Winning
Proposals
2001-2002 Secretary's Award for Innovations in
Health Promotion and Disease Prevention
St. Louis Medical Waste
Incineration: Community Coalition for Clean Air
Kim Edy
Washington
University in Saint Louis, School of Medicine
Abstract
By burning the plastic in medical waste, incinerators create
dioxin and release toxic mercury into the air. Human exposure
to dioxin correlates with birth defects, diabetes, heart
disease, endometriosis, and cancer. As a clean alternative,
autoclaving (high-pressure steam sterilization) neither
creates dioxin nor releases mercury. A multi-state region
sends nearly 5000 tons of medical waste per year to St.
Louis incinerators. St. Louis suffers from unnecessary exposure
to dioxin and mercury. Also, the incinerator is in a low-income,
low-education, high minority St. Louis neighborhood. In
an environmental injustice, this disadvantaged community
bears the toxic burden for the entire region. Finally, the
debate on medical waste incineration lacks the community's
input. This project has 3 objectives: 1) To improve air
quality by ending medical waste incineration. 2) To end
the health disparity of a disadvantaged neighborhood incinerating
the multi-state region's waste. 3) To increase the community's
control of its environmental health (by education and organization).
To meet these goals, this project will: 1) Raise community
awareness of medical waste incineration. 2) Build a diverse
coalition (of community, students, non-profits). 3) Train
community members as leaders in environmental health. 4)
Build bridges among community, students, business, law,
and non-profits. We used informational community meetings
to build a diverse coalition. Next, we will train community
members in environmental health and advocacy. Our multi-pronged
strategy includes: 1) Educating the sources of medical waste
(hospitals); 2) Helping enact legislation to raise St. Louis'
incineration standards; 3) Helping the community testify
at government hearings. This project trains the community
as leaders, rather than passive recipients of medical service.
We completed much of our strategy. Already, one St. Louis
medical waste incinerator has closed. Finally, this project
builds infrastructure for future environmental health campaigns.
The trained community leaders and coalition will tackle
new environmental health issues long after incineration
ends (and the medical students graduate and leave).
Youth
On Tobacco Advocacy (YOTA)
Robyn Lee and Seema Bhagat
University of Michigan, School of Public Health
Abstract
Youth
On Tobacco Advocacy (YOTA) is a peer education intervention
targeting fifth grade students, in Washtenaw County, MI
to teach them tobacco advocacy skills that can be used to
change policy at the organizational, local, state, and national
level. YOTA was created to fill a service gap present in
existing programs in Washtenaw County, all of which lacked
an advocacy aspect. The overall goal of YOTA is to empower
Washtenaw County youth through a county-wide intervention
to become anti-tobacco advocates that adopt healthy anti-tobacco
behavior.
The
foundation of YOTA relies on the peer education process
to teach fifth graders tobacco advocacy skills. YOTA peer
educators, or YOTAlogists, are high school students in 10th
- 12th grade that will learn anti-tobacco information and
disseminate this information for the purpose of becoming
anti-tobacco advocates themselves as well as teaching others
to become anti-tobacco advocates.
YOTA
will evaluate the effects of teaching advocacy skills to
youth around Washtenaw County by measuring delayed initiation
of tobacco use to the age of 14 years as cited in Healthy
People 2010. Participation of peer educators (grades 10th,
11th, and 12th in YOTA) and 5th graders, enrolled in public
high schools in Washtenaw County, will be increased to 20%
after three years. As a result of YOTA competencies and
anti-tobacco projects, self-efficacy around refusal skills
will increase by 50% in youth enrolled in YOTA. After four
years there will be an increase of 50% in the number of
anti-tobacco advocacy activities in Washtenaw County public
schools. To implement YOTA for the five year time period,
the applicants request $686,403.00.
Peer
Adolescent Lactation Support Group (PALS)
Marsha Baker, Nicole Miller, Ebony
Lynch, and DeShuna Dickens
University of Illinois at Chicago,
School of Public Health
Abstract
One
of the objectives outlined in Healthy People 2010
is to increase to 75% the proportion of mothers who breastfeed
their babies in the early postpartum period. The low rates
of breastfeeding among African-American adolescent mothers
have been identified as a public health challenge, according
to The Department of Health and Human Services: Blueprint
for Action on Breastfeeding (2000). The influence of
peer relationships in this population can be extended into
the development of a program to improve breastfeeding rates.
The goal of the Peer Adolescent Lactation Support Group
(PALS) is to utilize peer education to promote breastfeeding
in African-American adolescent mothers attending an alternative
Chicago high school for pregnant and parenting teenagers.
PALS encompasses three phases: Phase I, recruitment of 10
peer educators; Phase II, peer educator training sessions;
and Phase III, on-site peer education presentations. The
PALS program is based upon Ajzen and Fishbein's theory of
reasoned action. In accordance with this theory, the PALS
intervention will attempt to increase the intention to breastfeed
among participants by improving personal attitudes through
information sharing and modifying social norms via peer
modeling. The following objectives have been outlined for
the end of the Phase III educational intervention: 1) At
the end of the Module 5 teaching session, 75% of participants
will be able to identify five benefits of breastfeeding;
2) By the end of Module 5, there will be a 65% increase
over baseline of improved attitudes towards breastfeeding;
and 3) By the end of Module 5, there will be a 65% increase
over baseline of intention to breastfeed.
