Aultman Hospital | Health Care in Canton Ohio - …...newborn care services, level 2 trauma services, hospice, long-term care, physical rehabilitation and psychiatric care. Aultman

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2016 Community Health Needs Assessment Aultman Hospital

Aultman Hospital, located at 2600 Sixth St. SW, Canton, Ohio 44710, is a not-for-profit, short-term acute care

general hospital with 820 inpatient beds. Aultman Hospital offers a comprehensive mix of inpatient and

outpatient services, including adult cardiac catheterization and open-heart surgery, level 3 obstetric and

newborn care services, level 2 trauma services, hospice, long-term care, physical rehabilitation and psychiatric

care.

Aultman Specialty Hospital, located on the fourth floor of 2600 Sixth St. SW, Canton, Ohio 44710, is a not-for

profit, long-term acute care hospital with 30 inpatient beds. The Aultman Specialty Hospital provides long-term

acute care for patients with medically complex respiratory, cardiac and renal conditions, neurological disorders

and wounds. The average length of stay is 25 days. Typically, patients are transferred to Aultman Specialty

Hospital from intensive care units, step-down units or other local hospitals.

Aultman Health Foundation’s mission, vision and values:

Mission – Our mission is to lead our community to improved health.

Vision – Aultman Health Foundation will be the leading health system in designing products and services for the

communities we serve.

Delivering the highest quality.

Achieving service excellence.

Offering a competitive price.

Innovating toward disease prevention and wellness.

Values – We will:

Recognize and respect the unique talents of every Aultman team member

Exceed patient, enrollee and student expectations

Success through teamwork

Promote a highly reliable organization

Educate our community

Cost-effective management of resources

Trust, integrity and compassion in all relationships

Aultman Hospital and Aultman Specialty Hospital are pleased to present this joint Community Health Needs

Assessment (CHNA) report to fulfill a requirement in the federal Patient Protection and Affordable Care Act,

enacted in March 2010, requiring every tax-exempt hospital to conduct a CHNA to identify and prioritize the

significant health needs of the community and develop an implementation strategy to address those significant

health needs identified. The 2015 Stark County Health Needs Assessment serves as the basis for this CHNA

report and is available at https://cantonhealth.org. The 2015 Stark County Health Needs Assessment assessed

the health needs of the Stark County community. The process took into account the broad interests of that

community, including leaders and representatives or members of medically underserved, low-income and

minority populations, and those with special knowledge of or expertise in public health. The 2015 Stark County

https://cantonhealth.org/pdf/2015%20Preliminary%20Findings.pdf

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Health Needs Assessment utilized a variety of data sources, including federal, state, and local data. This report

utilizes the information, assessment and prioritization of the significant health needs of Stark County from the

2015 Stark County Health Needs Assessment. We have provided additional information to support this CHNA

and comply with CHNA requirements.

You may submit written comments on this CHNA report to Melissa Warrington at Aultman Hospital, 2600 Sixth

St. SW, Canton, Ohio 44710 or at [email protected]. Any written comments received will be

considered in conducting the next CHNA. You may also contact Melissa Warrington at 330-497-3984 or

[email protected] to obtain a copy of this CHNA report at no charge.

Christopher Remark

Chief Executive Officer

Aultman Hospital

2600 Sixth St. SW

Canton, Ohio 44710

Stark County

CHNA report approved by the board: Oct. 12, 2016.

CHNA report initially posted to the website: Dec. 27, 2016.

Tax identification number: 34-0714538

mailto:[email protected]


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TABLE OF CONTENTS

EXECUTIVE SUMMARY ................................................................................................................................... 4

COMMUNITY SERVED .................................................................................................................................... 5

DEMOGRAPHICS AND RESOURCES OF THE COMMUNITY ................................................................................ 6

SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY ......................................................................................... 8

PROCESS OF OBTAINING DATA .................................................................................................................... 10

PROCESS FOR IDENTIFYING AND PRIORITIZING COMMUNITY HEALTH NEEDS AND RESOURCES TO MEET THE SIGNIFICANT HEALTH NEEDS IDENTIFIED ...................................................... 13

PROCESS FOR CONSULTING WITH PERSONS REPRESENTING THE COMMUNITY INTERESTS ............................ 16

INFORMATION GAPS THAT LIMIT THE HOSPITAL’S ABILITY TO ASSESS THE COMMUNITY HEALTH NEEDS ....................................................................................................................... 16

EVALUATION OF IMPACT OF ACTIONS IN PRIOR CHNA ................................................................................. 18

COLLABORATING PARTNERS ........................................................................................................................ 30

SOLICIT WRITTEN COMMENTS ..................................................................................................................... 31

APPENDIX A – CHNA Advisory Committee and Stark County Annual Health Improvement Summit Participants ............................................................................................................... 32

APPENDIX B – 2015 Stark County Health Needs Assessment Community Survey Summary .............................. 36

APPENDIX C – 2015 Stark County Health Needs Assessment Community Leader Web Survey Summary ............................................................................................................ 39

APPENDIX D – Community Commons Summary ............................................................................................ 40

APPENDIX E – Stark County Health Rankings and Roadmaps .......................................................................... 42

APPENDIX F – Aultman Health Talks ............................................................................................................. 44

APPENDIX G – WOW Education and Screening .............................................................................................. 51

APPENDIX H – 2015 Cancer Prevention Community Outreach ........................................................................ 54

APPENDIX I – Infant Mortality and Safe Sleep Outreach ................................................................................ 69

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EXECUTIVE SUMMARY

Aultman Hospital and Aultman Specialty Hospital define the “community served” to be Stark County, Ohio.

Development of this 2016 Community Health Needs Assessment (CHNA) began with collaboration among the

Stark County Health Department, Canton City Health Department, Massillon City Health Department, Alliance

City Health Department, Mercy Medical Center, Alliance Community Hospital and Aultman. The collaborative

partners contracted with the Center for Marketing & Opinion Research, LLC to identify primary and secondary

community data, solicit input from those representing the broad interests of the community, and prepare the

2015 Stark County Health Needs Assessment. The Stark County Health Needs Assessment Advisory Committee

(Advisory Committee) was formed from a variety of health and social services agencies and volunteers

representing the broad interests of the community to guide the process and provide input for the 2015 Stark

County Health Needs Assessment. The 2015 Stark County Health Needs Assessment is available at

https://cantonhealth.org.

Following the 2015 Stark County Health Needs Assessment, the Stark County Annual Health Improvement

Summit (the “Summit”) was held Feb. 24, 2016 to prioritize the health needs of the community based on the

primary data from the community survey and community leader survey, secondary data and participants’

knowledge and experiences in the community. Summit participants included members of the Advisory

Committee as well as other community representatives.

Aultman Health Foundation contracted with the Quality Management Consulting Services to utilize the 2015

Stark County Health Needs Assessment and prepare this 2016 joint CHNA report for Aultman Hospital and

Aultman Specialty Hospital.

The significant health needs of the Stark County community are in prioritized order:

1. Access to health care

2. Mental health

3. Infant mortality

4. Obesity and healthy lifestyle choices

5. Heroin/opiate use

https://cantonhealth.org/pdf/2015%20Preliminary%20Findings.pdf

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COMMUNITY SERVED

In developing this CHNA, we identified the “community served” by Aultman Hospital and Aultman Specialty

Hospital as Stark County, Ohio. Communities within Stark County include the following:

City Zip Code

Alliance 44601

Beach City 44608

Brewster 44613

Canal Fulton 44613

East Sparta 44626

Greentown 44630

Hartville 44632

Limaville 44640

Louisville 44641

Magnolia 44643

Massillon 44646-44648

Maximo 44650

Middlebranch 44652

Minerva 44652

Navarre 44662

North Lawrence 44666

Paris 44669

Robertsville 44670

Uniontown 44685

Waynesburg 44688

Wilmot 44689

Canton 44701-44718, 44721, 44735,

44750, 44767, 44799

North Canton 44720

East Canton 44730

Source: Datasheer, L.L.C. (2016). Zip-codes.com. Retrieved from http://www.zip-codes.com/search.asp on May

18, 2016

The Ohio Department of Health requires each hospital that is registered in Ohio to file an Annual Hospital

Registration and Planning Report by March 1 of each calendar year for the previous calendar year. A review of

the patient origin data from the Annual Hospital Registration and Planning Report for Aultman Hospital for 2015

supports the definition of the “community served” as being the community and residents of Stark County, Ohio.

Of the 24,609 total admissions to Aultman Hospital in 2015, 17,627, or 72 percent, resided in Stark County at the

time of admission. For 2014, 73 percent of total admissions resided in Stark County at the time of admission.

http://www.zip-codes.com/search.asp

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Stark County accounts for a vast majority of admissions to Aultman Hospital. While for purposes of this report, it

is appropriate to limit the “community served” to Stark County, Aultman’s service area encompasses the

northeastern Ohio counties surrounding Stark County as well.

A review of the patient origin data from the Annual Hospital Registration and Planning Report for Aultman

Specialty Hospital for 2015 also supports the definition of the “community served” as being the community and

residents of Stark County, Ohio. Of the 187 total admissions to Aultman Specialty Hospital in 2015, 125, or 67

percent, resided in Stark County at the time of admission. For 2014, 64 percent of total admissions resided in

Stark County at the time of admission. Stark County accounts for a vast majority of admissions to Aultman

Specialty Hospital.

DEMOGRAPHICS AND RESOURCES OF THE COMMUNITY

Community Demographics The following provides a summary of Stark County community profile characteristics. Please refer to the 2015

Stark County Health Needs Assessment, pages 152 – 203 and pages 204 - 212 for additional information on the

community profile.

Population. In 2014, Stark County has a total population of 375,736. The Stark County population is projected to

decrease to 361,130 by 2030, a 5.3 percent decrease from 2010.

Race/Ethnicity. In 2014, among Stark County residents, 88.8 percent are white, 7.3 percent are African-

American, 0.8 percent are Asian, 0.2 percent are Native American, and 2.7 percent are from two or more races.

In 2013, it was estimated that 6,295 Stark County residents are of Hispanic origin.

Age. In 2014, approximately 22.6 percent are less than 18 years of age, 8.9 percent are 18-24 years of age, 23.3

percent are 25-44 years of age, 28.7 percent are 45-64 years of age and 16.6 percent are 65 years of age or

more. The median age in 2014 is 41.5 years.

Income. In 2014, median household income is $45,641. In 2013, per capita income is $39,046. Of Stark County

families, 11 percent have a family income below the poverty level.

Education. In 2014, of persons 25 years of age and over, 10.9 percent have no high school diploma, 39.2 percent

are a high school graduate, 20.8 percent have some college but no degree, 8 percent have an associate degree,

14.1 percent have a bachelor’s degree and seven percent have a master’s degree or higher.

Source: Office of Research (2016). Ohio County Profiles. Retrieved from

http://development.ohio.gov/files/research/C1026.pdf on May 18, 2016.

http://development.ohio.gov/files/research/C1026.pdf

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Community Resources Aultman Hospital operates the following satellite units:

Aultman Carrollton, located at 1020 Trump Road, Carrollton, Carroll County, Ohio 44615, providing

diagnostic radiology, therapy and urgent care services.

Aultman Louisville, located at 1925 Williamsburg Way, Louisville, Stark County, Ohio 44641,

providing therapy services.

Aultman North, located at 6100 Whipple Ave. NW, Canton, Stark County, Ohio 44720, providing

diagnostic radiology, therapy and urgent care services.

Aultman Tusc Therapy, located at 2615 Tuscarawas St. W, Canton, Stark County, Ohio 44710,

providing therapy services.

Aultman West, located at 2051 Wales Ave. NW, Massillon, Stark County, Ohio 44646, providing

therapy, radiology and urgent care services.

Aultman Woodlawn, located at 2821 Woodlawn Ave. NW, Canton, Stark County, Ohio 44708,

providing short-term rehabilitation and transitional care to patients who need additional treatment

after being hospitalized.

The following identifies the number of health care facilities, by type, that are available in Stark County:

Facility Type Number of Active Facilities

Ambulatory Surgical Facility 14

Dialysis Center 7

Home Health Agency 19

Hospice 5

Hospital 7

Nursing Home 39

Outpatient Physical/Speech Pathology 2

Residential Care/Assisted Living 29

Federally Qualified Health Center1 5

Source: Ohio Department of Health 92016. Long-term care, non-long-term care, and CLIA Health Care Provider.

Retrieved from http://publicapps.odh.ohio.gov/eid/Provider_Search.aspx on June 26, 2016.

1Source: U.S. Department of Health and Human Services (2016). Federally Qualified Health Centers. Retrieved

from http://www.fqhc.org/find-an-fqhc/ on June 26, 2016.

http://publicapps.odh.ohio.gov/eid/Provider_Search.aspx

http://www.fqhc.org/find-an-fqhc/

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SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY

Those representing the broad interests of the community, including representation for the medically

underserved, low-income and minority populations, and those with expertise in public health participated in the

process to identify and prioritize the significant health needs of the community using health indicators identified

in the 2015 Stark County Health Needs Assessment. The significant health needs of the Stark County community

are listed below in prioritized order.

1 ACCESS TO HEALTH CARE

A large portion of county residents still do not have access to basic health care services.

Lack of affordable insurance/health care was the most important health issue for Stark County residents.

The demographic groups most likely to need access to free or reduced-cost screenings were least likely to be aware that they were available.

25 percent of community survey respondents receive health care most often from a place other than a primary care or family doctor.

26.9 percent of community survey respondents needed a medical specialist that they were unable to find locally.

73 percent of community health leaders reported that community residents have difficulty getting needed medical services.

In Stark County, there is one primary care doctor for every 1,279 residents.

12 percent of Stark County residents reported not being able to see a doctor because of cost in the past year.

2 MENTAL HEALTH

The need for mental health treatment and intervention continues to increase, especially for youth.

69 percent of community health leaders felt that people with mental illness are not being adequately served.

Stigma, lack of mental health providers and transportation were identified as the top three barriers to receiving needed mental health services.

There are 6.7 psychiatrists per 100,000 residents in Stark County.

In 2014, there was one mental health provider for every 582 Stark County residents.

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3 INFANT MORTALITY

Stark County has one of the highest disparity in birth outcomes of any large urban center in Ohio.

Ohio ranks 48th in the nation in overall infant mortality and 49th in infant mortality for African-American babies.

10.4 percent of community survey respondents reported that either they or an immediate family member had a child of low birth weight.

16.3 percent of community survey respondents reported that they or an immediate family member experienced the death of a child before age one.

17.3 percent of community survey respondents reported that either they or an immediate family member had a child that was born prematurely.

In 2013, seven percent of births in Stark County were low birth weight.

Low birth weight births for black babies were nearly double the rate for white babies.

In 2012, the Stark County infant mortality rate was 9.8, compared to 7.6 for Ohio.

4 OBESITY AND HEALTHY LIFESTYLE CHOICES

A large portion of county residents are overweight, not exercising regularly and not making food

choices based on nutrition.

92 percent of community survey respondents felt that it was at least somewhat important to have

weight loss programs available in Stark County.

17 percent of community survey respondents reported that they have not exercised in the past

month.

46.5 percent of community survey respondents described themselves as overweight.

29.6 percent of community survey respondents reported using tobacco at least occasionally.

27 percent of Stark County adults are physically inactive.

Seven percent of Stark County residents have limited access to healthy foods.

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5 HEROIN/OPIATE USE

Heroin use has been steadily rising in Stark County.

In 2014, the number of people seeking opiate treatment since 2006 has increased more than 200 percent in Stark County.

92.6 percent of community survey respondents felt that heroin was a serious problem in Stark County.

The number of unintentional drug overdose deaths in Stark County has increased from 10 in 2003 to 59 in 2014.

Between 2006 and 2014, there was a 210 percent increase in the number of opiate/heroin users in Stark County who sought treatment from a Mental Health Recovery Services Board.

Source and additional information: Center for Marketing & Opinion Research, LLC (2015). 2015 Stark County

Health Needs Assessment, pages 8-11.

PROCESS OF OBTAINING DATA

The Center for Marketing and Opinion Research conducted the 2015 Stark County Health Needs Assessment

with the collaborative partners and members of the Advisory Committee (Appendix A). The first phase of the

project was a random sample telephone survey of Stark County households. The second phase consisted of

reviewing and analyzing secondary data and demographic information from various sources identified on page

235 of the 2015 Stark County Health Needs Assessment. The third phase consisted of a web survey of

community leaders who were knowledgeable in public health. The Center for Marketing and Opinion Research

compiled this information and prepared the 2015 Stark County Health Needs Assessment. Finally, the Summit

was held on Feb. 24, 2016 to prioritize the health needs of the community based on the primary data from the

community survey and Community Leader survey, secondary data and participants’ knowledge and experiences

in the community.

Primary data: Community Survey

A random sample telephone survey was conducted of Stark County households that included a representative

sample of Stark County residents, as well as an oversample of African-American and Canton households. The

final sample consisted of 800 respondents. Data collection began on June 1 and ended on July 10, 2015 for the

community survey and began July 13 and ended on Aug. 25, 2015 for the oversample of African-American and

Canton households. Please refer to the 2015 Stark County Health Needs Assessment, pages 15-131 and page 233

for additional information on the community survey and pages 236 – 241 for the community survey instrument.

Exhibit B of this report provides a summary of the community survey results.

