Let’s Play!Engaging Youth and Families in Physical Activity and

Exercise

Tai J. Mendenhall, Ph.D., LMFTUniversity of Minnesota

Jerica M. Berge, Ph.D., LMFTUniversity of Minnesota Medical SchoolWilliam J. Doherty, Ph.D., LMFT

University of Minnesota

Collaborative Family Healthcare Association 15th Annual ConferenceOctober 10-12, 2013 Broomfield, Colorado U.S.A.

Session #A2a Friday, October 11, 2013

Faculty DisclosureWe have not had any relevant financial relationships

during the past 12 months.

Objectives

At the conclusion of this presentation, participants will be able to…•Describe the core tenets, principles, and action strategies of the Citizen Health Care model.•Describe how Citizen Health Care has been applied across two diverse community settings to engage youth in physical activity.

Objectives, con’t

Participants will: •Describe how the Citizen Health Care model is used across different health conditions, including obesity prevention and diabetes management.•Outline key differences between Citizen Health Care and other models of collaborative and community-based work.

Introductions

Conventional / “Standard” Care• Hierarchal structure

– Provider/Patient– By Specialty

• Provider-consumer design– Care as “goods/services”– Providers give, patients take

• Expert-driven– Providers’ wisdom valued / Providers active– Patients’ wisdom untapped / Patients passive

• Challenged by contemporary contexts…

Healthcare: The Current Context

• Rapid and constant change

• From acute care to preventive and patient-oriented care

• From provider/consumer services to provider/patient partnership

Trends toward Family & Community-based InterventionsWe are moving away from doing care “on” people to doing care “with” them

Tapping into patients’ and families lived-experience and wisdom requires professionals to “unlearn” their expert-roles and work more collaboratively within the context(s) of more flattened professional hierarchies

Citizen Health Care• Citizen Health Care (CHC) is a way to engage

patients, families, and communities as co-producers of health and health care

• CHC encompasses an identity-shift for professionals (from “expert” to “citizen”)

• Core principles and planning strategies permeate projects, but no two projects look wholly alike

Origins of Citizen Health Care

• Family Therapy• Medical Family Therapy• Collaborative Family Health Care• Democratic Political Theory• Contemporary Community Organizing

Strategies• Community Based Participatory Research

Citizen Health Care (CHC):Core Principles

• The greatest untapped resource for improving health care is the knowledge, wisdom, and energy of individuals, families, and communities who face challenging health issues in their everyday lives.

Core Principles, con’t

• People must be engaged as co-producers of health care for themselves and their communities, not just as patients or consumers of services.

Core Principles, con’t

• Professionals can play a catalytic role in fostering citizen initiatives when they develop their public skills as citizen professionals in groups with flattened hierarchies.

Core Principles, con’t

• If you begin with an established program, you will not end up with an initiative that is "owned and operated" by citizens. But a citizen initiative might create or adopt a program as one of its activities.

Core Principles, con’t

• Local communities must retrieve their own historical, cultural, and religious traditions of health and healing, and bring these into dialogue with contemporary medical systems.

Core Principles, con’t

• Citizen health initiatives should have a bold vision (a BHAG – a big, hairy, audacious goal) while working pragmatically on focused, specific projects.

Examples Citizen Health Care Projects

• Partners in Diabetes (Regions Hospital / UMN)• A Neighbor Giving Encouragement, Love and

Support (“ANGELS”) (Wake Forest University)• Family Education / Diabetes Series (“FEDS”)

(St. Paul Department of Indian Work / UMN)• Activated Patient Project (Como Clinic / UMN)• Students Against Nicotine & Tobacco Abuse

(“SANTA”) (HHH Job Corps / UMN)

Examples, con’t• Intimate Partner Violence (IPV) in the Hmong

Community: Tacking an Old Problem in a New Way (Lao Family of Minnesota / UMN)

• Reducing Tobacco Use in Southeast Asian Communities (MPAAT / UMN)

• Hennepin County Citizen Professional Project (Hennepin County / UMN)

• Sisters Together Overachieving in Raising Kids (“STORKS”) (Broadway Clinic / UMN)

Family Diabetes / Education Series(the “FEDS”)

• Members of the Native American community who have lived experience with diabetes (as patients or family members) working in partnership with providers in the provision of education and support in culturally appropriate ways

• Designed and implemented through a democratic and collaborative partnership between patients, family members, and providers

FEDS / Introduction

• Engages low-income, urban-dwelling AIs and their families in an active forum of education, fellowship, and support

• Participants include patients and family members (n = 40-60), medical and behavioral health providers (n = 4-5), and tribal elders (n = 4-6)

FEDS / Meetings

• Meetings start with members conducting foot checks and recording each other’s weight/ BMI, blood pressure, and blood sugar

• Meals consistent with AI culture and traditions are prepared and shared communally, along with discussions about ingredients and indicated portion sizes

FEDS / Education

• Educational forums take place in the contexts of talking circles, small and large group discussions, and a variety of lively activities (e.g., traditional music, dancing and aerobics, impromptu theater/role-plays)

• Forums encompass active collaboration between community leaders and Western providers

FEDS / Educational Topics, con't

● Diabetes in the AI Community● Dietary Guidelines & Portion Sizes● Exercise & Physical Activity ● Obesity & Weight Control● Foot Care & Wound Care● Blood Glucose Monitoring & Control ● Eyes and Teeth: Dental Care / Retinopathy

FEDS / Educational Topics, con't

● Blood Pressure & Cholesterol● Heart Disease & Stroke● Stress Management & Strategies● Medical Services & Supplies● Working with your Doctors● Sticking with it: Staying Motivated

& Family/Social Support● Review: Putting it all Together

Targeted Activities to Engage Youth

• East Metro Diabetes Initiative• St. Paul Public Schools / Indian Education• Diabetes Education in Tribal Schools• Community Gatherings and Events• Community Theater• Local Media

Paha Sapa: Play it Forward

Contact Information

• Tai J. Mendenhall, Ph.D., LMFT, CFT• University of Minnesota• Family Social Science• 290 McNeal Hall; 1985 Buford Ave.• Saint Paul, MN 55108

• Office: 612-624-3138• Email: mend0009@umn.edu

Learning Assessment

Audience Question & Answer

Session Evaluation

Please complete and return theevaluation form to the classroom monitor

before leaving this session.

Thank you!