UCLA Mobile Clinic Project
Kevin Riley, Walter Coppenrath,
Koy Parada, and Neelofer Tayyib
University of California at
Los Angeles, School of Medicine and School of Public Health
Abstract
The
UCLA/GWHFC Mobile Clinic Project is a student run, street-based
health care and social support initiative designed to promote
the health and well-being of unsheltered homeless, transiently
housed, and low income individuals in the Hollywood area
of Los Angeles. The project is an interdisciplinary effort
of the University of California Los Angeles, involving students
from the Schools of Medicine and Public Health, and the
undergraduate college. The clinic represents a unique collaboration
between UCLA and the Greater West Hollywood Food Coalition
(GWHFC), a non-profit, volunteer-run organization that has
been serving meals to the West Hollywood homeless community
for over 13 years.
Since
October 2000 the Mobile Clinic has provided services on
a weekly basis to approximately 500 homeless individuals
- services ranging from basic medical treatment, health
education, referrals to local health and social service
organizations and assistance in obtaining needed social
services. We operate directly on the street in an industrial
area of Hollywood, providing services through a mobile van
and in "rooms" constructed with poles and tarps
on the sidewalk. Our efforts strongly support the goals
of Healthy People 2010 in extending access to quality health
services to a substantially underserved population. We recognize
that obtaining and maintaining an optimal state of health
serves as a source of stability and foundation for our clients
and therefore we strive to provide outstanding and ongoing
medical attention, knowing that we are the primary source
of medical care for them.
Healthy
Transitions: A Dialogue with Prison Women on Health and
Well-Being
Kia
McLean, Emily Wang, and Victoria Mobley
Duke University, School of Medicine and School of Public
Health Abstract
The
majority of women in United States prisons belong to groups
that systematically experience race, class, and gender oppression,
and thus suffer from poor health. To this end, prisons are
a critical place to address health issues of socially marginalized
and disadvantaged women, and confront the multitude of problems
that lead to their incarceration. Women entering prison
are at a turning point as they reevaluate mistakes and wish
to change behaviors. This offers an opportunity to provide
sorely needed interventions to reduce risky behaviors.
We
started the "Healthy Transitions" program at the
North Carolina Correctional Institute for Women to target
inmates during the transition into prison. There are two
components to the program. The first, the "Women's
Exchange on Health and Well-being" is a 4-week course,
covering topics including pregnancy, HIV and AIDS, rape,
domestic violence, and substance abuse. The curriculum allows
the women to engage in dialogue about their own life experiences
in a safe and nonjudgmental environment. The course conveys
the message that good health is not just about maintaining
one's physical health, but also one's mental and emotional
well-being. The second component, the Healthy Transitions
Women's Resource Center, contains books, pamphlets, and
videos on topics discussed in the class. A student facilitator
staffs the resource center to provide one-on-one interaction
that is not possible during the class.
Through
the "Healthy Transitions" program, we provide
knowledge, foster self-esteem, and encourage long-term behavioral
change. Ultimately, this program takes women, who are forgotten
by many, and empowers them to lead healthy lives.
IDX:
An Interdisciplinary Healthcare Experience
Tony Martin, Kathryn Momary, and
Kevin Cahill
University of Florida, School
of Allied Health, School of Dentistry, School of Medicine,
School of Nursing, and School of Pharmacy
Abstract
Problem:
The future of public health depends upon further integrating
diverse healthcare professions into effective, patient-focused
teams. Unfortunately, such interdisciplinary interaction
is not yet common in most practice models and is decidedly
lacking in current educational models. Objective:
IDX: An Interdisciplinary Healthcare Experience allows teams
of healthcare students to assess, diagnose, treat, and educate
a patient. Students practice teamwork and learn a working
knowledge of the skills of other health disciplines. Implementation:
A patient case and scoring criteria were developed. The
case was designed to elicit participation from all represented
disciplines. Student teams were judged in two areas: videotaped
interactions with the patient and case presentation to a
panel of clinical faculty. Student participants were recruited
from the Colleges of Pharmacy (PharmD students), Medicine
(MD and PA students), Nursing (BSN students), Health Professions
(OT and PT students), and Dentistry (DMD students). Patients
were trained actors. Results: Based on the number
of participants, the performance evaluation results, and
the positive feedback from participants and faculty judges,
this event successfully develops novel, case-based interdisciplinary
interaction. Feedback from participants described this competition
as a unique opportunity for team members to show other disciplines
their contributions to patient care. Innovation:
There are currently limited opportunities for interdisciplinary
interaction in existing curricula. This type of event is
an invaluable tool directing more of such interaction. It
allows students from multiple disciplines to learn more
about each other's knowledge base and skill sets. Such interactions
have a ripple effect, once students are exposed to such
interactions, they will come to expect it and rely upon
it in actual clinical practice. Through such interdisciplinary
healthcare education, students break down barriers and misperceptions
between professions.
