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Rural Health Outreach Programs: Stabilization and Sustainability. Adrianne J. Lane EdD, RN-BC, CNE President Kimberly Herrmann Community Outreach Manager SouthEastern Indiana Cancer Health Network, Inc. Presentation Objective.

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rural health outreach programs stabilization and sustainability

Rural Health Outreach Programs: Stabilization and Sustainability

Adrianne J. Lane EdD, RN-BC, CNE

President

Kimberly Herrmann

Community Outreach Manager

SouthEastern Indiana Cancer Health Network, Inc.

presentation objective
Presentation Objective
  • Discuss steps relevant to sustaining community based health programs long-term.
  • OR
  • Discuss strategies to increase the potential for long term sustainability
who are we
Who are We?
  • SouthEastern Indiana Cancer Health Network, Inc. (SEICHN)
  • Began in 1999
  • Incorporated October 2002
  • Serve SEI, particularly Dearborn, Ohio, Ripley, Franklin, Switzerland Counties
seichn
SEICHN
  • Primary Purpose: To promote the health of adults in SEI as it relates to cancer by increasing knowledge and practice of cancer screening techniques.
  • This will be accomplished by:
    • Providing annual screening opportunities and educational programs
    • Identifying and securing ongoing funding for screening
    • Establishing community linkages to promote our overall goal
what have we done related to these goals
What have we done related to these goals?
  • To date SEICHN has delivered 9 continuous years of cancer screening and education in a five county region
  • Provided effective, continuous health care by breaking down barriers of Cost, Distance, and Fear
  • Based on data gathered in conjunction with our Breast Health programming, identified collaborators and in 2006 started a Free Clinic serving underinsured adults in SEI
seichn statistics to date
SEICHN Statistics to date
  • Over 2000 free mammograms
  • Cancer education to more

than 2500

  • Breast Health Participant Profile
    • 60 % insured, with over half reporting no

coverage for screening services

    • Majority working Full time
    • >55% family income <$25,000/year
slide8

In the Beginning

  • Advanced practice nurses
  • Residents of underserved communities
  • Substantial numbers of uninsured women
  • Poor state cancer screening statistics
  • Desire to create a program to meet needs
  • Recognition of need for model to guide us
chose to use a logic model
Chose to use a Logic Model
  • Systematic and Visual
  • Understanding of Relationships
  • Conceptual Map

(Kellogg, 2000)

  • Provide a methodology
    • Outline and Link
      • Goals
      • Objectives
      • Activities
      • Measurable Outcomes

(Health Foundation of

Greater Cincinnati, 2001)

slide10

Define the problem

Logic Model

Schema

Identify the intervention

State the goal

Outline key objectives

Determine outcomes

slide11

Define the problem

Lack knowledge & access

to malignancy screening

Identify the intervention

Create model based

program to meet needs

State the goal

Increase knowledge &

practice and linkages

Outline key objectives

Develop infrastructure

Provide screenings

Secure Funding

Determine outcomes

Increase awareness

Increase resources

Stabilize program, etc.

slide12

Lack knowledge and access

to malignancy screening

Create a model based program

To meet malignancy

Screening needs

Increase knowledge & practice

& Increase linkages

Develop infrastructure

Provide screening

Secure funding

Increase Awareness

Increase Screening

Increase Support

Stabilize Program

Track data and disseminate

seichn stabilization sustainability focus on key objectives
SEICHN Stabilization & Sustainability -------Focus on Key Objectives
  • Develop an Infrastructure
    • (Infrastructure)
  • Provide Screening
    • (Implementation)
  • Secure Funding
    • (Sustainability)
implementation 2000
Implementation--2000
  • Network with nurses from Local Health Departments in our own communities
    • Provide continuing education on breast health
    • Provide breast models and literature to health depts.
    • Serve as resources
    • Build community trust in organization
  • Work with local American Cancer Society
  • Plan full day breast health programs including free mammography via mobile unit
sustainability 2000
Sustainability--2000
  • Funding from Indiana Women’s Commission
  • Investigate potential funding sources
  • Create a timeline for strategic grant submissions
  • Networking
infrastructure 2002
Infrastructure--2002
  • Logic Model continues to guide us
  • SEICHN incorporated……spurred by funding issues
    • “One Page at a Time”
implementation 2002
Implementation--2002
  • Continue networking with nurses from Local Health Departments in our own communities
  • Provide ‘Road show’ to health department boards
  • Continue working with local American Cancer Society
  • Continue offering ANNUAL full day breast program in each county, including free mammography via mobile unit---

