Changing Health and Changing Lives

Changing Health and Changing Lives

Kaweah Health Community Outreach services are helping people find their way to healthier lives.

Every day, the work of Kaweah Health’s Community Outreach is changing lives by leading people down healthier paths. Offering a broad spectrum of activities and services, the Community Outreach team links people in Tulare County with key resources so they can enjoy healthier lives.

Community Outreach’s services now include 10 community health workers working throughout Tulare County. Their focus includes a diabetes-education program in English and Spanish, diabetes support groups, chronic pain workshops, chronic disease self-management workshops, nutrition education, Medi-Cal enrollment, and falls prevention.

And the help is much needed. According to the 2017 Tulare County Community Health Assessment, the county’s diabetes rate is nearing twice the state-wide average, and it’s the fifth-highest among California counties. Also concerning, the death rate for heart disease in Tulare County is 30 percent higher than the state average. These are the sobering realities Kaweah Health’s Community Outreach team is working to change.

Diabetes, an area of special focus for the outreach program, is often seen as a death sentence by some, so educating people about it is crucial. The diabetes program uses a pharmacist, who explains how to manage insulin levels and bring glucose levels under control. Community Outreach Manager Alma Torres-Nguyen notices the program is making a difference, “There is a lot of misunderstanding about insulin and how it works. The pharmacist is very involved in teaching everyone. We have seen a number of participants learn to control their diabetes through the program and say they are no longer afraid of it.” There are now more than 20 communities working collaboratively with Kaweah Health to improve local health.

The Healthy Lindsay-Healthy Community grant is funded by the Lindsay District Hospital, and the work is made possible through a strong collaboration with the Lindsay Family Resource Center. Through this local funding, a federal grant from the Administration for Community Living, and a strong partnership with Partners in Care, Kaweah Health’s Community Outreach Department is able to provide evidence-based support through the Empowerment for Better Living program. This program offers chronic disease self-management education workshops to help adults with ongoing conditions and caregivers understand how healthier choices can improve quality of life, boost self-confidence, and inspire positive lifestyle changes. The programs provide new ways to exercise and make friends, and the leaders are seeing truly remarkable changes in participant health and outlook. The program includes a monthly community walk at the Lindsay Park, Bailoterapia (dance therapy), and mental health workshops that are helping participants control their fears.

Community Health Worker/Promotora Marisela Gonzalez has been working to help residents improve their health for 13 years. She has previously worked with Kaweah Health’s Hospice and currently works with Lindsay’s community members, where she helps with diabetes and chronic illness management and a new mental health support program. “I lead support groups and dance therapy classes in English and Spanish. It’s been very popular, and we now offer them twice a week. I also do exercise therapy and chair exercise,” Marisela explains. “People are drawn to our programs in Lindsay through word of mouth and referrals, and they like that we offer the classes regularly.”

The participants in the new mental health part of the program are grateful for what is covered in the classes, including learning to cope with anxiety and releasing anxiety through dance therapy. “It has taken time for people to open up since the pandemic, but we are seeing very shy people now able to socialize and deal with anxiety,” Marisela says. “One woman got a new job and started working, even though she thought she couldn’t. Another woman was depressed because she couldn’t have babies, but she said her experience in our program has changed her life.”

The other piece of the Administration for Community Living – Empowerment for Better Living – focuses on falls prevention. This program works with older adults and adults with disabilities to engage them in evidence-based programs such as Tai Chi, Bingocize, and Matter of Balance, which can help reduce falls and falls-risk. Community Health Workers Kirk Mills and Dina Cardenas have been working hard over the last year to build this program, establish partners, and provide the workshops for hundreds of participants throughout the county. Both are certified Tai Chi Instructors and work as a team to deliver these programs, creating synergy to maintain the interest of the participants. In Kirk’s observation, these programs have not only reduced their fear of falling but have also helped many seniors increase their socialization and reduce isolation coming out of the current pandemic. Kirk relates, “You can see the light coming on as they participate in the program and realize they can socialize again and have a good time with their peers.”

Eustolia Zamora-Bonilla, “Estee,” is a Community Health Worker with more than 20 years of experience empowering local residents and advocating for healthy environments and communities. One of her biggest responsibilities is leading the Nutrition Education Obesity Prevention (NEOP) Program in Tulare County, which provides nutrition education for children. Estee works with 16 early education centers in Tulare County, training preschool teachers how to deliver nutrition and obesity education. She was also instrumental in organizing and launching the Dinuba Farmers Market in 2014. “The farmers market is so important for giving people in this area access to nutritious food,” Estee says. “There are some very small and poor communities around here like Sultana and London that are food deserts.” In many of these communities, Estee trains resident leaders to interact with residents by providing spokesperson training, health education, and Zumba fitness certification. In this way, resident leaders are empowered to become involved and make lasting changes where they live. “I love helping people change. After working with them, I see them progress in their lives. They become important people in their community. It’s incredibly fulfilling to be a part of.”

Kaweah Health is also reaching local residents through the Health Navigator Project, a Medi-Cal enrollment program funded by a California Department of Health Care Services grant. This project has made great strides in connecting important services to the people who need them most: homeless, immigrants and their families, low-wage workers, uninsured children, and youth adults.

The Health Navigator Project has enrolled nearly 500 individuals into Medi-Cal who would otherwise have no access to health care. The project serves people of all ages, most of which are limited English speakers and low-wage workers. Health Navigators like Anis Reyna work with dozens of people on sometimes very complicated cases. They may need to obtain documentation from federal agencies or troubleshoot requirements of an application to ensure that everything is in order. “It’s rewarding when the people you help are so grateful,” says Anis. “Sometimes they call us back to say that they finally got the help they needed, and they are so relieved that they feel better.”

One of the focuses of the project was to connect with young adults, many of whom struggle to make ends meet with the cost of healthcare and the rising cost of food. The outreach team used the Health Navigator Program to reach this group by developing a TV commercial educating them about the importance of having health coverage and how it can help them save money for other important needs. The commercial is making a great impact, helping young adults apply to and navigate programs like CalFresh and Medi-Cal, which allows them to eat and stay healthy on a limited budget.

Kaweah Health’s Community Outreach team members serve on a number of community committees and coalitions such as the Tulare County Diabetes Alliance, Healthy Lindsay, Healthy Community Stakeholder’s Committee, and Network Leaders on the Move Tulare County Partnership, among others. The team also supports the Samaritan Center Free Clinic in Visalia with a full-time staff member and provides other services there such as Medi-Cal enrollment assistance and diabetes education. These important partnerships and collaborations leverage time and resources to provide quality programs that improve the health of Tulare County residents.

Community Outreach Manager Alma Torres-Nguyen is proud of the team she leads, “My Community Outreach team is amazing! They are compassionate, caring individuals who understand the community and are willing to go the extra mile to meet people where they are and assist them with their needs. I am privileged to work with this team, and going home every night I know that the work we do makes a difference!”

What is a promotora?

Promotoras, or promotores de salud, are Spanish-speaking community health workers. Promotoras serve as liaisons between their community, health professionals, human and social service organizations, often taking the role of advocate, educator, mentor, outreach worker, role model, or interpreter.