Texas Vision Health Education Integration Collaborative (TVHEIC)
Texas Trails: The Story of Vision Health Integration 2010-Present
With six months remaining in the fiscal year, Prevent Blindness Texas (PBT) received funding in March 2010 from Prevent Blindness America’s Centers for Disease Control and Prevention’s National Vision Preservation Initiative Award (Component 2B-Integration) to develop a statewide vision health education plan and project with a primary partner in the state health department. This was an exciting and yet entirely new prospect for PBT! And yet, an opportunity to bring eye health education to Texas in an unprecedented way, was irresistible.
The purpose of the award is to integrate vision and eye health education at the state and local level through existing state programs. Therefore, on the proverbial “clock”--PBT needed to pursue enthusiastic, pragmatic partnerships within the Texas Department of State Health Services (TXDSHS). Initially, PBT attempted to model its efforts after the extremely successful on-going collaborative in vision health and preservation beginning in 2008---the Prevent Blindness Tri-State (New York, New Jersey and Connecticut) and its partnership with the New York State Health Department. Whereas, the New York State Health Department was able to accept funds from Prevent Blindness Tri-State’s CDC award to establish a presence within the New York State Health Department (NYSDH) Health Promotion and Chronic Disease Prevention Division and create a vision health integration specialist with additional professional staff. The TXDSHS Health Promotion and Chronic Disease and Prevention Unit was not structured in such a way as to receive funds to off-set salaries or staff time to devote to the Vision Health Initiative.
Although, the door had closed—a window opened! The Diabetic Eye Disease Program and the Cardiovascular Disease Unit (within the HPCDPU) were willing to provide a roster of state approved primary and specialty clinics which would receive bilingual (Spanish and English) eye health materials through the PBT CDC award. It was determined that the clinics would receive eye health materials for men, women and children but that if the clinics chose to participate in follow-up survey and data collection; it would be without further interaction with the HPCDPU and PBT.
Although, the opportunity to send the bilingual eye health materials to state approved clinics was a good beginning, it did not meet the requirements of the CDC award to have a strong alliance with a state health department partner. Therefore, it became necessary to engage with colleagues from throughout the vision healthcare community in Houston and elsewhere in Texas to find a responsive agency, unit, division or office within the TXDSHS. Since time was of the essence, it was necessary to consider the demographics of Texas and who was most in need of immediate eye health education and resources—the Texas Commissioner of Health and Human Services has specific offices in its organizational structure that work in collaboration with other agencies and councils within TXDSHS such as the Texas Diabetes Council-Office of the Governor. With no time to lose PBT made for the border—PBT called the Coordinator of Special Initiatives for the Office of Border Health (OBH). Although, they too, could not accept funding to offset salaries or “buy” staff time—they did have an idea.
The 2007 Health Risk Factors in the Texas-Mexico Border report had not been sufficiently sampled regarding vision health. From Brownsville to El Paso, Texas, the summary of health-related risk factors and trends among residents of fifteen Texas counties along the US-Mexico border needed a Behavioral Risk Factor Surveillance System Vision module to be developed and implemented between 2010 and 2012. PBT had the necessary funds to begin planning and developing the vision module in collaboration with the OBH and the TXDSHS Center for Health Statistics.
The aims of the CDC award are twofold: 1) To integrate appropriate and effective vision preservation strategies into existing programs and functions within the state health department. 2) To promote public health strategies among community partners in organizations and institutions. Using the BRFSS, a nationwide telephone based survey of randomly selected adults that gathers information on many conditions and behaviors known to influence personal health would now include vision health in Texas for between 15 and 32 border counties. This would establish a primary partner within the TXDSHS and within the Texas Health and Human Services Commission.
In August, 2010 PBT negotiated a formal Memorandum of Understanding with the TXDSHS-Office of Border Health to identify existing programs in chronic disease and health education along the Texas-Mexico border. It was determined that the primary plan is to improve the 2007 Behavioral Risk Factors Surveillance System (BRFSS) vision module. OBH received $45, 360.00. In September 2011, the sample from the BRFSS vision module will be available for PBT to analyze the data and build credible vision health education strategies for a public health campaign in cooperation with 3-6 school districts, 124 clinics, 41 community health centers. (The centers were provided by Texas A&M University College of Architecture-Center for Housing and Urban Development—Colonias Project (colonias are unincorporated communities that lack vital community infrastructures such as —electricity, sewage, etc. needed for habitability. Residents pay county taxes but often have little to no access to municipal resources, i.e. fire, police, etc. Access to health education and care are priorities and are usually delivered by community health care workers also known as promotores.
From June, 2010-May, 2011, 153 clinics and centers received bilingual eye health literature to aid health care providers and certified community health workers in educating the clients/patients about vision health as it relates to general eye health and specific diagnoses-diabetes, glaucoma, age related macular degeneration, etc. In September and October all clinics were surveyed through a process evaluation by a telephone.
Three evaluators were hired to contact each clinic at minimum 3x over an eight-week period to determine the efficacy of bilingual eye health literature in improving the education of Texas border residents and some non border residents. The first database and its findings was compiled and analyzed in March, 2011. A second survey and data analysis will be available in September, 2011.
