Integrating research, education and practice in the development of an interprofessional educational program on healthy aging.

Transcription

1 LOYOLA UNIVERSITY CHICAGO HEALTH SCIENCES DIVISION Integrating research, education and practice in the development of an interprofessional educational program on healthy aging. Lisa Skemp PhD, RN, FGSA, FAAN

2 Purpose Describe development of the Interprofessional Study Abroad Program on Capacity Building for Healthy Aging in the Caribbean, United States, and South India. LOYOLA UNIVERSITY CHICAGO

3 Background Population aging 3 Global Health education and practice 1,2 LOYOLA UNIVERSITY CHICAGO

4 Interprofessional Community Capacity Building Objectives: for Healthy Aging Program Integrating academic role: Describe the development of the interprofessional program on community capacity building for healthy aging Describe components of the interprofessional Culturally Informed Healthy Aging (CIHA) model Identify program outcomes and recommendations LOYOLA UNIVERSITY CHICAGO

5 Academic Research Background Elders In St. Lucia: Status and Care Systems Ethnographic Community Study (Arnesberg & Kimball, ) Funding: NYISM; U of I, NIH NINR F31

6 Expectations and Elder Care Networks in a St. Lucian Village Elder Care Assumptions Challenged *Skemp Kelley, L. (2005). Growing old in St. Lucia: Expectations and elder care networks in a St. Lucian village. Journal of Cross-Cultural Gerontology, 20, *Skemp Kelley, L. (2005). Gendered Elder Care Exchanges in a Caribbean Village. Western Journal of Nursing Research, 27(1), *Skemp Kelley, L. (2005). Minor Children and Adult Care Exchanges with Community Dwelling Frail Elders in a St. Lucian Village. Journal of Gerontology: Social Sciences, 60B(2), S62-S73. 7 *Skemp Kelley, L. (2007). Not too good, not too bad elder care in a St. Lucian village. Health Executive. 9(1),

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8 Interprofessional Program on Community Capacity Building for Healthy Aging

9 Culturally Informed Healthy Aging (CIHA) Community Capacity Building Anthropology- Community Study (Arensburg & Kimball, 1965) Epidemiology- Population indicators Public Health Nursing- Human response to health and illness and licensed to provide individual to community practice Skemp, L., Dreher, M., & Lehmann, S. (2016) Healthy Places Healthy People A Handbook for Culturally Informed Community Nursing Practice. (3 rd Ed). Indianapolis: Sigma Theta Tau 9

10 Culturally Informed Healthy Aging: CIHA Skemp & Peacock Skemp, L., Dreher, M., & Lehmann, S. (2016). Healthy Places Healthy People. A Handbook for Culturally Informed Community Nursing Practice.. (3 rd Ed). Sigma Theta Tau

11 Systematic Ongoing Community Assessment Community Cultural Inquiry Community Health Assessment Environment *Spatial Population Environment *Spatial Population *Temporal *Temporal Social Organization Social Organization Elder Community Cultural Inquiry Elder Community Health Assessment Older Persons Environment *Spatial *Temporal Older Population Older Persons HEALTH Environment *Spatial *Temporal Older Population HEALTH Older Persons Social Organization Older Persons HEALTH Organization

12 Culturally Informed Strategies CIHA Participatory Strategies Mapping Review of documents and artifacts: e.g. internet, newspapers, flyers, signage Informal and formal interviews Observations (field notes, photos, videos) Participatory Observation Network analysis

13 Community Diagnosis List of community issues Prioritize WITH community partners Format for stating: Risk of (amputation) or Promotion for Among (elders in Hillside) Related to (walking barefoot/flip-flops, lack of knowledge about IDDM, diet, exercise, mountainous terrain, transports, poverty, access to services) 13

14 Community Planning & Prioritizing Community awareness of the issue Motivation to resolve or better manage Resources to manage or build capacity to address the issue Expertise Potentiality for growth and/or Severity of outcomes Speed in which issue addressed or problem can be resolved 14

15 Community Planning, Implementation and Evaluation Community Advisory Board Health Plan Goals Priorities Measurable outcomes Operational Plans [Activity/strategic plans] Cost effectiveness Evaluation: benchmarks 15

16 Educational Learning Modalities Readings, discussion and facilitation Cross-national on-line discussion with follow-up discussion points International Host Professors and Facilitators University Professors ( Director & Disciplinary), Staff Past Students Intensive 1 week host country courses on history, culture, health, healthcare Host Facilitators and US Director mentor students in the field Return reflection

17 Learning Outcomes Discuss *** history and culture Work with translators and interpreters and use conversational **** Describe the *** health care system Describe the *** (partner agency) initiatives Apply the culturally informed healthy aging model by: Applying strategies for partnering with students, disciplinary colleagues, mentors and community members; Applying strategies for assessing cultural capital and health for healthy aging of communities; Applying skills and strategies to develop culturally informed programs; Identifying strategies to evaluate the process and outcomes of programs; and Developing skills in program dissemination

18 Learning Activities Identify personal and professional goals Maintain a descriptive and reflective daily personal journal Active engagement in learning CIHA activities Confidential descriptive and reflective field notebook Digital and hard copy CIHA assessment for partners and next group of students Formal presentation Paper on personal and professional experience in the course (2 weeks after return)

