Baptist Health Jacksonville Community Health Needs Assessment Implementation Plans. Health Disparities. Preventive Health Care.

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1 Baptist Health Jacksonville Community Health Needs Assessment Implementation Plans Health Disparities Infant Mortality Prostate Cancer Heart Disease and Stroke Hypertension Diabetes Behavioral Health Preventive Health Care Smoking and Smokeless Tobacco Nutrition Prostate Screening Mammography Built Environment Access to Food/Food Deserts 1

2 Baptist Medical Center Jacksonville Implementation Plan Strategic Priority Adult Type II Diabetes Goal Increase awareness and understanding of diabetes and pre diabetes to reduce morbidity and hospital admission due to diabetes. The Problem Strategies Best Practice Indicator Evaluation Diabetes is the 7th leading cause of death. The total cost of diabetes in 2007 was estimated at $174 billion for the year. Diabetes is the leading cause of kidney failure, new cases of blindness, and non-traumatic lower limb amputations. Diabetes disproportionately affects minority populations and the elderly and its incidence is likely to increase as minority populations grow and the U.S. population becomes older. It is important to diagnose both prediabetes and diabetes early and to provide education regarding self- Offer diabetes and prediabetes screening and education at local churches through faithbased partnerships and other organizations. Work with the American Diabetes Association to promote awareness and educate the. Provide information on how to access low cost or free medication for the uninsured and underinsured. Provide diabetes and prediabetes screening at CDC COMMUNITY GUIDE: Diabetes Prevention and Control: Self- Management Education Advancing Diabetes Self Management: Community Health Center, Inc. CDC Prediabetes Screening Test Helps users learn whether they are at risk for prediabetes and type 2 diabetes Adults with Diabetes Duval = 11.4% Clay 8.8% St. Johns 7.1% Nassau 6.8% Process Document and track participants who present with abnormal glucose levels. Short Term Ensure follow up with PCP. If no known PCP, provide referral to ensure treatment is provided. Long Term As compared to 2012, Increase the number of underserved or uninsured adults screened for diabetes by 20% in For 2013, Screen 500 adults for prediabetes by using the Centers for Disease Control Pre-Diabetes Screening Tool. For 2013, Increase 2

3 management strategies and lifestyle changes. Why is it a problem? The lack of access to routine primary care and diabetes self-management education, along with the inability to afford medications and diabetes testing supplies makes it more difficult for people with diabetes to optimally control diabetes. events such as the American Diabetes Association Diabetes Expo, Women's Heart Connection, health fairs, etc. learning of underserved or uninsured adults regarding diabetes signs and symptoms as measured by increased scores comparing pre and post tests. 3

4 Baptist Medical Center Jacksonville Implementation Plan Strategic Priority Heart Disease and Stroke Goal Increase awareness and understanding of heart disease and stroke in the underserved population. Reduce unnecessary hospital admission due to heart disease or stroke in the underserved population. The Problem Strategies Best Practice Indicator Evaluation Heart disease and stroke are the leading causes of death in all counties in the region. Heart disease is also very costly economically with projected costs in 2010 of $316 billion on health care services, medications, and lost productivity. Why is it a problem? Unhealthy diet, lack of exercise, being overweight and smoking causes the problem. The lack of access to care such as routine primary care physician visits and the inability to afford Offer blood pressure and cholesterol screening at local churches through faith based partnerships. Provide heart health education, blood pressure, cholesterol, weight, and BMI screening though the Women s Heart Connection event. Work with the American Heart Association to promote awareness of the impact of heart disease. Offer Enhancing Heart Health for Seniors program to Hearts for Life: Provides screening and increase knowledge of cardiovascular risk factors and encourage healthy cardiovascular behaviors. The Heart Truth aims to inform women about heart disease; particularly women aged 40 to 60 and women of color, who are at higher risk of heart disease. Age-Adjusted Death Rate due to Coronary Heart Disease Nassau: deaths/100,000 population Clay: deaths/100,000 population Duval: deaths/100,000 population St Johns: 70.5 deaths/100,000 population Process Document heart health screening results Short Term Monitor referrals made to PCP or EMS for abnormal values. Long Term Evaluations: As compared to 2012, increase the number of adults screened for heart disease by 10% in year one, 15% in year two and 20% in year three. In 2013 Increase the targeted adult population s awareness of the risk of untreated and undiagnosed heart disease as measured by comparing pre and post testing results. 4

5 prescription medications also exacerbates the problem. older adults through senior centers, our faith partners, and other organizations. Provide stroke Education specific to signs and symptoms for the underserved. Media Campaign on the Warning Signs of Stroke The goal of this media campaign was to increase public knowledge of the warning signs of stroke. In 2013, increase the targeted adult population s learning of signs and symptoms of heart disease as measured by increased scores comparing pre and post test results. Provide education and information on how to access low cost or free medication for the uninsured and underinsured. 5

