Tillery, NCTillery, NC

Understanding Health Understanding Health and Wellness Needsand Wellness Needs

A Community’s PerspectiveA Community’s Perspective

The Tillery CommunityThe Tillery Community

CCT Philosophy of Health CareCCT Philosophy of Health Care

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

Understanding the CommunityUnderstanding the Community

Why the interest?Why the interest?

Comin’ HomeComin’ Home Aging in placeAging in place Community supportCommunity support Contextually and culturally embodied Contextually and culturally embodied

Community built practiceCommunity built practice

Door to Door SurveyDoor to Door Survey

SF-12 and environmental questionsSF-12 and environmental questions 104 participants (100 in 1996)104 participants (100 in 1996) Students from ECU and UNC-CHStudents from ECU and UNC-CH Assess the health related quality of life of Assess the health related quality of life of

residents of those in 5 mile radius of Tillery residents of those in 5 mile radius of Tillery Community CenterCommunity Center

Finding out about the Community: Finding out about the Community: Student PerspectivesStudent Perspectives

Hardworking peopleHardworking people Self SufficientSelf Sufficient SpiritualSpiritual Family and Community Family and Community

OrientedOriented FriendlyFriendly WelcomingWelcoming WarmWarm

Gender 42 males (34), 61 females (34)

Race 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 from industry

79 no, 21 yes

Smells outside home from industry

53 no, 47 yes

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

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

Limited in kind of activities due to physical health

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 accomplished less than like due to emotional problems

3 all of the time, 12 most of the time, 16 some of the time, 14 a little of the 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 LifeCommunity Quality of Life

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 The Road to Wellness: The Need for Interprofessional Practicefor Interprofessional Practice

Wellness NeedsWellness Needs

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, Evaluation of Individual Needs, Interests, and GoalsInterests, and Goals

Planning Group Goals and Planning Group Goals and ActivitiesActivities

Link to Environmental and Social Link to Environmental and Social Justice IssuesJustice Issues

Philosophy of Health Care Philosophy of Health Care

History of TilleryHistory of TilleryImpact of history, race, Impact of history, race, gender, gender,

and socioeconomic and socioeconomic status status

Occupational Justice Occupational Justice IssuesIssues

Role of the Environment in Shaping Role of the Environment in Shaping PracticePractice

InterpersonalInterpersonal Physical (manmade and natural)Physical (manmade and natural) Societal (economic)Societal (economic) CulturalCultural TemporalTemporal

FundingFunding

Learn and Serve Grant Learn and Serve Grant (1996-2002)(1996-2002)

National Environmental National Environmental Health Sciences Institute Health Sciences Institute Grant (2004-2007)Grant (2004-2007)

Personal Donations Personal Donations In-kind contributions from In-kind contributions from

OT ECU Department OT ECU Department

Conditions Commonly Conditions Commonly AddressedAddressed

Repetitive Stress, Work-Related InjuriesRepetitive Stress, Work-Related Injuries DiabetesDiabetes ObesityObesity Metabolic Disease (cardiac, Hypertension, CVA)Metabolic Disease (cardiac, Hypertension, CVA) ArthritisArthritis Orthopedic ProblemsOrthopedic Problems Low visionLow vision DepressionDepression AsthmaAsthma

Favorite ActivitiesFavorite Activities

Physical – parachute games, the Gospel Slide Physical – parachute games, the Gospel Slide dance, and Tai Chi; healthy food preparation dance, and Tai Chi; healthy food preparation (banana bread, trailmix, veggie pizzas)(banana bread, trailmix, veggie pizzas)

Cognitive – table games, Nutrition Jeopardy Cognitive – table games, Nutrition Jeopardy and Concentrationand Concentration

Emotional – collages, scrapbooking, and craft Emotional – collages, scrapbooking, and craft projectsprojects

Spiritual – groups end with a group prayer Spiritual – groups end with a group prayer circlecircle

Outcomes for ParticipantsOutcomes for Participants

Occupational performanceOccupational performance Client satisfactionClient satisfaction Role competenceRole competence Health and wellnessHealth and wellness PreventionPrevention Quality of lifeQuality of life

Indirect Skills Learned by StudentsIndirect Skills Learned by Students

Client-centered careClient-centered care Being a change agent in the systemBeing a change agent in the system Accessing resourcesAccessing resources Cultural competencyCultural competency Independent thinking and actingIndependent thinking and acting Collaboration and consultationCollaboration and consultation