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U. of C., South Side NCPs do Grand Rounds

In the medical field, grand rounds do not typically involve dramatic reenactments of grief-induced depression due to community or domestic violence, or panelists who have had harrowing sexual experiences like becoming pregnant right out of grade school or contracting HIV from a partner they thought they could trust.

But the Community Grand Rounds program, which paired the Center for Community Health and Vitality at the University of Chicago Medical Center with several South Side lead agencies in LISC/Chicago's New Communities Program and Elev8, had a more broad-based, less medically oriented audience than the usual scenario, and the partners adjusted the format and tone accordingly.

Photo: Courtesy University of Chicago

A scene from the production of "For Colored Girls ... ," presented as part of the Community Grand Rounds project at the Power Circle Church in South Chicago.

“Typically, a grand rounds discussion is around something an inch wide and a mile deep,” says Doriane Miller, M.D., director of the Center for Community Health and Vitality, which received a National Institutes for Health grant to conduct the meetings in the 34 communities that comprise University of Chicago’s primary service area.

But when the University of Chicago met with NCP groups to discuss the Community Grand Rounds concept, they “said they didn’t want people talking at them,” Miller says. “They wanted conversations with not just university faculty but also members of the community involved in doing work in these areas.”

Brandon Johnson, executive director of NCP lead agency the Washington Park Consortium, notes that the Community Grand Rounds were based on the World Health Organization’s broader definition of health, which includes not only one’s own vital signs but those of the family and community environment.

“It’s in line with what the New Communities Program does,” he says. “Just as we’re looking at comprehensive community development, they’re looking at comprehensive health factors. What’s most encouraging is that it’s community based and focused. It’s a balance between academic health factors and community sentiment about health. It did a good job to respect community sentiment and translate that into best practices.”

Photo: Courtesy University of Chicago

Dr. Doriane Miller (center) of University of Chicago Center for Community Health and Vitality led the Community Grand Rounds project, which rolled out in South Side New Communities from October 2010 through June of this year.

The planning phase of the program, which began in March 2010, also included the Near North Healthcare Services Corp. and Northwestern University’s Alliance for Researchers in Chicagoland Communities, a clinical and translational sciences group. The partners to the effort discussed the most pressing health needs in each community and what sorts of approaches they might take to address them through community education events.

The issue of mental health in young people, specifically depression that results from the aftermath of the violence they’re exposed to, ranked top on the list. The group eventually chose seven topics to be presented in Auburn Gresham, Englewood, South Chicago, Woodlawn, Washington Park and Quad Communities. The Community Grand Rounds ran from October 2010 through June 2011.

“The community partners said, ‘Don’t do this at University of Chicago or Northwestern, but set up where we are, in the community,’ ” Miller recalls. “Each event was at a community site, whether a school, church or community center, facilitated by a community partner.”

Second-Hand Drive-By Victims
The first Community Grand Rounds, held at Perspectives Charter School in Auburn Gresham—site of that community’s Elev8 programming—featured a play that Miller wrote, titled “It Shoudda Been Me.”

Photo: Courtesy University of Chicago

Ernest Sanders, NCP organizer and communications director for Greater Auburn Gresham Development Corp., helped to coordinate--and then acted in-- a production about a teenager's murder called "It Shoudda Been Me."

The story focused on a 15-year-old whose best friend had been killed in a drive-by shooting. The formerly “rock solid” B-plus student started skipping classes, handing in sub-par assignments, and getting into minor tiffs with people he had considered friends, Miller says.

“He finds out he is suffering a grief reaction and depression as a result of the murder of his friend,” she says. “His parents start to talk about this and finally stage a family intervention to get the young man some help.”

About 175 people attended that first session, which Miller says was “timely in terms of what the community is thinking about. We had a post-play discussion that I facilitated with a pediatrician who does work with depression, plus a community-based psychologist who talked about early recognition, treatment, and resources available in the community.”

Scheduled to run from 5:30 to 7:30, the session went until about 9 o’clock, and those who missed it had the chance to see it later on CAN-TV, which broadcast the event three times during the month of November, Miller says.

“We decided to do a play and act it out, and see if folks could identify with what’s happening on the stage,” says Ernest Sanders, NCP manager and communications director at Greater Auburn-Gresham Development Corp., lead agency for both NCP and Elev8. “Especially among youth, they typically don’t have an outlet. We wanted to demonstrate that and, at the same time, have folks in the room who could provide some sort of support to youth who have mental health issues.”

That focus on mental health draws from the Elev8 program in Auburn Gresham, which has discovered that the No. 1 reason why Perspectives students visit the in-school health clinic is due to mental health-related issues, Sanders says. “For me, that was just like, ‘Wow, we’ve got to do something about that.’ This is my way of engaging that, or at least attempting to provide some answer there,” he says.

Photo: Courtesy University of Chicago

Spirited discussions took place about a variety of health and wellness issues during the Community Grand Rounds.

“Folks got to hear first-hand testimonies and share their story of what they were going through,” Sanders adds. “It was an eye-opener for everyone in the room.”

Community Violence, Domestic Violence
Another session, held last November at the K.L.E.O. Community Family Life Center in Washington Park, focused on community violence, mediation and interruption.

