1. SPARC SICKNESS PREVENTION ACHIEVED THROUGH REGIONAL COLLABORATION
A Community Outreach Program to Promote Influenza and Pneumococcal Immunizatins To the Diabetic Population
SPARC
SICKNESS PREVENTION ACHIEVED THROUGH REGIONAL COLLABORATION
NIC March 2003 Regina Purinton, RN, BSN, CPHQ

2. A Community Outreach Program to Promote Influenza and Pneumococcal Immunizations To the Diabetic Population

3. A Community Outreach Program to Promote Influenza and Pneumococcal Immunizatins To the Diabetic Population
SPARC’s Mission
A non-profit health organization working in local communities to improve and extend the quality of the residents lives through the use of prevention services
SPARC
Serves over 650,000 people in
Berkshire County Massachusetts
Litchfield County Connecticut
Dutchess and Columbia Counties in New York.
Prevention services such as
Adult, and adolescent immunizations including flu and pneumococcal
Screening for
Breast Cervical, and Colorectal cancer
Hypertension and Cholesterol
SPARC collaborates with
Hospitals VNAs
Boards of Health DPH both local and state COA
Physician practices Public schools
Health Systems Churches
Local, state, and National including the CDC Elder services
(Center for Disease Control and Prevention) Community Centers
And through this program pharmacies 3 Peer Review Organizations
SPARC has designed and implemented programs for
Delivering Pneumococcal immunizations
Enrolling Women in mammogram programs
Arranging Hepatitis B immunizations clinics in schools
Implementing drive through flu clinics
NIC March 2003 Regina Purinton, RN, BSN, CPHQ

4. How Does SPARC Work?
SPARC works with collaborators to design and implement programs to increase access to and the use of prevention services
SPARC does not provide services
SPARC works with community agencies, MD offices, hospitals, health systems, churches and local businesses as well as peer review agencies and the CDC

5. Influenza and Pneumococcal
A Community Outreach Program to Promote Influenza and Pneumococcal Immunizatins To the Diabetic Population
Influenza and Pneumococcal
Pneumonia and Influenza rank 5th among the ten leading causes of death in the United States
Flu shots can reduce the rate of hospitalization
A substantial number of adults 50–65 years of age have one or more chronic conditions
Statistics from CDC
Pneumonia and Influenza rank 5th among the ten leading causes of death in the United States* for 65 years and older according to National Center for Health Statistics for 2000
Flu shots can reduce rate of hospitalization*
A substantial number of adults 50–65 years of age have one or more chronic conditions*
NIC March 2003 Regina Purinton, RN, BSN, CPHQ

6. Why We Chose to do this Program
A Community Outreach Program to Promote Influenza and Pneumococcal Immunizatins To the Diabetic Population
Why We Chose to do this Program
Patients with Diabetes are at risk for Influenza and Pneumonia
Opportunity to increase access to adult immunization for this specific population in the community
Opportunity to design, implement and pilot a new outreach effort
Recommended by ACIP, ADA and contributes to 2010 Healthy People Goals
Why We Chose to do this Program
Patients with Diabetes are at risk for Influenza and Pneumonia
Opportunity to increase access to adult immunization for this specific population in the community
ACIP recommends -Influenza vaccine should be recommended for patients with diabetes.Persons aged 2-64 years who are at increased risk for pneumococcal disease or its complications if they become infected should be vaccinated. Persons at increased risk for severe disease include those with chronic illness such as diabetes mellitus
ADA recommends
Healthy People 2010 goal is to increase the population at risk
Results from the Behavioral Risk Factor Surveillance System
Bureau of Health Statistics, Research and Evaluation Bureau of Family and Community Health June 1998
Diabetes Prevalence Four percent of Massachusetts adults, equivalent to approximately 196,000 persons, reported having been diagnosed with diabetes. And the rate of diabetes increased dramatically with age Source: Massachusetts BRFSS
Health Status Forty-two percent of people with diabetes in Massachusetts reported their health as fair or poor. After controlling for age and sex, people with diabetes were two and a half times as likely as those without diabetes to report their health as fair or poor (Figure 2). Diabetic individuals (17%) were also two and a half times as likely as people without diabetes (7%) to report that their physical health was not good on any day during the past month.
NIC March 2003 Regina Purinton, RN, BSN, CPHQ

7. Berkshire County Massachusetts
A Community Outreach Program to Promote Influenza and Pneumococcal Immunizatins To the Diabetic Population
Berkshire County Massachusetts
Northern Berkshire County is in the western part of Massachusetts
Seen here in the left corner of the map of Massachusetts.
The population of all Berkshire County is a approximate 139,352 ( from 1990 Federal Census)
NIC March 2003 Regina Purinton, RN, BSN, CPHQ

8. A Community Outreach Program to Promote Influenza and Pneumococcal Immunizatins To the Diabetic Population
NIC March 2003 Regina Purinton, RN, BSN, CPHQ

