“Erase the Stigma by Breaking the Silence”

The following blog piece was written by Dr. Bobbi Holt-Ragler. She is a Community Health Advocate (CHA) with the Center for Healthy Communities-Center of Excellence for Health Disparities. She uses her skills as an educator and nurse to raise awareness about health issues that plague her community. Her contributions to the Center and her community are always appreciated.

Recently, we have been saturated with media coverage of acts of assault and vicious acts of violence committed on innocent people. Also, live streaming of suicide has become a common trend.  One may draw the conclusion that such actions by some of these individuals committing the crime may have been the result of a mental health issue. While we may not be certain of this fact; however, it raises many questions. Such as, were there any red flags or warning signs that were missed by family members and loved ones?  Also, were there any attempts made to obtain professional help; was professional help offered or made available to them?  Some of these questions may never be answered and will forever remain a mystery.

As a responsible citizen, we can no longer keep silent to the issues of mental health, but we must take action to raise the awareness of the problem.

Our nation has been in crisis for quite some time regarding mental health.  According to the 2017 Mental Health Report, there are over 40 million people that are struggling with a mental health problem; however, only half of these individuals receive the needed treatment.  In addition, the number of mental health professionals has decreased, and the number of teen suicide rate has increased.

Why is this so?  We can conclude that the stigmas regarding mental illness still exist.  Also, less attention has been given to the problem and there is a lack of available resources. Can we continue in silence? The answer is no.  If mental health is openly discussed as other health conditions such as heart disease and diabetes, perhaps more attention will be given to management and treatment of the problem. We advocate the importance of saving lives and the need to know CPR for heart attack, know your numbers for your blood pressure, and how to recognize a stroke with F.A.S.T.  So, why can’t we advocate for more education on mental health and encourage more community education on the recognition of signs and symptoms of a mental health crisis?  This approach may help to erase the stigma and offer an opportunity to learn more about how to access community resources.  

The media has drawn attention to the need for open dialog on mental health.  What we are witnessing daily on social media will require each of us to step out of the silence mode and talk more to heighten the awareness of the fact that there is more work to be done with our mental health system.

CHA’s Go Red

CHA eventHeart 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.

CHA Interview with Gloria Carter, RN

chaheartThe 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.

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. 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.

USA Community Health Advocates Build Garden for Local Residents

Shout out to the Med School Watercooler from the University of South Alabama College of Medicine for highlighting the work of Community Health Advocates:

Frewin Osteen and Judy Johnson, community health advocates (CHAs) for the University of South Alabama Center for Healthy Communities (CHC), are the creators of a community garden at Ridge Manor Apartments located in Whistler, Ala.


CHAs assist their communities by bringing awareness and education to specific health issues. They are volunteers who work with the USA Center for Healthy Communities to support the fight against health disparity and promote a healthy lifestyle to those in need.


Osteen, a social worker in Prichard, Ala., and Johnson, a resident of Ridge Manor, wanted to give the elderly and disabled population a chance to participate in a community garden. “Improving the health and well-being of local residents was one of the aims when building the community garden,” Osteen said. “Gardening was something many of the residents expressed an interest in, but they simply did not have access to any of the tools or space to do so.”


Ten raised garden beds were built with the help of residents and volunteers in the community. “The gardens get residents doing something they enjoy, and as a result they are becoming more active,” Osteen said. “The gardens are just the right size as to not overwhelm the residents participating.”


After applying with the garden committee and signing a contract stating that they will respect and maintain their assigned space, residents who work in the garden are each assigned a bed of their own.


Osteen hopes that by growing and learning about vegetables in their gardens, residents will also learn the importance of nutrition and consume healthier foods. “If we show residents how to grow vegetables, plus how to prepare and eat them, then I think we benefit the community and their health,” Osteen said.


Read the full article.

CHA Led Project: Container Gardening

container-1On November 11, 2016, Barbara Hodnett, Community Health Worker (CHA) with the Center for Healthy Communities, launched the container gardening project at Bethel AME Church. Design to help individuals living on low/fixed incomes and land poor or apartment dwellers, the container project provides an opportunity for participants to learn:

  • How to build a container garden
  • How to plant and care for their gardens, including herb gardens and how to grow plants from seeds
  • How to use recycled household products for gardening

The series of four classes are being taught by Denise Heubach of the Mobile County officecontainer-2 of the Alabama Cooperative Extension System. The goal is to improve the nutritional food value for families at a lower cost while also assisting participants to increase their self-efficacy. Ms. Hodnett hopes to publish a cookbook from recipes submitted by participants in the container gardening project.

Learn more about the CHA program.

