health outcomes in patients with diabetes and discover what the potential interventions are to improve such outcomes.
Building an Effective Collaborative Care Team to Address Diabetes in Special and Vulnerable Populations: Tailoring Care for Social Context
This session focused on the necessary elements to develop a high functioning patient-centered team for diabetes prevention, management, and treatment in primary care. The session addressed the roles of all members of the team including the critical role of leadership and clinical champions to building an effective collaborative team. This session laid the groundwork for the full series by engaging participants in a discussion of how to tailor diabetes care for social context. The conversation focused on the key elements needed for treating diabetes in the primary care and community setting with an emphasis on team-based approaches to wellness.
Developing the Role of Community Health Workers and other Support Staff in Diabetes Prevention, Treatment, and Follow-Up
Community Health Workers (CHW) have been shown to be especially successful reaching hard to access populations such as agricultural workers and their families as well as the homeless and residents of public housing. In this session, participants and faculty explored the role of CHWs in the diabetes care team. Case studies and real-world discussion provided examples of both effective and ineffective integration of CHWs into the clinical care team. Participants discussed the scope of practice and most effective roles for CHWs within the diabetes care team as well as the role of clinical champions and leaders in effectively mobilizing the skills of CHWs and other team members.
Diabetes Continuum of Care: Using Behavioral Health and Substance Use Disorder Integration to Address Older Adults with Cognitive Impairments and Diabetes
This is the second webinar in the continuation of our Diabetes in Special & Vulnerable Populations: A National Learning Series. Diabetes affects more than 30 million people in the United States. Multi-tiered efforts to prevent, treat and manage diabetes are critical in reducing the burden of diabetes, particularly for medically underserved racial and ethnic minority populations. In addition to higher prevalence, ethnic and racial minority patients with diabetes have higher mortality and higher rates of diabetic complications.
Diabetes Continuum of Care: Impact of Health Literacy on Patients’ Diabetes Management and Self-Care
NCHPH partnered with members of the Special and Vulnerable Population Diabetes Task Force to provide a Learning Collaborative (LC) addressing critical issues to improve diabetes control in health centers nationally. NCHPH provided expertise in public housing primary care and provided a more in-depth exploration of strategies, tools, and resources needed to create positive change in diabetes control among health center patients. The LC sessions also provided in-depth knowledge and skills in order to address the unique needs of people experiencing homelessness, residents of public housing, migratory and seasonal agricultural workers, school-aged children, older adults, Asian Americans, Native Hawaiians and other Pacific Islanders, LGBT people, and other vulnerable populations.
Diabetes Continuum of Care: Improving Emergency Preparedness for Diabetes Management
Natural disasters, disease outbreaks, and other emergencies can happen at any moment. Managing diabetes can be difficult during these events because they may cause widespread and long-lasting impacts on supplies, and health services. This four-session learning collaborative listed the frequent barriers that health centers face to provide effective emergency preparedness for patients with diabetes, explored the role of enabling services staff to help diabetic patients during disasters, and identified promising practices for effective personalized diabetes care during emergencies.
Diabetes: Culturally and Linguistically Appropriate Services
Minority groups are affected by diabetes at significantly greater rates when compared to non-Hispanic white Americans for reasons that are multidimensional. Diabetes educators need be mindful of the cultural traditions and customs among all cultural and ethnic groups and to recognize socio-economic challenges that may exist. When diabetes education programs are delivered using culturally appropriate methods in diverse populations, they can result in improved patient health behavior, knowledge, health status, and self-efficacy. During this session, NCHPH explored strategies to provide culturally and linguistically appropriate services to diabetic patients.
Empowerment and Self-Management of Diabetes – The Pharmacist and Diabetes Care Learning Collaborative
The goal of this learning collaborative is to discuss with pharmacists how to integrate diabetes education and management into practice, so patients can make the best use of their medications and achieve the desired therapeutic outcomes.
