Taylor Lynn Meadows
"It's kind of fun to do the impossible." -Walt Disney
Leadership
Issue:
Health indicators of rural communities need to be improved (SCRHAP). There is a domino effect surrounding the rural community’s health that need clinical intervention.
Explanation of Issue:
According to the South Carolina Rural Health Action Plan, SC is rated 42nd in health in the United States. Rural areas have a unique set of challenges residents face on a regular basis, therefore creating and fulfilling a solution needs to be just as distinctive. The SC RHAP is a great resource to have because it works as a launching pad for my leadership initiative of improving the health of rural residents. Due to its contents, it is a great means as a validity to this research (second key insight). A major setback rural communities experience is access to healthcare. This is important because healthcare is not just for a broken arm, but also imperative for heart disease, diabetes, and obesity management. Health concerns of that nature is an issue that needs constant and consistent monitoring. If a resident of a rural community cannot make it to a health center regularly, that patient will ultimately lose control of their health. This is something that is preventable and unnecessary, similarly to what I explained in my third key insight “Accepting Accountability”.
Leadership Goal:
To analyze findings from a rural population wide study that recognizes health indicators and barriers residents face in order to provide better healthcare solutions as well as implement new ways rural residents can create a healthier lifestyle for themselves. Translational science (first key insight) will lead healthcare providers from doing the research, to having the patient approach the healthcare provider, to finally a clinical intervention of the healthcare workers reaching the community through programs and open meetings.
General Solutions:
Comparable to what I stated in the explanation, there is one specific hindrance that first must be solved, and that is the individualistic barriers rural areas encumber. Meaning, it will take a number of unique ideas to conquer the obstacle. The end-goal is to encourage and create a community where healthy options are available and chosen.
Detailed Plan with Interventions:
Assessment of community life
We need to determine where the ‘popular’ locations are to host the meetings. Making the meetings more accessible, by holding the meetings in frequented places such as local grocery stores and popular main street restaurants.
Frequent and consistent community-based Meetings
Host meetings at popular places in town. The meetings will be informal and are surrounded around the idea that healthcare professionals (registered dietitians, nurses, doctors) are available to the residents. This idea comes from the concept of the “Walk with a Doc” program (https://walkwithadoc.org/who-we-are/metrics/). Focusing on having healthcare providers open and available.
The cornerstone of this project is eating healthier and moving more. We can determine best ways to evaluate the outcome by measuring body composition, efficacy in healthy eating, stronger healthcare provider networks, and a trusting relationship between providers and residents.
Emerging research shows that healthcare professionals often do desire to provide exercise and fruit and vegetable prescriptions, when offered and trained to do so (Kearney et.al., 2005) (http://www.countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/policies/exercise-prescriptions) and see legitimate results of patients following through.
There is a misconception that says moving more equals being present at the gym. However, gym time is not the priority, but being ambulatory is. In rural communities, there are many barriers to going to fitness centers multiple times a week. For example, financial, community, transportation barriers are very prevalent as well as in general, lacking the extra time to leave more pressing matters like children or older parents.
Having efficacy in the ability to eat healthfully also includes having food options available for tasting and education at the meetings. This will allow and encourage residents to try new foods and recipes. This is measurable by conducting a pre/post attitudinal survey. The intent of this is to show the resident that the healthier choice can be the easier choice. We want to create and instill habits of choosing an apple over a chocolate bar.
Cultivating a trusting relationship between the providers and residents is measured by the amount of engagement shown by the resident and the provider. This is done by creating an open conversation without predisposed judgements. The goal is to create an even playing ground and to allow a peer-like relationship between both parties.
Taking anthropometric measurements (body mass index, body fat percentage, circumferences) and hand grip strength.
This part of the meeting is optional participation. Our goal is to not make anyone feel uncomfortable. However, an incentive would be that the patient can learn their own health markers and are given ideas on how to decrease/increase BMI and BF%. As well as learn how to increase overall strength and the importance of doing so.
For those with interest in potential gym memberships we create a relationship with a local fitness center that would reduce or totally cover membership dues. Also, health insurers sometimes reduce gym fees in exchange for proof of a healthy lifestyle (https://www.silversneakers.com/anthem/).
Disseminate the knowledge acquired.
Keep detailed notes on meetings and measurements. This is important to tell other what worked and what did not work. By keeping account of how the meetings are ran and where they were located, it will allow the providers of care to reach the most amount of people and make the biggest difference. A major aspect of this is to note some of the most consistent barriers that seem evident for residents. Importantly, some of the barriers that are revealed are not meant for the healthcare providers to handle alone.
Quarterly, create a presentation open to the public, but mainly for community planners. Therefore, the information and results gathered are constantly being disseminated. While creating the presentation, I will utilize the SBAR method (key insight 3). Within the presentation, have recommendations based off of residents and my own research (key insight 2). Thus, the presenting aspect acts as translational science (key insight 1).
Evaluation:
We will never arrive at success, yet that gives us the opportunity to continue to strive towards it. I will know that success is coming when there is a change in outcomes in the rural communities. I use ‘is coming’ because, like most things in the Public Health sector, this action plan will be continuous with the goal of constant improvement. We as a community cannot climb the ladder to advance in our health if access to information is limited. Once we begin the process of breaking that barrier there is a domino effect in increased knowledge, positive attitude towards healthy lifestyles, individual self-efficacy, and planned intention. Those four attributes are the foundation for change. My hope is with more residents seeing how small decisions affect large outcomes, there will be more open communication between healthcare providers and the residents of the community. The only way to cultivate that relationship is to first foster a new setting where healthcare providers and patients are tearing down the hierarchy and practicing a round-table approach to healthy living.
I will know improvements have been made when (as a community) BMI and other percentages are presenting themselves as lower, and the residents of that area understand (and are excited) about the positive direction their futures are moving in.
Closing Thoughts:
Overall health is something that I am very passionate about. Working in correlation for a public health awareness campaign is something I have dabbled in but would love an opportunity to fully dive in at the ground level and go out in the field and help to inspire and educate residents on how important it is to take care of your body.