Needs Assessment Focus Group with Healthcare Providers

Many thanks to the following participants for their time and insightful contributions:

• Mary Jane Beatty, MSW, North Hills Youth Ministry Counseling Center
• Ruth Divis, LPN, Manor Care Nursing Home
• Suzie DeVore, Administrator, Orion Personal Care Home
• Susan Guido, MD, ER Physician, Sewickley Valley Hospital
• Basil Marryshow, MD, Orthopedic Surgeon
• Margie Martinelli, RN, Wellness Nurse, Ingomar United Methodist Church
• Shirley McIlvried, RN
• Jim Pschirer, Pharm.D., Director of Operations, UPMC Shadyside
• John Schrenker, DDS, Private dental practice in Glenshaw
• Beth Wesesky, RN, Psychiatric Nurse, Western Psychiatric Hospital

Question #1: What are the most pressing healthcare issues specific to low income individuals and families?

• Education about alternative treatments and medications
• Mental health advocacy and information
• Coordinated care, especially for the elderly
• Under-funding of low income programs. Medicare and Medicaid do not reimburse at a high enough level, pose too many restrictions and completing the reimbursement forms is time consuming.
• Low income individuals do not seek help due to lack of funds. They do without
  medications, glasses and dental care until the problem becomes chronic and severe.
• Need to preach and practice prevention. Special attention was focused on dental health and the role prevention and good dental hygiene plays in overall health.

Question #2: Do you find that there are more health care issues relating to the lower income population?

Overall, the answer was "yes."

• Undereducation and lack of information
• There is a cycle of poverty; children do what their parents do
• Greater incidence of drug and alcohol problems
• Low income population seeks mental health care later than the rest of the population.
• Low income seniors cannot afford personal care homes
• Active dental disease is a health problem, especially for the low income population, and can be linked to other chronic health care illnesses, such as coronary artery plaques. Pregnant women with periodontal disease have lower birth weight infants. The dentists can often identify existing illnesses through dental examinations.

Question #3: There are a high number of youth and pregnant women who start, or continue to use, tobacco products even though they are aware of the benefits of stopping tobacco use. What outreach methods do you see as most effective to this target audience? Do you feel that advertising and statistical information has an impact on these demographic groups?

• The panel sited pictures as the means that most impresses youth to avoid tobacco
  use.
• Therapists find one-on-one involvement helpful.
• In some instances, the individual is more likely to quit smoking when he/she has seen how smoking has affected someone they know.
• The panel discussed techniques that have been tried to help the smoker quit, such as raising prices and regulations in public places; however, these approaches are not too effective. One panel member explained that although government regulations are needed to reduce smoking, cigarette taxes that the government receives makes that option less likely. If smoking were restricted, the tobacco-growing states would not vote for candidates who support these controls.
• The panel felt that smokers construct a worldview that smoking is okay. They
  make up their mind to quit for their own personal reasons.

In summary, the results of the panel discussion indicated the following needs:

• Education
• Greater accessibility to services
• Advocacy to assist with coordination of care management and accessing services
• Public awareness focusing on prevention, and reducing stigmas attached to mental health issues
• Partnerships between all of the patient’s health care providers, and between the health care providers and community resources
• Increased funding for low-income programs
• Increased services to seniors that include transportation, counseling and coordination of care