Chevron Corporation Helps Family Medicine Promote Patient Self-Management of Chronic Diseases

The Miller School’s Department of Family Medicine and Community Health received a $100,000 gift from Chevron Corporation to encourage patients in Miami’s Overtown and Little Haiti communities to take a more participatory role in managing their own health care—especially in the face of chronic diseases such as diabetes.

For eight years, the department has operated a community-based outreach program through Jackson Health System’s Jefferson Reaves Sr. Health Center, which provides medical care to patients across Miami-Dade County.

As many as 17 percent of patients who seek care at Jefferson Reaves have diabetes, and for each person diagnosed with the disease, at least 10 more are at risk or undiagnosed. With those statistics in mind, the department operates what John G. Ryan, Dr.P.H., associate professor of family medicine and director of primary care/health services research and development, calls a “clinic within a clinic” funded through a multi-year gift from the United Health Foundation.

The foundation gift helps support the department’s efforts to promote health awareness and participation among members of the Overtown and Little Haiti communities. While the program emphazes diabetes awareness and management, its services are administered by a multidisciplinary team that provides health care for an array of other medical conditions as well.

To address patient self management of diabetes, the department developed a curriculum which explains what it means to have the disease and teaches patients how to care for and monitor their condition, and seek treatment when needed. Such educational and group activities, along with personal interaction and one-on-one training and evaluation, are intended to make participants aware that they are equally responsible for their own health, in partnership with trained medical professionals. To date, some 1,000 people have participated in the program, which also addresses mental health, women’s health and obstetrics.

The Chevron gift will complement the United Health Foundation-funded program to ensure that participants become empowered and receive the tools they need to better monitor chronic health conditions. “When untreated, diseases such as diabetes can lead to problems with the skin and feet,” says Dr. Ryan, “so we will provide patients with a ‘foot care package’—a small plastic tub and mirror—which allows them to examine and care for their feet. It’s a small but important first step in helping patients participate in their own health care self management. Next steps might include reimbursement for transportation to medical appointments, or small stipends for medication, but for now we’re starting small.”

Such distributions, however, do come with accountability, as participants are expected to attend ongoing classes and seminars about health-related topics specific to their condition.
Dr. Ryan wants patients in the largely low-income target communities to know that money should not be a barrier to health. “Preventative steps and regular care don’t cost a lot,” Dr. Ryan says. “If we can catch diseases like diabetes in the early stages and encourage patients to monitor and care for themselves—before conditions become serious—we can prevent a host of other problems, saving money and lives in the long run.”

Once patients are in the program, they become more aware of their general health and become an integral member of their own health care team. And, perhaps most importantly, they share the information they learn with family members, friends, and others in the community.

“The Jefferson Reaves Sr. Health Center project serves a critical role in our community. We are proud to support this initiative as part of our global effort to help build and maintain healthy communities in the places where we operate,” says Alexandra Valderrama, regional manager for policy, government, and public affairs for Chevron Downstream, Latin America.

Chevron, one of the world’s largest integrated energy companies, is focused on creating sustained economic growth by building human and institutional capacity, targeting resources toward providing for basic human needs, education and training, and economic development.
The Department of Family Medicine and Community Health has a long history of community service, with a mission to improve access for patients and the effectiveness of primary medical care throughout the Miami-Dade community.

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