Daily, our providers take the time to counsel our patients on the proper choices to achieve better health outcomes: eat more fruits and vegetables, cut out fast foods, exercise more, take your medication, check your sugar levels, etc. We have found that it’s better to show our patients how to make healthy choices than to simply tell them. Alliance Medical Ministry provides a Wellness Programs that, when combined with our comprehensive medical home, gives our patients the tools they need to make lifestyle changes to improve their overall health. These pieces include the community garden, diabetes education, nutrition classes, exercise classes and group visits. By incorporating these options with our clinical care, we are not only increasing access to care, we are giving our patients the education and tools to change health behaviors and overcome social and economic factors.
COMMUNITY GARDEN: The 2013 Wake County Community Health Needs Assessment
shared that 74% of our residents do not eat enough fruits and vegetables, and if your household earns less than $50,000 the likelihood of eating fresh foods decreases immensely. The average Alliance patient earns $19,907 for a household of three. Cost is an economic barrier to healthy eating. That is why we collaborated with the Inter-Faith Food Shuttle (IFFS) in 2009 to establish a community garden on the Alliance campus to offer fresh vegetables to our patients. Produce harvested from the garden is individually bagged, combined with healthy recipes, and handed directly to patients by their provider or nurse. We are able to offer fresh vegetables to our patients, but more importantly teach them about healthy eating options. This reinforces the advice of providers and increases compliance.
DIABETES EDUCATION CLASSES: To promote health behavior change and improve long-term outcomes for patients with chronic disease, Alliance started diabetes education classes to address both the educational and behavioral changes necessary to promote lasting change. In a typical office visit, our providers spend 20 to 30 minutes with a patient. That is not much time when you must address a variety of complex issues. By offering extra health education classes, our patients can learn about diabetes and how to manage their health on a limited budget. The added benefit is the peer support that occurs in a group setting. Patients see that they are not alone and learn from other patient’s questions. We also incorporate garden activities into our curriculum. Our Certified Diabetes Educators utilize the garden by preparing class meals, offered recipes, nutritional information and providing fresh vegetables to participants. Classes occur on Saturdays and are offered in English and Spanish. To incorporate the whole family in this program and to ensure that childcare is not a barrier, we are working with the Poe Center to offer a pilot kids program, “Growing Healthy Gardens,” while the Diabetes Education Class is occurring. This program will educate kids on where their food comes from and healthy choices. We are starting this pilot with three initial sessions with the hopes of incorporating it with all of our Diabetes Classes.
NUTRITION CLASSES: In the fall of 2013, we started nutrition classes that are fully kicking into action in 2014. Once again in partnership with Inter-Faith Food Shuttle we are incorporating their “Cooking Matters” curriculum into our Wellness Program. This program is an interactive nutrition education program that teaches families how to get the most nutrition on a limited budget. These courses provide a long-term strategy to address hunger by ensuring that families can prepare nutritious meals that are balanced, tasty, and economical. We have trained an AmeriCorps Member and other volunteers to offer classes at Alliance.
EXERCISE CLASSES: Recently we also started a partnership with Dr. Howie Shareff of You Call This Yoga to offer adaptive yoga classes to our patients 20 times in 2014. His chair yoga classes allow all individuals to participate regardless of their athletic ability. The goal is to increase strength and flexibility while reducing stress.
GROUP VISITS: The group visit is an extended doctor’s visit where not only physical and medical needs are met, but educational, social and psychological concerns can be dealt with effectively. Patients normally spend 1.5 to 2 hours at Alliance for a typical visit. With the group visit, patients spend the same amount of time at Alliance, but now get to participate in an educational component and interact with other patients. A typical group visit starts with 12 to 15 patients learning about a specific health topic as led by the provider or educator. It is an interactive setting where patients benefit from hearing each others questions and offer up their own advice. After the education session, the discussion continues with a facilitator while the provider sees patients individually. Our patients get increased health education and the benefits of a peer group setting. At the first group visit conducted at Alliance, the most popular saying from the interaction was, “me too,” after hearing other patients comments and questions. We have completed our pilot phase of this program focusing on our diabetic patients and are now seeking to expand with other providers in our practice and to add a group for obese patients. The pilot has shown improved clinical numbers for those that participated in the group visit verses those that did not. Participants reported a higher understanding of their disease, increased confidence to manage their health and increased exercise.
OUTCOME
At Alliance we offer compassionate care. We do not judge, but instead offer a medical home model that builds a relationship with our patients. By offering access to health education, peer support, fresh foods and exercise in addition to primary care, we can take away barriers in making lifestyle changes. The different pieces of our Wellness Programs give our providers options to respond to each patient’s individual needs and achieve greater clinical outcomes. Without this program, our patients would not have access to diabetes educators, nutrition experts or even exercise classes. With 78% of our patients dealing with at least one chronic health issues, these options help to affect positive health behaviors and overcome social and economic barriers.
