4/20/22 Meeting Notes

• Mississippi

Year 4 with Mend - Dr. Sonia, Chris Fields, Kyskie Bolton

March - July contract- a bit behind schedule Kyskie starts next week, new staff at other health center, 2/3 hr training conducted for new staff to become MEND leader - mind and nutrition. Soon to embark on recruitment.

Contract with Heal Mississippi (central MS)- chris fields - MEND background - partner with another org to implement MEND (most likely a church) start date pending - Central MS health center may contribute some eligible children

started with existing diabetes prevention program with church and now evolved to MEND partnership - have afterschool programs and summer programs - implement into their core curriculum

Church internal meetings are a good place to present MEND - ministerial alliances - congregational health ministries - youth pastors

• Illinois
  
  

Cheri, Raj, Naila

Just getting started - COVID barriers - difficult to recruit to do an entire program - different focus/approach with education - online educational modules learning community - pandemic health navigator/community health workers program 600/700 state wide. Certification program/educational programs for CHWs. Recruit community health programs and get them educated because they have on the ground interactions with families to educate them and relay resources. Follow up on what they need to continue MEND - see how we can help them continue to use MEND

Q (MS): utilization of CHWs - how? train as mind and nutrition leaders? or recruitment?

A: start with education and lead into next generation of the grant - screening, referrals back to health centers

• Borinquen

Margarita - YR 4 of MEND

Finishing nutritional class tomorrow, next Tuesday last exercise and wellness class of first cohort of the year - end of program celebration in may - have retained 14 families! Made a big difference that providers are experienced and enjoy the work! Allow time to bond/befriend the kids by asking how their day was etc.

Started out with 16 families, dropped to 12 and then 2 families came back and maintained the 14 families

Emphasis on staff enjoyment which helps to build the program

Use community room - interested in church model for MEND

• El Rio

Stiina, Shelly - Year 4

Kick off/jump start event - this Saturday! 11 families attending - 14 kids - providing 5 to 10 min chat with family med. parent and family survey, step test, vitals and grocery store gift card raffle, info on orientation/info session on the 26th then program for the next 10 weeks. 2 sessions lead by BHCs and 3 by RDs. Retention plan - reach out and refer dietitian to get back on track with group or individual - make sure they are engaged. Scheduling is a concern.

Stiina - elementary school background and has reformed great interactive virtual tools and learning - borinquen/denver - starting with a visit with the family doctor - primary behavioral health/dietitians - good for staff and patients

Pediatrician is the lead for costal’s program

Reimbursement concerns for the provider - revenue - AZ charge for behavior health visits as a group - RD one on one can be charged

Q:how did you adapt curriculum schedule?

A: COVID has changed everything - same intensive dose - in person/asynchronous, virtual, combining things etc. just as long as we keep the integrity of the content/program - maintenance sessions once intensiveness is completed

what made it helpful or difficult? what adjustments? how to maintain? Funding?

Care cascade - opportunities to deep dive into care cascade - intensive intervention focus - but there are other things that can help ie care cascade - chronic diseases - blood test, medicines, controlled? Data shows over time there are some that aren’t controlled and when to intervene at patient and FQHC level - BMI over 30 over time - couple of drops - only 10 percent saw help and 3 percent sought help from Drs. mostly on their own - care cascade gives window into what people need and how we can help - show strategies that work - screen for SDOH - goal is to look at where there are gaps - map to show where to focus your energy - treatment options with proven benefits - intensive interventions (evidence based)

Shelly Whitlach - all about specific SDOH - no interventions in our actual program (survery info) now that they have behavior health team involved - CHWs can be on board to do this - in house - integrate back into all layers of support for families - community food distribution - incorporate additional resources into curriculum - integrate behavior health (10min talk with resources and contact cards) - destigmatize

alot this happened in year 2 and 3 - how to adjust in times of COVID in order to reach out/adapt etc.

CDC wants more primary care sites involved and reducing barriers - struggles with implementing over time - trying to engage more health centers and using all the tools you have to do the most intensive intervention