Center for Community Health & Prevention Annual Report (Internal)

Center for Community Health & Prevention

Building a Connected Community Sharing Our Progress

Nancy M. Bennett, MD, MS Director, Center for Community Health & Prevention

Message from Our Director Dear Colleagues, The COVID-19 pandemic has been a profound reminder that public health and health care systems are vital to everyone’s well-being, and that we must come together as communities – from the local to the global level – to protect and promote the health of all people. This requires a certain perspective on health – a broad vision that acknowledges the impact of the social and behavioral determinants of health. Nothing has shown this more clearly than the need for mitigation strategies to control the spread of COVID-19.

This is the premise on which the Center for Community Health & Prevention (CCHP) was founded – to help all people lead healthier lives through individual, community and policy approaches. For more than a decade, our community health efforts have combined the unique strengths of the Medical Center with those of our many community partners to address health disparities.

Especially now, we are eager and determined to advance our work. The knowledge, experience and partnerships we’ve gained over the last decade have helped our programs and services become more and more effective. Our staff have worked hard to increase the Center’s value throughout the region while championing the interdisciplinary education of students, faculty, staff and our community about prevention, the social determinants of health, and community engagement. We’ve created, evaluated and implemented evidence-based communicable and chronic disease prevention strategies that have supported thousands of individuals to live healthier lives.

Rural health has become a large focus of our mission, with staff working in counties across the Finger Lakes region.

Indeed, the ever-changing landscape of health and health care keeps us on our toes. Moving forward, the CCHP is dedicated to widening its reach and finding innovative ways to provide Rochester, and the surrounding region, with comprehensive preventive services. We look forward to doing this together.

We are here to help you connect with new partners, build trust and expand the University’s positive presence in community health – meeting individuals where they are in a way that’s meaningful to them.

Our past successes and the work we continue to do wouldn’t be possible without the support of University leadership and colleagues. We sincerely thank you for joining us in our quest for a healthier community.

We hope you enjoy this report and look forward to working with you to increase health equity in our city and our region.

In good health, Nancy M. Bennett, MD, MS

Our Mission: To join forces with the community to promote health equity; improve health through research, education, services, and policy; and establish local and national models for prevention and community engagement.

Gone Virtual Staff started working from home in late March and successfully transitioned our clinical services and community programs, including Promote Health. Prevent Cancer. and the Diabetes Prevention Program, to telemedicine and virtual learning.

Early in the pandemic, our clinical team shared insights and experiences about how to stay healthy - physically and mentally - during this time in a video titled “We’re in this Together.” A variety of resources on similar topics of health and wellness continue to be shared from our clinicians on our social media platforms.

January 2019

February 2019

March 2019

Our NYS Emerging Infections Program (EIP) team continued to collect flu surveillance data from Monroe County and the 6 surrounding counties during a severe and prolonged season

Ghinwa Dumyati, MD, director of the Communicable Diseases Surveillance and Prevention program, gave a podcast presentation for the Healthcare Association of NYS on antibiotic stewardship in nursing homes

Men’s Weight Loss Program launched

Colorectal Cancer Awareness Month The Cancer Services Program of the Finger Lakes Region (CSP-FLR) hosted educational awareness events at the Central Library of Rochester and Monroe County and Newark-Wayne Community Hospital

A Community Wellness & Healthcare Career Fair was held at East High, planned by students in the Biomedical Laboratory & Health Science career pathway with support from school staff and our Workforce Navigation team

Chronic Disease Prevention Through our clinical practice and community-based programs, our Center offers individual and group programs that address a variety of health topics aimed at helping prevent chronic disease in Rochester and the Finger Lakes region. The Center’s clinical referrals increased 80% from 2017 to 2019.

Comprehensive Area-Wide Nicotine

Cessation Program

Research shows that individuals who receive one-on-one counseling have an increased quit rate. Success rates are even higher when coupled with medication. The Center provides comprehensive services, including prescription of medication and subsequent counseling, sharing patients’ progress and care through their Electronic Medical Record (EMR).

