Change Master Projects Class of 2011

Farm to School in Kentucky: Improving Childhood Nutrition and Promoting Local Agriculture

Prepared by: Tracey Heflin, L.S.W., CM; Holly Niehoff, R.S.; Jayaram Srinivasan, M.D., M.P.H., CPH
Mentor: Scott LaJoie, Ph.D., M.S.P.H.

Full Report (pdf format)

Childhood obesity plagues Kentucky with severe biomedical, psychosocial, and economic consequences.  Farm to School offers a validated model which can improve childhood nutrition to help prevent obesity and its ramifications.  The approach simultaneously encourages economic stimulation by promoting local agriculture.  The framework has proven successful in various counties in Kentucky and in other states.  This project represented a coordinated approach from three Kentucky counties.  The Farm to School program was implemented in each of these counties based on the initial stages of development.  These efforts have helped improve childhood nutrition and have helped promote local agriculture in these communities

Public Health Preparedness Education: Why Are Available Resources Not Utilized?

Prepared by: Regene’ Collier, B.S.N., RN-BC; Mike Harmon, M.A., B.S.; Andrea Renfrow, B.S.N., RN;  
Tim Wright, B.S., RS
Mentor: Swannie Jett, Dr.P.H.c, M.S

Full Report (pdf format)

Imagine having to evacuate your home at a moment’s notice.  What would you take?  How would you survive if basic utilities were disrupted?  These are difficult questions to answer, but the time to address them is now, not when a disaster strikes.  As public health employees, we know the key is to be proactive and not reactive when planning for disasters.  While there are numerous resources available for the public to use to assist in their own preparation for disasters, the reality is many people are not ready. 
Although emergency response officials will be on the scene of a disaster, they may not be able to assist everyone immediately.  People must plan ahead in an effort to protect themselves and their families.
This KPHLI team collected qualitative data by sending a survey to all LHD directors to be dispersed throughout their agencies and communities.  The results indicate 73% of participants thought it was “possible to very likely “of an emergency event occurring.  However, only 34% felt prepared for an emergency event.  Other data revealed 37% felt the best method to educate was through the media, while 35% felt collaboration with community partners was the best method of preparation.
As a result, this KPHLI team developed an educational tool that can be used in a variety of settings.  The concept is basic disaster preparedness with the content being appropriate for schools, faith-based settings, or any other community education venue.  The video could also be utilized for public service announcements and social networks.

Know Your Resources

Prepared by: Brigid Adams-Morgan, B.A., M.B.A.; Roni Grigsby, B.S.; Sarah Reeves, AAS
Mentor: Louise A. Kent, M.B.A., ASQ CQIA

Full Report (pdf format)

Representatives of the Kentucky Department of Corrections, Northern Kentucky Independent District Health Department and the Kentucky Department for Public Health joined together to empower individuals that are homeless in the Metro Louisville area.  The goal is to provide healthcare resources to enable individuals that are homeless the opportunity to seek and access resources to ensure they maintain a healthy lifestyle.
Many individuals that are homeless become homeless due to health issues, including lack of affordable health care, mental illness and addiction issues.  “For families and individuals struggling to pay the rent, a serious illness or disability can start a downward spiral into homelessness, beginning with a lost job, depletion of savings to pay for care, and eventual eviction. One in three Americans, or 86.7 million people, is uninsured.”1

In Louisville it is common for individuals that are homeless to seek healthcare in the city’s emergency rooms, for issues ranging from a true emergency like a heart attack to a minor concern like a sore throat.  For some individuals, they even seek shelter at the emergency room during bad weather.  After interviewing some of Louisville’s public health officials and service providers, we learned that emergency rooms in the city are inundated with individuals that are homeless that do not really need emergency care. We plan to inform Louisville’s homeless population of their options for free healthcare services within the city, and how they can utilize these services to maintain a healthy lifestyle.  It is our hope that this project will alleviate the impact individuals that are homeless have on the number of unnecessary emergency room visits. 

