Fairness First Blog

Researchers’ voices in health equity

The Fairness First blog represents a space where researchers share with the broader community why health equity research matters to them, how do they connect to health equity, and what is the value of community engagement in the research process.

July 26, 2024

Celebrating Collaboration: Creative Partnership

Weaving together clinical education and patient care

This month we welcome Community Campus Partnership Support (CCPS) Program participants Dr. Holly Carroll and Heather Murray and two students, Alexandria Calca and Ian Splittorff. Longtime collaborators, Holly and Heather worked together over the past year to identify opportunities to increase access to healthcare for underserved people in Arizona and engage students in career paths that provide healthcare to people in underserved communities. Alex and Ian discuss their experiences as students working in the HUG Clinic and organizing an event (Healthy for HUG) to provide educational resources to community members.

The CCPS program funds partnership building activities that spark collaborative health equity research ideas and build capacity for community engaged research.

About the Team

University and Community Leads

Dr. Holly Carroll is the Associate Program Director for the Doctor of Physical Therapy (DPT) program at the Phoenix Bioscience Core. Heather Murray is the HUG Clinic Program Manager and has been a practicing clinician in physical therapy for over ten years. 

Students

Alexandria (Alex) Calca is pursuing a Doctor of Occupational Therapy degree at NAU’s campus in Phoenix. She received her bachelor’s degree at NAU in Flagstaff and has spent most of her life in Arizona. Ian Splittorff is a Doctor of Physical Therapy student in his second year. He grew up in Arizona and loves giving back to the community and volunteering with local groups.

Supporting University Partners

Several additional NAU faculty members participated in partnership building activities throughout the year. Supporting university partners include Lara Taggart, EdD, OTR/L (NAU, Occupational Therapy Program), Pamela Bosch, PT, DPT, PhD (NAU, Physical Therapy Program), Sarah Bolander, DMSc, PA-C, DFAAPA (NAU, Physician Assistant Program), and Hayley Root, PhD, MPH, ATC (NAU, Athletic Training Program).

About the HUG Clinic

Operated through the GateWay Community College, the Healthcare United at GateWay (HUG) Clinic is unique in that it facilitates hands-on clinical training for students while providing the community with much-needed, affordable care. In a state where many healthcare resources are limited, the clinic provides care to patients who travel from around the state for specialty services including physical therapy, occupational therapy, a pulmonary rehabilitation program, and ultrasounds. HUG patients come from economically disadvantaged families and the clinic provides pro bono care to meet the needs of these community members. The clinic is located in downtown Phoenix.

Developing a Partnership: Aligning Goals and Values

Aligning goals is an important aspect of developing a successful and meaningful partnership. Holly and Heather discuss how their roles, programming, and values complement each other.

HOLLY: I have collaborated on many projects with the HUG Clinic over the past eight years. Initially, the focus was on providing doctoral physical therapy (DPT) students integrated clinical education experiences with real patients. After sending students there for years, it became a passion and hope of mine to do more to give back to HUG as a clinical partner and to improve and expand our partnership. Over the past four years, Heather and I, along with some fabulous NAU students, have been creative with the addition of projects, events, and opportunities to give back to HUG and its clients.

HEATHER: When you look at the mission of Gateway and the HUG Clinic, our partnership with the Doctor of Physical Therapy program is a natural alignment. Our mission is to train the next generation of healthcare leaders and to provide specialty healthcare to uninsured community members and those who do not have the financial resources to cover their medical expenses. The work that Holly and I do together naturally aligns.

HOLLY: Both the HUG and NAU have missions that are focused around empowering students and improving the health of diverse members of our community. Our partnership has centered around clinical experiences that enable students to visit the clinic and treat patients. There couldn’t be a more natural alignment. 

Partnership Goals and Meaningful Impact

Here, the partners discuss their goals and why their work is important in their community.

HOLLY: Our goals for this past year were twofold. First, we wanted to explore ways to expand value-based healthcare services for underserved individuals in the state of Arizona. We did a couple of different things to support this goal. In addition to a “Lunch and Learn” with students to get their buy-in, we had meetings with leadership, the NAU Foundation, and our associate      dean. We wanted to bring together the right people to increase institutional buy-in and communicate the value of this partnership. In terms of expanding our reach, we thought about ways we can have more impact with patients in addition to the time that students spend with them at the clinic. Ultimately, our goal became figuring out a way to have a greater impact on the clinic’s patient community. This is where the idea for the Healthy for HUG event came from. The HUG had a long wait list and we wanted to use the event to connect with community members on the list and provide them with educational materials.

