| Education
is a critical component of creating sustainable programs
that extend and enhance the lives of people everywhere. Education
ensures that therapeutics are used appropriately, creates an environment
where illnesses are understood by the general population, where prevention
is emphasized and communities are mobilized for action. Education
also ensures that victims of disease are cared for, rather than ostracized.
Further, the predisposition for several chronic diseases is often
influenced by exposure to risk factors early in life. By educating
both parents and children about these critical risk factors; how to
recognize, avoid and counteract them, much suffering may be prevented,
with obvious benefits for our own and coming generations, both in
terms of well-being and health care costs.
Ultimately
the goal is disease prevention, improved advocacy and management
of disease, primarily focused on youth and at-risk underserved populations.
RATIONALE
The Health
Education program funded by the Bristol-Myers Squibb Foundation,
supports the development and replication of novel approaches aimed
at individuals in the community to learn more about their health
and well-being so that they can become more informed decision makers
about health care and they can actively participate in disease prevention
and management. In many of the grants, the Foundation seeks to be
a catalyzing force for changes in government or social policies,
supporting programs that can demonstrate the value of new approaches
to health care through educational efforts.
BENEFITS
Bristol-Myers
Squibb understands its responsibility as a global health care company
to participate in the prevention of disease and in a better understanding
of those afflicted by diseases everywhere the company conducts its
business. Effective and sustainable health education programs help
public and non-governmental organizations' (NGO) health care systems
better respond to public health crises and to address priorities
effectively.
Nearly all
the education programs focus on taking on major diseases, like hepatitis
B or cancer -- and creating model programs for either preventing
them or helping treat aspects of them in community settings. This
is accomplished primarily by building local capacity with the leadership
of local organizations. A hallmark of each grant is that services
they deliver can be sustained. Ultimately, the aim will be to improve
the health education infrastructure and capacity in developing countries
primarily by supporting programs that develop models for health
education that will lead to disease reduction and health protection.
In the process,
significant public health issues are being addressed by either expanding
awareness of the problems, leading to policy changes, or by developing
local solutions that can be expanded with partnerships or used by
governments. In all cases the grants are strategically aligned with
areas where Bristol-Myers Squibb has expertise and experience through
its businesses and in many cases where these businesses can provide
additional support, relationships and insights on the ground to
add both benefits and impact to these grants. Some of the grants
are disease specific, some are country specific and some are regional
in nature.
RESULTS
To date, the
Foundation has provided more than $13 million to projects that cultivate
innovative partnerships with community-based organizations, academic
research centers and health care institutions in the area of health
education. Many projects ultimately serve as models for national
and international use.
Some of the
key health educations projects that the Foundation is funding in
2004 along with some significant outcomes thus far include:
INFECTIOUS
DISEASES
Hepatitis
B Vaccination Education Program In China
The best approach
to trying to contain hepatitis B (HBV), the ninth leading cause
of death in the world and a disease that kills up to 300,000 people
in China each year, is through vaccinating newborns. The Foundation
has provided grants over the past two years to support a vaccination
education program in partnership with the Chinese Ministry of Health
and the Chinese Liver Foundation in six rural areas in China.
Outcomes:
- 2003
marked the second and final year of the grant -- and included
training nearly 2,000 local doctors and other health care workers
in preventing HBV, developing a program for video disc and showing
a program on local TV stations, in schools and in village health
clinics about preventing hepatitis B in rural areas. Parents were
also involved in an educational effort about HBV prevention in
local schools.
- Vaccination
rates have increased dramatically since the start of the education
campaign, from 30-40 percent levels prior to this health education
initiative to as high as 97 percent in one rural county.
- The
success of the Hepatitis B Vaccination Education Program has gained
a commitment from the Chinese Ministry of Health to roll out this
training program to the remainder of Shan'xi and Gansu provinces.
