“We used to do baby pictures for mothers. We’d ask if they want pictures of their new babies,” Bott says, recalling another favorite pastime.

Bott started helping at Saint Elizabeth Hospital in Danville. When that hospital merged with the facility that is now OSF HealthCare Sacred Heart Medical Center, Bott, aside from some breaks to deal with family matters, didn’t miss a beat. Today, she stops by OSF Sacred Heart on Fridays to give communion to patients who ask for it.

“I’ve been so blessed. I get more out of it than I give,” Bott says.

The benefits

Count Mia Harrier among those who marvel at Bott’s longevity and dedication. The program manager for community health at OSF Sacred Heart works with the hospital’s volunteers. She sees every day the health benefits to the helpers and the patients they serve daily.

“Our volunteers are a vital part of our team. They certainly do brighten our patients’ days,” Harrier says.

“Volunteers have a lot of [physical] steps they take in the hospital. Some have shared that they use step trackers, and they will get in a couple thousand steps per day,” Harrier adds, highlighting the physical benefits of volunteering. “They push patients in wheelchairs. They push the comfort cart. There are cleaning activities. It is a good way to keep moving.

“When it comes to mental health for our volunteers, they get to exercise something that feels really good,” Harrier says. “It feels good to your heart and your mind. It gives you things to be grateful for on a regular basis. As you interact with patients and learn their stories, you find yourself in a place where you’re displaying a lot of empathy and feeling like you’re able to do something good.”

Harrier also points out that older adults may not leave the house and get to talk to others often. Volunteering allows them to check both boxes.

Get involved

Whether young or old, Harrier and Bott encourage you to look into volunteer opportunities in your community. You can call the OSF hospital near you to ask about helping there.

“It’s such a fulfilling thing to do. There are so many areas to help. I wish I would have done other things,” Bott says. “What you put into it is what you get out of it.”

Interview clips - Cathy Bott

B-roll

Some experts have referred to trust as a social determinant of health – meaning a factor outside of a medical office that can influence as much as 80% of a person’s health and wellness. If someone doesn’t trust health information or their health care provider, they’re not likely to comply with what they need to do to be their best self.

Thus, the importance of Community Health Workers (CHWs). These  community health care workers are local, trusted members with a close understanding of the community they serve. This trusting relationship enables the CHW to facilitate access to services by serving as a link between health and social services and community organizations.

OSF HealthCare, through an innovative partnership with East Peoria-based Illinois Central College (ICC), has created new training for the next generation of digitally-enabled CHWs. Many of the CHWs will soon begin working with federally-qualified health centers (FQHCs), under a Medicaid Innovation Collaborative (MIC) contract with the state of Illinois. MIC is aimed at improving health and wellness by providing underserved individuals with a personalized approach to coordinated care that leverages CHWs and digital tools to provide the right care, at the right time, using the right method that works for the individual and their family or caregivers.

Karlen Sandall, manager of the OSF OnCall Digital Health Worker program, says the training makes it clear that trust is critically important and that connecting individuals with community resources is one way of providing help beyond the clinic or hospital.

“It shows we’re caring about not only what’s bringing them into our health care center, but also what’s going on outside of that; how we can bridge those gaps and keep them healthy all the way around, I think really shows we want to build trust with them, and we want to align them with the resources that are going to keep them safe and healthy.” 

Sandall says CHWs will be embedded in the communities they serve and will represent the diversity of those neighborhoods. Many in the first CHW class already served as Pandemic Health Workers which were developed during the early stages of the COVID-19 pandemic, helping to support individuals through digital tools to keep them connected to their care team and any resources they might need to keep them healthy and out of the hospital. Sandall says they’re passionate and most have already visited many community-based organizations (CBOs).

“To understand all of their offerings … to understand the funding because that changes a lot with CBOs. That’s something we learned with the pandemic and aligning individuals to resources so as they gather more expertise, they’re definitely going to be able to guide and support individuals from the community to the resources they need.” 

Maura Lansing is one of those passionate, newly-trained CHWs who also worked to support individuals during the height of the COVID-19 pandemic. She says the training through ICC went beyond what she already knew through first-hand experience.

“We talked about and learned about how we could become community advocates and we could actually plan community events based around a health care issue, and all the different ways we could reach out to the community at large, as well as helping individual patients.” 

Class uses specially-trained actors

Ann Willemsen-Dunlap of OSF Jump Simulation is a curriculum developer who designed the training to exceed core competencies identified but not yet finalized by the Illinois Board of Higher Education and the Illinois Department of Public Health. Willemsen-Dunlap incorporated the use of Jump’s standardized participants (SPs) – trained actors - a unique aspect of the curriculum.

“They’re trained to do both coaching and give feedback to our community health worker learners and help shape the way they go forward and interact with clients later. Not many programs have this,” Willemsen-Dunlap explains. 

The capstone project for the training included using an SP in a scenario with a man recently diagnosed with diabetes. Lansing used what she learned about motivational interviewing, which includes the OARS approach – open questions, affirmations, reflective listening and summary reflections. Lansing says every aspect helped build trust, and it was particularly impactful to acknowledge the recently-diagnosed man was trying to be the best grandparent by helping watch his grandchildren regularly.

“’I know that’s a lot of hard work. Can we possibly include a quick 10-minute walk each day with the grandchildren so that you don’t feel like you’re having to add exercise into your already busy schedule?’” Lansing says he felt heard and understood. “He seemed like, ‘Wow, she understands what I’m going through.’” 

