34th Annual Arizona Rural Health Conference
“Traditions and Technologies: Rural and Public Health Responding to Change”
July 30–August 1, 2007
You can register for the conference online. Payments accepted include Mastercard, Visa, and Purchase Order.
>> Go to Conference Registration
Session Descriptions
You will enjoy an exciting line-up of Keynote Speakers, General Sessions, Workshops, and Poster Sessions.
THEME ONE: HEALTHY LIVING
PROJECT DAP: SUBSTANCE ABUSE TREATMENT AND HIV PREVENTION IN RURAL AND URBAN AREAS
PRESENTERS:
Bridget Ruiz, Research Specialist Principal, University of Arizona-Southwest Institute for Research on Women
Sally Stevens, Executive Director, University of Arizona-Southwest Institute for Research on Women
DESCRIPTION:
This workshop will describe Project DAP (Determining Another Path). Project DAP is funded by the Substance Abuse and Mental Health Service Administration and is a collaboration between the University of Arizona’s Southwest Institute for Research on Women (SIROW), the Arizona Children’s Association (AzCA), and Pima and Cochise County Health Departments (PCHD; CCHD). Project DAP is implementing a substance abuse and HIV intervention for youth and their caregivers in Pima and Cochise Counties.
LEARNING OBJECTIVES:
• Learn about the program and evaluation design of Project DAP
• Learn about the differences in project implementation issues between urban
(Tucson) and rural (Sierra Vista, Douglas) areas.
• Learn about the curriculum implemented to educate youth and their caregivers about adolescent development (cognitive, biological, psychological), sexual health, and disease prevention.
• Learn of the preliminary baseline descriptions of the participants (e.g., demographic, substance use and mental health issues).
TII’QATSI: ADDRESSING TEEN PREGNANCY WITH A CULTURAL PERSPECTIVE
PRESENTERS:
Darren Vicenti, MD, Family Physician and Clinical Director, Hopi Health Care Center
Anna Lewis, MD, Physician and Coordinator, Health Promotions Disease Prevention Department, Hopi Health Care Center
DESCRIPTION:
This workshop will describe Tii’qatsi and our approach to decreasing teen pregnancy by introducing health education in schools using traditional cultural teaching, increased access to medical care, access to birth control and condoms, and education for community members using public media. An innovative aspect of this program is to rely on traditional Hopi teaching mechanisms to discuss teen pregnancy and sexual activity within a framework of historical gender roles and responsibilities and cultural preparation. We will present objective data regarding teen pregnancy issues in Indian Country and our Hopi community. Slides will include photos and descriptions of Hopi life and birthing ceremonies. We will open the conversation to discuss challenges that many of us experience, including approaching the subject of teen pregnancy, teaching safe sex in an atmosphere dominated by “abstinence only,” and providing condoms in public spaces.
THE ROLE OF HEALTHCARE PROVIDERS IN FIGHTING HUMAN TRAFFICKING
PRESENTER:
Kristen Denzine, Tucson Healthcare Provider Training Coordinator, ALERT
DESCRIPTION:
Human trafficking is modern day slavery. It is the act of subjecting a person to involuntary servitude, peonage, debt bondage, or slavery, for labor or commercial sexual services, through the use of force, fraud or coercion. The U.S. Department of State estimates 18,000 to 20,000 persons are trafficked across our borders each year for the purpose of forced labor and prostitution. The majority of victims are women and children. Arizona has long been recognized as a transit states for victims of human trafficking, but is growingly seen as a destination state as well and law enforcement lacks the resources to investigate all cases. Community health professionals have unique opportunities to encounter and help identify victims so we can bring an end to human trafficking in our communities.
GOAL:
Increase knowledge and understanding of what human trafficking is and how human trafficking is defined by federal and state law. Raise awareness that human trafficking exists and how it relates to rural communities in Arizona, especially in the context of Arizona as a border state.
LEARNING OBJECTIVES:
1. Clearly define federal and state definitions of human trafficking
2. Understand the differences between human smuggling vs. trafficking
3. Learn how healthcare providers can help identify possible victims of human trafficking
4. Understand how human trafficking affects our communities, especially in Southern Arizona
5. Become aware of what resources are available in Arizona for victims of human trafficking
6. Report on ALERT’s efforts to train healthcare providers throughout Arizona
POVERTY AS A PUBLIC HEALTH ISSUE
PRESENTER:
Karen Redwine Program Coordinator, Cochise County Health Dept.
