Hospital for Special Surgery survey defines need for health outreach programs

November 1, 2016, Hospital for Special Surgery
Hospital for Special Surgery conducted a musculoskeletal health needs assessment in communities in lower Fairfield County, CT. Credit: Hospital for Special Surgery

Hospital for Special Surgery (HSS), which has an Outpatient Center in Stamford, plans to increase outreach and educational programs to meet the needs of surrounding communities. To that end, the hospital recently conducted a survey to assess the muscle, bone and joint health needs of people living in lower Fairfield and Upper Westchester Counties. Efforts were made to ensure input from residents in all socioeconomic groups, including underserved communities.

HSS researchers found that arthritis and were the most common diagnosed musculoskeletal conditions affecting survey participants. Falls were also a significant problem in the community: 25% of respondents said they had fallen in the past year, and 9% had sustained a fracture when they fell. Back and shoulder pain were the most common musculoskeletal ailments among the underserved population. HSS presented the study at the annual meeting of the American Public Health Association in Denver on November 1.

"We currently offer free monthly lectures on different health topics at the Stamford Outpatient Center, as well as health education newsletters. In the interest of enhancing our programs that serve the community, it was important for us to learn more about their needs and any potential barriers to care," said Pamela Sanchez-Villagomez, manager, Stamford Education Initiative at Hospital for Special Surgery.

"Musculoskeletal diseases are among the most prevalent health conditions in the U.S., resulting in financial and social burdens, especially in underserved ," said Titilayo Ologhobo, associate director of Outcomes in the Public & Patient Education Department at HSS. "We collaborated with many community-based organizations in lower Fairfield County, and they played an essential role in the development and implementation of our survey." The AmeriCares Free Clinics, the Stamford Department of Health and Social Services, various senior centers in the region, and several additional public and private organizations were instrumental in gathering information.

A Community Health Needs Assessment questionnaire, available in both English and Spanish, was distributed by email, standard mail and in person. Researchers also conducted limited outreach via social media. Target communities included Stamford, Greenwich, Darien, Norwalk, Westport and New Canaan. Additional surveys were sent to residents of Upper Westchester County.

Questions focused on health status and quality of life; health behaviors and lifestyle; health education; use of and access to care; and children's health. As a follow-up to the questionnaire, interviews were conducted with 25 Spanish-speaking members of community-based organizations to obtain additional information about the underserved population.

A total of 357 people responded to the survey, ranging in age from 20 to 89. More than half (57%) of respondents were age 60 or older, and 73% were female. Osteoarthritis was the most common diagnosed musculoskeletal condition overall. The most frequent barriers to care were a lack of health insurance or the cost of insurance.

Additional survey results:

  • 79% rated their health as Good/Excellent
  • 45% said a musculoskeletal condition interferes with normal social activities
  • 46% reported stooping, bending and kneeling as the most challenging daily activity

Among those with arthritis, other chronic conditions reported included:

  • High cholesterol (48%)
  • High blood pressure (42%)
  • Being overweight (37%)

In addition to the monthly community health seminars at its Stamford Outpatient Center, HSS currently offers a Tai Chi class at the Over 60 Senior Neighborhood center in Stamford. A bilingual instructor speaks both English and Spanish.

Armed with the information gleaned from the survey, HSS educators plan to expand wellness programs to meet the diverse needs of the community. "With what we learned from the survey, the Stamford Outpatient Center, which opened in 2015, is now well positioned to develop additional programs to promote good health and enhance mobility in local communities, particularly in underserved areas," said Sandra Goldsmith, assistant vice president, Education & Academic Affairs at Hospital for Special Surgery. Lectures, small group workshops, and exercise classes will be among the offerings.

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