By Beth Blevins
Public health students at Oklahoma State University (OSU) are tackling real-life problems at Critical Access Hospitals (CAHs) in the state. In collaboration with the Oklahoma Office of Rural Health (OORH), Master of Public Health (MPH) students enrolled in the Designing Public Health Programs course are creating projects that address challenges faced by the hospitals.
“The programs that the students create are in direct response to priorities identified in the hospitals’ Community Health Needs Assessments (CHNAs),” said Lara Brooks, OORH Rural Health Analyst. “The students are divided into groups of two to four during the semester, and they then work on a priority from one of the previous year’s CHNAs.”
The program focuses on CAHs that do CHNAs (particularly nonprofit CAHs, which are required by the IRS to do a CHNA every three years). “Every fall I make a spreadsheet pulling out the priorities identified in the CHNAs and share that with the course instructor, who goes through and weeds it down according to what could be applicable to students in the course,” said Brooks.
This year’s topics addressed sexual health and education for adolescents, smoking cessation, opioid prevention for young adult males, physical activity, healthy lifestyles, and adolescent and parent counseling as prevention for future drug and alcohol abuse. Past programs have included mental health first aid, the creation of a Narcotics Anonymous (NA) group, and a dental hygiene program for nursing home residents.
“The really interesting part is the creativity in the projects,” Brooks said. For example, one group that was assigned “physical activity” as a priority utilized the state parks as an opportunity to get outside. “They went to that community and looked around and saw that the sidewalks aren’t great so they thought outside the box. They visited the nearby state park, got maps, and created a program around being active using the state park.”
Another year, a group from the class created a program on healthy eating that included grocery store tours, working with the local grocery store to host events and to highlight healthy products. “The fresh set of eyes and ideas are what make the collaboration so interesting,” Brooks said.
Brooks visits the students on the first day of class giving them an overview of OORH and its grant programs, describing a CHNA, and talking about common themes and priorities across the state. She then returns on the last day of class when students give their presentations. Brooks also acts as an intermediary between the students and the hospitals since the students do not have time to visit them themselves. She delivers their projects to the hospitals’ CEOs, “making sure they know they can ask follow-up questions,” Brooks said. “At the end, they will have a binder of the program the student group created, along with implementation steps, a budget overview, an evaluation plan, and the students’ own needs assessment.”
The collaboration between OORH and the course creates a three-fold opportunity—for the students, the hospitals, and for OORH. “From the hospital’s perspective, they have the opportunity to have a group of students creating a program just for them,” Brooks explained. “From the student’s perspective, they have the chance to create a real program for a real community to address a real need. And at OORH, we get the opportunity to introduce rural areas of the state to a group of students each spring.”
Stephany Parker, who taught the course this spring, said that the collaboration “brings students and communities closer together in an applied way and opens up communication channels with OORH as an essential resource for public health professionals.” Parker continued, “OORH is our connection to those real-life settings, circumstances and community leaders. The programs and materials students develop are creative, comprehensive, and provide clinic partners with a plan for implementation consideration.”
Andrew O’Neil, a recent student in the course, concurs. “(The course) gave me an understanding of health outcomes, determinants of health, and resources available to implement programming in rural communities, which will be useful as I continue my studies and research addressing rural-urban health disparities,” he said.
So far about 80 students have participated in this coursework/collaboration since its inception in 2016. OORH’s work with this collaboration requires no special funding. “When I deliver the binders to the hospital CEOs, it’s in conjunction with a site visit to the CAH, something that would normally be funded under the Flex program,” Brooks said.
Because OORH is part of the OSU Center for Rural Health, it probably makes a collaboration like this easier, Brooks said. “A program like this is probably easier to replicate with the university-based State Offices of Rural Health since they have that relationship on campus.”
“Nonetheless,” she added, “I know that a lot of folks who work for their state health departments are alumni of public health programs in their states, so if anyone wanted to replicate this it would be fairly simple, just by making a relationship with that program.”
What I’m working on right now: Community Health Needs Assessments
Last place I traveled to: New Orleans, LA, for the Annual NRHA Conference
Best advice I ever received: “Make yourself a resource to others.”
Favorite thing about working at a SORH: My background is Agricultural Economics,
and I feel that working for the OK SORH allows me to continue in my chosen field and
niche of rural and community development.
