Currently Funded Research Projects
Advanced Education Nursing Traineeship (AENT)
Advanced Nursing Education Expansion (ANEE)
This award is to support students enrolled in the newly implemented online Doctor of Nursing Practice/ Master of Science in Nursing (DNP/MSN) primary care Nurse Practitioner (NP) program. The objective of this ANEE Project is to maintain the high number of full time nurse practitioner (NP) students who are enrolled in this program by providing additional funding for full time enrollment. The second objective is to offer strong MSN students who apply part-time an opportunity to come into the program in a full time position with financial support.
Nurse Faculty Loan Program
Advanced Nursing Education Grants: Growing the Next Generation of Nursing Leaders (NGNL)
The goal of this project is to grow the next generation of young nurse leaders from our Medical University of South Carolina (MUSC) online PhD and DNP programs, who will be the vanguards in solving health care disparities among rural and underserved populations in our complex health care environment. Our aim is to produce a nursing leadership workforce that is 1) early career 2) diverse and culturally competent and 3) adept in interprofessional team research skill sets. We will attract early career Post-BSN students to the PhD and DNP Online programs through creative recruitment, innovative marketing and focused mentoring strategies that encourage a younger and diverse applicant pool to study at our programs. Once admitted, we will bolster the skills sets of younger, disadvantaged, and minority online students to navigate doctoral level coursework using the Next Generation of Nursing Leaders Program (NGNL). With the guidance of a nationally recognized consultant on cultural competence, faculty will evaluate and expand the DNP and PhD curricula and clinical experiences to ensure the cultural competencies of our graduates for use with rural and underserved populations. To develop graduates with interprofessional team research skill sets, the faculty will utilize the online environment to construct interdisciplinary group learning experiences that supplement the traditional model of one-on-one research mentorship. Faculty will first map the core concepts of interest among the DNP and PhD students and faculty, and then create what we will call Scholarly Communities of Practice (SCOP). We will use SCOP forums to organize and scaffold research and clinical projects of the DNP and PhD students and faculty, so that the full continuum of knowledge development to knowledge dissemination in a particular topic is readily shared. Each group, led by experienced faculty mentors, will model and practice core teamwork skills in their interaction on projects. Online PhD and DNP students will engage in collaborative efforts of scholarly production with faculty and peers of like interests, learning to work in teams with a common interest but composed of diverse talents and perspectives. Invited interdisciplinary and international guests will be encouraged to collaborate within the SCOP forums.
Camera Adherence Monitoring (CAM): Proof of concept increasing medication adherence and reducing clinician inertia using a low-cost CareCam platform
Southeastern Virtual Institute for Health Equity and Wellness (SE VIEW) - Project 10
The goal of this cooperative agreement with the United States Department of Defense is to develop educational and outreach programs and conduct community-based research on health disparities and to address the high rates of disease occurrence, disability and mortality in rural, low-income or minority communities.
National Chronic Disease Screening Program: Screening for Diabetes in Underserved Rural Communities in South Carolina
Preventing Venous Leg Ulcers with Cryotherapy: A Randomized Clinical Trial
The R21 Pilot Project (NINR—1R21NR010604-01) “Cryotherapy for Venous Disorders: A Pilot” demonstrated that cooling inflamed skin affected by venous disorders significantly reduced blood flow after a four-week intense cryotherapy intervention. This new trial will assess the efficacy of this home-based cryotherapy intervention by adding sequenced tapered cooling after a 30-day intense cooling period. The goal is to reduce skin blood flow of chronically inflamed skin, decrease the incidence of venous leg ulcers and pain, and improve quality of life. A myriad of surgical, pharmacologic, and non-pharmacologic therapies such as compression bandages are often tried, many with limited success. More than 70% of patients with venous disorders such as insufficiency develop edema, skin damage, and ulcers. Ulcer prevention is warranted because of the significant socioeconomic implications in terms of lost workdays and wages, decreased productivity and increased health care costs. Clinicians focus on the multiple treatment approaches, often without consideration of how patients can contribute to their own self-care. Our 9-month intervention is based on principles of heat transfer and cryotherapy theories involving microcirculation. With input from a cryotherapy expert and participants who completed the R21 pilot, we propose a sequenced intervention strategy, where cooling will be dosed daily for 30 minutes for the first month, and then decreased to twice weekly dosing in months 2–3, once weekly in months 4–6, then prn in months 7–9. We will measure blood flow, skin