In September 2010, the first Texas Vision Health Integration Collaborative Workshop was held in Houston. It attracted 35 institutions and organizations from across the state to determine the best practices for vision health education strategies with respect to diabetes. Among the members of the Steering Committee are Texas A&M University, University of Texas Health Science Center, Texas Department for Assistive and Rehabilitative Services, Texas Health and Human Services-Center for the Elimination of Health Disparities University of Houston-College of Optometry, Texas Diabetes Council, and the University of Texas Health Science Centers-Schools of Public Health-El Paso, San Antonio and Houston, and City of Houston Health Department. The Steering Committee meets monthly to work on the aims of the Collaborative and Workgroup Formation-Early Detection and Prevention, Workplace School Safety Injury Prevention, and Education and Community Outreach. Workgroups have acquired members from around the state to formulate a work plan conducive with the CDC National Vision Health Initiative. And again, in September, 2011—there will be a statewide Conference with the Texas Department of State Health Services Office of Border Health for the Vision Health Collaborative and its public, private, and academic partners to discuss the progress in the border region.
The Texas Vision Health Education Integration Plan and Project (TVHIPP) has begun incorporating health education strategies with three border area independent school districts (two in the lower Rio Grande valley in La Sara and Willacy counties and one in East Texas-La Marque. The vision health education curriculum is bilingual. Sixty master teachers are developing lesson plans and activities unique to the border community and East Texas. In this “train the trainer” method, 66 teachers will teach at minimum 10 other teachers at their grade level and are expected to have eye health as part of the Texas education curriculum in grades Pre K-12 in at least five border counties in fall, 2011.
Prevent Blindness Texas and the Texas Department of State Health Services Office of Border Health have a formal Memorandum of Understanding until 2012 to find ways to work with existing state health department programs such as diabetic eye disease, nutrition, obesity, and hypertension for the half million Texas residents living along the border. In addition to primary and specialty clinics, centers, school and hospital districts—other health education venues are being developed with at least 13 of the 35 Collaborative partners and their academic programs—post doctoral and professional. Of special interest, is the development of the Work Place School Safety and Injury Prevention Work Group in conjunction with the Education and Community Outreach Work
Group. Business/corporate partners and the inventory of health care providers for the border region are being cultivated through each Group—especially Early Detection and Prevention. State agencies, academic partners, and independent ophthalmologists and optometrists are convening to bring urgent education and eye healthcare resources to the lower Rio Grande Valley.
In 2011, the Texas Vision Health Integration Plan and Project will continue work methodically with specific chronic diseases; diabetes, and cardiovascular/hypertension related health issues. Public health campaigns will help educate specific populations in border counties and parts of East Texas. In cooperation and collaboration with public and private organizations, adults and children will learn about eye health and the health resources in their communities which can prevent blindness and unnecessary vision impairment.
In fourteen months, the story of Texas vision health integration galloped ahead with the help of devoted partners, especially the Texas Department of State Health Services Office of Border Health and Texas A&M University’s College of Architecture The Center for Housing and Urban Development—through its Colonias Project.
The Texas Vision Health Integration initiative measures its recent success by implementing a practical approach using bilingual eye health materials, a wide range of professional colleagues, a very limited staff and professional volunteers in area independent school districts, county hospital districts, and 153 clinics and community health centers.
In a frugal and yet deliberate manner, eye health information and access to healthcare services for Texas is being delivered to Texas residents who are most in need of these resources to improve their overall health and self-sufficiency through this innovative project to integrate eye health into existing state health and education programs through the Centers for Disease Control and Prevention’s Vision Health Initiative. Through this opportunity, Prevent Blindness Texas has developed a consortium of public, private and academic partners to aid the State of Texas regarding the eye health needs of border health residents and their communities. Due to its effectiveness in using local and state resources already in place, this initiative has the willingness of Valley citizens and area leaders to begin the next phase of the project in summer, 2011 which is a bilingual public health awareness campaign for eye health. The campaign will encourage eye examinations and eye safety with a referral to healthcare offered by both public and private healthcare providers. As a result of this campaign, border residents will know how to better their vision health and that of their families and where to seek assistance. Allowing Texans to take the lead in providing direction for improving the health of their communities is a powerful and pertinent way to make a lasting difference in the lives of the citizens of this state. The Texas Vision Health Integration Project has come a long way in a short amount of time, and we are willing to do more if given the opportunity through reinstating the CDC Vision Health Initiative and its objectives for the individual states.
Below is a listing of our recent and upcoming Mayoral Proclamations:
- Mayor and City Council Harlingen; Wednesday, August 17, 2011, 5:30 pm
- Mayor and City Council McAllen; Monday, August 22, 2011, 4:00 pm
- Mayor and City Council Texas City; Wednesday, September 7, 2011, 5:00 pm
- Mayor and City Council Galveston; Thursday, September 8, 2011, 4:00 pm
- Mayor and City Council La Marque; Monday, September 12, 2011, 6:00 pm
Billboards on Highways 77, 83 and I-45 will promote the SAVE YOUR EYES NOW-PROTEJA SU VISTA HOY CAMPAIGN until the end of September. To view a campaign billboard nearest you, click on the images below:
Download the Save Your Eyes Now-Proteja Su Vista Hoy Press Release.
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Download the Save Your Eyes Now-Proteja Su Vista Hoy Newsletter in Spanish.