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Final lomboy nosorh congregational health presentation

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  • Mission Statement and emphasis given to the fact that this is a Judeo-Christian effort, and my area as a Subject Matter Expert in this particular area.
  • Basic definition—although this is NOT a new concept, it has not yet been fully defined since it is an emerging field.
  • President Obama in the new administration supports this effort and renamed it The Center for Faith-Based and Neighborhood Partnerships. Current materials now available.
  • Note QUICK facts.
  • The Original Swiss Cheese Model is a systems approach showing how they can be aligned. If there is a failing in one or more systems, there are “gaps” in the system. One or more gap can cause an overall system plan to fail. However, if all of the parts “sectors of the community” align, we can maximize the potential to increase overall health of a community (whether or not the sectors are health driven).
  • This is an illustration of a TYPICAL rural community. Notice the mouse who represents the Swiss Cheese Model. 5 sectors of the community (health, faith, civic, medical, government) Notice the silos and the individual colors representing different sectors of the community.
  • If we were to take the silos, and more identify points of common interest and mission, and merge them for the common goal of increasing overall health—and take it from an AERIAL view, which is God’s perspective (and the churches), it could potentially look like the next slide.
  • This is a puzzle Venn Diagram—notice that it appears as a stained glass window. The window has 2 purposes to see in and to see out. If both the church and the community call upon the strength of their congregations and the power behind it, together we can leverage people, resources and knowledge to attain our goal. Notice that cycle wheel indicates the 10 essentials of public health services. If we cognitively utilize these tools in our efforts. We can challenge ourselves to think and respond differently.
  • Given this understanding of congregational health, the VDH OMHPHP and the SORH invested in a Congregational Health Assessment Pilot to understand the health needs of the community with input from each sector of the community. How can we move forward in the second stage of the pilot with Best Practices once the results were in?
  • This slide demonstrates the STRENGTH of the church. US has over 268k congregations with over 176M adherents. I WILL DEMONSTRATE HOW THIS NUMBER IS FAR FROM BEING AN ACCURATE COUNT.
  • Taking it down from the US level to Virginia, there are nearly 7.8k congregations with over 2.9 ADJUSTED – shows ~3.8M members.
  • Drilling down further to the county level, we see that Essex County had listed 20 churches. I personally identified 46 churches. Over half of the churches in Essex do NOT report their adherents. Some denominations choose not to participate while others simply do not have the data required to participate. The latter is the case with most African-American denominations. ~267 documented congregations with ~177M adherents in a US population of over 300M. IMAGINE THE TRUE NUMBERS!
  • Selection process
  • Transcript

    • 1. Community Engagement Models:   A Broad-brush Rural Congregational Health Initiative National Organization of the State Offices of Rural Health Reverend Andrea Lomboy August 5, 2010
    • 2. The Congregational Health ReSource, LLC (CHR) is a Judeo-Christian company and ministry devoted to improving health awareness from the perspective of “body, soul (mind, will, and emotions), and spirit” from a BIBLICAL approach. “ Our desire is to bring together the promise of medicine with the power of faith to lessen the gap between the secular and the sacred, increasing synergies and infusing the potential to build healthier communities.”
    • 3. Definition
      • Congregational health is the focus of a congregation—an assembly of people who meet for worship and religious instruction in a designated locale—that is dedicated to being sound in body, soul, and spirit and to experiencing freedom from physical disease or pain. It unites the best practices of:
        • 1. Public health – Protecting and improving community health through such means as applying preventive medicine, providing health education, controlling communicable diseases, and monitoring environmental hazards.
        • 2. Faith-based principles – Relying on the belief that God is the Great Physician who has the ultimate power to heal and cure with or without the use of medical practices; using wisdom (applied knowledge) to make consensual and informed treatment decisions; turning to God-given resources such as health care providers, pharmaceuticals, hospitals, etc. as needed; and leveraging the network and support offered within the faith community.
    • 4. Introduction
      • “ The church is the only community-based organization that is found in virtually every community in this country. It is able to reach people of all ages, races, and economic backgrounds and it can strongly influence people’s values and personal life choices. Because the church is generally more integrated into the life of individuals and communities than our modern medical establishment, it can better enable people to assume responsibility for their own health.”
      www - Health and Welfare Ministries General Board of Global Ministries The United Methodist Church New York, New York
    • 5. “ The particular faith that motivates each of us can promote a greater good for all of us. Instead of driving us apart, our varied beliefs can bring us together to feed the hungry and comfort the afflicted; to make peace where there is strife and rebuild what has broken; to lift up those who have fallen on hard times.” www www.nationalserviceresources.org/links/guidance-faith-based-and-community-organizations-partnering-federal-government-pdf www.nationalserviceresources.org – President Barack Obama www.flu.gov/professional/community/cfboguidance.html Office of Faith-based & Neighborhood Partnerships
    • 6. Religion, Spirituality & Public Health
      • FACTS to ponder (The US is a very religious nation):
          • 93% of Americans believe in God
          • 89% of Americans report affiliation with a religious organization
          • 83% of Americans say religion is fairly or very important to them
          • 62% of Americans say that they are members of a church or synagogue
          • 58% of Americans pray every day (and 75% weekly)
          • 42% of Americans attend religious services weekly or almost weekly (and 55% at least monthly)
          • democrats.science.house.gov/Media/.../2008/.../Koenig_Testimony.pdf
    • 7.
