Stepping Up

Imagine needing health care but not knowing where to go or not having the resources to get the care you need. Thousands of people face this situation every day in America. Through a unique program funded by The Wellmark Foundation, the Sanford Health Parish Nurse Institute in Sioux Falls, S.D., is stepping up to meet a health care need in the community.

Stepping into Good Health (SIGH) is an outreach program of the Sanford Health Parish Nurse Institute that provides foot care, general health screenings, and diabetes and cardiovascular disease education to members of the community’s underserved population. SIGH was funded in 2005 through a $48,310 grant from The Wellmark Foundation and is carried out with the help of nearly a dozen parish nurses and more than 200 volunteers.

SIGH, which began in November 2005, has served more than 450 people at its twice-weekly clinics. Of the 350 clients served in just the first year, 40 percent returned for more than one visit, says Becky Blue, clinical nurse specialist at the Sanford Health Parish Nurse Institute. “All of the volunteers have done such a great job of welcoming clients and building relationships that we’ve had a surprisingly high number of return visitors,” says Blue.

Follow-up testing was possible for many clients due to this high return rate, says Blue. Results showed 38 percent of repeat clients had improved blood pressure, 27 percent had improved glucose levels, 15 percent had improved cholesterol levels, and 95 percent had improved foot health. In addition, 100 percent of clients who were identified with having diabetes or cardiovascular concerns received self-management training from SIGH volunteers.

According to Ingrid Rasmussen, SIGH coordinator, more than a dozen people gather each Tuesday afternoon at the Good Shepherd Center in downtown Sioux Falls for foot care and fellowship. Monday afternoons draw similar crowds at the nearby First United Methodist Church. Each gathering includes a good mix of members of the community’s underserved population, volunteers from eleven local churches, and medical professionals from the community.

Many SIGH clients are not able to read, write, or navigate the health care system, says Rasmussen. In addition, many do not have health insurance. “One third of the people we see have no primary health care provider,” says Rasmussen. SIGH has served as the first step to link this underserved population to diabetes and cardiovascular disease prevention and education, and to a wide variety of other community resources and health care providers. “We try to educate clients on primary care providers in the community who may be able to serve their needs and to address each client’s other concerns, covering everything from food to daycare to counseling.”

Rudy, a client who has visited the SIGH clinic several times since the fall of 2005, says the information he has gained at the clinic has positively impacted his life. “I am more aware of my diet and exercise now, and my foot care has definitely gotten better,” says Rudy. “Knowing that the program is designed to keep me informed of my health makes me feel good. The clinic reinforces my awareness of healthy living.”

Rasmussen says that a typical visit to the SIGH clinic includes a welcome from a church volunteer; information exchange session with a parish nurse; blood screenings for glucose, cholesterol, and triglycerides conducted by a pharmacy instructor and students; warm foot bath given by a church volunteer; and comprehensive foot assessment and care provided by a certified foot care nurse. The visit ends with a healthy snack and gift of a new pair of socks provided by church volunteers as well as an optional blessing and prayer. The atmosphere is always positive at the clinic, says Rasmussen. “Some days it’s downright jovial while other days it’s a very peaceful place for people to soak their feet and relax. All in all, it’s a good combination of a lot of listening, a lot of laugher, and a lot of solitude.”

According to Blue, one of the most important aspects of the SIGH program is to utilize members of local churches as volunteers. “The volunteers help to create a place of grace, a warm environment, and a place where people aren’t asked about their income or resources, but where they are just welcomed and served,” says Blue. “The interaction of the volunteers and nurses with SIGH clients is building important relationships in the community that might not otherwise have developed. There’s a great deal of research that indicates that the two most important things to help people out of poverty are education and relationships…we are happy that SIGH is able to offer both.”

Rudy agrees that the SIGH volunteers are making a difference. “I like to come in and see the volunteers often. I like the clinic because of the positive interaction. Friendliness is inviting. I find the experience very informative, reassuring, and comfortable,” he says. “I’m impressed by the volunteers because they are eager to share their knowledge about health to my benefit. They are welcoming and caring. That is why this place is special.”

The Sanford Health Parish Nurse Institute, formerly the Sioux Valley Parish Nurse Institute, has received additional grants from the Sanford Health Foundation (formerly the Sioux Valley Foundation), Sioux Falls Area Community Foundation, and Thrivent Financial for Lutherans Foundation that will enable the SIGH clinic to continue to operate through 2007. SIGH hopes to gain 200 - 300 new clients next year and for repeat visitors to rise to 50 percent. Future areas of interest include eye care, additional diabetes education sessions, and counseling services. For more information about SIGH, e-mail Becky Blue.