240622 Community Outreach & Patient Empowerment (COPE) for Navajo Living with Chronic Diseases

Tuesday, November 1, 2011: 2:30 PM

Tammy Yazzie , Gallup Service Unit, Navajo Nation Community Health Representative Program, Window Rock, AZ
Mae-Gilene Begay, MSW , Community Health Representative/Outreach Program, Navajo Nation Division of Health, Window Rock, AZ
Shirley Cisco , Shiprock Service Unit, Navajo Nation Community Health Representative Program, Window Rock, AZ
Sonya S. Shin, MD, MPH , Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA
Rebecca Hutchinson, MD , Department of Internal Medicine, Beth Israel Deaconness Medical Center, Boston, MA
Hannah Sehn , Division of Global Health Equity, Brigham and Women's Hospital, Gallup, NM
COPE (Community Outreach and Patient Empowerment) is a formal collaboration between the Navajo Nation Community Health Representative (CHR) Program, Gallup and Shiprock Service Units of the Indian Health Services (IHS), and Brigham and Women's Hospital. COPE objectives are 1) to provide the CHRs with training, support and resources, 2) to improve the health of patients with poorly-controlled chronic conditions, and 3) to prevent diabetes mellitus and other chronic conditions by working with high-risk families. COPE has three components: 1) CHR training focused on health education and health promotion; 2) enhanced communication between CHRs and providers; and 3) Health Promotion Package for COPE clients (i.e. patients with uncontrolled chronic conditions). Health education covers topics such as diabetes, nutrition, and alcohol use. Competency assessment and training by Navajo-speaking IHS providers ensures that CHRs deliver high-quality, consistent information. Health promotion training covers counseling techniques such as motivational interviewing. IHS physicians perform patient home visits to provide one-on-tone training and facilitate communication with primary providers. Regular meetings between CHRs and providers are intended to form linkages between clinic- and community-based teams. CHRs visit COPE clients every two weeks over 12-18 months to deliver structured teaching sessions. Interactive flipcharts use culturally appropriate visual images and Motivational Interviewing techniques to cover topics such as diabetes basics, hypertension, medication adherence, nutrition, diet and exercise. COPE evaluation includes clinical indicators and health utilization of COPE clients, and formal feedback from CHRs, providers, and educators.

Learning Areas:
Assessment of individual and community needs for health education
Chronic disease management and prevention
Diversity and culture
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Program planning

Learning Objectives:
To identify the three components of the COPE program To formulate how such an intervention could be applied to other Native American communities

Keywords: Community-Based Health Promotion, Chronic Diseases

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am an Acting Community Health Representative Supervisor for Navajo Nation, and my service unit has been implementing the COPE project since early 2010.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.