Project T.E.A.C.H.

(Teaching Equity to Advance Community Health)

A Winning Collaboration to Achieve Health Equity.

A Word from the Director:

Dear partners,

This website contains the PowerPoint presentations from the last Project TEACH training along with the various useful resources last updated in November 2012.

As a last deliverable, Project TEACH is proud to announce TEACH DL (Distance Learning). We have recorded and uploaded screencasts—short presentations enhanced with audio—of our training modules. You can access these screencasts at http://www.screencast.com/users/Project_TEACH_DL/folders/Project%20TEACH%20DL.

Cheers!

Angela

Angela Sauaia, MD, PhD

Director

Project TEACH

About The Program

Funded by the Colorado Health Foundation, Project TEACH provides targeted training, technical assistance and support to community based organizations involved in projects that improve health care access and promote healthy living among underserved populations.

What We Offer

Free one-on-one training to Colorado community-based organizations involved in health disparities projects.

During the training you will learn:

Health Disparities Data: Obtaining and understanding the health disparities data in your region
Cultural Competence: Working collaboratively with individuals from diverse cultures
Community Engagement: How to engage your target community(ies) to address their needs
Evidence-based Interventions: How to find, adapt and use interventions shown to work (and what to do if there aren't any...)
Evaluation: How to show your success and learn how to improve your efforts
Grant Writing: Have one of our faculty work with you on your grant
Access to Healthcare: Best practices in identifying, enrolling and guiding eligible individuals into health insurance programs and how the reformed health care system may impact communities in Colorado

In addition, participants receive a USB drive loaded with county level health disparities data, validated tools to measure nutrition, physical activity and other health behaviors, websites where you can find evidence-based interventions, as well as many other resources related to the topics listed above. Most of the work is done via phone and e-mail, with one live workshop.

We Are

Angela Sauaia, MD, PhD (Director)
Nicole Tuitt, MPH (Assistant Director)
Tim Byers, MD, MPH
Ginger Harrell, BA
Cerise Hunt, MSW
Carol Kaufman, PhD
Mariana Ledezma-Amorosi
Laurie Schneider, MPH
Kris Wenzel, RN, MBA
and all AHECs personnel

We are a partnership between the University of Colorado Denver, the Area Health Education Centers (AHECs) and the Colorado School of Public Health Center for Public Health Practice.

For more information or to apply, please e-mail the Assistant Director, Nicole Tuitt, or the Project Director, Angela Sauaia, MD, PhD, for more information.

Project TEACH Evaluation

Project TEACH Evaluation Results

Services and Resources

Project TEACH Workshop Presentations

Testimonials:

Many thanks to you all and for all your hard work. There is no doubt that your good trainings and information will continue to have long lasting positive effects for those who have attended.

Best wishes!

Tawney

Nicole,

Thank you for everything you and Angela have done to support nonprofits in Colorado! You should be very proud of your amazing work.

Thank you!

Mara

It was an empowering training when I took it - Thank-you for all your work on this for our benefit.

Liza Marron

San Luis Valley Local Foods Coalition

Mapping Health Disparities in Colorado

Geographic Information Systems (GIS) can be used to visually depict health disparities. Project TEACH created GIS maps of the social determinates of health , chronic disease risk factors, disease incidence, and mortality rates in Colorado as a tool to inform policy, resource allocation efforts and targeted interventions to address disparities.

Health data were obtained from the Colorado Department of Public Health and Environment Regional Health Profiles and Health Disparities Data in 2009. Data were mapped using ArcMap GIS software and county level mapping. The data stratification are based on Jenks Natural Breaks Classification method.