9. Program Participants SPARC Massachusetts Department of Public Health
A Community Outreach Program to Promote Influenza and Pneumococcal Immunizatins To the Diabetic Population
Program Participants
SPARC
Massachusetts Department of Public Health
Local Adult Immunization Collaborators
Community pharmacists
Flu clinic providers
SPARC work with collaborators to develop a flyer listing the dates, times and locations of public flu clinics throughout the area.
The Northern Berkshire Adult Immunization Collaborates
SPARC shared information and updates regarding vaccine supplies, educational materials, standing orders and criteria for immunization, etc.
The DPH is represented at the local adult immunization collaborators.
Community pharmacies
Flu clinic providers- The Northern Berkshire VNA, and physician practices
NIC March 2003 Regina Purinton, RN, BSN, CPHQ

10. Engaging the Pharmacies- Sending Out Letters
A Community Outreach Program to Promote Influenza and Pneumococcal Immunizatins To the Diabetic Population
Engaging the Pharmacies- Sending Out Letters
The purpose of the program
Describing collaborating partnerships
Explaining the role of the pharmacist
Introducing the project coordinator
Providing next steps
The letter was sent out from SPARC and supported by the Adult immunization Collaborative and DPH. The letter explained the goal of the program to increase the access to a flu shot for an at risk population persons with diabetes.
Recognizing the pharmacist unique position of identifying a diabetic customer who has prescriptions filled and or purchases diabetic supplies.
The Project Coordinator was identified and her role in coordinating the program.
NIC March 2003 Regina Purinton, RN, BSN, CPHQ

11. Next Steps Follow-up phone call
A Community Outreach Program to Promote Influenza and Pneumococcal Immunizatins To the Diabetic Population
Next Steps
Follow-up phone call
Review of purpose, responsibilities and support
Copies of materials shared and reviewed
Delivery of materials arranged
Personal visit to answer any questions
System set-up for questions and problems that might arise
The Program Coordinator call all the pharmacies.
This may take some time, due to the need to identification the person who can make the decision to participate in the program.
Then reaching the pharmacist, reviewing the program, sharing educational materials so that they are comfortable with information being distributed from their pharmacy
This may result in several phone call to each pharmacy over a period of weeks.
Scheduled an appointment with the pharmacist for delivery of materials.
Coordinator will need to gather a supply of materials and or print flu clinic schedules.
NIC March 2003 Regina Purinton, RN, BSN, CPHQ

12. Implementing Outreach
A Community Outreach Program to Promote Influenza and Pneumococcal Immunizatins To the Diabetic Population
Implementing Outreach
Display immunization posters and schedules in the pharmacy
Pharmacist identified the diabetic customer as they picked up medications and or supplies
The pharmacists placed a flu/pneumococcal immunization clinics schedule and diabetes/flu brochure in the customers bag
Meeting with the pharmacist
Review purpose of the program
Review materials to be placed in the customers bag
Brochure for Diabetes and the Flu
Flu clinic schedule
Request that posters be displayed in a highly visible area
Suggest posting the flu clinic schedule in highly visible area i.e. at the entrances, on the door and at the pharmacy counter
Provide pharmacist with a contact for supplies
NIC March 2003 Regina Purinton, RN, BSN, CPHQ

13. Materials Community Immunization Schedules SPARC Posters
A Community Outreach Program to Promote Influenza and Pneumococcal Immunizatins To the Diabetic Population
Materials
Community Immunization Schedules
SPARC Posters
CDC Diabetic/Influenza Brochure
If you Have Diabetes, a Flu Shot Could Save Your Life
Gather Materials
SPARC poster
Print local flu clinic schedule
Acquire CDC brochures from
DHP
The MassPRO
or print a supply
NIC March 2003 Regina Purinton, RN, BSN, CPHQ

14. Community Media Campaign
A Community Outreach Program to Promote Influenza and Pneumococcal Immunizatins To the Diabetic Population
Community Media Campaign
Flu/pneumococcal immunization clinic schedules distributed to physician offices
Flu/pneumococcal immunization clinic schedules placed as inserts in local newspapers
Local radio and community access TV advertisement
NIC March 2003 Regina Purinton, RN, BSN, CPHQ

15. A Community Outreach Program to Promote Influenza and Pneumococcal Immunizatins To the Diabetic Population
This is the cover of the Berkshire Flu Clinic Schedule
The cover is very striking this year after all we are competing with Smallpox for attention!
The Flu Clinic Flyer provided information, statistics, and sites, dates and time of flu clinic in Berkshire county.
The publication was used as
a newspaper insert for the local Sunday paper the Berkshire Eagle on October ---,2002
As a poster
A reference at pharmacies, physician practices and Council on Aging
NIC March 2003 Regina Purinton, RN, BSN, CPHQ