DESCRIPTION:
This workshop will allow attendees to gain a deeper understanding of what it is like to be living poor in the Land of Plenty, and how that becomes a Public Health issue, as well as an ethical dilemma. Actually started as a cultural competency presentation, this workshop has been adapted to serve as a Public Health introduction to the emerging “culture of poverty”.
LEARNING OBJECTIVES:
The goal of this workshop will be to recognize poverty as a public health issue. At the end of the workshop participants will be able to:
• differentiate between situational and generational poverty
• gain an insight into the culture of poverty
• identify strategies for working with people living in poverty
POSTER TITLE: CAP IT OFF/SKIN CANCER AWARENESS CAMPAIGN
PRESENTER:
Linda L. Thomas BSN,RN,PHN TB Coordinator, FDIH, FDIH/Public Health Department
DESCRIPTION:
Cap It Off started in the summer of 2004 in the FD area. focuses on Health risks associated with the sun and preventive measures that will improve an individuals lifestyle. This presentation will inform individuals, families and communities on how to promote a healthy life style, identify risk factors associated with the sun, and how to identify, and prevent skin cancer in native Americans. Knowledge is power.
POSTER TITLE: THE HUALAPAI HEALTHY HEART PROGRAM
PRESENTERS:
Nicky Teufel-Shone Project Coordinator/Associate Professor, UA Zuckerman College of Public Health
Karen Hays, Case Manager, Hualapai Health Department
DESCRIPTION:
The goal of the Hualapai Healthy Heart Program is to prevent heart disease risk factors in community members diagnosed with diabetes. The prevalence of diabetes in the Hualapai Indian Community is > 40% and heart disease, a complication of diabetes, is the leading cause of mortality. This program uses local social support, innovative recruitment and retention strategies, and group and individual education to promote and teach participants to make healthy changes in their diet and activity patterns. BMI, blood pressure, HbA1c, and lipid levels are tracked as indicators of program impact and behavior change.
POSTER TITLE: STATUS AND NEEDS OF PROBLEM GAMBLERS AND THOSE AFFECTED BY PROBLEM GAMBLING IN RURAL ARIZONA
PRESENTER:
Paula Burns, Education/Prevention Administrator, AZ Office of Problem Gaming
DESCRIPTION:
A 2001 prevalence study conducted for the problem gambling program then at the Arizona Lottery, reported that 80% of the adults in Arizona gamble. A small but significant number of people who gamble are going to have adverse effects as a result. The National Gambling Impact Study Commission determined that there is a relationship between accessibility of gambling and the increase of gambling problems. There are 12 casinos in rural areas. Of the 7 rural counties with casinos, two have on gambling-treatment provide and five have none. The goal of this presentation is to educate the audience regarding problem gambling as a public health issue in rural Arizona.
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THEME TWO: JOBS INTO CAREERS
MENTORSHIP FOR NURSING CAREERS IN THE NAVAJO NATION
PRESENTERS:
Barbara Overman, Associate Professor, University of New Mexico,
College of Nursing
Ursula Knoki-W
ilson, President, N-NURSE
DESCRIPTION:
The Navajo Nurse Mentorship Project grew from findings of community based research examining interests and needs related to career advancement among health workers in New Mexico and Arizona Indian country. A unique University-community partnership was formed between University of New Mexico Nursing faculty and Navajoland nursing leaders to build community capacity to support career advancement for nurses from this community.
LEARNING OBJECTIVES:
• Identify key elements in developing strategies for advancement in nursing careers for underrepresented groups.
• Differentiate the Navajo Mentorship Pathway from other mentorship models.
• Recognize the importance of a culturally based solution to build capacity within communities.
REVERSING RURAL PROVIDER SHORTAGES THROUGH WORKFORCE PROGRAMS AND FEDERAL DESIGNATIONS
PRESENTERS:
Tracy Lenartz, MPH, Designation Specialist, and
Fabian Valle, MS, Workforce Programs Manager; Arizona Department of Health Services, Office of Health Systems Development
DESCRIPTION:
Primary care provider shortages are a common challenge in rural health care settings. This workshop will give an overview of workforce programs offered through the ADHS Office of Health Systems Development, including the Arizona State Loan Repayment Program, National Health Service Corps, J-1 Visa Waiver Program, and the National Interest Waiver Program.
LEARNING OBJECTIVES:
• Understand the criteria and benefits of Health Provider Shortage Area (HPSA)
and Medically Underserved Area/Population (MUA/MUP) designations.