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Community Health Leader Survey

A web survey of community health leaders was conducted between Nov. 2 and Nov. 18, 2015. A list of 602 email

addresses of potential survey respondents was provided and out of 476 valid email addresses, a total of 72

surveys were completed. Please refer to the 2015 Stark County Health Needs Assessment, pages 132-151 and

pages 233-234 for additional information on the Community Health Leader survey and pages 242-248 for the

Community Health Leader survey instrument. Exhibit C of this report provides a summary of the Community

Health Leader survey results.

Secondary data: Secondary data sources were reviewed and analyzed to identify areas of concern when considered alongside the

survey data. Analysis included survey data in conjunction with health and demographic data. Please refer to

pages 152-223 and page 234 of the 2015 Stark County Health Needs Assessment for additional information on

secondary data and page 235 for sources of secondary data utilized. The following is a summary of the

secondary data from the 2015 Stark County Health Needs Assessment.

Stark County is ranked 41st in Ohio for health outcomes, with one being the healthiest and 88 being the

unhealthiest county. The ranking measures how long people live and how healthy people feel while alive (page

160). The leading cause of death in Stark County in 2012 was heart disease, followed by cancer (page 163). In

2015, 1.3 percent of babies born in Stark County were very low birth weight and 6.5 percent were low birth

weight (page 167). Stark County Infant mortality for 2014 was 8.2, compared with 6.8 for Ohio (page 171).

Stark County is ranked 37th in Ohio for health factors. Health factors measures health behaviors, clinical care,

social and economic, and physical environment factors. In Stark County, 22 percent of adults are smokers,

compared with 21 percent for Ohio (page 176). 27 percent of Stark County residents are physically inactive,

compared with 26 percent for Ohio (page 177). In 2011, 34.3 percent of Stark County adults were overweight

and 30.7 percent were obese, compared with 36.2 percent and 29.7 percent for Ohio, respectively (page 177).

The food environment index uses indicators that contribute to a healthy food environment with zero being the

worst and 10 being the best. Indicators include limited access to healthy foods and food insecurity. Stark County

has a food index of 7.1, compared with Ohio’s index of 7.1 (page 178). In Stark County, 14 percent of adults

report excessive drinking, compared with 18 percent for Ohio (page 180). Unintentional drug overdose deaths

in Stark County is 11.1, compared with 16.9 for Ohio (page 181).

Stark County is ranked 10th for clinical care. Clinical care includes access to care and quality of care with one

being the best and 88 being the worst. 14 percent of Stark County residents were uninsured in 2012, compared

with 11 percent for Ohio (page 186). Stark County’s Medicaid recipients have increased from 57,693 in 2008 to

67,549 in 2012 (page 186). Stark County has 1270:1 resident to primary care physician ratio and 1738:1 resident

to dentist ratio, compared with 1336:1 and 1746:1, respectively for Ohio (page 187). Stark County has 582:1

residents to mental health provider in 2014, compared with 716:1 for Ohio (page 192).

Stark County is ranked 47th for social and economic factors. This ranking includes community safety, education,

employment, family and social support, and income with one being the best and 88 being the worst (page 204).

In 2013, Stark County has a 7.5 percent unemployment rate, compared with 7.4 percent for Ohio (page 207).

The Stark County per capita personal income is $39,046 in 2013, compared with $41,049 for Ohio (page 211)

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and 23 percent of Stark County and Ohio children live in poverty (page 210). In 2013, 35 percent of Stark County

children live in single parent households (page 213) and in 2012, 40 percent of Stark County children are eligible

for free lunch (page 215).

Stark County is ranked 80th for physical environment. This ranking includes environmental quality and built

environment (limited access to healthy food, access to recreational facilities and fast food restaurants) with one

being the best physical environment and 88 being the worst. In 2011, the average daily air particulate matter in

Stark County is 14, compared with 13.5 for Ohio (page 218). For 2013-2014, four percent of the Stark County

and Ohio population is potentially exposed to water exceeding a violation limit (page 220). In 2010, seven

percent of Stark County residents have limited access to healthy foods, compared with six percent for Ohio

(page 223).

Additional data: In April, 2016, Aultman Health Foundation contracted with the Quality Management Consulting Group (QMCG)

to collect additional data and prepare this CHNA report. Additional data was collected by QMCG from the

following sources:

Institute for People, Place and Possibility (IP3) (2016). CommunityCommons (Stark County Health Indicators

not meeting state average benchmarks). Retrieved from http://www.communitycommons.org/chna/ on June

24, 2016. (Appendix D).

QMCG identified CommunityCommons as a reliable source of data and information for the

Stark County community. CommunityCommons is a mission driven organization with the goal

to make custom tools publicly available whenever possible to increase the impact of those

working toward healthy, equitable and sustainable communities. The tools are used to gain a

deeper understanding of community assets and opportunities and then to use the data to

convey knowledge through partnerships and collaboration. The people that manage the

CommunityCommons site are the Institute for People, Place and Possibility, the Center for

Applied Research and Environmental Systems, and Community Initiatives. Partners include

Robert Wood Johnson Foundation, Kaiser Permanente, American Heart Association, Centers for

Disease Control and Prevention and the University of Missouri. Appendix D provides a summary

of those Stark County indicators identified by CommunityCommons as not meeting

benchmarks, comparing Stark County indicators with Ohio and the U.S. data sources and dates

are identified in the summary.

University of Wisconsin Population Health Institute School of Medicine and Public Health (2016). County

Health Rankings. Retrieved from http://www.countyhealthrankings.org/#app/ohio/2012, on May 27, 2016.

(Appendix E).

QMCG identified County Health Rankings and Roadmaps as a reliable source of data and

information for the Stark County community. The County Health Rankings and Roadmaps

program is a collaboration between Robert Wood Johnson Foundation and the University of

Wisconsin, Population Health Institute. The annual County Health Rankings measure vital

http://www.communitycommons.org/chna/

http://www.countyhealthrankings.org/#app/ohio/2012

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health factors and provide a snapshot of how health is influenced by our environment. The

Roadmaps provide guidance and tools to understand the data, and strategies that communities

can use to move from education to action. The Roadmaps help communities to look at the

many factors that influence health, focus on strategies that work, learn from each other, and

make changes that will have a lasting impact on health. Appendix E provides information for

Stark County with those areas to explore highlighted. The County Health Rankings & Roadmaps

2016 identifies adult smoking and adult obesity as areas to explore for Stark County. Areas of

strength identified for Stark County include uninsured, mental health providers, preventable

hospital stays and high school graduation. Data sources and dates for each indicator are

identified in Appendix E.

PROCESS FOR IDENTIFYING AND PRIORITIZING COMMUNITY

HEALTH NEEDS AND RESOURCES TO MEET THE SIGNIFICANT

HEALTH NEEDS IDENTIFIED

A multi-stakeholder collaborative (Advisory Committee), including a range of organizations representing the

broad interests of the community (Appendix A), worked together to collect and analyze health indicators,

identify significant health needs of the community, and identify resources available to address the health needs

identified. The Center for Marketing and Opinion Research conducted the community survey and analyzed

secondary data to identify the top seven community health concerns based on the types of health conditions or

needs of the community. From there, the Community Leader web survey was conducted and the five significant

health needs of the Stark County community identified based on common themes that appeared throughout the

multiple sources of data and that had sufficient support by Community Leaders to identify them as a significant

health need. Please refer to the 2015 Stark County Health Needs Assessment, pages 5, 7-8, 133 and 233-234 for

a detailed description of this process. The five significant health needs were prioritized during the Summit on

Feb. 24, 2016. The prioritization was based on participants’ knowledge and experiences of the burden, scope

and severity of the significant health need in the community. Organizations participating in the Summit and

groups represented by each organization are listed in Appendix A.

Potential health care facilities and resources which may be available to address and improve the significant

health needs of the community are identified on the following pages.

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1 ACCESS TO HEALTH CARE – Resources

Access Health Stark County – a network of physicians and other health care providers to simplify access to health care services with a special focus on low-income, uninsured patients in Stark County.

Health Care Resource Guide – provides a listing of health services available in the county that accept patients on a free or sliding fee scale and most that accept Medicaid and/or Medicare.

Prescription Assistance Network (PAN) – provides access for vulnerable populations to pharmaceuticals and education through the PAN charitable pharmacy.

United Way 2-1-1 – three-digit telephone number that can be used to access community resources.

Aultman Medical Group.

Aultman Working on Wellness program – complimentary health education and noninvasive screenings.

Aultman Health Talks – free health education and access to medical experts.

Aultman Care Coordination – referrals when members need to seek and receive care outside of network providers.

Aultman Cancer Center – free screening opportunities for uninsured and underinsured.

AultCare medical plans – provide a network of providers that span the spectrum of specialties.

Aultman Infusion Therapy Department – medication reimbursement program for uninsured.

Community health fairs – complimentary screenings and education.

2 MENTAL HEALTH – Resources


Mental Health and Addiction Recovery – provides access to a state-of-the-art mental health recovery system including Suicide Prevention Coalition, Solace of Stark County, YOUth Choose, and Bullying Prevention - The Olweus* Program.

Aultman Hospital’s inpatient psychiatric unit and outpatient psychiatric program.

Aultman Behavioral Health Center.

Aultman Cancer Center’s Knowledge is Power – educational series on cancer prevention that increases awareness of mental health and supportive care.

Aultman Cancer Center’s Moving Forward – survivorship support program.

Aultman Health Talks – free health education and access to medical experts.

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3 INFANT MORTALITY – Resources


Stark County THRIVE – community agencies working together to decrease the infant mortality rate in Stark County and to decrease the disparity in birth outcomes between Caucasian and African-American infants.

KOBA – free home visiting program that provides education to all pregnant African-American women in Stark County.

Cribs for Kids – provides safe sleep education and a Pack ‘n Play® to all families in need.

Aultman partnership with THRIVE – coalition to select, implement and evaluate a data-informed birth outcome and equity project.

4 OBESITY AND HEALTHY LIFESTYLE CHOICES – Resources

Live Well Stark County – coalition of community leaders to promote policies and programs that support wellness through healthy nutrition, physical activity and tobacco-free behaviors.

Creating Healthy Communities – focus on policy, system and environmental changes surrounding healthy eating, active living and tobacco-free environments.

StarkFresh – focus on increasing people’s consumption of fresh, locally sourced, healthy and affordable foods through equal food access and educational opportunities.

The Ohio State University Extension Expended Food Nutrition Education Program – free nutrition education for low-income adults with children and youth.

Stark County Park District – over 90 miles of trails, 14 parks, 778 educational programs and events and nearly 8,000 acres of land.

Green Alliance – plan for a sustainable environment for all now and for the future.

Aultman’s Working on Wellness – free health screenings and education.

AMG Cardiovascular Consultants.

Aultman’s smoking cessation classes.

Aultman’s wellness nurse – speaking engagements.

Aultman’s seniors programs.

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5 HEROIN/OPIATE USE – Resources

Health Care Resource Guide - provides a listing of health services available in the county that accept patients on a free or sliding fee scale and most that accept Medicaid and/or Medicare.

Mental Health and Addiction Recovery – access to a state-of-the-art mental health and recovery system.

Aultman drug take-back center.

Aultman inpatients linked with support programs at discharge.

PROCESS FOR CONSULTING WITH PERSONS REPRESENTING THE

COMMUNITY INTERESTS

Persons representing the broad interests of the community, including those with knowledge of or expertise in

public health, participated in the CHNA process through the community survey and Community Leader web

survey, as members of the Advisory Committee and as Summit participants. The community survey included a

random sample telephone survey of Stark County households that included a representative sample of Stark

County residents as well as an oversample of African-American and Canton households. Telephone interviews

were utilized to ensure representativeness of the population. The final sample consisted of 800 respondents.

Data collection from telephone interviews began on June 1 and ended on July 10, 2015. The oversample of

African-American and Canton households began July 13 and ended Aug. 25, 2015. Please refer to the 2015 Stark

County Health Needs Assessment page 233 for additional information on the community survey. The

Community Leader survey was a web-based survey with 72 surveys completed from a total of 476 invitees with

valid email addresses. Invitations were sent on Sept. 30, 2015 and two reminder invitations were sent on Oct.

20 and Oct. 28, 2015. The Advisory Committee (Appendix A) guided the development of the survey and

approved the health information provided.

The Advisory Committee held meetings on the following dates to review indicators, identify significant health

needs of the community and identify existing health care facilities and resources which are potentially available

to address the significant needs identified. Please refer to Appendix A for Advisory Committee participating

organizations and the groups each organization represent.

June 25, 2015

Aug. 6, 2015

Sept. 9, 2015

Nov. 4, 2015

Dec. 17, 2015

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During the earlier meetings, the Advisory Committee reviewed preliminary research findings, discussed content

for the Community Leader web survey, and discussed the need for additional data for the assessment, including

data on cultural competency, gaps in service and youth. The Advisory Committee agreed to use the Community

Health Improvement Cycle process as the assessment model for the CHNA. The Advisory Committee discussed

the timing for updating the Indicators Report and identified data sets to be used for completing the Stark County

Health Needs Assessment. Individual hospitals discussed their priorities and programs that are addressing those

priorities. The later meetings included discussions of community health improvement plans and programs

addressing community needs.

On Feb. 24, 2016, during the Stark County Annual Health Improvement Summit, the five significant health needs

of the community were discussed and prioritized followed by a discussion of existing resources and activities

within the community addressing those significant health needs. Summit participants identified the top three

needs as those needs to be included in the community health improvement plan. Please refer to appendix A for

participating organizations in the Summit and the groups represented by each organization.

All required sources from those representing the broad interests of the community participated in the CHNA

process.

Written comments on the previous CHNA report and implementation strategy were solicited through Aultman

Hospital’s and Aultman Specialty Hospital’s websites. However, neither Aultman Hospital nor Aultman Specialty

Hospital received written comments on the prior CHNA report or implementation strategy.

INFORMATION GAPS THAT LIMIT THE HOSPITAL’S ABILITY TO

ASSESS THE COMMUNITY HEALTH NEEDS

No information gaps were identified during the CHNA process.

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EVALUATION OF IMPACT OF ACTIONS IN PRIOR CHNA

The 2013 CHNA identified access to health care, obesity and lack of healthy lifestyle choices and the need for

additional mental health services as the significant health needs of the community served. Aultman Hospital and

Aultman Specialty Hospital chose to address all three significant needs in the 2013 Implementation Strategy.

The following identifies the need, action taken and impact of the action in addressing the need.

Need 1: ACCESS TO HEALTH CARE

Objective: Promote and increase the usage of primary care physicians among Stark County residents regarding preventive health care and early interventions to identify chronic diseases.

Action: Improving access to health care. Aultman Medical Group of Aultman Hospital and Aultman Specialty Hospital employed the following physician practices to provide care to the communities they serve:

Aultman Medical Group North Canton Medical Center – multispecialty physician practice with more than 200 support services and clinical employees including approximately 35 physicians, specializing in primary care, allergy, dermatology, oncology, counseling, podiatry and audiology.

Dunlap Family Physicians – a three-office practice serving primary care needs for Wayne County, including Orrville, Apple Creek and Dalton, with seven providers focusing on care from newborns to seniors.

Dr. Kevin Hill – internal medicine provider in Canton.

Canton General Surgery – four board-certified surgeons operating in Canton and Orrville.

Stark County Surgeons – two board-certified surgeons operating in Canton and Massillon.

Michael Rich, M.D. – psychiatrist with more than 20 years of experience serving Stark County.

Heart Core – three open-heart surgeons with nearly 60 years of combined experience in cardiothoracic surgery.

Family Medicine of Carrollton – five providers located in Carrollton providing primary care to patients of all ages.

Aultman Internal Medicine Orrville – board-certified internal medicine physician.

Aultman Endocrinology – two board-certified endocrinologists serving Orrville and Canton.

Canton Plastic Surgeons – Dr. Zaheer Shah, board-certified plastic surgeon with more than 30 years of experience in reconstructive (including trauma) and cosmetic surgery.

Impact: All members of the community are impacted by having greater access to physician practices in the community.

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Action: Aultman Medical Group of Aultman Hospital and Aultman Specialty Hospital published a new website, www.aultmanmedicalgroup.com, in 2015 to increase access to practices for patients. The website includes a breakdown of all available specialties, bill pay instructions and patient portal links for current patients. The website also features a comprehensive search function that allows patients to search for physicians based on specialty, gender, location and whether the physician is accepting new patients. Each physician’s availability is tracked weekly and updated on the website to feature the most recent access status.

Impact: All members of the community are impacted by having access to physician availabili ty by patient preference.

Action: In December 2015, Aultman Medical Group (AMG) of Aultman Hospital and Aultman Specialty Hospital created referral listings available to AMG providers and patients. Referral listings are used at Aultman Specialty Hospital and in several Aultman Hospital departments, including the emergency room, home care, rehabilitation and all immediate care areas. The referral listings help to inform patients of providers in the area and their availability. Community departments also have updated referral lists for visitor inquires.

Impact: Aultman Hospital and Aultman Specialty Hospital patients and visitors to community departments are impacted by having access to referral sources.

Action: Aultman Health Talks provides the community with free health education and access to a medical expert on a monthly basis. Providers and health care experts lead discussions on a multitude of topics such as nutrition, heart disease, diabetes, weight management, exercise, emotional health improvements, Alzheimer’s disease, depression, cancer, fall prevention and advanced directives.