temperature, pain, quality of life, and the incidence of leg ulcers after months 1, 3, 6 and 9. Eligible participants will be randomized to treatment (low compression cooling wrap) or usual care (low compression non-cooling “sham” wrap). Participants in both groups will receive all study related materials including standardized instruction, skin thermometer, specially designed low compression wraps, leg elevator pillow, and compression stockings, and during an in-depth orientation session. We hypothesize that cryotherapy will enhance the largely ineffective non-pharmacologic self-care usual care model, that is, telling patients to wear compression stockings, elevate the legs, and get more exercise. These strategies are generally inadequate in achieving sustained change. Among our research methods we include rigorous process, impact and outcome monitoring. In an era of expectation for technological and pharmaceutical “fixes”, this self-care strategy, if efficacious, could be an economical way to decrease morbidity and pain for thousands of patients, frequently viewed as non-responsive to self care. Prevention of ulcers is also a major potential source of saved medical dollars. This trial is significant due to the burden of venous disorders, the complex physical characteristics of the population including excessive obesity and co-morbidity and the need to reach patients with a feasible, motivational, and supportive strategy to promote self-care. The objective is to establish a new practice standard for prevention.
Novel Wound Powder RGN107 to Reduce Wound Odor, Pain and Exudate at End-of-Life
Palliative care can provide comfort and support for individuals at the end of life who have a wound. Such people frequently face distressing symptoms that profoundly affect quality of life. Wound care research on feasible comfort measures is minimal to address physical symptoms such as pain, odor, and wound drainage (exudate) that often accompany wounds that develop at the end of life. We propose to study a wound comfort intervention comprised of a low-cost wound powder, RGN107 that can be sprinkled on wounds using a squirt bottle. After several applications, the powder forms a “crust” seal border over the wound, protecting it from dressings that can stick to the fragile wound bed and preventing manipulation from wiping, both of which can cause pain. The goal is to augment usual wound care, adding to the comfort and quality of life of dying individuals as well as their caregivers. No previous studies have determined the feasibility of using a specially developed wound powder to examine adherence to a wound comfort protocol for individuals receiving hospice care. Our pilot data indicate that RGN107 is nontoxic, and efficacious, providing substantial relief from pain and exudate from venous leg ulcers. We propose to extend these findings to a highly challenging population of hospice enrollees with wounds such as pressure ulcers. Approximately 50% of the individuals who develop wounds have tried various methods to manage symptoms, but continue to suffer from uncontrolled wound pain, odor, and exudate. The purpose of our study is to examine the feasibility of an enhanced wound care approach and examine monitoring of adherence, measures of signals of efficacy in the control of symptoms, and impact on quality of life after use of RGN107. This R21 will employ a comparative group design to determine feasibility in two models of a hospice organization, home based care and inpatient hospice that will target 50 individuals with life expectancies more than 1 month, but less than 6 months. We will tailor the training for each model recognizing the variability of caregivers. In the inpatient setting, training will be delivered over the three shifts and over several days. In the home, the registered nurses that plan wound care, along with associated agency and family caregivers will be instructed in the home setting over several training sessions. A DVD of wound procedures will be used to reinforce learning. Our team will monitor adherence by fidelity processes such as making regular visits to assess caregiver performance, evaluating the wound itself, and reviewing documentation. Data collection sources include project records, patient/provider logs, surveys and interviews conducted at three time points, baseline, and then weeks 2 and 4. We hypothesize our intervention will enhance comfort care and quality of life at the end of life for both the patient and the caregiver.
Southeastern Virtual Institute for Health Equity and Wellness (SE VIEW) - Phase 1: Project 2
This 4-year project aims to work with faith communities, businesses, primary care providers and schools in Williamsburg County to increase awareness of causes of CVD, with an emphasis on obesity, to improve the health of citizens of the County. An Asset Map was developed identifying programs and activities of each entity to identify local resources. Practices were encouraged to join the OQUIN network to improve evidence-based care. Work-site health screening activities were encouraged and we evaluated the access to care and medications of workers with hypertension from one large company. The school district and several faith communities received funding to implement projects that provided education and screening to their constituents. A local Community Health Advisory Board directs activities of this project.