• Determine whether their community is currently designated and current score
(if relevant).
• Consult online resources and HSD contacts for assistance to determine whether
their community meets criteria for designation (if not already designated).
• Use knowledge of a variety of workforce programs (including the Arizona State
Loan Repayment Program, National Health Service Corps, J-1 Visa Waiver
Program, and the National Interest Waiver Program) and their requirements to
assess whether any may be used to recruit and retain health professionals to
their community.
• Follow through with application process and access online resources or HSD
contacts as questions arise.
ACCREDITED WORK-BASED LEARNING: EDUCATION FOR RURAL HEALTH
EMPLOYEES
PRESENTERS:
R. Cruz Begay, Dr.P.H., Assistant Professor, Northern Arizona University
Roger Bounds, PhD, CHES, Assistant Professor, Northern Arizona University
DESCRIPTION:
The Pathways into Health organization developed partnerships with Northern Arizona University telemedicine system, and health care provider organizations in rural Arizona to develop a program in accredited work-based learning. Accredited Work-Based Learning is a promising approach to advancing the careers of rural health employees. A recently funded initiative for AWBL is being implemented in Arizona’s Indian Country and uses creative strategies while facilitating system changes to improve career skills and increase retention in frontline health care workers.
LEARNING OBJECTIVES:
• explain the difference between accredited work-based learning and on the job training
• name and understand at least three tolls and settings that may be used in work- based learning
• understand the importance of system changes in the implementation of a program of work-based learning.
THE NORTHERN ARIZONA ALLIED HEALTH INITIATIVE
PRESENTERS:
Sean Clendaniel, MPH, Northern Arizona Area Health Education
Center/ North Country Community Health Center and Department of Health Sciences at Northern Arizona University
Effie Hacklander, PhD, Yavapai College- US Department of Labor: Community-Based Training Grant Project Director
DESCRIPTION:
The Northern Arizona Allied Health Initiative is an alliance between Yavapai College, Northern Arizona Area Health Education Center, two state four-year universities, area employers, workforce organizations and K-12 educational institutions joined together to increase the supply and distribution of certificates, licensed and/or degreed allied health workforce in Northern Arizona. The Initiative’s goal is to create training programs at all levels. This includes not only the degree and certificate programs the college partners offer, but also continuing education/ continuing medical education classes.
LEARNING OBJECTIVES:
At the end of this workshop participants will be able to:
1) Define infrastructure needs for different learning modalities
2) Develop community-based partnerships to leverage resources
3) Create and sustain an Allied Health program that serves a rural area
4) Construct curriculum on a standard-based model to meet required competencies
5) Meet a regional need through a “growing our own health professionals” approach
POSTER TITLE: MIGRANT FARMWORKERS: WHO WILL TELL THEIR STORY? PHOTO INSTALLATION
PRESENTER:
Jill de Zapien, Associate Dean for Community Program UA Zuckerman
College of Public Health
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THEME THREE: RURAL COMMUNITY DEVELOPMENT
EXPANDING HEALTHCARE COVERAGE: OPTIONS & PRIORITIES
PRESENTERS:
Veronica Venturini, Strategic Health Programs and Policy Administrator,
Healthcare Group of Arizona;
Kevin Driesen, Regional Administrator, Arizona Health Care Cost Containment System
DESCRIPTION:
With funding provided by the Robert Wood Johnson Foundation, in cooperation with Healthcare Group of Arizona, community-based initiatives were organized to increase health care coverage options available to Southern Arizona residents.
Goal: To increase awareness of the data collection activities and community development strategies that were organized during the 18-month Initiative in efforts to increase health care coverage options in southern Arizona’s border communities, so that vested participants can become familiar with strategies that can be modeled in similar communities interested in increasing access to health care services and coverage.
LEARNING OBJECTIVES:
i) Provide an overview of the mission and functions of the Arizona Healthcare Cost
Containment System and Healthcare Group of Arizona.
ii) Describe the Robert Wood Johnson Foundation-State Coverage Initiatives Grant
goals and deliverables.
iii) Describe the key data collection and community based strategies/ partnerships
developed and outcomes.
iv) Present potential future opportunities for network and community capacity
development throughout counties around increasing health care coverage options.
v) Through the question, answer and open discussion session create an
environment of information exchange around best practices and lessons learned
to generate future network, partnership and coalition development opportunities.
