A Healthier Future for West Virginia - Healthy People 2010

7 - Educational and Community-Based Programs

Objectives | References

Background

National Overview. In the past century we have witnessed a shift from infectious disease to chronic, lifestyle-related illness as the major antecedent to mortality and morbidity in the United States. In the past few decades alone, the paradigm shift from infectious disease to chronic disease has resulted in the knowledge that the health of a community does not solely rest on an individual's health status, but also on the social, educational, and physical resources available that are conducive to improving health status. Today, an increasing number of communities across the nation have adopted various community planning processes to reduce the negative poor health choices and replace them with positive health behaviors through education of the community.

The settings/channels in which educational and community-based programs prosper are as diverse as our nation's population. The most successful communities have involved multiple sectors of the community: public health, health care, businesses, local government, schools, civic organizations, voluntary health organizations, faith organizations, and many other groups and private citizens who are interested in improving the health status of their community.

Over the next decade, it is projected that the composition of the nation's population will become more racially and ethnically diverse. For us to continue to make progress in reducing health disparities and increase access to care for ethnic and cultural minorities and for the elderly, educational and community-based programs must be culturally competent, age appropriate, and gender specific.

State Overview. The West Virginia Bureau for Public Health (WVBPH) has responded to the shift from infectious to chronic disease by placing a greater emphasis on preventing chronic disease through promoting more healthful behaviors. Preventive approaches that hold the greatest promise for changing behaviors are community-based efforts that focus on both individual and societal influences. The Division of Health Promotion has numerous programs and networks aimed at increasing the capacity of local community groups to promote health. The three channels that will be addressed in the Educational and Community-Based Objectives are community, schools, and worksites.

Community Health Promotion. Community health promotion focuses on the community to promote informed decision-making on health issues. Health behavior change occurs more often, is more successful, and is longer lasting when the need for such a change is decided upon by the community members themselves. Many health problems cannot be solved by individuals alone, nor do they exist in a vacuum. Community health promotion programs must therefore use broader approaches, drawing upon as many facets of community life as possible.

With limited resources available, the need exists for increased coordination and collaboration among the various county, regional, and statewide initiatives. The West Virginia Health Promotion Program within the WVBPH has addressed this need through the network of West Virginia Health Promotion Specialists (WVHPS). The WVHPS provide locally based technical assistance to support communities in their community health promotion endeavors. This, in turn, enables the Community Health Promotion Program, through the WVHPS network, to establish and support community health promotion at a local/county level as well as accomplishing West Virginia Healthy People 2010 Objectives.
School Health Promotion. Two strategies are currently being implemented in West Virginia to improve the health status of West Virginia's children: activities of the Governor's Cabinet on Children and Families and the WV Department of Education working with the WV Bureau for Public Health. In 1990, the legislature created the Governor's Cabinet on Children and Families. The Cabinet brings together state agency leaders to oversee the delivery of services to children and families, including the elimination of barriers to access. The mission is to enhance the ability of families to protect, nurture, educate, and support the development of their children so that each child's full potential is achieved. The overall goal of the strategy is to shift from an illness/treatment model to one that promotes health, development, and well-being.

Family Resource Network. One aspect of the Governor's Cabinet on Children is the statewide system of Family Resource Networks (FRNs). The intent of establishing the FRNs was to develop a family-centered, comprehensive, community-based system for the provision of social services, programs, and facilities for families and children. At this time, there are 45 Family Resource Networks covering the 55 counties. The common mission of the 45 FRNs is to facilitate a system of prevention, education, and early intervention activities aimed at enabling families, children, and their communities to reach their fullest potential through community-based planning activities. The various FRNs do not accomplish this charge alone; all persons, organizations, and community groups, especially consumers of services, are invited to become active members.

West Virginia Children's Health Insurance Program. Another accomplishment of the Governor's Cabinet on Children and Families is the West Virginia Children's Health Insurance Program. On April 9, 1998, Governor Cecil Underwood signed into law the West Virginia Children's Health Insurance Program (WVCHIP). This new program can help all children get the necessary and preventative health care they need to grow into strong, healthy adults. Phase I gives health care coverage to children through age five years whose household income does not exceed 150% of the Federal Poverty Level (FPL). There are about 1,700 children eligible for Phase I of WVCHIP. Children in this phase are provided services from the WV Medicaid Program. Phase II may help more than 20,000 children between the ages of six and 19. Since the WVCHIP first reviews children to see if they may be eligible for Medicaid, there maybe another 20,000 children who qualify for Medicaid but are not enrolled.

