RCHC Community Project Abstracts

Back to subject search page or search by preceptor site Enhancing Domestic Violence Screening and Outreach at Santiam Medical Associates by Addressing Barriers Faced by Battered Woman in Rural Communities Project Date: 4/27/2009 This project aims to evaluate the preparedness of Santiam Medical Associates to recognize and refer victims of domestic violence (DV) to resources. Another key objective was to illuminate the myriad of barriers faced by victims of DV in rural communities and the ways in which providers can become better equipped to assist these victims. It is thought that 1 in 10 women in Oregon between the ages of 20-55 (more than 85,000 women), have been physically or sexually assaulted by a current or former intimate partner in the last five years.1 Nearly one-third of American women (31%) report being physically or sexually abused by a husband or boyfriend at some point in their lives.2 Women in rural communities face specific challenges to accessing resources. Rural physicians can play an integral role in improving the lives of their battered patients if they are aware of the problem and provide a safe and confidential environment for women to disclose. During my rotation, I administered an anonymous survey to the employees of the Santiam Family Medical office to assess their awareness of DV, preparedness to ask about abuse, whether they felt equipped to refer patients to appropriate resources and their thoughts on barriers women face while seeking safety from abuse in Stayton. Based on the results of the survey, I collaborated with a non-profit domestic violence organization to develop a training workshop for the staff on addressing DV in a medical setting. In addition, I was able to provide prevention and education materials on DV for the physicians and staff to distribute to patients in need of information and community resources. Care Management for Foster Children at North Bend Medical Center Project Date: 4/27/2009 An improved system of implementing health care recommendations for foster children and an increased ability to track this vulnerable population would provide benefits to these children to ensure their health care needs were being met. Pediatricians at North Bend Medical Center in Coos Bay, Oregon have served at least 140 foster children in the past three years and recently hired a Care Manager to ensure adherence to health care recommendations for specific populations. I explored the specific recommendations for health care visits, tests, and referrals for foster children and developed a system to implement and track these patients. Community connections were established between the Department of Human Services and the clinic. A summary of recommendations was compiled for distribution to clinicians to increase awareness. A “health profile” was created to consolidate health information of foster children for increased accessibility for clinicians and foster families. Lastly, a series of care management plans was created to improve adherence to current recommendations for the Care Manager to utilize. The documents created and connections established will provide a framework to ensure that foster children are receiving adequate health care. The Underutilization of Available Social and Healthcare Services by Seniors in Junction City, OR Project Date: 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. Resources Available for Patients with Dementia in Columbia County, Oregon Project Date: 3/17/2008 Dementia represents a major health issue for geriatric patients in the United States. This study serves primarily as a community profile and assessment of the resources available to patients with dementia, specifically Alzheimer's disease and their families in Columbia County, Oregon. The study evolved during preliminary conversations with the staff of the primary care internal medicine clinic in St. Helens, Oregon. They identified the availability of resources for dementia as a consistent challenge in offering guidance to their patients. A survey of local resources was conducted which included site visits to nursing homes and senior centers, contacts with social workers, and internet searches for resources. The local resources were compared with those described in the medical literature and the National Alzheimer's Association. Questions to evaluate the effectiveness of the local resources were prepared for patients with dementia and their caregivers. A simple handout was prepared to identify key resources in the community and at large. Intimate Partner Violence: Toward an Inclusive Paradigm Project Date: 2/11/2008 Background: Intimate partner violence (IPV) is an important public health concern, associated with many significant adverse psychological and physical health consequences. The Centers for Disease Control and Prevention estimates an annual national cost of IPV of $5.8 billion, with $4.1 billion attributable to direct medical and mental health services costs. A large body of evidence shows that a substantial percentage of victims of IPV are males. Despite widespread recognition of the impact of IPV on public health, and despite concentrated efforts for better prevalence data collection processes by the CDC and others, the role of male victims in prevention and treatment strategies is frequently underestimated and marginalized. To facilitate better understanding of male victimization and informed intervention strategies within the community, we sought to elucidate the services available for male victims of IPV in Eugene, Oregon. Methods: We performed a literature search on national, state and local prevalence rates of male victims of intimate partner violence. Data on community resources for IPV were gathered using the Internet, the community phonebook, and resource listings provided by the City of Eugene. We conducted interviews with staff members of community organizations providing services for IPV to ascertain service availability by patron sex. Results: We found that the majority of community IPV services were available to men and women with relatively few instances of sex-specific eligibility for services. Significant discrepancy existed between advertised sex-specific eligibility for services and actual sex-specific eligibility for services. Conclusions: Of the available resources in Eugene, Oregon dedicated to providing services to victims of IPV, nearly all of them are available to men as well as women. Nonetheless, several barriers to care were identified that may hinder access by men to these resources. These include IPV data collection processes that exclude men from survey pools, intervention strategies that seek to