GIS maps created by Katharine von Rueden, MPH

Maps:

Racial distribution: Asian American/Pacific Islander; Black; White/Hispanic; American Indian/Native Alaskan; White/non-Hispanic

Percent Asian American/Pacific Islander

Percent Black

Percent White/Hispanic

Percent American Indian/Native Alaskan

Percent White/non-Hispanic

Social determinants: Educational attainment; health insurance (child/adult); poverty status (child/adult)

High School Graduation

College Degree

Child Health Insurance

Adult Health Insurance

Child Poverty

Adult Poverty

Risk factors: Current tobacco use; overweight (child/adult); obesity (child/adult)

Conditions: Diabetes; cancer(all types); breast cancer; cervical cancer; colorectal cancer; prostate cancer

Mortality: Diabetes; heart disease; malignant neoplasms; cerebrovascular disease

Mortality Diabetes Mellitus

Mortality Heart Disease

Mortality Neoplasms

Mortality Cerebrovascular

Success Stories

El Paso County, Colorado

Rocky Mountain’s Program of All-Inclusive Care for the Elderly (PACE)

By: Joel Dickerman, DO, Medical Director

“As medical director for the Rocky Mountain PACE program, I have had the opportunity to apply both research skills and principles in equitable health care delivery I learned from Project TEACH to the patients of our program. Rocky Mountain PACE provides care to frail elderly patients of El Paso County Colorado, a majority of which represent underserved minorities with multiple chronic diseases. When we noticed our clients were utilizing the emergency room and hospital for routine medical services we developed a morbidity and mortality review process to determine the factors leading to this increased utilization instead of assuming our patients were simply "non-compliant" or unconcerned about cost. Our analysis revealed we had little insight in the complex nature of our patients (multiple medical conditions, limited support systems, and isolation from community-based services) and that we had not taken the time to understand the unique medical, social, and cultural needs of our patients. As a result we have undertaken a more proactive "conversation" with our patients and their families - a process that has not only led to decreased utilization but has improved patient outcomes (including patient and family satisfaction) and greatly enhanced patient and medical provider rapport.

Project TEACH taught me the importance of individual patient, family, and cultural needs in developing comprehensive treatment plans that are effective, efficient, and most importantly patient and family centered. Rocky Mountain PACE is not just succeeding economically (by controlling utilization) but thriving to provide patient and family centered care that is effective and promotes a strong patient-provider relationship. The results of this morbidity and mortality review process have been presented at the state and national level and are currently being adopted both by the Colorado Springs Regional Care Coordination Organization Program for Medicaid and the Memorial Health Care System of Colorado Springs. Many thanks to the Project TEACH program - from our clients and providers!”

Larimer County, Colorado

The Women’s Resource Center

By: Bill Stout, Development Director

“I began work as the Development Director of the Women’s Resource Center in November of 2010, one year ago. At that time I had a great deal of nonprofit human service experience, including grant writing, but no experience in public health and disease prevention. I found the training to be very useful and unlike any other options out there because it was so clearly focused on public health and health/wellness promotion. Project TEACH helped me in three primary ways:

Training

The two-day training was detailed enough to be useful. The fact that it was face-to-face training was important because we were able to discuss ideas in detail, explore questions, and have healthy debate. It was a morale builder to understand that other agencies have similar challenges and to brainstorm together about solutions. The class provided a flash drive with a large amount of detailed resources which I have used frequently.

Networking

Through Project TEACH I made several contacts in my own and nearby communities that I have met with since the training for collaboration. My agency is stronger because we now know of people and other programs that are potential partners.

Follow-up Consulting

Two months after the training my agency applied for a very competitive grant at the federal level, Healthy Communities 2020. I asked the Project TEACH staff for assistance in planning this project and writing the grant, and they provided expert advice and critique with short turnaround time. The Women’s Resource Center was just notified that we received the maximum amount of this grant. The grant will allow us to diversify our health efforts to include Type Two diabetes prevention and early detection.

