ALLIED HEALTH IN URBAN COMMUNITIES
(Register for independent study for 2 credits)
Thursdays, 4:30 - 6:30, Rm 313
Fall 1999

Occupational Therapy Gail Fisher 996-4371 gfisher@uic.edu

Physical Therapy Michelle Bulanda 355-2517 mbulan1@uic.edu

Human Nutrition and Dietetics Sandra Gomez 413-9896 sgomez2@uic.edu

Course Objectives:

Upon completion of this course students will be able to:

Demonstrate a broad understanding of the determinants of health such as environment, socioeconomic conditions, behavior, and medical care.

Demonstrate intermediate level knowledge and skills to facilitate access to health and social services for individuals, families and communities.

Apply principles of the process of needs assessment, program planning, implementation and evaluation within and urban community context.

Demonstrate, at a beginning level, effective interdisciplinary allied health practice in a class room setting.

Review qualitative data from consumers/clients and providers, extract/analyze vital information and use as a program planning tool.

WEEK/ DATE
Presenter
Topic

1: 9/2
Gail Fisher, MPA, OTR/L (and other faculty)
Introduction to the course, fieldwork component, and community sites. Overview of OT, PT and HND and how they relate, interdisciplinary teamwork.

2: 9/2
Thubi Kolobe, PhD, PT
What is community, urban health issues?

3: 9/9
Michelle Bulanda, MS, PT
Issues affecting access to health, characteristics of underserved populations.

4: 9/16
In-class case study, facilitated by faculty
Roles of OT, PT and HND within a particular community setting that is underserved.

5: 9/23
Fabricio Balcazar, PhD and parent advocate
Strategies to facilitate consumer empowerment, becoming an advocate.

6: 9/30
Consumer panel
Consumer perspectives.

7: 10/7
Sandra Gomez, MS, RD and Mary Futrell
Perspectives on providing community-based services to underserved populations.

8: 10/14
Class cancelled to allow for agency site visits.

9: 10/21
Graduates and Students Panel
Graduates and students who have had experience at the community sites will share their perspectives.

10: 10/28
Rebecca Mullis, PhD, RD
Community based needs assessment and program planning.

11:11/4
Rebecca Mullis, PhD, RD
Program implementation and evaluation within a community context.

12: 11/11
In class time to work on final project, each group will have a faculty facilitator/advisor.

13: 11/18
Faculty and students
Presentation of final projects.

14: 11/25
NO CLASS
THANKSGIVING HOLIDAY.

15: 12/2
Faculty and students
Presentation of final projects.

The Neighborhood:
Type of neighborhood: This inner-city, urban community; public housing
Location: near west side of Chicago
Total population: 46,197 (old data - should have gone up now)
Ethnic breakdown: 74% African-American
Income: In 1990, 72% of the families had incomes below 200% of the poverty level.
Food Stores and Restaurants: In the immediate 1 mile block, there are two-three stores selling convenience foods and limited fruit and vegetable selection. In the broader geographic area, there are a few Chinese, soul food, and Italian restaurants.
Playground facilities: No outside playground in the immediate neighborhood; although there is the James Jordan Boys and Girls Club nearby.
Health care facilities in the neighborhood: Mile Square Health Center, UIC Medical Center (about 2 miles South).

The School
Grades offered: preschool through 8th grade
Location: in the heart of the inner-city area
Description of the student population: 99% African-American, 90% reside in the immediate school area and walk to school, 100% qualify for school meals at no cost or at a reduced price.
Student mobility rate: about 30%

Healthy Schools, Healthy Communities Great Cities Grant
Funding agency: UIC Great Cities Initiative
Funding period: 1 year
Departments funded: Human Nutrition and Dietetics, Occupational Therapy, Physical Therapy
Resubmission options: The school can seek continuation funding but availability is not certain.
Required focus for the programs: This one year pilot project is a spin off from the federally funded grant described below. It should be a partnership between a community agency (or school) and UIC.

Overall description of the larger project funded by the U.S. Department of Health and Human Services, Health Resources Services Administration:
Mile Square Health Center School Site: Henry Suder Elementary School
Address: 2045 W. Washington/MC 698 Chicago, IL 60612-2494
Project Director: Cynthia Barnes-Boyd PhD, MSN
Phone Number: (312) 413-7810
Health Services Funding: $236,994
Partners: Henry Horner Chicago Boys and Girls Club, West Side Future (for case management), and the University of Illinois.

Description: The Better Care For Youth Clinic at Henry Suder Elementary School provides medical and health education and staff development. Healthy Schools, Healthy Communities projects provide family-centered, community-based primary care. Experiences from the HSHC sites indicate that children and parents alike find the health centers to be "user-friendly" and supportive of getting all family members attached to a medical home. Emphasis has been given to conflict management programs with the implementation of several school-wide presentations on topics such as gang violence and conflict resolution. In addition, an after-school program entitled Responsibility In The Gym has been developed to complement both the health education efforts (by providing opportunities for exercise) and the conflict management efforts (by teaching responsibility and self-evaluation).

Program Goals (from 1997 annual report to HRSA, submitted by Dr. Boyd) Goal 1 To establish an interagency school health service partnership which coordinates the resources of a health center, elementary school, social service agencies and the community and UIC.
Goal 2 To provide comprehensive health protection and preventive care using a service model that includes health care and health education.
Goal 3 To provide community specific health promotion and prevention education in the areas of nutrition, fitness, violence prevention, health maintenance, healthy life-styles, substance abuse, effective parenting and personal development.
Goal 4 Based on information about the incidence of preventable health problems in the student population, develop culturally relevant, literacy sensitive prevention focused health education interventions for teachers, students and parents.
Goal 5 Develop an accident prevention program which includes a revised environmental assessment tool and interventions suitable for conduct in the home.

