Broadening the Scope of a Family Medicine Residency Program to include community outreach to a fishing village in rural Nicaragua AAFP Global Health conference Sept 13, 2014 Danielle Richardson PGY3 Lauren Gaw MA Marianne McKennet MD Kendra Brandstein MPH

Activity Disclaimer ACTIVITY DISCLAIMER It is the policy of the AAFP that all individuals in a position to control content disclose any relationships with commercial interests upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflicts of interest (COI), and if identified, conflicts are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity. Danielle Richardson, Lauren Gaw, Marianne McKennett, and Kendra Brandstein have indicated they have no relevant financial relationships to disclose.

Background of Scripps Family Medicine Residency We are small community program south of san diego.

Background of Scripps Family Medicine Residency Our patient population is made of medically underserved communities along the California and Baja California border region Our curriculum focuses on border health issues and community medicine Our training is based on the COPC model Continuity clinic in FQHC

Scripps Family Medicine Residency in Chula Vista, CA

Scripps Family Medicine Residency in Tijuana, Mexico

Scripps Family Medicine Residency in San Quintin, Baja California

Scripps Family Medicine Residency’s Global Health Goals Train and inspire family physicians to care for underserved populations locally in Chula Vista, across the US-Mexico Border, and internationally

Scripps Family Medicine Residency’s Global Health Goals Broaden residents’ knowledge about global health issues Create a collaborative partnership with other organizations serving this population Support an international community clinic

Playa Gigante, Nicaragua

Playa Gigante, Nicaragua

Community Background Playa Gigante is a small fishing community on the south western coast of Nicaragua. It is very isolated but is quickly becoming known for its proximity to superior surfing and beautiful landscape. The majority of people live on $3-7 USD/day. 79% of the population has no greater than a 6th grade education. The average age of residents is 26 years old.

Variety of housing, use wells and latrines

Background of Project WOO Project Wave of Optimism was created in 2006 by two avid surfers that served as Peace Corps volunteers in Central America. Their mission is “to facilitate community-driven development in Latin American surf travel destinations.” by Nick Mucha, and Adam Monaghan,

Vision Project Woo’s vision is to build positive relationships within the community Encourage local empowerment Help raise awareness of local issues and promote local participation and leadership.

Community Meeting

Needs Assessment The results of a 2012 needs assessment showed the overwhelming need and desire for a local health clinic 80% of the people involved rated it as their top priority and need. Residents of Gigante also highlighted health education as a key issue that they would like to see addressed.

The Playa Gigante Community Health Center The 850 square foot community health center opened in Playa Gigante in early 2014.

The Playa Gigante Community Health Center Run by the local Comité de Salud Staffed by a full time physician and a clinic manager

Our work together thus far Pediatric Screenings and Nutrition Assessments Explain how we discovered prob of anemia and junk food

Our work together thus far Community Outreach and Education

Our work together thus far Anemia Initiative: Screen and treat all children under 5 y/o Start a community spinach garden Community nutrition classes Work with schools to create a healthier learning environment

Future joint projects might include HTN and Diabetes Brigades Woman’s Health Water and Sanitation Nutrition

Next Steps Strengthen our relationship with WOO, other NGOs, and the MINSA Develop formal curriculum that includes longitudinal resident involvement Faculty preceptors travel to Nicaragua with the residents Integrate this project into our community medicine month

Challenges Explore ways to financially support the community health center as well as our partnership Longitudinal funding for resident and faculty travel Evaluation of outcomes

Discussion Experience among participants who have established longitudinal global health experiences