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Baltimore MD 21201-1512

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Project SHARE Curriculum

Student Health Advocates Redefining Empowerment

Introduction

In the spring of 2010, a team of faculty librarians from the Health Sciences and Human Services Library (HS/HSL) at the University of Maryland, Baltimore (UMB) responded to a grant solicitation for an NLM Information Resource Grant to Reduce Health Disparities.

The team of faculty librarians researched peer to peer student programs, health advocacy programs, and health disparities.  The vision was to build a cadre of young community health advocates. During the proposed project, these young health advocates would gain a robust complement of skills including finding and applying quality health information, making good health choices, identifying health disparities and the components of community health and wellness, developing advocacy roles, and employing communications strategies. To sustain the project, the team envisioned creating a replicable educational model usable not only in Baltimore City but in other communities as well.

UMB is located on the west side of downtown Baltimore.  The University is home to schools of Medicine, Dentistry, Pharmacy, Nursing, Law and Social work in addition to a Graduate School, several institutes, and the University of Maryland Medical Center.  There is a strong university commitment to community engagement and outreach to West Baltimore.

Baltimore City, where the proposed project would take place, posed many challenges. According to the 2010 census, the population of Baltimore City was approximately 620,000.  African-Americans made up 64% of the population; whites 28% and 7% were Hispanic or Asian.  There were over 4000 homeless citizens and 17% of the population lacked health insurance.  Twenty-six percent of the population over the age of 25 did not complete high school and 19.3% fell below the federal poverty line.

 The 2010 Baltimore City Heath Disparities Report Card concluded that health disparities would only be eliminated with collaborative, multi-agency and community efforts ensuring that all communities had fair access to the resources and opportunities necessary to be healthy.   Health disparities existed for every major indicator of health in Baltimore City.  Many outreach efforts in communities to reduce disparities involved showing community members how to access information or providing them with health information.  However, by also empowering people with the skills and tools to advocate for themselves and for their communities, there would be a greater opportunity for success.

We made a decision to step outside of our comfort zone and extend the reach of our proposal beyond quality information access.  Our proposal entitled “Empowering Student Community Advocates to Reduce Health Disparities” had three primary aims:

Aim 1 - Empower high school students as community health advocates.
Aim 2 - Promote improved health in Baltimore neighborhoods.
Aim 3 - Develop a replicable Student Health Advocacy program.

To our delight and fear, we received funding for Grant G08LM0011079 beginning on March 15, 2011.

 The program started at the beginning of academic year 2011-2012.  In addition to dedicated HS/HSL faculty librarians and staff, we were fortunate to have wonderful partners in the Vivien T Thomas Medical Arts Academy, a West Baltimore high school focused on preparing students for health careers,  The program was named Project SHARE - Student Health Advocates Redefining Empowerment.

M.J. Tooey, SHARE Principal Investigator
Associate
Vice President, Academic Affairs
Executive
Director, HS/HSL

Prior to the end of the 2010-2011 school year, the SHARE team develped an application  process and conducted student interviews .  Twelve rising sophomore or junior students were selected to participate in the program. The grant covered hourly wages for the students to participate in the year-long program.  Tee shirts and computer notebooks were provided to each student.  A room within the library with tables, chairs, whiteboards and lockers became the SHARE program’s “space.” Guidelines and expectations for class attendance, participation, and performance were established. The grant also supported hiring an intern to work with the program for ten hours per week. The interns were master’s degree students in community health from another university.  These interns were essential to the coordination and success of the program.  Although it was initially prposed that a library school student would be appropriate, a) no library school student applied for the positions, and b) the skillset the Masters in Community Health students brought to the process was invaluable and appropriate to the needs of the program.

An Advisory Committee consisting of representatives from VTTMAA, university community engagement staff, parents, and eventually students was formed to keep communication lines open and gather further suggestions for program development. An occasional newsletter was sent out regarding program activities.

The curriculum for the first year was developed as the year progressed.  Starting with coursework on articulating health information needs, locating quality health information resources, and finally, searching for the information, the foundation was built for future curricular needs.  Since it was the first year, the curriculum was built by determining student needs and interests.  The students met every week for two hours throughout the school year.  During spring break and at the end of the academic year, students attended for six hour days for full weeks. The time remaining at the end of the academic year engaged the students well into the summer. Field trips, guest speakers, and supplemental field work enhanced the curriculum.  Throughout the year, student progress reports were developed and discussed with the students by the program coordinators.  A festive capstone event with a speaker delivering a brief keynote, was held to acknowledge student accomplishments over the year. Of the 12 students who began the year, seven remained and made it to the Capstone.  Two students were selected to serve as SHARE Ambassadors.  In this capacity they served on the Advisory Committee and mentored students in the following year’s program cohort.

