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Promoting Health Literacy at Hawthorne Education Center

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Promoting Health Literacy at Hawthorne Education Center Jennifer P. Rho, MD, MPH – PowerPoint PPT presentation

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Title: Promoting Health Literacy at Hawthorne Education Center


1
Promoting Health Literacy at Hawthorne Education
Center
  • Jennifer P. Rho, MD, MPH

2
Hawthorne Education Center Rochester, MN
  • Rochester Public Schools facility dedicated to
    adult and family literacy
  • Serves 3000 learners per year, 700 per day
  • Employs 60 teachers and staff members
  • 100 volunteers per week
  • Highly committed learners, staff and volunteers

3
Hawthorne Education Center Rochester, MN
  • Courses of study English as a Second Language,
    Adult Basic Education, GED, High School Diploma,
    Hand in Hand, Citizenship preparation
  • Ages 15-80, average age 25-30
  • Represents 30 countries including U.S. born
    learners
  • gt80 living below federal poverty level

4
Health at Hawthorne A Challenge
  • At least one ambulance per month at school prior
    to health promotion activities (pre-2005)
  • Obvious health disparities among learners
  • Pervasive problems with health care access
  • High uninsurance
  • 34 of Hawthorne learners are uninsured vs. 3
    uninsured in Rochester area (2007)
  • Low health literacy - many those who have
    insurance act functionally uninsured

5
Literacy Levels
6
Health at Hawthorne An Opportunity
One of the main reasons Hawthorne learners say
that they are learning English is so that they
can talk with their doctor.
7
The Early Days
  • Environment was ripe for health promotion at
    Hawthorne
  • Eager public health student
  • Helped in whatever way I could

8
Hawthorne Health Services
  • Opened Sept 2005
  • Collaborative among Hawthorne Education Center,
    Migrant Health Services, Olmsted County Public
    Health and Winona State University
  • Open 4 days per week
  • Free to Hawthorne learners and family members
  • 4 providers, public health nurse, office
    assistant, Americorps VISTA volunteer
  • Funded through donations

9
Hawthorne Health Services
  • Promote health literacy through
  • Providing health education
  • Providing limited health services at Hawthorne
  • Identifying and accessing sources for health
    insurance and primary health care
  • Collaborating with others in the community
  • Providing case management for learners with
    ongoing health concerns

10
What We Have Accomplished
  • 5500 patient visits at the clinic since opening
  • Additionally
  • Annual health fair serves 400 learners/year
  • Annual flu shot clinic provides gt200
    vaccinations/year
  • Multiple other community partnerships-Mayo Breast
    Clinic
  • Multiple health ed programs
  • Introduced hundreds of health professionals to
    health literacy
  • Jobs skills to community members - medical
    interpretation
  • Very few ambulance visits to Hawthorne since
    clinic opened

11
Service-Learning
  • Provides opportunity for reciprocal learning
    about health literacy
  • Train the next generation to provide
    patient-centered care
  • Provides manpower to implement health promotion
    activities
  • Great opportunity to build relationships
  • gt50 nursing students/yr
  • Varying number of med students
  • Health fair, flu shot, screenings, exercise
    class, book club

12
Annual Health Fair
  • 400 learners
  • Great community participation
  • Guide for participants
  • Follow-up survey
  • Nutrition
  • Weight loss
  • Exercise
  • Dental Care
  • Blood pressure
  • (Stress)

13
Annual Cold and Flu Clinic
  • Education-focused
  • Service-learning
  • Classroom based
  • Video
  • Posters
  • Flu shot clinic

14
Health Literacy Book Club
  • Taught by nursing students and medical students
  • ESL level 5
  • Small groups
  • Health Literacy Special Collection
  • http//www.healthliteracy.worlded.org/
  • Staying Healthy Florida Literacy Coalition
  • Culture and Health
  • Ask Me 3