Gardening to Achieve Health and Build Relationships

constructing-bedsOn October 26, 2016, the
Community Health Advocate (CHA) led community garden project in the Ridge Manor Apartment homes held a blessing ceremony to launch the project. Attendees also planted the first seeds and plants in the new garden. Developed by CHAs Frewin Osteen and Judy Johnson, the project focuses on three objectives:

  • Improve healthful food consumption by providing opportunities for homegrown fresh fruits and vegetables
  • Promote intergenerational activities in which participants from diverse age groups, races, and cultures can cultivate new experiences
  • Promote both physical and mental health through: healthful food production, physical movement, urban ecosystem, intergenerational and intercultural opportunities, and horticultural therapy.

filling-bedsTo be truly community based, the project leader and partners reached out to Ridge
Manor residents to form a gardening committee and developed relationships with local schools, government,  business, and churches to build a broad coalition of support for the project. Community partners include:

Activities related to the community garden include:

  • The construction of raised beds and boxes to allow those with disabilities and older adults to participate. Up to 20 families living in Ridge Manor will have a garden plot.
  • Instruction on best practices of gardening and plant care for all participants
  • Weekly opportunities for interaction for gardeners, community partners, and participating youth to discuss progress.
  • Healthy food preparation demonstrations

The community garden is a CHA led project with support from the Center for Healthy Communities.

September HDRG Recap: Sustaining Community Health Advocates for the Long-term

At the September 16, 2016, meeting of the Health Disparities Research Group, Ms. Sarah Wraight, graduate research assistant with the Center for Healthy Communities and Master’s candidate in the department of Sociology, Anthropology, and Social Work, together with

Ms. Candis Patterson, Health Education Specialist with the Center for Healthy Communities, presented “Will they stay or will they go? Long term commitment to a community health advocacy program.” Based on interviews with the several of the longest serving  and currently active Community Health Advocates (CHA), their presentation explored the factors that allowed this group of CHAs to continue working with the Center for Healthy Communities through the more than 10 years of the program’s history.

In describing the elements that have contributed to their continued relationship with the CHC, Ms. Wraight and Ms. Patterson discussed their findings with special emphasis on three key themes:

  • Spirituality and Community Trust
    • Support provided by individual pastors and churches
    • Key church ministries where CHAs can plug in the health advocacy work
    • Churches provide gathering place considered trustworthy and safe, providing an open space for health education activities
  • Self and Collective Efficacy
    • Pride in being able to give to their own community
    • Desire to pass the torch along to other individuals to continue the work
  • Professionalism and Networking
    • Professionalism comes from the support of the University staff in training and providing assistance with CHA events
    • Meetings and program activities provide opportunities to meet and brainstorm ideas for future projects

Ms. Wraight and Ms. Patterson also explained that in addition to describing the factors that kept them connected to the program, the CHAs interviewed shared their goals for future health advocacy efforts.  The strongest themes regarding future CHA work included:

  • Developing more partnerships with organizations and institutions in Mobile
  • Moving into advocacy to directly influence policy change
  • Addressing mental health issues

The presentation was based on a poster presentation given by Ms. Wraight, Dr. Roma Hanks (Co-Director of the Community Engagement Core with the Center for Healthy Communities and Chair of the Department of Sociology, Anthropology, and Social Work), and Ms. Patterson at the Women’s Health Update Conference held at UAB in August. Dr. Hanks, who was unable to attend the HDRG meeting, has directed the CHA work for several years and designed the project methodology used for the research presented in the poster. They are currently drafting a manuscript to further detail their research on the continuity of the CHAs.

Read more about the work of the CHA program.

Educating the Community for Better Health Outcomes

The Community Health Advocate (CHA) program provides motivated community members with training and resources to become active contributors and participants in activities addressing health needs in their communities. As a part of the program, CHA’s are encouraged to identify health concerns and develop their own strategies/programs for addressing these with support from the Center for Healthy Communities. Four CHA sponsored events held in June 2016 demonstrate the breadth of issues addressed by the CHAs.

CHA Courtney Williams June 2016 Cropped
Courtney Williams speaking at June 2 Disaster Preparedness workshop.

On June 2, 2016, CHAs Courtney Williams and Latika Muhammad hosted a Disaster Preparedness workshop at the Toulminville library in Mobile, AL. During the workshop, both women stressed the importance of preventing medical issues by being properly prepared. To that end, the workshop covered:

  • Creating a family disaster plan and ensuring that each member of the family knows the plan thoroughly
  • Preparing medications (type and amount) in the event of an evacuation order
  • Knowing the contact information for local emergency contacts

In closing the workshop, Courtney invited participants to register for CPR training.

On June 6, 2016, CHA Gloria Carter hosted a workshop titled “Lewy Body Disease and Other Dementias” at the Revelation Missionary Baptist Church. Facilitated by Kitty Bradshaw, an RN with Covenant Care, the workshop provided participants sought to help participants understand the signs and stages of different types of Dementia. The topic was important as Dementia is often not talked about; and many caretakers for Dementia sufferers are family members. Often this caretaker will ignore his/her own needs while focusing on their loved one. This can negatively affect their own health status through neglecting to take medications, developing poor eating habits and experiencing depression and anxiety. During the workshop, Ms. Bradshaw mentioned that often times the person suffering from dementia outlives the caretaker.  Eligible workshop participants received continuing education credits toward their nursing or social work licenses.

