Running head: SERVICE LEARNING PROJECT PLAN

Service Learning Project Plan

Naomi Everett
Frostburg State University

SERVICE LEARNING PROJECT PLAN

Service Learning Project Plan

Name: Naomi Everett
Date: July 18, 2015
Community or population of interest
The city of Brunswick, Maryland is located in southern Frederick County. According to
2010 U.S. Census data, Brunswick has a total population of 5.870 (U.S. Census Bureau, 2010).
Tables 1, 2, and 3 exhibits population by sex and age, ethnicity, and race.
Table 1
Population by Sex/Age
Male

2,884

Female

2,986

Under 18

1,591

18 & over

4,279

20-24

323

25-34

735

35-49

1,406

50-64

1,099

65 & over

578

(U.S. Census Bureau, 2010)

Table 2
Population by Ethnicity
Hispanic or Latino

290

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Non Hispanic or Latino

3
5,580

(U.S. Census Bureau, 2010)

Table 3
Population by Race
White

5,063

African American

438

Asian

97

American Indian and Alaska Native

10

Native Hawaiian and Pacific Islander

Other

72

Identified by two or more

189

(U.S. Census Bureau, 2010)

Table 4 exhibits the leading causes of death in Frederick County in the year 2010.
Table 4
10 Leading Causes of Death in Frederick County, 2010
Malignant Neoplasms

332

Diseases of the Heart

316

Chronic Lower Respiratory Diseases

92

Cerebrovascular Diseases

88

Accidents

62

Influenza and Pneumonia

46

Alzheimers

37

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Kidney Disease

31

Diabetes Mellitus

23

Septicemia

23

Intentional Self-Harm (Suicide)

21

(Frederick County Health Department, 2012, slide 7)

The population of focus for this service learning project is the many people living with
chronic illnesses in Frederick County, specifically Brunswick, Maryland. Chronic illnesses for
the purpose of this project include: asthma, heart disease, cancer, and diabetes. The prevalence
rates for these chronic conditions and there risk factors for Frederick County are depicted in
Table 5.
Table 5
Prevalence of Chronic Disease and Chronic Disease Risk Factors in Frederick County
Prevalence

Incidence

Rate 2011

Rate 2009

Angina or Coronary Disease

2.6%

High Cholesterol

35.3%

High Blood Pressure

22.6%

Diabetes (excluding gestational)

9.4%

Chronic Obstructive Pulmonary Disease

7.1%

Adult Asthma

13.0%

Cancer (per 100,000 and are age-adjusted to 2000 US standard population.)

(Frederick County Health Department [FCHP], 2014).

463

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Review of literature and health outcomes data

According to the Centers for Disease Control and Prevention (CDC), chronic illness are
the leading cause of death and disability in the United States of America citing heart disease,
stroke, cancer, diabetes, obesity, and arthritis among the most common, costly, and
preventable of all health problems (Centers for Disease Control and Prevention [CDC], 2015,
para. 1). As of 2012, about half of all adults117 million peoplehad one or more chronic
health condition(s). One of four adults had two or more chronic health conditions (CDC, 2015,
para. 1). 48% of all deaths in 2010 were caused by heart disease and/or cancer (CDC, 2015).
CDC reports multiple health risk behaviors that, if modified, positively affect the mortality and
morbidity of those living with chronic illnesses. These modifiable behaviors include: increasing
physical activity, controlling blood pressure, increasing consumption of fruits and vegetables,
smoking cessation, and reducing binge drinking (CDC, 2015). How does this data translate to
Frederick County?
Frederick Memorial Hospital is the only hospital in Frederick County and, unfortunately,
serves as the medical home for many in our community with chronic illness that are not being
managed by a primary care provider. People without access to medical homes or any kind of
primary medical care tend to rely on hospital emergency rooms for their care (Frederick
Memorial Hospital [FMH], n.d., p. 36). 25% of FMH ED visits in 2010 were for non-emergency
management of chronic illnesses (FMH, n.d.). The overarching goal of the Frederick Memorial
Hospital (FMH)s 2013 Community Health Needs Assessment (CHNA) of Frederick County,
Maryland is to collect data that will serves as a research tools to be used by various entities in
Frederick County that positively impact our communitys health status (Frederick Memorial
Hospital [FMH], n.d.). Based upon CHNA data, FMH has identified the following objectives:

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reduce emergency department (ED) visits related to asthma, reduce deaths from heart disease,
and reduce overall cancer death rate, reduce ED visits due to diabetes (FMH, n.d.).
In an effort to address these objectives Frederick Memorial Hospital launched the Bridges
Program (Bridges) in 2012. Bridges uses Building Healthy Communities through MedicalReligious Partnerships as model for its program (Bennett & Hale, 2009). In their book, Bennett
and Hale (2009) explain that health care works best when patients assume greater responsibility
for their own health, [and because it this] community outreach and patient education have taken
on increased importance (Project MUSE, n.d., para. 1). The most important element of Bridges
is the enlistment of Lay Health Educators (LHE). LHE are volunteers that commit to a series of
10 educational sessions and then present this information to their faith communities. The LHE
could be a parish nurse and anyone in the faith community that has a passion for health and
wellness and the ability to communicate what they learn to their faith community. Two cohorts
have already been trained but there is no LHE coverage for the Brunswick area. A map that
combines the distribution of LHE over Frederick County and areas of high density of medically
at-risk population reveals that Brunswick would benefit greatly with support from LHE and has
been designated a target area for Bridges (Appendix).
The three major health concerns for those living with chronic illnesses in Frederick
County are: improving outcomes, avoiding hospital admission and emergency department visits,
and improvement of self-management skills.
Your selected health concern focus
The selected health concern focus for my service learning project is improving outcomes
for people living with or at risk for chronic illnesses; namely: asthma, heart disease, cancer, and
diabetes. This population issue needs to be addressed to prevent deaths associated with chronic

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illnesses. In addition, improved self-management of chronic illnesses will improve the quality of
life for the individual as well as better utilize healthcare dollars by reducing emergency room
visits and hospitalizations. The goal is to provide care within the community setting, rather than
in the hospital.
Three possible nursing interventions
Three possible interventions that specifically address modifiable health behaviors
include:

Promote chronic illness self-management programs though wellness education.

As previously mentioned, health care works best when patients assume greater
responsibility for their own health, [and because it this] community outreach and
patient education have taken on increased importance (Project MUSE, n.d., para.
1). Providing wellness education to those living with chronic illnesses will
increase their ability to self-manage their disease.

Address obesity by promoting physically active lifestyle and healthy eating. CDC
defines obesity as having a BMI of 30 or greater (Centers for Disease Control and
Prevention [CDC], 2010). Obesity contributes to the following medical
complications: stroke, heart disease, lung disease, cancer, and liver disease (CDC,
2010). Two interventions that the CDC recommends to address adult obesity are
increasing physical activity and improving access to healthy foods (CDC, 2010).

Increase access to primary care services by ensuring individuals affected by

chronic illness have a medical home. The medical home is a cultivated
partnership between the patient, family, and primary provider in cooperation with
specialists and support from the community (U.S. Department of Health and

