Bay
Area Healthy Living Support and Communication Platform-BayHeal
Vision:
Empowering individuals to demand, access, utilize healthy living options, make
informed decisions and engage in self-development activities for durable
holistic & quality health outcomes.
Target:
Africans and recent immigrants from Africa living in Bay Area:
Alameda |
Napa |
Santa Clara |
|
| Contra Costa | San Francisco | Solano | |
| Marin | San Mateo | Sonoma | |
1.0 ABSTRACT
This concept note is about any minority population groups but is more specific about Africans and recent immigrants from Africa (from here on referred to as
beneficiaries) in the West Coast Bay Area. It is also about how best they can
be involved in owning skills for health living and outcomes in USA[i].
In 2012, a friend knocked
on our door, her roommate was having a baby. This was in Los Angeles CA. It was
2:00 am. We rushed her to a hospital which we had googled and fortunately was
15 minutes away. She did not have insurance, we collected money towards that.
She was admitted and delivered a bouncing baby girl. The previous week, we had
helped another person who had chest pain. We prevailed on him to go to the
hospital. This was a saving moment for him. He was diagnosed with a buildup of
fluid in the pleural space. A month before I had talked to a friend who was
complaining of frequent micturition, thirst and frequent fatigue after simple
daily activities. I escorted her to Hospital and she was diagnosed with Diabetes.
In Boston MA, a friend continued complaining of stomach pain and she could
point it out in the right lower quadrant. It turned out she had appendicitis, a
diagnosis arrived at after we rushed her to Hospital. A mother was overwhelmed
by developmental delays of her son. She even relocated for fear of stigma among
the African communities that had embraced her on arrival in USA. But,
counseling and reassurance enabled her overcome her own fears and she is now a
strong advocate in her area for children with disabilities. A doctor and mother
to a daughter who had sickle cell disease never gave up seeking treatment for
the daughter. The family went through all the processes of an autologous bone
marrow transplant, the daughter is now free of sickle cells. I[1] have attended many African
community, cultural and social events[2] as part of my own
understanding of other Africans, how they socialize and also as an appraisal,
the precursor for starting a dedicated healthy living support platform. As a
volunteer and Trustee with the African Empowered Communities-USA[3], we reach out to Africans
new in USA and engage them in activities that increase awareness, world view,
cultural sensitivity and utilization of the service delivery systems in USA.
The goal being full utilization and full integration. There are patterns
through which beneficiaries can be mobilized, empowered to become fully
involved participants in healthy living. This tool is a mobilization tool
tailored for Africans new in America. It can be copied for other immigrant
communities too. It is based on Using Community or Social Events
(UCEs/USEs) to continue mobilizing beneficiaries of healthy living in USA. On
outcome is making health, nutrition and a quality life part of their plans[4].
The
Executive Summary:
This project is geared at
promoting practices that in turn improve on quality of life, mental-health and
nutrition of beneficiaries[5]. The concept note is
divided into the following sections: 1.0 Abstract
is a short narrative and introduction 1.1, Background, shows who the
beneficiaries are, attempts a social diagnosis and then shows activities geared
at obtaining healthy outcomes. It further introduces opportunities where diet,
play and mental health are integrated in beneficiary daily, community and social
events. 1.2. Goal, 1.3 introduces the Management plan, 2.0. Shows how Using
Community or Social Events (UCEs/USEs) to continue mobilizing beneficiaries of
health services, 2.1. Description, 2.1.1 Long
Term Objective, 2.1.2. Short Term Objective, 2.2 Problem Statement and Justification, 2.3. Proposed Interventions
/Solutions, 3.0 Project Technical
Approach / Activities, 3.1. The following are the aspirations, 4.0. Monitoring
and Evaluation, 5.0 Sustainability.
1.1 Background and Diagnosis:
Innovative ways to get
beneficiaries to access the life improving health services in their vicinities[6]. Cause and effect
scenarios play a major role on decisions to place importance on health or
prioritize it. Responses can be placed in three categories whose acronym is
CAT. C
for chasing; A for aversion; T for tenacity.