Impact: Approximately 10 sessions are held each month. Aultman hosted 2,215 attendees in 2013, 3,113 in 2014 and 2,914 in 2015. Please see Appendix F for a listing of topics and number of attendees for each session.

Action: Improve community access to care through the Working on Wellness (WOW) program. WOW provides the community with complimentary health education and noninvasive screenings. The registered nurses staffing the program share information on how to access a primary care provider and provide referrals to the emergency department or a primary care physician for follow up.

Impact: WOW sponsored a total of 390 events in 2013, 363 in 2014 and 399 in 2015. In 2013, WOW educated 18,623 and screened 3,218. In 2014, WOW educated 14,498 and screened 2,612. In 2015, WOW educated 25,789 and screened 2,961. Please see Appendix G for a listing of the number of participants by type of screening and breakdown of screening recipients by race and age.

Action: Care coordination services are provided when members need to seek and receive care outside of the AultCare or PrimeTime health plans’ network of providers.

Impact: All AultCare and PrimeTime health plan members are impacted by having access to information on available providers.

http://www.aultmanmedicalgroup.com/

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Action: The Aultman Cancer Center hosts several free screening opportunities to help uninsured and underinsured in the community. Multiple screenings are offered including breast, cervical, colon, oral, head and neck, lung, prostate and skin.

Impact: In 2013, 348 screenings were provided, 261 were provided in 2014 and 332 in 2015. Follow-up care for all abnormal screenings has effectively been accomplished through the navigation program.

Action: AultCare offers individual AultOne, employer group and PrimeTime Health Plan Medicare Advantage plans. Network providers span the spectrum of health care specialties to meet the needs of enrollees and keep care locally based.

Impact: All plan participants are impacted by having access to local health care specialists.

Action: Each year for the Great American Smokeout, Aultman Heart, Cancer and Community teams work collaboratively to provide complimentary CO2 screenings and tobacco education in the hospital lobby to visitors and staff. Tobacco treatment specialists are on hand to promote tobacco cessation classes. This is a multidisciplinary effort to target cancer and heart disease.

Impact: In 2015, a tobacco treatment specialist had 73 interactions with visitors and staff, three received complimentary screenings and three signed up for tobacco cessation classes.

Action: The Aultman Infusion Therapy Department began a medication reimbursement program for uninsured patients in 2007 and a copay assistance program in 2013.

Impact: Led by an oncology-certified registered nurse, the program was successful in recovering $842,000 in drug costs in 2013 (medication replacement program for uninsured) and $38,000 in copay assistance for insured patients. In 2014, approximately $935,000 was recovered in drug costs and $76,000 in copay assistance, and in 2015, $1.1 million was recovered in drug costs and $88,000 in copay assistance.

Action: Aultman departments attend several community health fairs to share education and offer complimentary screenings. The multidisciplinary approach to serving the community enhances both knowledge and access to care. Several Aultman departments participate, including the heart center, cancer center, labor and delivery, dietary and stroke. The community health fairs target a specific population, including seniors and minorities.

Impact: Aultman participates in four or more fairs annually, reaching more than 2,000 individuals.

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Action: Aultman/Access Health Stark County collaboration. In February 2015, Aultman established a partnership with Access Health Stark County (AHSC) to coordinate follow-up care for patients discharged from Aultman’s Emergency Department. When patients with Medicaid or those who are uninsured and do not have a primary care provider are discharged, they are referred to Lifecare Family Health & Dental Center (Lifecare). Because there was no one designated to ensure that this follow-up appointment/care was arranged, the teams from Aultman, AHSC and Lifecare developed a process for post-emergency department care coordination. The target population is patients within the age range of 50-64, with Medicaid or who are uninsured, do not have a primary care provider and have a diagnosis of congestive heart failure, chronic obstructive pulmonary disease, hypertension or diabetes. The goals of this collaboration are:

Reduce overutilization of the emergency department for primary, non-urgent medical care.

Reduce the medically homeless by establishing patients with a primary care provider.

Decrease the uninsured population.

Impact: Since November 2015, Aultman has engaged 342 patients at the emergency department for potential enrollment in care coordination. The average enrollment for care coordination at Access Health is 22 patients per month. Aultman is currently following 99 active clients who have answered a follow-up call. Since November 2015, Aultman served 39 uninsured clients. Attempts to re-engage clients in the program are made through text messages and postcards.

Action: Aultman Transportation Outreach. Aultman’s Transportation Outreach program serves the area’s Amish population with non-emergency medical transportation to Aultman Hospital, its outlying health facilities and Aultman Specialty Hospital. With transportation a particular concern for those in rural areas and others, this reliable and dependable service makes health care accessible to patients who are unable to drive or have limited mobility.

Patients are met at their home, or at one of 200 churches in the community, to be taken to their medical appointments, radiation treatments, dialysis or physical rehabilitation. Family members ride at no charge. This on-demand, door-to-door service has routes and schedules changing daily in response to the riders’ requests to ensure that patients and their families arrive at their destination safely and on time. The program includes four vehicles, one of which is equipped to accommodate two wheelchairs. The driver assists passengers in boarding and departing the vehicle.

Impact: In 2015, the program served 3,302 people, of which 70 percent were seniors. Three vehicles traveled 119,000 miles and made approximately 4,400 passenger trips per vehicle. Distance and lack of transportation are barriers to accessing care. A significant number of Amish families in rural areas have come to depend on Aultman’s transportation services for medical appointments. This number continues to grow. Aultman obtained a new vehicle in 2015 through a grant from the Stark County Mobility Services Committee to enable expansion of services to hundreds of people.

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Need 2: OBESITY AND LACK OF HEALTHY LIFESTYLE CHOICES

Objective 1: Promote wellness and healthy lifestyle initiatives within area school districts.

Action: Kids Kick the Can® (KKTC) Program. The Aultman KKTC curriculum program was developed in 2015 by Aultman’s community wellness nurse with support and collaboration from The Ohio State University Extension, the Canton City Health Department and the Canton City School District. The third-grade educational program addresses water consumption, sugar and its effects on the body, and promotes play for 60 minutes a day. The student workbook, game piece and classroom poster were created by the Aultman Health Foundation. A partnership was created with California Public Health Advocacy for the use of their Kick the Can trademark.

Impact: The program was introduced to a select group of teachers in 2015, in preparation for the soft launch in the spring of 2016. Approximately 50 fourth-grade students from the Canton City School District ARTS Academy at Summit participated in an art contest for the KKTC characters. A pilot of the curriculum was launched at a Cedar Elementary and Clarendon Elementary open house, reaching 500-600 students and parents.

Action: Aultman Healthbyte. Through a partnership with Canton City School District (CCSD), Aultman employees provide healthy messages on the Channel 11 health segment. Segment topics include health, wellness and behavior change.

Impact: CCSD TV 11 reaches over 80,000 people. The educational outreach began in 2014 and continues today.

Action: The Working on Wellness (WOW) program. The WOW program, staffed by registered nurses, provides free health screenings and education throughout the community. The WOW van visits area schools to educate on topics ranging from exercise and sun safety to hand-washing and influenza. A popular curriculum shared is the MyPlate program, which promotes healthy eating to local schoolchildren by providing colorful placemats to teach children about food groups and creating “smart” plates for meals.

Impact: In 2013 the program reached 2,473 students, in 2014 the program reached 5,051 and in 2015 more than 10,527 received education through this program.

Action: The Ambassador Program. AMG Cardiovascular Consultants partners with area colleges, universities and high schools to provide education and leadership opportunities that are aimed at reducing obesity and promoting a healthy lifestyle. Program partners include Malone University and Aultman College, working with two local high schools, Louisville and Canton South. Partners and school representatives meet regularly as a wellness council to determine monthly projects for the students. Each school has Aultman Ambassador students who serve as program representatives and provide the necessary leadership to carry out the educational activities, including organized school health fairs, tailgates and community races. Ambassador students promote wellness messages and activities through the Ambassador webpage and social media outlets. An example of this program’s reach into the community was in 2015 when the students worked with the Louisville Chamber and local rotary club to support the Walk with a Doc program and the Leopard Mile downtown walking path. These efforts delivered positive newspaper articles, Facebook and Twitter posts. The Ambassador program has been in place at Louisville High School for five years and at Canton South High School for four years.

Impact: Students attending the participating schools are impacted by having access to education on reducing obesity and promoting a healthy lifestyle.

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Objective 2: Promote wellness and healthy lifestyle initiatives within worksites.

Action: The Working on Wellness (WOW) van visits companies and businesses to provide screenings and general health information. WOW provides noninvasive health screenings, including blood pressure checks, height, weight and body mass index/percentage of body fat. Several worksites are visited, some on a monthly basis, to share education and provide wellness screenings. Worksites visited regularly include Habitat ReStore, United Parcel Service and Refuge of Hope.

Impact: In 2013, WOW provided 3,057 blood pressure screenings, 2,431 in 2014 and 2,819 in 2015. In 2013, WOW provided 2,371 body mass index readings, 1,397 in 2014 and 1,561 in 2015.

Action: An Aultman tobacco treatment specialist visits worksites to provide employees with smoking cessation classes. Both JLG Industries and the Eric Snow YMCA benefited from this complimentary service in 2015.

Impact: The two programs reached a total of 15 individuals.

Action: Live Well Stark County Collaborative. Aultman is a member of Live Well Stark County, a coalition of community leaders working together to make the county healthier by promoting policies and programs that support wellness through healthy nutrition, physical activity and tobacco-free behaviors. In addition to Aultman, other coalition leaders include Mercy Medical Center, Stark Parks, The Ohio State University, Canton Parks and Recreation, Stark Fresh and the Stark County Health Department.

Impact: Aultman worked with other Live Well collaborators to promote smoke-free environments at two worksites – the JR Coleman Childcare Center and the Community Gardens in Massillon. In addition, no-smoking signs were added to many Stark Parks trails.

Action: Speaking Engagements in Stark County. Aultman’s wellness nurse speaks at local organizations and companies throughout the county to educate, unite, offer resources and help bring healthy programs to the community.

Impact: One visit to the local rotary club helped bring about the creation of the Louisville Leopard Mile downtown walking path. This impacts all members of the community by having access to education and resources that promote a healthy community.

Additional speaking engagements included:

2013:

Topics: Healthy eating and motivation.

Audience: Schools, churches, CCSD TV 11 viewers, fairs, seniors and rotary clubs.

Numbers reached: Approximately 29 events and 676 people. One radio and two television show audiences.

2014:

Topics: Healthy eating, heart disease, behavior change, motivation and sugar consumption.

Audience: Churches, schools, television and radio audiences, farmers markets, senior fairs, seniors, and civic center basketball attendees.

Numbers reached: Approximately 58 speaking engagements and/or events, and approximately 3,350 people. One radio show and three television show audiences.

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2015:

Topics: Healthy eating, heart disease, behavior change, motivation and sugar consumption.

Audiences: Schools, churches, CCSD TV 11 viewers, fairs, seniors and rotary clubs.

Numbers reached: Approximately 57 speaking engagements or events, and approximately 786 people reached. Audiences of four television appearances on CCSD TV 11, reaching more than 80,000 viewers.

Objective 3: Promote sustainable partnerships and programs for healthy lifestyles.

Action: American Heart Association’s National Walking Day. Aultman Health Foundation, American Heart Association and the Stark County community worked collaboratively to organize walks on the Aultman campus, hospital outbuildings and at community sites in 2013. The program continued to grow in 2014 and 2015. In 2015, a social media campaign was launched and the Stark Walks competition inspired others to “get moving” on National Walking Day. Several Aultman units attended to offer wellness education and noninvasive screenings to attendees.

Impact: Each year, the number of community participants grows, in addition to the number of partners involved. In 2014, more than 200 walkers participated. In 2015, multiple walks were held:

Aultman main campus had 200-300 participants.

Aultman outbuildings had 50-75 participants.

The Community Walk in Massillon brought together the following partners: Live Well, AultCare, Ernie’s Bike Shop, Canton City School District, American Heart Association, Second Sole, Blue Herring Restaurant and Aultman Hospital. There were 100 participants and the #starkwalks contest social media hits reached more than 3,000.

Action: Downtown Leopard Mile. In 2015, a mile-long walking path was developed in downtown Louisville. The Aultman Ambassador program worked with the rotarians and community to paint the downtown mile.

Impact: All members of the community are impacted by having access to a safe walking path environment in the community.

Action: Walk with a Doc Program (WWAD). The WWAD program was launched in October 2015. Monthly walks are held across the county to engage individuals in exercise while providing access to a local physician.

Impact: Some walk sites have attracted up to 45 participants per event, with an estimated 300 participants from October 2015 through July 2016.

Action: Ohio Hospital Association. Aultman Hospital and Aultman Specialty Hospital are represented on the Ohio Hospital Association’s Good 4 You Program. The nutritional program was developed by a statewide hospital community to improve the nutritional value of food and drinks offered by hospitals. Aultman implemented the healthy cafeteria option, which provides a listing of nutritional values for all foods in the cafeteria on the employee portal.

Impact: All Aultman Hospital and Aultman Specialty Hospital employees, patients and visitors are impacted by having access to the nutritional value of food and drinks available in the cafeteria.

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Action: American Heart Association’s National Eating Healthy Day. Aultman Hospital and Aultman Specialty Hospital partnered with the American Heart Association to aggressively promote healthy eating for one day on campus and in the community. A healthy recipe card contest was implemented for employees. The recipe cards were made available to employees and visitors in the cafeteria. Aultman dietitians created a healthy “MyPlate” menu for a local restaurant.

Impact: All Aultman Hospital and Aultman Specialty Hospital employees and visitors are impacted by having access to healthy recipes. The “MyPlate” menu restaurant patrons benefit by having healthy options.

Action: Families Helping Families (FHF) Program. The FHF Program is a six-month health intervention program led by a certified health coach. In 2015, the FHF program was offered at two locations in the city of Louisville. The program addresses behavioral health, nutrition and exercise. Participants were offered free health screenings in three-month increments. The health coach worked directly with champions of each site to develop sustainable programs.

Impact: One program site continues with 22 active participants, offering a Bible-based health plan in the summer and a church-sponsored garden.

Action: Blood screening at local farmers markets. In 2013, the Stark County community identified the need for AIC blood tests to determine prediabetes and diabetes. Multiple farmers markets in Stark County were chosen as the sites to reflect different social-economic and diverse populations. The Aultman blood screens were accompanied by standard WOW education and other noninvasive health screenings. All services offered were complimentary.

Impact: Providing free blood tests for prediabetes and diabetes, and educational material impacts those participating members of the community who aren’t aware of their diabetes status, making them aware of risks and prevention.

Other obesity and healthy lifestyle community support programs.

Action: Aultman Heart Center’s community education programs. The heart center sponsors two to five programs per month in schools, civic centers, theatres, temples, churches, cultural centers, YMCAs, golf clubs, hotels, farmers markets, the Pro Football Hall of Fame, fire departments, parks and the hospital. Topics include early heart attack care and education, CPR, heart catheterizations/PTCA, risk factors, STEMI, treadmill stress tests, signs and symptoms, prevention, treatment, warning signs, cholesterol, heart health, tobacco cessation, exercise and nutrition. Target audiences include elderly, children and mothers with young children, parents, physicians and the general public.

Impact: In 2014, 33 programs were conducted. In 2015, 17 programs were conducted with 1,820 attendees. In 2016 through June 3, 8 programs were conducted with 790 attendees.

Action: Aultman Weight Management program. The goal is to assist individuals to become healthier by offering tools to lose weight successfully and keep it off. Trained medical staff members offer knowledge, expertise and guidance through all three phases of the medically monitored weight management program.

Impact: The program served approximately 78 participants in 2014 and 55 participants in 2015.

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Action: The Vegan Diet Support Group, led by an Aultman cardiac rehabilitation nurse and cardiologist, offers information and encouragement to people on vegan or plant-based diets. Activities include food label-reading sessions, quarterly potluck suppers, and tips on how to order at restaurants. The cardiologist is available to share the latest medical research.

Impact: The support group, introductory classes and other group functions attracted 535 attendees in 2014 and 376 in 2015.

Action: Aultman Hospital’s and Aultman Specialty Hospital’s Generations “Healthier Together” Program (formerly known as PrimeTime Seniors) offers individuals aged 50 years and over wellness, educational and social opportunities to stay active, engaged and have fun. Sports leagues, exercise classes and travel opportunities are offered throughout the year.

Impact: Participants are impacted by having access to programs and opportunities targeted for those members of our community aged 50 and over.

Action: The Sharon Lane Health Information Center offers many resources for healthy lifestyles including a full lending collection of wellness books, videos, cookbooks, literature and anatomical models. As a centralized service center, a part-time staff member is on hand to promote Aultman’s health and wellness offerings to consumers and employees. The staff member also serves as a community navigator, directing individuals seeking assistance and support from community services.

Impact: Participants are impacted by having access to health and wellness educational materials.

Action: Aultman “Give it Up” tobacco cessation classes are held regularly and offered complimentary to the community. Group sessions are held for one hour, once a week, for six weeks. Classes are led by a tobacco treatment specialist and cover topics ranging from how to create a quitting plan to staying tobacco-free.

Impact: In 2013, the program educated 81 participants, 45 graduated (completing four sessions) and 35 quit smoking. In 2014, 117 participated, 71 graduated and 42 quit smoking. In 2015, 21 classes were held with 123 participants, 52 graduated from the program and 34 quit smoking.