19 Interprofessional Program on Community Capacity Building for Healthy Aging Caribbean

20 Caribbean Foot Care, Diet and Exercise 20

21 Midwest United States Sudanese Refugee-Immigrant Diabetes, Stress Management Anti-bullying Anglo/Hispanic Community Elder Care, Immigration, Diabetes, Vote & Vaccinate

22 South India Foot Care, Oral Care, Diet and Exercise

23 Program Outcomes Caribbean Programming Protocols In 36 island health clinics No amputations in participants Digital materials South India Programming Protocols In 3 haddis and 5 PHCs Health Programs 1 partial toe amputation Stores with footwear Awareness and Attitude Digital materials Uptake expand to rural and tribal area urban (Palliative Care)

24 Development and Sustainability Healthy Aging purpose Consumer, interprofessional, nurse facilitated Community centered and aging capacity issue contextual Ongoing virtual and in person communications Boosters Upstream essential and active Go with the flow in planning and ongoing partnership

25 Student Process Outcomes Explore and reflect on personal/professional self, social determinants in a cultural context, rights, responsibilities, strengths, and concepts such as poverty, poor, vulnerable, marginalized Assumptions and pre-judgments Interprofessional/civic collaboration through lens of other disciplines/members focused on the shared CIHA purpose Community is central and healthy aging contextual Upstream essential and active Go with the flow in planning and ongoing partnership Dignity & respect of self : rights and responsibilities working in solidarity with others Dignity & respect of others - individuals and communities Challenges & informs what one knows and does back home.

26 I will never look at my patients just as patients again they are people who come from a community and an understanding of that community are critical to my being a nurse changed the way I see myself and others more empathetic more just

27 Students N=44 DNP, PhD & BSN in Nursing Anthropology Pharmacy Global Health English Education Public Health Medicine Dentistry Informatics Health Coaching Athletic Training Pre-PA Interdisciplinary Studies Social Work Psychology

28 Partners St. Lucia Villagers and Ministry of Health University of Iowa Global Health Campus Iowa John A. Hartford Center of Geriatric Nursing Excellence Franciscan Missionaries of Our Lady Health System, Louisiana National Hartford Center of Gerontological Nursing Excellence WHO AHAA members and steering committee Louisa County Public Health Sudanese Community Association Pheasant Ridge Neighborhood Center Swami Vivekananda Youth Movement, Karnataka, India svym.org.in Vivekananda Institute for Indian Studies Villagers Interdisciplinary Students Volunteers Widernet, University of North Carolina University of Iowa College of Dentistry University of Iowa College of Public Health University of Iowa College of Nursing

29 Why do we care about culture? Living and life. 29

30 Why do we care about culture? Sanitation and safety. 30

31 Why do we care? Walking and foot care. 31

32 Why do we care about culture? My home. 32

33 Why do we care about culture? The troublesome child

34 Next Steps Emerging design 3 years for outcomes/uptake Capacity building vs problematizing communities Life happens for the individual & community Funding comes and goes Continue evaluation research Culturally informed local digital libraries and hand-held devices for field use. DNP and advanced interprofessional students & providers Expand to Chicago neighborhoods Atlanta Georgia: Family Involvement in Care ADRD

35 Funding University of Iowa Global Health University of Iowa Iowa Hartford Center of Geriatric Nursing Excellence NIH, NINR New York Institute for the Study of Man Wellmark Foundation Sigma Theta Tau International Sister Agnes Marie Fitzsimons Endowed Professorship in Gerontological Nursing Loyola Health EQ WiderNet Carnegie Foundation Voices of Angels Intel Stanley Foundation Rockefeller Foundation MacArthur Foundation USAID USICD Skillsoft Microsoft Hewlett Foundation US Department of State

36 References 1. Merson, M.H. & Page, K.C. (2009). The dramatic expansion of university engagement in global health. Implications for U.S. policy. A report of the CSIS global health policy center. Center For Strategic & International Studies: Washington, D.C. 2. He, W., Muenchrath, M., & Kowal, P. (2012). Shades of Gray: A cross-country study of health and wellbeing of the older populations in SAGE countries, International Population Reports. US Department of Health and Human Services. National Institutes of Health, National Institute on Aging. U.S. Department of Commerce. Economics and Statistics Administration US Census Bureau. 3. U.S. Census Bureau. (2014). 65+ in the United States: 2010, U.S. Government Printing Office, Washington, DC. 4. Arensburg,C., & Kimball, S. (1965). Culture and community. New York: Harcourt, Brace & World, Inc. 5. Skemp Kelley, L. (2005). Growing old in St. Lucia: Expectations and elder care networks in a St. Lucian village. Journal of Cross-Cultural Gerontology, 20, Skemp Kelley, L. (2005). Gendered Elder Care Exchanges in a Caribbean Village. Western Journal of Nursing Research, 27(1), Skemp Kelley, L. (2005). Minor Children and Adult Care Exchanges with Community Dwelling Frail Elders in a St. Lucian Village. Journal of Gerontology: Social Sciences, 60B(2), S62-S Skemp Kelley, L. (2007). Not too good, not too bad elder care in a St. Lucian village. Health Executive. 9(1), Skemp, L., Dreher, M., & Lehmann, S. (2016) Healthy Places Healthy People A Handbook for Culturally Informed Community Nursing Practice. (3 rd Ed). Indianapolis: Sigma Theta Tau LOYOLA UNIVERSITY CHICAGO