Description of program components and activities School-based clinic - providing service to all students on public assistance. Clinic staff includes the following: Clinic director, nurse supervisor, two nurses, one front desk person who also does data entry in the computer. The clinic provides emergency medical care to students, and refers cases to appropriate clinics as needed (e.g. Mile Square, UIC, etc.). The clinic is open 5 days a week and operates during regular school hours. The clinic also operates during the summer vacation, when summer school is in progress.

Boy-talk, Girl-talk: school based health education curriculum to prevent pregnancy in this high-risk populations. Run by the clinic director (female) and the data entry clerk (male). This program is limited to students in grades 3 through 5, and is offered once a week for the entire school year. This provides a platform for children to ask questions about their changing bodies (during puberty and also pregnancy), childbearing and child rearing. Hands-on program includes providing chip-operated baby dolls that cry at specific times and can be subdued using certain techniques, need to be fed, etc.

Nutrition: This component is designed to promote healthy eating habits among children, with some focus on weight maintenance and weight loss as needed. The overall prevalence of overweight and obesity is about 40%, with higher prevalence in older than younger students and among female than male students. All students receive some money from home to purchase snacks during the day. The majority of the students have a television in the room where they sleep; inactivity levels are high and overall activity level is low. This may be related to the safety concerns of the parents as well as lack of playground facilities in the neighborhood.

Healthy Schools, Healthy Communities Initiative A federally funded grant to design and implement a model of education for practice with urban under-served populations.  As more allied health professionals move into community-based practice, new skills are needed to meet the unique needs of the client and programs.  Students in occupational therapy, physical therapy, and human nutrition and dietetics will enhance their ability to work in community settings with urban populations and become leaders working to improve the quality of care offered in urban settings.  The project will focus on services for children, the elderly, and persons with chronic disabilities, especially African Americans and Latinos.

Grading:

Attendance and Participation 25%

Journaling for lecture/readings 30% (6 lectures/readings, 5% each)

Participation in in-class case study 05%

Preparation for final project planning session 10%

Final project 30%

Attendance and Participation: This type of course requires students to be present to be exposed to new perspectives, ideas, and content. It also is enriched when students share their own perspectives and experiences. We expect students to be active participants in every aspect of this course. Any absence should be cleared prior to class by the course coordinator for your discipline. All others are considered unexcused. Any unexcused class will automatically remove 5 - 10% from your grade (5% from attendance portion, 5% from Journaling due to inability to complete). Students who have excused absences are required to journal for any assigned readings as well as for one additional article they obtain from the library on the topic of discussion.

Journaling: Students are expected to journal on the class session and any assigned readings for the following dates: September 2, September 9, September 23, September 30, October 7, and October 21. The journal entry is due one week after each of the above dates, and can be turned in in class the following week. The journal should provide an opportunity for the student to reflect on the class session and reading(s) and to write about reactions to the material covered. The journal would typically include how you feel about what was presented and discussed, what you think about it, how the content fits with your own experience, how the content might relate to the your future internships and practice, and the most important points from the readings and how they can be applied to practice.

In-class case study: In Week 4, students will break into interdisciplinary groups. A case scenario will be presented which requires students to brainstorm potential needs to be met, program ideas and approaches, and how to implement these programs. Each group will share outcomes with the total group at the end of the class. Each group will have a faculty facilitator, and students will be graded on their contributions to this case exercise.

Final Project: The final project will provide an opportunity for students to work again in (different) interdisciplinary teams. Each team will be assigned to one of the community based fieldwork sites. The team will visit the site, interview a staff member at the site, and read background information on the site, including staff and consumer interview and focus group transcripts.. The team will learn about what has already been accomplished by previous students at the sites, both by reading summaries of students' projects and by interviewing former students. This information gathering must be completed before November 11 The team will develop ideas about other OT, PT and HND services that could benefit the sites and provide students with productive learning experiences, and will plan further needs assessment and/or implementation of services. Each team will present their ideas to the rest of the class during the final two weeks in a 35-minute presentation/discussion session. A brief written component such as a handout or program planning worksheet will also be required, details to follow. There will be both group and individual components to the grade for this assignment.

Grading Scale

100-90% A

89-80% B

79-70% C

69-60% D

Project Director Gary Kielhofner 312.996.6901 kielhfnr@uic.edu

Project Coordinator Gail Fisher 312.996.4371 gfisher@uic.edu

Co-Project Director Deborah Walens 312.996.5220 dwalens@uic.edu

Project Faculty Christine Helfrich 312.996.4626 helfrich@uic.edu

Project Faculty Brent Braveman 312.996.3717 bbravema@uic.edu

Project Adm. Asst. Maria Hernandez 312.413.0124 hernandz@uic.edu

Department of Physical Therapy
1919 West Taylor Street, M/C 898
Chicago, IL 60612-7251
312.996.7764

Co-Project Director Sandy Levi 312.996.1503 sanlevi@uic.edu
Project Faculty Demetra John 312.996.1505 demetra@uic.edu

Department of Human Nutrition and Dietetics
1919 West Taylor Street, M/C 517
Chicago, IL 60612-7253
312.996.8055

Co-Project Director Carol Braunschweig 312.996.1209 braunsch@uic.edu
Project Faculty Sandra Gomez 312.413.9896 sgomez2@uic.edu

School of Biomedical and Health Information Sciences
1919 West Taylor Street, M/C 530
Chicago, IL 60612-7249
312.996.8036

Co-Project Director Annette Valenta 312.996.1452 valenta@uic.edu

Research Assistant Laura Brubaker 773.334.9173 lbruba1@uic.edu