Barry Taniguchi, Community First’s chairman, said, “There is no way to transform health care and achieve a sustainable system without coming together.”
Barry Taniguchi, Community First’s chairman, said, “There is no way to transform health care and achieve a sustainable system without coming together.”
Community First’s grassroots initiatives are meant to do just that — bring the community together to tip the idea of health care from one of treating disease to taking care of one’s health. These initiatives would never work without strong support and collaboration with like-minded organizations. To that end, the nonprofit has been working with many local groups to change health care attitudes from the bottom-up.
During the past several years, two initiatives have been ongoing in East Hawaii — the Blood Pressure Educator and Advance Health Care Directive projects. These initiatives serve as a catalyst to change attitudes about health care by empowering community members to make changes in their own lives. The University of Hawaii at Hilo School of Nursing students are honored to be involved in both projects.
In 2014, the blood pressure project was started and the first group of nursing school students went into sixth-grade classrooms. The spark for the project was the fact that high blood pressure exacerbates other health conditions, but in many cases can be controlled with minimal intervention. Community First, the UH-Hilo nursing department and local community schools cooperate to increase student awareness about blood pressure and the effects it can have on health.
Fifth- and sixth-graders are given a blood pressure monitor for one week and asked to take blood pressure readings from as many adults as possible during that week. Many of your children and grandchildren probably participated in this project. Not only has this collaboration assisted in helping students learn the basics of taking blood pressures, but it also has made an impact on their families and communities in recognizing hypertension and the importance of following up with their caregivers.
Nursing school seniors gain valuable experience and exposure while coordinating presentations and giving instruction to elementary and intermediate schoolchildren. Teachers, administrators, nursing students and younger participants all thoroughly enjoy the experience. It is these types of deep interactions that can keep our community connected. I have seen our nursing students grow as this project tests the real world application of their skills.
There are several strategies used by the senior nursing students to reach the students, such as interaction, hands on, the garden hose analogy and visual teaching aids. Students are excited to learn and to be able to take this information home and share it with others. Exercise, diet and lifestyle change also are incorporated into the education.
The outcomes of the Blood Pressure Educator initiative have been overwhelmingly positive. It has revealed that sixth-grade students are able to explain and demonstrate the basics of blood pressures, know the difference between normal and high blood pressures, and are able to educate others about blood pressures. With these educational tools, students are able to make better choices and help their families and communities to do the same.
One strength of Community First is the ability to find synergies with collaborative organizations. The Advance Health Care Directive initiative is another example of what our community is capable of when we combine our resources. Community First volunteers provide a free 90-minute class and an open follow-up session to help people complete their AHCDs. The Hawaii County Aging and Disability Resource Center provides a regular and comfortable venue for classes. The East Hawaii IPA, Hospice of Hilo and Hilo Medical Center are able to refer patients to the classes to get help completing the AHCDs. Those who attend regularly comment on the tremendous value given through these free classes.
In the spring of 2017, a second nursing school student group worked with the AHCD initiative. This group brainstormed a novel way to engage greater numbers of younger patients in thinking about advance care planning. One common AHCD form used in Hawaii is three pages long. Our nursing students created a mini-AHCD that fits in your wallet. The design on the reverse side was aesthetically pleasing to catch a patient’s attention. It contained the basic AHCD directions and encouraged patients to learn more about completing the full AHCD forms. These mini-AHCDs were distributed to participating physicians’ offices to increase interest and engagement with populations that might not be thinking about completing an AHCD.
As we begin the next semester I am looking forward to growing these programs. We are coming together, and we will transform our health care system.
Dawn Frizell, MSN, is an assistant professor at the UH-Hilo School of Nursing. This column was prepared by Community First, a nonprofit organization led by KTA’s Barry Taniguchi, and supported by a volunteer board of local community leaders. Community First was established in 2014 to help the community respond to the health care cost crisis and support initiatives that change health care from just treating disease to caring for health. To learn more about Community First, visit CommunityFirstHawaii.org.