      • “ If the religious congregations in America all had health programs, then two-thirds of the U.S. population would be exposed to disease detection, disease prevention, and health promotion efforts. Since persons of all ages participate regularly in religious congregations, this means that health education efforts would occur at all ages, from the young (focused on substance abuse prevention and character development) to the middle aged (focused on healthy eating, exercise, stress-reduction, etc.) to the elderly (focused on volunteering, mentoring and generative types of activities).”
      • – Harold M. Koenig, MD, Professor of Psychiatry & Behavioral Sciences, Associate Professor of Medicine, Duke University Medical Center
      • There is every reason to suggest that religious involvement is related to better health.
      • Religious beliefs, practices, and rituals are shown to improve health.
      • Some research has suggested that communities where high portions of the population are members of religious groups have better health in general, even the non-religious people who live in those communities.
    • 8. Public Health System
    • 9. Using a Systems Approach to Address the Need Align Community Sectors to Promote Health “Swiss Cheese Model” Adapted James T. Reason BMJ 2000;320:768-770 We must align our organizations, people and resources, or we we will NEVER maximize or obtain the desired outcome for community/public health. If the gaps in each organization align, many will fall through the holes!
    • 10.  
    • 11.  
    • 12. This concept is a collaborative effort by A. Lomboy (CHR) and S. Triggs, (VDH OMHPHP)
    • 13. Purpose
      • Identifying Community-based Leaders
        • Develop health/faith public-private relationships and/or partnerships
      • Identify Community-based Assets
        • Uncover existing programs and assets within the community from materials to services
        • Educate the public about overall health issues while increasing awareness of prevention and treatment options
      • Developing a Community-wide Congregational Health Assessment
        • 5 survey tools were developed (civic, clergy, education, government and medical)
        • Illuminate root causes of existing health inequities, promoting social justice that could influence changes in funding policies
        • Use the pilot as a framework that can be replicated in other communities
      The purpose of the congregational health assessments is to advance the congregational approach to health by:
    • 14. 268,240 documented congregations with 176,477,348 adherents in a US population of over 300M *The data in these reports come from the Religious Congregations and Membership Study which is collected by the Association of Statisticians of American Religious Bodies (www.asarb.org). They collect these data by asking denominations to submit counts at the county level of congregations and membership. Some denominations choose not to participate while others simply do not have the data required to participate. The latter is the case with most African-American denominations. **Estimated total including non-reporting congregations.
    • 15. Congregations Virginia Statistics for Congregations and Memberships T he Association of Religion Data Archives, www.thearda.com Members
    • 16. These statistics are only for reporting churches. 46 Churches in Essex County *Please note the discrepancy. This indicates that there are MORE congregations than even documented.
    • 17. Selection Process
      • The following four counties were selected because of need and access to care challenges. They also were identified as having one or more of the following:
        • Virginia Medically Underserved Area (VMUA)
        • Mental Health Professional Shortage (MHPSA)
        • Primary Care Health Professional Shortage (HPSA)
        • Dental Health Professional Shortage (DHPSA)
      • 3 Critical Access Hospitals (CAH) in Virginia (out of 7)
        • Bath Community Hospital, Hot Springs - Bath County
        • ValleyHealth Shenandoah County Hospital, Woodstock - Shenandoah County
        • ValleyHealth Page Memorial Hospital, Luray - Page County
      • 1 SHIP Hospital (out of 24) was selected:
        • Riverside Tappahannock Hospital , Essex County
    • 18. Surveys
      • Five categories of community leaders were addressed:
        • 1. Civic –local associations and business community leaders
        • 2. Government –local mayor, county medical director, county executives
        • 3. Medical and health services–hospitals, clinics, health departments, private-public doctors, and other health practitioners including psychiatrists and social workers 
        • 4. Education –principals, school counselors, school superintendents, and boards of education
        • 5. Faith –pastors, clergy, lay leaders, congregational members
    • 19. Methodology
      • Development of congregational health assessment tools was necessary
      • and developed online through SurveyMonkey.com
      • 5 databases were developed for each survey type
      • A tremendous amount of effort was involved in the survey!