Action: Outpatient counseling with a dietitian and a diabetes management program led by certified diabetes educators.

Impact: Participants have an increased awareness of diet and diabetes management.

Action: The Aultman Cancer Center established a Community Outreach Subcommittee responsible for determining community needs, tracking outreach activities and making recommendations to the Cancer Committee regarding planning and events. The group commenced in 2014 in an effort to meet the needs of the community by completing the 2014 Aultman Cancer Center Community Needs Assessment. Community outreach and screening initiatives were implemented in 2015.

Impact: Please see Appendix H for the 2015 community screening and outreach initiatives, and evaluation of the effectiveness of the events.

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Action: Aultman Hospital established a Community Outreach Subcommittee responsible for determining community needs, tracking outreach activities and making recommendations regarding infant mortality and safe sleep. The group commenced in 2014 in an effort to meet the needs of the community.

Impact: Please see Appendix I for the 2014 and 2015 outreach initiatives and impact of the effectiveness of the events.

Action: Day Care Center. Menus of meals provided to the Aultman Day Care Center are reviewed by a dietitian to monitor salt and fat content, keeping the menus within recommended guidelines.

Impact: Children at the Aultman Day Care Center are impacted by receiving healthy meals.

Action: Community Harvest. Excess food items from the Aultman cafeteria are distributed to local food kitchens though Community Harvest.

Impact: Individuals receiving meals through the local food kitchens benefit by receiving nutritional meals.

Action: Patient room menus. Food options for patients are available in each unit. Printed menus educate the patient on nutritional content and provide optional food choices. Most menus indicate items that are high in sodium and provide the carbohydrate count. Many of the menus have additional information that is specific to the patient needs in particular units. For example, the oncology menu has high-protein, high-calorie shake options. The heart menu identifies those foods with high fiber, high sodium and indicates the carbohydrate count.

Impact: Inpatients at Aultman Hospital and Aultman Specialty Hospital benefit by having healthy options and educational information to make healthy meal choices.

Action: On-site dining options: Breakaway Café and Season’s Café. Each March, during National Nutrition Month, Aultman features new items, free samples and special pricing on new healthy food choices. Dietitians are available, with information covering a wide range of nutrition topics. The café provides calories, fat and fiber content for many food items. The food items that are made in-house, such as the grab ‘n go salads, include complete nutritional labels with allergy information. Signage on the salad bar indicates those items that should be used sparingly, and those that are low in calories and nutrient-dense.

Impact: Hospital staff and visitors utilizing the cafés are impacted by having educational material available to make healthy food choices.

Action: Pepsi contract. Aultman meets quarterly with Pepsi representatives to review product usage, comparing carbonated to non-carbonated beverages and sugar to non-added sugar items.

Impact: Consumption of healthy options has increased over the last five years. Aultman will continue to monitor to ensure that offerings reflect many non-carbonated, no added sugar items.

Action: Other vendor resources. Aultman meets with vendors to encourage offerings of items that are lower in sodium, have a clean label and promote health.

Impact: Hospital staff and visitors are impacted by having healthy food choices.

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Need 3: NEED FOR ADDITIONAL MENTAL HEALTH SERVICES

Objective 1: Promote and encourage mental health wellness and substance abuse prevention throughout Stark County.

Action: Increase awareness of mental health wellness promotion and substance abuse prevention programs, activities, initiatives, events, resources, screenings and examinations available within Stark County to community partners and residents.

Collaboration with Quest and The Crisis Center – 2016.

Create detox protocol - in progress.

Project DAWN (Death Avoidance With Naloxone) - 2015 (provided six times).

Medical health education awareness series, open to Aultman employees, with the goal to make the series available to the community.

Aultman hosted symposium with Judge Forchione, “Stop Heroin from Killing” on June 15, 2015.

Aultman Hospital representatives serve on several committees and subcommittees to discuss awareness of mental health.

Pam Tapp, Aultman psychiatric nurse, serves as a council/committee member on the following:

Mental health Board Opiate Task Force Stop Heroin from Killing, Judge Forchione’s Committee Suicide Awareness Task Force

Aultman Licensed Social Worker Lyn Gastin serves as a council/committee member on the following:

MIAA Mental Illness Addiction Awareness SMART Stark Multidisciplinary Team Community Awareness

o Current focus on adult protection mental health. o Domestic violence amongst elderly.

Impact: By promoting awareness of resources available within the community, residents may better avail themselves of these services, thus improving health and wellness. Specifically, project DAWN served 14 families.

Action: Increase access to and usage of mental health wellness promotion and substance abuse prevention programs, resources, activities, initiatives, events, screenings and examinations available to Stark County residents.

Aultman Cancer Center hosts Knowledge is Power, an educational series for cancer patients and family members to educate on cancer prevention and increase availability of mental health and supportive care.

Moving Forward is a monthly survivorship support group provided by Aultman Cancer Center to provide patients with therapy, behavioral health, financial advocacy, dietary and integrative therapy. The focus is on survivorship needs and availability of mental health and supportive care.

Monthly Health Talks are offered to the community and cover a range of topics, including stress management techniques and mind/body medicine.

Aultman “Give it Up” tobacco cessation classes are held regularly and offered complimentary to the community. Group sessions are held for one hour, once a week, for six weeks. Classes are led by a tobacco treatment specialist.

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Impact: By promoting awareness of resources available within the community, residents may better avail themselves of these services, thus improving health and wellness.

The cancer education series, “Knowledge is Power.”

2014: Four weekly sessions held in May, five sessions held in September. Approximately 12-14 attended each session.

2015: Five weekly sessions held in January, April, July and October. Approximately 11 attended each session.

“Moving Forward” - monthly survivorship support group/screening sessions.

2015: Held the second Thursday of each month. Approximately 10 attended each session.

Objective 2: Increase mental health substance abuse awareness and education throughout Stark County.

Action: Improve mental health and substance abuse awareness and education to the community.

Working with local law enforcement and the Stark County Mental Health and Addiction Recovery organization, Aultman Hospital serves as a drug take-back location during Take Back Drug Day.

Participate in Drug Awareness Day by setting up an educational booth, staffed by Aultman, to share resources for drug awareness and mental health.

Each year for the Great American Smokeout, Aultman Heart, Cancer and Community teams work collaboratively to provide complimentary CO2 screenings and tobacco education, offered in the hospital lobby to visitors and staff. Tobacco treatment specialists provide tobacco counseling and encourage participation in the complimentary cessation classes.

Impact: During Take Back Drug Day, 41.5 pounds were collected in 2013, 47.5 pounds in 2014 and 133.5 pounds in 2015. At the Great American Smokeout in 2015, a tobacco treatment specialist had 73 interactions with visitors and staff, three received complimentary screenings and three signed up for tobacco cessation classes.

Objective 3: Increase awareness and usage of mental health and substance abuse treatment opportunities available throughout Stark County.

Action: Promote and encourage mental health and substance abuse treatment programs, activities, initiatives, resources and classes to Stark County residents. Inpatients are encouraged and linked with support programs at discharge. On April 29, 2016, Aultman hosted a Healing Voices event associated with the mental health board.

Impact: Inpatients identified as being at-risk are impacted with encouragement and information to follow through with necessary support programs.

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Action: Develop and promote the importance of using a system/patient navigator to access mental health care.

Behavior navigator in the emergency department was established in 2014 to increase access, decrease length of stay by one-half hour, and increase community linkage to necessary services.

Project RED was established in 2015 to re-engineer discharge. A hospital-wide initiative from the Agency for Healthcare Research and Quality encompasses twelve components to ensure a successful and optimal discharge process. The impact is lower readmissions, lower utilization and improved quality of care. Aultman has implemented four components: 1) every patient will have a follow-up appointment with a primary care physician and/or specialist; 2) the primary care physician and/or specialist will be aware of any pending tests or results at discharge; 3) necessary home services will be scheduled; and 4) the department instruction tool will be updated and improved. The goal is to initially decrease readmission, and promote follow-up with the primary care physician and psychiatric provider.

Impact: No data is available at this time. Follow-up appointments have been initiated. This will impact all hospital discharges. In 2015, Aultman Hospital discharged 21,249 and Aultman Specialty Hospital discharged 180.

COLLABORATING PARTNERS

Aultman Hospital and Aultman Specialty Hospital collaborated with Mercy Medical Center, Alliance Community

Hospital, the Canton City Health Department, the Stark County Health Department, the United Way of Greater

Stark County, the Massillon City Health Department, the Alliance City Health Department and organizations

participating on the Advisory Committee, and the Summit participants, identified in Appendix A, to conduct the

2015 Stark County Health Needs Assessment and prioritize the significant health needs of the community.

The collaboration contracted with Center for Marketing & Opinion Research, LLC to conduct the Stark County

health needs assessment and prepare the 2015 Stark County Health Needs Assessment. The Center for

Marketing & Opinion Research provides public opinion research services to colleges and universities, hospitals

and health care organizations, businesses, and community-based organizations and government agencies.

Services include telephone, web and mail surveys, field, intercept and key informant interviews, focus group

administration, as well as a wide range of consulting services.

Areas of Expertise:

Community Image, Awareness and Preference Studies

Community Needs Assessments and Community Health Needs Assessments

Levy Research, Including Message Testing, Data Mapping & Voter Modeling

Public Opinion Research & Polling

Key Stakeholder Research

Collaborative Polls in Select Counties

Service and Provider Satisfaction Studies

Fan Engagement and Experience

http://www.cmoresearch.com/collaborative_polls.php

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Strategic Plan Research

New Markets, Services or Products Testing

Key Stakeholder, Customer, Employee Satisfaction/Engagement Studies

Aultman Health Foundation engaged Bricker & Eckler LLP/Quality Management Consulting Group, located at 100

South Third St., Columbus, Ohio, to prepare this CHNA report. Jim Flynn is a partner with Bricker & Eckler’s

health care group, where he has practiced for 25 years. His general health care practice focuses on health

planning matters, certificate of need, nonprofit and tax-exempt health care providers, and federal and state

regulatory issues. Mr. Flynn has provided consultation to health care providers, including nonprofit and tax-

exempt health care providers and public hospitals on community health needs assessments. Christine Kenney is

the director of regulatory services with the Quality Management Consulting Group of Bricker & Eckler LLP. Ms.

Kenney has over 36 years of experience in health care planning, policy development, federal and state

regulations, certificate of need, and Medicare and Medicaid certification. She provides expert testimony on

community need and offers presentations and educational sessions regarding community health needs

assessments. She has been conducting community health needs assessments in accordance with the affordable

care act requirements since 2012.

SOLICIT WRITTEN COMMENTS

Written comments concerning this CHNA report and related Implementation Strategy may be submitted to

Corporate Controller Melissa Warrington at Aultman Hospital, 2600 Sixth St. SW, Canton, Ohio 44710 or at

[email protected]. Any written comments received will be considered in conducting the next

Community Health Needs Assessment.


32


APPENDIX A

Participating Organizations Advisory Committee

Stark County Annual Health Improvement Summit Participants

Committee Summit Organization Populations Represented

X X Stark County Health Department*

All populations of Stark County, including the medically underserved, low-income and minority populations.

X X Canton City Health Department*

All populations of Canton, Stark County, Ohio, including the medically underserved, low-income and minority populations.

X X Alliance Community Hospital


X X Pegasus Farm Therapeutic equestrian center representing those age three to adulthood with special needs and adults with developmental disabilities.

X X Prescription Assistance Network

Medically underserved, low-income and minority populations of Stark County.

X X Mercy Medical Center All populations of Stark County, including the medically underserved, low-income and minority populations.

X X Aultman Hospital and Aultman Specialty Hospital

All populations of Stark County, including the medically underserved, low-income, and minority populations.

X X Sisters of Charity Foundation of Canton


X X Austin Bailey Health and Wellness Foundation

Private grant-making foundation focused on support programs that promote the physical and mental well-being of the citizens of Stark, Holmes, Tuscarawas and Wayne Counties with emphasis on health care affordability, concerns of the uninsured, underinsured, the poor, children, single parents and elderly. In addition, advocates programs that address the mental health needs of individuals and families.

X X Mental Health & Recovery Services Board of Stark County

Ensuring the behavioral health needs of Stark County residents are met in the most efficient, economic and effective way possible. Providing mental health and substance abuse prevention, intervention and treatment. Responsible for assessing the needs of the community and ensuring that a continuum of care is in place.

X X Community Advocates All populations of Stark County, including the medically underserved, low-income and minority populations.

33



X X Stark County Family Council

Partnership of local government entities, community agencies and families who work together to promote a system of care for families with children/youth ages birth through 21.

X X Health Foundation of Greater Massillon

Provide funds targeted to programs and projects related to health and wellness of greater Stark County, particularly involving those in need.

X X Access Health Stark County

Assist with access to health care for low-income, uninsured residents of Stark County.

X Stark County Medical Society

Physician advocate and patient advocate for affordable health care services, service provider to meet professional needs and interests of members, voice for public issues impacting health care, and advocate for patient-physician relationships.

X X United Way of Greater Stark County

Improve the quality of life in the community by leading in the development of solutions to critical social issues in the areas of education, income and health. Fund programs that address the community’s most important issues like poverty, domestic violence and child care.

X X The Aultman Health Foundation


X Summa Health All populations of Stark County, including the medically underserved, low-income and minority populations.

X X Stark Parks/Live Well Stark County

Coalition of community leaders working together to make Stark County residents healthier by promoting policies and programs that support wellness through healthy nutrition, physical activity and tobacco-free behaviors.

X X Stark County Community Action Agency

Serving all individuals and families in critical need of services.

X X Alliance City Health Department*

All populations of Alliance, Stark County, Ohio, including the medically underserved, low-income and minority populations.

X Massillon City Health Department*

All populations of Massillon, Stark County, Ohio, including the medically underserved, low-income and minority populations.

X X Ohio State University Extension Office

Helping all Stark County residents build better lives, better businesses and better communities.

X Walsh University

Catholic higher educational community. Creating leaders through service to others by tutoring and mentoring school children, assisting low-income families, distributing meals, preventing recidivism among nonviolent offenders, and performing missionary work around the world.

X Molina Healthcare of Ohio

Serving members, including Medicare and Medicaid individuals.

34



X Scott’s Training Center Training and business solutions. Representing local business.

X Coming Together Stark County

Promoting diversity, inclusion and dignity for all people in Stark County.

X Buckeye Health Plan Health insurance company for Ohio’s Medicaid population.

X YWCA Canton Mission to eliminate racism and empower women. Provides emergency shelter and early care and education to prevent homelessness.

X Lighthouse Visions, Inc. Empowering foster youths and other youth of Stark County with basic life skills.

X Carroll County General Health District*

All populations of Carroll County, including the medically underserved, low-income and minority populations.

X Latino Business League Promoting advancement and development of the Latino community.

X Lifecare Family Health & Dental Center

Providing health services for beneficiaries of Medicare, Medicaid and most private insurances with payment options based on ability to pay.

X North Canton YMCA Cause-driven organization for youth development.

X United Healthcare Community Plan

Health care coverage for beneficiaries of Medicaid, Medicare and other state health care programs.

X North Canton Medical Foundation

Provides medical care and health education programs for the community.

X Northeast Ohio Medical University

Collaboration with educational, clinical and research partners to train health professionals and medical researchers who impact the region and beyond.

X

Northeast Ohio Medical University, Area Health Education Center Program

Enhancing health career opportunities.

X Stark Fresh Innovate and educate ways to help break the systematic cycle of poverty through equal food access.

X Stark Community Foundation

Responding to local needs and challenges through carefully designed funds and programs. Strengthen Stark County by providing an improved quality of life for residents of the community.

X Canton Regional Area Health Education Center

Enhancing health career opportunities with recruitment, training and professional development activities.

X Deli Ohio LLC Local business providing natural products from Ohio.

X THRIVE – Toward Health Resiliency for Infant Vitality & Equity

Improving infant mortality.

X CIRV - Community Initiative to Reduce Violence

Collaborative effort to reduce gun violence and associated homicides.

35



X Alliance Community Garden Committee

Providing a peaceful community space for healing, learning, growing, offering education and beautification.

X SMHA - Stark Metropolitan Housing Authority

Providing subsidized housing and resident initiative programs for eligible county citizens.

X Stark County Job and Family Service, Children Services Division*

Low-income children and families of Stark County.

X Stark County Educational Services Center

Assist in providing a quality education for pre-kindergarten to twelfth-grade students.

X Affinity Medical Center Service Massillon with geriatric psychiatry, family medicine and heart health services.

X Greyledge Consulting Management and organization development consulting firm.

X Health Policy Institute of Ohio

Statewide center that informs Ohio health policy by forecasting health trends and analyzing key health issues.

X

Stark County Urban Minority Alcoholism Drug Abuse Outreach Program

Meeting the substance abuse education, prevention and treatment needs of African- and Hispanic-Americans.

X Gentlebrook Providing services that span the lifetime needs of persons with developmental disabilities and older adults.

X ICAN Housing Support for homeless veterans.

X Creating Healthy Communities

Committed to preventing and reducing chronic disease statewide.

X

Stark County Community Action Agency – Head Start Program

Quality early childhood education.

X Pathway Caring for Children

Serving children and families of northeastern Ohio.

X Aultman Medical Group Medical practice providing affordable health care and preventive care through access to primary care physicians, specialists and services.

