Engagement of Adults in Wellness Center Activities to Reduce the Risk of Chronic Disease

1. Engagement of Adults in Wellness Center Activities to Reduce the Risk of Chronic Disease Indiana University Anne Belcher, PhD, RN, PNP Susan Moore, PhD, RN, FNP-BC, GNP-BC Indianapolis Public Schools Jim Grim, MA, Director of Community Engagement Graduate Students Kevin Boone, MSN, RN, ANP-BC Robert Ingram, MSN, RN, ANP-BC Jan Neylon, MS, RN, ANP-BC

2. Near Westside

3. Best Practice of Community-Based Participatory Research Evidenced by the GINI Project • Greater Indianapolis Neighborhood Initiative (GINI) • Engaged residents from the neighborhoods in their community to plan and implement strategies to improve their quality of life. • Seven Goals • Housing • Public Safety • Beautification • Economic Development • Education • Health • Civic-Youth Engagement

4. George Washington Community High School (GWCHS)Near Westside Five Year Health Plan • Goal: Improve the level of individual and community environmental health • Indicators: Increase the level of physical activity and awareness of • proper nutrition for near Westside students and residents. • Action Steps: • Support broad community use of the Westside Wellness Center • Conduct healthy life style events at the school – Westside Wellness Center – PARCS (Physically Active Residential Communities and Schools) • Develop health promotion messages to the community • Provide information to residents about risk factors for chronic disease • Improve residents access to healthy foods

5. GWCHS – Community Partnerships • More than 50 organizations and businesses partner with GWCHS • Anchor partnerships serve 735 students, 1,489 family members, & 6,205 community members • Average $2 million in services provided annually • Indy Parks manages & staffs Washington pool (open evenings & weekends) • Mary Rigg Neighborhood Center employs three full-time staff members for coordination of activities at the school; serves families • Hawthorne Community Center supports after-school programming • Midtown Community Mental Health provides onsite counseling • Learning Well, Clarian/HealthNet staff teen clinic, nurse practitioners

6. Westside Wellness Center atGeorge Washington Community High School • Facilities: 6,000 sq. ft. space housed within the school building • Exercise Areas • Free weight and machines • Cardio equipment • Group instruction area • Wellness Center Office • Existing pool: Operated by Indy Parks • Participants • GWCHS Students and Staff • Near Westside Residents • Staff • Full-time Wellness Center Coordinator (graduate of IUPUI program) • GWCHS Physical Education Teachers, Coaches, Staff • IUPUI students – School of Physical Education – School of Nursing

7. George Washington Community High SchoolNational Community School Award 2006 • A full-service community school draws upon the resources of its entire community to support student learning by providing needed services to strengthen the students, their families, and communities. • Collaborative Partners: • Community & Faith-Based Organizations • Neighborhood Leaders • Businesses • Local Universities • School Staff • Student Families (573 engaged in 2009-10, 165 multiple times) • Anchor Partners: • 3 Community Centers led by Mary Rigg Neighborhood Center • IUPUI & USA Funds

8. George Washington Community High SchoolStatistics • 94% Attendance Rate in ‘09 • 88% in 2006 • 23 of 29 AYP Categories Met in 2008 • 2 of 29 in 2006 • Combined ISTEP Scores • Spring 2008-2009 • 19.4% Pass • State Average Combined ISTEP 62.7% Pass • 100% of 2008 graduates accepted to college • 49% 2009 graduation rate • State average 73% • Average household income • $17,321 • Enrollment 2010-11 • 703 Students • Student Demographics • Caucasian 42% • Hispanic 30% • African American 23% • Multi-racial 5% • Lunch Programs • Free & Reduced 81% • Universal feeding • 78% Students in health promo/fitness program, 09-10

9. Health Literacy Survey of PARCS Participants • Purpose • Health literacy is a social issue affecting races and ethnic groups. Research demonstrates decreasing health literacy correlates with poor health outcomes. • The aim of this project was to explore health literacy and community-based education needs to underserved populations. The target population attends the Westside Wellness Center located at GWCHS.

10. Methods of Survey • The questionnaire was reviewed for content analysis by three faculty, community residents, and graduate students. • 175 participants of the PARCS Program were contacted to complete a questionnaire covering demographics, health literacy, and center effectiveness.

11. Sample Characteristics (N = 67)(Baseline) • Demographics of the population demonstrated lower education levels, larger members of minorities, and lower income. Health issues included hypertension, diabetes, and obesity.

