Sunshine School Health Fair educates students, community about healthy habits

A crowd of about 200 students from Kindergarten to twelfth grade made its way into a school gym in rural Newbern, Ala. The students wandered with their friends to displays at about 15 or so tables set up along the gym walls. They planted spinach seeds in decomposable pots of soil at one table, had jump rope contests at another and marveled at the amount of sugar in a single Pop Tart at another. 

Sunshine Health Fair

A UA nursing student checks the blood pressure of a student at the Sunshine School Health Fair in Newbern, Ala. on Sept 27.

In between the activities, they had their glucose levels tested, their body mass indexes measured and their blood pressure checked.

This was all part of the first health fair hosted on Sept. 27 by the Sunshine School in Newbern, which is located in the Black Belt region of Alabama.  The event was open to students, parents and the surrounding community as part of a nearly $900,000 grant from the National Institutes of Health to develop and support collaborative research between academic researchers and residents of Alabama communities disproportionately impacted by poor health.

The grant project, “UNITED: Using New Interventions Together to Eliminate Disparities,” or Project UNITED, is a partnership of The University of Alabama’s College of Community Health Sciences and the College of Communication and Information Sciences and the Black Belt Community Foundation. The grant was funded by the Community Based Participatory Research Initiative of the National Institute of Minority Health and Health Disparities, an institute of the National Institutes of Health.

The three-year planning grant is focused on reducing obesity in rural Alabama through community-based participatory research. The Sunshine School was one of the sites chosen by the Project’s community advisory board for a pilot study, said John C. Higginbotham, PhD, associate dean for Research and Health Policy for the College of Community Health Sciences,  director of the College’s Institute of Rural Health Research and one of the grant’s principal investigators.

The other principal investigators are  Kim Bissell, PhD, associate dean for research for the College of Communication and Information Sciences and director of the Institute for Communication and Information Research, and Felecia Jones, MBA, executive director of the Black Belt Community Foundation.

As part of the partnership, the school came up with a list of ways Project UNITED could help, including the organization of a health fair, which Principal Charla Jordan said was a success in educating both students and the community about health.

“As a kid, you hear about issues like high blood pressure and associate that with adults,” she said. “But here they are learning and realizing that these things are possible with young kids as well.”

College faculty, physicians from the area, medical students at the College of Community Health Sciences and students and faculty from the University’s Capstone College of Nursing were in attendance to help with the screenings. They said that from their observations, the health fair served its purpose.

Michele Montgomery, PhD, RN, assistant professor at  the Capstone College of Nursing, said she screened children who had elevated blood pressure and needed to be referred to a physician. For this reason alone, Montgomery said the health fair was a benefit to the children.

“You don’t know if they are getting a regular health checkup,” she said. “Like these kids (with elevated blood pressure)—they may not have noticed otherwise if not getting a physical. Health behaviors they develop now—like healthy eating and exercise—will help them later in life.”

Eunice Briggins, a mother of three who currently attend the school and two who have already graduated, said she came for her health screening to support the school, and she’s glad she did.

“I now know I need to cut down on my salt intake with my girls and me to lower my blood pressure,” she said, as she turned to her daughter beside her. “Did you know you’re only supposed to eat one Pop Tart out of the package?” she asked with a laugh.

Briggins said she’s glad the health fair was held because she says it’s a way to keep students and families healthy.

“That’s especially if they aren’t going out to get checked,” she said. “Some people don’t have transportation.” 

Project UNITED also plans to work with Druid City Garden Project, a Tuscaloosa-based organization that uses school gardens and educational programs to help communities establish healthy eating habits and reduce obesity, to plant a garden at the Sunshine School. The organization was present at the health fair with its spinach seed-planting activity.

Project UNITED will also organize workshops to enhance research knowledge and skills of community members and university faculty as it relates to community-based participatory research. 

Higginbotham said that community-based participatory research component was a key part of the health fair as well as the screenings and education, so data were collected from students with parental consent and child assent and anyone from the community who consented.

“One of the things [the Sunshine School] wanted to do was not only see where their kids stood with regard to a lot of health indicators, but they wanted to expand that beyond their students to parents and the community as a whole,” Higginbotham said. “The school wanted to have a role in improving the health of their whole community.”

College partners with nursing on nearly $1M grant to address multiple chronic conditions patients

University of Alabama students are learning the value behind the “two heads are better than one” concept when addressing the health care needs of rural communities.

The Capstone College of Nursing received a $997,173 grant from the U.S. Department of Health and Human Services to implement a collaborative team-based approach to working with patients who have multiple chronic conditions.

Chronic conditions are conditions that last a year or more and require ongoing medical attention. They include both physical conditions – arthritis, cancer, HIV infection – as well as mental and cognitive disorders, such as ongoing depression, substance addition and dementia. Multiple chronic conditions are two or more chronic conditions that affect a person at the same time.

“People are living longer, but they are getting sicker earlier,” said Dr. Leigh Ann Chandler Poole, assistant professor in nursing and coordinator of the Nurse Practitioner Concentration in Mental Health and Primary Care for Rural Populations. “What we’re doing is not working, so we’re moving to models that use interprofessional teams to provide quality patient-centered care.”

The primary component of the three-year grant is the development of interprofessional grand round teams. These teams will be comprised of graduate-level students from the College of Community Health Sciences, the School of Social Work and the Nutrition Department, as well as nurse practitioner students in the Capstone College of Nursing, who will be taking lead on this project.

Each nurse practitioner student will be assigned patients, from rural areas, who have multiple chronic conditions, and they will follow those patients for up to a year. Nurse practitioner students will meet with their patients, do the initial workup and then present the patient to the interprofessional grand round team via telemedicine.

The team will meet on a weekly basis to come up with a plan on how to improve the patient’s quality of life and decrease problems associated with the multiple chronic conditions. That plan will then be presented to the patient’s primary care provider who will ultimately decide whether or not to implement the recommendations made by the team.

“This incorporates all disciplines, working together as a team and learning from each other and from the patient to develop best evidenced-based practice plans for the patient,” Poole said. “The patient needs to be part of the process in deciding what will work for them. The providers need to know their patient and their motivations and determine how we can best help the patient achieve their health-related goals.”

According to the Department of Health and Human Services, multiple chronic conditions are associated with substantial health care costs in the United States. Approximately 66 percent of the total health care spending is associated with care for over one in four Americans with multiple chronic conditions.

With the Affordable Care Act, health care providers have to prove what they’re doing works in order to get reimbursed, Poole said. For instance, if someone with congestive heart failure is readmitted to the hospital within 30 days, the hospital will not be reimbursed. But they still have to provide the care.

“We hope to provide quality team-oriented care, and find evidence that this process works in improving the patient’s quality of life and health status and, at the same time, decreases the financial burden associated with multiple chronic conditions,” Poole said.