Prevention
And Management Of Hepatitis B Infection In China -- White Paper
Based
on the highly successful childhood vaccination program, the China
Foundation for Hepatitis Prevention and Control (CFHPC) will engage
key opinion leaders to develop a comprehensive strategy to combat
the escalating health challenge of hepatitis B infection. This "White
Paper" will outline the current and emerging health challenge of
HBV infection, the projection of consequences for individual patients,
communities at large and the nation as a whole, as well as the necessity
for aggressive interventions to prevent an escalating health crisis.
The
paper will state the importance for all stakeholders -- policy makers,
health administrators, health care professionals, counselors and
private care givers -- to take full advantage of dedicated programs
offered to educate and intervene towards prevention of further infection.
Further, an CFHPC advisory board will develop guide lines for prevention
and intervention programs with focus on research and education of
rural as well as urban health care providers.
This
strategic installment in the public health agenda of China is supported
by a $50,000 grant from the Bristol-Myers Squibb Foundation.
CANCER
Hungarian
Hospice Foundation Reduces Stigma Of Cancer For Patients In Hungary
Utilizing
a $290,000, three-year grant from the Foundation, the focus has
been on support for psychosocial counseling for cancer patients
and their families in a country where cancer care has been given
a low priority and where culturally, cancer is still seen as a death
sentence. In addition to providing telephone counseling as well
as face-to-face counseling at the Hospice and at five regional oncology
centers, efforts are also focused on developing efficient and effective
screening methods to identify patients who have significant distress/anxiety/depression
so they can be referred for face-to-face counseling.
Outcomes:
- A
pilot study has been initiated using distress management clinical
practice guidelines of the National Comprehensive Cancer Network
in the U.S. and such tools as Distress Thermometers, the Brief
Symptom Inventory and the Hospital Anxiety and Depression Scale.
Using these instruments will provide objective and faster diagnostics
than ones currently employed.
- This
project has been shared with members and staffers of the European
Union Parliament.
ICAN
Cancer Counseling Program Expands In Florida
With
research that indicates that only 10 percent of cancer patients
who require emotional support are adequately referred for psychosocial
care, the Bristol-Myers Squibb Foundation, in partnership with the
Alliance for Children and Families and Cancer Care, established
a model program to enhance affordable and accessible counseling
resources available to cancer patients at the community level. Called
ICAN (the Individual Cancer Assistance Network), it was first initiated
in 2001 in the Tampa, Florida area and then spread to 24 other Florida
counties. It brings a resource for individualized, comprehensive
cancer treatment and care to the community setting, where most cancer
treatment in the United States is delivered.
While
many of the country's comprehensive cancer centers provide a variety
of services and supports in the hospital, these are not following
the patient to the community and are certainly not being coordinated
centrally in the community. ICAN seeks to be a model to change that.
It has tapped into the existing resource of community mental health
workers and has given them special training in cancer so they can
become part of the patient's comprehensive cancer team. It provides
a clear alternative and supplement to group-based support. Some
people will not discuss issues of intimacy, for example, in a group
setting. This leaves issues unaddressed and ongoing causes of distress.
With ICAN, the Foundation has sought to test a new model for building
an individualized , community-based resource for patients.
Outcomes:
- The
third phase of the program was launched in Miami-Dade in 2003.
It was adapted to serve the unique needs of Miami-Dade's multiethnic
community, by training counselors who are fluent in English, Spanish
or Haitian Creole.
- Toll-free
numbers are staffed by trained specialists, including Spanish
and Creole-speaking counselors. More than 30 local counselors
-- 90 percent bilingual in English and either Spanish or Creole
-- have been trained to provide psychosocial support throughout
the county to patients referred through ICAN.
MENTAL HEALTH
EUFAMI
Helps Destigmatize Mental Illness In Europe
Support
began in 2003 with a $247,000 grant to a pan-European NGO called
EURFAMI, for a program to combat stigma and discrimination in people
with severe mental illness and their families. Specifically the
Foundation has funded an advocacy development workshop to train
spokespeople -- usually family members and caregivers of those suffering
from mental illness -- to bring the message against the stigma and
discrimination that surrounds mental illness across Europe, targeting
health professionals, the media, policy makers and the general public.
