1. Introduce new project at PSHMC (Relevance to your field site intervention and to you personally) 2. Discuss ethnography and field site projects (3. Review and discuss assignment 3 (Date change to next Weds, Oct 24th)
The charge of the garden is to participate in community outreach in underserved areas in the community – help people stay healthy rather than just treating illness
USDA food desert map – many of your field sites are located within these areas
Mike – potentially drive into food deserts and deliver produce, health screenings, etc
Pilot program – giving prescriptions to patients for produce at farmers markets, and then tracking blood pressure, weight, BMI, weight gain in pregnant women, etc . Will serve 100 families and six farmers markets during 2010 season with plans to expand. “Maine, Massachusetts tackle healthy eating.” The Nation’s Health. Oct 2010: 9.
“Let thy food be thy medicine” – Hippocrates
Just some ideas to consider given recent changes at PSHMC. Bridge to your field experience / most have been good, almost ¾ plan on visiting again. This is encouraging because, as you know, we don’t want you to see your role as being a consultant
Your role is more of an ethnographer
Med anthro – applying ethnographic principles and practices to medicine. Diseases are social with a biological aspect
What’s interesting is that this list is equally applicable to your clinical practice
As you go about this process, without the shackles of anatomy, you’ll understand the value of this approach
If this isn’t inspiring or momentus that’s fine. This is a learning experience rooted in the community – for some it may be more but if not, it’s ok. Questions/concerns. Please feel free to email me or meet in my office
Plenary 10 18-12 final
Introduce new project at PSHMC Discuss ethnography and field site projects Review and discuss assignment 3
– Significant socio-economic barriers– Lowest level of socio-economic barriers
How do we work with community organizations to improve access to healthy foods and education/information?
An empirical research method for learning about cultural phenomena and discovering the nature of peoples
Learning the culture of the group under study before deriving explanations of their attitudes/behaviorPhysical geography and climate
Historical research Active field notes Participant observation Interviews Questionnaires Geography/topography
Build a rich history of your site Develop relationships & trust Identify key informants Take rigorous notes & cross-check with informants › Quote your informants Understand your biases and assumptions Keep an open mind
Give voice to an underserved population Contextualize your observations Identify themes and patterns that can inform effective intervention strategies Determine variables for future research and develop a testable hypothesis Propose more culturally-sensitive plans for project implementation Identify key questions about existing programs and policies
You are not a consultant, you are a learner We are not expecting you to ‘save’ the organization or its clients Think long-term about your involvement with the organization There will be many opportunities for leadership/action in medical schoolQuestions or concerns? email@example.com C1747 – Diversity Office
Goals: › Eliminate preventable disease, disability, injury, and premature death › Achieve health equity, eliminate disparities, and improve the health of all groups › Create social and physical environments that promote good health for all. Goals (cont.) › Promote healthy development and healthy behaviors across every stage of life. Objectives › 37 focus areas
Models serve as frames from which to build; Provide structure & organization for the planning process Many different models, common elements, but different labels. A Generalized Model for Program Planning 26
Biology/ Genetics Behaviors Social Environment Physical Environment Policies and Interventions Access to Quality Health Care/ Services 27
Assessments Summary (III) • Social • Justify need for an • Environmental intervention/programThe way • Behavioral • Identify possible solutions it is… What are the behaviors (interventions) to healthDescribe that impact health problem I problem? Next Paper: The Program/Intervention • Risk and ProtectiveAnalyzing Factors Associated Itargeted with/Influence IIbehavior Behaviors II III 28
Behavior = What people do or don’t do Factors = influence behaviorAn analysis of the determining (predisposing[facilitate or hinder person’s motivation to change,e.g., knowledge, attitudes, beliefs, etc.], enabling[barriers or vehicles created by society or system,e.g., access to hl, resources, rules, etc.], andreinforcing [feedbacks & rewards by peers, relatives,employers, etc.]) factors that influence the chosenbehavior and health problem.
Health Care Environment. › Facilities, clinics, providers, etc. › Cost, distance, transportation, hours, etc. Other Environmental Conditions. › Availability of fast food, cigarettes, billboard, alcohol , sports, laws, etc. Skills – ability to perform task. 40
Social Support Family and Peer Influences Advise/Feedback from Providers Benefits of the Treatment/Action Social and Economical Benefits Adverse Consequences 41
Theory - “a set of interrelated concepts, definitions, and propositions that present a systematic view of events or situations by specifying relations among variables in order to explain and predict the events of the situations” (Glanz, Lewis, & Rimer, 2002, p. 25) Concept - primary elements of theories or building blocks of theory (Glanz et al., 2002)
“A theory based approach provides direction and justification for program activities and serves as the basis for processes that are to be incorporated into an intervention/program (Cowdery et al., 1995, p. 248) “Theories can provide answers to program developers’ questions regarding why people aren’t engaging in a desirable behavior of interest, how to go about changing their behaviors, and what factors to look at when evaluating a program’s focus” (van Ryn & Heaney, 1992, p. 326).
Perceived Susceptibility – is he/she vulnerable to health problem? Perceived Seriousness – how serious is the the illness/problem? Perceived Benefits – anticipated value of the recommended action. Perceived Barriers – cost involved in taking a particular action. Motivation/Cues to Action & Self-efficacy.