Food insecurity worsened during the COVID-19 pandemic. This is especially problematic for patients with chronic diseases like hypertension, diabetes, and obesity. When people do not know when or where they will eat their next meal, finding food often takes priority over managing their health.
To increase access to food, Westside Family Healthcare in Delaware piloted a program called Feeding Families. The program supports the health of families who screened positive for food insecurity and have at least one family member with a chronic disease. For one full year, 50 families received fresh food weekly from a home-delivery service and met virtually with a Westside nutritionist and social service coordinator to receive customized education, cooking tools, and recipes. Preliminary findings from an evaluation by the University of Delaware Center for Research in Education and Social Policy show those participants overall have better access to food, healthier eating habits, and reduced chronic disease.
“Focusing on food insecurity and the factors that contribute to illness, or the social determinants of health, has always been the mission of community health centers like Westside,” said Megan Werner, M.D., MPH, Associate Medical Director of Population Health and Quality at Westside. Our care teams can support patients with chronic disease using virtual interventions tailored to unique cultural, social, and health needs.” Read more about the program in their Impact Brief (PDF - 770 KB).
(Published June 2022)
Neighborhood Healthcare combined team-based care and virtual technology to pilot a new model for caring for patients with chronic disease.
With the onset of COVID-19, many of the quality metrics at the health center deteriorated, particularly those related to diabetes and hypertension. This brought new urgency to quality improvement work. However, the availability of telehealth and remote patient monitoring brought new opportunities as well.
The center launched a new virtual care team in early 2021 to target the needs of patients with diabetes and hypertension. The team received special training to provide care for new-onset diabetes, hypertension, and nicotine cessation.
The team sees patients two days a week. Most patient visits are virtual. In-person appointments occur when needed for labs, retinal screening, foot exam or patient education. Visit duration is 15-30 minutes.
Compared with the center’s usual care, the virtual team offers improved patient communication and care coordination, longer appointments for time-intensive services, standardized care with greater adherence to best practice guidelines, and improved access to affordable medication.
After one year, the team had completed 2,200 patient visits, enrolled 631 patients, and “graduated” 193 patients who no longer needed intensive services. Among hypertension graduates, 84% remain controlled. Among diabetes graduates, 89% have their most recent A1c level at less than 8%.
The health center also reports that among its graduates, staff see a reduction or elimination of disparities in outcome by race and ethnicity.
In coming months, the center plans to expand the size and scope of the team to allow more patients to benefit from this new model of care delivery.
Neighborhood Healthcare serves San Diego and Riverside counties. It has 20 sites, and serves about 78,000 patients per year.
(Published June 2022)
When COVID-19 made in-person health center visits more challenging, the Broward Community & Family Health Centers faced a problem.
Routine tobacco screening of patients had helped to spark a successful smoking cessation program, and the Florida center’s staff members were loath to end their efforts. Instead, they decided to experiment with an online approach.
The venture paid off; indeed, remote sessions work better for some people. This is especially true of those who work from home or have limited time to travel to the center’s five locations due to childrearing or other family commitments, said Jamal Lawson, the community outreach manager.
Nova Southeastern University and the Florida Department of Health support the program. It includes four weekly sessions with trained instructors and provides patients with nicotine patches or lozenges to help them transition to a healthier lifestyle.
Virtual sessions have a smaller number of people in each group, ranging from three to 14 participants, compared to the typical 10 to 20 for the in-person gatherings, and the smaller group size works well for some patients. In addition, staff have found it easier to schedule multiple time slots, including a class that runs from 5 p.m. to 6 p.m., which is popular with working people. Although it is still too early to assess long-term success, Lawson said 90 percent of participants were initially successful at giving up tobacco.
Now that center staff have learned how successful remote sessions can be, they plan to keep it as a choice even after in-person sessions resume. Lawson said the payoff is patients who are thrilled about becoming non-smokers.
“They never thought they could quit,” he said.
(Published April 2022)