In addition, we also received a grant from the CDPHE Office of Health Disparities to establish the project “Promotoras: Saving Women’s Lives in Larimer County”. The project has two main goals: providing more Patient Navigation services in a culturally competent manner, and strengthening the collaborative efforts of women’s healthcare providers. No member of this healthcare team provides all services, so efforts to coordinate services are vital to support a full continuum of care. The project will share the cultural competency expertise of the Women’s Resource Center with medical providers. Latina women suffer disproportionately from negative outcomes of breast and cervical cancers. This project combats this disparity by improving and expanding the efforts of the Women’s Resource Center (WRC) in Latina communities to provide early detection and follow up services for these two common and deadly cancers. Through this project Latina women will be empowered to better manage their own health. The project combines interventions that mutually support one another: education, access to care, referrals, screening, and treatment. Promotoras and Patient Navigators will implement these interventions. The Promotoras Project will reach 6,190 Latinas in its first year. Also in this year 100 women will be connected with cervical screening, 20 will be connected with cervical cancer treatment, and 100 will receive mammograms. The staff members of 8 medical providers will improve their cultural competency for serving Latinas.”

Fort Collins and Loveland, Colorado

Coalition for Activity and Nutrition to Defeat Obesity (CanDo) http://www.candoonline.org

by Jessica Hinterberg, MPH, CHES and Virginia Clark

"The Coalition for Activity and Nutrition to Defeat Obesity (CanDo) was established in 2003 as a community-based task force with 200 members, to address obesity in Fort Collins and Loveland, CO by promoting physical activity and proper nutrition. The vision of CanDo is for Fort Collins and Loveland to become model 21^st century communities in which healthy lifestyles are valued and practiced by citizens and opportunities for physical activity and healthy eating are created and supported by local government, worksites, schools and the health care community.

CanDo works with schools, worksites, health care settings, and the community to achieve their mission. In the CanDo School Health Initiative, we partner with Thompson and Poudre School Districts to promote wellness through mini-grant opportunities, technical assistance, advocacy, and the provision of resources on healthy eating and active living. CanDo encourages schools to use the Coordinated School Health Model to work towards building a healthy school environment for students, staff, and families.

CanDo supports worksite wellness through the Fort Collins Well City Initiative and the Loveland Well Workplace Initiative and provides free technical assistance to on navigating the Well Workplace Model. CanDo believes that people are more likely to try to lose weight if advised to do so by a physician or other health professional. Thus, we offer helpful resources to providers on our website and technical assistance on educating patients on healthy living. CanDo supports health initiatives in community gardens, recreation centers, and faith-based communities.

In May 2011, Virginia Clark and I from CanDo had the opportunity to attend the Project TEACH training in Northern Colorado. What a wealth of information! The two-day training provided in-depth resources on a variety of topics that directly apply to the work we do daily within our coalition. We especially enjoyed learning about potential data resources at the local, state, and national levels and evidence-based health programs. After participating in Project TEACH, we took the opportunity to share Project TEACH resources with our health systems community health educators team. Virginia and I reviewed specific resources that we felt the rest of our staff would be most interested in. The presentation was well-received and staff were appreciative to have additional resources to search for data and evidence-based health programs. Thank you Project TEACH staff for your expertise, time and resources delivering quality training!"

University of Colorado Denver Faculty

By: Carol Kaufman, PhD, Project TEACH faculty, Associate Professor of Public Health, Centers for American Indian and Alaskan Native Health

"I've been a faculty member with Project TEACH since 2009. My work with Project TEACH began innocently. Dr. Sauaia had been asked by the CDPHE to provide a special Project TEACH training to an organization working on an American Indian reservation. Through a incidental conversation, she knew I conducting intervention research with American Indian communities. She asked if I could help with the special training. I said of course. I had no idea…

…I had no idea how much I could learn about the many vibrant and creative organizations that work so hard to provide desperately needed services to such a diversity of underserved communities. Perhaps so telling about the energy and commitment of these organizations are the connections that are made in the room across participating organizations. As faculty present material across the modules of Project TEACH, participants share challenges and concerns and learn a great deal from one another. Those lessons set the stage for local networks and collaboration. Those lessons also have challenged me to reconsider my own partnerships and to think critically about networks in my own projects.