Chasing papers and
documentation requirements, chasing the dollar to pay bills and chasing an ‘Americanness’ embracing and pursuing
happiness in the present, replacing receding nostalgia. In other words, doing
away with old life!
There is an aversion for
hospitals which in their psyche are places of doom; anecdotal feedback is
resplendent with conversations alluding to lengthy procedures and invasiveness;
many deliberately turn away or dislike healthy living patterns that take them
away from set ways; many have ingrained tabooist
tendencies that affect placing trust in health systems and providers. Such
remarks like “I cannot undress before ‘them’ are common.”
Tenacity is explained by
belief in that African perpetual virility, invincibility and a post arrival
shock. The belief is that of an African who arrived when many years of
socialization have rewarded a healthy life, weight gain and longevity. That
inertia becomes the survival closet or locker whose access is only open to an
owner. Past deeply held beliefs and ways that enabled one to navigate life in
Africa are now questioned through apparent stories of consequences of reckless
lifestyles around diet, play and mental-health. But all is not gloom and dire
straits!
The following can be the
opportunities:
1.
To establish a resource and drop-in center
as a static facility to conduct activities geared at entrenching good Diet,
Play and Mental Health (DPM) living practices. Themes will be linked with International
days of celebration, religious festivity days and other social-cultural events[7].
2.
To design, develop and maintain a website
with updated tips and information on healthy living targeting Africans new in
America. The website will be a portal highlighting African community events and
activities e.g. Moroccan, Zimbabwean, Angolan, Senegalese, Ivorian, Gambian,
Ghanaian, Ugandan, South African, Cape Verdean, Swazi, Lesotho and Kenyan. The
website has the advantage of anonymous information sharing and as an
interactive social media tool.
3.
To develop a schedule to promote and
engage Africans in conscietization and owning of good Diet, Play and Mental-Health
(DPM) practices[8]. This will use informal
and formal meetings as means of guiding conversation and decisions to adopt
healthy living lifestyles. Households will be encouraged to engage in such
activities like ‘game nights.’ It will then be possible to start healthy living
conversations or even continue with them.
4.
Develop a yellow pages pull out with addresses
and locations where beneficiaries can meet, socialize and start or continue
conversations around diet, play and mental health living. The pull out will be
a hard copy used as a desk reference tool.
5.
Link up with service providers and solicit
for space, time and tailored opportunities to increase beneficiary conscientious
utilizing of services. Such spaces will be booked at gyms, cinemas, recreation
parks and other venues[9].
6.
Develop the “drums-and-fire” networks
to check on or support each other as part of adherence and decision support
mechanisms. This will tap into contacts’ lists as well as a list-serve. This
will also employ another mobilization tool among Africans called the “ear-to-the-ground.”
This derives from ancient African ways of sharing information[10]. Info-blasts will be
maintained through the list-serve, elders of communities, religious leaders and
social media platforms.
7.
Involve Africans in extravaganza
activities focusing on health with the support of Certified Therapeutic
Recreation Specialists (CTRS), social workers and counselors. It is hoped that
retreats, camps and seminars focusing on knowledge sharing will be the main
activities. These will integrate events recognizing elders and leaders who have
helped beneficiaries to embrace and adhere to healthy living practices.
1.2 The Diet, Play and Mental-Health (DPM)
goals:
To engage Africans in
activities that help them achieve physical, cognitive, social empowerment and
skills through participation. The target are is San Francisco, Oakland,
Brisbane, Richmond, Concord, Colma, Treasure Island, Daly City, South San
Francisco and San Jose. Africans have established entertainment, food art,
sport, residences, businesses and networks in these areas. It is these that
will be tapped into.
1.3 Management and Community Liaison:
Thomas Rogers Muyunga
Mukasa is the lead and reporting focal person.
2.0
Using Community or Social Events (UCEs/USEs) to continue mobilizing beneficiaries
of health services:
2.1.
