From my experiences as a former community health worker advocating for better housing conditions to improve a child’s asthma exacerbation to supporting a victim of homelessness through his worsening depression, I recognized how intricately linked social determinants of health were to physical and mental health. I was excited to see how the Baystate Health Wellness on Wheels (WoW) bus expands this further by delivering care directly into the community in Springfield, MA. The Springfield population is a thriving and diverse melting pot, made up of a BIPOC majority population, and consequently, one that is especially disenfranchised. This community houses a high density of families in public or low income housing and many households have an average income of less than $53,000. The COVID-19 pandemic has isolated these communities even further and exacerbated ongoing health issues. The aims of the bus in addressing these issues are two-fold: deliver precision community health and establish an interprofessional classroom for health professions students.
Precision community health offers a unique way to tailor health interventions by providing practical, community-specific solutions. To put this into practice, the WoW bus team used GIS mapping to pinpoint communities in need of services and collaborated with community partners who have longstanding trust within the communities. The team developed community care plans focused on each communities’ individual needs and translated this to effective outreach, education, and service initiatives. Furthermore, in developing an interprofessional classroom, the WoW bus creates an immersive learning experience for health professions students by offering opportunities for building partnerships with important networks in the community and joining efforts in addressing health disparities.
Some of the services offered by the WoW bus include blood pressure and diabetes screening, health education, COVID-19 testing and vaccines, and care coordination with referrals. The WoW bus team is one that is interprofessional and united in their commitment to the public health of Springfield and experiences in community health. Recent WoW bus initiatives integrated a mobile vaccination team. It is hoped that continuing this unique model will incorporate more interprofessional members such as physicians, advanced practitioners, nurses, pharmacists, physical therapists, occupational therapists, community health workers, and students across these disciplines. While the team stays within their scope of expertise to care for their patients, this care is very closely-coordinated, with constant communication and troubleshooting to ensure that gaps are not missed. Working through critical public health issues in this practical setting affords an invaluable learning opportunity.
Pharmacy students at Western New England’s College of Pharmacy and Health Sciences and medical students at UMass Chan Medical School had the opportunity to participate in this interprofessional classroom as part of the Population and Community Health Clerkship (PCHC). The PCHC is a two week experience that students partake in during the fall semester under an academic or community preceptor. PCHC aims to contextualize many of the key public and population health concepts we learn through our coursework through service, problem-solving, and advocacy. We worked closely with the WoW Bus team to understand its trajectory and work on outreach projects to further the goals of the WoW bus. We reimagined ways to expand the focus on precision community health by developing innovative health education tools. Our first step was partnering with key stakeholders who work intimately with community based organizations in Springfield. We were curious to learn how they established meaningful connections within their community, unique socioeconomic issues they were confronting, and their recommendations on best forms of outreach. The spectrum of health literacy and understanding of successful educational practices were essential in developing outreach tools. We created a social media campaign and a proposal for a monthly event series, “Brunch at Brightwood”, to raise awareness of chronic health conditions. Our experience was supplemented with 413Cares training to navigate care coordination for our future patients. The WoW bus vaccination event was a firsthand application of community-based care during which we created care packages and health education materials geared towards vaccine hesitancy. Our PCHC experience culminated in sharing our efforts in a final virtual symposium with other students. The clerkship included an advocacy component, pitched to healthcare providers and local politicians, in which we presented an idea for the addition of a community health worker to the WoW bus team. From our research, we emphasized the role of community health workers in addressing the barriers to care by effectively reducing healthcare costs and being the final link in attaining better racial health equity.
The PCHC experience offered a cohesive opportunity to grow more uniquely attuned to the health inequities exacerbated by socioeconomic challenges. We allied with key stakeholders and leveraged their expertise to advocate for the Springfield community. The far-reaching impact of a coordinated effort increased our accountability as community partners towards furthering the bus’s emphasis on community-based care. Integrating a team of medical and pharmacy students also extended this interprofessional learning experience to understanding more about each other’s scope of practice. This experience offers students an opportunity to think about how they will share their knowledge with their peers and also seek out further opportunities to be involved in interdisciplinary care with the end goal of better patient outcomes.
Pooja Dutta, 2nd year PURCH medical student, UMass Chan Medical School – Baystate