In This Issue:
CHAD MORRIS, Ph.D., Director
For many of our Colorado projects, we have come to the end of not only an annual cycle but a three-year project cycle. While in the thick of administering these projects, incremental change can easily get lost. So we decided to use this newsletter as an opportunity for our team to reflect on a few of the projects we designed and helped breathe into life across multiple years.
Before we dive into what comes next, we want to take time to celebrate our successes. The journey was not always easy or linear. Indeed, some of these projects took a year, or more, just to firm up the curricula, a realistic scope, and community engagement. Fortunately, we have wonderful, innovative partnerships with community and state agencies, like the Colorado Department of Public Health and Environment.
Together, we have helped to move the needle on healthy behavior change for both persons facing health disparities and the providers serving these at risk populations. Whether the wins are large or small, BHWP, and other teams across the nation who are in the business of promoting wellness, can take pride in our accomplishments. We are changing the world, one person, one community at a time.
Wellness in Practice: Success Stories
Motivational Interviewing (MI) Training Institute
CINDY MORRIS, Psy.D., Clinical Director
Two years ago, the BHWP team envisioned creating a Motivational Interviewing Training Institute, where interdisciplinary providers would come to the Anschutz campus for MI intensives. Our team believed that the Institute would complement our existing programs to support wellness and behavior change. We were able to achieve this goal and are excited to continue to offer ongoing MI trainings several times a year on our campus.
At the same time, we have been pleasantly surprised by the interest from groups we didn’t intend to target for MI training. We have had many requests to adapt our MI trainings, both beginning and advanced, for targeted audiences who work with diverse populations and across a range of service settings. Our partnerships this year provided opportunities to tailor our MI trainings for occupational therapy and medical students as well as people who work in human services settings, corrections, primary care practice, and community health clinics. We adapted our trainings to meet these providers’ unique needs, such as increased program engagement, promoting vaccinations, treatment adherence, healthy behaviors, and smoking cessation.
With each new partnership, we are challenged to create a unique training experience that is both relevant and meaningful to participants, and which encourages novel applications of our Motivational Interviewing for Behavior Change (MIBC) training programs. During MI trainings, we have witnessed “ah-ha” moments when something just clicks as well as how the experiential exercises spark new ideas that lead to solutions for old problems. The new momentum and excitement generated during trainings creates an opportunity to energize daily practice. In turn, we are inspired by training participants’ commitment and dedication to their work and the people they serve.
We are looking forward to our upcoming MIBC – Level II (Advanced) training on July 31st and August 1st.
Registration is open for two upcoming BHWP Trainings!
Click below to learn more.
Motivational Interviewing for Behavior Change – Level II: July 31 – August 1, 2018
Rocky Mountain Tobacco Treatment Specialist Training Program: October 15 – 18, 2018
Collective Impact for High Public Service Utilizers
DEREK NOLAND, M.P.H., Community Liaison
The Collective Impact for High Public Service Utilizers Project started in July 2015 and BHWP oversaw the success of the project over the following three years. This innovative project reduced health inequalities around the greater Denver metropolitan area by screening people who were homeless or at-risk of homelessness for chronic diseases, focusing on cancer, diabetes, COPD and related respiratory conditions, and cardiovascular disease. Most importantly, the project employed Peer Navigators (PNs) to meet with the clients. The PNs were uniquely qualified to help the clients they served, as they had common past life experiences, and received additional training. PNs assisted their clients through navigation to services, education about chronic diseases, advocacy, and by serving as role models of recovery.
In order to access the hard-to-reach individuals the project served, PNs were placed in several key agencies over the course of the project. Two PNs were placed within the Metro Community Provider Network (MCPN), which operates medical clinics out of numerous locations in the Denver metropolitan area. Another PN was housed in the main branch of the Denver Public Library and served people who frequented the library. HOPE for Longmont, which offers outreach community resources and sheltering services, employed a PN who worked on-site and on the streets. Bridge House in Boulder hosted a PN for part of the project, who connected walk-in clients to a variety of services. Additionally, all of these organizations helped to screen people for housing opportunities, referring qualified candidates for consideration and placement.
Support for the partner agencies and the PNs was provided by a number of specialized organizations and key project personnel. The Metro Denver Homeless Initiative (MDHI) coordinated the search for housing opportunities, offered numerous training opportunities to the PNs, and collaborated with BHWP to provide general project support. The Colorado Mental Wellness Network (CMWN) provided many PN training resources, offered the PNs free enrollment in their 80-Hour Peer Specialist Training (which two PNs completed), and was a valuable source for identifying project personnel. Each partner agency designated a site supervisor; these individuals provided day-to-day oversight for the PNs in their place of work and were invaluable in assuring their success. A Peer Liaison served as an intermediary between BHWP and the PNs, while supervising their trainings and providing important professional and personal support on a regular basis. BHWP coordinated these roles and organizations, devised a strategy to evaluate the project’s impact, and convened a project Coalition with regular meetings to first design and then guide the project’s work.
Over the course of the three-year project, over one thousand people who were homeless or at-risk of homelessness were helped by the PNs and important lessons were learned about the value of PNs in assisting vulnerable populations. As excitingly, all of the PNs who were in place at the conclusion of the project accepted full-time employment at distinct area agencies to continue to serve in a similar capacity—clear confirmation of their work’s impact and value. For more information on the Collective Impact Summary, including important lessons learned, please refer to our Project Playbook.
