Four County Health and Wellness Project

The project targeted three distinct audiences: school-age children, adults age 18 to 64, and the elderly. All clients had access to women’s health education, health screenings, hypertension counseling, smoking cessation counseling and education, mental health counseling, group and individual fitness activities, a cardiopulmonary resuscitation (CPR) certification course, domestic violence education, cooking and nutrition classes, and diabetes education.

School-age children received primary medical care services, well child exams, scoliosis screenings, testicular and breast self-exam education, safety and violence education, and parenting classes for teen parents. These services were provided at the school-based health centers. Elderly clients had access to the same services as other adults in addition to medication assistance and driving and home safety classes. Services for adults and the elderly were provided at the Four County Wellness and Fitness Center, the Lafayette Senior Center, well-known local agencies, and community events.

The project used a new and innovative method of health education and health behavior change called “health coaching.” Tested during the original grant period and implemented during the no-cost extension, this method involves a trained health coach who assists clients in understanding their current health status, defining client-specific goals, and developing strategies to overcome personal barriers to achieving those goals.

The project provided coaching services over the telephone and through materials mailed directly to clients. This method allows access to health information, advice, and counseling regardless of geographic location, inclement weather, schedules, and other potential barriers.

The project also delivered more than 1,000 units of safety/violence education, as well as 1,000 units of testicular/breast self-exam education and scoliosis screenings. In addition, the project provided approximately 350 units of women’s health education; 250 units of hypertension counseling; 175 units of safety classes for seniors; 175 units of domestic violence prevention education; 130 units of illness screening, treatment, well-child exams, and glucose/hypertension screening; and 70 units of diabetes education.

Other communities may want to consider providing fewer services at fewer facilities with a larger staff. Facilities are expensive to initiate and maintain. Taking services to the population—to the places they already frequent—is more likely to succeed than asking potential clients to come to a new facility they know little about and trust even less.

Project planners believe that, had the health coaching model been implemented earlier, the Four-County Health and Wellness Project would have been able to serve a substantially larger number of clients and would have had a greater impact on promoting meaningful health behavior change. This approach has great potential for replication in other rural communities where extreme geographic separation between clients and services is the norm.

The project was unable to secure new funding to sustain the services provided through the grant. The school-based clinics were turned over to the schools to administer as resources allow. The Wellness and Fitness Center closed. Although the network has disbanded, this project laid the foundation for these organizations to continue working together as new opportunities arise.