…I had no idea that the lessons I had learned in my own work could have so much relevance for so many organizations in Colorado. My work is about problem-solving and generating the evidence to show that programs are successful or not. My work is about figuring out a way to take a program that works in one setting and implement it in another very different setting. These are exactly the same challenges that Colorado organizations face: many of them work in rural areas, many work with underserved populations, all of them have very few resources. They are looking for a way to make their programs successful – many of the tools I use are also useful to these organizations. Many of the adaptation guidelines I use are also useful to these organizations. To give credit where credit is due – the strength of my presentation draws from the the great questions and feedback in the discussions in Project TEACH about intervention adaptation and implementation.

…I had no idea how much I’d learn from my co-TEACHers. The diversity of topics we cover is remarkable. We have core grant-writing skills: Logic models, data source, evidence-based interventions, and evaluation, but also the critical elements to organizations – the things that are necessary in order to have all those core grant-writing activities: community engagement, cultural diversity, and organizational sustainability. I am simply impressed with the depth of experience across such a broad set of topics, and my colleagues’ ability to find interesting and engaging ways to share that experience with participants. The colleagueship of the team is clear in the way presentations build upon one another – and how the integration of topics has become increasingly seamless.

Finally, I had no idea how much I’d enjoy the project. Lest readers of this story think we have achieved workshop nirvana, please know we face many challenges and make mistakes. I am honored to be a part of a team that can find humor and humility in what we do, and who are so open to learning and improving. I am honored to have met so many from organizations who are committed to improving the health and well-being of Colorado. They inspire me. I am honored to be a part of Project TEACH."

El Paso County, Colorado

Latino American Health Network

and

God's CLIP: Christian Ladies In Prayer

by Ada Torres, MA, Executive Director

Latino American Health Network

http://www.lahn-cs.org/

The Latino American Health Network (LAHN) grew out of an informal advisory council of Promotores at Our Lady of Guadalupe Church, in Colorado Springs, Colorado. In June of 2002, the Promotores Advisory Council partnered with the health promoters to create and administer a survey to assess the needs of this population. Out of this effort grew not only an invaluable fund of information about how to better serve this population but also the recognition of the need to create a more formal entity to track the health needs of this community and to advocate for improved health services. In September of 2002, the Latino-American Health Network (LAHN) was formalized as an independent group. In November of 2002, we adopted our name and a guiding statement of Values, Visions and Operating Principles.

Through a generous grant from the Congress of the Mission to administer aggressive diabetes and mental health outreach programs, LAHN was initiated at Our Lady of Guadalupe Church. Subsequently, LAHN acquired non-profit status under its own 501(C)3 charter with the Internal Revenue Service in 2005. LAHN bases its efforts to serve the Latino community on certain fundamental assumptions, beliefs and values related to health care within the Latino-American/Spanish-speaking community:

•There are specific needs within this community related to linguistic, cultural, spiritual, economic, and other issues.

•There is an essential need to work to understand these issues in order to better serve this community.

•There is a great need to link this community to existing resources and solutions.

•There is a need to foster collaborative efforts to link existing organizations.

•There is a need to expand services and possibly create new services while being mindful of not inadvertently depleting existing resources.

•There is a need to develop remedial and incremental goals and a way to monitor progress in achieving these goals.

•There is an immediate and ongoing need to creatively and persistently pursue sources of funding in order to achieve these goals.

I went to project TEACH training in Pueblo at the insistence of my good friend, and longtime collaborator, Angela Sauaia, who directs TEACH. The training was so fantastic, I asked TEACH to conduct an extra training in the Colorado Springs area. I personally recruited several local community-based organizations and public health agencies, and TEACH brought the training to our region on a very short around time.

Today, LAHN is in a position to widen and deepen its impact within the local community. Various non-profit organizations look to LAHN for consultation and referral support in grant-seeking to serve populations that are uninsured or under-insured for healthcare.

