RCHC Community Project Abstracts

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End-of-Life Care Decision Making in the Illinois Valley
Date of project: 3/16/2009

The importance of end-of-life care can not be understated, it is the last thing we do for our patients. It has been an area of research and systemic improvement for 15 years, but we continue to see limitations in our care, namely short median stays in hospice (17 days in Oregon) and rural/urban discrepancies in percentages of resident deaths that are hospice enrolled (46% in Multnomah County vs. 36% in Josephine County). This project attempts to delineate patients' values in when considering end-of-life (EOL) care in order to examine some the upstream variables that determine how and when we provide EOL care. The design was a qualitative assessment of community members' values in EOL care decision-making through individual semi-structured interviews and anonymous voluntary surveys of community members and primary care providers (PCP). It was found that among patients that have discussed EOL with their doctor, PCP was the most influential person in their decision on EOL, though specialist and family members were also important inputs.

Underage Drinking in Southern Oregon's Illinois Valley
Date of project: 9/8/2008

The U.S. Surgeon General recently addressed the country's underage drinking problem in his 2007 Call to Action to Prevent & Reduce Underage Drinking. Underage drinking is especially prevalent in rural communities like the Illinois River Valley in Southern Oregon. This project analyzed the Illinois Valley's underage drinking problem, evaluated the best approach to help ameliorate it, and attempted to improve it. It was concluded that boosting alcohol prevention education and raising awareness in the community would have the most impact.

HPV Vaccination in the Illinois River Valley: A survey of attitudes and availability, with recommendations for increased vaccination
Date of project: 2/12/2007

Gardasil, the vaccine against 4 strains of the Human Papilloma Virus, is currently a hot topic among women’s health providers and also the mainstream media. My project attempted to identify the best method for improving vaccination rates amongst young women in the Illinois River Valley. I found that no providers in the Illinois River Valley offered the vaccine, due to lack of demand, prohibitive costs and difficulty in purchasing. Young women who were interested in receiving the vaccine were referred to the County Health Department a 25-35 minute drive, which was prohibitive for some patients. Although, I would have liked to be able to recommend that providers in the IVR offer the vaccine to their patients, my research was not able to support that conclusion. Instead, I recommend provider education and a concerted effort to encourage vaccinations through the School Based Health Programs and continued referral to the County Health Department.

Forming an Emergency Operations Plan for Josephine County
Date of project: 8/9/2004

The Josephine County Public Health Department, in conjunction with local physicians, emergency services personnel, infectious disease experts, and other interested parties, are currently working on an Emergency Response Plan in the event of natural disaster or acts of bioterrorism. This is in conjuction with Health Resources and Services Administration funding for Josephine and jackson Counties to create a Hospital and Healthcare System Bioterrorism Preparedness Program. This plan seeks to designate how resources in Josephine County will be used in the case of natural disaster such as fire, earthquake, or emerging infectious disease, or intentionally caused disasters such as Smallpox, chemical releases, or intentionally food-bourne illness. The geographical layout of Josephine County brings specific challenges to developing a plan for use of alternative care sites, Stategic National Stockpils resources, medical personnel, and transporation during an emergency that must be planned-out in advance to best coordinate the services necessary. Joesphine County has the unfortunate advantage of having a recent natural disaster, the Biscuit Fire of 2002, which has helped motivate Josephine County to work together on this plan, and has provided insight to its necessity. This project describes Josephine County and the Emergency Response Plan that has been developed by the Josephine County Public Health Department.

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