Healthcare and a haircut: New approaches to community health

By Rod Moore | September 4, 2019


Barbershops and blood pressure screenings. Faith and food choices. Libations and lifesaving. Partnerships are popping up in surprising places as advocates committed to eliminating health disparities tap the power of neighborhood businesses, churches, synagogues — and even a few bartenders and barbers. 

Could your next partnership come from a most unexpected place? Read on for details from these recent success stories.

Intervention at the barbershop

After recognizing that African Americans are less likely to receive flu vaccines annually, or ever, Kaiser Permanente Mid-Atlantic first launched a pilot program ago four years ago to vaccinate people at places they already frequent — in this case, a barbershop in West Baltimore.

Now, as part of its expanded Good Health & Great Hair program, Kaiser sets up mobile stations outside barbershops and salons in West Baltimore to provide an array of no-cost services, including screenings for body mass index, blood pressure and blood sugar, HIV tests, screenings for liver and kidney disease, and take-home colorectal cancer tests. Patients who need it are referred to further medical care, either at a Kaiser Permanente facility or elsewhere.

“When this began as an immunization program, we soon recognized a huge need,” says Destiny-Simone Ramjohn, Kaiser Permanente's director of community health for greater Baltimore. “Our partner shops quickly said, 'What if we were to run this program virtually year-round?'”

Recognized with a National Association of Health Services Executives award earlier this year, the program now includes four area barbershops and salons and includes services from 10 other community partners such as Healthcare Access Maryland and Black Mental Health Alliance. The outreach served more than 3,500 individuals between September 2018 and June 2019, according to Kaiser data.

Last year, an Ambassador program was added to create a supplemental network of barbers and stylists trained to disseminate important health information to clientele and make referrals to the program, according to Ramjohn. Given the receptivity to the program, a Spanish-speaking outreach is now being planned for targeted salons, barbershops, churches, and marketplaces, she says.

Reading, writing, and free physicals

Preventive care can be a challenge when the patients are pint-sized. Leaders at Horizon Health in eastern Illinois thought, “What better time to close care gaps than a back-to-school party?”

For adults, the Back-to-School Bang, held at Horizon's Paris, Illinois, clinic, is all about physicals, dental care, and eye exams; for kids, the lure is free backpacks, face painting, and a bounce house.

Now in its fifth year, attendance has grown steadily, and this year a total of 38 vendors (22 of which were community organizations) participated. In 2017, Horizon welcomed more than 250 children and families, with more than 60 children brought fully up to date on their vaccinations.

“This year we gave away 350 backpacks and performed 71 school/sport physicals. Based on the number of backpacks given away, our numbers increased by about 75 kids this year,” says Frank, explaining that it's hard to give definite numbers since not every child takes a backpack. “But we can tell attendance increases every year.”

“As the event grows, we have had other community organizations reach out to ask us how they can be involved,” says Erin Frank, public relations and marketing manager at Horizon Health. Participating organizations include the local police and fire departments, Bee Well of Edgar County, the local Lions Club, and more.

“And not only are other community organizations involved, but we also have lots of businesses who donate money or supplies,” Frank says. That broad participation is key not only to allowing Horizon to offer more educational events and free services, but in making Back-to-School Bang a full community event, not just a health fair.

Faith, food, and fitness

In Camden, New Jersey, where poverty levels are high, a coalition of providers sought the assistance of local faith leaders to promote healthy eating and exercise, a natural fit given the highly devout community.

The Camden Coalition of Healthcare Providers (CCHP), which comprises local health systems, primary care providers, and partnering and residential organizations, spearheads the program with the cooperation of 30 community leaders across nine churches and mosques. Called Faith in Prevention, the program, an initiative of the New Jersey Department of Health, has doubled in size and will launch its sixth year this October.

At kickoff events, nurses conduct free biometric assessments of congregation members. That's followed by a six-week evidence-based educational curriculum called Faithful Families Eating Smart and Moving More in which trained “lay leaders” teach participants about healthy eating, fitness, and understanding the impact of trauma on health. The program is already seeing weight loss and increased activity levels among its participants.

“One of our program leads noted that a participant recently lost 12 pounds because she stopped drinking soda and exercised more,” said Maritza Gomez, CCHP program coordinator for community engagement.

The state continues to support the outreach with additional funding, which now includes the neighboring cities of Patterson, Trenton, and Newark.

The additional partners of Antioch Baptist Church and Cooper's Ferry Partnership have signed on more recently.

Firefighting and health audits

Stress and burnout have been a growing concern for physicians and clinicians; likewise, the concern for first responders is now on the rise.

The high stakes of saving lives at the scene of emergencies (or witnessing the aftermath) can take a toll. A 2016 studyby the International Association of Firefighters found that firefighters and paramedics are exhibiting levels of PTSD similar to that of combat veterans.

Last year, a firefighter with Santa Clara County Fire Dept. proposed that the California Center for Functional Medicine, a functional and integrative medicine clinic, take on a six-month health audit of firefighters at his fire station, monitoring variables such as sleep and nutrition to better understand possible links to post-traumatic stress disorder, cancer, and suicide. (A study by the National Institute for Occupational Safety and Health tracking the health of 30,000 firefighters from 1950 through 2009 showed that firefighters get cancer at a higher rate than the general population.)

Technology partners supplied biometric monitor such as Fitbits and Oura rings in order to gather valuable data such as heart rate variability and sleep patterns. Identifying firefighters with disrupted sleep allowed them to offer advice on how improve their sleep, like dietary changes or meditation.

“For our initial cohort of 18 people, we showed the aggregate average increase of 35.7% deep sleep,” says Sunjya Schweig, MD, chief executive officer and co-director of CCFM. “We also showed an almost 11% decrease of awake time during the night.” Schweig said his vision is to expand the program through grant coverage to make it available more widely, including through a virtual content delivery system paired with coaching.

Up next, the San Ramon Fire Department's new recruit class will be starting the program this fall, with the goal of capturing baseline levels to improve statistical accuracy.

Bartenders as lifesavers

Ventura County Behavioral Health Department knew it had a serious problem on its hands. Based on its statistics, suicide accounted for 41 percent of deaths of men aged 45 – 64 between 2014 and 2017 in the county, northwest of Los Angeles. The alarming statistic prompted an unusual initiative called Bartenders as Gatekeepers, which launched in July 2019.

The idea was to choose places where men would feel comfortable (bars) and with people who already offer a listening ear (bartenders) and were in a good position to flag potential crisis situations.

Volunteer bartenders are trained by Ventura County behavioral staff members to spot warning signs of suicide ideation and depression, with the goal of intervening in emergency situations and suggesting resources or offering a referral in less immediate cases. To that end, specially designed drink coasters printed with an 800 number and QR code give bartenders a discreet way to connect.

The program has two bars signed up and is actively recruiting as many as 10 more, said Kiran Sahota, senior behavioral health manager at Ventura County Behavioral Health. “The stigma around suicide and talking about suicide makes it hard to entice bar owners to join the cause,” Sahota said. “Those that have joined the project so far have been able to relate [because] they've had patrons who have died by suicide.”

The project will evaluate the effectiveness of the outreach by tracking any increase in utilization of supportive services in the country.

Rod Moore is a frequent contributor to athenahealth's Knowledge Hub.

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