identify only female victims in the health care setting, and language and terminology in educational materials that phrases IPV as a gender-specific form of violence. Access to Cancer Support Services in Florence, OR Project Date: 12/31/2007 A diagnosis of cancer can be traumatic for a patient, and psychosocial support services have been found to help patients through their battle with cancer. Rural communities present a challenge when trying to provide cancer support services because of limited resources, traveling distances for the patients and the volunteers, and lack of a structure to educate patients about resources. In Florence, OR, a town with an elderly population that is greatly impacted by cancer, psychosocial support services are abundant, but often underutilized. In January, during my rotation, a new Cancer Resource Center (CRC) opened in Florence as a partnership between the American Cancer Society and Peach Health Medical Group. Its mission is to connect cancer patients with the available resources in the community. I decided to investigate the level of awareness of cancer support services among my preceptor’s patients and to work towards connecting patients in the clinic with the CRC. Through interviews with patients in my preceptor’s clinic, and with several individuals involved with the CRC, I concluded that there is a great need for the CRC in Florence and that patients are receptive to the idea of the CRC. The final product of my project was the creation of a referral form that can be used in the exam rooms at the time of cancer diagnosis to direct the patients to the CRC for educational and psychosocial support. Primary Prevention of Child Sexual Abuse in Coos County, Oregon Project Date: 10/15/2007 Child abuse is a significant problem in Coos County, OR, where child abuse and neglect rates are persistently higher than average for the state of Oregon. Despite the high prevalence of child abuse, there are no primary prevention programs that educate and empower adults to prevent child abuse. This project focused on creating a primary prevention program to aid adults in preventing child sexual abuse. With the assistance of the Coos County Child Advocacy Center, I created educational materials that met three goals. First, the program helps disseminate information about child sexual abuse and increases awareness. Second, the program teaches parents and organizations that serve youth actions they can take to prevent child sexual abuse. Third, the program teaches adults how to recognize and report child sexual abuse. The ultimate goal of this program is to help adults in the Coos County area decrease the incidence of child sexual abuse. “Healthy Futures: Nurturing Children’s Development.” Project Date: 10/15/2007 A child’s early experiences profoundly influence his brain development and how he will interact with the world throughout his life.1 Increasingly, instruction and support in providing the nurturing and stimulation that children require for proper brain development is imparted to inexperienced parents by community resources. 2 One such resource, the Maternal Case Management program at the Jefferson County Health Department in Oregon, has just been eliminated due to low utilization. The Healthy Start program in Jefferson County is facing the same fate, also due to low utilization. The fact that both the teen pregnancy and child abuse rates in Jefferson County are higher than the Oregon state average suggests that lack of need of these social services is not the reason for their low utilization.3,4 Rather, lack of awareness of these social services is to blame for their low utilization, according to the local Community Health Improvement Partnership (CHIP) in Jefferson County. To increase awareness, and thus increase utilization, of social services available to infants and children in Jefferson County, I created a comprehensive list of these resources and made it available at the nurse’s station at the Labor and Delivery Department of Mountain View Hospital, the major hospital in the county. To encourage new parents to access this list of resources, I also created a video that explains the neurodevelopment that results from adults’ early interactions with infants, and the importance of enlisting social services when necessary to ensure that these interactions are positive and promote a child’s healthy development. This video is available in both English and Spanish, and will be required viewing for patients who deliver at Mountain View Hospital, prior to their discharge. Screening and Intervention for Psychosocial Risks: Analysis of Barriers to Appropriate Utilization of Social Services for Obstetric Patients in Astoria, Oregon Project Date: 2/7/2005 Most communities have social services available to, or directed towards the Obstetric population when they are identified as having specific needs. Unfortunately for the community of Astoria, Oregon, the obstetric patients in need may not be aware of the social services available to them. To further complicate the problem, there are no dedicated obstetric social workers in this community to identify high risk Obstetric patients and help them access and navigate the systems that administer these services. The individuals that are called upon to help obstetric patients connect with available resources are the health professionals caring for these patients such as the nurses, midwives and obstetricians, who are already overworked in their existing roles. This community project includes a survey of social services that are available to obstetric patients in the community of Astoria, Oregon: current methods used to identify patients with needs and facilitate connecting patients to these services; and based on this research, recommended changes to improve this process. A comprehensive list of the available social services was compiled to improve patient and provider awareness of available social services. Assessment of services available to seniors in Baker City, Oregon Project Date: 7/5/2004 The population of those over 65 in the United States is rapidly expanding, a trend that has profound implications for health care practitioners and organizations serving seniors. Rural communities in particular are seeing a surge in this population. Observation of physicians in Baker City, Oregon and their interactions with elderly patients demonstrated that primary care practitioners are often called upon to connect seniors with appropriate resources, both medical and social. Navigating the numerous agencies and trying to determine which services are provided can be frustrating for physicians, seniors and their families. A survey of services available to