M.J. Tooey, SHARE Principal Investigator
Associate
Vice President, Academic Affairs
Executive
Director, HS/HSL

In year two, the curriculum was approached differently.  Students were still interviewed prior to the end of the academic year.  The second year attracted a larger pool of applicants.  Twelve students were again selected. Based on experiences from Year One, the year was compressed and shortened with students meeting twice a week for two hours for a total of four hours per week.  The program coordinators and instructors had observed that retention and commitment issues arose when students only met once a week.  In Year Two the program began in October and ended with the conclusion of the academic year.  The program was modified during holidays and academic breaks including library staff commitments to professional meetings.  More community engagement was added during Year Two with activities such as staffing a booth at a city-wide health fair, visits to homeless shelters, and sponsoring a health fair for VTTMAA in the spring. The program again concluded with a capstone event.  This time one student was selected to deliver an end of the year address.  There was also a keynote speaker.  The university president who had heard about the program, delivered the address.  Of the 12 students who began Year Two, 11 finished the program.

At the conclusion of Year Two the team felt the curriculum had been more successful.  A more compressed program allowed for greater continuity and follow-through.  The curriculum itself was minimally changed from Year One but the different structure contributed to greater success.

M.J. Tooey, SHARE Principal Investigator
Associate
Vice President, Academic Affairs
Executive
Director, HS/HSL

The third year of the grant focused on developing a replicable model for the SHARE curriculum.

  1. Lessons from the previous two years were reviewed and merged.
  2. A template was developed in order to assure lesson congruity.
  3. Each lesson was mapped to a health education standard.
  4. Individual lessons were grouped into six modules around themes.  The modules introduced in 2014 were:
    1. Overview of Health Disparities
    2. Quality Health Information
    3. Taking Charge of Your Health
    4. Smart Food Choices
    5. Crafting and Delivering the Message
    6. Promoting Health and Wellness in Your Community
  5. Library faculty and staff who had worked on lessons were assigned to complete the lessons using the template.
  6. An online design for making the curriculum available was created.

    M.J. Tooey, SHARE Principal Investigator
    Associate
    Vice President, Academic Affairs
    Executive
    Director, HS/HSL

Although all modules are intended to be the complete SHARE Curriculum, users may pick and choose the modules that might be appropriate for their environment.  Modules can stand alone. Users are encouraged to modify the basic lessons to meet their needs and the needs of their communities.  The lessons can be big budget or low budget; high tech or low tech; and are equally applicable to urban, suburban, or rural communities.  Flexibility and local flavor are highly encouraged.

After reviewing or using the curriculum, users are encouraged to share their experiences, successes, modifications, or suggestions.  This is a living, breathing, evolving curriculum.  Therefore, the Project SHARE team will be making regular changes and enhancements to lessons and modules as we incorporate feedback from practitioners in the field.

While conceptualizing, writing and receiving the grant was exciting and writing the curriculum was both challenging and exhilarating, the real joy in this project came from working with the students.  They grew and thrived and pushed boundaries.  It was so compelling to see them grow in understanding the issues, realizing injustice, and becoming advocates for themselves, their families and their communities.  No matter where they are or where they go, they will always be Project SHARE students and it was an honor to have their trust and work together.

M.J. Tooey, SHARE Principal Investigator
Associate
Vice President, Academic Affairs
Executive
Director, HS/HSL

  1. 2009 Maryland Report Card: Baltimore City-Vivien T. Thomas Medical Arts Academy [internet]. Baltimore: Maryland State Department of Education; c1998-2009. Graduation; Baltimore City-Vivien T. Thomas Medical Arts Academy; 2009 [cited 2010 July 12]; Available from: http://mdreportcard.org/index.aspx
     
  2. Balcazar HG, Byrd TL, Ortiz M, Tondapu SR, Chavez M. A randomized community intervention to improve hypertension control among Mexican Americans: Using the promotoras de salud community outreach model. J Health Care Poor Underserved [Internet]. 2009;20(4):1079-94.
     
  3. Baltimore City Health Department. Neighborhood Health Profiles [Internet]. 2008 cited 7/14/2010]; [1]. Available from: http://www.baltimorehealth.org/neighborhood.html
     
  4. Baltimore City Health Department, Office of Epidemiology and Planning. 2010 Baltimore City Health Disparities Report Card [Internet]. cited July 14, 2010]; [13]. Available from: http://www.baltimorehealth.org/info/2010_05_25_HDR-FINAL.pdf
     
  5. Baltimore City QuickFacts from the US Census Bureau [Internet]. cited 7/14/2010]
     
  6. Belden A, Park MJ, Mince J. AIDS Prevention for Adolescents in School: A high school-based STI/HIV/AIDS prevention program In: Card JJ[, Benner TA[, editors. Model programs for adolescent sexual health: Evidence-based HIV, STI, and pregnancy prevention interventions. [Internet]. New York, NY, US: Springer Publishing Co; US; 2008 p. 187-95.
     