12. Results of Survey • Graduate nurse practitioner students discussed self-care with at least four participants at each exercise session. • Sixty-seven individuals completed the questionnaire to determine exercise program effectiveness and clients’ needs. • The exercise program was viewed very positive with suggestions of increasing the hours. 93% of the participants came to lose weight, get fit and to become more healthy. • From the sample, 67% wanted to talk to a nurse about specific chronic illnesses. • 95% of the clients had been seen in the past year by a health care provider. • Correlations of health literacy and exercise attendance were not significant.

13. Selected Results of Survey

14. Community Based Education Clients Seeking Health InformationSummary of 14 days (75 Clients Seen)

15. Survey: Health Literacy Need Help Reading Ability to Read

16. Mentoring • Over two semesters, three Adult Nurse Practitioner graduate students provided mentorship to fifteen undergraduate community nursing students. • Mentoring involved sharing community experiences, real life work experiences, and interactions with the community population on question and answer formats. • Presented health information to community residents in a professional but strategic way to impact their health decisions. • Collaborated with other Service Learning Assistants in the School of Physical Education to formulate appropriate care plans for clients of the community.

17. Summary of Survey • Preliminary results have been positive with participants requesting health education. • Correlations may not have been significant due to a select population volunteering to participate in the survey. • Recommendations include extending health information opportunities to other community centers using the same model.

18. Distance Research Education Site Community Engagement Research Teaching Service Service Participatory Professional Learning Action Community Research Service Engagement of Faculty Work in and with the Community Positive Outcomes of Civic Engagement Partnerships By Bringle, B., Grim, J., & Officer, S.

19. University Engagement By Bringle, B., Grim, J., & Officer, S.

20. Quality of the Partnership • Closeness • Frequency of Interaction • Diversity of Interaction • Interdependency • Equity • Mutually satisfying processes • Mutually beneficial outcomes • Integrity • Coherent, shared values • Mutual vision for change • Mutual commitment By Bringle, B., Grim, J., & Officer, S.

21. Grants and Other Fundingfor the Community • Grant funding • HUD COPC grant,1997-2002, $395,000 • Annie E. Casey Foundation grant, $225,000 • WEPIC University of Pennsylvania replication grant, 1999-2001, $51,000 • HUD New Directions grant, 2002-2004, $150,000 • Bank One/Chase grant, $75,000 • ICC Listening to Community grants, 1998, 2005, $2,500 • USA Funds grants, 2005 - 2010, $895,000 • US Department of Education grant, 2009 -2014, $2.4 million total award • Other leveraged funding • Federal Work Study • Service Learning Assistants (more than $35,000 annually) • Stipend support for IUPUI faculty (approx. $3,000 - $10,000 annually) • IUPUI student scholarships (more than $55,000 annually) • Office of Neighborhood Partnerships (approx. $75,000 annually) By Bringle, B., Grim, J., & Officer, S.

22. Research, Scholarship, and Dissemination • The “Scholarship of Engagement” • More than 24 presentations • U Pennsylvania/Community School Conferences • HUD conferences • Indiana Black Expo & Student Success conferences • Other related professional conferences • Publications include 6 journal articles and book chapters • Research and program evaluation by the IUPUI Center for Urban and Multicultural Education • Numerous visitors (5 from foreign countries) to the university and GWCHS to learn about school/university/community partnerships By Bringle, B., Grim, J., & Officer, S.

23. Challenges with the Project • The site has limited access and availability. • School of Nursing used one location on the Westside for health education (limited exposure). • There were undefined marketing strategies for the community and the referral based clinic. • Community was not fully aware of resources available. • Referred participant’s follow-up was sometimes insufficient. • The program did not reach those in most need. • Ways to increase the number of PARCS participants who engage in education.

24. Future Implication • There is a need for expansion of the health engagement program to community centers and other PARCS sites. • Strategic marketing should occur in the community and also targeted at the Hispanic population. • Discussion is occurring to include mental health services by graduate students in the School of Nursing. • Linkages of university faculty and community partners to enlarge and ensure sustainability of the program in the community. • Expand the service learning opportunities to include more intra-professional student exchanges.

25. Acknowledgements • Special thanks to • Indiana University School of Nursing for materials for client education • George Washington Community High School and PARCS Program for allowing the SON to be part of their programs • Indiana University, Center for Service Learning at IUPUI for providing scholarships for students, Robert Bringle, Starla Officer, & Jim Grim • Near Westside Community Centers (Hawthorne and Mary Rigg)