Public Health 101

Prepared by: Amanda England, M.P.H., CHES; Katherine Gilson, B.S., M.P.H.; Bobbye Gray, RN, B.S.; Joe Haner, B.S.I.E.; Deborah Mayberry, CHES Health Educator III, HANDS Specialist
Mentor: David Dunn, Sc.D, M.P.H

Full Report (pdf format)

The future of public health will evolve to meet the new challenges as they are identified and confronted.  Whether confronting bioterrorism attacks, emerging infections, lifestyle behaviors, disparities in health status, increases in chronic diseases and injury rates, or looming natural disasters, the public health workforce needs to strengthen its educational base to meet these new health challenges now more than ever.  We find ourselves in a continually expanding public health arena and in an era of a shrinking economic crisis.  The future ability of local health departments to meet the basic community health needs, let alone lift their communities to the highest levels of health possible, will require the public health workforce to, not only, know the expanding role of the public health system; but also, to cross-train to help fill that role to meet community needs.  It would be impossible to ensure that each citizen has access to a web of services that promote health, prevent illness and injury, diagnose disease early, provide disease treatment that is efficient and effective, persuade a reluctant public to change behavior, educate the legislature to pass laws that protect and promote health, and encourage scientists to develop and test technologies to prevent illnesses or detect and cure them.1

Point of Dispensing Standard Operating Guidelines Template and POD Pocket
2011 Balderson Leadership Project Award Runner-up

Prepared by: Jonathan Dye, B.A., RS; Jessica Gover, B.A.; Jane Jones, AS; Srihari Seshadri, M.B.B.S., M.P.H.; Jarrod Simpson, B.S., RS
Mentor: Shawn Crabtree, M.S.S.W., M.P.A.

Full Report (pdf format)

The Incredibles Team was initially formed to create a standardized, certification program for Preparedness Staff much like that currently in place for Registered Sanitarians.  Our team began work immediately and was on our way to reaching our goal.  The Incredibles knew this project required buy in from the Kentucky Department for Public Health (KDPH) Preparedness Branch.  Without this backing, our project would be nothing more than a year long project; not being utilized if KDPH Preparedness Branch was not on board.  After some time, it came to light that this project would not be ideal for us to conquer as a similar idea was already coming down the pipeline from a national perspective.  At that point, the Incredibles were forced to return to the drawing board to determine an appropriate and timely project to complete.

After much discussion and seeking input on what was important to the state from members of the KDPH Preparedness Branch, it was determined that our team could make strides in helping to bring more standardization to preparedness via a different avenue.  Instead of taking on standardizing the staff of preparedness, it was determined that we could begin on a slightly smaller scale and bring standardization to preparedness planning.  This would be done through standardizing one area in which preparedness was responsible for developing planning: Point of Dispensing Sites (PODs). 

Our project would continue to evolve over the course of this process.  We began with an idea to create Standardized Point of Dispensing (POD) Guidelines and a POD pocket.  The POD Standard Operating Guidelines (SOG) would be a basic document that could be utilized by preparedness staff across Kentucky to create their localized planning.  It would enable all POD planning in Kentucky to look the same and be in the same format.  Each plan would be different because each jurisdiction is different, but the content would be presented in the same format so it would be easier to navigate.  We also planned to create a POD pocket which would be utilized as Just In Time Training material.  The POD Pocket would contain a model POD layout, model POD Incident Command System (ICS) Chart with Job Action Sheets. 

Our plans then began to grow from there.  After speaking with the KDPH Preparedness Branch Strategic National Stockpile (SNS) Coordinator, Michael Johnson, we determined it would be ideal if we could create standard Job Action Sheets to accompany our other materials.  Then in casual conversation with Dr. Ruth Carrico of the University of Louisville, it was suggested we create a Smart Phone App to house all of our newly created materials to provide easier accessibility to users.  This led to the idea to create Just In Time Training (JITT) Videos; very short, precise videos that would streamline the Just In Time Training process and ensure everyone received the same JITT. 