Willemsen-Dunlap says the digitally-equipped and trained CHWs will not only coordinate care with FQHCs and their provider partners, they’ll help by serving as additional eyes and ears for medical providers.

“When it comes to interacting with the clients and seeing what’s happening in their home or living environment … they can take that back to the provider and help the provider understand what might need to be tailored in some specific way to maximize treatment effectiveness.” 

More advanced training will enable them to help individuals and families use digital tools that might be needed for education, remote monitoring, or even a virtual exam. They can also provide calming reassurance, especially at a stressful time during a pending or recent diagnosis.

“Having this neutral third party who’s able to manage the tech and be that intermediary and that calming, confident presence is going to be very important,” Willemsen-Dunlap stresses. 

The next training session for becoming a certified digitally-enabled CHW starts July 11 through ICC. It includes 12 sessions of online instruction (Monday and Wednesday evenings) over the first six weeks, followed by a two-week internship for participants who do not have previous CHW experience.

Here is more information and an option to register.

Video Clips with Karlen Sandall, manger Digital Health Worker program, OSF OnCall

Video clips with Ann Willemsen-Dunlap,  director of Educational Development, Jump Simulation and Education Center

Targeted text reminders and other interventions erased disparity in the rate of breast cancer screening between economically advantaged and disadvantaged patients, according to an OSF HealthCare study published in Population Health Management.

While screening has been shown to reduce breast cancer deaths, women who are economically disadvantaged are less likely to have breast cancer screening and more likely to die of the disease, often because the breast cancer isn’t detected until it reaches a more advanced stage. Mammography screening rates plummeted during the COVID-19 pandemic, which only increased the disparity between economically advantaged and disadvantaged patients.

OSF HealthCare researchers analyzed the effectiveness of interventions created and supported by the OSF OnCall digital health team to reduce that disparity, with: text messages that included a link to schedule a mammogram and information about the importance of breast cancer screening; calls from a digitally-enabled community health worker (CHW) to help schedule mammograms and solve challenges such as transportation; and an invitation to a health fair offering on-site mammograms. Breast cancer screening rates more than doubled among Medicaid patients who received interventions.

The National Comprehensive Cancer Network (NCCN) guidelines recommend annual mammography for most women beginning at 40 and earlier for women at higher risk for breast cancer.

 “Previous studies have found that similar interventions help increase the rate of breast cancer screening, but not whether they would reduce disparities among different populations,” said Jonathan A. Handler, MD, FACEP, FAMIA, senior author of the study and senior fellow, OSF Innovation at OSF HealthCare.

The study included more than 4,000 women in two groups: an economically disadvantaged group (those with Medicaid coverage), and an economically advantaged group (those with private commercial insurance). All were 41 or older, were aligned with an OSF primary care physician and appeared to be overdue for their mammogram – typically by two years or more. All with Medicaid were randomly assigned to one of three intervention arms and compared with a subset of commercially insured women randomized to receive no intervention

All in the Medicaid group received the first intervention (at least one text message reminder). The moderate intervention arm also received additional educational content, a reminder text after a mammogram was scheduled, and phone outreach by a CHW to answer questions, assist with scheduling a mammogram, and address other issues related to the screening. The third arm had all of those interventions, and also received an invitation to a health fair where attendees could participate in interactive educational activities, schedule a mammogram or receive a same-day mammogram at the health center after attending the event.

In the Medicaid group, the rate of mammogram screening more than doubled following the interventions, from 5.4% to 11% of eligible patients. Interventions targeted only to the Medicaid group reversed the disparity in screening rates. Before interventions, the Medicaid group had 2.6% lower breast cancer screening rate than those with private insurance. After the interventions, the Medicaid group’s screening rate was 3.7% higher than those with commercial insurance who had been randomly assigned to receive no intervention.

Medicaid covers mammograms

Researchers determined Medicaid participants who had moderate to maximum intervention had a significant improvement in screening rates. Many in this group were reluctant to get a mammogram because of the expense until learning from a CHW that appropriate screening is covered by Medicaid.

Screening rates also increased after intervention among privately-insured women who were assigned to intervention arms. Therefore, researchers said economically disadvantaged women might require more intense intervention than their economically advantaged counterparts, with private insurance, to close the disparity gap moving forward.

“The goal is equity in health outcomes, not always standardization of an intervention or what we think of as equality. So it’s vital to strategically implement interventions among patients who would most benefit,” said Sarah Stewart de Ramirez, MD, MPH, principal investigator of the study, medical director for Population Health Services at OSF HealthCare, and associate dean for Population Health Equity Innovation at the University of Illinois College of Medicine Peoria. “For example, we found that simply providing interventions such as a text message equally to the entire patient population might actually widen that disparity, because economically advantaged patients have fewer hurdles to access care and therefore are more likely to be able to act on those reminders.” 

Dr. de Ramirez added, “Ultimately, we hope to find an engagement approach that achieves equity while also improving screening rates for all women. It’s imperative that we continue to study new population based interventions so we can apply them with the same science as clinical interventions, and ensure our patient populations receive the highest level of care, wherever they are.”

The study was funded by the American Hospital Association’s Institute for Diversity and Health Equity and Blue Cross Blue Shield of Illinois.

Visit osfhealthcare/innovation to learn more about how OSF HealthCare is working to transform health care.

Sample of video message for education efforts