Engaging with Healthcare Effectively

in order to receive that care. Neil, of the eight behaviours into our characteristics, which ones do you feel are the most challenging for people to manage? And do you have any strategies that you give them? I think let's, let's start with behaviors. I think one of the most challenging things we find for some of our community members is actually healthy diet. And we keep saying that food is health, food is, food is something that is basic. And I think part of the issue for particularly our urban population is having access to healthy food. So what we're, what try to do is actually identify locations that can provide food. We work with some of the local food banks to provide food at central drop-off locations for our patients. But I think that probably is one of the basic issues that we face for all ages of patients. You know, secondarily, I think is participation in screenings more for men than for women, interestingly. We find that women are more apt to get the kind of screenings necessary than men are. And so what we try to do is go out to places where men congregate in an effort to provide blood pressure screenings or screenings that might impact their health. Oftentimes in the urban community it's a community of color which has a higher incidence of heart disease and stroke. So we focus there. Smoking, less of an issue. Alcohol doesn't seem to be as much of an issue as it used to be in the past. I think drug abuse is probably more of an issue than either smoking or alcohol, which really isn't in the original eight behaviors that you discussed, but I think it's something that probably ought to be looked at at some point in the future. Physical activity varies. If you feel you live in a safe area where you can physically get out and walk or take advantage of public parks, not an issue. So what we have done as an organization is actually fund playgrounds on school properties, particularly for children and adolescents to be able to obtain that kind of physical activity in the hopes that the parents or the caregivers of those individuals will also take advantage of that safe zone, if you will. Stress doesn't come up as an issue, but I have to believe living in an environment where there's a higher level of drug abuse, a higher level of violence, a higher level of domestic issues, that that exists. We do find that there is a shortage of behavioral health providers. It is something that we're trying to address by hiring as many as we can to work in those local communities, but that has been a very big challenge for us, as well as many other organizations in in our local communities. Engaging with health care, once we find the right pathway, once we get the right individual from their community, we're usually able to begin that process. Maintaining that, as I had mentioned in one of the other questions, is a little more challenging. But once we're able to find that touch point, that that individual that they trust, it seems to be working. And sleep hasn't come up, but I have to believe, you know, other than for me, it's an issue. When you look at the 12 characteristics, and I'm just scanning them right now, I think communication is one that's somewhat challenging because we recognize that not everyone learns the same way, hears the same way, and wants to be educated the same way. Having been married to an educator for decades now, I've learned that some people are tactile, some people are visual, and some people want to read a document. But the reading level in the communities that are challenged typically is a little bit lower. So it's a matter of almost feeding them information. We try to use videos when we can because it seems like people are comfortable watching videos on a smartphone. So that's been somewhat helpful. I don't think in most cases people are proactive enough to monitor their vital signs and alert their health care provider with those vital signs. I think this is one of those things you've got to pull rather than push, and it's a matter of providing them the equipment and making sure that they understand how to use it, and that you actually follow up with a telephone call or some kind of contact or create a buddy system in order to assure that things are happening. We had something that we called, we created years ago called Buddy Check 11. And it was on the 11th day of every month, we had two women peered up throughout the community saying, remember to do a breast self-exam to see if you had breast cancer or to see if you had a lump or something like that. We found that that, interestingly, that simple concept was very successful, but we do find that there's a difference between trying to get women to review their own health status versus men. I think the men are becoming much more challenging for us. Knowing their conditions and their causes, again, challenging. It's a matter of education. And I think lifestyle changes, we begin that process, but again, in an urban area, becomes very difficult because the communities are always changing. And the level of safety that they feel, I think, changes. And I have to believe there's a stress level that's constant that rises and falls throughout all of these communities. But that pretty much touches the eight and the 12.