36


APPENDIX B

2015 Stark County Health Needs Assessment

Community Survey Summary

The following is a summary of the Community Survey results from the 2015 Stark County Health Needs Assessment.

Overall Needs and Health

Most important health issue (top 3)

Lack of affordable insurance/health care 27.9%

Obesity 12.1%

Cancer 10.6%

Are there health services or programs needed? Yes 49.5%

No 50.5%

Services/programs needed (top 3)

Affordable health care/insurance 12.3%

More free clinics 11.9%

Rehabilitation for drugs and alcohol 9.7%

Health Care Programs and Services

Importance of having programs and services (top 3 listed as “very important”)

Prenatal care 80.6%

Diabetic care 79.2%

Blood sugar checks 71.4%

Health topics most interested in (top 3)

Diabetes/blood sugar control 34.5%

Weight loss/management/obesity 24.8%

Cardiovascular/heart health 19.6%

Access to Care

Aware of places to obtain free routine screenings

Yes 36.7%

No 63.3%

Insurance coverage

Not insured 4.8%

Employer paid 38.5%

Private insurance 11.9%

Medicare/Medicaid 42.9%

Where receive health care most often (top 3)

Primary care or family doctor 75.0%

Emergency room 8.3%

Hospital clinic 3.6%

Have primary care provider Yes 84.4%

No 15.6%

Last routine physical exam

Within the past year 75.6%

Within the past 2 years 8.9%


5 or more years 8.9%

Last dental visit

Within the past year 63.9%



5 or more years 15.9%

Needed specialist unable to find locally Yes 26.9%

No 73.1%

37


Follow-up: Specialist unable to find (top 3)

Orthopedic surgeon/doctor 18.8%

Dermatologist 17.3%

Neurologist 11.5%

Smoking/Tobacco, Alcohol and Prescription Drug Use

Tobacco use

Everyday 22.0%

Some days 7.6%

Not at all 70.4%

Interested in hospital smoking cessation program

Very interested 16.7%

Somewhat interested 31.8%

Not at all interested 51.5%

Alcohol use

Everyday 2.6%

Some days 48.5%

Not at all 48.9%

OxyContin and Heroin Use

Know someone who has taken OxyContin or prescription to get high

Yes 15.3%

No 84.7%

How serious of a problem is heroin in Stark County?

Very serious 74.1%

Moderately serious 18.5%

Not too serious 3.8%

Not really a problem at all 3.5%

Know someone who uses heroin regularly Yes 14.3%

No 85.7%

Know someone who overdosed from heroin Yes 65.8%

No 34.2%

Care for Children and Safe Sleep Guidelines

Familiarity with sleep guidelines (% very familiar)

Always put baby in crib alone 81.6%

Always put baby to sleep on their back 76.3%

Firm mattress and fitted sheet only in crib 81.6%

When started prenatal care

Months 1-3 81.8%

Months 4-6 18.2%

Months 7-9 0.0%

Have you or immediate family member

Had a child that had low birth weight 10.4%

Had child that was born prematurely 17.3%

Experienced death of child before one 16.3%

Exercise

Exercise in past month Yes 83.0%

No 17.0%

How often exercise per week

Not at all 10.5%

Once in awhile 15.0%

1-2 times 21.8%

3-4 times 27.6%

5-7 times 25.2%

Follow-up: What’s making it difficult to exercise? (top 3)

Physical limitations 58.0%

Laziness/procrastination 21.0%

Too busy/no time 19.8%

38


Obesity and Access to Healthy Food

Self-described weight

Overweight 46.5%

About right 46.7%

Underweight 6.7%

Main problem getting needed food

Cost of food 39.0%

Quality of food 26.1%

Time for shopping 26.3%

Safety 8.1%

Distance from the store 10.0%

Something else 5.4%

How difficult to get fresh food and vegetables in neighborhood

Very difficult 4.9%

Somewhat difficult 13.0%

Not at all difficult 82.1%

How often eat fresh fruits and vegetables

0-1 times/week 6.7%

2-4 times/week 29.6%

Once a day 33.4%

2-4 times a day 27.0%

5 or more times a day 3.4%

Immunizations

Get flu vaccination in past year Yes 52.3%

No 47.7%

Child had flu vaccination in past year Yes 56.4%

No 43.6%

Children’s vaccinations up-to-date Yes 96.5%

No 3.5%

Summary of Tests

Within past year

Blood pressure check 92.4%

Blood cholesterol check 66.6%

Mammogram (females only) 48.6%

PSA test (males only) 25.8%

Colonoscopy 13.1%

Skin cancer check 11.2%

Within past 2 years

Blood pressure check 3.3%

Blood cholesterol check 9.1%

Mammogram (females only) 11.5%

PSA test (males only) 7.6%

Colonoscopy 9.3%

Skin cancer check 5.4%

Public Transportation

Own a vehicle Yes 87.5%

No 12.5%

Have access to good public transportation Yes 69.6%

No 30.4%

Source: Center for Marketing & Opinion Research, LLC (2015). 2015 Stark County Health Needs Assessment.

39


APPENDIX C

2015 Stark County Health Needs Assessment

Community Leader Web Survey Summary

The following is a summary of the Community Health Leader survey results.

Top 3 most important health needs Access to care

Mental health issues

Obesity and lack of healthy lifestyle choices

Top 4 additional community needs that need to be addressed

Alcohol abuse

Senior health and services

Nutritional education

Substance abuse

Top 4 populations not adequately served

People with mental illness

Homeless/transient

Individuals addicted to drugs and alcohol

Individuals living in poverty

Top 5 additional programs, resources or services needed that are not currently available

More dental services/clinics

Additional mental health services/facilities

More free and low-cost health clinics

In-home care for seniors/programs for seniors

Nutrition-based programs

Top 4 emerging health needs

Aging services/services for elderly

Drug and alcohol abuse/addiction

Access to affordable health care

Healthy food at affordable prices/nutrition education

Top 3 barriers that prevent residents from receiving needed medical care

Transportation

Cost

Lack of understanding/knowledge of programs and services available

Top 3 suggestions to improve access to health care

More community education/information about available programs

Easier/more accessible/affordable transportation

Continue to expand community-based services

Top 3 suggestions to improve healthy behaviors

More community health education, outreach and workshops

More availability of low-cost or free physical activity/exercise programs

Form local support groups

Top 3 barriers that prevent residents from receiving needed mental health services

Stigma

Lack of providers

Transportation

Source: Center for Marketing & Opinion Research, LLC (2015). 2015 Stark County Health Needs Assessment.

40


APPENDIX D

Community Commons

Stark County Health Indicators Not Meeting Average Benchmarks

Social and Economic

Stark County Ohio U.S.

Children eligible for free/reduced-price lunch 46.11% 44.5% 52.35%

Household with public assistance income 6.03% 3.33% 2.82%

Insurance – population receiving Medicaid 19.53% 19.37% 20.75%

Lack of social or emotional support 19.7% 19.5% 20.7%

Population receiving SNAP benefits 15.28% 14.95% 12.98%

Poverty – Children below 200% federal poverty level 45.27% 44.34% 44.21%

Poverty – Population below 200% federal poverty level 34.36% 34.33% 34.54%

Unemployment rate 5.5 4.8 4.7

Physical Environment


Low food access 26.59% 24.97% 23.61%

Use of public transportation 1.06% 1.62% 5.06%

Clinical Care


Cancer screening – mammogram 58.8% 60.3% 63%

HIV screening 73.36% 68.3% 62.79%

Dental care utilization 27.7% 27.6% 30.2%

Federally qualified health centers/100,000 population 1.07 2.01 2.15

Lack of prenatal care 26.24% 26.2% 17.3%

Lack of consistent source of primary care 19.19% 18.65% 22.07%

Population living in a health professional shortage area 100% 32.45% 33.13%

Health Behaviors


Tobacco usage – current smokers 23.4% 21.7% 18.1%

Tobacco usage – former or current smoker 54.92% 49.10% 44.16%

Walking or biking to work 1.66% 2.59% 3.37%

41


Health Outcomes


Asthma prevalence 15.3% 13.8% 13.4%

Cancer incident – prostate/100,000 138.1 127.1 131.7

Depression (Medicare) 20.1% 18.1% 15.4%

Diabetes (Adult) 10.7% 10.14% 9.11%

Heart disease (Adult) 6.1% 5.1% 4.4%

High cholesterol (Adult) 41.13% 38.70% 38.52%

High cholesterol (Medicare) 48.63% 46.26% 44.75%

Infant mortality/1,000 births 8 7.7 6.5

Low birth weight 8.9% 8.6% 8.2%

Mortality – pedestrian accident/100,000 1.1 1.0 1.7

Mortality – suicide/100,000 13.5 12.1 12.3

Obesity 30.5% 20.1% 27.1%

Overweight 36.0% 35.8% 35.8%

Poor dental health 19.8% 18.7% 15.7%

Institute for People, Place and Possibility (IP3) (2016). CommunityCommons (Stark County Health Indicators not meeting average benchmarks). Retrieved from http://www.communitycommons.org/chna/ on June 24, 2016.

http://www.communitycommons.org/chna/

42


APPENDIX E

Stark County Health Rankings

University of Wisconsin Population Health Institute School of Medicine and Public Health (2016). County Health Rankings. Retrieved from http://www.countyhealthrankings.org/app/ohio/2016, on May 27, 2016.

Stark (ST) STARK COUNTY ERROR MARGIN TOP U.S. PERFORMERS^ OHIO RANK (0F

88) Health Outcomes 45 Length of Life 34 Premature death 7,100 6,800-7,400 5,200 7,500 Quality of Life 57 Poor of fair health** 16% 15-16% 12% 17% Poor physical health days** 3.8 3.6-3.9 2.9 4.0 Poor mental health days** 4.0 3.8-4.1 2.8 4.3 Low birth weight 9% 9-9% 6% 9% Health Factors 36 Health Behaviors 36 Adult smoking** 19% 19-20% 14% 21% Adult obesity 31% 28-33% 25% 30% Food environment index 6.9 8.3 6.9 Physical inactivity 26% 24-28% 20% 26% Access to exercise opportunities 80% 91% 83% Excessive drinking** 18% 17-18% 12% 19% Alcohol-impaired driving deaths 39% 35-43% 14% 35% Sexually transmitted infections 382.3 134.1 460.2 Teen births 33 32-34 19 34 Clinical Care 10 Uninsured 13% 12-14% 11% 13% Primary care physicians 1,270:1 1,040:1 1,300:1 Dentists 1.650:1 1,340:1 1,710:1 Mental health providers 520:1 370:1 640:1 Preventable hospital stays 53 51-56 38 65 Diabetic monitoring 86% 83-89% 90% 85% Mammography screening 58% 55-62% 71% 60% Social & Economic Factors 43 High school graduation 89% 93% 83% Some college 63% 61-65% 72% 63% Unemployment 5.7% 3.5% 5.7% Children in poverty 22% 18-25% 13% 23% Income equality 4.4 4.2-4.5 3.7 4.8 Children in single-parent households

36% 34-38% 21% 35%

Social associations 12.8 22.1 11.4 Violent crime 297 59 307 Injury deaths 63 59-66 51 63 Physical Environment 81 Air pollution – particulate matter 14.0 9.5 13.5 Drinking water violations Yes No Severe housing problems 14% 13-14% 9% 15% Driving alone to work 86% 85-86% 71% 84% Long commute – driving alone 25% 24-26% 15% 29% Areas to Explore Areas of Strength

^10th/90th percentile, i.e., only 10% are better.

Note: Blank values reflect unreliable of missing data. **Data should not be compared with prior years due to changes in definition/methods.

http://www.countyhealthrankings.org/app/ohio/2016

43


County Health Rankings & Roadmaps Building a Culture of Health, County by County

2016 Measures & Data Sources

Measure Data Source Years of Data

HEALTH OUTCOMES

Length of Life Premature death National Center for Health Statistics – mortality files 2011-2013

Quality of Life Poor or fair health Behavioral Risk Factor Surveillance System 2014 Poor physical health days Behavioral Risk Factor Surveillance System 2014 Poor mental health days Behavioral Risk Factor Surveillance System 2014 Low birth weight National Center for Health Statistics – natality files 2007-2013

HEALTH FACTORS

HEALTH BEHAVIORS

Tobacco use Adult Smoking Behavioral Risk Factor Surveillance System 2014

Diet and Exercise

Adult obesity CDC Diabetes Interactive Atlas 2012

Food environment index USDA Food Environment Atlas, Map the Meal Gap 2013

Physical inactivity CDC Diabetes Interactive Atlas 2012

Access to exercise opportunities Business Analyst, Delorme map data, ESRI & US Census Tigerline Files

2010 & 2014

Alcohol and Drug Use

Excessive drinking Behavioral Risk Factor Surveillance System 2014 Alcohol-impaired driving deaths Fatality Analysis Reporting System 2010-2014

Sexual Activity

Sexually transmitted infections National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

2013

Teen births National Center for Health Statistics – Natality files 2007-2013

CLINICAL CARE

Access to Care Uninsured Small Area Health Insurance Estimates 2013 Primary care physicians Area Health Resource File/American Medical Association 2013 Dentists Area Health Resource File/National Provider Identification file 2014 Mental health providers CMS, National Provider Identification file 2015

Quality of Care

Preventable hospital stays Dartmouth Atlas of Health Care 2013

Diabetic monitoring Dartmouth Atlas of Health Care 2013 Mammography screening Dartmouth Atlas of Health Care 2013

SOCIAL AND ECONOMIC FACTORS

Education High school graduation U.S. Department of Education (EDFacts) 2012-2013 Some college American Community Survey 2010-2014

Income Children in poverty Small Area Income and Poverty Estimates 2014 Income inequality American Community Survey 2010-2014

Family and Social Support

Children in single-parent households

American Community Survey 2010-2014

Social associations County Business Patterns 2013

Community Safety

Violent crime Uniform Crime Reporting – FBI 2010-2012 Injury deaths CDC WONDER mortality data 2009-2013

PHYSICAL ENVIRONMENT

Air and Water Quality

Air pollution – particulate matter1 CDC WONDER environmental data 2011 Drinking water violations Safe Drinking Water Information System FY2013-14

Housing and Transit

Severe housing problems Comprehensive Housing Affordability Strategy (CHAS) data 2008-2012 Driving alone to work American Community Survey 2010-2014 Long commute – driving alone American Community Survey 2010-2014

1 Not available for AK and HI. A collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

44


APPENDIX F Aultman Health Talks 2013

Date Topic Speaker Location Time Attended

1/3/2013 Thur Compassionate Journey Terry Livengood, MA, CT West 6-7:30 p.m. 16

1/9/2013 Wed Healthy Weight Loss Dave Speicher, MS, CSCS, PES, CES Orrville 6-7 p.m. 18

1/9/2013 Wed Basics of LASIK Sanjeev Dewan, M.D. North 6-7:30 p.m. 10

1/10/2013 Thur Minding Your Health Sara Sayer, MA & Steve Graef, Ph.D. West 6-7:30 p.m. 21

1/15/2013 Tue Ring in the New Year with Healthy Eating Jennifer Perdue, RD North 2-3:30 p.m. 32

1/16/2013 Wed Kick the Tobacco Habit Sara Schaub North 6-7:30 p.m. 10

1/17/2013 Thur Total Joint Replacement Timothy Conlan, M.D. West 6-7:30 p.m. 25

1/22/2013 Tue 10 Tips to Managing Diabetes Liz Heiser, RN West 2-3:30 p.m. 15

1/23/2013 Wed Adult ADHD Mimi Godzan, RN North 6-7:30 p.m. 40

1/24/2013 Thur Urinary Incontinence in Women Bob Bowden, M.D. Orrville 6-7 p.m. 16

1/24/2013 Thur Safety and Security at Home Chris Feller West 6-7:30 p.m. Cancelled

1/29/2013 Tue Wicked Winter Woes Connie Leggett, RN Carrollton 2-3:30 p.m. 4

2/5/2013 Tue Reducing Your Risk of Heart Disease Adene Keller, RN West 2-3:30 p.m. 18

2/6/2013 Wed Know the 10 Signs Jennifer Miller North 6-7:30 p.m. 70

2/7/2013 Thur Varicose & Spider Veins Stephen Sanofsky, M.D. West 6-7:30 p.m. 21

2/12/2013 Tue MyPlate Linda Brunk, RN North 2-3:30 p.m. 17

2/13/2013 Wed Aesthetics of Eyelid Surgery Sanjeev Dewan, M.D. North 6-7:30 p.m. 25

2/14/2013 Thur The Heart of Leadership Michael Gallina West 6-7:30 p.m. 33

2/19/2013 Tue Fall Prevention Sheree Nuske, RN West 2-3:30 p.m. 23

2/20/2013 Wed Diabetes Diet Sean Beach, RD, LD North 6-7:30 p.m. 46

2/21/2013 Thur Minding Your Health Sara Sayer, MA & Steve Graef, Ph.D. West 6-7:30 p.m. 17

2/26/2013 Tue Caregiver for the Cancer Patient Brandy Hahn, RN North 2-3:30 p.m. 9

2/27/2013 Wed Medicare Fraud and Identity Theft Don Hartman, Pro Seniors of Ohio Orrville 2-3 p.m. 12