FROM PROGRAM TO POLICY: EXPANDING THE ROLE OF COMMUNITY COALITIONS
PRESENTERS:
Anne Hill, Graduate Research Assistant;
Jill Guernsey de Zapien, Associate Dean for Community Programs;
Joel Meister, Professor; University of Arizona, Mel and Enid Zuckerman College of Public Health
DESCRIPTION:
Community coalitions are important mechanisms for addressing local health issues because they engage community members as active participants in setting health priorities, making decisions and implementing strategies to achieve improved health status. At the U.S.-Mexico border, community coalitions and their university partnerships have been instrumental in addressing the dramatic rises in the prevalence of obesity, diabetes and its complications. Goals: To document the process by which five community coalitions moved from a programmatic to a policy focus and to demonstrate how these coalitions used community-based participatory approaches to promote systems change at the local level. We explored the CDC’s REACH 2010 Community Change Model as the teaching and analytic framework for supporting and documenting coalition transition.
LEARNING OBJECTIVES:
1) Learn about community coalitions at the U.S.-Mexico border;
2) Understand the process and catalysts by which coalitions transitioned their focus
from program to policy; and
3) Recognize the importance of community/university partnerships and participatory-
based collaborations for community change.
SELF-RELIANCE: A FRONTIER TRADITION AND REMEDY FOR HEALTH SYSTEM ILLS
PRESENTER:
Terry Leef, Director, White Mountain Communities Special Health Care District
DESCRIPTION:
Citizens of southern Apache County self-impose a secondary property tax and use the revenue to sustain and develop their health care delivery system. The structure and function of this model will be examined, with an eye toward helping particpants adapt the model to their locality. A history of this initiative’s development will be provided, as will summaries of revenues and disbursements, creation of jobs, and facility development.
LEARNING OBJECTIVES:
• describe the legislative framework for this model
• list potential partners,
• describe leadership roles and skills necessary for development of the model, and
• identify potential opportunities for, and obstacles to, replicating the model in
other localities.
INCREASING ACCESS TO CARE FOR RURAL/NATIVE AMERICAN COMMUNITIES THROUGH COMMUNITY DEVELOPMENT COLLABORATION
PRESENTERS:
Colleen McGregor, Community Development Program Manager;
Kim Russell, Native American Community Development Manager, Arizona Department of Health Services/Office of Health Systems Development
DESCRIPTION:
This workshop will increase attendee’s awareness of community development resources available to Native American, rural and urban communities seeking to increase access to primary health care services; and of current networking and partnership activities and present future opportunities to collaborate in network and partnership development around the mission of increasing access to care for vulnerable, underserved and uninsured populations.
LEARNING OBJECTIVES:
1. Summarize the mission and functions of the OHSD/PCO Office
2. Describe the roles of the NA/Community Development (CD) programs.
3. Describe key Native American, rural and urban collaborations and partnerships and the outcomes of those relationships.
4. Present future opportunties for network and partnership development across
programs, disciplines and concentrations with a focus on increasing access to
health care services
5. Through question, answer and open discussion session create an environment for
information exchange around best practices to generate future network,
partnership and coalition development opportunities.
POSTER TITLE: RURAL PEOPLE, RURAL POLICY, A 5 -YEAR W.K. KELLOGG FOUNDATION INITIATIVE
PRESENTERS:
Joyce Hospodar, Senior Program Coordinator;
Jennifer Peters, Coordinator for Community Health Promotion, Rural Health Office, UA Zuckerman COPH
DESCRIPTION:
This poster will outline the focus and goals of the W.K. Kellogg Foundation Rural People, Rural Policy Initiative, profiling each of the ten organizations currently included in the Southwest Regional Network as well as the types of policy issues currently being worked on or considered within the network.
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THEME FOUR: RURAL HOSPITALS AND HEALTHCARE NETWORKS
RETHINKING EMERGENCY DEPARTMENT DESIGN IN RURAL ARIZONA: BANNER PAGE HOSPITAL EMERGENCY DEPARTMENT EXPANSION
PRESENTERS:
Anne Bilsbarrow, A/A, Smith Group
Sandra Sharon Haryasz, RN, CEO, Page Hospital
Elizabeth Faulk, MD, Emer
gency Department Director, Page Hospital
L
yle Steely, LEED AP, Architecture, Smith Group
DESCRIPTION:
Rethinking Emergency Department Design in Rural Arizona through collaboration to discover and implement solutions that improve efficiency and environment for staff, administrators, patients and their families. This project’s design integrates effective planning with innovative design principles to create significant changes in patient care and staff satisfaction at Banner Page Hospital.