I strongly believe that the TEACH trainings helped me get two recent grants. The first project, The Spanish/English Promotora Training & Community Outreach: Cancer Focus, was funded through the CDPHE Office of Health Disparities Grant Program to reduce cancer health disparities in the Spanish speaking Latino community of El Paso and Pueblo Counties. The project included training Spanish speaking men over the age of 35 to be Promotores (health promoters) to work with the community to increase the number of people being screened for breast, cervical and colorectal cancers as well as to promote informed decision making related to prostate cancer. In 2009/2010 grant year, the training of 20 Promotora/es reached approximately 250 Latinos one-on-one and approximately 100 women and 10 men received patient navigation services for mammograms, pap smears, prostate exams and colonoscopies. Our training curriculum includes Colorado cancer statistics, the role of promotores and patient navigators, motivational interviewing, cancer screenings and treatments, self care and safety issues, practicum on conducting presentations, breast, cervical, colon, and prostate cancer biology.

The second project, the Latina Breast Health Campaign is currently funded by the Susan G. Komen Race for the Cure, Southeastern Colorado Affiliate until March 30^th, 2012. This project uses Promotoras to teach Spanish speaking Latinos, along with monolingual English and Bilingual women, about breast health. In addition, we provide free patient navigation services so more Latinas can get screened for breast cancer – the number one cancer killer of Latinas. We have re-applied with our local Komen affiliate to continue this work in both El Paso and Pueblo Counties in 2012-2013. We also plan to apply to several other foundations for funding of this project, as well as for other health projects we plan to implement in the new year re: diabetes and obesity issues in the Latino community.

We are extremely grateful to Project TEACH for helping us obtain these two competitive grants. The knowledge we have gained has been extremely valuable to us, and we have been able to share some of this knowledge with other small non-profits looking to get funded as well. The entire staff has been both professional and personal in their care and teaching of mainly inexperienced project staff. A huge thanks to all of them.

Ute Mountain Ute Tribe

Public Health Department

By: Marissa Maxwell-Kaime, RN, Director

"As a registered nurse for many years, I had many nursing qualifications to step into the position of Public Health Director for the Ute Mountain Ute Tribe in 2006. My passion being health promotion and disease prevention I was excited to embark on this new aspect of my career. What I lacked, however, was experience with grant writing.

I was asked to attend a Project TEACH class in Grand Junction for the Diabetes Prevention Program. I was unaware of Project TEACH at this time and began the learning process of successful grant writing. Being so new to this process my learning curve was quite steep.

Later Project TEACH was able to do training at our tribe which I promoted and attended. At this training I was able to assimilate even more information. The two-day face-to-face training was very beneficial as we were able to ask questions as they arose and get immediate feedback. Also, we were given a flash drive with many resources that has proved invaluable.

At this time we were trying to implement a successful weight loss program for the tribe but did not have the funds to accomplish it. We had determined to use Weight Watcher as it is an evidenced based weight loss program, but no research had been done on Weight Watchers among the Native American population in general or the Ute Mountain Ute population in particular.

Through Project TEACH we were able to develop a Pilot Weight Watchers Program for the ladies of the Tribe. This enabled us to acquire evidence based data which we will be able to utilize in future grant writing. This program was a success for the ladies who attended. Because of our initial Pilot Program we were able to introduce Weight Watchers to the Casino employees and classes continued in that venue after the Pilot Program came to an end.

Since that time I was fortunate to attend a third Project TEACH training that was held in Durango. With each training I have acquired more information and resources that have enabled me to be a more valuable team player on grant writing committees for the Tribe.

I am also very thankful for the Project TEACH staff who are available for feedback even after the training has ended. I feel Project TEACH has been very instrumental in providing me with the knowledge and assistance I have needed to become more proficient at grant writing. I will gladly attend even more trainings as I am able to glean new information each time I attend. I applaud the work Project TEACH is accomplishing among the underserved population of the state of Colorado."