Southeastern Virtual Institute for Health Equity and Wellness (SE VIEW) Phase 2: HPHC (Healthy People in Health Communities)
This initiative was funded in the Phase 1 SE VIEW award as a project to promote lifelong health through healthy lifestyles and access to primary preventive health care and necessary medications. This 3-year project aims to establish Health Information Exchange (HIE) between Williamsburg Regional Hospital and one or more local primary care practices in Williamsburg County. MUSC OCIO is actively involved in not only establishing HIE in the County, but potentially linking the County with regional health care. The principal approaches are: a) developing community dialogue about ongoing needs and resources, b) providing health education and grants for local programs, c) supporting health screen/referral for care, d) assessing and overcoming barriers to health care and medications, e) strengthening the local health care delivery network, f) building local capacity to sustain these efforts, and g) promoting and assisting the adoption of electronic medical record (EMR) systems and other HIT tools by local caregivers.
Controlling Blood Pressure in Treatment Resistant Hypertension: A Pilot Study
Background: Treatment resistant hypertension (TRH), i.e., blood pressure (BP) above goal on >3 BP medications affects millions of people and contributes to health disparities. In clinical trials, where patient compliance is confirmed and BP meds are systematically titrated to attain control, ~20% of patients have TRH, which suggests limited effectiveness of current treatment strategies contributes to TRH. This pilot study examines the feasibility, safety, and preliminary effectiveness of four evidence-based approaches to improving BP control in TRH. The four strategies include adding an aldosterone antagonist in eligible patients (AAEP), renin treatment-guided therapeutics (RTGT), clinical hypertension specialist care (CHSC), and RTGT+CHSC.
Hypothesis: Defining pathophysiological mechanisms (RTGT) and/or expert consultation (CHSC) will improve BP control more than ‘blindly’ adding an aldosterone antagonist in eligible patients (AAEP).
Specific aim: Assess the feasibility, safety, and preliminary comparative effectiveness in a diverse group of patients and clinical settings of four evidence-based treatment strategies for treatment resistant hypertension (TRH) to test the hypothesis that RTGT and/or CHSC are more effective than AAEP for controlling BP in TRH.
Hypothesis: Eliciting patient, provider and staff experiences and insights post intervention will identify barriers and facilitators to implementing AAEP, RTGY, and CHSC that will inform design of the demonstration study.
Specific Aim: Conduct post-intervention patient questionnaires and interviews and staff and provider focus groups and an online SWOT to identify barriers and facilitators to AAEP, RTGY and CHSC that will inform the demonstration study in real world practice settings.
Methods: 8 diverse clinics (>1 community health centers, single & multi-site primary care clinics, community residency training programs) that provide care for a diverse patient population will be randomized to 1 of 4 study arms. Each cilnic will enroll 18 TRH patients (36/arm). All clinics receive BpTRU monitors and training to standardize BP measurements and ‘eliminate’ white coat hypertension. Key study data include patient demographics, visits, BP values, meds, and lab data. Post study focus groups and strengths, weaknesses, opportunities, threats (SWOT) analysis with providers and staff and patient questionnaire and interviews will be used to evaluate several dimensions of the study and guide the demonstration study design.
Significance: TRH is common medical condition, and relatively ineffective treatment regimens are a significant contributing factor. The long-term goal is to establish practical, effective, and widely replicable approaches for controlling BP in TRH and reducing clinical complications and related health disparities.
USC Community Transformation Grant
This CDC-funded 5 year project aims to reduce CVD risk in SC by: 1) enrolling more PC practices in a Practice network and 2) increasing the implementation of evidence-based care related to CVD. A variety of interventions are employed including audit & feedback to providers related to evidence-based care and HTN/lipid control, an annual meeting, quarterly newsletter, training in Lean Six Sigma, and support for 8 people identified by 7 practices to be trained as QI Professionals producing QI projects related to reducing CVD.