Year 3 ----- 2000, 2001, 2002

  • Seek collaboration with businesses, clubs, and fraternal organizations
  • Maintain ‘branding’/look of all posters and newspaper ads
sustainability 2002
Sustainability--2002
  • Writing grants based on timeline
  • Investigate potential funding sources
    • Susan G. Komen Foundation
    • Avon Breast Care Fund
    • Regional Foundations
    • Local Businesses
  • Networking
  • Received funding for several of the grant submissions: Komen Foundation, Health Foundation of Greater Cincinnati, Ripley County Community Foundation
infrastructure 2009
Infrastructure--2009
  • Logic Model continues to guide us
  • SEICHN, Inc. since October 2002
  • Community Outreach Manager since 2007
slide24

Lack knowledge and access

to malignancy screening

Create a model based program

To meet malignancy

Screening needs

Increase knowledge & practice

& Increase linkages

Develop infrastructure

Provide screening

Secure funding

Increase Awareness

Increase Screening

Increase Support

Stabilize Program

Track data and disseminate

implementation 2009
Implementation--2009
  • Continue offering ANNUAL full day breast program in each county, including mammography via mobile unit---Year 10
  • Provide community education on variety of cancer topics
  • Active partnerships with local health departments, local newspapers, ACS, Trinity Health Clinic, REMC, St. Elizabeth Medical Center (IBCCP provider)
  • Continue seeking collaboration with businesses, clubs, and fraternal organizations
  • Continue ‘branding’/look of all posters and newspaper ads
sustainability 2009
Sustainability--2009
  • Continuous Funding secured:
    • Greater Cincinnati Komen Foundation since 2001
    • Indiana Breast Cancer Awareness Trust since 2006
    • Avon Breast Care Foundation since 2007
    • REMC since 2007
  • Repeated Funding secured:
    • Health Foundation of Greater Cincinnati
    • UC College of Nursing
    • Ripley County Community Foundation
    • Speaking of Women’s Health of Batesville
stabilization sustainability
Stabilization & Sustainability

Infrastructure

Implementation/Screening

Funding/Sustainability

ongoing evaluation
Ongoing Evaluation

Formative

Summative

  • Ongoing assessment of each component of Logic Model
  • Ongoing assessment of community needs
  • Ongoing assessment of status of barriers of cost, distance and fear
  • Based on Logic Model Outcomes
    • Increase Awareness
    • Increase Screening
    • Increase Support
    • Stabilize Program
    • Track data and disseminate
  • Annual Evaluation and Report
in summary
Presentation GoalIn Summary
  • Discuss steps relevant to sustaining community based health programs long-term.
  • OR
  • Discuss strategies to increase the potential for long term sustainability
let s remember
Let’s remember……

Key Steps

Keys Strategies

  • Logic Model
  • Key Components of
    • Infrastructure
    • Implementation
    • Sustainability
  • Evaluation
  • Presence: Community Trust
  • Collaboration
  • Leadership
  • Public Relations
  • Knowledge: Continuing Education & Development
  • Strategic Funding
  • Consistent annual and ongoing Programming in each of 5 counties
references
References

Centers for Disease Control and Prevention (1997). Reaching women for mammography screening: Successful strategies of national breast and cervical cancer early detection program (NBCCEDP) grantees. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Retrieved 1/8/08 from http://www.cdc.gov/cancer/nbccedp/bccpdfs/mamog.pdf

Fitzpatrick, J., Sanders, J., & Worthen, B.  (2004).  Program evaluation:  Alternative approaches and practical guidelines.  Boston:  Pearson/Allyn and Bacon.

Health Foundation of Greater Cincinnati (HFGC).  (2001).  Evaluation Packet.  Cincinnati, Ohio.

W.K. Kellogg Foundation. (2000). Using logic models to bring together planning, evaluation, and action:  Logic model development guide.  Battle Creek, Michigan.