Community Health Improvement Plan INTEGRIS Canadian Valley Hospital. Community Health Improvement Plan Report FY 2016

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Community Health Improvement Plan INTEGRIS Canadian Valley Hospital Community Health Improvement Plan Report FY 2016

Plan Overview INTEGRIS Community Health Improvement Plan (CHIP) was developed from results of a health needs assessment from each facility s community. Using a community-driven strategic planning tool for improving community health called Mobilizing for Action through Planning and Partnerships (MAPP), we collaborated with community partners. MAPP can improve the effectiveness and performance of local public health systems. INTEGRIS mission to improve the health of the people and the communities we serve aligned strategically with the plan s goals and objectives. The priority health issues for the three year cycle were heart disease, obesity and mental health. The target was the underserved and minority populations in our service areas. Goals were based on the public health data health according to adults who are obese, the number of poor mental health days per month, and the heart disease age-adjusted death rate. The table below shows Oklahoma s rates of heart disease, mental health and obesity according to the latest substantiated data available. Though we have a three to four year lag time in public health data, state data allows for broader and longer term consistency. The issues with the lag in time generally mean the programs we do now do not show up in the data for about three to four years. However, the action steps in the facility s plans were completed one hundred percent. Success was measured using individual programs goals, completed action steps, and using output numbers based on number of attendees and events. The table below shows how the public health data has slightly improved in the priority issues we addressed in the plan. Oklahoma Public Health Date Priority Health Issue Heart Disease death rate (per 100,000 peo- 1 st year of CHIP 2 nd year of CHIP (2014) (2015) not final data not final data 242.1 deaths (2007) 235.2 deaths (2010) final final 3rd year of CHIP (2016) not final data To decrease or maintain the rate Outcome (as of 2015) -6.9 deaths Mental Health (number of Poor mental health days in the last 30 4.5 days (2011) 4.2 days (2012) To decrease or maintain the rate -0.3 days Obesity rate (adults) 31.1% (2011) 32.2% (2012) To decrease or main- +1.1% INTEGRIS Canadian Valley Hospital had their own action steps tailored to fit the available resources and cultural needs of their specific community. System wide strategies were developed for uniformity and for improved data collection. The framework for developing the action steps were based on prevention, education and collaboration. It is important to remember, this was a community-driven health improvement plan. INTEGRIS efforts are only a piece of the overall evaluation on a community health improvement plan. The collaborations with local coalitions including other non-profits, public health and other stakeholders are the key to a unified force in creating a culture of health in Oklahoma.

Due to the lag time in public health data, we began programs that could be evaluated through pre and post testing. In year three, staff were trained in evidence based programs giving the department a wider scale, more uniform system to be able to collect more appropriate outcome measures. System wide evidence based programs will make data collection real time and more accurate to our specific programs. The table below represents Canadian County s public health data for the 3 year cycle showing substantiated data. County Year 1 Year 2 Year 3 Canadian-Yukon 2008-2010 2010-11 2012-13 Heart Disease-deaths 148.4 206.0 190.1 Mental Health-days 25.3% 23.7% - Obesity 32.5% 30.6% 31.7% *Heart Disease-Number of deaths per 100,000 people *Obesity-Adults over 18 years of age, BRFSS, 2012 rates *Mental Health-percent of population who reported 4 or more poor mental health days per month, BRFSS, 2012 *2014 State of the State s Health Report, Oklahoma State Department of Health Community Impact The decrease in output data for total events is a result of implementing more programs as opposed to large events and health fairs. The total attendees decrease can be attributed to the difference in estimating the number of people attending the Festival of the Child. For FY 16, we chose to only count those that stopped at our booth. The same can be said with the Yukon Middle School Health Fair. Participants were only counted if they attended one of the two classes we offered. Therefore, while it appears the numbers have decreased, we are implementing higher quality, evidence -based programs with specific measurable outcomes. The way we changed counting events had an effect also. If an event was reported more than one time in a quarter, we decided to show the frequency of the event as opposed to listing it each time. For example, if a6 week class was implemented, it was counted once with a notation that it was reoccurring weekly but only counted one time. Hence, there is a decrease in the number of events. Local programs include Diabetes Empowerment Education Program (DEEP), Kids in the Kitchen, Yoga for Kids, Community Cardiopulmonary Resuscitation, quarterly community screenings at the Dale Robertson Center, the Mustang Community Center and the El Reno Senior Center, and the Red Dirt Jeep Health Fair. Here a some examples of the highlighted programs along with total impact numbers.