Our free counseling services are currently available in-person or by telehealth, phone or tablet, for UR Medicine patients who self-refer or are referred through the EMR by their primary or specialty care provider.

The CCHP tobacco team is also collaborating with the Rochester Model Tobacco Dependence Treatment Program for hospitalized patients, directed by John Grable, MD, PhD, professor of clinical medicine at the University of Rochester Medical Center (URMC).

Within this collaboration, Dr. Grable’s team begins tobacco counseling for patients while they are in the hospital and then refers these patients to the CCHP to continue their tobacco dependence treatment upon discharge.

April 2019 10 graduates of the Community-Based Participatory Research (CBPR) Training Program were recognized and celebrated

Celebrated the 10th anniversary of the Dr. David Satcher Community Health Improvement Awards with a special dinner honoring community partnerships and former awardees.

Diabetes Prevention: Reaching Our Most Vulnerable Populations In 2019, CCHP trained facilitators from community organizations, churches, clinical practices and other locations to run the Diabetes Prevention Program (DPP) at their sites. Our team helped identify barriers to running programs and supports the organization in program recruitment, retention and delivery.

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Diabetes Prevention Program participants reached through programs facilitated at Faith, Hope and Charity Worship Center, Central Church of Christ, Exercise Express, LLC, CCHP and UR Medicine’s Strong Ties clinic.

In Our Neighborhoods: DPP staff collaborated with community partners to develop several healthy living resources that help residents prevent prediabetes and type 2 diabetes.

• Signage for safe walking paths in JOSANA and Edgerton neighborhoods • A guide to healthy food sources in Monroe County • An interactive map that allows users to find low-cost recreation centers in their area

“This is a personal quest for me to have as many people – people who look like me, in my community – as knowledgeable as possible about diabetes and prevention.”

Karen Rogers Owner/Trainer Exercise Express, LLC DPP Facilitator

“It’s particularly important for patients in the Strong Ties clinic with serious and persistent mental illness and a diagnosis of prediabetes to learn new strategies to help aid in decreasing health risks. We encourage our DPP participants to get off the bus one stop earlier and walk the rest of the way home, incorporate simple chair exercises and add healthy fruits and vegetables to their diets. Small, realistic goals can make positive lifestyle changes fun!”

– Jessica Hashim, RN-BSN, Level III, Diabetes Prevention Program facilitator at UR Medicine’s Strong Ties clinic

Hosted a native health meeting with community partners to discuss how to create pathways to lessen Native American health disparities 13 CCHP staff participated in the University’s Diversity Conference

May 2019

June 2019

Hosted 70 people at The Little Theatre for a free community screening of the documentary Someone You Love: The HPV Epidemic and panel discussion, co-sponsored with the Wilmot Cancer Institute, Monroe County Medical Society and WXXI’s Second Opinion

The 13th E. Cowles Andrus Summer Fellowship kicked off

11 CCHP staff participated in United Way “Day of Caring” projects at The Arc of Monroe, Ballantyne Day Services

100% of the students enrolled in the Teen Health and Success Partnership graduated from high school

Cancer Prevention: Increasing Education and Breaking Down Barriers to Screening

The Cancer Services Program of the Finger Lakes Region (CSP-FLR) promotes age-appropriate breast, cervical and colorectal cancer screenings for uninsured men and women. CSP-FLR serves individuals in Monroe, Seneca, Yates, Livingston, Wayne and Ontario Counties.

National Accreditation Program for Breast Centers (NAPBC) The goals of this grant are to: (1) increase the number of women screened according to clinical guidelines (2) improve the quality of breast cancer screening and diagnostic follow-up among age-appropriate patient populations.

These goals can be accomplished by enhancing and/ or expanding existing patient navigation services at NYS breast centers accredited through the NAPBC. CCHP exceeded the grant goal by 113%, contacting 1,702 women. We assisted 732 women with scheduling, transportation, daycare, etc. to receive their overdue mammograms.