Expanding Diabetes Prevention and Management Through Health Center Outreach
In this training hosted by the National Center for Health in Public Housing, we addressed diabetes resources for CHWs, explained the roles and competencies of CHWs in diabetes prevention with an emphasis on nutrition, physical activity programs and other lifestyle interventions, and how CHWs can help patients with diabetes crack food insecurity and other social determinants of health through community resources.
This learning collaborative was comprised of a mix of outreach and diabetes educators from at least 10 health centers in or immediately accessible to public housing. Utilizing evidence-based models such as those developed by the Centers for Disease Control and Prevention (CDC), Community Preventive Services Task Force or National Health, Lung, and Blood Institute (NHLBI), the four learning modules allowed for the implementation of process for weight screening and tracking patients with abnormal BMI and HbA1c.
Exploring Cultural Competency and Humility in the Care of HIV Patients
People are shaped by their culture. An individual’s diverse beliefs, behaviors, attitudes toward medicine, and even the outcome of their medical treatments are all influenced by the cultures that comprise them. The cultural and ethnic diversity of the HIV/AIDS epidemic in the United States is well known. The vast majority of people living with HIV/AIDS (PLWHA) today are members of historically underserved and marginalized populations, most notably racial and ethnic minorities. This four-session learning collaborative explored cultural humility and showed how to reduce stigma and discrimination.
FQHCs and PHAs – Opportunities for Collaboration to Improve Resident Health
During this presentation, NCHPH provided an insight on the background of health centers and public housing residents. NCHPH also discussed the impact of public housing and health along with opportunities for collaboration between health centers and public housing authorities. Case examples of resident health improvement were presented related to health insurance coverage, senior health programs and community safety.
Health for All – Increasing Inclusion for Patients with Disabilities
Previous research has indicated that individuals with physical or intellectual disabilities often struggle to access the resources and care necessary to live independent and healthy lives. Scholarship has also indicated that providers and supporters of these individuals often face frustration and burnout when they are unable to provide patients with the support they need.
In this 4-part learning collaborative, Dr. Kevin Lombardi MD MPH and the NCHPH research and clinical quality team facilitated a set of interdisciplinary and collective sessions designed to engage with the latest data, clinical/social guidance as well as recommendations from leading providers on how to maximally support individuals with disabilities.
Improving Public Housing Health Center Service Delivery Through Cultural Competence and Health Literacy Learning Collaborative
Research on health literacy from the Institute of Medicine (IOM) states that over 90 million U.S. adults do not have needed literary skills to access and navigate U.S. health systems (Rudd & Anderson, 2006). As a result, patients disengage from the health system until they have no choice, thus ignoring their care and seeking alternative remedies or ways of coping.
Improving Cultural Competency for Behavioral Health Professionals Serving Residents of Public Housing
Behavioral health services form a crucial part in providing quality health care services, particularly to populations of diverse cultural backgrounds living in public housing. Behavioral health services that adhere to cultural competency have shown to engender more positive health outcomes such as better adherence to medications and treatments, building trust between healthcare providers and their patients, and has contributed to the creation of more sustainable ways of providing care to patients overall.
To assist Public Housing Primary Care (PHPC) Health Centers grantees in increasing their capacity to provide quality behavioral health services to patients from diverse cultural backgrounds, NCHPH will be conducting a 5-part learning collaborative. This learning collaborative will focus in helping behavioral health professionals increase cultural and linguistic competency.
Management, Education and Support, Nutrition, Physical Activity, Smoking Cessation, and Psychosocial Issues
Residents of public housing are particularly at risk of developing diabetes and diabetes-related complications due to the many social factors that impact their health. A recent HUD publication indicates that HUD-assisted adults have the highest prevalence of diabetes diagnosis, with 17.6% reporting ever having been told they had diabetes. During this session NCHPH explored ways to manage diabetes through programs that address education and support, nutrition, physical activity, smoking cessation, and psychosocial issues.