seniors was conducted, as well as interviews with organizations providing resources. It was concluded that while there are a multitude of opportunities for seniors in Baker City, a large portion of seniors were not making use of se services. Although there are a number of reasons for this, it is hypothesized that utilization of services may increase if health care providers are able to more easily access contact information. In order to aid practitioners in this endeavor, a comprehensive list of services for seniors in the Baker City area was produced. Transition Services for Children with Disabilities in Malheur County Oregon Project Date: 1/5/2004 Children with disabilities often have multiple medical problems and members of their pediatric healthcare teams who are very involved with their lives, but as the transition from childhood to adults, they may be at risk for inadequate healthcare. They are also more likely to be unemployed or earn lower wages as adults than children without disabilities. If those children and parents are provided with adequate resources during the school-age years, they will be more apt to have a smooth transition to adult healthcare providers, hold down a job, play a role in the community, and possibly live independently as adults. Parents visiting the Treasure Valley Pediatric Clinic are often unaware of resources available to their children for these purposes. This project addressed resources available in Malheur County, Oregon to help children transition from childhood to adulthood. Organizers at Ontario High School, The Malheur County Health Department, and Treasure Valley Pediatric Clinic were contacted. Topics addressed included medical care, vocational training, secondary education, and independent living. This project found that though there are many resources available for job training, life skills, secondary education, and community activities while children are in school, more need to be available to address recreation and healthcare transition from pediatrics to adult care. Identifying senior services available in John Day, OR and making those services known to seniors and families caring for the aging in John Day and Grant Co. Project Date: 5/5/2003 The nations population of people over age 65 has grown and will continue to grow in the coming years. Many people in this age group need assistance with health and daily activities and communities are having to find ways of providing assistance and educating the public about those assistance programs. This community project attempted to identify the senior services available in John Day, OR and make those services known to seniors and families caring for the aging in John Day and Grant Co. The design was observation of medical staff’s identification of senior patient’s needs and the referral system for those patients and families to senior services. Patient and staff knowledge and utilization of senior services was also observed. There are many resources and contacts available for seniors in John Day and Grant County, but no concise compilation of information for those needing senior services now or in the future and a noted under utilization of some services. There is a mechanism in place for identifying people in need of senior services, but it is mainly used only for hospitalized patients and it was felt that the rest of the medical community and general population would benefit from knowledge of the senior services available in the community. The only handout readily available was geared more for hospital and nursing home staff to use or give to those patients and families in those settings. Furthermore, the handout was more of a listing of phone numbers and details betters utilized by the medical community than the general population. Therefore, the final product of this project was development of a concise handout to be, given to patients and families in the clinics, hospital emergency room, and newcomers and the general population via the chamber of commerce. Adoption and Rural Family Practice Project Date: 9/23/2002 Adoption is an important option to be considered by mothers who are facing unplanned pregnancy. Often women who are unprepared on several fronts for parenthood and who have neither access to nor acceptance of abortion as an option are not introduced to this third and vital possibility for their child. Current societal views and lack of physician education may limit how often it is discussed, especially within the scope of a rural family medicine practice. This project examined the current climate regarding adoption in Lebanon/Sweet Home and attempted to gather information on physician/counselor education and readiness to offer adoption as an option to their patients/clients. One-on-one interviews, journal research, and a survey distributed among family medicine and OB-gyn physicians, adult and family service counselors, and school guidance counselors were employed to gather information. It was evident that there is much work to be done in providing instruction and information about adoption to those on the front lines of dealing with unplanned pregnancy Help for the Homeless? An exploration of the Assistance Programs Available to the Homeless Population of Salem, Oregon. Project Date: 5/6/2002 Conducted in the community of Salem, Oregon from May to June of 2002, this project sought to explore the needs of the city's homeless population in order to determine if adequate assistance programs are currently in place. Initial interviews with homeless individuals seeking medical treatment were followed by an attempt at characterizing the demographics of this position. Utilizing this initial data, a survey was prepared, and distributed to homeless individuals, that sought to identify which needs were not being satisfactorily met by Salem-area assistance program currently in place. Each agency was contacted and a description of the provided services was obtained, with emphasis on theconcerns raised by survey responders. It was then possible to compare the perceived needs of the homeless population with the services in place to address them. In general, the homeless of Salem, Oregon are pleased with the assistance they receive, but are not very aware of all the programs and agencies available. Further, there is limited communication between these various agencies, and each assistance program is not fully aware of the others in the community. To address this weakness, a current Salem-area resource guide, detailing the services offered to the homeless, was prepared and distributed to local agecies so that a more coordinated effort can be achieved. Back to subject search page or search by preceptor site