1. Session II: Community Intervention using C-SORT Methodology Medical Library & Peyton T. Anderson Learning Resources Center Macon, GA reference.ill@gain.mercer.edu Memorial University Medical Center Health Sciences Library Savannah, GA library@memorialhealth.com

2. Objectives 1. Participants will define a community intervention as distinct from a patient clinical question. 2. Participants describe the elements of the C-SORT methodology 3. Participants will work in groups to identify and locate online resources to use when preparing a community intervention, including: 1. CDC Statistical Resources 2. Healthy People 2020 3. County Health Rankings 4. Participants in groups will present their evaluation of the community intervention resources to the class. 5. Participants will apply the final steps of C-SORT Methodology through proactive class discussion.

3. Objective 1 Participants will define a community intervention as distinct from a patient clinical question. Participants describe the elements of the C-SORT methodology

4. Your patient Shannon, a 19-year-old African American female, visits her local health clinic for her annual STD screening. Shannon is asymptomatic but tests positive for Syphilis. Tests also reveal Shannon is 3-weeks pregnant.

5. Formulating a Clinical Question Patient or Population 19-year-old African American female with Syphilis and in 1st trimester of pregnancy, no known allergies Intervention Treatment with Penicillin Comparison Alternative treatments Outcome a healthy pregnancy and delivery for mom and baby; prevention of congenital syphilis in baby

6. Multiple Cases

7. C-SORT Methodology 1.Community/ Characteristics 2.Standard 3.Options 4.Response 5.Transformation

9. Objective 2 Participants describe the elements of the C-SORT methodology

10. Letter – MeaningAddressesExample C – CommunityThe community in which the physician is immersed. Namely, the group title of those with whom the physician is working. Obesity is a problem throughout the population. Among children and adolescents, the prevalence of obesity is highest among older and Mexican American children and non-Hispanic black girls. The association of income with obesity varies by age, gender, and race/ethnicity. Patients living in the American South C – CharacteristicsSpecific characteristics of the community or patient group. This is the element that requires attention; the need. Access to and availability of healthier foods can help people follow healthful diets. For example, better access to retail venues that sell healthier options may have a positive impact on a persons diet; these venues may be less available in low-income or rural neighborhoods. The places where people eat appear to influence their diet. S-StandardNon clinical standard of care relative to the specific characteristic. Clinical standards are addressed via clinical questions. This standard relates more generally to psychosocial, economic, educational standards answering the question "What works?. Reduce the proportion of children and adolescents who are considered obese Increase the proportion of Americans who have access to a food retail outlet that sells a variety of foods that are encouraged by the Dietary Guidelines for Americans O- OptionsDefines options/opportunities available such as events, resources, or other potential solutions in place to address or bolster the characteristics under investigation. Consider the interaction and interdependence of various factors. Public Health Department, educational resources, local campaigns, CDC, Lets Move R – ResponseOutlines the community physicians desired response to the characteristics under investigation. Describes what he/she will do as a responsive physician to strengthen or ameliorate desired outcomes or community direction. Community presentations on the effects of childhood obesity, billboards, school presentations. Developing website with tools to help providers, parents, children, and entire community with the issue. T – TransformationDiscusses how the physicians actions will transform the community long term into a stronger population. Related to standards as needed. To reduce the prevalence of obesity in Muscogee County and its surrounding community, and to encourage the community as a whole to lead healthier lives. Year 1Year 2Year 4

11. C Community/Characteristics Letter – Meaning AddressesExample C – Community The community in which the physician is immersed. Namely, the group title of those with whom the physician is working. Obesity is a problem throughout the population. Among children and adolescents, the prevalence of obesity is highest among older and Mexican American children and non-Hispanic black girls. The association of income with obesity varies by age, gender, and race/ethnicity. Patients living in the American South C – Characteristics Specific characteristics of the community or patient group. This is the element that requires attention; the need. Access to and availability of healthier foods can help people follow healthful diets. For example, better access to retail venues that sell healthier options may have a positive impact on a persons diet; these venues may be less available in low-income or rural neighborhoods. The places where people eat appear to influence their diet.