Personalized Bio-behavioral Weight Loss Intervention for African American Women
The Medical University of South Carolina provides a comprehensive training environment that includes senior scientists with expertise in bio-behavioral interventions, genetics, and health disparities research. The candidate has a strong interprofessional and inter-institutional mentoring team with complementary expertise in the development of community based randomized controlled trials (RCT), genetics, obesity prevention and treatment, bio-behavioral interventions, biostatistics and epidemiology.
The research plan, which builds on the training objectives, is directly responsive to the National Institute of Nursing Research's (NINR) mission of integrating the biological and behavioral sciences, employing new technologies to research questions, improving research methods, and developing the scientists of the future. The broad goal of this research is to identify key components for development of efficacious socio-culturally tailored behavioral interventions for long-term weight loss in low socioeconomic status (SES) obese AA women. The socio-cultural preferences will be incorporated into behavioral change strategies, the communication of genetic information, and the adaptation of the format and delivery of the evidence-based Diabetes Prevention Program materials and approaches to promote weight loss. To meet this goal, the candidate will conduct an exploratory study using genetic database secondary data analyses. Secondly, an intervention development phase, with 80 obese AA women living in public housing neighborhoods in the Charleston, SC region, to integrate new knowledge and skills from genetics while advancing skills in bio-behavioral research intervention development and methodology. The results of the proposed preliminary studies will inform a larger, adequately powered and resourced community based RCT for obese AA women, that incorporates the use of genetic information and socio-cultural preferences to prescribe tailored weight loss strategies and promote long-term weight loss outcomes.
A Peer Navigator Intervention for Individuals with Spinal Cord Injury
Communication Intervention for Adolescent Immunizations: Cluster Randomized Trial
Though recommendations for adolescent immunizations have increased, adolescent immunization rates fall well below childhood rates. Missed opportunities for immunization are documented, though the conversations that contribute to vaccine hesitancy and refusal are less documented. The process of health communication between health providers, adolescents, and parents that characterizes information transfer in preventive health visits remains a critical but under-explored site for intervention. Most communication studies between adolescents and health providers use surveys, post-hoc interviews, or code health topics.
This study will record 120 spoken interactions pre- and 120 post-intervention between providers and diverse adolescents and parents in South Carolina and Oklahoma discussing recommendations for tetanus/diphtheria toxoid/acellular pertussis (Tdap), meningococcal conjugate vaccine (MCV 4), and human papillomavirus vaccine (HPV) at preventive health visits. Using methods from discourse analysis, patterns of communication and decision making will be compared to parental willingness to accept vaccines to determine best practices. Applying an integrated health behavior model, findings will be used to develop, test, and implement a provider-patient/parent communication intervention in two pediatric practice-based research networks representing multicultural populations to monitor variations for cultural tailoring.
Focus groups of adolescents, parents, and providers in online and face-to-face environments will refine the intervention and preferences for intervention delivery. Using simulation methods for provider prompting and patient priming, the intervention will be randomly allocated to 6 clinical practices in a cluster randomized trial. Guidance from the USPSTF Counseling and Behavioral Interventions Work Group will be used to evaluate the intervention. Subsequent follow-up will rate visits using the Structured Communication Adolescent Guide (SCAG) recording and repeating discourse analysis to determine changes in communication practices and immunization rates at the practice level.
The Promise of Nursing for South Carolina Grant Application
This grant application is for development of an educational innovation: a virtual pre-entry program, the Promise of Nursing Toolbox (PONT) that will address our known student challenges and identify tools for success at entry. Students will be required to review and complete the electronic toolbox modules prior to the first day of class. Once admitted, we will bolster the skills sets of students to navigate ABSN coursework using PONT. We will offer ongoing access, additional supportive retention efforts through educational intervention, referral and integration of the faculty advisor role in the individualized academic success plan.
