For outreach success, target population’s needs

Disease prevention not always a top priority

Health care organizations across the nation have found the Healthy People 2000 data issued by the U.S. Department of Health and Human Services useful when structuring community outreach programs. That’s because the goals of this national prevention program provide measurable outcomes to target. They are:

• Increase the span of healthy life for Americans.

• Reduce health disparities among Americans.

• Achieve access to preventive services for all Americans.

Three years ago, Mid-Florida Medical Services in Winter Haven joined forces with other local organizations to identify the population most at risk for non-achievement of the target indicators, says Joel Thomas, MA, director of marketing and public relations at the health care facility. They selected the geographic area by studying information from the Florida census.

Although improved health was the reason for the alliance, the group acknowledged that they would have to address the neighborhood’s economic development if they were to improve health care. They realized that a Haitian living in a shack was more concerned about basic needs, such as food, than chronic disease prevention, explains Thomas.

"We identified four priorities on which to focus our efforts: We plan to develop jobs, improve housing, help entrepreneurs develop businesses, and improve the health status of the community," he says.

To determine how to improve the health of the community, they organized focus groups and surveyed neighborhood residents. Their research showed the community was interested in improving cardiovascular health, diabetes awareness, chemical dependency, and mental health. The alliance hoped to increase participation by asking the community what health topics interested them, rather then looking at data and statistics gathered by the hospital or other agencies.

Currently, a committee created to target health care is developing screening services and identifying sites, times, and promotional and educational support for the programs. There is a lot to consider.

"Transportation is a big problem. We have to figure out how to get people to the educational and preventive services," says Thomas.

While Mid-Florida Medical Services selected a geographic area where their efforts could impact the broad based goals, others have used the data to target health care concerns identified in the guidelines such as mental disorders or substance abuse.

Choosing target areas

When Johnson Memorial Hospital in Franklin, IN, joined with businesses and other health care organizations to improve the health of the community, they looked at the 22 priority areas identified in the guidelines to determine which categories to target. "We obtained some data from our local state health department and compared it with the Healthy People 2000 objectives and looked at where we were in comparison to their benchmarks for the year 2000," explains Janette Helm, MA, RN, CHES, director of education and training at the hospital.

Maternal and infant health was one national priority the Indiana community selected to target by establishing a clinic to provide health care to low-income women and children. Some of the goals in this area include increasing prenatal care in the first trimester and reducing infant mortality, fetal alcohol syndrome, low birthweight, and tobacco use during pregnancy. ( For details on Johnson Memorial’s community partnership, see Patient Education Management, March 1997 , pp. 33-35.)

During its mid-year report in 1995, the U.S. Health and Human Services Department reported progress for two-thirds of its Healthy People 2000 goals. For example, Americans are more active, use fewer drugs, and smoke less. However, areas that lacked progress included homicide, nutrition, teen pregnancy, occupational injuries, and chronic disease.

Although the goals were established in 1990, the target date for reaching the program goals is 2000. That date was set so organizations would have a decade to make an impact, says Thomas. The key to a successful outreach program is to acknowledge that success will not happen overnight, he says.

[Editor s note: For a copy of the Midcourse Review of Healthy People 2000, contact: the National Health Information Center at P.O. Box 1133, Washington DC 20013-1133. Telephone: (800) 336-4797 or (301) 565-4167. Fax: (301) 984-4256. World Wide Web:]

Leaders training for the Chronic Disease Self-Management Program — Aug. 12-15, 1997, at Stanford University in Palo Alto, CA. The fee for the four-day training is $600. On-site room and two meals per day are available for an additional $65 per day. Stanford trainers also can come to individual facilities to train up to 25 leaders at your facility for $10,000, plus expenses.

The Chronic Disease Self-Management Program was developed at Stanford to help people live with such chronic illnesses as heart disease, lung disease, stroke, or arthritis. Evaluation of the program showed that patients who attended spent fewer days in the hospital and had fewer outpatient visits.

For registration materials or more information about the program and how it can be offered through your facility write, e-mail, or fax Kate Lorig, Diana Laurent, or Virginia Gonzalez at: Stanford Patient Education Research Center, 1000 Welch Road, Suite 204, Palo Alto, CA 94304. Telephone: (415) 723-7935. Fax: (415) 723-9656.

[Editor’s note: Patient Education Management will print notices of educational conferences and events. Send information at least three months prior to the event. Address: Susan Cort Johnson, Editor, Patient Education Management, P.O. Box 740056, Atlanta, GA 30374. Telephone: (916) 362-0133. Fax: (404) 262-7837. E-mail:]