3/6/2013 Wed Common Back Disorders Mark Cecil, M.D. North 6-7:30 p.m. 36

3/7/2013 Thur Total Joint Replacement Michael London, M.D. North 6-7:30 p.m. 18

3/12/2013 Tue Skin Care & Wound Care Cynthia Sponseller, RN West 2-3:30 p.m. 9

3/13/2013 Wed Controlling Diabetes Cheryl Michaels, RN, BSN North 6-7:30 p.m. 35

3/14/2013 Thur Medicare Today Sharon Smith West 6-7:30 p.m. 30

3/19/2013 Tue Hearing Aids Chris Herberghs, LHAS North 2-3:30 p.m. Cancelled

3/20/2013 Wed Cancer Screening and Prevention Tina Brechbill, CNS Sharon Lane 2-3:30 p.m. Cancelled

3/26/2013 Tue Massage & Mobility Lyn Sabino, LMT West 2-3:30 p.m. 13

3/27/2013 Wed Safety and Security at Home Chris Feller North 6-7:30 p.m. 10

3/28/2013 Thur Irritable Bowel Disease Kahil Korkor, M.D. West 6-7:30 p.m. 35

4/3/2013 Wed Varicose & Spider Veins Stephen Sanofsky, M.D. North 6-7:30 p.m. 26

4/4/2013 Thur A.R.I.S.E. 5 Strategies to Manage Our Stress Steve Graef, Ph.D. Carrollton 6-7:30 p.m. 25

4/9/2013 Tue Volunteer Services Lori Harmon North 2-3:30 p.m. 6

4/10/2013 Wed Helping Children with ADHD Mimi Gozdan, RN North 6-7:30 p.m. 11

4/11/2013 Thur Common Hand Disorders Ira Richterman, M.D. West 6-7:30 p.m. 28

4/16/2013 Tue The Patient’s Role in Patient Safety John Sutton, M.D. North 2-3:30 p.m. 7

4/17/2013 Wed Droopy Lids Jamie Zucker, M.D. North 6-7:30 p.m. 23

4/18/2013 Thur The ABC’s of Foot Pain and Function Steven Gross, M.D. West 6-7:30 p.m. 26

4/24/2013 Wed Lou Gehrig’s Disease Pam Cazzolli, RN, ALS Educator North 6-7:30 p.m. 7

4/25/2013 Thur Fall Prevention Sheree Nuske, RN West 6-7:30 p.m. Cancelled

5/8/2013 Wed Total Joint Replacement Timothy Conlan, M.D. North 6-7:30 p.m. 34

5/9/2013 Thur What is Asthma? Tim Larson, RT West 6-7:30 p.m. 8

5/14/2013 Tue Colon Cancer Kahil Korkor, M.D. North 2-3:30 p.m. 9

5/15/2013 Wed Abdominal Aortic Aneurysm Brett Butler, M.D. North 6-7:30 p.m. 13

5/16/2013 Thur Living with Alzheimer’s for Caregivers Katie Heavner West 6-7:30 p.m. 18

5/21/2013 Tue Medicare Today Sharon Smith, Medicare Educator West 2-3:30 p.m. 18

5/22/2013 Wed Happy Tails, Happy Life! Sandy Warder North 6-7:30 p.m. 11

5/23/2013 Thur Shoulder & Knee Pain Eric Johnson, M.D. West 6-7:30 p.m. 18

5/28/2013 Tue Explaining Strokes John Andrefsky, M.D. North 2-3:30 p.m. 15

5/29/2013 Wed Pneumonia Vaccines Lewis Humble, M.D. North 6-7:30 p.m. 4

6/4/2013 Tue Healthy Summer Recipes Sean Beach and Miranda Taylor North 6-7:30 p.m. 51

6/5/2013 Wed 10 Tips to Managing Type 2 Diabetes Liz Heiser, RN, CDE North 6-7:30 p.m. 43

6/6/2013 Thur Advances in Total Hip Replacement Anthony Pentz, M.D. West 6-7:30 p.m. 15

6/11/2013 Tue Hearing Aids Bob Formoso, LHAS North 2-3:30 p.m. 44

6/13/2013 Thur Skin Care & Wound Prevention Cindy Sponseller, RN West 6-7:30 p.m. 10

45



6/18/2013 Tue Lumbar Spinal Stenosis Phillip Immesoete. M.D. West 6-7:30 p.m. 40

6/20/2013 Thur Peripheral Vascular Disease Jeffrey Prem, M.D. West 6-7:30 p.m. 20

6/25/2013 Tue Emergency Preparedness Shannon Helfinstine, Ph.D. North 2-3:30 p.m. 8

6/26/2013 Wed Common Sport Injuries Eric Johnson, M.D. North 6-7:30 p.m. Cancelled

7/9/2013 Tue Lower Back Pain Vincent Wake, M.D. Carrollton 6-7:30 p.m. Cancelled

7/10/2013 Wed Cancer Genetics & Prevention Kisa E. Weeman, M.D. North 6-7:30 p.m. 8

7/11/2013 Thur Current Shoulder Treatment Steven Coss, M.D. West 6-7:30 p.m. 25

7/16/2013 Tue MyPlate Linda Brunk, RN Carrollton 2-3:30 p.m. 25

7/17/2013 Wed Adult ADHD Mini Gozdan, RN North 6-7:30 p.m. 18

7/18/2013 Thur Varicose & Spider Veins Stephen Sanofsky, M.D. West 6-7:30 p.m. 36

7/23/2013 Tue Medicare & Medicaid Fraud Don Hartman, Pro Seniors of Ohio West 2-3:30 p.m. 12

7/24/2013 Wed Home Safety for Individuals with Dementia Michelle McCann, DPT, MTC North 6-7:30 p.m. 13

7/25/2013 Thur Heart Disease & Plant-based Nutrition Terry Tegtmeier, M.D. West 6-7:30 p.m. 54

7/30/2013 Tue Treatment of IBD Kenny Yung, M.D. North 6-7:30 p.m. 27

7/31/2013 Wed Diabetes Self-management Cheryl Michaels, RN North 6-7:30 p.m. 27

8/7/2013 Wed Venous Disease Brett Butler, M.D. North 6-7:30 p.m. 25

8/13/2013 Tue Treatment Options for Kidney Failure Abhijit Kontamwar, M.D. North 6-7:30 p.m. Cancelled

8/14/2013 Wed Snooze or Lose Clifford Johnson, M.D. North 6-7:30 p.m. 50

8/15/2013 Thur Fall Prevention Sheree Nuske, RN West 6-7:30 p.m. 12

8/20/2013 Tue Happy Tails Erica Breedlove & Debra Neff-Maurer North 2-3:30 p.m. 8

8/21/2013 Wed Medicare Today Sharon Smith, Medicare Educator North 6-7:30 p.m. Cancelled

8/22/2013 Thur Deep Vein Thrombosis Jeffrey Prem, M.D. West 6-7:30 p.m. Cancelled

8/27/2013 Tue Knowing Your Kidneys Abhijit Kontamwar, M.D. West 6-7:30 p.m. 27

8/28/2013 Wed Cataracts Sanjeev Dewan, M.D. North 6-7:30 p.m. 28

8/29/2013 Thur Maintaining Our Childhood Joy Michael Gallina West 6-7:30 p.m. 22

9/3/2013 Tue Treatment of Neurologic Disease with Botox Ryan Drake, M.D. West 2-3:30 p.m. 17

9/4/2013 Wed Heart Disease – Prevent the Event Adene Keller, RN North 6-7:30 p.m. 19

9/5/2013 Thur Total Joint Replacement Jeffrey Dulik, D.O. West 6-7:30 p.m. Cancelled

9/10/2013 Tue Empty Nest Barbara Fordyce, Ph.D. North 6-7:30 p.m. 13

9/11/2013 Wed ACL Injuries Eric Johnson, M.D. North 6-7:30 p.m. 1

9/12/2013 Thur Total Joint Replacement Timothy Conlan, M.D. West 6-7:30 p.m. 13

9/17/2013 Tue Massage and Mobility Lyn Sabino, LMT West 2-3:30 p.m. 12

9/18/2013 Wed Basics of LASIK Sanjeev Dewan, M.D. North 6-7:30 p.m. 12

9/19/2013 Thur Compassionate Journey Terry Livengood, MA, CT West 6-7:30 p.m. 6

9/24/2013 Tue Hearing Aids Dana Hout, LHAS North 2-3:30 p.m. 29

9/26/2013 Thur Medicare Today Sharon Smith, Medicare Educator West 6-7:30 p.m. 51

10/3/2013 Thur Varicose & Spider Veins Steven Sanofsky, M.D. North 6-7:30 p.m. 8

10/8/2013 Tue Arthritis of the Foot & Ankle Daniel Charlick, M.D. West 2-3:30 p.m. 12

10/9/2013 Wed Headaches & Migraines Ryan Drake, M.D. North 6-7:30 p.m. 30

10/10/2013 Thur Help for Vertigo Victims Chad Gooding, MS, PT West 6-7:30 p.m. 50

10/13/2013 Tue Carotid Artery Disease Brett Butler, M.D. North 6-7:30 p.m. 16

10/16/2013 Wed Total Joint Replacement Timothy Conlan, M.D. North 6-7:30 p.m. 20

10/17/2013 Thur Diabetes Self-Management Cheryl Michaels, RN West 6-7:30 p.m. 20

10/22/2013 Tue Ghosts, Goblins & Jack-o-lantern Smiles Michael Gallina Carrollton 2-3:30 p.m. 22

10/23/2013 Wed Common Sports Injuries Eric Johnson, M.D. North 6-7:30 p.m. Cancelled

10/24/2013 Thur Medicare Today Sharon Smith, Medicare Educator West 6-7:30 p.m. 24

10/29/2013 Tue Cataracts Sanjeev Dewan, M.D. Carrollton 6-7:30 p.m. 6

10/30/2013 Wed Fall Prevention Sheree Nuske, RN North 6-7:30 p.m. Cancelled

11/5/2013 Tue Medicare Today Sharon Smith, Medicare Educator North 2-3:30 p.m. 43

11/5/2013 Tue Conquering the Holidays Nicole Wade, D.O. Carrollton 6-7:30 p.m. 8

11/6/2013 Wed Helping Children with ADHD Mimi Gozdan, RN North 6-7:30 p.m. 15

11/7/2013 Thur Total Joint Replacement Michael London, M.D. West 6-7:30 p.m. Cancelled

11/12/2013 Tue Living with Asthma Tim Larson, RT West 2-3:30 p.m. Cancelled

11/13/2013 Wed Healthy Mom & Healthy Baby Linda Brunk, RN & Melinda Wiles, RN North 6-7:30 p.m. Cancelled

11/14/2013 Thur 10 Tips for Managing Type 2 Diabetes Liz Heiser, RN West 6-7:30 p.m. 36

11/19/2013 Tue Wound Care Cindy Sponseller, RN Carrollton 2-3:30 p.m. Cancelled

11/20/2013 Wed Kick the Tobacco Habit Sara Schaub & Chadi Bou Serhal, M.D. North 6-7:30 p.m. 12

11/21/2013 Thur Fibromyalgia Mark Pellegrino, M.D. West 6-7:30 p.m. 35

11/26/2013 Tue The Affordable Care Act – 2014 Mike Novelli North 2-3:30 p.m. 46

Total: 2,215

46


Aultman Health Talks 2014

Date Topic Speaker Location Time Attended 1/8/2014 Wed Restoring Smiles: A Medical Mission in

Vietnam Keshav Magge, M.D. NCMC 6-7 p.m. Cancelled

1/9/2014 Thur Forgiveness at the Bedside Terry Livengood, MA, CT NCMC 6-7:30 p.m. Cancelled

1/13/2014 Mon Colon Cancer Renee Schlabach, M.D. Orrville 6-7:30 p.m. 12

1/14/2014 Tue The Affordable Care Act – 2014 Mike Novelli West 6-7:30 p.m. 35

1/15/2014 Wed Cataracts and IOL Sanjeev Dewan, M.D. NCMC 6-7:30 p.m. 12

1/16/2014 Thur Common Back Disorders Mark Cecil, M.D. NCMC 6-7:30 p.m. 21

1/21/2014 Tue Living with Asthma Tim Larson, RT West 2-3:30 p.m. 15

1/22/2014 Wed Personal Protection Plan Ken Sheely, Deputy Sheriff West 6-7:30 p.m. 22

1/22/2014 Wed Aultman Weight Management Richard Jones, M.D. Orrville 6-7:30 p.m. 22

1/23/2014 Thur What is a Hospitalist? Athena Andreadis, M.D.,

Katie Wright MSN, RN, PCCN NCMC 6-7:30 p.m. 6

1/29/2014 Wed Acupuncture Patrick McFeely, M.D. West 6-7:30 p.m. 22

2/3/2014 Mon Diabetic Foot Health Jason Suppan, DPM Orrville 6-7:30 p.m. 14

2/5/2014 Wed Heart Attack: What Everyone Should Know

Beth Chenevey, RN, BSN, CCRN NCMC 6-7:30 p.m. Cancelled

2/6/2014 Thur What’s New in Total Joint Replacement?

Timothy Conlan, M.D. West 6-7:30 p.m. Cancelled

2/12/2014 Wed Happy Heart Michael Gallina NCMC 6-7:30 p.m. 21

2/13/2014 Thur Lower Back Pain Vincent Wake, M.D. West 6-7:30 p.m. 24

2/18/2014 Tue Medicare Answers Lynn Helscher West 2-3:30 p.m. 27

2/19/2014 Wed Understanding Diabetes Bobbie Randall, RD, LD West 6-7:30 p.m. 18

2/20/2014 Thur Heart Attack: What Everyone Should Know

Ron Manes West 6-7:30 p.m. 19

2/26/2014 Wed Healthy Diabetic Diet Dean Beach, RD NCMC 6-7:30 p.m. 39

2/27/2014 Thur Life’s Simple 7 Linda Brunk, RN & Helene Moncman Carrollton 2-3:30 p.m. 19

3/3/2014 Mon Hip/Knee Joint Resurfacing/Replacement Rodney Miller, M.D. Orrville 6-7:30 p.m. 21

3/5/2014 Wed What’s New with Varicose Veins? Stephen Sanofsky, M.D. NCMC 6-7:30 p.m. 18

3/6/2014 Thur Mobility through Yoga & Massage Lyn Sabino, LMT West 2-3:30 p.m. 23

3/ 11/2014 Tue Diabets – The Basic Facts Cheryl Michaels, RN West 6-7:30 p.m. 36

3/12/2014 Wed Restoring Smiles: A Medical Mission in Vietnam

Keshav Magge, M.D. NCMC 6-7:30 p.m. 8

3/13/2014 Thur Urinary Incontinence in Women Amy Hughes, FNP NCMC 6-7:30 p.m. 30

3/19/2014 Wed Sleep Apnea Clifford Johnson, M.D. NCMC 6-7:30 p.m. 50

3/20/2014 Thur Heart-healthy Diet Terry Tegtmeier, M.D. NCMC 6:30-8 p.m. 50

3/24/2014 Mon What is a Hospitalist? Robert Sabota, M.D. Orrville 6-7:30 p.m. 8

3/26/2014 Wed Living a Diabetic Lifestyle Bobbie Randall, RD, LD NCMC 6-7:30 p.m. 36

4/2/2014 Wed What’s New in Total Joint Replacement?