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cancer screening and awareness events were held between August and December.

Individuals screened:

BREAST CANCER 462 CERVICAL CANCER 93 COLORECTAL CANCER 114

Promote Health. Prevent Cancer. (PHPC) CCHP and Wilmot Cancer Institute collaborate on the PHPC initiative to provide health promotion and cancer prevention education to community members throughout our region.

Programs held in 7 counties in 2019: Monroe | Genesee | Orleans | Livingston | Schuyler | Yates | Ontario 136 community members enrolled.

July 2019 Family, Food and Fun, a grant-funded community-based program wrapped up after 4 years.

The 16-week group program promoted increased physical activity and healthy eating as a way to prevent or manage chronic disease.

The 2nd of 3 preventive medicine residents joined us for a 4-month rotation at the CCHP

Jana Darlington, MPH, of the CSP-FLR led a Walk & Talk with a Doc at the Westside Farmers Market to help community members learn about cancer services and screenings

Workforce Navigation To address the social determinants of health, we offer workforce programs for at-risk students and University of Rochester (UR) employees.

Workforce Navigation program staff continue to support college-bound students living in the City of Rochester and UR employees during this difficult and uncertain time. Staff work one-onone with students and employees to actively plan for college and promotions, helping them with tasks like career planning, navigating financial aid and developing strong applications for college and potential jobs.

Teen Employment at UR – Teen Health & Success Partnership (THSP) THSP developed more career pathways, including pharmacy and nursing in 2019.

87

high school students employed through THSP

5

graduates received full scholarships to college

86

of the THSP % graduates enrolled in college

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departments across 6 UR locations hired THSP high school students

Rochester Health Profession Opportunities Grants (ROC-HPOG) The Center works in collaboration with community partners to provide support and training to low-income individuals for entry and professional growth in healthcare fields.

20 HPOG clients received promotions and/or attained a new job in health care.

August 2019 After 3 years, Tienes Salud, a grant-funded health program tailored to the Hispanic community, concluded. More than 65 health talks were delivered in the Project Hope neighborhood.

Collaborated with 80 providers and cancer prevention advocates across the region on how to break down screening barriers for uninsured individuals. Participants gathered to share ideas in Monroe and Ontario Counties.

Musa Massaquoi, CPhT ROC-HPOG participant

October 2019

September 2019 Throughout the year, our Promote Health. Prevent Cancer. initiative with Wilmot Cancer Institute provided individuals across the region with the tools to make and maintain healthy lifestyle choices. A free 8-week class kicked off in Penn Yan in September.

“HPOG mentors point the light behind you to help you shine. I wouldn’t be a Pharmacy Technician if I wasn’t getting any help. My team in the Outpatient Pharmacy at Strong Memorial Hospital is very supportive and has really shown me this is the best place for me.”

CCHP started collaborating with the Women’s Health Practice at the University of Rochester Medical Center on its efforts to reduce the number of pregnant patients who smoke, with a goal of decreasing the percentage of low birth weight infants and preterm births. Our tobacco team provides training and mentoring for OB Nurse Care Managers on Self-Determination Theory and tobacco dependence treatment.

Isabel V. Sawhill, PhD, a senior fellow in Economic Studies at the Brookings Institution, was the keynote speaker for the 9th annual Dr. Bernard Guyer Lecture in Public Health.

Research Regional Health and Wellness Data Mapping Clinical data on 13 counties from Rochester Regional Health Information Organization’s (RHIO) Community Health Indicators Report are featured on RocHealthData, a website developed and supported by the CCHP and the University’s Clinical & Translational Science Institute (UR CTSI).

It contains health measures, such as obesity, and is the first detailed local population health dataset containing a total sample of more than 600,000 observations.

Community-Based Participatory Research (CBPR) Program CBPR provides faculty, trainees and individuals from community organizations the opportunity to learn about research together and form collaborative research teams. The 7-month training program, which is co-sponsored by the Center and UR CTSI, involves participants at every stage of the research process, with the ultimate goal of applying for funding on joint projects.