West Virginia Healthy Schools Program. The second strategy is the state's Healthy Schools Program. In a collaborative effort, the WV Department of Education and the WV Bureau for Public Health are working together to facilitate the bridging of school health programs with prevention programs from health care institutions and the community at large. The purpose of the WV Healthy Schools Program is to develop and strengthen school health programs designed to prevent important health problems and improve educational outcomes. The WV Department of Education and the WV Bureau for Public Health are dedicated to extending this program to all county school systems through continued professional development opportunities. The Healthy Schools Program has three areas of emphasis: building the state education agency and the state health agency infrastructure for school health programs, strengthening school health education to prevent important health-risk behaviors and health problems, and development of national training and demonstration centers for school health programs. Healthy Schools focuses on the following areas: school health education, school health services, school health environment, child nutrition services, physical education, counseling, school/community collaboration, and teacher/staff wellness.

Worksite Health Promotion. The worksite is one of the best arenas for reaching working-age adults. Worksite health promotion programs can provide the social support and cultural change initiatives for modifying behavioral norms. There are three basic categories of worksite health promotion and wellness programs: awareness and education, individual behavior change programs, and initiatives that strive toward creating a healthy and supportive environment at the workplace. The WV Bureau for Public Health partners with the two leading forces in worksite health promotion in the state - the Wellness Council of West Virginia and the Public Employees Insurance Agency's (PEIA) "Pathways to Wellness" program.

Wellness Council of West Virginia. The Wellness Council of West Virginia (WCWV) is dedicated to the provision of services and programs for employers seeking to establish and sustain results-oriented worksite wellness programs that impact the health status of employees and their families. As a charter member of the Wellness Council of America, the nation's premier resource in worksite health promotion, WCWV is able to provide a vast array of services and resources to state organizations and their employees.

PEIA Wellness Program. An extension of PEIA's coverage, Pathways to Wellness is a free wellness program available to all state employees. Pathways is dedicated to helping people live healthier lives through health promotion and education. Their website contains information on the many programs offered, low-fat recipes, health-related facts, and an online program to help users get motivated for daily exercise. The wellness interventions that Pathways provides to its members include health risk appraisals, health screenings, newsletters, brochures, incentive-based behavioral modification programs, and nutrition/weight- loss programs.

Previously offering services on a regional basis, the Pathways program expanded statewide at the end of 1998. There are currently 53 public worksites enrolled in the program, with that number expected to increase to 110 in the year 2000.  Along with the worksite-based program, PEIA-insured individuals receive a comprehensive bimonthly health newsletter mailed directly to their homes, as well as access to information via the Internet through the program's web site.

The Objectives

FLAGSHIP OBJECTIVE
OBJECTIVE 7.1. Increase the high school completion rate of those under the age of 25 in West Virginia to at least 95%. (Baseline: 90% in 1998)

Data Source: West Virginia Department of Education (WVDOE)

OBJECTIVE 7.2. Increase to 50% the proportion of West Virginia school districts that have a school nurse-to-student ratio of at least 1:1,000. (Baseline: 1:1,700 reported in the 1998-99 school year; state law mandates 1:1,500 for K-7th grade)

Data Source: WVDOE

OBJECTIVE 7.3. Increase to 66 the number of worksites in West Virginia that are "Well Workplace" designees. (Baseline: 44 in 1999)

Data Source: Wellness Councils of America

OBJECTIVE 7.4. Ensure that at least 80% of local health departments will collaborate within their respective districts to assure the establishment of at least one ongoing health promotion initiative for people aged 65 and older. (Baseline: 59.1% in 2000)

Data Source: Local Health Department Annual Program Plan

Meeting the Objectives

Community Health Promotion. It cannot be stressed enough that to increase the success of a community-wide intervention the community must be the leading force in the entire process, from needs assessment to implementation and evaluation. People are more receptive to change if they are invited to be involved versus a governmental agency stating what they are going to do. A community effort involving all stakeholders will be required to increase the high school completion rate of West Virginia's adolescents and young adults. The WVHPS provide locally-based technical assistance to support communities in their community health promotion endeavors. This, in turn, enables the WV Health Promotion Program, through the WVHPS network, to establish and support community health promotion at a local/county level as well as accomplishing West Virginia Healthy People 2010 Objectives. The WVHPS network can also assist a community group by linking them with other statewide networks such as the Adolescent Health Coordinators, Community Development Specialists for Substance Abuse Prevention, regional FRN directors, PATCH groups, local health departments, and other networks that have contact with the school system as well as the worksite environment. With this wealth of various networks, a community group has the technical assistance resources to achieve this important objective.