3 great things about rural health in my state: The people, the people, the people-
Truly those involved in rural health in Oklahoma are the best people you will ever meet.
If I weren’t doing this, I would…probably be in finance or banking.
Favorite quote: “Be the change that you wish to see in the world.” ― Mahatma Gandhi
The Region D SORH meeting was held June 28-30 in Oklahoma City, Oklahoma. The meeting was attended by 32 participants, representing every state in the region. The Region D Planning Committee put together a fantastic agenda with speakers from the Federal Office of Rural Health Policy, CMS, Maine Rural Health Research Center, NORC, the Heartland Telehealth Resource Center and presentations on data use and strategies to address rural opioid issues. If you were unable to attend the Region D meeting and would like to learn more about Project ECHO, check out the presentation here. The meeting included a unique tour of the mobile telehealth unit from Oklahoma State University. All meeting presentations can be found on the NOSORH website. Thank you to the Oklahoma State Office of Rural Health for hosting!
Corie Kaiser is the Director of the Oklahoma Office of Rural Health. She joined the Office of Rural Health in 2005. In that time, she has maintained the office’s community engagement programs as well as coordinated and maintained quality and performance improvement programs to assist critical access hospitals. She is a member of the National Rural Health Association and serves on the board of the National Organization of State Offices of Rural Health. Corie is a native rural Oklahoman and currently lives in Edmond, OK with her husband and two sons.
What is the most important thing you are working on right now?
As of July 1, Oklahoma now has a new QIO as a result of the restructuring. We now have to work with the Texas QIO. We need to form new partnerships again and figure out everyone’s role. In addition, we are working to implement Phase 3 of MBQIP for 34 CAHs. We are working with another school that has a Pharmacy school attached to it for pharmacy students to review orders for Phase 3. This is an exciting prospect in some very challenging times.
What inspires you and excites you most about working for a SORH?
I grew up in a small, rural town and still have family who live there. My grandma taught me to be a true servant. I love helping people and the work we do at the SORH really allows me to help “my own” people throughout the state. We really have the flexibility to take our programs where we want and to make the best of our program dollars. We always have the future in mind and are always trying to make things better.
What is one characteristic that you believe every SORH leader should possess?
I believe you always need to be willing to ask for help. I encourage the hospitals to do this too. We may not always have the answers, but we can find someone who does. I have learned to say “I don’t know, let me get back with you,” and then I always make sure to get back to them.
The Oklahoma State Office of Rural Health (SORH) has recognized the importance of evaluating the success of grant initiatives, so much so, that they decided to hire an internal evaluator to analyze grant program outcomes. Oklahoma’s SORH Program Evaluator, Pete Walton, plays an important role in the SORH’s efforts toward accountability. Being on staff allows Walton to have better access to those working on program activities as well as records, history, and important information that may not be available to an external consultant.
According to Walton, it is important to set up effective program measures while writing the grant. He believes it is critical to sit down with all staff and discuss not only the goals of the grant guidance, but also the goals of the office. Taking both priorities into consideration, he then helps staff develop goals and objectives that are meaningful. His next priority is to establish an effective mechanism to capture data to show the impact of activities. He feels it is important to set up an easy system to gather data so that all staff are able to easily input data. This legwork completed prior to the grant beginning sets up the grant program for success. After the grant program begins, data collection can begin immediately since the system is already established. It is then Walton’s responsibility to ensure that everyone is submitting data on grant activities including both internal staff and external contractors. Walton meets regularly with those working on grant activities to review data to make sure activities are on track to achieve outcomes and make course corrections as necessary.
Corie Kaiser, director of Oklahoma’s SORH, says, “Hiring an internal evaluator has been one of our best decisions.” She continues, “Pete has been a great addition to our office and has really helped us to collect data and stories to show outcomes.”
Walton has developed a helpful evaluation template that can be found on NOSORH’s website. As SORHs prepare for the approaching grant writing season, it may be helpful to review this template to make sure grant program goals and objectives are in line with grant and office goals and objectives.
Does your SORH have a “Promising Practice”? We’re interested in the innovative, effective and valuable work that SORHs are doing. Contact Kassie Clarke, Branch editor, at email@example.com to set up a short email or phone interview in which you can tell your story.
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