“It Takes a Library”
CHRISTINE GARVER-APGAR, Ph.D., Research Director
Individuals with overlapping vulnerabilities such as homelessness, mental health conditions, and/or substance use conditions often have complex needs, yet these priority populations experience a vast array of barriers to accessing services. Across the U.S., public librarians are being called upon to address the immediate needs of their most vulnerable customers, particularly in urban cities with rising rates of individuals experiencing homelessness.
Denver Public Library (DPL) is increasingly filling a gap in helping to provide priority populations with access to human services, including benefits, substance use counseling, and crisis and mental health services. To meet this community need, DPL has operated a social work department since 2014. For the past few years, DPL and the Colorado Mental Wellness Network (CMWN) have received funding from multiple sources to initiate a Peer Navigator program at DPL and provide clinical supervision through the on-site social work department staff and CMWN. The most recent funding from the Department of Human Services, Office of Behavioral Health in 2016 was used to launch the “It Takes a Library” program with partnerships between CMWN (lead grantee), DPL, Denver Human Services, and BHWP.
Since 2015, Peer Navigators (PNs) have been employed at DPL to provide support and facilitate access to resources for DPL customers. At a practical level, PNs help individuals find resources such as temporary housing, food, or transportation, obtain important documents (e.g.IDs, Social Security Cards, etc.), refer customers to social services such as mental health or substance use treatment, and aid customers with tasks requiring computer and health literacy (e.g. filing for unemployment, signing up for benefits, securing insurance, etc.). Importantly, PNs offer customers far more than practical assistance. They offer people a human connection, emotional support, empathy, courtesy, and respect.
“I got to be the person I needed years ago.” – Peer Navigator at Denver Public Library
“It Takes a Library” has been successful on multiple levels. Within the past year alone, Peer Navigators and Social Workers have assisted nearly 3,000 customers at DPL. The Program has worked closely with the library Security Department to change the culture, and library staff members have expressed tremendous appreciation and gratitude for the program. PNs serve as a referral resource when librarians encounter customers who require services they are not trained to provide.
“The peer navigators are invaluable. They form connections with customers and remind both library staff and customers that everyone is a human being deserving of your time and consideration.” – Librarian at Denver Public Library
In 2018, the City of Denver recognized the value of peer support and the success of this program. Starting this month, the city of Denver has created city-funded positions for Peer Navigators at DPL, and the number of PNs will increase from four to six starting in January of 2019. Through the creation of these positions, job security is greatly strengthened for PNs at DPL, as program will no longer be reliant on soft funding.
BHWP has been privileged to partner on this successful effort, and we will continue to champion efforts to expand peer support services throughout the city of Denver and nationally.
JIM PAVLIK, M.A., Program & Policy Analyst
BHWP provides technical assistance (TA) to local public health agencies across Colorado working in the areas of adult cessation and facilitating health systems change. In June, we closed the final year of a three-year cycle. In the past three years, we’ve had several successes as a statewide community working to drive prevalence rates down in the face of dwindling attention to this issue, shrinking budgets, and macro-socioeconomic countervailing forces.
Providing TA means providing agencies existing tools and resources, connecting them to other professionals with on-the-ground expertise, conducting research and translating new scientific findings for application in clinical and public health settings. Sometimes, it means creating new resources when the existing materials just don’t suffice.
One of the things I’m most proud of this year as a TA provider is changing the nature of our bi-monthly Learning Community Calls—where the various agencies working in BHWP’s domains come together to share their experiences and learn from their peers. This past year, we had local public health agencies describe ongoing success stories with an emphasis on the nuts and bolts of what inspired these programs, what delays were overcome along the way, what alterations were made from inspiration to execution, and what the plans are for the future.
Writing about the successes we’ve had as TA providers puts me in an uncomfortable position. On the one hand, BHWP has spent a lot of time over the last several years changing what we provide TA on, the overall structure of the way TA is provided, and how that provision is evaluated for continual improvement. And while that’s exciting for an organizational policy nerd like me, it isn’t particularly flashy. I also don’t want to imply that I deserve any credit for the hard work of creating and executing these programs. And thirdly, even if I had three times the space to highlight all the great work, it still wouldn’t be enough space to write about all of it. So instead, I’ll mention four.
Weld County implemented a QuitLine referral program at their local food bank. Eagle County shared strategies and successes working with the Dental Health Alliance. Broomfield County described how they were able to tie tobacco cessation services to pre-existing processes (at a Detention Center and with their Diabetes Prevention Program). And Northeast Colorado Health Department detailed the long path toward working with the provider of court-ordered substance abuse treatment. Overall, these programs (and the countless others I didn’t mention), demonstrate the advancement of the patient-centered medical home away from only a patient-focused, doctor-led intervention model toward a whole person model where any site in a person’s life can serve as a hub of care—what we call a “health neighborhood”.
This is all great work worthy of replication in communities across the state. Since the beginning of the new cycle on July 1, I’ve already heard two great success stories I hope to share during this year’s calls—and we’re barely just getting started!