The mission statement of the Bureau for Public Health in West Virginia is "To transform and strengthen state and community capacity to protect, promote, and improve the health of the public in West Virginia into the 21st century." One of the basic public health services that is ensured by state code is community health promotion. Currently, local health departments across the state are collaborating with various community groups and statewide networks to assess the needs of the communities they serve. Many of the identified needs that have surfaced as a result of this process can and will be targeted at the populations mentioned in this chapter.

School Health Promotion. The state and county educational systems are the primary groups that can make the objectives a reality. They have the ability to survey and assess the needs and perceptions of the students currently enrolled in the public school system. The state and county educational officials can make any needed improvements in the services and programs they offer to all students to improve the high school completion rate. One important caveat is that state and county officials cannot address this objective alone, but need feedback and active participation from the community. Current models of school health services reflect an understanding that children's physical and mental health are linked to their abilities to succeed academically and socially in a school setting.

Because school systems often partner with businesses in other endeavors, wellness activities should be included in this process. For example, a "Well Workplace" designee could elect to provide health education instruction (after appropriate training) to a partner elementary, junior/middle, or high school within their community. Health education and community-based programs delivered through personal involvement of working men and women will benefit tomorrow's work force as they participate in today's classrooms.

The school setting can provide two different opportunities to achieve Objective 4: community service provided by students and volunteer opportunities for those who are 65 and older. High school students must complete a certain amount of community service before they graduate from public schools -- this creates an excellent opportunity to provide at least one ongoing health promotion initiative for people aged 65+ by collaborating with the local health department.

Worksite Health Promotion. The women and men who compose West Virginia's work force can become the most important group to realize the objective of a 90% high school completion rate. These women and men would not be a part of the work force if they had not at least completed high school or a GED program. Even though there are a few exceptions to this, many successful people have risen to influential positions through hard work, dedication, work experience, and, most importantly, a high school diploma. Those who are interested in the worksite setting could serve as mentors to youth who are at risk of not completing high school.

Worksites can serve as the link between the need for additional school health nurses and the professionals who can meet this need. Worksites can link state and county educational officials with nursing professionals who may be interested in donating time and skills to school health needs in West Virginia.
Worksite wellness programs should extend membership to retirees in addition to those currently employed. If the resources are not available, companies can look to the various networks and the Wellness Council of West Virginia for technical and grant-writing assistance. These types of actions will make this objective obtainable by 2010.

Work Group Members

Chuck Thayer, MS, Work Group Co-Leader, Division of Health Promotion, WVBPH
Anne Bolyard, MS, Work Group Co-Leader, Division of Health Promotion, WVBPH
Elizabeth Richmond, RHEP Site Coordinator, Country Roads Consortium
Lamont Nottingham, EdD, MPH, West Virginia University (WVU) - Charleston Division
Lew Holloway, MS, Wellness Council of WV
Bart Thompson, MA, Bethesda United Methodist Church
Helen Matheny, MS, WV State Medical Association
Debbie Coen, MS, CHES, WVU
Carla See, MS, CHES, WVU
Lenore Zedosky, Office of Healthy Schools, WVDOE
Brenda Isaac, Kanawha County Board of Education
Sandra Burrell, MA, Division of Health Promotion, WVBPH

References/Resources

CDC. Healthy People 2010 Objectives: Draft for Public Comment. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, 1998.

CDC. 1999 State Health Profile - West Virginia. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, 1999.

State of West Virginia Home Page and Related Links. http://www.state.wv.us. 1999.

West Virginia Bureau for Public Health Home Page and Related Links. http://www.wvdhhr.org". 1999.

West Virginia Bureau for Public Health. Behavioral Risk Factor Survey 1997. Charleston, WV: West Virginia Department of Health and Human Resources, 1998.

West Virginia Bureau for Public Health. West Virginia County Health Profiles - 2000. Charleston, WV: West Virginia Department of Health and Human Resources, 1997.

West Virginia Bureau for Public Health. West Virginia Vital Statistics 1998. Charleston, WV: West Virginia Department of Health and Human Resources, March 1999.

West Virginia Office of Healthy Schools. School Health Task Force 1997: Building a Healthy Future. Charleston, WV: West Virginia Department of Education, 1997.

For More Information

Community Health Promotion Program
Office of Epidemiology and Health Promotion
Room 319
350 Capitol Street
Charleston, WV 25301-3715
Phone: (304) 558-0644; Fax: (304) 558-1553

This page was last updated June 13, 2001.
For additional information about HP2010, contact Chuck Thayer at (304) 558-0644 or Chuck.E.Thayer@wv.gov