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

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Presentation on theme: "Promoting Health Literacy at Hawthorne Education Center Jennifer P. Rho, MD, MPH."— Presentation transcript:

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

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

3 n Courses of study: English as a Second Language, Adult Basic Education, GED, High School Diploma, Hand in Hand, Citizenship preparation n Ages 15-80+, average age 25-30 n Represents 30+ countries including U.S. born learners n >80% living below federal poverty level

4 Health at Hawthorne: A Challenge n At least one ambulance per month at school prior to health promotion activities (pre-2005) n Obvious health disparities among learners n Pervasive problems with health care access n High uninsurance –34% of Hawthorne learners are uninsured vs. 3% uninsured in Rochester area (2007) n 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 n Environment was ripe for health promotion at Hawthorne n Eager public health student n Helped in whatever way I could

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

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

10 What We Have Accomplished n 5500 patient visits at the clinic since opening n Additionally: –Annual health fair serves 400 learners/year –Annual flu shot clinic provides >200 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 n Very few ambulance visits to Hawthorne since clinic opened

11 Service-Learning n Provides opportunity for reciprocal learning about health literacy n Train the next generation to provide patient-centered care n Provides manpower to implement health promotion activities n Great opportunity to build relationships n >50 nursing students/yr n Varying number of med students n Health fair, flu shot, screenings, exercise class, book club

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

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

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

15 Mayo Patient Ed Pilot n Field test Mayo Patient Ed materials with Hawthorne learners n 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 n 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 n Initial meeting n Chose topic - healthy living n Chose items to review n Chose evaluation methods (Doak & Doak) –SAM –Individual and group review for learners n Met with teachers (ESL, Reading, GED, Diploma). Reviewed items and SAM. Did SAM together on food pyramid n Teachers chose which items they wanted to review with their class n Reviewed 1 item per week for 4 weeks

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

19 n 8-10 classrooms per item n Lead by a patient educator n 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 n Individual Evaluation –Read designated pages –Circle words that they did not understand –Multiple choice questions to assess understanding of content n Group review/teaching n Debriefing with teachers, learner feedback In The Classroom

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

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

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

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

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

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

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

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

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