Patient Engagement Strategies for the Collaborative Care Team: Group-Visits
Pre-visit planning includes scheduling patients for future appointments at the conclusion of each visit, arranging for pre-visit lab testing, gathering the necessary information for upcoming visits and spending a few minutes to huddle and handoff patients. This can be particularly challenging for vulnerable populations such as agricultural workers, the homeless and residents of public housing. This session will explored strategies and tools for diabetes pre-visit planning that can be successful for vulnerable populations. Participants and faculty brought case studies and real life scenarios to the discussion in order to facilitate problem-solving conversations about how to address challenging scenarios. The session also addressed how to best incorporate pre-visit planning into a team-based setting that includes CHWs.
Patient Intervention Strategies for the Collaborative Care Team: Pre-Visit Planning
Group visits have been shown to be an effective strategy to address diabetes management in a number of health settings. During group visits, participants have a greater opportunity to ask questions, run the discussion and provide one another with peer support. CHWs can be particularly effective in setting up and helping run group visits at health centers. During this session, participants discussed different models for group visit and explored best practices used in health centers. The session relied on case studies and real-life scenarios to discuss challenges and successes using group visits with vulnerable populations.
Phases of Diabetes Care
Diabetes care can be organized into three phases: pre-visit, intra-visit, and post-visit. Opportunities exist during each phase to introduce practice changes that can help engage and support patients in their diabetes care and management. Health care teams can optimize diabetes encounters by taking a planned, continuous improvement approach to visits, which includes pre-visit preparation (by both patients and practices), intra-visit coordination (among practice team members), and post-visit follow-up (among the practice team and with patients).
Promoting Healthy Choices and Community Changes: A Virtual Workshop for Community Health Workers
Community Health Workers (CHWs) or “Promotores de Salud” form a crucial part in communities as they bridge the gap between under-served community members and access to health care and community resources. The purpose of this learning collaborative provided by the National Center for Health in Public Housing (#NCHPH) is to increase the knowledge of Community Health Workers (#CHWs) or “Promotores de Salud” on how to effectively promote healthy choices and changes at the individual and community level to improve the overall health outcomes among Hispanic communities living in public housing.
Smoking Cessation
Public housing residents are more likely to smoke and suffer from health conditions that are exacerbated by smoking and secondhand smoke exposure, such as asthma, diabetes, and COPD, compared to the general adult population. The National Center for Health in Public Housing (NCHPH) hosted a call as part of its learning collaborative on improving access to smoking cessation services for public housing residents. Participants discussed needs, challenges faced by PHAs during the implementation process and HCs shared smoking cessation services and best practices.
Supporting Implementation of Smoking Cessation Programs in Public Housing Primary Care Settings
This NCHPH Learning Collaborative discussed ways to debunk the myth that smoking is an effective way to deal with stress, enumerated various proven stress management techniques, in depth, that can be used to maintain a quit, and discussed how to successfully teach these techniques to patients.
Implementing Smoking Cessation Programs in Health Center Settings
This Learning Collaborative aimed to identify barriers to implementation of and strategies to establish smoking cessation programs in primary care settings through a series of four sessions: a didactic webinar, covering the behavioral aspects of cessation counseling, the FDA approved medications for cessation and some basic Motivational Interviewing techniques, and a subsequent three learning collaborative sessions, detailing how to conduct each counseling session whether they are individual or group. NCHPH provided a written Protocol booklet to be used as a guide during actual sessions.
The Impact of Nutrition on Diabetes Prevention and Diabetes Management
This presentation will cover best practices for nutrition care, top eating patterns for people with diabetes, and ADA resources that can be used in practice.
Women’s Health Program: San Ysidro Community Health Center
Women’s Health Programs provide an excellent opportunity to counsel patients about preventive care and to provide or refer for recommended services. These assessments should include screening, evaluation and counseling, and immunizations based on age and risk factors. In this interview, San Ysidro Community Health Center shares the activities that are part of their Women’s Health Program.
Women’s Health Program: South Boston Community Health Center
Women’s Health Programs provide an excellent opportunity to counsel patients about preventive care and to provide or refer for recommended services. These assessments should include screening, evaluation and counseling, and immunizations based on age and risk factors. In this interview, South Boston Community Health Center shares the activities that are part of their Women’s Health Program.