The session looked at resources around violence mitigation, models for confronting violence, and the immediate health consequences of violence, Johnson says. Speakers included staff from the K.L.E.O. center, violence “interrupters” from the anti-violence group CeaseFire, and a person who had been paralyzed in a shooting incident.

“It was very much a dialogue,” he says. “Not only did we look at various programs and models being used to stem violence in our communities, but we heard from community members about how violence had affected them. It was a good session in that it was cathartic in allowing people to express their pains and struggles, but therapeutic in that there were options and proscriptions for moving forward, especially for parents with children affected either as victims or perpetrators.”

Placing an issue like violence in the WHO’s broader health rubric gives a community more options to address it, Johnson says. “If you have diabetes, they’re not just going to tell you to take insulin; they’re going to tell you to diet, exercise, and this is what happens if you don’t treat it, and these are the possibilities if you do,” he says. “If you diagnose the issue, you can think about it as something that can be rectified and cured.”

Photo: Ernest Sanders/GADC

Panelists at a Community Grand Rounds event called "Live Life Before You Give Life.

South Chicago NCP hosted a session on domestic and intimate partner violence, which drew upon that community’s participation in LISC/Chicago’s Building Community Through the Arts program and the subsequent inclusion of arts planning in the NCP process. “We were able to capitalize on their particular quality-of-life plan and have a dramatic presentation … around domestic violence,” Miller says.

Called “Wish You Were Here,” the monologue performance was given by a grandmother who raised her granddaughter because the child’s father had killed her mother. The performance raises questions about why doctors sometimes don’t recognize signs of domestic violence. “It’s a soul-searching investigation for the grandmother and her family, and it raised issues around how to think about this from a medical perspective,” she says.

Sexual Health, Diabetes, Asthma
Other sessions focused on sexually transmitted diseases and pregnancy, preventative medicine around diabetes and obesity, health issues with regard to older adults, and how to deal with asthma, Miller says, and all received enthusiastic reactions.

Photo: Courtesy University of Chicago

Brandon Johnson (right) of Washington Park Consortium saw the Community Grand Rounds as entirely congruent with the New Communities Program's comprehensive mission.

Teamwork Englewood
took on two sessions, one about HIV and pregnancy and one about asthma, says Jacques Conway, executive director. “It was really good for us,” he says. “The issues they brought forth to the community are something we’re dealing with on a regular basis.”

The HIV and pregnancy session, held at Urban Prep Teen High School, brought together University of Chicago medical personnel and young men and women who had experienced both sexually transmitted disease and unplanned pregnancy. These included an athlete who had to drop out of college when he got a girl pregnant, and a girl who became pregnant at age 14, right out of grammar school.

“It got heated, too, which was good,” Conway says. But “just talking with the kids afterward, they still to a certain degree don’t’ believe it can affect them. … They still feel, ‘I know who I have sex with, I know it’s OK.’ ” The idea has arisen to do a mini-series on the topic, building on the session, since it seemed to leave unfinished business.

The asthma session, which included medical personnel, asthma sufferers and parents of children who have the disease was a bit more formal, Conway says. They discussed medicines to treat it, getting children in the habit of using their inhalers, and dealing with a combination of asthma and allergies.

“It was a great initiative by the University of Chicago,” he says. “They’ve certainly been transparent and open to comments, feedback and complaints. … Many of their administrators and doctors participated, and they were helpful and informative, and we had a chance to see them. You have an idea of what these intellectual doctors look like. When you see them outside their buildings, they look like ordinary people.”

Photo: Ernest Sanders/GADC

"They didn't want people talking at them," Miller says of NCP groups. "They wanted conversations with not just university faculty but also members of the community involved in doing work in these areas."

Miller returns the compliment to Teamwork and other NCP groups. “The involvement of our NCP partners has been absolutely spectacular,” she says. “They made sure the content we presented and the information shared with community partners was relevant to day-to-day realities, as opposed to programs that talk about the medical model of care. … The feedback we received, the results we had in terms of audience participation surveys, show that people found it to be a very valuable and important experience.”

The experience deepened University of Chicago’s ties with the communities involved, Miller says. “Universities in general come in with their own agenda,” she says. “They don’t listen to a community about their priorities. They figure out programs in a vacuum with minor consultation from communities. Partners say, ‘This could have been better if you had just talked to us in the first place.’ ”

But programs that involve people at the grassroots from the outset are more likely to last, Miller says. “It’s that level of not just community engagement but also thinking about positive community programs that are involved in health and well being and revitalization in the broadest sense is why we decided to partner with NCP,” she says. “Often times, people have the answers and solutions at hand. People often tell me, ‘I have a PhD of the streets. I understand my community’s needs and priorities. If you bring the best science and what we know, we can bring solutions.’ ”

The Center for Health and Vitality hopes to bring Community Grand Rounds to Chicago Lawn and other communities the project did not visit in 2010-11. “This is something that’s seen of tremendous value to the university, in terms of partnership,” Miller says.

“It was a very unique way for the university to set up shop in the community and not just be known virtually,” Sanders adds. “They came out into the community and made a presence. That’s one of the deliverables. Everybody sees the University of Chicago as the University of Chicago. It can’t be touched. The only way you get there is the emergency room.”

To read about another joint New Communities Program-University of Chicago project, called Asset Mapping, please click here.

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