Our second goal was to explore a plan to engage future healthcare providers in Arizona to become stewards of societal health by providing team-based care that promotes the well-being of underserved individuals. The students were the most amazing part of this whole project. In addition to the event itself, the students from physical therapy, occupational therapy, athletic training, and physician assistant programs at NAU had the opportunity to work together, plan the event, and develop educational materials for the community. These are all great outcomes that will have a lasting impact, as Heather now has educational materials that she can continue to share with patients and at other community events.

A Special Place in the Community

HEATHER: Across the board, healthcare costs and the cost of living are rising. With the price of co-pays or out-of-pocket costs, many of our patients simply can’t afford the costs of treatment, even if they have insurance. Many people would have to go without services, so it’s important to have a pro bono clinic where people can receive high-quality treatment. I don’t know if we toot our own horns enough about the quality of treatment the students provide. We have our supervised licensed clinicians who apply evidence-based research to each patient’s treatment and we can spend a whole hour providing high-quality, direct patient care. When was the last time you were able to spend an hour with a dedicated healthcare professional? I’m proud to see all the work our students and clinicians do with their patients.

Looking into the future, pursuing partnerships, organizing more community outreach and workshops, and expanding our ability to provide services are going to make the clinic more robust. Additionally, we have NAU students participate in capstone projects to support our work.   One future interest is to develop a durable medical equipment closet. Many organizations have loan closets from which clients can borrow equipment or pay a small fee. We’d like to take this a step further and provide medical equipment to patients that they can keep. Often, patients come to the clinic with ill-fitting or broken equipment, which poses a safety risk to themselves and their caregivers. Developing programs like this and the quality of patient care we provide makes us a special place for the community.

HOLLY: My goal is to be able to help Heather and the HUG Clinic to see more patients and not have an extensive waitlist. Our students reflect on our goals, and they see the big picture so clearly. 

ALEX: As students, we really enjoy interacting with the patients at the clinic. That’s not something students always get during educational experiences. Being able to connect with and provide beneficial information to people who appreciate it is the coolest opportunity.

Interprofessional Development for Students

In addition to providing care at the HUG Clinic and pursuing their studies, students in the Bioscience Core’s healthcare programs participate in interprofessional activities that facilitate learning between students pursuing different healthcare professions. These events are key for developing a better understanding of the healthcare landscape and prepare students to work in cross-disciplinary relationships as they move forward in their careers.

HOLLY: I really wanted Alex and Ian to participate in this conversation to provide their perspectives as students. Our patients and students are the “why” behind the work we do. They are our focus. As a university, we understand the importance of pro bono work, community involvement, and giving back to the community in any way we can.

IAN: The interprofessional events are crucial to our professional development as students. Once we graduate, we’re going to be working with people who are in different medical and healthcare fields. I’ll need to know how to work with primary care physicians, occupational therapists, people who do medical imaging, and many other medical and healthcare professionals after I graduate and begin working as a physical therapist. It’s important that we’re starting to develop these interprofessional skills while we’re in school and we’re able to network with students in other areas. It’s cool that we can learn from each other and teach each other about our different fields. This approach will help us provide better treatment to patients when we become professionals.

ALEX: These cross-disciplinary events are just one example of the great opportunities students are exposed to. Not all programs offer this kind of interactive opportunity and it’s awesome that NAU makes this a priority and has been proactive about helping students with professional development. 

IAN: It’s been so cool to collaborate and learn from other students who are studying different areas of healthcare. We all go to the same school but we have classes at different times. Now that we know each other’s faces from the Interprofessional Education events, it’s nice to say hi and ask how their program is going. We can better understand and empathize with each other and learn about what we’re all good at so that we can better treat our patients.

Healthy for HUG: A Student-Organized Health Education Event

Working collaboratively with other students, Alex and Ian organized a health education event to share practical, health-related information with community members.

ALEX: As Holly mentioned earlier, the HUG Clinic had a pretty lengthy wait list. Since they work on a semester basis, not everyone on the list would be seen within the next three months. To find a solution for this, we considered how we could provide information to people who might not be receiving services and might not have access to healthcare.

IAN: One of the main goals of the Healthy for HUG event was to create an environment that supports health equity. We partnered with a community outreach program called Chicanos Por La Causa (CPLC). CPLC was formed in the 1960’s to address discrimination against the Mexican American community. Today, they focus on creating health equity and providing resources to individuals and families. We were excited to have them be part of the event.

