The Nebraska Action Coalition’s, “Striving for Health Equity in Nebraska,” aimed to address social determinants of health by piloting a project delivering school health fairs, and improving access to care via an advanced practice registered nurse (APRN)-led clinic for rural and underserved populations.
The project team was able to complete both projects. Additionally, a manuscript to Nursing Education Perspectives journal is being prepared for submission.
Summary of completed project
- Nursing students who participated in the school health fairs project were educated in social justice and health equity topics and learned how nurses can play a role in supporting their communities while promoting health-wise behaviors amongst school-aged children. Relationships with Creighton University were strengthened to aid in the school health fair project.
- Building off the 2019 Nursing Innovations Fund, the University of Nebraska Medical College APRN nurse-led clinic continued to integrate the Community Health Worker as a key member of interdisciplinary health care teams, especially as it relates to mental health for those in rural and underserved communities in the state.
The Nebraska Action Coalition continued to be successful in fostering local partnerships and implementing projects, including a Certified Nursing Assistant Mentoring Program and a diversity in nursing pipeline intervention. They built on their history by continuing to forge new relationships while bringing innovation to their work.
The Nebraska Action Coalition focused on three projects designed to address health equity in under-resourced areas through innovative programs that focus on housing and access to health and health care. The project included:
- a pilot to identify and improve housing in a defined vulnerable area within the state;
- a survey to assess and establish a baseline of the Community Health Worker (CHW) role in the state; and
- a pilot study to assess the effectiveness of a mentoring project to support nurses’ aides in furthering their education.
Summary of completed project
In partnership with Live Well Omaha, the Action Coalition developed a pilot project to inspect and grade properties in collaboration with the Omaha Housing Authority, Nebraska Tobacco Alliance, and the Omaha Health Kids Alliance. They also developed a model worksheet for tenants to use to maintain healthy homes.
The Coalition administered a CHW survey in partnership with the Center for Reducing Health Disparities, a division of the University of Nebraska Medical Center College of Public Health. The survey results were disseminated through a report to stakeholders.
Lastly, the Nursing Pipeline Committee was formed, and a pilot program was developed to increase the number of nurse aides becoming registered nurses in the state. Phase one of the mentoring program was implemented with five nurse aides joining.
- Development of an evidence-based checklist tool for tenants to maintain healthy homes; this tool is now in use by the Omaha Housing Authority. Results from the pilot showed “improvement of tenant knowledge of healthy homes” and “improvement of the grade of the property.”
- A CHW survey and subsequent report, which was foundational in securing a state-wide CHW workforce assessment and three-year HRSA grant, focused on promoting and supporting the CHW in the state.
- Five nurse aides participated in the mentoring program, with two participants applying to nursing school and one being accepted.
The Nebraska Action Coalition planned on pursuing two projects. One project focused on involving nurses on a health literacy taskforce to develop a health literacy tool. Due to the departure of the lead for this project, the tool was not completed. The second project focused on involving nurses on a multidisciplinary supervision committee to develop guidelines for Community Health Workers (CHWs) across interdisciplinary settings. The third goal of project was to educate and engage nurse leaders on the role of CHWs and the supervision and value of this role to interdisciplinary teams.
Summary of completed project
In collaboration with the Douglas County Health Department and other partners, the Nebraska Action Coalition brought the perspective of the nurse as supervisor as part of the range of backgrounds of supervisors of community health workers to be included in a community health worker supervision toolkit. Following a “2018 Leadership/Culture of Health Conference,” the Action Coalition collected data on community health workers across the state. The Action Coalition did this in collaboration with the University of Nebraska Medical Center College of Public Health, its Center for Reducing Health Disparities, and Nebraska’s Department of Health and Human Services. Additionally, an open house included 40 participants from varied backgrounds including business, academia, diverse nursing organizations, and health care leaders to brainstorm and develop action plans focused on building a diverse nurse pipeline. In partnership with the A Place at Home, a homecare agency which employs diverse nurse aides, the Diverse Nurse Pipeline implemented a pilot for five pairs of mentor/mentees.
Members of the Action Coalition have participated in a number of statewide conferences to share information on the project to “raise up” the CHW role as an important interdisciplinary healthcare team member and the supervision direction, delegation, policy, regulation, and leadership roles related to the CHW role. Over 300 nurses (10 percent of the state’s nurses) were informed of the CHW role and the transformation of the interdisciplinary care team. A curriculum on the CHW supervision began in February 2019. The interdisciplinary team produced a report (Nebraska Department of Health and Human Services as the lead author, along with the Action Coalition and four other authors) that will be available in April 2020. Education of the healthcare profession on the importance of the CHW role to interdisciplinary health and healthcare teams remains a priority of the Nebraska Action Coalition.