6 Baptist Medical Center Jacksonville Implementation Plan Strategic Priority Infant Mortality Goal To reduce the high infant mortality rate in the assessed areas. The Problem Strategies Best Practice Indicator Evaluation Duval County has a high rate of neonatal intensive care beds compared to the state. The rate of low birth weight babies was the highest in Duval and Putnam counties. Duval County had the highest infant mortality rate for St. Johns and Clay counties had the lowest infant mortality rate for Why is it a problem? Infant mortality is an important measure used to compare the health and well-being of populations across various geographical regions and among races. It continues to be one of the most widely used indicators of the overall health status of a. Facilitate group counseling sessions for new mothers who are experiencing difficulty adjusting to parenthood. Work with the Healthy Start Coalition to provide the Nurse Family Partnership that employs nurse home visitors who support first time mother s health during pregnancy, care of their child, and their own personal growth and development. Provide parenting classes with emphasis on safe sleep in vulnerable communities in collaboration Franklin County Infant Safe Sleep and SIDS Risk Reduction Initiative conducting trainings, promoting infant safe sleep though outreach and advocacy. Nurse-Family Partnership The home visitors focus on improving maternal health, promoting competent parenting, and enhancing parental lifecourse development. Infant Mortality Rate Red > 8.3 Green <= 7.3 In-between = Yellow Unit: deaths/1,000 live births Duval 8.8 deaths/1,000 live births Clay 5.6 deaths/1,000 live births Nassau 7.6 deaths/1,000 live births St Johns 5.4 deaths/1,000 live births Process Document and track expecting and new mother who participate in lactation classes. Document and track participation in safe sleep classes. Document and track success of Nurse Family Partnership. Long Term For participants in the Nurse Family partnership, the infant mortality rate will not exceed 10 deaths per 1,000 live births. Increase learning for those participants in the parenting and breast feeding classes as measured by increased scores comparing pre 6

7 with faith based partners and other organizations. Provide parenting classes and breast feeding basics classes in vulnerable communities in collaboration with faith based partners. Hold infant CPR classes for Family and Friends in the vulnerable assessed areas. and post tests. For 2013?, Hold two, 3-hour CPR classes for the Family and Friends class for the vulnerable assessed target areas that include safety information & practice/validation /check-off of performance of CPR techniques. Participant learning to be evaluated as measured by scores from pre and post test results. 7

8 Baptist Medical Center Jacksonville Implementation Plan Strategic Priority Mammography Goal To detect breast cancer in its earliest stage of development. To educate women in the assessed areas about the importance of regular mammograms. The Problem Strategies Best Practice Indicator Evaluation Aside from nonmelanoma skin cancer, breast cancer is the most common cancer among women in the United States. It is also one of the leading causes of cancer death among women of all races and Hispanic origin populations. Screening prevalence was lower among women with less than a high school education and for women with low income. Insured women had a point higher screening prevalence than uninsured women. Even among women with health insurance, 16% were not Partner with American Cancer Society, the National Football League and faith-based partners to recruit women in Health Zone 1 who meet the criteria for a free mammogram. Partner with Komen Foundation to provide free mammograms for women in the assessed areas who are uninsured and have not had a mammogram with in one year. Provide education on Prevention Care Management The Prevention Care Management program is a centralized telephone system to increase cancer screenings among women aged years. The Alabama Breast and Cervical Cancer Coalition: Works to address the barriers that prevent lowincome women from receiving breast and cervical cancer Breast Cancer Incidence Rate Red > Green <= In-between = Yellow Unit: cases/100,000 females Duval = cases/100,000 females Clay = cases/100,000 females Nassau = cases/100,000 females St. Johns = cases/100,000 females Process Record and track participants who meet the criteria for mammogram. Document number participants who meet the requirements for free a mammogram. Document number participants who required referral for care for continued services. Long Term Recruit 200 women in Health Zone 1 8

9 up-to-date with mammograms. Black women have the highest breast cancer death rates of all racial and ethnic groups and are 40% more likely to die of breast cancer than white women. Why is it a problem? Despite professional recommendation s and public support in favor of regular mammography, only about half of US women get an annual mammogram, even if they have insurance to cover the test. Many have trouble affording the co-pay. early detection of breast cancer and breast health in Health Zone 1 in addition to the other assessed areas. Provide breast health education at health fairs in the assessed areas. screening services. Coalition includes faithbased partners and health professionals. who meet the requirements for a free mammogram. Increase the number of women educated about the risk of untreated and undiagnosed breast cancer by comparing pre and post testing results. 9

