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Service Delivery Innovation Profile

Interactive Workshops Enhance Access to Health Education and Screenings, Improve Outcomes for Low-Income and Minority Women


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Snapshot

Summary

Keystone Mercy Health Plan's Health Ministry Program sponsors a series of health events aimed at promoting health education, health literacy, and preventive health care among low-income and minority women. In partnership with local churches, the program provides free, interactive workshops and educational materials that address the health needs of underserved communities, along with individual health assessments and screenings. Preliminary data suggest that the program has enhanced access to health education and screenings and improved key health outcomes among a subset of participants with diabetes and other chronic health conditions.

Evidence Rating (What is this?)

Moderate: The evidence includes overall participation rates, as well as comparisons of pre- and post-implementation data on health indicators for a group of 825 participants with diabetes who participated in workshops over a period of approximately 6 weeks.
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Developing Organizations

Keystone Mercy Health Plan
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Date First Implemented

2000
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Patient Population

Race and Ethnicity > Black or african american; Vulnerable Populations > Impoverished; Insurance Status > Medicaid; Vulnerable Populations > Racial minoritiesend pp

Problem Addressed

Low-income individuals (especially minorities) are at higher risk of developing chronic conditions (e.g., diabetes, some cancers, and cardiovascular and respiratory diseases) and often have difficulty accessing and navigating support services to help them address and prevent health problems.
  • Less access to care, with more illness: Persons living below the poverty level are significantly less likely to have a usual source of medical care1 and to access preventive health care services2 than are those with higher incomes. They are also more likely to experience difficulty in communicating with providers regarding health care needs,3 report low overall health scores, and suffer from a variety of chronic illnesses.4
  • Especially among African Americans: African-American women are particularly at risk; in 2005, they were much more likely to die from breast cancer (34 percent), stomach cancer (2.4 times), heart disease (35 percent), and diabetes (more than 2 times) than were non-Hispanic White women.5

What They Did

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Description of the Innovative Activity

The Health Ministry Program sponsors a series of health events aimed at promoting health education, health literacy, and preventive health care among low-income and minority women. In partnership with local churches, the program provides free, interactive workshops and educational materials that address the health needs of women, along with individual health assessments and screenings. Key elements of the program include the following:
  • Free, interactive workshops: The Health Ministry Program holds roughly 12 workshops each year that address the health needs of women. Each workshop focuses on a different core theme, usually with at least one large-group presentation followed by a number of smaller breakout sessions from which participants can choose. Examples of themes include breast cancer detection, stress management, controlling diabetes, physical activity, and diet and nutrition. Representatives from national associations (e.g., the American Diabetes Association and the American Cancer Society) as well as Keystone Mercy Health Plan medical directors often lead workshop sessions, covering basic health information, along with specific preventive steps that women can take to keep themselves healthy. Sessions also feature motivational speakers who encourage participants to lead healthy lifestyles. Workshops vary in length and usually draw between 50 and 250 participants; attendees also receive a nutritious meal. Workshops are held at 1 of 12 selected churches located throughout the greater Philadelphia region; programs rotate between the churches to make the sessions accessible to women who may not have access to transportation.
  • Large-scale health event: The program also sponsors one large-scale, all-day health event each year that typically draws between 2,500 and 5,000 attendees. This event covers a variety of health topics and also has an entertainment component (e.g., a gospel music concert). Because of its size, this event must be held at one of the area's auditorium-style churches; free bus transportation allows those who live in other areas to attend.
  • Six-week intensive series: In addition to stand-alone health events, the program sponsors "The 40-Day Journey," a intensive series of workshops aimed at preventing, controlling, and reversing chronic conditions by focusing on nutrition, physical activity, water intake, and medication compliance. Participants meet weekly over the course of 6 weeks to learn how to understand and proactively manage their health. Many (but not all) participants already suffer from a chronic disease.
  • Health assessment and screenings: At all workshops and events, the Health Ministry Program offers free individual health assessments and screenings, provided by a team of physicians and nurses. Available screenings include (among others) measurement of height, weight, blood pressure, body mass index, body circumference and girth, glucose, hemoglobin A1c, total cholesterol, and triglycerides. Health assessments also examine each participant's level of physical activity, diet, and other lifestyle choices.
  • Healthy living guide: Each participant receives a healthy living guide, a free publication featuring articles written specifically for the program by medical experts and health professionals. The guide focuses on prevention, awareness, and education to help women make appropriate health decisions.

Context of the Innovation

Keystone Mercy Health Plan is Pennsylvania's largest Medicaid managed care plan, serving more than 300,000 Medicaid recipients in southeastern Pennsylvania. In addition to providing quality services for individuals, the plan is dedicated to improving the health status of the communities it serves and empowering the poor and disadvantaged. In early 2000, Keystone executives Maria Pajil Battle and Sister Renee Yann collaborated with representatives from several other Keystone departments to develop a community-based awareness and education program. On examining patient data, the executives identified a number of health disparities among women, especially minorities, and decided to design an intervention to address them.

Did It Work?

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Results

Preliminary data suggest that the program enhanced access to health education and screenings and improved key health outcomes among a subset of participants with diabetes and other chronic diseases.
  • Improved access to education and screenings: More than 60,000 participants have attended the workshops and health events to date, with many of these attendees receiving free health screenings and assessments. Most attendees would likely not have had access to such education and services in the absence of this program.
  • Improved health: Comparisons of data gathered at baseline and after 6 weeks of involvement with the program's educational track on diabetes found that participants reduced triglyceride levels (by nearly 20 percent), low-density lipoprotein (22 percent), fasting blood sugar (17 percent), weight (4.6 percent), resting heart rate (5 percent), and systolic blood pressure (nearly 6 percent).

