First-ever community health model takes root in San Antonio

Community Health Club Graduates of the Community Health Club pose at Santa Fe Episcopal Church in San Antonio
Jason Rosenfeld, M.P.H., speaks at the Community Health Club graduation Jan. 8.

Spearheaded by UT Health San Antonio faculty and students, a new model for taking health education directly into neighborhoods has been implemented for the first time in the United States.

The idea, called Community Health Clubs, has taken root in the Harlandale community on San Antonio’s South Side. On Jan. 8, six members of Santa Fe Episcopal Church, which hosted the club, graduated from the six-week program.

“We’re trying to give community members the knowledge they need, to equip them to make the healthiest decisions possible, but it goes beyond that,” said Jason Rosenfeld, M.P.H., assistant director of global health education of the Center for Medical Humanities & Ethics. “The power of this health education model is not just education, it’s behavioral changes. We’re bringing communities together.”

Rosenfeld, a former Peace Corps volunteer, worked extensively with Community Health Clubs in Africa after receiving his master’s in public health from Emory University.

“The model was developed in Zimbabwe in the mid-1990s by a group called Zimbabwe AHEAD,” Rosenfeld explained. “They had noticed that with traditional water and sanitation hygiene education that knowledge was increasing but that they were not achieving behavioral changes. So the hypothesis was that part of the reason was that there was no real mechanism for consensus building, for bringing people together to discuss problems and then identify solutions.

“And that’s where the club model came in. It was to create a group of volunteers who would be dedicated to working together and learning together but then taking action.”

After joining the Health Science Center in 2011, Rosenfeld and Ruth Berggren, M.D., director of the Center for Medical Humanities & Ethics helped form and still manage with local sponsors Community Health Clubs in Haiti, the Dominican Republic and Burkina Faso.

But Rosenfeld wanted to test the model in developed countries such as the United States. Last year, armed with an invitation to form a club from the Rev. Will Wauters of Santa Fe Episcopal, and with the emergence of Zika, Rosenfeld thought the time was right. With $4,000 in funding from the Community Service Learning mini-grant program, the project was launched.

At Santa Fe Episcopal, about 10 volunteers interested in community health came together each week for six weeks to learn about the mosquito-borne Zika virus, Rosenfeld said. The group, now named the Alpha Health and Wellness Club, learned about the life cycle of mosquitoes, mosquito-borne illnesses, what is Zika, how is it transmitted, how do you prevent transmission, what are the signs and symptoms of Zika, and what are the community resources to partner with in fighting Zika.

UT Health medical students served as facilitators for the sessions.

Madeleine Puig, a second-year medical student from Laredo and one of the student leaders, said she has always been interested in community health and that the health club experience was especially rewarding.

“We’re not just giving them information,” she said. “We’re trying to start a discussion and get them involved in the health education process and spread it to their community. Health professionals can’t do it all.”

Now, Rosenfeld said, the Community Health Club at Santa Fe Episcopal belongs to its members.

“The purpose of the club is to share and disseminate information as widely as possible,” he said. “Their job now is to identify strategies for sharing what they’ve learned about Zika.”

He added that the club may identify other needs and topics, and that other clubs might be formed in other neighborhoods.

“The club is moving forward,” Rosenfeld said. “There will be a connection between the club and the Center for Medical Humanities & Ethics. (THE San Antonio Metropolitan Health District) is working with them and the Texas Department of State Health Services regional office is interested in replicating the club model in the Valley, particularly with Zika since it was locally transmitted in the Valley.”

All in all, Rosenfeld believes, the Community Health Club model works.

“The best way to get people together is to start solving simple problems,” he said. “And once you solve simple problems… you can take on larger issues.”

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