We will develop content modules via a learning management system (LMS). These will be self-directed sessions that involve an activity (self assessment, Tegrity recording, quizzes) are learner centered with progression based upon content mastery. Students at risk for academic success will be identified prior to the start of the program, referred to campus resources and their faculty advisor. This will ensure that students do not get behind before they can be identified and supported.Program Grant funds for this toolbox will support start up funding for: design and implementation of the PONT, workload for a Program Administrator to track compliance, facilitate referral for support, purchase of instruments to assess learning and study strategies and greater educational efficiencies by allowing more faculty time for small group remediation sessions. It is our belief that learner initiated acquisition of success skills for an accelerated curriculum will decrease the demand on faculty with curricular progression. This decreased demand will allow the CON to expand program capacity by 15% (fall 2013 and spring 2014) without additional faculty or compromising student success.
Ethno-Cultural Barriers to Health Literacy/Disease Management in AAs
More research is needed in this area, as health literacy not only measures a person’s ability to read and comprehend, but also the ability to act on medical instructions and information. This is particularly true for the African American (AA) community which suffers disparate impact from chronic illness. The substantive aim of this descriptive, mixed method study is to explore the effects of beliefs and culture on health literacy and ultimately the management of diabetes in AAs from four regions in South Carolina. Our methodological aim is to develop a reliable, valid and generalizable survey tool with items that represents cultural beliefs, values, experiences and preferences for health information. This study is innovative in that it acknowledges the heterogeneity of the AA community and will apply theoretically grounded models to guide the substantive and methodologic aims. We will use focus groups and cognitive interviews in year one and instrument pre-testing and population survey implementation in years two and three. Findings from this study will guide the selection of messages and strategies that will be subsequently tested within targeted populations to improve health outcomes. This study can advance the science as it relates to promoting health literacy and disease management among vulnerable populations.
Virtual Interprofessional (VIP) Education
Smartphone Medication Adherence to Stop Hypertension (SMASH)
The MedMinder contains 28 compartments (4 potential dosages per day across seven days) and is programmed to remind patients when to take their medications. Initially, one receives a blinking light from the particular compartment for 30 minutes. If not opened during that time, a loud chime is activated for 30 minutes. After that, an automated personalized call goes out to the patient (and a significant other if desired) to remind the patient to take their missed dose. Patients were also told how the devices are programmed to relay information (e.g., BP, when meds are taken, tray refilled, etc.) to a teleprocessing center where personalized summary reports could be sent back to the patient and/or their doctors at the FQHC. All 21 patients were receptive to using such a system for management of medication usage and monitoring of BP, if it was provided to them. All liked the idea of staying connected to their doctor via such a system. Based upon their comments and suggestions for delivery of reminder, motivational, and reinforcement messages, we have developed SMASH, a prototype model for a mobile health medication and BP monitoring system with interconnected linkages between the patient and healthcare provider.
Importantly, the prototype system will be further refined prior to and following the initial proof of concept clinical trial via input from the patients and providers. Their input will help ensure refinements are made if needed in the mobile health adherence enhancement model to make it fully acceptable and feasible for a larger scale pilot feasibility clinical trial which will follow.
Smartphone Medication Adherence Stops Hypertension (SMASH) Among Hispanics
Technology Applications Center for Healthful Lifestyles (TACHL)
One of the biggest challenges public health researchers face is the development of efficacious, cost-effective lifestyle intervention and healthcare management programs which can be personalized to meet the specific needs and characteristics of individuals. TACHL provides a unique opportunity to address this challenge. The Center provides an outstanding environment to engage in multi-disciplinary based research with scientists from diverse disciplines at MUSC, University of South Carolina (USC) and Clemson University. Through multi-institutional collaborations it develops, evaluates and commercializes technology for individuals, worksites, community groups and health care provider networks to foster efficacious health promotion, disease prevention and health care management and work force capacity-building. Products include software and information systems for mobile smart phones, personal digital assistants, iPad®/tablet technologies, web based computer assisted programs, interactive call centers and others which will implement and monitor various programs including physical activity, diet, stress reduction, smoking prevention/cessation, biomarker monitoring and medication adherence. Product development is guided by the preferences of various users. For example, youth may prefer interactive game based computer technology applications for health behavior change, young adults may prefer smart phone delivered interventions and self-monitoring/adherence programs while seniors and others may prefer direct contact with healthcare call centers via phone and/or video conferencing via computer interface.