Community Engagement Partnering with the Community during the Pandemic The Center has worked closely with the UR CTSI to assist in communication efforts related to COVID-19. An ad-hoc work group was developed with representatives of community organizations, the Monroe County Department of Public Health (MCDPH), Partners + Napier and Causewave Community Partners to develop the Six Feet Saves campaign.

The campaign placed messaging about COVID-19 transmission and physical distancing in more than 100 locations throughout the City of Rochester and the region. In addition, our staff echoed these messages in a variety of videos posted on social media. We helped develop a flyer and social media posts, in English and Spanish, about the importance of seeking care for chronic disease management, emergencies and well-child care. Most recently, we collaborated with community partners to share simplified information on COVID-19 testing, including why someone should be tested and area testing sites.

We continue to work with our Community Advisory Council and the Community Engagement Task Force to disseminate information on topics, such as testing and wearing masks, to populations most at risk. Each of these volunteer groups is comprised of leaders from area community-based organizations invested in community health and education.

December 2019

November 2019 CSP-FLR participated in a Rural Health Day event with the Wayne County Rural Health Network.

A full-day Center-wide staff retreat was held at YMCA Camp Arrowhead.

13 CCHP staff participated in the East Avenue Grocery Run for the 6th year, raising funds in support of Foodlink.

Center Director Nancy M. Bennett, MD, MS, presented “History of Vaccines: A Cavalcade of Success against Bacteria, Viruses and Cancer” to the Rochester Academy of Medicine.

Health Policy The 2019-2021 Monroe County Community Health Improvement Plan and 2019-2021 Monroe County Community Health Needs Assessment were completed as a result of a collaborative effort between the area health care systems, MCDPH and community partners. Community Health Policy & Education Director Theresa Green, PhD, MBA, and Health Policy Coordinator Rachel Allen, MS, coordinated the Community Health Improvement Workgroup (CHIW) and led the community-informed process.

The CHIW switched to virtual meetings at the onset of the pandemic and continues to meet monthly. Focus areas of the CHIP include Maternal Child Health Equity (guided by the Maternal-Child Health Advisory Group) and Mental Health and Well-Being (guided by the Monroe County Office of Mental Health and local experts).

The University earned the Carnegie Foundation for the Advancement of Teaching’s “Classification for Community Engagement” for the first time. Rochester is now one of 359 nationwide to hold the distinction. Dr. Green co-led a UR work group that prepared the application.

Education CCHP is committed to educating students, faculty and staff about all aspects of community.

We actively teach courses and lead lectures in the School of Medicine & Dentistry and School of Nursing, as well as in various graduate and undergraduate programs at the UR. We work with students from surrounding colleges to connect them with agencies engaged in community health work.

In response to interrupted learning caused by COVID-19, and the need for additional medical school courses, Dr. Green and Community Health Education Coordinator Carolyn Settle, MPH, coordinated an additional block of the Community Health Improvement Course for eight third-year medical students. These students were able to work both remotely and in the Rochester community following proper guidelines. Some of the work included addressing health disparities surrounding homelessness, syringe services at Trillium Health and working with Alianza Agricola to help supply food, cleaning supplies and masks to migrant farmworkers. The CCHP was also able to host the 14th annual E. Cowles Andrus Summer Fellow remotely.

In 2019, CCHP co-hosted 11 Public Health Grand Rounds and 10 Got Health? Talks.

Faculty and staff led 21 local and national presentations. 12 students and 3 Preventive Medicine Residents were hosted by CCHP faculty and staff.

Communicable Diseases Surveillance and Prevention (CDSP) The CDSP program, guided by the Centers for Disease Control and Prevention (CDC), includes the NYS Emerging Infections Program (EIP), one of 10 in the country, and Healthcare-Associated Infection Prevention Collaboratives.

