Purpose
The primary purpose of the Sickle Cell Foundation of Greater Montgomery (SCFGM)
Outreach Education Program is a continuation to improve the system of reaching
parents of infants identified at birth as carriers of sickle cell trait (SCT),
to provide follow-up counseling and improve access to appropriate educational
materials. This project will also continue to partner with local health departments,
comprehensive care centers, private hospitals and federally qualified primary
health centers to expand outreach case management and education activities
to individuals with sickle cell disease (SCD) and those of childbearing age
with sickle cell trait (SCT) in rural counties of Central and Southeast Alabama.
Challenges
The challenge has been the lack of adequate staff to reach families in the
rural parts of the counties in this region. Many patients with SCD in these
rural areas of Alabama are poorly educated and socio-economically disadvantaged.
Their education becomes a challenge for us because many of these patients
are unaware of the serious nature of their condition. This is especially true
for young mothers with infants identified with SCD that should be on the prophylactic
penicillin treatment. Many of the rural counties in Alabama are considered
under served by health care providers who offer sub-specialty care. Many patients
have to drive long distance to Montgomery, Birmingham or Mobile for treatment.
Goals and Objectives
- Goal I:
- To continue to improve follow-up rates for newborns with SCD identified
in Central and Southeast Region of Alabama by the Alabama Department of
Public Health (ADPH) through the newborn screening program.
- Objective I:
- Maintain an organized method of follow-up for newborns identified
with abnormal hemoglobin screen in Central and Southeast Region of Alabama
by the ADPH.
- Goal II:
- To expand preventative care for adolescents with SCD through outreach
and education.
- Objective I:
- Maintain an education program for adolescents and their parents to
resolve issues they may face transitioning to adult care (TAC).
- Objective II:
- Maintain an organized method of follow-up for newborns identified
with abnormal hemoglobin screen in Central and Southeast Region of Alabama
by the ADPH.
- Goal III:
- To maintain a training and education program to focus on health literacy
as a tool to improve compliance with treatment regimens.
- Objective I:
- Identify health literacy issues that may prohibit individuals with
SCD from understanding health information that may limit their ability
to be compliant with medical regimens and recognize the complications
of their disease.
- Objective II:
- Improve dialogue between patients and the service providers by offering
an opportunity to learn about new approaches to care through distance
learning via video conferencing/web casting.
Methodology
- Goal I:
- To improve follow-up rates for newborns with SCD identified in the Central
and Southeast Region of Alabama. SCFGM entered into a partnership agreement
with the Alabama Department of Public Health (ADPH) and the University of
Alabama Birmingham Comprehensive Sickle Center (UABCSCC) to provide a systematic
approach to educate, counsel parents and provide long term follow-up for
newborns diagnosed with an abnormal hemoglobin.
- Goal II:
-
- Objective 1:
- SCFGM is a part of a collaborative study between the UABCSCC and University
of South Alabama Comprehensive Sickle Cell Center (USACSCC) to focus
on Transition to Adult Care (TAC) issues. The TAC team at USACSCC includes
the pediatric hematologist, nurse coordinator, case manager, sociologist
and psychologist. The SCFGM youth support groups will give input as
a focus advisory group.
- Objective 2:
- An education program on the implications of SCT for teens of childbearing
ages in the rural counties of Central and Southeast Alabama was developed.
We are providing education and non-directive counseling on medical and
scientific information about sickle cell disease that is sensitive and
accurate. A process of information transference is age appropriate and
will enable these teens to understand their own hemoglobinopathy and
make informed decisions about reproduction choices and their general
health care needs.
- Goal III:
-
- Objective I:
- Identify health care literacy issues that hinder individuals with
SCD from understanding health information that may limit their ability
to care for their medical problems by the following methods:
- a health education needs assessment to determine our patient’s
health care literacy needs.
- While imparting information to patients and families, the staff
will elicit feedback to ensure that the information is understood,
appropriate, and useful. Literacy appropriate materials will be
developed for patients identified as being at-risk for literacy
problems.
- Objective II:
- Offer physicians, nurses, allied health providers, patients and the
public an opportunity to learn about new approaches to improve overall
health care literacy and clinical care through long distance video conferencing
and web casting.
Evaluation
The project will be evaluated both for quantifiable and qualitative outcomes.
Quantifiable outcome indicators will include the number of participants to
sign-up and attend each seminar. The provider participation will be monitored,
as well as, the improvement in their knowledge level. The increase attendance
of parents and young adults support group meetings will also be used as an
indicator. Qualitative outcomes will include the health care literacy assessment
and post evaluation surveys given at the end of each seminar. Seventy-five
percent will be the benchmark for post education evaluations. Participants
of all the education programs will complete both a speaker and a course evaluation
to measure the effectiveness of the education.
Experience to Date
SCFGM has monitored the occurrence of SCD through its participation with
the ADPH and the newborn screening follow-up program, over the last ten years,
out of the 2,012 newborns identified with SCT, SCFGM has provided follow-up
education and counseling for 1,837 of those parents or guardians. 2) Out of
the 103 newborns identified with abnormal hemoglobins, referrals and follow-up
were made for 103 families to the Baby Step Program. This program was created
by UAB Children Youth Sickle Network to improve access to care and education
for children and mothers in rural counties in our region and 3) cooperating
with UAB and USA to complete a summary evaluation on issues relating to transition
preparedness for forty-six young adults between to ages of 13 and 18 years
of age.
Text of Annotation
Our project will address issues relating to three areas of concerns for individuals
with SCD and SCT in rural counties in Central and Southeast Alabama. These
issues will be addressed by accomplishing: 1) Improve follow-up rates for
newborns with SCD identified in Central and Southeast Region of Alabama through
the newborn screening program, 2) Expand preventative care for adolescents
with SCD through outreach and education and 3) Establish a training and education
program to focus on health literacy as a tool to improve compliance with treatment
regimens.
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