Problem Addressed: Heart Disease and Stroke

Healthy People 2010 Objective: 12-8

Web Address: None

SNAPSHOT

The Healthy Hearts Program was developed by the Ellaville Primary Medicine Center (EPMC), a hospital-based rural health clinic, to identify and reduce modifiable risk factors for heart disease in Schley County. The program is a collaborative effort between EPMC, Georgia Southwestern State University School of Nursing, Schley County Board of Education, and Schley County Health Department. The program conducts screening and health education for employers, and elementary and high school students. In addition, the program assists with the purchase of hypertension medications. Local industries participate in the program by having employees screened at work and also receiving health education during working hours.

THE MODEL

Blueprint: The Healthy Hearts Program is a collaborative effort designed to identify and reduce modifiable risk factors for heart disease in Schley County through screening and health education for employers, and elementary and high school students. EPMC provides overall project responsibility and coordination while the School of Nursing is responsible for developing the Healthy Hearts nutrition program at the Schley County Elementary School. The Schley County Board of Education provides space for screenings, notifies parents of the program, and obtains permission for student participation. The Schley County Health Department works with EPMC to develop and implement a referral system for clients who are identified as hypertensive but cannot access the Georgia State Hypertension program. In addition, the program assists with the purchase of hypertension medications. The local pharmacy agreed to charge the program Medicaid rates on all drugs. The patient is responsible for half of the cost of the medication, and the grant purchases the other half.

The project was designed by EPMC to allow nurse practitioners (NPs) together with registered nurses (RNs) to provide screening, health education, and follow up. The services are offered at the clinic and in a community setting, such as schools and industries. Outreach is also provided to local churches, senior citizen centers, and recreation programs. Services are available to the entire community, and the outreach programs are targeted to county elementary and high school students, and factory employees. Bilingual outreach workers assist with health education to those with limited English proficiency. NPs manage chronic, stable, and common acute episodic health problems at EPMC and refer more complicated medical problems to a physician, who like EPMC, provides care on a sliding fee scale. Eight local industries agreed to participate in the program by allowing employees to be screened at work and receive health education during working hours.

A Federal Rural Health Outreach grant supports the program. It is funded for three years, with decreasing funding over the course of the grant’s life. The program supports an NP (0.5 full-time employee [FTE]), half-time RN, and licensed practical nurse (0.5 FTE). Office personnel are paid by EPMC, while three health outreach workers are paid from a Migrant Health Program federal/state grant. In addition, there are limited in-kind donations from a local internal medicine doctor and pediatrician in the community.

Making a Difference: The program was fully implemented in September 2001. Currently, the program works with local industries to develop an ongoing work wellness program. The program intends to measure success by:

meeting the action plan objectives;
increasing participation in health screening;
increasing individual employee and student participation in health promotion activities and focus groups; and
demonstrating a measurable and sustained change in modifiable risk factors, such as how many people have stopped smoking, how many people have controlled hypertension, and how many people have reached their targeted weight.

Beginnings: The program, in the demonstration phase, was initiated in May 2001 and fully implemented in September after the family nurse practitioner and health outreach workers began health screenings at the local industries and elementary school. The screening results showed that there were a high number of adults and children who had modifiable risk factors, undiagnosed or untreated hypertension.

The program was developed by EPMC, which enlisted the help of the above mentioned network members. Local industries participated in the program by having employees screened at work and receiving health education during working hours.

Challenges and Solutions: Currently, the program faces challenges relating to the participating employer setting aside time and space for the program to do the screening. It is also difficult to coordinate efforts with the School of Nursing. The school did not have nursing classes scheduled during the summer and did not have a “community health” nursing course, so students were not always available.

The program only works with clients in Schley County. The clinic is well established and known in the community and the surrounding area. The targeted work force is reached through flyers. The program also uses local newspapers and radio to announce other events. In addition, the project has been presented at a national conference.

PROGRAM CONTACT INFORMATION

Mary Anne Shepherd, RN, FNP-C

Healthy Hearts Program, Ellaville Primary Medicine Center

P.O. Box 65

Ellaville, GA 31806

Phone: (229) 937-5321

Fax: (229) 937-2232