Collaborating with the Community in Primary Care: Teaching and Modeling Community-Responsive Practice

Society for Teachers of Family Medicine Group on Community Medicine Spring 2005

Goals and Objectives

 Understand the importance of collaboration with the community when initiating COPC projects  Be able to identify some characteristics of community academic partnerships that work  Identify methods for institutions to create a collaborative environment and find a "win-win" scenario which accomplishes training goals and community agendas  Have a working knowledge of 4 successful sustained collaborations pairing agencies and three Family Medicine Departments in which COPC is modeled and taught

THEORETICAL FRAMEWORK

Determinants of Population Health Tarlov AR. Ann NY Acad Sci 1999;896:281-293

Actual Causes of Death, 2000           Tobacco 435,000 (18.1%) Poor Diet & Physical Inactivity 400,000 (16.6%) Alcohol Microbial Agents Toxic Agents Motor Vehicles Firearms Sexual Behavior Illicit Drug Use Total 85,000 (3.5%) 75,000 (3.1%) 55,000 (2.3%) 43,000 (1.8%) 29,000 (1.2%) 20,000 (0.8%) 17,000 (0.7%) 1,159,000 (48.2%) Mokdad AH, Marks JS, Stroup DF, Gerberding JL. JAMA 2004; 291(10):1238 1245

Racial & Ethnic Disparities In Health      

Risk Behaviors Medical Care SES Social Support Group/Community Determinants

– Social Capital – Income Inequality – Community Environment

Stress

Environment Community Group Individual

Understanding Inequalities in Health Kaplan GA. Ann NY Acad Sci 1999, 896:117-199

Prisoners of the Proximate McMichael AJ. Am J Epidemiol 1999; 149:887-97

RE-AIM Model

Public Health Impact = Reach X Efficacy * Adoption X Implementation X Maintenance Glasgow RE, Vogt TM, Boles SM, et al. AJPH 1999; 89(9):1322-1327 Glasgow RE, Lichtenstein E, Marcus AC, et al. AJPH 2003; 93(8):1261-1267

Collaboration & Community Medicine

 Interest or Inclination AND  Competent Community Organization  Capable, Trusted Community Leaders

Collaboration & Community Medicine

  Common Interests Overlapping Missions   Trust Time  Keeping On

Who’s here



Fit, Fun, & Thin-some

– Rosalyn Arnaud, Community Health Nurse and Director of the Daughters of Charity Neighborhood Health Partnership – Carol Bebelle,Director of the Ashe Cultural Arts Center – R. A. Meriwether, MD, MPH; Tulane Dept of Family & Community Medicine

Who’s here

 Penelope House – Marty Adams, PhD; USA Dept of Family Medicine – D’ana Snow, PhD; USA Dept of Family Medicine – Reda Haynes-Penelope House, Mobile, Alabama – Allen Perkins, MD, MPH; University of South Alabama Dept of Family Medicine.

Who’s here

 Bridging Health Together: – Kim Gudzune, MS3 – Jim Theis, MD; Tulane Dept Family & Community Medicine.

Who’s here

 PATH – Dave Ward, President and CEO of Daughters of Charity Health Services of New Orleans – Father Jim DesHotels, FNP, Daughters of Charity – Robert Post, MD; LSU Dept of Family Medicine

Environment Community Group Individual