TACHL fosters more efficacious health promotion, disease prevention, and healthcare delivery/ adherence related programs applicable to all South Carolinians. These advances will help meet the long term vision of the Center which is to improve the health and well-being of all South Carolinians, provide indirect economic benefits to the state via improved work productivity, decreased absenteeism and decreased health care costs. The Technology Center will also foster economic growth to the state via the commercialization of new technology products, development and recruitment of companies involved in various aspects of software and systems technology development and program delivery. A diversity of new jobs will result including software and hardware developers, technology based educational training, clinical intervention, publishing and advertising positions among other high-tech business related occupations. The 10-year goal is to become a multi institution based national center of excellence. Most importantly, the activities of TACHL will help contribute to a reduction in the chronic disease health disparities ravaging the state and result in improved health and well-being of all South Carolinians.
Enhancing Kidney Donation Through Live Organ Video Educated Donors (LOVED)
Chronic Kidney Disease is diagnosed in four times as many African Americans (AAs) as Whites and nearly twice as many AAs perish from the condition. Kidney transplantation offers the best outcomes for patients with End Stage Renal Disease (ESRD) but rates of procurement far outnumber cadaver organ availability, especially among AAs. A superior option is living donor kidney transplantation (LDKT). Since AAs comprise only 18.5% of LDKT recipients, innovative and culturally preferred strategies are needed to increase LDKT within the AA community. We hypothesize that a patient-centered, two tiered culturally sensitive education/motivation intervention targeting AA ESRD patients and potential donors (PDs) using mobile health (mHealth) technology will result in: 1) increased ESRD patients’ willingness to ask for donation; 2) increased number of PDs who complete medical evaluation; and, 3) increased number of LDKTs. We will leverage mHealth technology as the delivery mechanism to maximize large scale dissemination potential. Guided by behavioral change and technology acceptability theories, the Live Organ Video Educated Donor [LOVED] program will be developed to address two domains. LOVED I will be tailored for AA ESRD patients and navigated by an AA LDKT recipient. LOVED II will be tailored for potential LDKT donors and navigated by an AA LDKT donor. iPad program delivery will include testimonial audio/video clips, home-work assignments, videoconferencing, chat room sessions, and text/emails. The proposed mixed methods research utilizes qualitative and quantitative studies in a 3 phase process of development that will involve:
Smartphone Delivered Meditation for BP Control Among Prehypertensives
Stage 2 pre essential hypertension (preEH; 130-139/<90 mmHg) entails a 3-fold risk of developing EH and 2-fold risk of cardiovascular disease (CVD) events compared to those with optimal blood pressure (<120/80 mmHg). Prevention programs are needed which can be sustained by preEHs and readily disseminated by healthcare providers. Psychological stress is a risk factor for future EH and CVD. Stress reduction via meditation has shown promise in reducing blood pressure (BP) but adult studies have not determined optimal dosage level nor evaluated dosage adherence objectively. Multiple underlying biobehavioral mechanisms linking meditation with BP reduction also require additional scrutiny. The proposed research will address these issues by further developing and optimizing a smart phone breathing awareness meditation program (Tension Tamer:TT). Stage 2 preEH 21-50 year old African Americans and Whites balanced by geographical locale (urban vs. rural) and healthcare providers from 12 practice sites (6 urban/6 rural with 12,843 stage 2 preEHs) within the OQUIN practice based research network will be enrolled.
Pediatric Epilepsy Depression Screen (PEDS) Study
RWJF New Careers in Nursing: Mentoring Future Nurse Leaders
In SC, the 2nd degree student does not have access to state loans, incentives or scholarships, thus the RWJ monies allow the opportunity and the ability to focus on nursing. NCIN students are selected using academic performance, demographic data, Expected Family Contribution and FAFSA. The NCIN Team evaluates the data and offer to the selected students.
Leadership is our strength and is integrated within the curriculum. The scholars must participate in a leader activity and have sponsored the MS Community Walk, joined professional organization(s) and become a student Tutor(s). Mentoring is a key factor to success. We have asked our NCIN Scholars to buddy with a subsequent RWJ cohort student and to identify a person from their community who is interested in health care to visit the campus (face to face and virtual). Each scholar has a faculty mentor and both participate in NCIN meetings and activities. This connection to people is seen as integral to student success.
