The 2017 STARS and STRIPES program launched on June 12th with an orientation session introducing students and parents to program instructors and staff. Ms. Mary Williams, Center for Healthy Communities (CHC) community outreach coordinator, opened the event and provided an overview of what all participants could expect over the summer and introduced the instructors and program assistants for the 2017 session.
In welcoming the students, Dr.Errol Crook, Director and Principal Investigator for the CHC, encouraged the young people to take advantage of the opportunities ahead of them and support each other through the program and future challenges as they move on to college and into careers in the medical sciences. He stressed that the CHC focuses on health disparities and sees education and knowledge building as a key component of helping communities to develop their own capacity to advocate for equity and improvement.
Drawing on her experiences as an immigrant to the United States, Dr. Martha Arrieta, Director of Research Core, continued the theme of encouraging the STARS and STRIPES participants to take their futures into their own hands and to make the most of their participation in the program. She also challenged the group to remain curious; explaining that curiosity is the foundational principle of research. In asking the questions — specifically what, when, where, who, and why — researchers move forward in identifying problems and finding solutions.
Mary Williams welcoming the STARS and STRIPES students.
After the greetings, Ms. Williams introduced the program assistants and instructors who intern explained the program of study for the summer:
The Sentinel Surveillance to Monitor Progress toward Health Equity project aims to develop and implement a surveillance system to capture the information necessary to monitor progress towards health equity for health disparate populations. One key element of this project is the engagement of community members through a Community Advisory Board (CAB). Recently, Mrs. Leevones Fisher, a community activist and member of the CAB, shared a little about her reasons for participating in the CAB and the importance of continued investment in research.
Tell us a little bit about yourself and your background.
I grew up in the Trinity Gardens community of Mobile, AL. My family of nine consisted of mom, dad, and six siblings. After attending school at Trinity Lutheran School and graduating from Trinity Gardens High School, I did undergraduate studies at Talladega College where I majored in chemistry with a minor in math. After receiving my degree, I moved to Atlanta, GA, to teach school for five years. I returned to Mobile when my mother fell ill with cancer. I started working in Alabama, married and had one son. I’ve been in Mobile ever since.
I stared the Bay Area Women Coalition (BAWC) in 1997 in response to the many problems with crime in the neighborhood. My brother had been murdered. The children of friends had been murdered. Crime in our community was bad at that time with police and service workers afraid to come into the neighborhood. As a result of the organizations advocacy and focus on improved housing, the crime rate has gone down. We’ve constructed 50 new homes and build two affordable housing subdivisions – with one made up of apartments for seniors. We’ve also renovated or repaired over 400 houses and are currently working with community gardens to improve access to healthy food.
How did you become involved with the Community Advisory Board for the Sentinel Surveillance Project?
It all started when I attended a workshop at Bishop State Community College 10 years ago. Dr. Crook and Dr. Arrieta came to the workshop to talk about health. I talked to them about health and how the university needs to be more involved with the community. The relationships shouldn’t be a one-way thing.
Why did you decide to become part of the CAB?
One reason I joined the CAB is I wanted to give my opinion on the neighborhood and what is happening as a community member. Being a apart of the group provided an opportunity to see things improve and grow; and I wanted to monitor the growth of the impact the project would have on the community.
Give us a few highlights of your time as a CAB member. Is there any one memory that stands out?
One thing that stands out is when I got the chance to go to the national conference and meet others from across the country and share during the poster session. It was an eye-opening experience to find out that so many people were interested in what we are doing.
What community needs are you most concerned about?
Health is a big concern, especially women’s health. Most of the women in our community are the heads of households and they are not in good health. When we don’t take care of ourselves, it means that we are not taking good care of our family.
How do you see the sentinel surveillance project addressing these issues in the community?
Poor housing is a big issue. But, I’ve learned that health is also one of the main issues. Poor housing and poor health go together. If people are not healthy, they don’t care about the housing part. They are just trying to get well. Health helps housing and housing helps health. The two go together. Poor health means that you can’t keep up your house.
Have you ever been involved in research before, if so how is this similar or different?
Yes has been involved in research before this project. I did a lot with with the College of Business, Dr. Semon Chang. He had us go door to door to do an assessment of the community, a housing assessment. With Dr. Ken Hudson, we tried to figure out why the housing and health issues were such a detriment in the neighborhood. Both surveys were done because we had gone out to find the information we needed to make a change on the housing issue. The impact was we learned that poor housing had an impact on health conditions. This led to trying to find out what could be done about health conditions.