13. Centers For Disease Control 1.Taking the health pulse of our nation 2.Detecting and responding to new and emerging health threats 3.Tackling the biggest health problems causing death and disability for Americans 4.Putting science and advanced technology into action to prevent disease 5.Promoting healthy and safe behaviors, communities and environment 6.Developing leaders and training the public health workforce, including disease detectives

14. C Community/Characteristics Need to update this slide with CDC image… looking for one.

17. County Health Rankings Ranking the health of nearly every county in the nation, the County Health Rankings illustrate what we know when it comes to whats making people sick or healthy. The County Health Roadmaps show what we can do to create healthier places to live, learn, work and play.

25. S - Standard Letter – Meaning AddressesExample S-StandardNon clinical standard of care relative to the specific characteristic. Clinical standards are addressed via clinical questions. This standard relates more generally to psychosocial, economic, educational standards answering the question "What works?. Reduce the proportion of children and adolescents who are considered obese Increase the proportion of Americans who have access to a food retail outlet that sells a variety of foods that are encouraged by the Dietary Guidelines for Americans

32. O- Options Letter – Meaning AddressesExample O- OptionsDefines options/opportunities available such as events, resources, or other potential solutions in place to address or bolster the characteristics under investigation. Consider the interaction and interdependence of various factors. Public Health Department, educational resources, local campaigns, CDC, Lets Move

35. Letter – Meaning AddressesExample R – Response Outlines the community physicians desired response to the characteristics under investigation. Describes what he/she will do as a responsive physician to strengthen or ameliorate desired outcomes or community direction. Community presentations on the effects of childhood obesity, billboards, school presentations. Developing website with tools to help providers, parents, children, and entire community with the issue. Response: Childhood Obesity

40. Letter – Meaning AddressesExample T – Transfor- mation Discusses how the physicians actions will transform the community long term into a stronger population. Related to standards as needed. To reduce the prevalence of obesity in Muscogee County and its surrounding community, and to encourage the community as a whole to lead healthier lives. Transformation: Childhood Obesity

44. Letter – MeaningAddressesExample C – CommunityThe community in which the physician is immersed. Namely, the group title of those with whom the physician is working. Obesity is a problem throughout the population. Among children and adolescents, the prevalence of obesity is highest among older and Mexican American children and non-Hispanic black girls. The association of income with obesity varies by age, gender, and race/ethnicity. Patients living in the American South C – CharacteristicsSpecific characteristics of the community or patient group. This is the element that requires attention; the need. Access to and availability of healthier foods can help people follow healthful diets. For example, better access to retail venues that sell healthier options may have a positive impact on a persons diet; these venues may be less available in low-income or rural neighborhoods. The places where people eat appear to influence their diet. S-StandardNon clinical standard of care relative to the specific characteristic. Clinical standards are addressed via clinical questions. This standard relates more generally to psychosocial, economic, educational standhttp://youtu.be/1t_H_DBHmGQards answering the question "What works?. Reduce the proportion of children and adolescents who are considered obese Increase the proportion of Americans who have access to a food retail outlet that sells a variety of foods that are encouraged by the Dietary Guidelines for Americans O- OptionsDefines options/opportunities available such as events, resources, or other potential solutions in place to address or bolster the characteristics under investigation. Consider the interaction and interdependence of various factors. Public Health Department, educational resources, local campaigns, CDC, Lets Move R – ResponseOutlines the community physicians desired response to the characteristics under investigation. Describes what he/she will do as a responsive physician to strengthen or ameliorate desired outcomes or community direction. Community presentations on the effects of childhood obesity, billboards, school presentations. Developing website with tools to help providers, parents, children, and entire community with the issue. T – TransformationDiscusses how the physicians actions will transform the community long term into a stronger population. Related to standards as needed. To reduce the prevalence of obesity in Muscogee County and its surrounding community, and to encourage the community as a whole to lead healthier lives. Year 1Year 2Year 4

