I believe we are made for community - meant to be with people and for people. To me, community engagement looks like aligning with what our community cares about and providing resources and aid to further their mission. This has been at the core of my role as the Community Engagement Chair for CHEqI. As I stepped into this position, my goal was to promote new community partnerships that enrich teaching, learning, research, address critical social issues, and contribute to the public good in the Greater Lafayette area. During this time, I was completing an elective course that gave me the opportunity to spend time at Lafayette Transitional Housing Center (LTHC) weekly and interact with adults experiencing homelessness. One man, who I had spoken to regularly throughout the semester, requested help with his medications and presented me with a Tums bottle filled with seven different drugs. He had just been released from prison and the medication punch cards he was given were not working for his current circumstances. He needed to save space in his bag, so the best solution was one container for all of his medication. I got the opportunity to review each of his medications with him - what they were called, what they were for, and how often to take them. A medication reconciliation document was printed and put inside the Tums bottle. I left that interaction knowing that this man was set up for success and better health outcomes - no matter how unconventional - because we were able to meet him where he was and find a solution that worked for him after developing a relationship over the semester. In this instance, the barriers between him and a better health outcome were not a lack of medication or even a lack of desire for health. It was his lack of housing and need for a healthcare provider he could trust.
Many of you reading this post might already know how impactful social determinants of health are on patient outcomes. ASPE estimates that “clinical care impacts only 20 percent of county-level variation in health outcomes, while social determinants of health (SDOH) affect as much as 50 percent.” These factors include housing, food and nutrition, transportation, social and economic mobility, education, and environmental conditions. I was given a front row seat as to how one of these factors was significantly affecting the health of my community while at LTHC and I was finally forced to confront the realization that many students in healthcare professions, like myself, are likely unprepared to handle a situation like this. How do we find a way to equip our healthcare students to not only understand these social determinants of health, but also allow them to engage in the community to actually help mitigate and eliminate those barriers that exist? How do we foster knowledge and passion for underserved populations and change the mindset of students to go beyond just clinical care? How do we best serve community organizations who are on the front lines of social justice? In response to these questions, I created semester-long community-based internships for CHEqI students to participate in. In my experience, many volunteer opportunities are quick “one and done” experiences. These are still good experiences, but they simply cannot hold as much value to an organization or to students as a longitudinal experience can. Our goal for these internships was to strategically engage with our community in order to provide more valuable long-term service in as many areas within the social determinants of health.
The process of developing these internships required a lot of networking, consistent meetings with community organization leads, and an entire semester of advertising. It felt like an uphill battle trying to help students understand the unique opportunity that these internships would provide them. But after a year and a half of these internships being up and running, we have had two interns successfully complete semester long internships with LTHC and have two interns finishing year long internships with Valley Oaks Health. The impact that these interns have had within their community partner organizations have been far more than I ever could have imagined when dreaming up these internships. These programs have focused on housing, social and economic stability, and education in addition to clinical care. At LTHC, our interns have made as lasting impact via the implementation of an electronic health record (EHR), the creation of a systematic process to screen guests for readiness to quit smoking, and the initiation of “Health Moments” to educate guests on specific health topics that are relevant to adults experiencing homelessness. The EHR goes beyond just asking questions about primary care providers, health insurance, and substance misuse - LTHC staff are now more equipped to bridge these gaps in care and provide pertinent resources to patients. A CHEqI intern was able to provide more extensive smoking cessation programming within LTHC in order to equip staff members to effectively screen and aid patients ready to quit. Lastly, one of our interns was responsible for inviting health experts to LTHC to discuss dental care, reproductive health, first aid, diabetes management, and harm reduction with the guests. At Valley Oaks, our interns have been working hard for a year to expand the educational reach of an online mental health advocacy website and work closely with staff to educate them on public health expertise that can better promote and protect the health of communities. I am so proud of what these interns have been able to accomplish alongside their community organizations. These internships have brought so much value to the Greater Lafayette community and I know they will continue to positively impact health outcomes into the future. Ultimately, I cannot wait to see what our CHEqI interns choose to do in the future after the experiences they have had and how they seek to better engage their community to provide the most well rounded care possible.
Allyson Prichard
2023 PharmD Candidate
Purdue University College of Pharmacy