What have you learned about research through this process?
It has to continue. When you start looking at one thing, you find something else that has to be addressed. We need to continue investing in research to address issues in the community with people. Housing work led to health research, and we learned that it is big and needs to be narrowed down to certain areas. There are so many issues with health, which is very different than housing. So we must continue researching to understand the issues and how they work together and how they can be addressed.
Has the experience changed the way you consider or approach research in other areas of your life?
Yes… keep researching looking at every facet from infancy to old age. Pick an age and you can research and find out so many fascinating facts about that age. Whether it is finance or spiritual needs, there is so much that can be researched. I used to think of research as trying to find a cure for cancer or something. But, it is multifaceted.
Would you encourage others people in your life to participate in or be a part of leading/shaping research projects as a result of your involvement with Sentinel Surveillance?
I would. I would like for them to be a part of it not just because they are receiving something; but, because they want to see a different in their community. We need to research how this could happen. I think of President Kennedy saying, “Ask not what your country can do for you – ask what you can do for your country.” This always resonated in my mind because most people when asked to participate in research want something in return.
Any final thoughts on research.
We need to keep the ball rolling because I don’t think the need for research will ever end.
Dr. Hudson began his talk by outlining the theoretical foundations of and major influences on his work. Citing the work of Dr. William Julius Wilson on race and labor markets and the work of Clayton and Byrd on the history of minority health disparities, Dr. Hudson outlined three eras in American history focusing on race and labor relations, and the provision of medical care. After the civil rights movement, institutions such as hospitals couldn’t overtly discriminate on race, but they could, however, discriminate based on the ability to pay. Currently, the primary mechanism for covering the cost of health care in the United States is health insurance, which is usually provided by either an employer, family members, or a government program such as Medicare or Medicaid.
Within this context, Dr. Hudson relayed the findings from his team’s analysis of the health insurance data from the CPS. The findings reaffirmed what was already known; the ACA substantially reduced the rate of uninsured Americans. They also found that the expansion of Medicaid was the primary mechanism for this reduction, even though 19 states chose not to participate in the Medicaid expansion program..
Dr. Hudson and his team are currently preparing their findings for publication.
On Friday, March 31, 2017, Dr. Hattie Myles is retiring from her role as the Assistant Dean for Student Affairs and Educational Enrichment at the University of South Alabama College of Medicine. Over her long tenure with the University, Dr. Myles has led many critical initiatives. The Center for Healthy Communities (CHC) is particularly thankful to Dr. Myles for her service as Co-Core Director of the Community Outreach Core for the Center for Healthy Communities’ Center of Excellence in Health Disparities. For over 10 years Dr. Myles has spearheaded the CHC’s Pipeline Program which has encouraged, supported, trained, and mentored high school and undergraduate students from health disparate communities as they have pursued college preparation, undergraduate and graduate education, and career paths in the biomedical professions. She has made a tremendous impact on the lives of countless students. We are proud of all she has accomplished and wish her the best in her well-deserved retirement.
The College of Medicine is hosting a retirement reception for Dr. Myles on Friday, March 31, 2017, from 3 to 5 p.m. at the Terrace on the second floor of the USA Student Center.
Heart Disease is the leading cause of death for women nationwide and it is often linked to other chronic diseases such as diabetes. Go Red for Women is an annual month-long advocacy campaign developed by the American Heart Association with the goal of “encouraging awareness of the issue of women and heart disease” and “challenge women to know their risk for heart disease and take action to reduce their personal risk.” Continuing an annual tradition as part of 2017 Go Red for Women, Community Health Advocates (CHA) have worked with partners to sponsor events around the topic of women and heart disease.
On February 4th, CHA Barbara Hodnett hosted the hosted the Annual Go Red for Women Tea with the Good Samaritan Health Ministry at Bethel A.M.E. church. Kierra Giles, a student at UMS-Wright, spoke to the group about the importance of taking a proactive stance on heart disease.
CHA Ernestine Pritchett hosted a Go Red event at St. Joseph Missionary Baptist Church on February 11th. Speakers included Dr. Bobbi Holt-Raggler, Shelia Ross, and Reginald Andrews. They covered the topics of
Hypertension and hypotension
Stroke and stroke prevention
Living with a battery operated heart
An event hosted by CHA Gloria Carter on February 12th at Revelation Missionary Baptist Church featured Dr. Barbara Mitchell speaking with participants about heart disease. Health screenings were provided after the event.
