Jan Brano started attending smoking cessation workshops at Yale University Health Services YUHS Center for Health Education and Preventive Medicine in the summer of 1993. She had smoked for 20 years before then, and decided to stop because it was no longer socially acceptable. "Originally I was expecting them to come up with a sure-fire way to stop," she says. "Of course, they didn't." But the program did lend support, and that's what Ms. Brano needed to help her completely stop smoking five months after she began attending the sessions. "Meeting all the people there was what did it," says Ms. Brano, whose husband, Peter, is a University police officer. "Everybody was talking about their own experiences and weaknesses, then offering some support."
The smoking cessation workshop is just one of many programs sponsored by the YUHS's health education department. These range from a single, one-time lecture on a specific topic to periodic, multi-part series on various aspects of a chronic ailment. The majority of educational sessions last about 90 minutes and are held on the fourth floor of YUHS. Most are free to Yale Health Plan members, and many also are open to the larger Yale community free of charge.
Offered every Thursday afternoon, the smoking cessation workshop is "an ongoing program that's always open to Yale people," says Barbara Collins, R.N., program coordinator for the Center for Preventive Medicine. "Although not a formal teaching program, there are discussions regarding risk factors and strategies on how to stop smoking," she says. "The sharing and exchange of ideas results in a marvelous camaraderie amongst the participants."
The smoking cessation workshop was introduced in 1993, shortly after the YUHS instituted its Center for Health Education and Preventive Medicine in 1991. "At that time Dr. Stephanie Spangler was director at YUHS. Her idea was to do something formal on prevention," says Dr. Robert DeBernardo, physician and chief of health education and preventive medicine. Dr. Spangler asked Dr. DeBernardo to direct an investigation into types of formal prevention programs that would best serve patients. Many of the programs in place today are based on the feedback from patient surveys, focus groups with health care providers, and regular meetings with a committee of experts.
The staff of the center includes Dr. DeBernardo; Ms. Collins; health educator Sally Rinaldi, R.N., who is also coordinator of the AIDS Resource and Counseling Service; nutritionist Linda Bell, R.D.; and clinical manager Donna Konarski, R.N. Together they coordinate the programs that help members of the Yale community learn more about their health.
"Two programs frequently requested by members are stress management and an exercise program," says Dr. DeBernardo.
"Most programs are well attended," with between 10 and 30 participants, says Ms. Collins, adding that some of the most popular sessions are those on CPR, osteoporosis and skin cancer screening.
Often, a series will be presented in conjunction with a national awareness initiative. A five-part series on diabetes, for example, is supported by materials and guidelines from the American Diabetes Association, says Ms. Collins. Like the other programs, the diabetes series -- which is offered twice a year -- draws on the expertise of YUHS medical staff and other Yale-affiliated professionals for lectures and presentations.
Participant interaction is an important component of the success of YUHS education programs, says Ms. Collins. Judy Madeux, associate director for quality and utilization management, agrees. "I think people in the Yale Health Plan are usually pretty assertive," she says. "They're not shy. We're fortunate in that the population we serve is well informed."
"There's a sense of awareness for health education of family members," notes Ms. Bell. The nutritionist sees many graduate students whose parents may be exhibiting behavior that is risky to their health and, as a result, the students are "very much interested in preventive medicine," she says. "There's much talk about heart disease, cancer, osteoporosis -- there's a good level of awareness about that. I also see many people who are vegetarians, and they want to make sure they're eating right."
Such high levels of feedback -- which take the form of not only in-session discussions, but also written evaluations -- help in the ongoing assessment process, say the health educators. "A great informational source for us, too, are the deans and masters," adds Ms. Madeux. "They are so in touch." The concern residential college deans and masters have shown about the prevalence of undergraduate smoking, for example, actually has helped expand the smoking cessation program, says Ms. Madeux. She and other members of the health education department currently are involved in promoting a stop- smoking poster contest among Yale students.
"We wanted to raise everyone's awareness that smoking is a problem for college-age students," says Ms. Madeux. "We also thought that generating the concept from the people we were targeting makes sense. We want to bring home the message, so receiving feedback from program participants is so important."
For their part, most of the participants have said they have learned a great deal from the health education programs. Barbara Reif, director of student and alumnae/i affairs at the School of Nursing, attended a two-part session on migraine headaches earlier this year. She hasn't had a migraine since, she says.
"It may be coincidental," says Ms. Reif, whose headaches began five years ago, "but I haven't experienced what I used to refer to as a 'sick headache,' but now call a migraine." Ms. Reif says that in the sessions she learned how to "anticipate the problem issues and how to avoid them." For instance, when she found out that caffeine is associated with the onset of migraines, she immediately diminished her intake of the stimulant.
Clarinetist Frank Tirro, a professor at and former dean of the School of Music, participated in a two-part series on "Topics Addressing Asthma," offered for the first time in October, in order to learn how to control his environment-induced asthma. "It's a seasonal thing," he says. "I'm apparently very allergic to one kind of tree here in Connecticut. Although I had treatment at the Yale Health Plan, I really didn't understand the nature of the illness, what asthma is."
By taking part in the series, "I think I did learn quite a lot," notes Professor Tirro, adding that he now better understands what's involved in creating an asthmatic situation. "I also learned about the different kinds of medicine prescribed in the treatment of asthma." The series will be offered again next semester.
Other health education department programs include:
The department also publishes a newsletter, which is sent out to Yale Health Plan members during the academic year. The periodical, called Care, covers different health topics each issue. "One of the nice things about the newsletter is that we try to have salient articles from our clinicians themselves," says Dr. DeBernardo. "We also include in it our calendar of upcoming events." Yale Health Plan member services also publishes a separate newsletter, Yale Health Matters, for members. It complements the health education department's newsletter in that it "covers topics that are more focused on how to use the system," says Dr. DeBernardo.
When preparing and presenting its programs, the Center works closely with other departments. The allergy department, for example, "plays an important role in prevention of respiratory problems," says Ms. Collins. Large-scale offerings such as immunizations garner an excellent response, she adds. "Thus far 2,500 people have come to YUHS to receive the flu vaccine the department began offering in mid- October."
More programs are available upon demand, says Ms. Collins. "The Center's mission is to be responsive to our members and to reach our mutual goal: maintaining a healthy lifestyle."
-- By Felicia Hunter