1. Tillery, NC

2. Understanding Health and Wellness Needs A Community’s Perspective

3. The Tillery Community

4. CCT Philosophy of Health Care Concerned Citizens of Tillery (CCT) believes that the conditions necessary for good health - including recreational facilities, excellent schools and medical facilities, lifelong learning opportunities, nutritious food, and economic development - will not be granted by outside institutions, but will be created by a strong community working in equal partnership with other organizations and institutions. (ECU OT and SW, AWHC, People’s Health Clinic) Concerned Citizens of Tillery (CCT) believes that the conditions necessary for good health - including recreational facilities, excellent schools and medical facilities, lifelong learning opportunities, nutritious food, and economic development - will not be granted by outside institutions, but will be created by a strong community working in equal partnership with other organizations and institutions. (ECU OT and SW, AWHC, People’s Health Clinic)

5. Understanding the Community

6. Why the interest? Comin’ Home Comin’ Home Aging in place Aging in place Community support Community support Contextually and culturally embodied Community built practice Contextually and culturally embodied Community built practice

7. Door to Door Survey SF-12 and environmental questions SF-12 and environmental questions 104 participants (100 in 1996) 104 participants (100 in 1996) Students from ECU and UNC-CH Students from ECU and UNC-CH Assess the health related quality of life of residents of those in 5 mile radius of Tillery Community Center Assess the health related quality of life of residents of those in 5 mile radius of Tillery Community Center

8. Finding out about the Community: Student Perspectives Hardworking people Hardworking people Self Sufficient Self Sufficient Spiritual Spiritual Family and Community Oriented Family and Community Oriented Friendly Friendly Welcoming Welcoming Warm Warm

9. Gender42 males (34), 61 females (34) Race81 African Americans (89) 15 Caucasians (11 C + others) Employment67 not employed Heating36 gas (20), 26 central, 7 wood (7) Cooling41 AC, 40 central, 9 fans Smell mildew or mold89 no, 14 yes Home flooded80 no, 23 yes Smells inside home from industry 79 no, 21 yes Smells outside home from industry 53 no, 47 yes

10. General Health14 excellent (16), 24 very good (12), 33 good (38), 26 fair (29), 7 poor (5) Health limitations for moderate activities 16 a lot (18), 23 a little (26), 64 not at all (57) Health limitations for stair climbing 21 a lot (17), 25 a little (26), 54 not at all (57) Daily activities accomplished less than like due to physical health 9 all of the time, 12 most of the time, 22 some of the time, 18 a little of the time, 42 none of the time Limited in kind of activities due to physical health 5 all of the time, 10 most of the time, 14 some of the time, 20 a little of the time, 52 none of the time Daily activities accomplished less than like due to emotional problems 3 all of the time, 12 most of the time, 16 some of the time, 14 a little of the time, 57 none of the time

11. Daily activities less carefully than usual due to emotional problems 2 all of the time, 6 most of the time, 14 some of the time, 11 a little of the time, 67 none of the time Pain interfere with daily activities 46 not at all (27), 21 a little (29), 14 moderately (8), 14 quite a bit (25), 7 extremely (10) Felt calm and peaceful27 all of the time (14), 45 most of the time (51), 15 some of the time (13), 14 a little of the time (17), 2 none of the time (5) A lot of energy18 all of the time (11), 36 most of the time (43), 25 some of the time (32), 15 a little of the time (11), 9 none of the time (3) Downhearted and depressed3 all of the time (1), 2 most of the time (8), 18 some of the time (14), 22 a little of the time (28), 59 none of the time (49) Physical and emotional health interfered with social activities 5 all of the time (1), 2 most of the time (5), 14 some of the time (5), 19 a little of the time (11), 64 none of the time (76)

12. Community Quality of Life Community Needs Assessment—A focus group study provided the following description of the community quality of life: Everyone has a hand in making the community work, Together like one big family, We’ll all come back to Tillery, Go back to the old values or we’re lost, We need things that complement the community, The land is power, I have a different view of white people and black people working together

13. The Road to Wellness: The Need for Interprofessional Practice

14. Wellness Needs Wellness Group—A five week wellness program focused on physical activities, nutrition, social support and safety. What did the occupational therapy wellness group mean to its participants? Data analysis yielded five themes: fellowship through togetherness, learning new things and education, a different outlook on well-being, having fun, and leadership. OT and Social Work Home based services--OT and Social Work

16. Evaluation of Individual Needs, Interests, and Goals

17. Planning Group Goals and Activities

18. Link to Environmental and Social Justice Issues Philosophy of Health Care History of Tillery Impact of history, race, gender, and socioeconomic status and socioeconomic status Occupational Justice Issues

19. Role of the Environment in Shaping Practice Interpersonal Interpersonal Physical (manmade and natural) Physical (manmade and natural) Societal (economic) Societal (economic) Cultural Cultural Temporal Temporal

20. Funding Learn and Serve Grant (1996-2002) Learn and Serve Grant (1996-2002) National Environmental Health Sciences Institute Grant (2004-2007) National Environmental Health Sciences Institute Grant (2004-2007) Personal Donations Personal Donations In-kind contributions from OT ECU Department In-kind contributions from OT ECU Department

21. Conditions Commonly Addressed Repetitive Stress, Work-Related Injuries Repetitive Stress, Work-Related Injuries Diabetes Diabetes Obesity Obesity Metabolic Disease (cardiac, Hypertension, CVA) Metabolic Disease (cardiac, Hypertension, CVA) Arthritis Arthritis Orthopedic Problems Orthopedic Problems Low vision Low vision Depression Depression Asthma Asthma

22. Favorite Activities Physical – parachute games, the Gospel Slide dance, and Tai Chi; healthy food preparation (banana bread, trailmix, veggie pizzas) Physical – parachute games, the Gospel Slide dance, and Tai Chi; healthy food preparation (banana bread, trailmix, veggie pizzas) Cognitive – table games, Nutrition Jeopardy and Concentration Cognitive – table games, Nutrition Jeopardy and Concentration Emotional – collages, scrapbooking, and craft projects Emotional – collages, scrapbooking, and craft projects Spiritual – groups end with a group prayer circle Spiritual – groups end with a group prayer circle

24. Outcomes for Participants Occupational performance Occupational performance Client satisfaction Client satisfaction Role competence Role competence Health and wellness Health and wellness Prevention Prevention Quality of life Quality of life

26. Indirect Skills Learned by Students Client-centered care Client-centered care Being a change agent in the system Being a change agent in the system Accessing resources Accessing resources Cultural competency Cultural competency Independent thinking and acting Independent thinking and acting Collaboration and consultation Collaboration and consultation