Description
2.1.1 Long Term Objective:
The objectives, among
others, include; managing the project, conducting a social mapping exercise to
develop an information matrix with input by Africans, empowering beneficiaries
to participate in initiatives to improve on their health, engage in community
and social events to raise awareness on link between diet, play and mental-health.
Disseminate information in form of newsprint pull outs, social media apps and
use of other communication means. Set up African community event days where
among other activities, proper nutrition is encouraged, health, hygiene,
livelihood and socializing are promoted.
2.1.2 Short Term Objective:
2.1.2.1. To identify and
generate a list of venues in San Francisco, Oakland, Brisbane, Richmond, Colma,
Treasure Island, Daly City, South San Francisco and San Jose where drop-in
meeting places where ‘diet, play and healthy living’ retreats or camps can be
conducted.
2.1.2.2. To identify and
work with focal persons in San
Francisco, Oakland, Brisbane, Richmond, Colma, Treasure Island, Daly City,
South San Francisco and San Jose.
2.1.2.3. To identify and
generate a list of health and human services facilities in San Francisco,
Oakland, Brisbane, Richmond, Colma, Treasure Island, Daly City, South San
Francisco and San Jose where drop-in meeting places where ‘diet, play and
healthy living’ services are provided.
Make a list and develop a yellow page news print pull out.
2.1.2.5. To set up a
management team for the full cycle of the project.
2.2 Problem Statement and Justification
Africans new in America
are faced with overwhelming activities that affect the way they access health
care services and the way they engage in healthy living. A paucity of tailored and funded programs
catering to ‘diet, play and mental health’ among Africans has left them to
access other integration and social services which are well funded but subsume
the need for a stand-alone DPM program.
This is a gap that can be filled by dedicated communication for behavior
change.
2.3 Proposed Interventions /Solutions (April
2015-March 2016)
2.3.0. To establish a
resource and drop-in center as a static facility to conduct activities geared
at entrenching good Diet, Play and Mental-health (DPM) practices, by April 2015.
2.3.1. The first proposed
activity is setting up linkages through department of health, SF, Mayors’
offices and other service providers whose mission is geared towards health and
development. Meanwhile a social media and hotline facility will soon be
established by May 2015.
2.3.2. To identify and
generate a list of venues in San Francisco, Oakland, Brisbane, Richmond, Colma,
Treasure Island, Daly City, South San Francisco and San Jose where drop-in
meeting places where ‘diet, play and healthy living’ retreats or camps can be
conducted, by June –July 2015.
2.3.3. To identify and
work with focal persons in San
Francisco, Oakland, Brisbane, Richmond, Colma, Treasure Island, Daly City,
South San Francisco and San Jose, by May 2015.
2.3.4. To identify and
generate a list of health and human services facilities in San Francisco,
Oakland, Brisbane, Richmond, Colma, Treasure Island, Daly City, South San
Francisco and San Jose where drop-in meeting places where ‘diet, play and healthy
living’ services are provided. Make a
list and develop a yellow page news print pull out, by June 2015.
2.3.5. To set up a
management team for the full cycle of the project, by May 2015.
2.3.6. To design, develop
and maintain a website with updated tips and information on healthy living
targeting Africans new in America, by May 2015.
2.3.7. To develop a
schedule to promote and engage Africans in conscietization and owning of good
Diet, Play and Mental-Health (DPM) related practices. This will use informal
and formal meetings as means of guiding conversation and decisions to adopt
healthy living lifestyles. Households will be encouraged to engage in such
activities like ‘game nights.’ It will then be possible to start healthy living
conversations or even continue with them.
2.3.8. Develop a yellow
pages pull out with addresses and locations where Africans can meet, socialize
and start or continue conversations around diet, play and healthy living.
2.3.9. Link up with
service providers and solicit for space, time and tailored opportunities to
increase African new Immigrants’ conscientious utilizing of services.
2.3.10. Develop the
“drums-and-fire” networks to check on or support each other as part of
adherence and decision support mechanisms. This will tap into contacts’ lists
as well as a list-serve. This will also employ another mobilization tool among
Africans called the “ear-to-the-ground.” This derives from ancient African ways
of sharing information. Info-blasts will be maintained through the list-serve,
elders of communities, religious leaders and social media platforms.