16. A Community Outreach Program to Promote Influenza and Pneumococcal Immunizatins To the Diabetic Population
Listing all the flu clinics in Berkshire county.
Recognizing the agency providing the flu clinics.
Frequently asked questions in which the criteria for the at risk population is incorporated.
Provides additional resources for information such as American Lung association, MassPRO, Department of Public Health, Adult immunization Campaign, County Health Departments SPRC and the CDC.
With websites, phone numbers, and addresses.
NIC March 2003 Regina Purinton, RN, BSN, CPHQ

17. VISITING NURSE ASSOCIATION & HOSPICE OF NORTHERN BERKSHIRE, NC.
A Community Outreach Program to Promote Influenza and Pneumococcal Immunizatins To the Diabetic Population
VISITING NURSE ASSOCIATION & HOSPICE OF NORTHERN BERKSHIRE, NC.
FLU CLINIC SCHEDULE 2002
**INTENDED FOR THOSE OVER 65 YEARS OF AGE AND THOSE WTH CHRONIC DISEASES
**MASSACHUESTTS RESIDENTS ONLY
10/30/02 SPRUCES AM WLLIAMSTOWN
11/04/02 ASHLAND STREET APTS AM N. ADAMS
11/04/02 HARPER CENTER 1-3 PM WILLIAMSTOWN
11/05/02 ST. JOSEPH’S COURT AM N. ADAMS
11/06/02 COLUMBIA VALLEY APTS AM ADAMS
11/06/02 COUNCIL ON AGING 1-3 PM ADAMS
11/07/02 BARRETT HOUSE APTS PM ADAMS
11/07/02 SAVOY SENIOR CENTER AM SAVOY
11/13/02 CHESHIRE SENIOR CENTER 12:30-2 PM CHESHIRE
11/15/02 MILLHOUSE APTS 2-4 PM ADAMS
11/18/02 CLARKSBURG TOWN HALL 1-3 PM CLARKSBURG
NIC March 2003 Regina Purinton, RN, BSN, CPHQ

18. A Community Outreach Program to Promote Influenza and Pneumococcal Immunizatins To the Diabetic Population
NIC March 2003 Regina Purinton, RN, BSN, CPHQ

19. Resources and Funding Grants Peer Review Agencies Local philanthropy
A Community Outreach Program to Promote Influenza and Pneumococcal Immunizatins To the Diabetic Population
Resources and Funding
Grants
Peer Review Agencies
Local philanthropy
Local businesses (banks)
Collaborators in-kind support
NIC March 2003 Regina Purinton, RN, BSN, CPHQ

20. A Community Outreach Program to Promote Influenza and Pneumococcal Immunizatins To the Diabetic Population
Challenges
Competition - the supply of brochures was underwritten by one chain – the other chain refused to use them
Obtaining corporate level approval for program
Labor intensive program, both coordination and material delivery
Measurement is difficult
A supply of If you Have Diabetes, A Flu Shot Could Save Your Life was underwritten by a chain pharmacy. This was great for the pharmacies in the area that were part of the chain, but competing pharmacies were not willing to accept the name of a competitor on the brochure. So, SPARC contacted several other sources including the DPH, the MassPRO and reproduced the a number of brochures with grant funding.
Some pharmacist were unable to make the decision to participate in the program locally. Corporate approval was necessary. This may require multiple phone calls, identifying the appropriate contract, share the materials, and obtaining approval on a timely basis.
Labor intensive:
Identify pharmacies in the community
Letter to pharmacies
Phone calls to pharmacies
Identify appropriate person
Follow up with appropriate person
gather materials – and or print materials
Deliver materials
Follow up with pharmacies
Media campaign
Measurement only in the number of participating pharmacies
NIC March 2003 Regina Purinton, RN, BSN, CPHQ

21. Successes Pharmacies cooperated The pharmacies suggest we do it again
A Community Outreach Program to Promote Influenza and Pneumococcal Immunizatins To the Diabetic Population
Successes
Pharmacies cooperated
The pharmacies suggest we do it again
The brochures were used up
Others want to replicate the project!
The pharmacies participated
They indicate they would do it again
Its good pr for them
The pharmacist we know who delivers shots likes it and is a great champion
One state department of health sent letters to other pharmacies within the state to suggest they try it
NIC March 2003 Regina Purinton, RN, BSN, CPHQ

22. SPARC SICKNESS PREVENTION ACHIEVED THROUGH REGIONAL COLLABORATION
A Community Outreach Program to Promote Influenza and Pneumococcal Immunizatins To the Diabetic Population
SPARC
SICKNESS PREVENTION ACHIEVED THROUGH REGIONAL COLLABORATION
Regina Purinton RN, BSN, CPHQ
Donna DiMartino RN, MSN
Douglas Shenson MD, MPH
NIC March 2003 Regina Purinton, RN, BSN, CPHQ