ALEX: We came up with the idea of creating five stations where we could provide education, free items, and handouts on a variety of topics. The first station focused on general resources, prevention, and vital signs. We talked about free vaccine clinics in the area and took the attendees’ blood pressure. The second station focused on caregiver support, home safety, and adaptive equipment. Students demoed assistive tools and provided 3D printed tools that patients can use to make day-to-day life easier. For example, attendees could take home an ergonomic grocery bag holder if they or someone in their family has difficulty holding things. We also shared information about support groups for caregivers and respite services, and handed out a list of medical equipment and loan closets where people can rent or purchase wheelchairs, shower chairs, and other things they need that are not covered by insurance.

IAN: The third station focused on medication management and nutrition. We handed out reusable laminated medication tracking sheets that can be accessed without a computer or other technology. Students also provided clients with information on interactions between medications and food, which isn’t always obvious. The fourth station addressed balance, fall risk, and general exercise. We offered handouts on activities clients can do at home to mediate fall risk if they’ve just had a surgery or are generally trying to improve their balance. Another handout detailed why exercise is beneficial for all systems of the body, including cardiovascular, brain, and physical health. Patients could take home a brief exercise program and a Theraband to use for different exercises. There was one patient who came in a wheelchair, and they loved seeing exercises that they could do in their wheelchair. Lastly, we organized a mindfulness station where we gave tips about how to be mindful, practice meditation, and use breathing exercises you can do to improve your mental health.

Language-Inclusive Event Planning

HOLLY: I want to note that most of the clients who attended the event speak Spanish. The students did an amazing job navigating language barriers throughout the event recruitment and the night of the event. They really focused on inclusive outreach to engage with our Spanish-speaking clients.

HEATHER: Anytime you’re doing event planning, there’s so much work behind the scenes. I want to commend the students who volunteered to participate in this event. They were great about looking at who our target audience is and being mindful of cultural differences and access to technology. To promote the event, Spanish-speaking students came into the clinic to make calls. We made sure that all of the printed materials were available in English and Spanish, and all of our marketing went out in Spanish. There were multiple Spanish-speaking speaking students at each station during the event so that each client could participate fully. Additionally, many clients don’t have an email and don’t use voicemail. The students were persistent, making multiple follow-up calls in an effort to engage with people on the waitlist. They were extremely organized and intentional about recruiting and inviting patients to the event.

Reflecting on Collaboration

HOLLY: I’m grateful for Heather. We’ve worked together for many years, and she puts up with my crazy ideas and is willing to try new things and figure out ways to meet our goals. But partnerships are also hard. I don’t mean that in a negative sense. It’s a lot of work to try and hold up your end of the bargain and it can be challenging to collaborate and coordinate a group of people. It’s often about the give and take and figuring out what we can do to support each other. In the end, seeing the students come together and hold the event was really rewarding.

HEATHER: It was really rewarding to take a step back and identify how to align our missions, provide services to patients, and support students who are studying in different fields. The more we talked and learned from each other, the more benefits we saw from these community health events. There are a lot of opportunities for students to give back to the community and for patients to be able to engage with students as a resource. I enjoy the development process we’re starting to go through.

It’s been gratifying to see how the students have worked together. They were so engaged and enthusiastic; Holly and I stood back and they planned the event. Their ideas were right on point, and they organized a successful event. The students are passionate about what they’re doing and this is a wonderful environment that fosters that passion. As they go into the workforce they’re going to have the mentality for collaboration.

ALEX: Identifying all of our strengths was a big part of the event planning process. It was important to play to our strengths and get to know each other. Recognizing that we’re all individual people outside of our student and work roles helped with teamwork as well.

Ideas for the Future

The group considers next steps, new directions, and how they might grow the Healthy for HUG event to further meet the needs of the clinic’s patients. 

HOLLY: Based on feedback from people who attended the event, we know that HUG clients want more events like this and they hope to learn more about other topics. In particular, there’s a lot of interest in information on mental health.

ALEX: For a first-time event, it went really well and we had a solid amount of people show up. Everybody who said they were going to come attended the event and I think they really valued the experience. I valued the experience of working with other students. I think it would be great if we could make this an annual event or even a semesterly or quarterly event.

HEATHER: Looking forward, it would be great to scale up this type of event. For example, our medical facility has a lot of parking space, and we could use this area to host a healthcare fair. We have space to provide more community-focused events and there are lots of ways to utilize our space, get more students involved, and expand our reach. We are developing family caregiving classes in our safe patient handling and mobility lab, and we have a kitchen where we could offer nutrition classes for the community.

The clinic and our students are an important educational resource to the community. There are so many opportunities to partner with universities to extend the amount of services that we’re able to give. The infrastructure of the health clinic is already in existence so when we have doctoral students here, it gives us a larger, more robust reach in our community.

Interested in learning more about health equity partnerships and research?

Visit CHER’s social media for short stories that highlight SHERC researchers, students, lab spaces, and more! Look for “Fit it in a Minute” posts.