In an era of spiraling healthcare costs, there’s a growing awareness of the positive role that experts from the healthcare field can play. That doesn't just mean doctors and other clinicians, but also food and nutrition professionals. And indeed, an increasing number of are reaching out to their local communities with informational programs that aim to connect the dots between the amorphous term “nutrition” and actual good health.
There may even be a financial benefit to community nutrition and wellness outreach programs in the form of insurance reimbursement, says Karen Lechowich, vice president of diversity and external relations for the Academy of Nutrition and Dietetics. Lechowich concedes that the “reimbursement area” for such efforts is “very complex and complicated,” but that “perhaps some insurance groups reimburse for group settings for diabetes education, for example, in a retirement center.” Also, she notes, the impact of the Affordable Care Act ("Obamacare," or ACA) on this area has not yet been fully explored but may well offer additional benefits for providing such services, given its emphasis on reducing healthcare costs through preventative care.
Others with their eye on the impact of the ACA point to the creation of large Accountable Care Oranizations (ACOs) and other healthcare delivery models that will be reimbursed not on individual fee or service charges but with "flat fees" negotiated for large groups of individuals using the ACO. Such models would have a built in incentive to keep participants healthy and better educated about health and nutrition issues so they can receive primary care or counseling before medical issues become critical hospitalization issues.
On the nutrition front, one of the more effective approaches to community outreach is the chef demo, which leverages the growing cultural interest in the culinary arts, the so-called "Food Network Effect." Many healthcare providers have found that such events can be a very effective outreach tool, especially for those most in need of nutrition education.
For example, when health and wellness cooking demos are presented at the Cardiac Rehab Center of the Geisinger Health System in Danville, PA, they are geared to the general community in the area and posted in community newspapers. These events tend especially to attract Geisinger's former cardiac patients and their families and that’s just fine with Rebecca Crotti, RD, Geisinger’s Healthy Selections Coordinator.
“In fact, one of our most popular Guest Chefs is one of our cardiac patients,” she says. “We always have a dietitian there with any of our Guest Chefs (many are restaurant chefs invited from the community) to make sure the appropriate educational message is provided.”
This summer, as in summers past, a 15-week long “Get Fresh Market” program, which includes a cooking demo repeated throughout the day, is held by Geisinger each Wednesday from 10 a.m. to 5:30 p.m. To support local and sustainable produce, a different in-season fruit or vegetable is highlighted each week in the cafeteria.
In June, strawberries were the first item spotlighted in a recipe that meets the Healthy Selections guidelines (30% of calories or less from fat, etc.). "We’ll provide recipe cards for that recipe as well as others featuring that item,” Crotti explains. Also disseminated are educational handouts detailing how to select and prepare the item, as well as its nutritional benefits. Such information is especially welcome for less familiar items such as okra and bok choy, Crotti notes.
Although all programs presented by the Food & Nutrition Services Department (typically in collaboration with the Wellness Department, the Clinical Nutrition Department, and the Sustainability Department) are open to visitors and guests of the nearly 900-bed system, they have until recenly focused on the internal audience, but that is changing. For example, “our Wellness page is in the process of switching to an external web page so the community can access it whenever they choose,” Crotti reports.
Geisinger’s Marketing Department does maintain a presence on broad market social media platforms such as Facebook and Twitter and it also has an Events page on the facility’s external website. “Especially during March—National Nutrition Month—we’re on the local TV news segments a lot promoting anything we’re doing for the public in regard to healthful eating,” Crotti points out. "There’s great excitement around the new Get Fresh Market." That event is held in Geisinger's state-of-the-art Expo Kitchen, where the cooking demos can be recorded and put on the hospital's website.
For the past nine years, there has been a Health & Wellness Fair held at the 130-bed Meadows Nursing & Rehabilitation Center in Dallas, PA, which is managed by Cura Hospitality. When clinical dietitian Rebecca Sims, RD, LDN, organized the first fair, she corralled 10 vendors to come and set up their tables. This past April, there were 33 and approximately 100 attendees from the community.
“Our objective is to provide an opportunity for the community to learn about Cura Hospitality and The Meadows and to take advantage of the free services offered at the Fair,” Sims explains. Services include screening or monitoring of hearing, vision, blood pressure, blood sugar and so forth.
The Center’s own Therapy Department conducts free balance testing, gait screening and more while Sims' table is the main nutrition location where attendees know they can get their Body Mass Index measured and get samples of nutritious but low-calorie snack packs from Nabisco, Crystal Light On-the-Go water-flavoring packets from Kraft and—new this year—NuGo high protein nutrition bars from NuGo Nutrition, along with all the corresponding literature from the manufacturers.
“Companies want to get their names out there,” Sims asserts. “Over the years, we’ve learned the best time to hold the Fair is during the week from 10 a.m. to 1 p.m., so we’ll not only attract retirees but also the moms and kids. ‘New’ companies keep calling me, so we’re growing. In order to get bigger, we’ll have to move outside under tents—and schedule a rain date,” she laughs.
Thus far, The Meadow’s dietary department has not gone out into the community to provide nutrition seminars, but “Tip of the Week” nutrition-based posters displayed in the cafeteria are seen by a wide audience that includes staff members, volunteers and residents' families, “so word does get out,” Sims says. A typical “Tip” might focus on Better Choices When Eating Out (Share an entrée; choose baked versus fried potatoes, etc.).
“In the future, your health insurance—that is, the premium you pay—may be more tied to your health risk, such as being a smoker or being overweight,” says Julie Jones, MS, RD, LD, director of nutrition services at Ohio State Wexner Medical Center. Therefore, Jones and her colleagues at Wexner, including nutrition events program director Chef Jim Warner, aim to give the community as well as the 50,000 Ohio State University staff and their family members who are covered by the facility’s insurance, the resources to live a healthy life.
The overall focus is on fitness, stress and relaxation, as well as nutrition, Jones says. Under the umbrella Culture of Health and Wellness program, Jones aims to get in on the ground floor, so to speak.
“We’re trying to connect ‘food’ and ‘nutrition’ for the patients, customers, clients. We’re showing them real food, how to buy it, how to cook it (demos and recipes provided), and translate it to how the body uses it. So, here at the Medical Center [and out in the community] we create the culture and provide the resources for people to be successful.”
Forging partnerships: Providing specific nutrition information and diet regimens tailored to the needs of discharged patients (including cancer, heart, diabetes, etc.) is a given, but Ohio State Wexner actively seeks to create partnerships in the community that will help them serve the underserved, a role that Warner (a 1979 CIA-Hyde Park grad) is particularly adept at. In fact, this year up to 80 programs—some in-house, some out in the community—will be presented, thanks in part to various partnerships.
“We try to partner with everyone, including the Columbus Public Health Department for a Health Fair,” Warner says.
Another partnership is with the Somali community in Columbus, reportedly the third largest in the country. “Since they’re a nomadic people, fruits and vegetables were not part of their traditional diet," Warner explains.
"We meet them where they are, at their community center and so forth, so that they’re comfortable in the surroundings. We’re teaching them, sometimes with an interpreter, about food and nutrition in a context they can understand. Although members of the first generation often stick to the old-style cooking, we talk to them about the need for fruits and vegetables. We’re also trying to reach out to the youth to teach easy ways to prepare food with reduced fat, reduced sugar and so forth.”