10 Baptist Medical Center Jacksonville Implementation Plan Strategic Priority Nutrition and Access to Food Goal To increase the awareness and understanding of the link between a healthy lifestyle and choosing nutritious foods will improve quality of life. The Problem Strategies Best Practice Indicator Evaluation Poor nutrition affects health and longevity, and is associated with numerous chronic diseases among adults. Childhood obesity affects about 25% of children in the United States and increases their likelihood of obesity during adulthood. The levels of overweight people in Clay, Putnam, and St. Johns Counties are above the state level of 37.8 percent. Survey respondents viewed obesity as the most serious health problem in their communities. In the region and in the state, percentages of teens at or above the 95 th percentile in BMI fall between 10 and Working with wellness coalitions and organizations to increase the number of healthy menu items and store displays to enhance access to healthy food choices in restaurants, neighborhood grocers. Provide support to local wellness coalitions in their efforts to improve nutrition by providing support for local gardens. Work with our faith-based Text4Diet a mobile phonebased intervention tool that addresses dietary behaviors. Choosing Healthy And Rewarding Meals (CHARM) School Program The goal is to promote healthy eating habits and teach life skills. Adults who are Overweight or Obese Red > 70.1 Green <= 67.2 In-between = Yellow Unit: percent Duval = 64.4% Clay = 67.2% Nassau = 60.5% St.Johns = 62.6% Process Record the results of pre and post tests implemented to track participants improvement. Short Term Increase the consumption of fruits and vegetables. Long Term In 2013, Increase the learning of the targeted population regarding preparing healthy meals as demonstrated by increased scores comparing pre 10

11 15 percent. St. Johns County is the exception with percentages much lower Why is it a problem? Many factors including inherited, environmental, cultural, and socioeconomic conditions can result in excessive weight gain. A poor diet can increase the risk for lung, esophageal, stomach, colorectal, and prostate cancers. partners by providing healthy nutrition classes for members of their congregations and the surrounding. Partner with Edward Water College to establish a Student Wellness Initiative that provides heart health screenings, physical activity, and nutrition training and education. and post tests. For those attending the Health Nutrition classes, 60% of the participants will report an understanding of the need to increase their consumption of fresh fruits and vegetables by increased scores comparing pre and post test. For those attending the nutrition classes, 50% of the participants will demonstrate an increased understanding of how to read food labels for its nutritious value by increased scores comparing pre and post test. 11

12 Baptist Medical Center Jacksonville Implementation Plan Strategic Priority Physical Activity Goal To increase the amount of physical activity of adults who live in the assessed areas. The Problem Strategies Best Practice Indicator Evaluation Process Implement a Adults who are Healthy Overweight or Track and Communities Obese monitor Walking individual Program in the Red > 70.1 participant assessed area Green <= 67.2 exercise time. In-between = Yellow in collaboration Unit: percent Short Term with faith- based partners Track and and other document adults engaging weekly organizations Duval = 64.4% in moderate and members. exercise. Most people do not get the recommended amount of daily activity. According to guidelines set by the Centers for Disease Control and Prevention, children and adolescents should get 60 minutes or more of physical activity per day, and adults 18 years and older should get 150 minutes of physical activity per week. Why is it a problem? Regular physical activity can help manage weight, reduce the risk for chronic disease, reduce anxiety and stress, and improve blood pressure and cholesterol levels. CDC COMMUNITY GUIDE: Behavioral and Social Support Interventions in Community Setting Focus on changing physical activity behavior through building, strengthening, and maintaining social networks that provide supportive relationships for behavior change. Clay = 67.2% Nassau = 60.5% St. Johns = 62.6% Long Term Evaluation Implement the Healthy Communities Walking Group Program to 3 faith-based partners in year one. Recruit 20 members to began the Walking program in year one. Increase the number of participants by 10% in year two and 10% in year 3. 12

13 Baptist Medical Center Jacksonville Implementation Plan Strategic Priority Smoking Cessation Goal To provide smokers with the support, guidance and resources to help them quit. The Problem Strategies Best Practice Indicator Evaluation Tobacco is the single greatest cause of disease and premature death in America today. The percentage of current smokers is high in comparison to the state level in almost every county in the assessment region. High school cigarette use has increased since 2008 in Clay and Duval Counties, but has decreased in all other counties in the assessment region and the state of Florida. High school students use smokeless tobacco less than cigarettes however its use has almost doubled in Clay, Nassau and St. Johns Counties Partner with the Northeast Florida Area Health Education Centers (AHEC) to provide smoking cessation classes. Quit Smoking Now is a six week program that provides support, guidance and resources to help participants become tobacco free. Provide tobacco facts and cessation literature to middle and high school students in the assessed areas. New York Nicotine Patch Program: Participants receive 6 weeks of nicotine patches and smoking cessation tips and other cessation resources. Adults who Smoke Red > 24.8 Green <= 20.8 In-between = Yellow Unit: percent Duval =18.6 % Clay = 20.8% Nassau = 19.3% St. Johns = 11.9% Process Document the number of sessions completed by participants. Document and track the number of successes Long Term For the smoking cessation program participants, establish a baseline smoking rate and decrease the number of people in the assessed areas who smoke by holding 3 smoking cessation programs in the assessed area in year one. Four smoking cessation programs in year 2 and 6 in year 3. 13

14 Why is it a problem? Smoking is responsible for more than 430,000 deaths each year. Nearly 20% of adult Americans currently smoke, and 3,000 children and adolescents become regular users of tobacco every day. The societal costs of tobacco-related death and disease approach 100 billion dollars each year. For 2013, a total of 500 middle and high school students will be provided with tobacco facts and other information through schools, faith partners and other youth organizations. 14

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