RCHC Community Project Abstracts

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Late-Life Depression and Psychosocial Factors: Clinical Screening Tools and Social Services for Older Adults in Junction City, Oregon.
Date of project: 10/12/2009

Depression in common among older adults in the United States. Contributing factors to depression include biological, psychosocial, and environmental elements. Bereavement, caregiver strain, social isolation, financial strain, and physical disability are among the many psychosocial factors that contribute to the development of depression. Depression among older patients is important not only because it compromises quality of life for patients and their families and undermines the ability to maintain health and independent living, but also because it is an independent risk factor for mortality. While the development of pharmacologic agents for the treatment of depression have made significant impact on quality of life for many individuals, the continued importance of screening for and addressing psychosocial issues cannot be overstated. The goal of this project was to screen older patients in the Junction City area for depression, explore the psychosocial context in which depression exists, and educate health care professionals on the community resources available to address issues such as financial strain and social isolation. The Patient Health Questionnaire 2 was used to screen for depression and a student-designed questionnaire was used to screen for social isolation, community involvement, and daily activities. These two questionnaires, combined with brief patient interviews, revealed some correlation between depression and social isolation. To address issues of late-life depression and the underutilization of social services in the Junction City area, a notebook was developed for use by health care professionals at the Junction City Medical Clinic that included 1) a series of clinical tools for screening for depression, dementia, and activities of daily living; 2) a series of journal articles on the role of psychosocial factors in depression; 3) a questionnaire for use in screening for social isolation and obstacles related to community involvement; 4) information related to enrollment in Medicare through the Senior Health Insurance Benefits Assistance program, the Oregon Prescription Drug Program, and social services available through the Senior & Disabled Services office in Junction City; and 5) an article on house calls.

Oregon Senate Bill 528: Expected effects on the Willamette Valley
Date of project: 9/7/2009

This study discusses the principal argument for the passing of Senate Bill 528 and the impact that field burnings have on the health of the surrounding communities. While there are documented studies that look at the correlations between negative health outcomes and field burning, few studies have looked solely at the direct causative effects.

The Underutilization of Available Social and Healthcare Services by Seniors in Junction City, OR
Date of project: 6/30/2008

As the population in the United States continues to age, well-developed and funded social and healthcare services aimed at improving quality of care and delivery of services for seniors are more important than ever. This study attempted to identify available social and healthcare resources in the Junction City service area as well as identify reasons for their underutilization. The design was to interview clinic practitioners, patients, senior center staff and patrons, and social workers in the community over a 5-week rotation in a primary care setting, as well as include conclusions from appropriate journal articles. Adequate social services resources and health care clinic practices were identified. They included a Lane County funded social worker/case manager assigned to Junction City as a liaison for seniors, a well-developed website directory dedicated to resources for Seniors and Disabled persons of Lane County, an active senior center with low cost daily activities. Healthcare related practices included a satellite community clinic, nursing home visits, and a generic drug sample machine. Many barriers to utilization of these serviced were elucidated. They included incomplete access to available resource information, which was primarily internet based, a lack of knowledge of available services by clinic physicians, difficulty with transportation, reluctance for help based on current seniors’ fierce independent nature, lack of anonymity in a small town, and stigma regarding mental illness. In conclusion, it was determined that a better flow of dialog and information was necessary between physicians, social workers, and community support centers (senior centers/churches) to enable seniors to find appropriate resources. However, it was also determined that full utilization will be difficult until attitudes towards community aid are altered and seniors, and their families, are more accepting of social services support.

Lane County’s Struggle to Help Newborns and Mothers: An Emerging Problem with Promising Solutions
Date of project: 2/12/2007

The process of nurturing an uncomplicated pregnancy, delivering a viable and healthy baby, and maintaining the normal growth and maturation of the baby and health of the mother has been the focus of the field of obstetrics and one of the most important medical issues in the United States and worldwide. Previous research has shown that Lane County has the highest perinatal and neonatal mortality rates in the state of Oregon and ranks among the highest in the nation. This study attempted to identify and shed light on the challenges that face mothers and babies in Lane County which contribute to the high perinatal and neonatal mortality rates and evaluate the effectiveness and availability of resources and regional public health institutions that can best serve this specific health care population. The population studied was the female patients who came to the Junction City Medical Clinic along with their newborns for well-child examinations. Each of these patients was asked about challenges that they had faced with regard to receiving adequate prenatal care during their pregnancies. Using patient-provided information further outside research, and dataset analysis, a patient questionnaire was designed to help the expecting mother from Lane County to assess her prenatal needs and to help her better identify the prenatal care resources available to her. The ultimate goal is to be able to better unify and collect these resources and organize them into a neat and convenient handout that provides patient the information they need and also educates them on the necessary prenatal topics. This handout will be made available to Lane County Public Health Department and to the Junction City Medical Clinic to distribute to patients who need prenatal care and health care for both mother and baby after delivery.

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