Department of Health and Human Services, Health Resources and Services Administration (HRSA) Delta States Rural Development Network Grant Program, award number D60RH30333-01-00, to implement its new and innovative program, “South West Alabama Health Improvement Initiative (SWAHII), in 18 of Alabama’s Counties (Barbour, Bullock, Butler, Choctaw, Clarke, Conecuh, Dallas, Escambia, Greene, Hale, Maco
n, Marengo, Monroe, Perry, Pickens, Sumter, Washington, and Wilcox). This funding allows for the promotion and encouragement of healthy communities. The goals of SWAHII are to: 1) reduce the prevalence of chronic disease in South West Alabama; and 2) reduce health care utilization and cost of persons with or at-risk of developing chronic diseases. The objectives are to: 1) reduce frequent use of the emergency room; 2) prevent unnecessary hospitalization; 3) reduce repeat hospital admission; and 4) support individuals in making life-style changes to prevent or reduce the impact of chronic disease and its associated risk factors through prevention and management strategies. The goals and objectives of the program are being accomplished through improved diseases prevention and management and care coordination in churches and rural health care facilities utilizing the evidence-based curriculum: The Body and Soul Wellness Program and Reducing Care Fragmentation Model: A Toolkit for Coordinating Care Program. The Body and Soul Wellness program encourages churches throughout Alabama to develop a wellness program designed to help their congregation lead a healthy lifestyle with a commitment from the leader (Pastor or designee). The Body and Soul Wellness curriculum, developed for African American churches, was developed by researchers at the University of North Carolina at Chapel Hill and Emory University. They worked together to develop, test, and distribute Body and Soul, a program that encourages proper nutrition among Black church members. The program incorporates healthy lifestyle education, church events, peer counseling, and has been proven to promote healthy food choices among participants. The Care Management of Chronic Diseases program component utilizes the “Reducing Care Fragmentation Model: A Toolkit for Coordinating Care.” This toolkit was designed for clinics, practices, and health systems focused on improving care coordination by transforming the way they manage patient referrals and transitions. The program encourages rural hospitals to seek out emergency room patients diagnosed with a chronic illness who require additional face-to-face care coordination. Participants in this program receive up to 9 months of supportive services. The program aims to reduce frequent use of the emergency room, hospital readmits, costs for care, and most importantly, improve life while coping with a chronic illness.
