Mary Ann Littleton, Ph.D. Associate Professor Dept. Community Health ETSU College of Public Health

1. ETSU Community partnerships II: a best practice for Community health education through interprofessional pedagogy Mary Ann Littleton, Ph.D. Associate Professor Dept. Community Health ETSU College of Public Health

2. Interprofessional community-based Rural Track Program • Interprofessional: Medicine, Nursing, Public Health, Psychology, Respiratory Therapist Students and Faculty. • Community-based: Meets in the community to work with community members and groups to identify health needs/assets, develop plans to address needs and build on assets, and implement programs and services. • Rural: Presently working in 7 rural communities in the region. • Program: Includes 2 courses run consecutively over two semester – Rural Health Research and Practice, and Rural Community-based Health Projects.

3. Descriptive study of Program as pedagogy • Objectives: • Describe the course process outcomes from 2005-2010. • Identify important pedagogical components of the program through reviewing course materials, evaluations, process outcomes, and by interviewing faculty.

4. Process Data: From 2005-2010 Community partners include individuals, groups, and organizations within 7 Counties • Carter, Cocke, Greene, Hawkins, Johnson, Unicoi and Washington Counties. Partnering agencies include: • School Boards • Health Councils • Neighborhood Associations • Senior Citizen Centers • Rural Clinics • Community-based Clinics • Hospitals • Church-Organizations • Veteran Associations • Community-based Coalitions • After-school Clubs • Non-profits • Migrant Farm Camps.

5. Process data: populations • Pregnant women • Adults (Rural White, African American, and Hispanic) • Adults managing diabetes (African American and Hispanic) • Children (Rural White) • Senior Citizens Groups (Rural White) • Adolescents (Rural White, African American) • Hispanic and migrant groups • Veterans

6. Topics covered • Smoking cessation (x2) • Smoking prevention • Breastfeeding • Diabetes prevention (x4) • Diabetes management (x3) • Diabetes and Nutrition (x2) • Nutrition and Exercise – Obesity (x3) • Disaster Preparedness (x2) • Pandemic Flu (x2) • Cancer • Interpreter services for Hispanic population • Environmental and Occupational issues related to migrant population (x2) • School-based immunization • Memory loss and Aging • Adolescent Mental Health (x4)

7. Assessment methods used • Windshield surveys (All groups) • Key Informant Interviews (All groups) • Individual Case Studies • Focus Groups (6 groups) • Community-based surveys (5 groups) • Clinic-based surveys (2 groups) • School-based surveys (2 groups) • Photovoice

8. Projects through time [few examples] • Pregnant women – Maternal and Child Health • Smoking cessation support group for pregnant women. (2008) • Clinic-based video intervention for pregnant women who smoke. (2009) • School-based education program on benefits of breast feeding. (2010)

9. African American Community – Wesley Heights and Greenville, TN • Community Mobilization dinner with pastors speaking about health. (2006) • Diabetes screening and educational breakfast. ( 2007) • Community dinner to educate on healthy cooking. (2008) • Community dinner to motivate for healthy lifestyles. (2009) • After-school program to promote healthy nutrition and exercise. (2010)

10. Hispanic Communities in Northeast Region • Hospital-based educational program on health care access for Hispanics. (Washington, 2005) • Video production on health care access for Hispanics. (Washington, 2006) • Diabetes health screenings and education at local flea market. (Unicoi, 2007) • Documentation of occupational risk for migrant workers. ( Unicoi, 2008) • Physician education program on migrant occupational hazards. (Cocke, 2009) • Community-based occupational hazards assessment. (Cocke, 2010)

11. Erwin and Unicoi County – rural non-Hispanic • Community-based senior educational program on ageing and memory loss. (2006) • Extensive school-based youth risk assessment. (2007) • School-based resources and information for adolescent mental health. (2008) • Piloted school-based adolescent mental health advocacy website. (2009) • School-based Facebook page for adolescent health advocacy. (2010)

12. Pedagogy • Interprofessional and community-based teaching methods uncovered: • Interprofessional faculty model how to engage in critical discourse, helping student groups form ideas and set appropriate boundaries for developing project activities. • The use of dialogue to build consensus. • Peer to peer learning and interpretation is an important part of the course. • Dialogues between students facilitate development of leadership skills. • Discovery learning – students realizing that questions and concerns of people in the community are not the same as those in the hospital bed. Forces them to see patients as individuals with families living within a community. • Observational learning: Asking students while at a community event “what do you see” --helps students get a community “lens” on things. • Asking students to describe the issue from their profession’s point of view. • Taking time to learn student’s interests, talents and comfort zones and matching that to their contributions. • Students being out of their comfort zone -- interprofessional pairing on activities. • Reflective learning: Taking time to reflect on the course activities – on the process. • Debriefing to help uncover student’s preconceived ideas.

13. Benefits of program • Helps communities define and address health issues. • Gives students immediate contact with future employers and communities with future workforce. • Enhances student’s resume. • Helps socialize students to working with peers in other professions. • Gives communities (especially the underserved) the sense that someone is committed to working with them over several semesters. • Provides increase visibility to communities about ETSU – helps recruits future students. • Enhances ETSU and Community relationships • Letters of supports. • Grants/partnerships • Incubator for community-based research grants. • Adheres to Community-based Participatory Research principles.

14. Program/community Needs • To better understand impact of program. • To provide leadership training for communities. • To educate campus-wide about the value of interprofessional education. • To avoid pigeon-holing students and faculty within professions. • To continually improve course to deal with interprofessional curricular issues [didactic vs. hands on, scheduling, requirements]. • To develop an interprofessional competency-based curriculum.

16. Photos!

17. questions