The Annual Go Red Heart Disease program at the Greater Allenville A.O.H. Church was hosted by Yolanda Anderson, Sharon Pugh, and Dr. Bobbi Holt-Raggler on February 16th. Dr. Brenda Rigsby with ABClinic Family Cares, Inc. spoke on heart disease prevention and management, and Dr. Jackie Smith gave a presentation on how to manage stress.
See our website for more information on the CHA program.
On January 13, 2017, the Center for Healthy Communities hosted its second forum on community-engaged scholarship, Strengthening the Community Engaged Research and Scholarship “Tool Box”. The one day event featured presentations, group engagement activities, and posters by researchers, students, and community members reflecting on the importance and value of community-engaged research.
Collaborating with co-researchers (community members) about research questions and considering a topic/issue of importance to tem
Maintaining the collaborative spirit through each phase of a project
Working with an idea of making social change and helping improve health
Improving relevance and trusted connections in the community through working with a team
Including the needs and realities of all community partners when planning for logistics, etc.
Stressing the need to ensure community dissemination is done and incorporates opportunity and authentic feedback
In their afternoon session, Jaquez and Vaughn focused on developing tools for community engaged-scholarship.They started by exploring the way researchers often understand communities and the need to alter this understanding so to recognize the strengths that already exist in the community. With this context, the speakers took the group of approximately 100 attendees through an interactive exercise in which groups provided one to three word answers to a series of five questions. Jaquez and Vaughn then mapped the responses into categories such as resources, institutional commitment, individual skills, sustainable goals and outcomes, relationships, and communication.
Dr. John C. Higginbotham from the University of Alabama rounded out the afternoon with his presentation “Photovoice, speed dating, and other things for working with communities.” Dr. Higginbotham used stories of projects in Alabama’s Black Belt to describe key elements of community-engaged research and the need for flexibility and creativity when working together. One example described a project in which researchers were to make presentations to community members about possible projects or partnerships. However, the in-person presentations were not best mechanism for the community members. So, to bridge the gap between researchers and community members, Dr. Higginbotham’s program allowed each researchers to make a three-minute video and then provided those videos online for community members to watch and decide who they wanted to work with. Throughout his presentation, Dr. Higginbotham stressed the need to incorporate community voices into decision-making both in the designing of research initiatives and the development of product arising out of those initiatives.
The program also spotlighted speakers from the USA community who shared their perspectives and experience with engaged research. Their presentations included:
According to one participant, the forum provided “a great opportunity for all of us to come together and learn from each other’s experiences, develop new networks, and build connections.” Another said, “…I certainly left inspired to continue work in this area.”
Videos from Strengthening the Community Engaged Research and Scholarship “Tool Box” are available on the CHC website.
The Center for Healthy Communities Education Pipe-Line program provides opportunities for rising high school juniors from underrepresented communities to participate in an intensive summer training program. Consisting of two phases — Student Training for Academic Reinforcement in the Sciences (STARS for rising juniors) and Special Training to Raise Interest and Prepare for Entry into the Sciences (STRIPES for rising seniors) — the program engages students in team-based learning to increase their knowledge base in the sciences by developing critical reading, thinking, and analysis skills in preparation for college pre-health pursuits. Funded as a part of the NIMHD Center for Excellence, the Program activities include:
Academic enrichment sessions during the summer
Participation in community service activities and health advocacy
An eight week internship in a health care provision site or a medical research facility upon high school graduation
The Community Health Advocate (CHA) program invites community members to actively cooperate with the Center for Healthy Communities (CHC) in identifying health priorities and developing strategies for addressing those priorities to individuals living within health disparate zip codes of Mobile County, AL. Recently, long serving CHA, Ms. Gloria Carter, shared a little about her experience in the program.
Tell us a little bit about yourself and your background.
I am a proud graduate of Lillie B. Williamson High School, class of 1968. I completed my LPN studies at Southwest State Technical Institute (now Bishop State Southwest Campus) in 1970. I completed my Registered Nursing Degree at the Providence School of Nursing in 1974. Additionally, I completed my Bachelors in Science degree in Health, Arts, and Education from the College of St. Francis in 1988. My work history includes Pediatric Intensive Care, Cardiac Care, Medical Surgical Nursing, and Dialysis. Combined, I have over 36 years of experience in Nursing and the Health Care Field.