Evidence Rating (What is this?)

Moderate: The evidence includes overall participation rates, as well as comparisons of pre- and post-implementation data on health indicators for a group of 825 participants with diabetes who participated in workshops over a period of approximately 6 weeks.

How They Did It

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Planning and Development Process

Key steps in the planning and development process include the following:
  • Forming a coalition: Keystone executives assembled a coalition of local and national health care providers and other community stakeholders, including Philadelphia-area clinicians and hospital staff, African-American clergy, local government officials, members of the Chi Eta Phi nursing sorority, and representatives from national associations including the American Diabetes Association and the American Cancer Society. This coalition served in planning and advisory roles throughout the development of the Health Ministry Program.
  • Identifying areas of need: The coalition used Keystone-generated patient data as well as statewide statistics to identify geographic areas of need, including sections of the greater Philadelphia region with particularly high prevalence of selected chronic diseases.
  • Collaborating with churches: The coalition identified 12 churches located in the geographic areas noted above; coalition members and project leaders met with leaders at each church to solicit participation, identify available church resources, and establish roles and tasks.
  • Securing initial funding and donations: Project leaders requested and received initial seed money from Keystone Mercy Health Plan and Eli Lilly and Company. The Health Ministry Program also received initial in-kind donations of materials, equipment, and screening supplies from various sources, which enabled the addition of a screening component to the program.
  • Launching major media campaign: The program hired a marketing firm to assist in developing and implementing a major media campaign to promote the Health Ministry Program, including flyers; public service announcements; guest appearances on various local radio stations; and outreach to area provider offices, community-based organizations, and churches.

Resources Used and Skills Needed

  • Staffing: Approximately 10 existing Keystone Mercy Health Plan staff members worked on developing and launching the Health Ministry Program, while 5 staff members are involved in the ongoing operations of the program. In addition, 100 Keystone staff volunteer to help with each large-scale health event, whereas 25 staff members volunteer at each smaller workshop. Some workshop speakers and presenters volunteer their time, whereas others receive stipends from the program. Clinicians who provide screenings at the workshops either volunteer their time or are hired through a temporary nursing agency.
  • Costs: The program's annual budget runs approximately $100,000.
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Funding Sources

Eli Lilly and Company; Keystone Mercy Health Plan
The Health Ministry Program is funded in part by foundation grants, with Keystone Mercy Health Plan providing a 50-percent matching donation for each grant received. Keystone also provides in-kind contributions of staff time and materials.end fs

Adoption Considerations

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Getting Started with This Innovation

  • Build a strong coalition: Assemble a group of committed organizations and community stakeholders who are able and willing to focus their efforts on the project for at least 1 year, if not longer.
  • Conduct careful research: Use targeted local data to identify areas of need within the community, thus ensuring the initiative addresses a proven disparity.
  • Keep communication a priority: Ensure that all coalition members stay abreast of any new developments, and emphasize full participation in meetings as a key component of participation. All coalition members who are part of the Health Ministry Program participate in a conference call every 2 weeks.
  • Make all partnerships mutually beneficial: Identify and share the goals and objectives for each coalition member upfront and be clear on the deliverables needed to satisfy the participation requirements for each partner.

Sustaining This Innovation

  • Do extensive outreach: In addition to using flyers, radio and television announcements, and other media outlets, conduct directed outreach by maintaining detailed participant lists and making phone calls to solicit future attendance.
  • Actively pursue funding: Dedicate staff time and resources to grant-writing, and conduct outreach to potential new funders. To boost fundraising success, develop a polished marketing package, and capitalize on any media coverage of the program.

More Information

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Contact the Innovator

Meg Grant
Director of Public Affairs & Marketing
Keystone Mercy Health Plan
200 Stevens Drive
Philadelphia, PA 19113
(215) 863-5688
E-mail: Meg.grant@kmhp.com

Tonya Moody
Vice President Sales & Marketing for Medicare VIP Plans
Amerihealth Mercy Family of Companies
200 Stevens Drive
Philadelphia, PA 19113
(215) 863-5700
E-mail: Tonya.Moody@AmerihealthMercy.com

Innovator Disclosures

Ms. Moody and Ms. Grant have not indicated whether they have financial interests or business/professional affiliations relevant to the work described in this profile; however, information on funders is available in the Funding Sources section.

Footnotes

1 Agency for Healthcare Research and Quality. National Healthcare Disparities Report 2009. March 2010. Available at: http://www.ahrq.gov/nhqrdr2009
2 United States Department of Health and Human Services. Health disparities: a case for closing the gap. June 2009. Available at: http://demo.tizra.com/mh3ss/1#/mh3ss/1
3 Agency for Healthcare Research and Quality. AHRQ News and Numbers: minorities, poor find communicating with doctors more difficult. June 2009.
4 Mead H, Witkowski K, Gault B, et al. The influence of income, education, and work status on women's well being. Womens Health Issues. 2001;11(3):160-72. [PubMed]
5 United States Department of Health and Human Services, Office of Minority Health. African American Profile. 2009. Available at: http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=51
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Disclaimer: The inclusion of an innovation in the Innovations Exchange does not constitute or imply an endorsement by the U.S. Department of Health and Human Services, the Agency for Healthcare Research and Quality, or Westat of the innovation or of the submitter or developer of the innovation. Read more.

Original publication: February 17, 2010.
Original publication indicates the date the profile was first posted to the Innovations Exchange.

Last updated: March 26, 2014.
Last updated indicates the date the most recent changes to the profile were posted to the Innovations Exchange.

Date verified by innovator: March 13, 2014.
Date verified by innovator indicates the most recent date the innovator provided feedback during the annual review process. The innovator is invited to review, update, and verify the profile annually.