In this presentation we will demonstrate the need to replace an existing Emergency Department with a new model that would address three key areas:
1. Staffing considerations for efficiency.
2. Planetree Philosophies for patient care.
3. Operational improvements through facility design.
IMPROVING MEDICATION RECONCILIATION IN SMALL RURAL HOSPITALS
PRESENTER:
Howard J. Eng, Assistant Professor, Rural Health Office, UA Zuckerman College of Public Health
DESCRIPTION:
Four Critical Access Hospitals (CAHs) participated in a medication reconciliation demonstration project. The medication reconciliation processes used in the four CAHs will be discussed. The systematic approach used to improvement medication reconciliation in the four hospitals and the results of the project will be presented.
Workshop attendees will gain an understanding of the medication reconciliation processes in small rural hospitals and how to improve those processess.
USDA RURAL DEVELOPMENT: FINANCIAL ASSISTANCE FOR RURAL COMMUNITY HEALTH PROGRAMS AND PROJECTS
PRESENTERS:
Leonard Gradillas, Community Programs Director;
Joel Trachtenberg, Community Programs Specialist, USDA Rural Development
DESCRIPTION:
This workshop provides an overview of the Rural Development Community Facility Loan and Grant Program. You will learn about what funds are available for Health Care and Medical Care related programs and projects that include Hospitals, medical, health and dental clinics, emergency and rescue vehicles, medical equipment, building facilities for behavior health care, skilled nursing and assisted living, telemedicine and more. You will learn what entities are eligible to apply, what locations are eligible and what purposes are eligible under program guidelines. You will see examples of these projects currently in place throughout rural Arizona.
HEALTH CARE REFORM ADVOCACY
PRESENTER:
Timothy Schmaltz, Coordinator/CEO, Protecting Arizona’s Family Coalition
DESCRIPTION:
Almost everyone agrees the health care system is a mess, with thousands uninsured, many more underinsured, growing premiums, high co-payments, lack of rural medical care, escalating costs, workforce shortages, facility closures, health care disparities among populations, and bad health care outcomes for many populations. How can you participate in creating solutions at state and federal level as citizen advocate and health care professional? Learn about potential solutions as well as effective advocacy skills. This is a how to workshop for learning practical skills of effective real world advocacy.
LEARNING OBJECTIVES:
• Provide detailed and comprehensive information about the current state of affairs in health care
• Enable agencies, agency leaders, professionals and citizens to participate effectively in advocacy efforts to create health care reform.
POSTER TITLE: RAISING AWARENESS ABOUT ALZHEIMER’S DISEASE IN ARIZONA
PRESENTERS:
Jennifer Westlund Community Care Coordinator, Banner Alzheimer’s Institute
Jan Dougherty, Director, Family & Community Services, Banner Alzheimer’s Institute
DESCRIPTION:
Raising awareness about Alzheimer’s disease in Arizona is essential if we are to find effective treatment and prevention strategies in the next decade. This session will discuss the creation and implementation of the Arizona Alzheimer’s Registry, a method to attract and enroll research participants into prevention and treatments trials around Arizona.
POSTER TITLE: TRADITIONAL AGENCY WITH CHOICE - A CONSUMER DIRECTED MODEL OF PERSONAL CARE
PRESENTER:
Ben Bledsoe Program Manager, Consumer Direct Personal Care
DESCRIPTION:
Attendees will be introduced to the four existing models of personal care recognized by Medicaid. Focus will be placed on consumer directed models, particularly Agency with Choice, and their benefits in rural areas: increased participant responsibility and role, decreased agency involvement, and caregiver quality improvement. Arizona’s existing and potential use of consumer directed programs in the Attendant Care Worker, Personal Care, and Homemaker programs will also be discussed. The Agency with Choice Model allows those receiving care to act as manager of their caregivers. Participants recruit, hire, train, supervise, and dismiss persons providing care. Consumer direction agencies act as support entities for participants and as the employer of record for caregivers. The session will show how care within the participants’ immediate network creates economic and cultural advantages for families and communities. Additionally, surveys of consumer directed program participants present high opinions of quality, satisfaction, and self-importance with low incidence of abuse and fraud. Attendees will receive instruction on how to take full advantage of these benefits while assuring safety and quality.
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