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Human Services [HRSA], n.d., para. 2). The medical home model promotes the
concepts of patient-centered care and increases a patients access to quality
primary services.
Your selected nursing intervention
I have selected the nursing intervention of promoting chronic illness self-management
programs though wellness education. I have selected this interventions because I agree with the
statement made by the Bennet and Hale (2009) that the best way to promote wellness is to assist
the patient to assume responsibility for their chronic illness(es).
The first goal to be met with this intervention is to increase the knowledge of chronic
illness prevention and management of the Brunswick Community by December 2016 as
evidenced by the participants ability to define three health promoting behaviors. The second
goal is to increase wellness behaviors in the Brunswick Community by December 2016 as
evidenced by the participants taking part in at least one of the following: influenza vaccination,
pneumococcal vaccination, increase in physical activity, weight loss, stated decrease in stress, or
smoking cessation.
Brief plan for conducting nursing intervention
I will contact our local faith community leaders to identify potential Lay health
Educators. While Brunswick does not have a formal ministerium, we do have Brunswick
Ecumenical Assistance Committee On Needs or Beacon. The primary function of Beacon is to
provide food and emergency financial assistance to those in need, the most vulnerable citizens
of the Greater Brunswick Community (Brunswick Beacon [Beacon], 2015, para. 1). While the
mission of Beacon is not specifically wellness, all of the major churches in Brunswick are
Beacon members. It is for this reason that I wish to present Bridges to Beacon member

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churches; to reach the faith leaders that are already actively participating in the community. I
will make the initial presentation to the President of Beason, Phil Graves, explaining what the
Bridges Program is entails and why Brunswick needs Bridges. Beacon member churches meet
quarterly. It is my aim to arrange for Janet Harding, FMHs Director of Cultural Awareness and
Inclusion, to make the full 30 minutes presentation at Beacons next member meeting. After the
presentation the member churches will bring this information back to their faith community. The
goal is to train at least two LHE in the Brunswick community. There is not enough time to
identify potential LHEs and have all the contracts signed before the next cohort starts on
September 8, 2015, but another cohort will begin training in January 2016.

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References

Bennett, R. G., & Hale, W. D. (2009). Building healthy communities through medical-religious
partnerships (2nd ed.). Baltimore, MD: The Johns Hopkins University Press.
Brunswick Beacon. (2015). About. Retrieved from http://www.brunswickbeacon.org/about/
Centers for Disease Control and Prevention. (2010). Adult obesity. Retrieved July 26, 2015, from
http://www.cdc.gov/vitalsigns/AdultObesity/index.html
Centers for Disease Control and Prevention. (2015). Chronic disease overview. Retrieved July
18, 2015, from http://www.cdc.gov/chronicdisease/overview/index.htm
Frederick County Health Department. (2012). Public health: Prevent-promote-protect Frederick
countys health [PowerPoint slides]. Retrieved from
https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=4&cad=rja&uact
=8&ved=0CDAQFjADahUKEwjL2qWwqOfGAhWBQT4KHQRbAIs&url=http%3A%2
F%2Fstatic1.1.sqspcdn.com%2Fstatic%2Ff%2F481003%2F16787910%2F13301169258
27%2FFredForumHealth1.pptx%3Ftoken%3DVYxVyYZ6Ne2a50ewMbVuf4HZGEs%2
53D&ei=HqirVcvTFoGDQGEtoHYCA&usg=AFQjCNFxdEhUzupqKl2sa2EVeL0olnDdJA&sig2=spiQRHZASW
KWQ796_KKLJg&bvm=bv.98197061,d.cWw
Frederick County Health Department. (2014). Community health assessment. Retrieved from
http://health.frederickcountymd.gov/DocumentCenter/View/307
Frederick Memorial Hospital. (n.d.). Frederick memorial hospitals 2013 community health
needs assessment for Frederick County, Maryland. Retrieved from
http://www.fmh.org/workfiles/Community%20Health%20Assessment%20PDF.pdf

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Health Resources and Services Administration. (n.d.). What is a medical home? Why is it
important? Retrieved from
http://www.hrsa.gov/healthit/toolbox/Childrenstoolbox/BuildingMedicalHome/whyimpor
tant.html
Project MUSE. (n.d.). Building Healthy Communities through Medical-Religious Partnerships.
Retrieved from http://muse.jhu.edu/books/9780801895777
U.S. Census Bureau. (2010). 2010 census interactive population search: MD - Brunswick city.
Retrieved from http://www.census.gov/2010census/popmap/ipmtext.php?fl=24

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Appendix

Lay Health Educator Distribution Map