Baptist Health Nassau Community Health Needs Assessment Priorities Implementation Plans Health Disparities Heart Disease Stroke Hypertension Diabetes Adult Type II Preventive Health Care Smoking and Smokeless Tobacco Nutrition Mammography Physical Activity Built Environment Access to Food 1
Baptist Medical Center Nassau 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 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 104.2 deaths/100,000 population Duval 117.3 deaths/100,000 population Clay 117.6 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: Increase the number of adults screened for heart disease by 10% in year one, 15% in year two and 20% in year three. Increase the awareness of the risk of untreated and undiagnosed heart disease by comparing pre and post testing results. Will increase learning of signs 2
afford 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. Provide education and information on how to access low cost or free medication for the uninsured and underinsured. Multifaceted 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. and symptoms of heart disease in the targeted population as demonstrated by increase scores comparing the pre and post test results. Hold 2 additional education sessions on heart health in the assessed areas. Hold 2additional education sessions on stroke signs and symptoms. 3
Baptist Medical Center Nassau 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 on-site education sessions and in collaboration with local faithbased partners and other organizations. Provide diabetes and pre-diabetes screening at health fairs. Work with the American Diabetes Association to promote awareness and educate the. CDC Diabetes Prevention and Control: Self- Management Education by diabetes educators. The Diabetes Self- Management Program Educates diabetics on techniques to manage symptoms, communicate with health care providers, and make informed decisions. CDC Prediabetes Screening Test Helps users learn whether they are at risk for prediabetes Adults with Diabetes Nassau 6.8% Duval = 11.4% St. Johns 7.1% Clay 8.8% 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 10% in 2013. 4
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. Provide information on how to access low cost or free medication for the uninsured and underinsured. and type 2 diabetes For 2013, Screen 100 adults for prediabetes by using the Centers for Disease Control Pre- Diabetes Screening Tool. For 2013, Increase learning of underserved or uninsured adults regarding diabetes signs and symptoms as measured by increased scores comparing pre and post tests. 5
Baptist Medical Center Nassau 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 Provide support to local wellness coalitions in their efforts to improve nutrition by providing support for local gardens. Work with our faith-based partners by providing healthy nutrition classes for members of their congregations and the surrounding. 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 Nassau = 60.5% Duval = 64.4% St. Johns = 62.6% Clay = 67.2% 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 participants learning of preparing healthy meals in the targeted population as demonstrated by increase scores 6
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. comparing pre and post test results. For those attending the nutrition classes, 50% of the participants will demonstrate an increased understandin g of how to read food labels for its nutritious value by increased scores comparing pre and post test. 7
Baptist Medical Center Nassau 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 Provide education classes on early detection of breast cancer and breast health for the high risk women. Provide follow up phone calls to for women 50 70 to increase breast cancer screening. Provide breast health information literature at health fairs and other health events. Prevention Care Management The Prevention Care Management program is a centralized telephone system to increase cancer screenings among women aged 50-69 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 > 120.7 Green <= 110.4 In-between = Yellow Unit: cases/100,000 females Nassau = 142.7 cases/100,000 females Duval = 129.7 cases/100,000 females St. Johns = 129.0 cases/100,000 females Clay = 108.1 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 As compared to 2012, hold at least 2 additional 8
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. screening services. Coalition includes faithbased partners and health professionals. education classes on early detection of breast cancer and breast health for the high risk women in the beaches. In 2013, increase the learning of the targeted population regarding the risks of untreated and undiagnosed breast cancer as measured by comparing pre and post tests. Provide health information on breast health in the targeted high risk assessed areas for 200 women. 9
Baptist Medical Center Nassau 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. 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 Nassau = 19.3% Duval =18.6 % St. Johns = 11.9% Clay = 20.8% 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 10
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. 3. For 2013, a total of 100 middle and high school students will be provided with tobacco facts and other information through schools, faith partners and other youth organizations. 11
Baptist Medical Center Nassau 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 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. Implement a Healthy Communities Walking Program in the assessed area in collaboration with faithbased partners and other organizations and members. CDC 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. Adults who are Overweight or Obese Red > 70.1 Green <= 67.2 In-between = Yellow Unit: percent Nassau = 60.5% Duval = 64.4% St. Johns = 62.6% Clay = 67.2% Process Track and monitor individual participant exercise time. Short Term Track and document adults engaging weekly in moderate exercise. Long Term Evaluation Implement the Healthy Communities Walking Group Program to 3 faith-based partners in year one. Recruit 15 members to began the Walking program in year one. Increase the number of participants by 12
13 10% in year two and 10% in year 3.