During the time KPHLI allowed, we were able to complete our original tasks – Standard Operating Guidelines for Point of Dispensing Sites and have begun the process of getting the POD Pockets in place.  The App is in the process of being completed and Phase I will be ready to go on June 30, 2011.  The JITT videos will be an ongoing process to be completed post-KPHLI.  The Incredibles want to ensure quality products are in place and are therefore taking the extra time to ensure these are the best output we can possible produce.  Michael Johnson, KDPH SNS Coordinator plans to have our project presented as a best practice this summer at the SNS Conference in Atlanta.

Reducing Teen Pregnancy

Prepared by: Amy Comer, APRN, M.S.N; Jason Holland, RS; Amy Hale, RN
Mentor: Karen M. Hunter, M.P.H., RD, LD, CHES

Full Report (pdf format)

The “Raincoats” KPHLI Leadership Team desires for there to be accurate, current, and accessible information in the community of Monroe County to promote and educate regarding family planning services at the Monroe County Health Department, so that teen pregnancy rates may be decreased in our area.  Upon completion of an informative video, this information will be presented during an educational health class at the Monroe County High School.  This class is currently taught by Health Department Staff.  This will be the start of furthering education in the community.  Furthermore, it has been found that teen pregnancy rates are occurring at a much younger age.  Many of the teens participating in the health education class “Reducing the Risk” already have children.  Therefore, it is also desired that the video be shared at lower grade levels in the future and through separate venues, such as our local television station.

Creating Asthma Friendly Child Care Centers in Kentucky

Prepared by: Jennifer Gulley, RN, B.S.N., AE-C; Connie Buckley, RN, B.S.N.
Mentors: Brandon Hurley, M.P.H; Valerie Hudson

Full Report (pdf format)

Child care providers play a major role in the health and safety of the children in their care.  Current asthma hospitalization rates among Kentucky’s youngest children (0-4 years) are 426 per 100,000 populations¹. According the Kentucky Division of Child Care there are over 110,000 children (0-12 years) in child care at any given time within a day.  It is estimated that a classroom or center with 20 children may have two or more children with asthma.  It is imperative that early care and educational providers understand asthma and know how to provide the best quality of care for children with asthma.  It is also important to integrate environmental management of asthma into the child care setting. ²   The Creating Asthma Friendly Child Care Centers in Kentucky: A Resource Guide does exactly this. 

Team Wee No Wheeze has partnered with the Kentucky Respiratory Disease Asthma Program (KRDAP), the Child Care Health Consultant Program, and the Division of Child Care to develop a guide that will assist child care providers, parents, and community partners with providing the most favorable environment possible to care for children with asthma.  The resource guide is entitled Creating Asthma Friendly Child Care Centers in Kentucky: A Resource Guide.  The guide will be presented to the KRDAP for dissemination and implementation in child care centers across Kentucky.  

With proper care and attention to environment, most children with asthma can lead normal, active lives, and can enter school with the same abilities as other children³.  For this purpose; the Creating Asthma Friendly Child Care Centers in Kentucky: A Resource Guide is designed to include the following:

  • Basic information about asthma
  • How to improve the early care and education environment to reduce asthma triggers
  • How to administer asthma medication
  • How to handle asthma emergencies

The development of the Creating Asthma Friendly Child Care Centers in Kentucky: A Resource Guide is the first step in assisting KRDAP to address the hospitalization rates for 0-4 year olds with asthma.  The KRDAP will be responsible for the implementation and dissemination of the guide. 

The KPHLI Team Wee No Wheeze is composed of two members; both are nurses with a special interest in asthma management, particularly for children.  After reviewing the Kentucky Surveillance Report 2009, and researching the status of child care in Kentucky, both members agreed that providing a resource such as the Creating Asthma Friendly Child Care Center s in Kentucky: A Resource Guide would be the best way to reach the children most affected by hospitalizations related to asthma.  

The goal of this project, as indicated in the 2009 Kentucky State Plan for Addressing Asthma is to “ensure that all children diagnosed with asthma in schools and licensed child care facilities receive optimal care.”4   Providing the resource guide to child care providers will assist them in the management of children in their care with asthma.