  7. Berkley-Patton J, Fawcett SB, Paine-Andrews A, Johns L. Developing capacities of youth as lay health advisors: A case study with high school students. Health Educ Behav [Internet]. 1997 Aug;24(4):481-94.
     
  8. Botvin GJ, Schinke SP, Epstein JA, Diaz T, Botvin EM. Effectiveness of culturally focused and generic skills training approaches to alcohol and drug abuse prevention among minority adolescents: Two-year follow-up results. Psychology of Addictive Behaviors [Internet]. 1995 Sep;9(3):183-94. Available from: http://dx.doi.org/10.1037/0893-164X.9.3.183
     
  9. Centers for Disease Control. Deaths, percent of total deaths, and death rates for the 15 leading causes of death in 5-year age groups, by race and sex: United States, 2006 [Internet]. Atlanta, GA: National Center for Health Statistics May 19, 2009 cited July 14, 2010]; [161]. Available from: http://www.cdc.gov/nchs/data/dvs/LCWK1_2006.pdf
     
  10. Fedder DO, Chang RJ, Curry S, Nichols G. The effectiveness of a community health worker outreach program on healthcare utilization of west baltimore city medicaid patients with diabetes, with or without hypertension. Ethn Dis [Internet]. 2003 Winter;13(1):22-7.
     
  11. Fisher EB, Strunk RC, Highstein GR, Kelley-Sykes R, Tarr KL, Trinkaus K, Musick J. A randomized controlled evaluation of the effect of community health workers on hospitalization for asthma: The asthma coach. Arch Pediatr Adolesc Med [Internet]. 2009 Mar;163(3):225-32.
     
  12. Ingram M, Sabo S, Rothers J, Wennerstrom A, de Zapien JG. Community health workers and community advocacy: Addressing health disparities. J Community Health. 2008 Dec;33(6):417-24.
     
  13. Johnson LP, Wallace BC. Training peer educators, Black MSM leadership, and partners for ethnographic community-based participatory research.In: Wallace BC[, editor. Toward equity in health: A new global approach to health disparities. [Internet]. New York, NY, US: Springer Publishing Co; US; 2008 p. 379-89.
     
  14. Kemp JM, Morsheimer ET, Reifman AS, Blane HT. Summer addictions studies program for high school honors students. J Alcohol Drug Educ [Internet]. 1996 Spr;41(3):55-67.
     
  15. Levine DM, Bone LR, Hill MN, Stallings R, Gelber AC, Barker A, Harris EC, Zeger SL, Felix-Aaron KL, Clark JM. The effectiveness of a community/academic health center partnership in decreasing the level of blood pressure in an urban african-american population. Ethn Dis [Internet]. 2003;13(3):354-61. 

There are so many people who need to be acknowledged and thanked for this project.

  • First of all thanks to the National Library of Medicine for trusting us enough to give us funding for this project.
     
  • Alexa Mayo was Project Manager in Year Three and has been with the project from its inception.  She has done anything that has needed to be done and filled too many roles to mention.  She has been my partner in crime for the entire journey.
     
  • Anna Tatro, the Project Manager during Years One and Two who really made the project “sing” for the students.
     
  • Interns Diana Beeson, Tamika Clanton, Junaed Siddiqui, Samara Withers.
     
  • National Library of Medicine Fellow (2010-2011), Yani Yancey.
     
  • Former and current HS/HSL Faculty and Staff – Gail Betz, Jaime Blanck, Aphrodite Bodycomb, Katherine Downton, Ting Fu, Raymond Hall, Ryan Harris, Robin Klein, Emilie Ludeman, Thom Pinho, Paula Raimondo, Meredith Solomon.
     
  • Partners at Vivien T. Thomas Medical Arts Academy (VTTMAA).
     
  • Partners and guest speakers from University of Maryland, Baltimore.
     
  • The Project SHARE Advisory Committee:  Marci Young, Janine Clarke Perez, Lisa Rawlings, Brian Sturdivant, Diana Beeson, Tameka Clanton, VTTMAA students James Brown and Antionette Moore.
     
  • The Project SHARE Students – Tia Adams, Brienna Ash, Alexis Brooks, James Brown, Maya Brown, Diamond Duncan, Trevana Eades, Shanel Green, Raquel Laster, Tyonia McLean, Antoinette Moore, Garnell Purcell, Tamara Robinson, Nykel Simms, Courtney Smith, Holly Stevenson, Deandra Wells, Angel Williams, Kashara Williams, T’ana Williams, Shawntania Wilson.  And their families for their support of our project.

M.J. Tooey, SHARE Principal Investigator
Associate Vice President, Academic Affairs

Executive Director, HS/HSL

 

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