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Sunday, January 23, 2011

Home sweet medical home: Project ASSERT's health promotion advocates

Part of the reason home feels so sweet is because it's comfortable and familiar. The medical home has many features that have long been familiar. One is the use of health promotion advocates or coaches to advise people on changing health habits.

This was one of the key ingredients of success of Project ASSERT, first developed in 1993. In this model, health promotion advocates who are drawn from the local community advise patients in a hospital's Emergency Room on health habits and help them with referrals to substance abuse and preventive health programs. Since its birth, the program has spread beyond Boston Medical Center to Yale-New Haven Hospital, and to Athol, Children's, St. Mercy, St. Anne’s, South Shore, and Whidden Memorial hospitals in Massachusetts.

An example: A frail, 67-year-old woman came into the Emergency Department at Yale-New Haven Hospital one evening last fall complaining about terrible abdominal pain. The medical staff immediately began to search for its cause and sought to ease her misery. As the emergency medical procedures went on, Gregory Johnson, a health promotion advocate from Project ASSERT, an innovative Yale health outreach program, approached her bedside and asked her a few questions. Her answers shocked the medical staff and probably saved the woman's life.

The grandmotherly woman revealed that she was a heroin addict, shooting up the drug several times a day. While the medical staff helped relieve her abdominal pain, Gregory took advantage of the woman's health crisis to help negotiate with her about entering into treatment for her addiction. She agreed, and he arranged for her admission to an area substance abuse program. He even found her transportation to the site and followed up later to make sure she stuck to her program.

"Doctors are busy treating acute medical problems," says Gregory. "They're not thinking about a whole other realm of treatment. If I hadn't intervened, we never would have known."

Read another story on a health promotion advocate.

Thanks to Marc Wortman for his article in the Yale Bulletin and Calendar of March 8, 2002.

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