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BY: JULIE TROCCHIO, BSN, MS

What a treat! Last month I was a reviewer for the Hospital Association of New York State's Community Health Improvement Award. Although I reviewed only a portion of all the submissions, I was impressed by the variety and creativity of the programs I saw.

Community health improvement programs are encouraged by both the state hospital association and the health department. The hospital association holds in-person education programs, webinars and the annual competition of outstanding community programs.

The Department of Health's New York State Prevention Agenda lists priorities, goals and objectives to improve the health of New Yorkers. It includes a group of 96 prevention objectives in six priority areas: Improve health status and reduce health disparities; promote a healthy and safe environment; prevent chronic diseases; prevent HIV/STDs, vaccine-preventable diseases and health-care-associated infections; promote healthy women, infant and children; and promote mental health and prevent substance abuse.

SPECIFIC AND COMPREHENSIVE APPROACHES
Some programs focused on specific activities, others were comprehensive in their approach. For example, one substance-abuse program focused on easy, safe and effective ways to dispose of leftover medications; another was more comprehensive, addressing not only drug disposal but also the prescribing of pain medication, consumer and family education, education in schools and instructions on administering naloxone for opioid overdose.

Meeting the New York State prevention agenda priority to promote the health of women, some programs promoted breast-feeding, but one program was more inclusive in addressing women's health, working with women one on one, in small groups and through education programs on prenatal and infant care, family safety and how to navigate the health system.

Two programs explicitly built on hospital expertise. One hospital developed a speakers' bureau, recruiting health professionals not only as faculty but as content experts for education, screenings and outreach programs. Another used its expertise in musculoskeletal medicine to develop an anterior cruciate ligament injury-prevention program for community athletes.

Attention to disparities was a feature of many of the New York programs, with two standouts. An initiative to close the gap on early diagnosis and treatment of breast and prostate cancer focused on historically underserved populations: African-American men, Spanish-speaking men and women and members of the Amish community. Another initiative zeroed in on preventing diabetes among Spanish-speaking mothers.

INNOVATION IN ACTION
Several programs took novel approaches to difficult community programs:

• To teach the importance of cancer screening, a hospital program paired participants with student athletes to walk and talk about cancer prevention.
• A mental health facility initiated a successful smoking cessation program after discovering that although most of its inpatients and outpatients smoked, many wanted to quit.
• A food pantry in a rural area with high rates of obesity realized that many community members had access to locally grown vegetables but did not know how to prepare them. The hospital started cooking classes.
• A mental health program was grant-funded but the program administrators wanted to know if it could be sustainable without the grant. The program instituted a mock-billing system and discovered it could continue the program with third-party payment from most of its participants.
• Increasing human papilloma virus immunization can be a challenge. A hospital partnered with a school art program, using masks taken from head and neck surgery patients and turning the masks into pieces of art. This was done to send the message: HPV immunization can prevent head and neck disease.
• A cardiac outreach program used cooking demonstrations, CPR education, Cardiac Trivia and a YMCA "Family Fun Day" to get its message out.

MY PICKS
The comprehensive substance abuse program got a high score from me, as did a healthy moms program. Several diabetes prevention programs, faithfully following the Centers for Disease Control's National Diabetes Prevention Program, scored very well. They all targeted a significant community need, included extensive collaboration and tracked their results.

My personal favorite was a hospital/school partnership. The two came together to develop a camp for students moving from elementary to middle school. The school covered locker combination practice, class schedules and how to navigate the middle school's sprawling building. The hospital covered health-related topics such as self-esteem, bullying, healthy living, healthy relationships and handling stress.

As a former school nurse and parent to past middle-schoolers, I know that these years can present social, emotional, physical and academic landmines. This can be the period when students start on a journey either toward success in school, social life and self-image or problems with school and relationships and dangerous behaviors. Preparing young people for the next few years could make a huge difference in their lives.

JULIE TROCCHIO, BSN, MS, is senior director, community benefit and continuing care, the Catholic Health Association, Washington, D.C.