National Surveillance of COVID-19 The work of our EIP team has greatly expanded in order to contribute to national COVID-19 surveillance. The EIP received a $1.7 million grant from the CDC to perform projects related to COVID-19, in addition to implementing surveillance for COVID-19 hospitalizations in Monroe and surrounding counties. The data contribute to COVID-NET, a national surveillance system for hospitalized cases of COVID-19.

Several national publications featured the data, including MMWR in April and August.

In addition, members of our staff volunteered at the Monroe County Department of Public Health (MCDPH) daily to help collect, analyze and share local numbers.

The MCDPH COVID-19 website has the most recent figures for the Greater Rochester region. The Center also houses the reports on its EIP web page. The Center continues surveillance and analysis of the racial and ethnic disparities in the impact of COVID-19.

The EIP is also performing an interview study sponsored by the CDC to understand exposures and risk factors for COVID-19 in healthcare personnel. The study will inform guidance for healthcare facilities domestically and abroad to protect the healthcare workforce.

Supporting Nursing Homes During the Pandemic Ghinwa Dumyati, MD, director of the CDSP and member of the Rochester Nursing Home Collaborative, regularly provides surveillance data on COVID-19 in the post-acute care setting and offers her infectious disease expertise and guidance as a liaison between area nursing homes, Monroe County and the NYS Department of Health. Three of our EIP staff contributed to a letter to the editor published in Infection Control & Hospital Epidemiology that outlined the many challenges faced by nursing homes and recognized the long-term care setting healthcare workers as “unsung heroes.�

“She is our superhero,” said Dallas Nelson, MD, associate professor of Medicine and medical director of UR Medicine’s Geriatric Group, Aaron Manor and The Schore Winds Nursing Home. “She has built an infrastructure and is really the first of her kind, with her level of expertise, to partner with the medical director community of nursing homes.”

“The COVID-19 data presented by Dr. Dumyati to the Rochester Nursing Home Collaborative is extremely helpful, allowing all participants to understand the extent of the disease and share solutions,” said Tom Mahoney, MD, director of the Nursing Home Collaborative and chief medical officer of Common Ground Health. “I firmly believe we could not have made the progress we did without Dr. Dumyati’s presentations and her expertise as we considered options.”

Human Papillomavirus Vaccine Impact (HPV-IMPACT) Monitoring Project This project monitors the impact of HPV vaccine on HPV types associated with cervical cancer precursors and cervical cancer. The rates of precancerous cervical lesions in Monroe County decreased by 55% in 18 to 39 year olds between 2008 and 2018. Monroe County surveillance is proving that the HPV vaccine is working. Vaccination rates in the County are among the highest in NYS. Respiratory Syncytial Virus (RSV) Surveillance In addition to the Center’s work in flu surveillance, the CDSP team also collects data on RSV hospitalizations in Monroe County and is part of the only national population-based surveillance platform for the virus.

Between October 2018 and April 2019, more than 1,300 cases of RSV occurred in Monroe County, with 33% of these cases requiring hospitalization. In contrast, more than 9,600 influenza cases occurred during the same time period and only 11% required hospitalization, highlighting the significant burden of RSV in the community.

Launched New Bacteria Surveillance The CDSP team began surveillance in Monroe County for extended-spectrum beta-lactamase-producing (ESBL) gram-negative bacteria, some species of which are categorized by the CDC as being a significant public health threat in the latest Antibiotic Resistance Threat Report. Initiation of this surveillance highlights the capability of the CDSP team to rapidly adapt to the changing public health landscape.

Ghinwa Dumyati, MD

CCHP in the News in 2019

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TV SPOTS

17

RADIO SPOTS

26

PRINT STORIES

37,300 people reached with 26 Facebook videos – Topics included tips for quitting smoking, health benefits of snowshoeing, as well as how to make vegan stuffed shells and carrot dogs.

Center for Community Health & Prevention | 46 Prince Street, Rochester, NY 14607 (585) 602-0801 | Fax: (585) 442-3372 | www.urmc.rochester.edu/community-health