6000 5000 4000 3000 2000 1000 0 Total Attendees/Participants 5044 3670 823 230 321 Q1 Q2 Q3 Q4 FY16 Q1 Q2 Q3 Q4 FY16 200 Total Events 185 150 100 50 18 15 12 140 Q1 Q2 Q3 Q4 FY16 0 Q1 Q2 Q3 Q4 FY16 1200 1000 800 600 400 200 0 Total Number of People Screened 964 494 245 155 70 Q1 Q2 Q3 Q4 FY16 Q1 Q2 Q3 Q4 FY16

DEEP-Diabetes Empowerment Education Program The DEEP (Diabetes Empowerment Education Program) is an evidence based program developed to provide the community with the tools to better manage their diabetes in order to reduce complications and lead healthier, longer lives based on principles of empowerment and adult education. The program was developed by the Midwest Latino Health Research, Training and Policy Center at the University of Illinois at Chicago in English and Spanish as a curriculum designed to engage community residents in self-management practices for the prevention and control of diabetes. The program is currently being implemented across the U.S., in Puerto Rico and Peru. DEEP curriculum educates participates on the priority indicators of heart disease prevention, nutrition and physical activity (obesity). Program curriculum also covers mental health issues including stress relief, depression and coping with diabetes. Target Health Indicator: Heart Disease, Obesity Goal: Long term: To decrease complications from diabetes. 7 days of the week at program completion. Quarterly Goal: For at least 80% of participants to be medication compliant 2015 2016 Location Enid, El Reno Yukon, Mustang, El Reno, Enid, Oklahoma City # Enrolled 29 72 # of participants who completed the 20 57 program ZIP code 73701, 73703, 73742, 73764, 73096, 73162, 73109, 73036, 73146 73703, 73701, 73064, 73099, 73132, 73127, 737119 fruit and vegetable Consumption (days they ate 5 or more servings in the last week) exercise (how many days they exercise at least 30 minute in the last week) 81% 74% 68% 77% monitoring their blood sugar (how many days they test their blood sugar in the last week) their medication compliancy (how many days they took their medication as ordered in the last week) 96% 94% 92% 85%

Yoga for Kids Yoga for Kids was developed by the University of Arkansas Division of Agriculture Research and Extension. The program is intended for ages 5-19 and incorporates adult yoga poses into kid-friendly yoga routines and games. Yoga for Kid s focus is helping kids achieve optimal physical, social and mental health. Practicing yoga builds strength, flexibility and confidence. Also, the breathing promotes relaxation and quiets the mind. Yoga and stretch breaks in the classroom are proven to improve concentration. This fun and simple exercise program combines breath, physical postures and mindfulness to help strengthen and calm the body and mind. Yoga for Kids promotes stress relief as well as physical activity. Target Health Indicator: Mental Health, Obesity Goal: 70% of participating staff implements yoga in the classroom at least twice per week. Short term Goal: Kids learn how to quiet themselves using the poses and breathing techniques demonstrated in yoga. FY 2015 FY 2016 ZIP code 73703, 73701 73099, 73701 # of children participating 542 1,808 # of staff participating 17 23 % of kids who dealt with stress in a - 59.5% % of kids who dealt with stress in a - 89% % of kids who felt happy and re- - 52.5% % of kids of felt happy and relaxed - 97.5% % of school administration and staff who rated the program as good % of teachers who will use yoga in the classroom to relax and to 6 month follow up: Number of teachers who are currently using yoga in the classroom at least twice 100% 100% 100% 100% 89% 100% (only 2 of the locations have hit the 6 month follow up mark)

Annual CHIP Report FY 2016