Timothy Conlan, M.D. NCMC 6-7:30 p.m. 63

4/3/2014 Thur Diabetes – The Basic Facts Bobbie Randall, RD, LD Carrollton 6-7:30 p.m. 10

4/8/2014 Tue DVT – Deep Vein Thrombosis Brett Butler, M.D. NCMC 6-7:30 p.m. 25

4/9/2014 Wed Basics of LASIK Sanjeev Dewan, M.D. NCMC 6-7:30 p.m. Cancelled

4/15/2014 Tue Benefits of Volunteering Debra Neff-Maurer & Lori Harmon NCMC 2-3:30 p.m. 13

4/16/2014 Wed Lumbar Stenosis Facts Phillip Immesoete, M.D. Orrville 6-7:30 p.m. 69

4/16/2014 Wed Oh, My Aching Legs! Thomas Watson, M.D. NCMC 6-7:30 p.m. Cancelled

4/23/2014 Wed Ears to You Denise Testa, AuD, CCC-A &

Amy Yoder, MA, CCC-A NCMC 6-7:30 p.m. 30

4/24/2014 Thur Anterior Hip Replacement/Arthritis Michael Knapic, D.O. Orrville 6-7:30 p.m. 19

5/1/2014 Thur Ankle Replacement Daniel Charlick, M.D. West 6-7:30 p.m. Cancelled

5/13/2014 Tue Living with Celiac Disease Bobbie Randall, RD, LD Orrville 6-7:30 p.m. 20

5/20/2014 Tue Heart Attack: What Everyone Should Know

Beth Chenevey, RN, BSN, CCRN West 6-7:30 p.m. 24

5/21/2014 Wed Positive Psychology: The Science of Happiness

Barbara Fordyce, Ph.D. NCMC 6-7:30 p.m. 89

47



Date Topic Speaker Location Time Attended 5/22/2014 Thur Living with Asthma Tim Larson, RT West 6-7:30 p.m. 6

5/27/2014 Tue Skin Cancer Leslie Murphy, M.D. NCMC 6-7:30 p.m. 20

5/28/2014 Wed Lung Cancer & CT Screening Program Brandy Hahn, RN, BSN, OCN West 2-3:30 p.m. 3

5/29/2014 Thur Abdominal Aortic Aneurism Jeffrey Prem, M.D., FACS NCMC 6-7:30 p.m. 35

6/4/2014 Wed Eye Care – You Should Be in Charge Frank Wienstock M.D., FACS NCMC 6-7:30 p.m. 39

6/5/2014 Thur Diabetes – The Basic Facts Liz Heiser, RN West 6-7:30 p.m. 25

6/10/2014 Tue You and Your Lower Back Pain Vincent Wake, M.D. West 6-7:30 p.m. Cancelled

6/12/2014 Thur What’s New in Rotator Cuff Treatment H. Steven Coss, M.D. West 6-7:30 p.m. 70

6/17/2014 Tue Living with Celiac Disease Bobbie Randall, RD, LD West 6-7:30 p.m. 20

6/18/2014 Wed Cataracts & Premium Implant Options Sanjeev Dewan, M.D. NCMC 6-7:30 p.m. 31

6/19/2014 Thur Ears to You Denise Testa, AuD, CCC-A &

Amy Yoder, MA, CCC-A West 2-3:30 p.m. 30

6/25/2014 Wed Osteoporosis & Compression Fractures Phillip Immesoete, M.D. NCMC 6-7:30 p.m. 48

6/26/2014 Thur Recognizing Delirium & Early Dimentia Elizabeth Baum, M.D. NCMC 6-7:30 p.m. 69

7/1/2014 Tue Droopy Lids Jamie Zucker, M.D. NCMC 6-7:30 p.m. 32

7/2/2014 Wed Skin Care & Wound Care Cindy Sponseller, RN NCMC 6-7:30 p.m. 24

7/8/2014 Tue Heart Attack: What Everyone Should Know

Ron Manes Carrollton 2-3:30 p.m. 8

7/9/2014 Wed Medication and the Elderly Elizabeth Baum, M.D. NCMC 6-7:30 p.m. 30

7/15/2014 Tue Get Movin’, Get Motivated! Linda Brunk, RN, CPN, ACE-CHC Morrow House

Auditorium 2-3:30 p.m. 40

7/16/2014 Wed Nutrition & Eye Disease Lawrence Karns, M.D. NCMC 6-7:30 p.m. 70

7/17/2014 Thur Bunions Ronald Cohen, DPM West 6-7:30 p.m. Cancelled

7/30/2014 Wed Living with Celiac Disease Bobbie Randall, RD, LD NCMC 6-7:30 p.m. 37

8/6/2014 Wed Modern Treatment of Peripheral

Vascular Disease Jeffrey Prem, M.D. NCMC 6-7:30 p.m. Cancelled

8/7/2014 Thur Prevent the Event Adene Keller, RN NCMC 6-7:30 p.m. 20

8/13/2014 Tue Cataracts & New IOL’s Sanjeev Dewan, M.D. NCMC 6-7:30 p.m. 21

8/14/2014 Thur Living with Celiac Disease Bobbie Randall, RD, LD Carrollton 6-7:30 p.m. 1

8/19/2014 Tue Itchy, Scratchy & Tingly Nicole Wade, D.O. Carrollton 6-7:30 p.m. 12

8/20/014 Wed Ankle Arthritis & Total Ankle Arthroplasty Daniel Charlick, M.D. NCMC 6-7:30 p.m. 37

8/21/2014 Thur Help for Vertigo Victims Chad Gooding, MS, PT West 6-7:30 p.m. 59

8/26/2014 Tue Medicare: Are You Ready for Tomorrow? Mike Novelli Amphitheater 1:30-3 p.m. 36

8/27/2014 Wed Heart Attack: What Everyone Should Know

Beth Chenevey, RN, BSN, CCRN NCMC 6-7:30 p.m. 45

9/3/2014 Wed Foot Health Awareness Steven Gross, DPM NCMC 6-7:30 p.m. 63

9/4/2014 Thur What’s New in Rotator Cuff Treatment?

Steven Coss, M.D. West 6-7:30 p.m. 43

9/9/2014 Tue Fall Prevention Sheree Nuske, RN NCMC 2-3:30 p.m. 32

9/10/2014 Wed Varicose Veins Brett Butler, M.D. NCMC 6-7:30 p.m. 18

9/11/2014 Thur You & Your Low Back Pain Vincent Wake, M.D. West 6-7:30 p.m. 43

9/11/2014 Thur Lumbar Stenosis Facts Phillip Immeseote, M.D. Orrville 6-7:30 p.m. 31

9/16/2014 Tue Happy Tails – Volunteer with Your Dog!

Debra Neff-Maurer & Erica Breedlove

West 2-3:30 p.m. 23

9/17/2014 Wed Oh, My Aching Legs! Thomas Watson, M.D. NCMC 6-7:30 p.m. 65

9/18/2014 Thur Total or Partial Knee Replacement? Jeffrey Dulik, D.O. West 6-7:30 p.m. 32

9/23/2014 Tue Get Movin’, Get Motivated! Linda Brunk, RN, CPN, ACE-CHC Morrow House

Auditorium 2-3:30 p.m. 71

9/24/2014 Wed What’s New in Total Joint Replacement? Tim Conlan, M.D. West 6-7:30 p.m. 20

9/25/2014 Thur Diabetes – The Basic Facts Cheryl Michaels, RN West 6-7:30 p.m. 38

10/1/2014 Wed Minimally Invasive Hip Replacement Jeffrey Dulik, D.O. West 6-7:30 p.m. 32

10/2/2014 Thur Diabetic Foot Health Steven Gross, DPM West 6-7:30 p.m. 35

10/8/2014 Wed Affordable Care Act Mike Novelli West 6-7:30 p.m. 18

10/14/2014 Tue Droopy Lids Jamie Zucker, M.D. NCMC 6-7:30 p.m. 22

10/15/2014 Wed Sleep Apnea Cliff Johnson, M.D. NCMC 6-7:30 p.m. 58

10/16/2014 Thur Oh, My Aching Legs! Thomas Watson, M.D. Carrollton 2-3:30 p.m. 30

10/21/2014 Tue The Founding of Aultman Hospital Richard Haldi, Author Amphitheater 6-7:30 p.m. 58

48


Date Topic Speaker Location Time Attended 10/22/2014 Wed Home Remedies in Urology Christopher Lohr, M.D. NCMC 6-7:30 p.m. 82

10/23/2014 Thur Bunions Ronald Cohen, DPM West 6-7:30 p.m. 24

10/23/2014 Thur Understanding Hernias Dean Borth, M.D. Orrville 6-7:30 p.m. 27

10/29/2014 Wed Reducing the Risk of Heart Disease John Paulowski, M.D. NCMC 6-7:30 p.m. 90

10/30/2014 Thur Cancer Prevention Brandy Hahn, RN, BSN, OCN West 6-7:30 p.m. 30

11/4/2014 Tue Surviving … and Enjoying the Holidays! John Coventry, LPCC CCC 6-7:30 p.m. 27

11/5/2014 Wed Advanced Directives Decision Making Jeffrey Marsh, M.D. Orrville 6-7:30 p.m. 12

11/5/2014 Wed What’s New in Total Joint Replacement? Tim Conlan, M.D. NCMC 6-7:30 p.m. 18

11/6/2014 Thur Diabetes – The Basic Facts Liz Heiser, RN West 6-7:30 p.m. 22

11/11/2014 Tue Living with Asthma Tim Larson, RT West 6-7:30 p.m. 22

11/12/2014 Wed Beauty: Blepharoplasty, Botox & Fillers Sanjeev Dewan, M.D. NCMC 6-7:30 p.m. 19

11/12/2014 Wed A Meal Plan for Thanksgiving Bobbie Randall, Med, RD, LD, CDE Orrville 6-7:30 p.m. 21

11/13/2014 Thur Affordable Care Act Mike Novelli West 6-7:30 p.m. 40

11/18/2014 Tue Estate Planning: It’s About Your Legacy Kathleen Stoneman Carrollton 6-7:30 p.m. 40

11/19/2014 Wed Kicking the Tobacco Habit Sara Schaub NCMC 6-7:30 p.m. 4

11/20/2014 Thur Fibromyalgia Mark Pellegrino, M.D. West 6-7:30 p.m. 39

11/25/2014 Tue Take Control: Managing IBD Decisions Khalil Korkor, M.D. West 6-7:30 p.m. 6

Total: 3,113



1/6/2015 Tue Starting Your New Year Right: A

Resolution for Your Heart & Spirit Michael Gallina West 6-7:30 p.m. 24

1/8/2015 Thur You and Your Lower Back Pain Vincent Wake, M.D. West 6-7:30 p.m. 25

1/14/2015 Wed Diabetes Basics for Newly Diagnosed Bobbie Randall, RD, LD NCMC 6-7:30 p.m. 11

1/14/2015 Wed Give It Up: Stop Smoking for Good! Lori Schaffner, RN Orrville 6-7 p.m. 5

1/15/2015 Thur Winter Asthma Strategies Tim Larson, RT West 6-7:30 p.m. 10

1/21/2015 Wed You and Your Shoulder Pain Brian Blake, M.D. NCMC 6-7:30 p.m. 45

1/22/2015 Thur Smoking Cessation Lou Ann Fulmer West 6-7:30 p.m. 15

1/27/2015 Tue Know the 10 Signs Kaylene Way West 6-7:30 p.m. 68

1/28/2015 Wed Vision Options: Is Lasik for You? Sanjeev Dewan, M.D. NCMC 6-7:30 p.m. 6

1/29/2015 Thur 10 Tips for Managing Type 2 Diabetes Liz Heiser, RN West 6-7:30 p.m. 25

2/4/2015 Wed Life’s Simple Seven Linda Brunk, RN & Helene Moncman NCMC 6-7:30 p.m. 31

2/5/2015 Thur Diabetic Basics for Newly Diagnosed Bobbie Randall, RD, LD West 6-7:30 p.m. 21

2/11/2015 Wed Itchy, Scratch, Tingly Nicole Wade, D.O. NCMC 6-7:30 p.m. 43

2/17/2015 Tue Fall Prevention Sheree Nuske, RN West 2-3:30 p.m. 13

2/18/2015 Wed Carotid Artery Disease Brett Butler, M.D. NCMC 6-7:30 p.m. Cancelled

2/19/2015 Thur Being Healthy on a Budget Carol Crawford, Deb Dysle,

Rachel Deitrick & Angela Quinn Amphitheater 1-2:30 p.m. 44

2/24/2015 Tue What is Osteopathic Medicine? Brett Buller, D.O. Orrville 6-7 p.m. 24

2/25/2015 Wed The Best Gift You Can Give to the

Next Generation Brian Layman & E. Lang

Gregory Center

5:30-7 p.m. 55

2/25/2015 Wed Heart Disease & Plant-based Nutrition Terry Tegtmeier, M.D. NCMC 6-7:30 p.m. 45

2/26/2015 Thur Living with Alzheimer’s for Caregivers Kaylene Way West 2-3:30 p.m. 55

3/3/2015 Tue The Founding of Aultman Hospital Richard Haldi, Author Amphitheater 1:30-3 p.m. Cancelled

3/4/2015 Wed Diabetes and Your Feet Ronald Cohen, DPM NCMC 6-7:30 p.m. Cancelled

3/10/2015 Tue Knee & Shoulder Pain in the Aging Athlete Brian Blake, M.D. West 6-7:30 p.m. Cancelled

3/11/2015 Wed Family Support & Diabetes Bobbie Randall, RD, LD NCMC 6-7:30 p.m. Cancelled

3/12/2015 Thur Vaccination: Past and Present Mandal Haas, M.D. Carrollton 6-7:30 p.m. 15

3/25/2015 Wed Preventing Diabetic Eye Problems Anson Miedel, M.D. Orrville 6-7 p.m. 25

3/26/2015 Thur Diabetes – The Basic Facts Cheryl Michaels, RN West 6-7:30 p.m. 18

3/31/2015 Tue Be Aware for Safe Care! John Sutton, M.D. NCMC 2-3:30 p.m. 8

4/2/2015 Thur Family Support & Diabetes Bobbie Randall, RD, LD West 6-7:30 p.m. Cancelled

4/7/2015 Tue High Cost of Fashion: Bunions, Hammertoes & Foot Problems

Daniel Charlick, M.D. NCMC 6-7:30 p.m. 29

49




4/8/2015 Wed Drug Abuse, Addiction & Recovery Julie Kreuz, PC-CR &

Melinda Kauffman, LPN, CDCA Orrville 6-7 p.m. 17

4/8/2015 Wed Cataract Options & Solutions for Presbyopia Sanjeev Dewan, M.D. NCMC 6-7:30 p.m. 21

4/9/2015 Thur Aultman Weight Management Richard Jones, M.D. Orrville 6-7 p.m. 35

4/14/2015 Tue Osteoporosis & Back Pain Phillip Immesoete, M.D. West 6-7:30 p.m. 21

4/15/2015 Wed Spinal Stenosis & Treatment Options Mark Cecil, M.D. NCMC 6-7:30 p.m. 70

4/16/2015 Thur What is a Hospitalist? Athena Andreadis, M.D. & Marlene Kromi, BSN, RN

West 6-7:30 p.m. Cancelled

4/29/2015 Wed Droopy Lids Jamie Zucker, M.D. NCMC 6-7:30 p.m. 29

5/6/2015 Wed Understanding ALS, Best Care

Management and Latest Research Pam Cazzolli, RN NCMC 6-7:30 p.m. 10

5/7/2015 Thur Reducing Your Risk of Heart Disease John Paulowski, M.D. West 6-7:30 p.m. 28

5/12/2015 Tue Living With Asthma Tim Larson, RT West 6-7 p.m. 20

5/13/2015 Wed Gluten-free and Celiac Basics Bobbie Randall, RD, LD NCMC 6-7:30 p.m. 20

5/13/2015 Wed Stress Management & Exercise Dave Speicher, MS, CSCS, PEC, CES Orrville 6-7 p.m. 26

5/14/2015 Thur Total Ankle Replacement Daniel Charlick, M.D. West 6-7:30 p.m. 25

5/19/2015 Tue Managing Behavior Changes with Dementia Elizabeth Baum, M.D. West 6-7:30 p.m. 43

5/20/2015 Wed Oh, My Aching Legs! Thomas Watson, M.D. NCMC 6-7:30 p.m. 65

5/21/2015 Thur Diabetes and Your Feet Ronald Cohen, DPM West 6-7:30 p.m. 25

5/27/2015 Wed Healing Movements & Touch Lyn Sabino NCMC 6-7:30 p.m. 15

6/4/2015 Thur Gluten-free and Celiac Basics Bobbie Randall, RD, LD West 6-7:30 p.m. 18

6/9/2015 Tue Nutrition and Eye Disease Lawrence Karns, M.D. West 6-7:30 p.m. 43

6/10/2015 Wed Life After Cancer Denise Rollyson, RN NCMC 2-3:30 p.m. 3

6/10/2015 Wed COPD, Lung Cancer Screening Info. Brandy Hahn, RN, BSN, OCN NCMC 6-7:30 p.m. 15

6/11/2015 Thur You and Your Low Back Pain Vincent Wake, M.D. West 6-7:30 p.m. 52

6/17/2015 Wed Summer Food Safety Tomeka Smith, CFPP Orrville 6-7 p.m. 13

6/23/2015 Tue Antibiotic Resistance Shannon Helfinstine, Ph.D. West 2-3:30 p.m. 15

6/24/2015 Wed Family Obesity and How to Correct It Linda Brunk, RN, CPN, ACE-CHC Orrville 6-7 p.m. 20

6/25/2015 Thur 10 Tips to Better Manage Diabetes Liz Heiser, RN NCMC 6-7:30 p.m. 32

6/30/2015 Tue Successful Aging Elizabeth Baum, M.D. West 6-7:30 p.m. 51

7/1/2015 Wed ANCMG Patient Portal Bobbie Lucas, CHTS-IS NCMC 6-7:30 p.m. 60

7/2/2015 Thur Peripheral Vascular Disease & Neuropathy Benjamin Nafziger, DPM Carrollton 6-7:30 p.m. 20

7/9/2015 Thur Advance Directives & End-of-life Planning Jeffrey Marsh, M.D. CCC 6-7:30 p.m. 36

7/14/2015 Tue Feminine Dryness Joann Krivetzky, M.D. West 6-7:30 p.m. 38

7/15/2015 Wed Heart Disease & Plant-based Nutrition Terry Tegtmeier, M.D. NCMC 6-7 p.m. 58

7/21/2015 Tue Give It Up – Smoking Cessation Lori Schaffner, RN Carrollton 6-7 p.m. 2

7/22/2015 Wed Vaccination: Past and Present Mandal Hass, M.D. NCMC 6-7:30 p.m. 15

7/23/2015 Thur No-nonsense Weight Loss Sean Beach, RD, LD West 6-7:30 p.m. 68

7/29/2015 Wed Parkinson’s Disease Ryan Drake, D.O. NCMC 6-7:30 p.m. 70

8/4/2015 Tue Obstructive Sleep Apnea Mark Brigham, M.D. Orrville 6-7 p.m. 10

8/5/2015 Wed Aultman Medical Group Patient Portal Mandy Steiner, BSN, RN, CHTS-PW, CMUA NCMC 6-7:30 p.m. 32

8/6/2015 Thur What’s New in Cancer Genetics? Kisa Weeman, M.D. West 6-7:30 p.m. 22