Reintegrating
Schizophrenic Patients back Into Daily Life Through Education
At
Sainte Marguerite Teaching Hospital Rehabilitation Centre in Marseille,
France, physicians and mental health workers have been using a variety
of social skills training educational modules for schizophrenic
patients and their caregivers. With an $83,000, 18-month grant,
the Foundation is supporting the development of a new module focusing
on Social and Personal Fulfillment. It is aimed at helping patients
recover a sense of personal competence and hope to help them live
normal lives, enabling them to find and then apply solutions to
concrete problems they might face in daily living. Ultimately, this
will help them gain social competencies, increase their independence
and allow them to insert themselves back into life outside their
treatment environment.
German
Family Care Givers Of Schizophrenic Patients Learn Strategies For
Coping With High Stress
The
BApK (Bundesverband der Angehorigen psychisch Kranker) offers weekend
workshops for family members of schizophrenia patients to share
experiences and receive training in mechanisms and strategies for
coping with stress related to the home care. Curriculum development
and delivery by experts in the field are supported through a $200,000
grant over three years. For each of three years, two annual sessions
(in the spring and fall) will gather 15 participants each for training
in coping strategies and sharing of experiences as care givers of
schizophrenic patients. Effectiveness evaluation will be managed
by an independent third party. A communication plan will be devised
with the intent to encourage for replication, based on indicators
of successful outcomes.
The
First Psychosocial Crisis Intervention Hotline For Children And
Youth Established In Greece
The
University Child Psychiatry Department at the "Aghia Sophia" Children's
Hospital, Athens, Greece will implement and operate a mental health
hotline and crisis assessment and support center, dedicated to the
dramatically increasing incidence of diagnosed reactive psychological
disorders.
The
hotline and support center will identify mental health problems
early and support and ensure easy access to appropriate mental health
services for children, adolescents and their parents, provide primary
advisory services along with guidelines regarding referral to mental
health specialists, offer information services on youth mental health
issues to health professionals, and record current needs in the
field of mental health of children, adolescents and their families.
The program is supported by a two-year, $500,000 grant.
CARDIOVASCULAR DISEASE
Cardiovascular
Health Initiative Targets New York Chinese-American Community
Heart
disease was the second leading cause of death for Asian-Americans
and Pacific Islanders in 2000. "You Are What You Eat" is a new effort
that addresses culturally appropriate cardiovascular health promotion,
funded by a grant from the Foundation to the Charles B. Wang Community
Health Center and the Chinese-American Healthy Heart Coalition in
Manhattan. Through a series of workshops for at-risk seniors and
through partnerships with local restaurants and bakeries, the initiative
aims to improve awareness of heart disease and stroke, empower seniors
to take control of their health and increase healthy options in
local eateries. While there is a general misconception that Asian-Americans
are at low risk of developing heart disease, in fact a third of
Chinatown community residents have no physical activity and over
a quarter are overweight, according to preliminary data.
Exploring
The Links Between Heart Health, Stress And Depression In Indigenous
Populations Of Central Australia
A
study funded by Bristol-Myers Squibb, with a $45,000 grant to the
Heart Foundation of Australia, will focus on gaining a better understanding
why heart disease is seen in indigenous populations in Australia
at levels far higher than other groups in the country. It is believed
that stress, depression linked to their socioeconomic disadvantages,
unhealthy behaviors and poorer access to health care may be responsible,
as they are coupled with stresses associated with dealing with poverty,
unemployment and depression. Answering these questions could lead
to new social services and other interventions to help both Indigenous
Australians and the general population.
METABOLIC
DISEASE
Robert
Wood Johnson University Hospital At Hamilton Screens And Teaches
Nutritional Health, K-8
The
Diabetes and Overweight Screening and Support Program for Children
and Teens in Mercer County will intensify efforts to prevent type
2 diabetes in youth through targeted strategies based on healthy
lifestyles for healthy weight management in youth between the ages
of 8 and 13 years. The program, an extension of the existing Diabetes
Screening and Support Program for Children and Teens in Mercer County,
will be school and community-based, and aim to raise awareness among
youth and parents of the problem of overweight leading to a clinical
predisposition for type 2 diabetes.