2.3.11. Involve Africans
in extravaganza activities focusing on health with the support of Certified
Therapeutic Recreation Specialists (CTRS), social workers and counselors.
3.0 Project Technical Approach / Activities
Project activities /
objectives will mainly involve mobilizing Africans to access DPM related
services.
3.1 The following are the aspirations:
(i). Designed and
presented concept note.
(ii). Identified the
leaders, role models and facilitators.
(iii). Developed the
strategic line concept note to become the blue print for budgeting. See the
fifteen needs checklist.[ii]
(iv). Demonstrated how
one can establish a well-coordinated and integrated use of community or social
events to integrate ‘Diet, Play, Mental-Health’ related services.
(v). Have rolled plans
and schedules for interventions to be carried out over a period of
implementation.
(vi). A yellow page pull
out with information that is ‘Diet, Play, Mental-health’ related.
4.0 Monitoring and Evaluation
4.1. Monitoring will be
continuous at various levels and will mainly be participatory in nature using
attendance and exit reports to gauge impact. The yellow pages will regularly be
distributed and updated; on spot visits at planned events will be an
opportunity to collect data and consolidation activities. Reported data will be collected and collated
for processing. Media outlets will be involved in reporting outcomes.
4.2. A monitoring tool
will be developed to report on uptake, popularity of program and any other
experiences.
4.3. This initiative will
also be monitored by sponsors. Quarterly implementation and financial reports
shall be sent regularly to sponsors.
4.4. Evaluation of impact
will be undertaken based on the following indicators:
i. Number of events in
different cities or localities
ii. Number of referrals
and linkages.
iii. Continuity.
5.0. Sustainability
5.1. The initiative will
focus on use of appropriate and locally available resources. The attendant
capacity building of the beneficiary communities in participatory skills is
hoped to have three outcomes: individual empowerment in linking diet, play on
mental health; increased utilization of services; and managing time for
self-improvement.
[1] Thomas Rogers M. M, is a resident
of USA since 2012. He worked in Uganda with Ministry of Health as an officer
under Communicable and Non-communicable disease Commission. He worked in 15
African countries under the Eastern and Southern Africa Health Network. In USA,
he is a volunteer with UCSF, HIV/Hepatitis Community Advisory Board. He has interacted
with many Africans in the Bay Area and this concept is the outcome of that
interaction. You are reading it because Thomas is soliciting support to start
the BayHeal Initiative.
[2] Food, Music/Entertainment,
Parenting, Grooming, Work and Housing are 6 aspects that draw Africans in Bay
Area together. Knowledge of dates, activities & venues (DAV tool) will get
one the numbers to reach out to with messages. Radio stations (e.g. KALW FM
91.7 has African night on Thursday-9am-11am).
[3] An organization engaged in
planning trade fares and market place-related activities all over California.
In the Bay Area, it has featured at: Santa Rosa, San Jose, Ashley and San
Francisco Market places.
[4] Health, nutrition, quality of life
plans include: Safe motherhood, mental-health, Oral Health, diet plans, medical
checkups, exercise and such activities promoting health.
[5] Eritreans (^ 400[ below 21; 100]),
Ethiopians (^300[below 21; 100), Somali (^200[below 21;90]), Ugandans (^300[below
21; 100]), Kenyans(^700[below 21; 300]), Sierra-Leoneans(^100), Senegalese
(^100), Liberians( ^100), Mozambiquans(^60) Angolans(^70) Ghanaians(^900[below
21; 400]), Nigerians(^1,000[ below 21; 400]), Zimbabweans(^100),
Congolese(^100), Egyptians(^500), Moroccans(^200), Zambians(^60),
Malawian(^40). These figures are arrived at from anecdotal responses. There
could be more. It requires a bigger sample, perhaps more resources and a better
structured inquiry will reveal better numbers.
[6]
San
Francisco, Oakland, Brisbane, Richmond, Concord, Colma, Treasure Island, Daly
City, South San Francisco and San Jose have services ranging from Hospitals,
Human Services’ Agencies, Department of Public Health and various support
organizations.
