Bread for the City
1525 Seventh Street, NW
Washington, DC 20001
http://www.breadforthecity.org
Anticipated Project(s): Healthy Living: Fitness and Medications
Bread for the City has several ideas on which to build from the 2008-2009 ISCOPES team’s project. The previous team provided the groundwork on health literacy with specific focus on medication compliance, as well as developed tools to assist low-literacy patients in understanding how to use medications correctly. The tools were pretested and approved by the clinic director. The medication compliance tools were to be utilized in conjunction with cooking, nutrition classes and exercise groups to teach participants how proper nutrition, regular exercise, and medication compliance work together to optimize health. Medication compliance learning tools have been completed and used in the clinic, and an aerobic exercise plan has been developed. Future projects can focus on nutrition and exercise in conjunction with monthly Peer Educator meetings and cooking classes to develop an overall knowledge among patients on how nutrition and exercise play an important role in every aspect of health.
Expectations of Team Members
Team members are expected to attend and actively participate in ISCOPES' team meetings, functions and program events, as well as be committed to the team's projects and the team process. Team members are expected to design and co-lead at least two learning sessions each semester. Members are also encouraged to aid in exercise classes and/or small group discussions with participants.
Past Projects
The 2008-09 Bread for the City ISCOPES team decided to divide into two teams: the Medication Administration Team to address the issue of health literacy and medication compliance, and the Fit for Fun Team to provide a holistic approach to patient health and education.
The Medication Administration project goal was to create a Medication Administration sheet especially geared toward low literacy and low health literacy clients at Bread for The City. Small round colored stickers were provided with the sheets so that a colored sticker placed on a pill bottle would correspond to the sticker on the medication sheet. The final version of the Medication Administration Sheet was made available in English and Spanish in print and electronic version.
In the Fit 4 Fun program, one of the community needs identified was awareness on how to make healthy lifestyle choices to help decrease the risk of heart disease, obesity, and diabetes (three highly prevalent diseases in the community). The team offered different exercises that participants can do to stay in shape and created a worksheet of easy at-home exercises for them to do without the conveniences of basic gym equipment. In addition, a group exercise class was planned to encourage the Fit 4 Fun participants to exercise and promote group participation and accountability. The exercise class included proper stretching techniques and various exercises that can be done at home as well.
The 2007-08 team utilized data from the previous year's team, which investigated and found deficiencies in health literacy among Bread's patient population. We created a medication card geared toward patients with low literacy to increase medication compliance. The team collaborated with the staff at Bread for the City to determine the most common medications prescribed for patients at the clinic. Using a structured interview format, the team collected patient responses to various pictograms to represent the common conditions such as, diabetes, high cholesterol, and hypertension. Based on their responses we drafted a template of the medication card.
Other Projects:
--Nutrition bulletin board displays.
--Walking maps around Bread for the City for a nutrition/fitness program called Fit for Fun.
--Buying scales for each room and developing handout for patients to facilitate discussion with providers about weight and health.
Site Description
Bread for the City (formerly Bread for the City/Zacchaeus Free Clinic) is a private, non-profit organization in the inner-city Shaw community of Washington, DC. The mission of the clinic is to "provide vulnerable residents of Washington, DC with holistic services, including food, clothing, medical care, legal and social services, in an atmosphere of dignity, respect, and peace...to alleviate suffering caused by poverty and to rectify the conditions that perpetuate it." The clinic provides services to over 7,000 working and unemployed underserved residents per month; most of whom do not meet eligibility requirements for Medicaid.
The Fit For Fun is a program developed by the Medical Director at Bread for the City, Dr. Randi Abramson, to promote healthy lifestyle choices among clients at Bread for the City who have a BMI greater than 30. Clients who volunteer for the program meet with the nurse for a baseline BMI measurement, as well as BP screening, and then they set goals to improve dietary intake, increase exercise habits, and/or stop smoking. They enroll for a period of 3 months, and at the end of 3 months, a monetary reward of $2 per pound of weight lost can be obtained. Included in the program are weekly/biweekly accountability phone calls, monthly "weigh-ins," and a cooking class once per month. Clients can reenroll in the program at the end of the 3-month period. The goal of this program is to empower BFTC clients to take ownership of their health in order to prevent and/or treat common diseases associated with low incomes, lack of education, and limited health resources.
The Shaw community is very culturally diverse, and includes many African Americans, Hispanics, Caucasians, and new immigrants from West Africa and Asia. Located in the District’s Ward 2, the clinic serves a population where the infant mortality rate is 12.4/1000 live births, and the leading causes of deaths include heart disease, cancer, stroke, HIV/AIDS, and homicide. In addition, 13.4% of all adult Medicaid recipients and 15.3% of all child recipients from DC reside in Ward 2.
Additional Information
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