Mercer
County school districts will work in close collaboration with Robert
Wood Johnson University Hospital At Hamilton to promote healthy
eating and lifestyle changes among their students, with school nurses
engaged in risk factor screenings to identify high risk youth. Parents
and teachers will be encouraged to enroll in the Robert Wood Johnson
Hamilton Center for Health and Wellness to take advantage of course
programs focused on healthy cooking, developing of exercise regimens
for themselves and family members, and active participation in the
Robert Wood Johnson University Hospital At Hamilton SHAPEDOWN program.
The
program receives two-year grant support of $218,000.
Harlem
Children's Zone Fights Childhood Obesity And Early-Onset Type 2
Diabetes In Black Youth
The
Harlem Children's Zone Obesity Initiative offers interventions to
address the imminent pediatric obesity health crisis in the Central
Harlem community, while investigating the efficacy of intense intervention
to improve caloric balance and education to sustain behavioral change
in students and their families.
The
program targets students in kindergarten through sixth grade by
providing three levels of interventions intended to prevent and
mitigate the health risks associated with obesity in 600 students,
annually. Of these students, 200 will attend Harlem Children's Zone
Promise Academy Charter School and 400 students will attend Harlem
Children's Zone after-school programs at five public elementary
schools in Harlem.
A
high intensity intervention group of students will receive healthy,
well-balanced school meals that meet or exceed the U.S. Department
of Agriculture nutritional guidelines, prepared by a dedicated expert
chef; will exercise at least one hour per day; will receive conceptual
education in the risk factors contributing to metabolic and cardiovascular
disease; and their parents will be offered monthly workshops that
promote health and fitness and cooking classes. Moderate and low
intensity interventions will be identical, but omit parental cooking
classes, and non-optimized school meals and cooking classes, respectively.
The
Harlem Children's Zone Obesity Initiative is supported by a $300,000,
three-year grant.
CDC
Foundation Trains Pediatricians And New Parents In Early Childhood
Metabolic Health
The
Healthy Lifestyles for Children Program aims to establish a healthy
caloric balance in early childhood (age 2-7). This early intervention
paradigm is favored based on a hypothesis that metabolic rate "setting"
may occur early in life, and may, if suppressed, predispose an individual
for adult obesity and its serious health consequences.
The
CDC will study, in collaboration with the American Academy of Pediatrics
(AAP), the Wake Forrest University School of Medicine and the American
Dietetic Association (ADA) the efficacy of parent health education
through a process referred to as "motivational interviewing," conducted
during scheduled visits to the pediatrician's office. The project
is designed as a small scale non-blinded clinical trial, with two
intervention groups (high and moderate), and a control group of
equal size.
A
three-year grant of $350,000 supports the training of participating
pediatricians and dieticians in Motivational Interviewing. The study
will evaluate the effectiveness of parental motivational engagement
and training by both pediatrician and dietician (high Intensity
intervention), pediatrician only (moderate), and neither (control)
in maintaining a healthy BMI and nutritional/exercise practices
in the young children.
Tribal
Colleges Prepares American Indian Nurses To Lead Metabolic Health
Program On Reservations
With
the incidence of heart disease is twice as high as in non-Indians
and is currently on the rise for American Indian women, and with
one in eight Native American adults suffering from type-2 diabetes,
due to genetic predisposition and dependency on high fat foods provided
through government food programs, the American Indian College Fund
takes a lead to fight the disastrous consequences of overweight
established in early life. The program that builds on "ownership"
of the responsibility to change within the tribal community, will
develop the curriculum for training of BSc nursing students at four-year
colleges to serve as trainers for Assistant Nurses in two-year programs,
in turn recruited to act as Youth Metabolic Health Leaders at tribal
community centers.
The
goal of this two-year demonstration project, supported by a $225,000
grant is to implement a program that leads to effective prevention
of obesity, diabetes and cardiovascular disease in American Indian
children and youth, and to replicate the program for large-scale
impact in the native American community.
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