I am the proud mother of 2 beautiful daughters, Kimberly Carter and Shameka (Micheal Jr.) Crusoe. I am also the proud grandmother of 4 grandchildren (3 boys and1 girl).
I am very active in my Christian Faith as I am a lifelong member of Revelation Missionary Baptist Church under the leadership of Pastor David Frazier. I have serve (d) in the following capacities: Health Ministry President, Matrons Auxillary, Senior Mission, Church School, and Youth Counselor.
How did you become involved as a CHA?
I became involved with the organization around 15 years ago after having a group meeting with Dr. Harvey White.
Why did you decide to join the CHA’s?
I decided to become a CHA as my beliefs aligned with Center for Health Communities and their mission of bridging health disparities within the faith based community and the entire community as a whole.
Can you tell us about projects that you have been involved in.
I have participated in quarterly health seminars, health screenings once a month, community health fairs, and many other volunteer service projects as requested by various organizations.
What has been your greatest experience as a CHA?
My greatest experience has been being able to network and partner with other health entities in spreading health education and wellness in my community.
What are community needs that you are concerned about?
I believe that one of the greatest needs is making the community aware and accessible to resources in order that we might decrease obesity, diabetes, strokes, and other health concerns in children as well as adults.
How do you see the CHA program addressing these issues in the community?
The CHA Program can continue to address these issues in this community by allowing the CHA’s to continuing to network, partner, and present under the leadership of Dr. Crook, Dr. Hanks, Dr. Myles, and Ms. Patterson. Additionally, the CHA Program can continue the opportunity to attend educational programs in order to present this information to the community that we serve to keep them abreast of new information.
Health Disparities Research Group (HDRG) is a multidisciplinary assembly of faculty, students, staff, and community representatives with a vision “to become an integral facilitator in eliminating health disparities through partnerships with our community.” Held the 3rd Friday of each month throughout the academic year, the meetings provide an opportunity to share research and cultivate a positive atmosphere for community-engagement in addressing health disparities.
The CHNA is a requirement for not-for-profit hospitals under the Patient Protection and Affordable Care Act. The assessment, conducted every three years, “should define the community, solicit input regarding the health needs of the community, assess and prioritize those needs, identify relevant resources, and evaluate any actions taken since preceding CHNAs.” To this point, Dr. Shaw and Dr. Bunch explained the methodology for the 2015-2016 CHNA:
Specify the relevant community served by the USA Health System — USA Medical Center, USA Children’s and Women’s Hospital, and Mitchell Cancer Institute
Create a comprehensive demographic profile using secondary data sources that provides information on the makeup of the community and prevalent conditions.
Conduct a telephone survey of individuals living in the defined community (Mobile County)
In discussing the demographic profile, Dr. Bunch pointed out some concerning trends for Mobile county, including:
While the 20% of individuals living below the poverty line remained steady between 2010 and 2015, the percentage of individuals near poverty (100%-149% Federal Poverty Level) increased.
While the percentage of residents who have a high school diploma has increased in the county, it is still far behind the rest of the country in terms of those who obtain a bachelor’s degree.
Infant death rates rose from 7.5 in 2010 to 10.2 in 2014. Among African Americans, the increase was 11.5 in 2010 to 14.4 in 2014.
After the discussion of the demographic profile, Dr. Shaw explained that the telephone survey was modeled on a similar survey that Mobile Infirmary conducted with healthcare providers. They then compared the responses from the provider survey with the community survey. They used two key sampling elements:
General community survey using a standard random digit dialled survey of residents of Mobile County (both landline and cell phones). This segment included 263 respondents from Mobile County.
Focused community survey included 257 respondents from zip codes within Mobile County where most USA Health System patients reside. To be included in this focused sample, the zip code area had to have at least 50 patients visiting either the USA Medical Center or the USA Children’s and Women’s hospital in fiscal year 2015.
The responses from the community survey were compared with those of the Mobile Infirmary provider survey. The responses showed striking differences between community members and healthcare providers on the “features of a healthy community”and “most important health issues;” however, there was considerable agreement between the community and providers over what healthcare services were difficult to obtain in Mobile County.
The final CNHA was presented to the Board of Trustees in August of 2016. Both the report and the recommendations for actions were approved by the board. The researchers commended the Board on its willingness to undertake a stringent assessment process and the development of more focused, quantifiable recommendations for meeting needs.
The 2015-2016 Community Health Needs Assessment is available online from the Health System.