15
Mayo Patient Ed Pilot
  • Field test Mayo Patient Ed materials with
    Hawthorne learners
  • Goals
  • To increase the health literacy of Hawthorne
    learners through the process of systematically
    evaluating patient ed materials
  • To empower the Hawthorne learners to advocate for
    themselves when they do not understand health
    info that has been provided to them
  • To utilize the expertise of the Hawthorne
    community (teachers and learners) to improve the
    quality of Mayo patient ed materials developed
    for Mayo patients

16
Participatory Methods
  • Hawthorne teachers and administrators
    participated in every aspect of development and
    implementation
  • Classroom based
  • Picked topic and individual materials to review
  • Chose methods
  • Gave input on the eval tools
  • ESL, GED, Diploma

17
How we included everyone
  • Initial meeting
  • Chose topic - healthy living
  • Chose items to review
  • Chose evaluation methods (Doak Doak)
  • SAM
  • Individual and group review for learners
  • Met with teachers (ESL, Reading, GED, Diploma).
    Reviewed items and SAM. Did SAM together on food
    pyramid
  • Teachers chose which items they wanted to review
    with their class
  • Reviewed 1 item per week for 4 weeks

18
Healthy living
  • Topic has been consistently important to adult
    learners

19
In The Classroom
  • 8-10 classrooms per item
  • Lead by a patient educator
  • Introduction - This is your chance to be the
    teacher, to teach us how we can make health
    information easier to understand for you and your
    family
  • Individual Evaluation
  • Read designated pages
  • Circle words that they did not understand
  • Multiple choice questions to assess understanding
    of content
  • Group review/teaching
  • Debriefing with teachers, learner feedback

20
Results
  • Teachers and learners were VERY engaged and
    motivated
  • Strong interest in healthy living info
  • All of the materials were beyond the literacy
    levels of the learners
  • Positives mutually beneficial, collaboration,
    community expertise, group interaction, valuable
    information
  • Negatives Too much data, too much time

21
Recommendations
  • Rewrite the 4 tested items to match ESL level 4
  • Establish process to selectively test pt ed
    materials with adult learners during development
  • Tie into CASAS - develop lesson plan

22
What have we learned over the past 6 years?
  • Hawthorne learners utilize available health
    services when health education is provided
  • Hawthorne learners participate more when the
    health topic is important to them
  • Health activities should be guided by the
    community as much as possible

23
A Note about Research
  • Research has never been the guiding force behind
    our health activities
  • Concerns about vulnerable population
  • Community-led research
  • Action-oriented
  • Education-focused
  • Marcia Drew Hohn, Ed. D.
  • Literacy Leader Fellow 1996-1997

24
Why We Have Been Successful
  • Health literacy has been a topic of mutual
    interest
  • Spirit of cooperation
  • Hawthorne remains in control
  • Reciprocal learning
  • Individual agendas are minimized - careful
    selection of partners
  • Efforts are a combination of civic engagement,
    community organizing, service learning
  • Grass roots, bottom up approach, flexible,
    responsive
  • No money to argue over

25
Community Engagement Strategies
  • Use existing community infrastructure when
    possible
  • Get involved in your community
  • Work with organizations not institutions-one
    exists to effect change, the other to maintain
    the status quo
  • Asset-mapping
  • Few organizations want another needs assessment
  • Win-win situations - can help offset lack of
    funding
  • Service-learning/Reciprocal learning
  • Face time is very important
  • The process is the product

26
Tips for getting started
  • Look for unique opportunities
  • Be humble - be a leader without being the
    expert
  • Utilize the practical expertise of community
    organizations and community members
  • Relationships take time - start small and get to
    know the community (all levels)
  • Minimize agenda setting
  • Recognize that the community way is different
    than the academic way
  • Plan to sustain the program

27
Future Plans
  • More collaboration
  • Mayo Med School
  • Mayo Ophthalmology
  • Mayo Dermatology
  • Public Health Immunizations
  • Revamped health fair
  • Healthy eating class
  • Expand offerings for health literacy book clubs
  • Work with Mayo Pat Ed to develop pt ed materials
  • PRECEDE-PROCEED
  • Hopefully some funding
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