MrsPritchett Bloodpressure edited
CHA Ernestine Pritchett having her blood pressure checked at the Health Fair.

On the 18th of June, CHA Barbara Hodnett hosted a “Health Fair for the Homeless” at Bethel A.M.E. church. Through the event participants received information on health issues impacting the group. The health fair featured:

  • a mental health station staffed by psychologist to provide information on mental health issue including stress, anxiety, and depression
  • A diabetes discussion station
  • A blood pressure screening station.

On June 25th, CHA Ernestine Pritchett continued the theme of disaster preparedness by hosting “How to Survive a Hurricane” at St. Joseph Missionary Baptist Church. The event focused on educating community members on what to do in case of a severe hurricane and other natural disasters. The American Red Cross and the Mobile County Emergency Management Agency were invited to teach survival training.

These events provide a snapshot of the activities undertaken by CHAs. Visit our website to learn more about the CHA program.

Bringing Community Health Advocates together for Networking and Sharing

CHAs attending the August 29 retreat.

On August 29, 2016, the Community Engagement Core of the Center for Healthy Communities  (CHC) hosted a retreat for Community Health Advocates (CHA) at 5 Rivers Delta Resource Center in Spanish Fort, AL. Titled Crossing Bridges We Have Built, the retreat focused on the longevity and sustainability of the CHA program which has been active for 10 years or more.

Speakers for the day addressed the sustainability of the CHA program as well as provided resources for participants. Sessions included:

  • An icebreaker session conducted by Dr. Roma Hanks which got the ball rolling with introductions and a great networking opportunity among the close to 15 CHAs participating in the event.
  • Shannon Shelley-Tremblay, project manager for CHC, provided an overview of university resources available to the CHAs as well as tips for navigating through the CHC webpage.
  • Sarah Wraight, a graduate research assistant in Sociology, presented the poster  highlighting some of the reasons why the CA program has experienced longevity.
  • Theresa McPhereson, an active CHA, led the group in relaxation techniques and encouraged them to find time for self-care.
  • David Stout, from the non-profit Alabama Arise, spoke to the group on advocacy and changes in Medicaid affecting the state.

    Mitchell Greene presenting his PowerPoint.
  • STARS and STRIPES participants Ja’Dasia Johnson and Mitchell Greene capped the  day by showcasing their PowerPoint presentations on heart disease and diabetes.

Advocacy and Empowerment for Change

With a focus on education and community empowerment, the Community Outreach Core of the Center for Healthy Communities (CHC) Center of Excellence strives to engage community members as active participants and contributors to activities and programs developed to address health issues and promote disease prevention activities. To that end, the Community Health Advocate (CHA) program offers an opportunity to actively cooperate with the CHC in identifying health priorities and developing strategies for addressing those priorities  to individuals living within health disparate zip codes of Mobile County, Alabama.

Community Health Advocate (CHA) Program

Initiated in 2006, the CHA program provides an introductory online training program to equip new volunteers to respond to basic health issues and disease specific questions in their communities. Beyond the introductory training, each CHA is encouraged to seek out and attend trainings in regional and local meetings in order to further develop knowledge and skills as well as learn about new programs for addressing needs in their communities. Monthly meetings provide opportunities for CHAs to interact with each other and CHC staff. Through these regular gatherings, CHAs can learn about upcoming events, discuss issues they are encountering, share ideas about possible new initiatives, and develop partnerships for future work.

In terms of outreach, CHAs have many opportunities for sharing the knowledge and tools that they have developed. While some activities are CHC-sponsored outreach events, CHAs also participate in health ministry events in local churches, health fairs, and health disparity workshops. CHAs are also encouraged to develop their own outreach activities with access to support and feedback from CHC staff. Given the community-based focus and collaborative values built into the CHA program, it has provided various types of services to the community over its 10 year history.

Youth CHA (YCHA) Program. The impetus for the YCHA program came from adult CHAs who expressed concern for young people in their community especially in terms of incorrect health information shared among youth and health disparities such as underweight births, the incidence of HIV, childhood obesity and poor nutrition.

CHA-Directed Projects. This CHC-supported  program encourages CHAs to use the knowledge gained in training combined with their cultural knowledge to design, implement and evaluate programs within their community. CHC supports CHAs with program development training and mentoring in grant writing. A new opportunity for CHA-led projects will launch in mid-2016.

In our next edition of the CHC Advocate, we look forward to spotlighting our newest team member–Candis Patterson who joined the CHC as the Health Education Specialist in late April.

To join the CHA program, contact: Dr. Roma Hanks (rhanks@southalabama.edu) or call (251)-460-6020.