MCW Community-Engaged Projects

Environmental lead disproportionately impacts vulnerable groups, including children living in low-income areas and ethnic and racial minorities. In Milwaukee, the highest lead levels are contained in old housing stock.

Advancing a Healthier Wisconsin (AHW) is funding a collaborative lead prevention project with the Medical College of Wisconsin, Children's Wisconsin, Children's Health Alliance of Wisconsin, and Social Development Commission (SDC). The project's goal is to increase the connectedness between the clinical enterprise, the City of Milwaukee Health Department (MHD), community response, and parental engagement following a positive lead test. Increased connectedness and communication will help mitigate ongoing lead exposures and decrease lead poisoning. We aim to evaluate how lead testing is accomplished and the mechanisms that clinics use to communicate with the community. The project anticipates impacting sustainable changes in testing practices, care coordination between primary care and the MHD, a deeper understanding of parental concerns, and reformed approaches to improving housing.

The project is currently connecting with individuals and groups with concerns about environmental lead, including parents and community leaders, community-based organizations, clinicians, the local and state health department, coalitions, and the city housing department. For more information, please contact Kairee Hamelin: khamelin@mcw.edu.

View project webinars to learn more about lead in Milwaukee and ongoing work of the partnership:

• Community Solutions to Lead Webinar
• Clinical Solutions to Lead Webinar
• Webinar Series Recap

project in the news

Overview
The Medical College of Wisconsin, in partnership with the Milwaukee County Organizations Promoting Prevention (MCOPP) Coalition, and Y-EAT Right, Nutritional Consultant for Healthy Living, received funding and collaborated with the Wisconsin Chronic Disease Prevention Program to implement evidence-based programs and activities through the CDC-funded: Improving the Health of Americans through Prevention and Management of Diabetes and Heart Disease and Stroke (1815 Grant) program. The 5-year 1815 project, which began in October 2018, was to carry out work to prevent and manage diabetes, heart disease, and stroke. Using CDC support, WI DHS, MCW, and MCOPP partners focused on implementing and evaluating evidence-based strategies to manage diabetes and prevent or delay the onset of type 2 diabetes in high-burden populations and communities.

Strategies and Work
The project work incorporated a health equity lens to reach populations most impacted by chronic diseases through communication, education, and skill-building. Strategies focused on Diabetes Self-Management Education and Support, Community Health Workers, Team-Based Care, Nutrition Education & Food Preparation Skill-Building, and Self-Measured Blood Pressure Monitoring.

As a part of the project, the Days of Learning podcast hosted by David Nelson, PhD, professor in the department of family and community medicine came to fruition. The Days of Learning podcast is a series focused on health, wellness, medicine, community engagement, and how these connect and influence chronic disease management and the health of our communities. In addition to the podcast, the Back to the Kitchen Series was created, hosted by Yvonne D. Greer, DrPH, RD, CD of Y-EAT Right, Nutritional Consultant for Healthy Living, and moderated by Dr. David Nelson from the Medical College of Wisconsin. Each session began with a recorded food demonstration and ended with a facilitated discussion around the session theme with community champions.

• Listen to the Days of Learning Podcast
• Watch Back to the Kitchen Series on YouTube

Outcomes

• Increased access to self-measured blood pressure programs and resources in community settings, with a tie to community health worker support
• Provided nutrition education and healthy food preparation skill-building to patients at risk for prediabetes and hypertension from
  underserved communities of color, specifically the North and South sides of Milwaukee's priority populations
• Established new community-clinical linkage to promote and refer patients with type 2 diabetes to Diabetes Self-Management Education and Support services or the Healthy Living with Diabetes Program

ACKNOWLEDGMENT:
This project was supported by funding from the Wisconsin Department of Health Services Chronic Disease Prevention Program Improving the Health of Americans Through Prevention and Management of Diabetes and Heart Disease and Stroke 5-year cooperative agreement (CDC-DP18-1815) from the Centers for Disease Control and Prevention.

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Milwaukee PROMPT: Prevention of Opioid Misuse through Peer Training

Background
Drug overdose is recognized as a leading cause of accidental death in the United States. In Milwaukee County between 2012 and 2015, drug overdose deaths related to opioids increased from 144 to 231 deaths per year. Heroin was the most common drug found in toxicology reports and the majority of overdose victims were white males with an average age of 43 years. Since 1999, prescription opioid sales have increased by 300% despite no change in the amount of pain reported by Americans. Higher prescription rates for opioid analgesics are associated with increased opioid use disorder (OUD), addiction, and diversion (defined as illicit transfer of opioids from the person to whom they were legally prescribed to someone else).

Project Strategies
Project Milwaukee PROMPT: Prevention of Opioid Misuse through Peer Training addressed opioid misuse among veterans at Dryhootch, a community partner which provides peer mentoring services to veterans returning from combat and has witnessed the rise in opioid addiction. The Milwaukee PROMPT team aims to work across disciplines to forge innovative ways to address OUD among veterans. The PROMPT project focuses on prevention of OUD in a subset of the Milwaukee veteran population by seeking to change their knowledge, attitudes and behaviors related to opioid use through a peer-delivered curriculum. Using community engagement (CE) strategies, we aim to develop and implement a trauma-informed, peer mentoring approach to OUD prevention. The team plans to merge focus group input from veterans with clinicians’ expertise to collaboratively develop an OUD prevention curriculum. The curriculum—delivered by peer mentor specialists at Dryhootch—will consist of targeted modules and will incorporate Trauma-Informed Care (TIC) strategies. Mental Health America Wisconsin (MHA) will support the peer mentors working with veterans by providing supervision, consultation, training, and program and curriculum development.

Partnerships
A team of partners from the Medical College of Wisconsin (MCW), Dryhootch, and Mental Health America of Wisconsin (MHA) have contributed to the development of this project. Dryhootch is a nonprofit organization founded in 2008 by a Vietnam veteran with a mission of “helping veterans and their families who survived the war, thrive in the peace.” Their coffee shop serves as a community rally point to provide a welcoming, drug and alcohol-free environment for veterans, families, and community members. From 2010-2014, Dryhootch administered a SAMHSA-funded grant to provide peer-to-peer recovery support services and found that generally, the 658 veterans who participated experienced positive outcomes in substance use, mental health functioning, and social and economic well-being. Dryhootch recognizes that peer support empowers veterans to overcome issues such as PTSD, traumatic brain injury, depression, drug and alcohol addiction, family relationship issues, unemployment, and homelessness and has collaborated with MCW for about a decade on health-related efforts for veterans. MHA is an affiliate of the national non-profit dedicated to helping all Americans achieve wellness by living mentally healthier lives. They have experience running programs for populations affected by opioid addiction, were the first organization in Milwaukee to have peer mentors and have observed that trauma is almost universal among the people they serve.

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