Much of what the Community Health and Wellness Department at Chester County Hospital does is geared toward chronic disease prevention. In recent years, it has entailed improving access to healthcare in historically underserved communities.
While this is a hospital-wide undertaking, Michele Francis, MS, RD, CDCES, LDN, Director of the Community Health and Wellness Department, and her modest staff could be considered its vanguard. They collaborate with local groups to stage health screenings within such communities.
Last year, in honor of Juneteenth, Francis and her staff, with support from the Abramson Cancer Center at Chester County Hospital, staged a colon cancer screening drive-by at Jubilee Evangelistic Ministries in Coatesville. Free take-home kits were given to 24 people – regardless of their insurance status – and were later collected from a designated drop box at the Coatesville Area Public Library and tested at the hospital. (Gift cards were awarded to everyone who returned a test kit.) From those results, five people were asked to undergo further diagnostic testing.
Francis and her department rarely do anything outside of the hospital on their own. Instead, they develop relationships with groups that have worked in these communities for years and try to cover the gaps in their coverage. For example, the W.C. Atkinson Memorial Services Center and Jubilee Evangelistic Ministries helped spread the word about the Juneteenth screening throughout Coatesville and Francis asked the Minority Nurse Educators of Chester County to take blood pressure readings during the event as well. The group and the Atkinson Center are also helping Francis identify churches in Coatesville that the hospital could donate several available automated external defibrillators, or AEDS, to. An AED is a device that’s used to help those experiencing sudden cardiac arrest.
"We really make the most of our resources by partnering with organizations like the Minority Nurse Educators," Francis says. "These working relationships also help our credibility among the very people we're trying to help because the groups we're collaborating with are entrenched in their communities."
A similar event was held in November outside of Penn Family Medicine New Garden in Kennett Square, PA which serves a growing Spanish-speaking population, much of which is under or uninsured. On this occasion, 19 people took a colon cancer screening kit home with them, and one person was asked to undergo further testing.
The department also screens for fall risk, heart disease, and osteoporosis, among other conditions. The screenings all use guidelines from national health organizations to categorize risk and recommend appropriate lifestyle changes and/or medical follow-up.
Importantly, they're all free and open to everyone, regardless of whether they have health insurance or not.
Chad Thomas, MPH, PMP, Community Health Education Coordinator for the Community Health and Wellness Department, holds a variety of certifications. His ability to speak Spanish is perhaps just as valuable to Francis and the department’s outreach to underserved communities.
He receives calls and does follow-up outreach among Spanish-speaking communities. He's also worked closely with the Iglesia Metodista Unida El Buen Samaritano in West Chester, PA to schedule and help facilitate health screenings for its parishioners.
"Chad has really helped us extend our reach," Francis says.
Thomas says many who registered for the November colon cancer screening could not speak English or read in any language. "So the instructions that we gave them had to be verbal," he says.
While registering people and explaining what’s about to happen to them in their native language may seem like a small task, it helps builds trust which is lacking in many minority communities. Francis believes that it's a gradual process that no single screen is going to resolve.
"It's about showing up for them again and again and proving that we can be helpful," she says. "That's what we’re trying to do."
