Tillery NC Understanding Health and Wellness Needs A

Tillery, NC

Understanding Health and Wellness Needs A Community’s Perspective

The Tillery Community

CCT Philosophy of Health Care n Concerned Citizens of Tillery (CCT) believes that the conditions necessary for good health - including recreational facilities, excellent schools and medical facilities, lifelong learning opportunities, nutritious food, and economic development - will not be granted by outside institutions, but will be created by a strong community working in equal partnership with other organizations and institutions. (ECU OT and SW, AWHC, People’s Health Clinic)

Understanding the Community

Why the interest? n n Comin’ Home Aging in place Community support Contextually and culturally embodied Community built practice

Door to Door Survey n n SF-12 and environmental questions 104 participants (100 in 1996) Students from ECU and UNC-CH Assess the health related quality of life of residents of those in 5 mile radius of Tillery Community Center

Finding out about the Community: Student Perspectives n n n n Hardworking people Self Sufficient Spiritual Family and Community Oriented Friendly Welcoming Warm

Gender Race 42 males (34), 61 females (34) 81 African Americans (89) 15 Caucasians (11 C + others) Employment 67 not employed Heating 36 gas (20), 26 central, 7 wood (7) Cooling 41 AC, 40 central, 9 fans Smell mildew or mold 89 no, 14 yes Home flooded 80 no, 23 yes Smells inside home 79 no, 21 yes from industry Smells outside home 53 no, 47 yes from industry

General Health 14 excellent (16), 24 very good (12), 33 good (38), 26 fair (29), 7 poor (5) Health limitations for moderate activities 16 a lot (18), 23 a little (26), 64 not at all (57) Health limitations for stair climbing 21 a lot (17), 25 a little (26), 54 not at all (57) Daily activities accomplished less than like due to physical health Limited in kind of activities due to physical health 9 all of the time, 12 most of the time, 22 some of the time, 18 a little of the time, 42 none of the time 5 all of the time, 10 most of the time, 14 some of the time, 20 a little of the time, 52 none of the time Daily activities 3 all of the time, 12 most of the time, accomplished less than like 16 some of the time, 14 a little of the due to emotional problems time, 57 none of the time

Daily activities less carefully than usual due to emotional problems 2 all of the time, 6 most of the time, 14 some of the time, 11 a little of the time, 67 none of the time Pain interfere with daily activities 46 not at all (27), 21 a little (29), 14 moderately (8), 14 quite a bit (25), 7 extremely (10) Felt calm and peaceful 27 all of the time (14), 45 most of the time (51), 15 some of the time (13), 14 a little of the time (17), 2 none of the time (5) A lot of energy 18 all of the time (11), 36 most of the time (43), 25 some of the time (32), 15 a little of the time (11), 9 none of the time (3) Downhearted and depressed 3 all of the time (1), 2 most of the time (8), 18 some of the time (14), 22 a little of the time (28), 59 none of the time (49) Physical and emotional health interfered with social activities 5 all of the time (1), 2 most of the time (5), 14 some of the time (5), 19 a little of the time (11), 64 none of the time (76)

Community Quality of Life n Community Needs Assessment—A focus group study provided the following description of the community quality of life: Everyone has a hand in making the community work, Together like one big family, We’ll all come back to Tillery, Go back to the old values or we’re lost, We need things that complement the community, The land is power, I have a different view of white people and black people working together

The Road to Wellness: The Need for Interprofessional Practice

Wellness Needs n n Wellness Group—A five week wellness program focused on physical activities, nutrition, social support and safety. What did the occupational therapy wellness group mean to its participants? Data analysis yielded five themes: fellowship through togetherness, learning new things and education, a different outlook on well-being, having fun, and leadership. OT and Social Work Home based services--OT and Social Work

Evaluation of Individual Needs, Interests, and Goals

Planning Group Goals and Activities

Link to Environmental and Social Justice Issues Philosophy of Health Care History of Tillery Impact of history, race, gender, and socioeconomic status Occupational Justice Issues

Role of the Environment in Shaping Practice n n n Interpersonal Physical (manmade and natural) Societal (economic) Cultural Temporal

Funding n n Learn and Serve Grant (1996 -2002) National Environmental Health Sciences Institute Grant (2004 -2007) Personal Donations In-kind contributions from OT ECU Department

Conditions Commonly Addressed n n n n n Repetitive Stress, Work-Related Injuries Diabetes Obesity Metabolic Disease (cardiac, Hypertension, CVA) Arthritis Orthopedic Problems Low vision Depression Asthma

Favorite Activities n n Physical – parachute games, the Gospel Slide dance, and Tai Chi; healthy food preparation (banana bread, trailmix, veggie pizzas) Cognitive – table games, Nutrition Jeopardy and Concentration Emotional – collages, scrapbooking, and craft projects Spiritual – groups end with a group prayer circle

Outcomes for Participants n n n Occupational performance Client satisfaction Role competence Health and wellness Prevention Quality of life

Indirect Skills Learned by Students n n n Client-centered care Being a change agent in the system Accessing resources Cultural competency Independent thinking and acting Collaboration and consultation