Our Diversity Committee focuses on recruitment, retention and support of underrepresented students, faculty and staff. The College goal is an organizational culture that promotes openness to diverse perspectives, inclusion and full participation of students, staff and faculty. We actively apply for and receive grants that support diversity and see this as sustainable. We continually search for measures to further advance this initiative.
PASOs in South Carolina: Promoting Prevention and Bridging the Gaps for the Vulnerable Latino Population
This project will provide coordinated leadership for the development and implementation of this program in the Charleston, Berkeley and Dorchester counties. Like most mothers, immigrant Latina mothers share the desire to have healthy families. However, in their new communities here in SC, they oftentimes lack the information and power to make an informed decisions for themselves and their families. PASOs provides a bridge between the Latino community and the health care system in order to maximize the health of Latino women and children, and provide them with access to needed resources.
Charleston PASOs: Improving Access to Health Services in the Tricounty Hispanic Community
Teen Health Advocate Leadership Program Planning Plan
Entering its fourth year, the Teen Health Leadership Program (THLP) demonstrates an effective partnership between an academic medical center and local public high school to address community concerns related to adolescent health and development. Johns Island, the site of the THLP, is a rural community plagued by poverty and isolation. Partnerships with community organizations and larger institutions are critical to bring necessary resources to the island. In collaboration with the school district and multiple community organizations, THLP seeks to empower high school students to assist and serve their community. Through innovative computer technologies and the internet, the THLP provides health literacy training, enabling the students to design and implement outreach projects to improve the awareness and use of quality health information in their community. The THLP has produced relevant results related to sustainable partnerships, health literacy and community engagement. First, participatory development of the program among partners and integration of the program into existing structures has produced a sustainable mechanism to support the program for years to come. Second, the internet and use of creative technologies are critical components to achieve health literacy when working with adolescents. Finally, with adequate support, adolescents can serve as messengers of positive health promotion to address the health concerns of their community.
Building Capacity in the Hispanic Community: A Health Promotion Program With A Focus on Health Literacy and Community Navigation
This application requests funding for one year to complete a thorough evaluation, manualization, and dissemination of a health promotion program that is an integral part of Abrazos, a family literacy program that targets young Hispanic families. Requests for program materials from across the state and the region has prompted the need to complete this evaluation process in order to be able to disseminate the program as a “Promising Best Practice”.
Abrazos is an established family literacy program in North Charleston supported by a partnership between the Medical University of South Carolina (MUSC) College of Nursing (CON), and the Charleston County School District (CCSD) to address the educational and health needs of the local Hispanic population. Hispanic mothers participate in “English For Speakers of Other Languages (ESOL)” classes while their children participate in an early childhood development program. An integral part of Abrazos is the MUSC CON health promotion program promoting health literacy through a relevant curriculum and building capacity by developing the skills of the participants to navigate community and medical resources.
The Abrazos program is funded by Title I, through the Charleston County School District. This very popular program has grown from serving 12 women and children and operating 2 mornings per week to now serving 50 women and children 4 days per week. Over the past 4 years, 172 families have participated in this program and anecdotal data suggests that improvements in accessing health services and community resources occur as a result of program participation. There are many family literacy programs – some are run by for profit or non-profit organizations, others are administered by state agencies. The Abrazos program is unique in combining family literacy with a health promotion component that is culturally and linguistically appropriate for
Hispanic families. There are no similar local programs, and we are unaware of any similar programs that exist within the state.
Recently the health promotion program was featured on SCETV in a program titled “Social Determinants of Healthcare” narrated by Dr. Ray Greenberg, MUSC President. (To view: Go to http://scetv.org/index.php/the_big_picture/ and search for the title “Social Determinants of Healthcare”. There are several clips, but you want the one that is not identified as an interview and is titled: “Recently, the Medical University of South Carolina hosted a conference to discuss the role social determinants . . . ”. Go to minute 16 to see live footage of the health promotion program). After this program was aired, multiple requests from around the region were received for copies of program materials. Prior to distribution of program materials, a rigorous evaluation of materials needs to be completed. Although Title I provides the funding for the program, there are no funds to support a thorough evaluation and manualization of the health promotion component.