45. Additional STD patients

46. Objective 3 Participants will work in groups to identify and locate online resources to use when preparing a community intervention, including: 1. CDC Statistical Resources 2. Healthy People 2020 3. County Health Rankings

47. Group Work Letter – MeaningAddressesExample C – CommunityThe community in which the physician is immersed. Namely, the group title of those with whom the physician is working. Group 1 & 2 C – CharacteristicsSpecific characteristics of the community or patient group. This is the element that requires attention; the need. Group 1 & 2 S-StandardNon clinical standard of care relative to the specific characteristic. Clinical standards are addressed via clinical questions. This standard relates more generally to psychosocial, economic, educational standards answering the question "What works? Group 3

48. Group Work Group 1: Community/Characteristics Evaluation at the National/State Level using CDC website Find the Syphilis Women Rates Group 2: Community/Characteristics Evaluation at the County Level using County Health Rankings Find the STD rates for Bibb or Chatham County Group 3: Standards Evaluation using the Healthy People 2020 Locate the standards that would apply to the STD case 10 minutes prep, 5 minutes per group for presentations Some things to look for as you review: What kind of information did you find? Was it easy to locate the data? Was the data recently updated? What was the data source? Any other findings from the site? How would this information help you to fulfill the C-SORT Methodology? Did the site link to other resources? What did you like or not like about the site?

49. Objective 4 Participants in groups will present their evaluation of the community intervention resources to the class.

50. Group Work Letter – MeaningAddressesExample C – CommunityThe community in which the physician is immersed. Namely, the group title of those with whom the physician is working. Pregnant racial minorities (predominantly black and Hispanic), women of childbearing years, patients living in the American South (http://www.cdc.gov/std/stats11/figures/e.htm )http://www.cdc.gov/std/stats11/figures/e.htm C – Characteristics Specific characteristics of the community or patient group. This is the element that requires attention; the need. STD infections, educational deficiencies, untreated syphilis S-StandardNon clinical standard of care relative to the specific characteristic. Clinical standards are addressed via clinical questions. This standard relates more generally to psychosocial, economic, educational standards answering the question "What works?. By Year 2020 reduce the number of congenital syphilis to 9.6 new cases per 100,000 live births. STD screenings for pregnant women, STD treatment services for women during childbearing years, antenatal syphilis screenings during first trimester, antibiotic treatment if tested positive, late (2-3rd trimester) prenatal care.

51. Objective 5 Participants will apply the final steps of C-SORT Methodology through proactive class discussion.

52. O- Options Letter – Meaning AddressesExample O- OptionsDefines options/opportunities available such as events, resources, or other potential solutions in place to address or bolster the characteristics under investigation. Consider the interaction and interdependence of various factors. Public health department, educational resources, STD prevention services, incorporation into sex education classes

53. Options for STD cases?

54. Letter – Meaning AddressesExample R – Response Outlines the community physicians desired response to the characteristics under investigation. Describes what he/she will do as a responsive physician to strengthen or ameliorate desired outcomes or community direction. Community presentations on safe sex practices, research studies with other physicians, participation in local programs in order to set example of screening practices. Response: STD Case

56. Letter – Meaning AddressesExample T – Transfor- mation Discusses how the physicians actions will transform the community long term into a stronger population. Related to standards as needed. To reduce and/or prevent future cases of congenital syphilis, to encourage women to seek screening and treatment early on during their pregnancies. Transformation: STD

57. Objectives 1. Participants will define a community intervention as distinct from a patient clinical question. 2. Participants describe the elements of the C-SORT methodology 3. Participants will work in groups to identify and locate online resources to use when preparing a community intervention, including: 1. CDC Statistical Resources 2. Healthy People 2020 3. County Health Rankings 4. Participants in groups will present their evaluation of the community intervention resources to the class. 5. Participants will apply the final steps of C-SORT Methodology through proactive class discussion.

58. Questions?