[7]
Bridge HIV study part of the join prep.org. , shape up San Francisco part of
the Opentruthnow.org. , ymacasf.org/bayview, SFrecpark.org, Project Open Hand
Diabetes Study, Stop Smoking Classes by SFSmokegree.org at 2550 23rd
St. Bldg. 40, 5th Floor, Solarium Classroom, SFGH (this may even
demystify or assuage the hospital aversion), HIPS Study on Communication
between Women and their doctors for 45-65 year olds; Study on Women’s Health,
Aging &Sexuality. Information such as: appointment scheduling at say,
Family Health Clinic (this may help improve on planning and attendance at
clinics). Cal wellness with tailored prevention, primary care, health
education/outcome plans and oral health.
[8]
Plans can be made to enable beneficiaries benefit from utilization of these
resources: Bayview, Hunters Point, Bernal Heights (in-door basketball Courts on
500 Moultrie St.), Balboa Park, Castro (the Eureka Valley Rec. Center on 100
Collingwood St.), Chinatown (Betty Ann Ong Chinese Recreation Center on 3rd
floor, 1199 Mason St. or the Willie Woo Woo Wong Clubhouse on 830 Sacramento
St.), Excelsior Park (McLaren Park, University St. at Mansell St.), Glen Park
&West Portal ( Glen Canyon Park recreation Center, Bosworth
&O’Shaughnessy Blvd.), Mission (Power play for 6-18, Boys & Girls Club
of SF Tenderloin Clubhouse, 115 Jones St.). Western Addition (Hamilton
Recreation Center 1900 Geary Blvd.)
[9]
See 8 above.
[10]
Anthropo-ethno tools.
[i] Health outcomes
represent two types of health outcomes: how long people live (length of
life) and how healthy people feel while alive (quality of life). We
promote efforts to avoid premature deaths (deaths before age 75).
Health-related quality of life (HRQoL) is a multi-dimensional concept that we
shall mainstream in all our interventions. It includes domains related to
physical, mental, emotional and social functioning. It goes beyond direct
measures of population health, life expectancy and causes of death, and focuses
on the impact health status has on quality of life. The CDC has defined HRQoL
as “an individual’s or group’s perceived physical and mental health over time.”
(Centers for Disease Control and Prevention. Measuring Healthy Days: Population
Assessment of Health-related Quality of Life. Atlanta, GA: Centers for Disease
Control and Prevention; 2000.)
[ii] The fifteen
needs among Africans and recent immigrants from Africa
1. Popularizing
registration for Health Insurance-Medical
2. Popularizing
registration for Health Insurance-Dentical
3. Access
to/ and making popular the usage of such programs like; RAPID (Rapid
Anti-retroviral Program Initiative for new diagnoses).
4. Mobilization
towards contributing population group in the San Francisco ground zero to HIV
initiative (“a first city in the world with no new infections, no stigma and no
deaths”).
5. Getting
involved in initiatives that erase financial and social barriers to get tested
and treated for HIV/Hepatitis/STIs (e.g., benefiting from early ARV initiation,
“universal” testing and avoidance of beachheads).
6. Building
structures against stigma related to attending hospitals and other tendencies
towards excuses to avoid hospitals or health care initiatives (e.g., using
African community “elders,” “mama,” “uncles” and community/social events).
7. Initiate
a poster person as a drive targeting long-stay Africans (who are now residents)
and new immigrants from Africa on the path to documented residents.
8. Families
with under-21 year olds need to know and be attached to “under 21 clinics.”
9. Nutrition
education
10. Play
and recreation as one way to maintain manageable body-mass index.
11. Negotiating
the benefits’ structure following a given diagnosis.
12. Negotiating
and accessing services of a well-mother/woman clinic for women/females.
13. Mapping
out and networking with other service providers
14. Design/disseminate good Diet, Play and Mental
Health (DPM) information, education, materials.
15. Develop Frequently Asked Questions along these
or any other health outcomes.
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