      • Methods of contact included:
        • Phone
        • Email
        • Door-to-Door Delivery
        • Direct to Community Leader
        • Leader to Leader
        • US Mail
        • Fax
    • 20. 46 churches total: 8 - Civic 16 - Clergy 3 - Education 5 - Government 6 - Medical * 38 Completed Surveys 30 churches total: 2 - Civic 6 - Clergy 0 - Education 0 - Government 2 - Medical 10 Completed Surveys 24 churches total: 2 - Civic 9 - Clergy 0 - Education 3 - Government 7 - Medical 23 Completed Surveys Luray, Page Woodstock, Shenandoah Bath Essex Final Survey Findings 30 churches total: 7 - Civic 9 – Clergy 5 – Education 2 – Government 7 - Medical *30 Completed Surveys
    • 21. Non-Clergy Findings Sampled secular organizations said that they could provide the following resources to local churches:
      • Funding
      • Teachers (including volunteers)
      • Medical Personnel
      • Facilities
      • Media & Advertising
      • Partnerships
      • Mailings
      • Referrals
      • Space
      • Policy & Systems Change
      • Programs & Services
      • Medical Equipment
      • Health Fairs
      • Counseling
      • Training
      • Reduced Rates
    • 22. Barriers
      • The top barriers secular organizations face in providing products and/or services to congregations includes the following:
        • Lack of information about the needs
        • Lack of staff and volunteers to provide services
        • Lack of funding
        • Fear of violating separation of church and state laws
      • In order to assist congregations, these organizations said they would need the following information in order to provide products and/or services:
        • Identifying information about the congregation
        • A list of needs
        • A clear, measurable plan to show the value of their contribution
      Assistance
    • 23. Clergy Findings Every Clergy survey completed indicated that they “believed there is a connection between physical, emotional, and spiritual health.” The clergy also overwhelmingly felt that “religious institutions should play a role in helping its congregations be physically healthy.” Nearly 80% of those who felt that way said it was, “appropriate to offer health education and health services to their congregations.” Based on this response, the clergy were asked if they felt their congregations would use a “combination of both spiritual and medical resources to maintain and improve their health.” The same 80% “ felt that they would use the resources.” Despite these findings, just over 10% said they have an active health ministry. *For the purposes of the survey, an “active” health ministry was defined as, “A ministry of a faith-based organization that provides health care services and/or health educational classes more than once a year.”
    • 24. Clergy Findings The following list are ways in which the various congregations currently support the health of its members:
      • Go with member’s to doctor’s appointments
      • Transportation to medical appointments
      • Help with health-related paperwork
      • Prayer
      • Provide meals
      • Visit members who are sick
      • Phone calls
      • Run a health food store
      • Pastoral care
      • Pay for medical bills
      • Health and preventative education
      • Support local free clinics (time & finances)
      • Anoint with oil
      • Lay hands on the sick
      • Use the Word of God to bring encouragement and comfort
      • Fellowship nights that can be used to address health-related issues
    • 25. Clergy Findings Top health concerns that “your” congregation is facing: These concerns are not surprising and are consistent with major causes of death in Virginia.
      • aging
      • heart disease
      • cancer
      • diabetes
      • high costs of medications
      • lack of insurance
      • obesity
      • affordable health care
    • 26. Barriers
      • The top barriers faith-based organizations face in providing products and/or services to congregations includes the following:
        • #1 response - Uncertain how to start one (48.3%)
        • #2 response - Lack of finances and resources
              • - Lack of volunteers and/or leaders
        • #3 response - Lack of time
        • Lack of health care expertise
        • Lack of community partnerships
      • The top cultural barriers that people face within their community are:
        • Racial biases
        • Fear of mistreatment or unequal treatment
        • Language barriers (cultural or linguistic)
        • Cultural beliefs
        • Perception of unequal treatment of persons
    • 27. Barriers
      • The top health care barriers that people face in their community:
        • #1 response - Lack of adequate and affordable insurance
        • #2 response - Lack of knowledge of resources that are available
        • #3 response - Lack of access to free clinics
      • The top socioeconomic barriers that people face in their community are:
        • Lack of sufficient income to afford basic necessities
        • Lack of transportation (public and private)
        • Unemployment
        • Lack of vocational training
      • The top social environmental barriers that people face in their community are:
        • Drug abuse
        • Poor social support network from within the community
        • Housing (non-availability, non-permissive cost, low-quality)
    • 28. Rural Congregations
      • In our broad-brushed analysis of the four counties in the pilot, the demographics reflect the following trend:
        • Membership average of 150
        • Primarily composed of senior adults with a much smaller representation of youth and children
        • A predominant female majority of members
        • Have been in existence for more than 50 years
        • Have a single, salaried leadership staff
        • Significantly segregated
        • Few churches have “active” health ministries
          • Nearly all of the churches felt they play a role in helping its members be healthy
          • All of the churches actively support the health of its members in one way or another
    • 29. Recommendations & Next Steps
        • Development of a model health ministry program at a statewide level
        • Health ministry toolkit/manual for congregations
        • Individual church member survey
        • Pilot model rural health ministry programs for congregations
        • Conduct further research
      • Engaging the faith community in these recommendations is essential to program success. And, the development of persistent, sustained relationships with congregations are absolutely necessary.
    • 30. By leveraging the strength of the faith community as a force multiplier in public health, community capacity can be significantly increased extending its reach, impact and value. How can the State Office of Rural Health contribute to this effort? Rev. Andrea Lomboy [email_address] Cell: 703/581-4323