8/11/2015 Tue All About Vaccines Nicole Wade, D.O. Carrollton 12-1 p.m. 18

8/11/2015 Tue Starting & Maintaining an Exercise Program

Joanna Bruno, M.D. NCMC 2-3:30 p.m. 21

8/12/2015 Wed Nutrition and Eye Disease Lawrence Karns, M.D. NCMC 6-7:30 p.m. 51

8/12/2015 Wed What’s New in Cancer Genetics? Kisa Weeman, M.D. Orrville 6-7 p.m. 18

8/18/2015 Tue Cancer Prevention Strategies Tina Brechbill, RN, MSN, CNS, AOCN, CBEC

West 6-7:30 p.m. 12

8/19/2015 Wed Healthy Feet Natalie LaScola, DPM NCMC 6-7:30 p.m. 36

8/20/2015 Thur The 10 Signs of Alzheimer’s Kaylene Way NCMC 6-7:30 p.m. 86

8/25/2015 Tue The At-risk Diabetic Foot Stephen Gross, DPM West 6-7:30 p.m. 24

8/26/2015 Wed AAA (Abdominal Aortic Aneurism) Jeffrey Prem, M.D. NCMC 6-7:30 p.m. 29

8/26/2015 Wed Ears to You Denise Testa, Au D, CCC/A, FAAA &

Amy Yoder, MA, CCC/A, FAAA Orrville 6-7:30 p.m. 17

9/1/2015 Tue Back to School with Asthma Tim Larson, RT NCMC 6-7:30 p.m. 3

9/2/2015 Wed Ears to You Denise Testa, Au D, CCC/A, FAAA &

Amy Yoder, MA, CCC/A, FAAA NCMC 6-7:30 p.m. 50

50



9/3/2015 Thur High Cost of Fashion: Bunions, Hammertoes & Foot Problems

Daniel Charlick, M.D. West 6-7:30 p.m. 16

9/8/2015 Tue Answers to Foot & Ankle Arthritis Peter Highlander, DPM, MS Orrville 6-7 p.m. 18

9/9/2015 Wed Beauty: Botox, Blepharoplasty & Fillers Sanjeev Dewan, M.D. NCMC 6-7:30 p.m. 15

9/10/2015 Thur Advance Directives & End-of-life Planning Jeffrey Marsh, M.D. West 6-7:30 p.m. 29

9/15/2015 Tue Living with Alzheimer’s for Caregivers Kaylene Way NCMC 6-7:30 p.m. 65

9/23/2015 Wed Breathing Easy with Asthma Denise Kelley, RT Orrville 6-7 p.m. 16

9/24/2015 Thur Chronic Kidney Disease Nishigandha Pradhan, M.D. West 2-3:30 p.m. 13

9/29/2015 Tue You and Your Low Back Pain Vincent Wake, M.D. NCMC 6-7:30 p.m. 44

9/30/2015 Wed Genitourinary Syndrome of Menopause

Joann Krivetzky, M.D. NCMC 6-7:30 p.m. 27

10/1/2015 Thur Droopy Lids Jamie Zucker, M.D. West 6-7:30 p.m. 15

10/6/2015 Tue Rheumatoid Arthritis: Just Diagnosed Amy Chambers, MSN/ED, RNC-OB NCMC 5:30-8:30 p.m.

18

10/7/2015 Wed Advance Directives & End-of-life Planning Jeffrey Marsh, M.D. NCMC 6-7:30 p.m. 12

10/8/2015 Thur Total Ankle Replacement Daniel Charlick, M.D. West 6-7 p.m. Cancelled

10/14/2015 Wed Sleep Apnea Clfford Johnson, M.D. NCMC 6-7:30 p.m. 33

10/20/2015 Tue Cancer Prevention Strategies Tina Brechbill, RN, MSN, CNS, AOCN, CBEC

Carrollton 2-3:30 p.m. 2

10/20/2015 Tue The ABC’s of Medicare Mike Novelli West 6-7:30 p.m. 33

10/21/2015 Wed Oncology Research: Changing the

Future of Cancer Treatment Janet Moore, BSN, RN, OCN NCMC 6-7:30 p.m. 12

10/21/2015 Wed Breast Cancer Awareness & Prevention Dean Borth, M.D. Orrville 6-7 p.m. 24

10/22/2015 Thur Estate Planning: The Best Gift You Can

Give to the Next Generation Cheryl Kirkbride, JD & Kim Cowgill, AAMS Orrville 7-8 p.m. 13

10/27/2015 Tue Women’s Health and Wellness Priyababl Ramaiah, M.D. NCMC 6-7:30 p.m. 10

10/28/2015 Wed Trauma: Informed Care Chadwick Sunday, LPCC-C Orrville 6-7 p.m. 17

10/28/2015 Wed Nutrition and Eye Disease Lawrence Karns, M.D. NCMC 6-7:30 p.m. 38

10/29/2015 Thur Thanksgiving Meal Planning &Diabetes Bobbie Randall, RD, LD West 6-7:30 p.m. 16

11/3/2015 Tue Helping Your Child Grieve Beth Wengerd CCC 6-7:30 p.m. 12

11/4/2015 Wed Spinal Stenosis & Treatment Options Mark Cecil, M.D. NCMC 6-7:30 p.m. 64

11/5/2015 Thur Reducing Risk of Heart Disease John Paulowski, M.D. West 6-7:30 p.m. 20

11/10/2015 Tue Advance Directives & End-of-life Planning Jeffrey Marsh, M.D. Orrville 6-7 p.m. 8

11/11/2015 Wed Modern Treatment for Urinary Incontinence

Steven Ochs, M.D. NCMC 6-7:30 p.m. 37

11/12/2015 Thur 10 Tips to Better Manage Diabetes Liz Heiser, RN NCMC 6-7:30 p.m. 28

11/17/2015 Tue Lymphedema Management Anna Frum, OTRL, CLT &

Kim Rook, OTRL, CLT West 6-7:30 p.m. 33

11/18/2015 Wed Managing Symptoms of Depression Beth McCready, MSW, LISW-S Orrville 6-7 p.m. 8

11/18/2015 Wed Fibromyalgia Mark Pellegrion, M.D. NCMC 6-7:30 p.m. 22

11/24/2015 Tue Cancer Genetic Counseling: What You

Need to Know Sarah Ossler, MS West 6-7:30 p.m. 8

Total: 3,247

51


APPENDIX G

WOW Program 2013 Summary of Services

# Educated 18,623

Screenings 3,218 Body mass index 2,371 74% BP 3,057 95% Hx HTN – history of hypertension 1,310 41% HTN meds 1,257 39% Family HTN 1,535 48% Males 1,413 44% Females 1,805 56% New knowledge gained 2,970 92% Behavior 1,985 62% Smokers 465 14% Race: White 2,728 85% Black 403 13% Other 87 3% Ages: <18 40 1% 18-30 288 9% 31-50 736 24% 51-70 1,425 46% 71-90 565 18% 91+ 16 1%

52



# Educated 14,498

Screenings 2,612 Body mass index 1,384 53% BP 2,424 93% Hx HTN – history of hypertension 1,084 42% HTN meds 1,012 39% Family HTN 1,166 45% Males 1,088 42% Females 1,517 58% New knowledge gained 2,278 87% Behavior 843 32% Smokers 316 12% Race: White 2,152 82% Black 388 15% Other 72 3% Ages: <18 45 2% 18-30 223 9% 31-50 525 21% 51-70 1,054 43% 71-90 592 24% 91+ 20 1%

53



# Educated 25,789

Screenings 2,961 Body mass index 1,561 53% BP 2,819 95% Hx HTN – history of hypertension 1,254 42% HTN meds 1,192 40% Family HTN 1,406 47% Males 1,186 40% Females 1,775 60% New knowledge gained 2,766 93% Behavior 1,605 54% Smokers 532 18% Race: White 2,335 79% Black 521 18% Other 105 4% Ages: <18 50 2% 18-30 184 6% 31-50 577 19% 51-70 1,351 46% 71-90 714 24% 91+ 29 1%

54


APPENDIX H

2015 Community Outreach Activities Summary Community outreach continues to hold a high priority in our hospital as well as our cancer program. Leading our Community to Improved Health is our mission statement and along with our community needs assessment, guides the decisions and direction of community outreach for our program.

Assessing Our Community Needs The community outreach subcommittee of our cancer committee completed a community needs assessment in 2014. Community outreach activities in 2015 have been guided by the results of this report as well as our organization and county needs assessment, national and registry data. All outreach activities in 2015 have been considered relative to community need and evaluated through the community outreach subcommittee. Recommendations have been discussed with the full cancer committee.

Upon review of the 2014 Community Needs Assessment and additional national, state and local data, the top cancer associated needs in our community identified were:

Access and affordability of health care.

Mental health and supportive care access.

High-risk health behaviors.

Cancer screening compliance and access.

Timely diagnosis and treatment.

Minority disparities.

Survivorship.

This information, along with survival statistics and evidence-based guidelines for screening and prevention support our 2015 outreach initiatives for our community.

2015 Cancer Prevention Community Outreach

2015 Cancer Prevention Initiatives Ongoing Initiative: Educate the public on cancer prevention with evidence-based strategies of:

• Achieving and maintaining a healthy weight. • Increasing physical activity. • Smoking cessation. • Focus on sun avoidance and skin cancer prevention education. • Alcohol moderation. • Healthy diet with decreased animal fat intake. • Add HPV educational materials. • Genetic counseling for high-risk persons.

New Initiatives:

Reach out to local schools to promote healthy lifestyle choices at an earlier age.

Track smoking cessation referrals and completion rates to evaluate the impact of our partnership.

55


Prevention Focused Events: Estimated community members reached: 6,870

Activity Date

Targeted Community

Need or Initiative

Evidence- based

Guideline or Intervention

# Attended

Process for Follow-

up/Evaluation

Sponsoring Organization

or Partnership

WHBC Health Matters radio spot – one-hour interview discussing cancer prevention, screening guidelines and general cancer education.

3/20 High-risk health behaviors

Educate the public on cancer prevention with evidence-based strategies

Provide resources to the community on screening guidelines and insurance coverage

ACS, NCCN, American Association of Dermatology (AAD)

On average, 4,200 adults aged 35 and older listen to this weekly interview.

Outreach Subcommittee review

Aultman Health Foundation WHBC radio

Canton Christian Women’s Conference

4/5 Target minority populations in our community

High-risk health behaviors



ACS, NCCN, ACOS, ASBS

100 Outreach Subcommittee review

Aultman Health Foundation Canton Christian Women’s Group

56


Activity Date

Targeted Community

Need or Initiative

Evidence- based


# Attended

Process for Follow-

up/Evaluation


or Partnership

Health Talk - lung screening, risk factors and prevention, smoking cessation




ACS, NCCN, CDC

10 Post-event survey Outreach Subcommittee review

Aultman Health Foundation The Laurels of Canton

Channel 11 public TV interview Interview on skin cancer prevention strategies - sun protection/tanning bed avoidance




Focus on sun avoidance and skin cancer prevention education

ACS, NCCN, AAD, CDC

Cumulative base of 130,000 viewers capable of tuning into the Channel 11 Time Warner Cable Canton Market. Neilson Ratings says 10 percent of those viewers at any one hour of the 24/7 programming,reaching approximately 1,300 viewers


Aultman Health Foundation Channel 11 public TV and Jackson High School

57


Activity Date

Targeted Community

Need or Initiative

Evidence- based


# Attended

Process for Follow-

up/Evaluation


or Partnership

City of Canton Health Fair/Stark County City Employee Health Fair. Provide education on cancer prevention and screening guidelines.




ACS, NCCN, AAD, CDC


Aultman Health Foundation Stark County YMCA

Health Talk - lung screening, risk factors and prevention, smoking cessation, treatment




ACS, NCCN, CDC


Aultman Health Foundation Aultman Health Talk series

Cancer Survivorship 6/10 Mental health and supportive care access

Cancer survivorship needs and awareness

ACS, NCCN, ONS



58


Activity Date

Targeted Community

Need or Initiative

Evidence- based


# Attended

Process for Follow-

up/Evaluation


or Partnership

Aultman Retiree Luncheon Cancer prevention/screening education




ACS, NCCN, CDC


Aultman Health Foundation

Adventist Church Health Fair Focus on breast and prostate screening guidelines. Included information on healthy lifestyle for cancer prevention.


Minority disparities





Aultman Health Foundation Adventist Church

What's New in Cancer Genetics? Community education on cancer genetics


Educate the public on cancer prevention with evidence-based strategies of genetic counseling for high-risk persons

ACS, NCCN 22 Post-event survey Outreach Subcommittee review


59


Activity Date

Targeted Community

Need or Initiative

Evidence- based


# Attended

Process for Follow-

up/Evaluation


or Partnership

What’s New in Cancer Genetics? Community education on cancer genetics

8/12 High risk health behaviors

Educate the public on cancer prevention with evidence-based strategies of genetic counseling for high-risk persons

ACS, NCCN 18 Post-event survey Outreach Subcommittee review


Great Trail Senior Women’s Golf Outing Community Education - breast cancer screening and cancer prevention






Aultman Health Foundation Minerva Senior Women’s Group

Cancer Prevention Strategies Community education on general cancer prevention including skin, colon and lung cancers




ACS, NCCN, CDC



60


Activity Date

Targeted Community

Need or Initiative

Evidence- based


# Attended

Process for Follow-

up/Evaluation


or Partnership

Radiation Therapy Basics and cancer treatment strategy

9/11 Community cancer education

NCCN, ACRO 25 Outreach Subcommittee review

Aultman Health Foundation Stark Radiation Regional Cancer Center Tuscarawas Senior Center

Breast Education with WOW van Breast health and information on upcoming screening event




Continue our focus on breast and lung cancer screenings and make them available throughout the year


30 Outreach Subcommittee review Screening event registration


61


Activity Date

Targeted Community

Need or Initiative

Evidence- based


# Attended

Process for Follow-

up/Evaluation


or Partnership

Pink Duck Event Breast health and screening







Aultman Health Foundation Progressive Ford

HOF Senior Health Fair Cancer screening/prevention education




ACS, NCCN, CDC


Aultman Health Foundation Pro Football Hall of Fame

62


Activity Date

Targeted Community

Need or Initiative

Evidence- based


# Attended

Process for Follow-

up/Evaluation


or Partnership

Cancer Screening and Prevention




ACS, NCCN, CDC



Cancer Research 10/21 Community cancer education

NCCN 13 Post-event survey Outreach subcommittee review


Breast Cancer Prevention and Screening







Aultman Health Foundation Canton General Surgery

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Activity Date

Targeted Community

Need or Initiative

Evidence- based


# Attended

Process for Follow-

up/Evaluation


or Partnership

Radiation Treatment for Cancer

11/15 Community cancer education

NCCN, ACRO pending Post-event survey Outreach Subcommittee review

Aultman Health Foundation Stark Radiation Regional Cancer Center Tuscarawas Senior Center

Great American Smokeout





ACS, NCCN pending Outreach Subcommittee review

Aultman Cancer and Heart Programs

Genetics Cancer genetics information



Genetic counseling for high-risk persons

ACS, NCCN pending Post-event survey Outreach Subcommittee review


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Evaluation of Effectiveness of Prevention Activities

In 2015, we successfully achieved the prevention outreach initiatives that were set for our program. Over 6,800

community members were reached through our 25 educational programs. A focus on healthy lifestyle choices as

a strategy for cancer prevention was the dominant theme for all of our community events. We again successfully

collaborated with the heart program, smoking cessation program, the diversity committee and the community

outreach nurse to ensure that we were able to reach our target audiences. We were also able to partner with the

Kent chapter of the Links, Inc. program to further improve our outreach to minority populations and will continue

this partnership in an ongoing initiative to advance our influence in our African-American community.

Sara Schaub, MSEP, TTS and her team of specialists trained in smoking cessation education were once again invited to our 2015 Cancer Screening Day. That day, they counseled 32 smokers, double the number in 2014. We have shown yearly improvement in the number of patients who are counseled at this event. The smoking cessation program has had a 33 percent completion rate from January to August in 2015 and 29 percent of those who have taken part in the program have successfully quit smoking. We would like to see this number continue to increase since our county has a higher than average smoking population. Our lung navigator also refers all patients who are screened as high-risk for LDCT screening to the smoking cessation program. She currently has 245 individuals in the lung screening program. We are continuing to evaluate ways to improve tracking of smoking cessation outcomes and improve the numbers of patients who complete the program. A partnership with the smoking cessation team continues to meet our goal to educate our community on cancer prevention strategies through smoking cessation. We will also seek ways to increase the number of successful participants.

Three of our community activities focused specifically on skin cancer prevention. We continue to consider this a priority in response to rising melanoma rates. Sunscreen and education were provided at screening day and an educational interview that targeted teens and youth provided opportunities for us to reach our community with this important message. We also included skin cancer prevention in a community health talk, as well as in the resources and discussions at each community event.

An exciting 2015 cancer prevention educational initiative was to partner with local schools in an effort to impact our community at a younger age and decrease future cancer incidence. We have partnered with one Stark County middle school to develop a pilot program to educate all of their sixth-grade students on cancer prevention and healthy lifestyle choices. This program will be implemented in spring of 2016. We are currently in the development phases of the curriculum and evaluation methods. If successful, we hope to expand this to other Stark County middle schools.

2015 Cancer Screening Community Outreach

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Cancer Screening Initiatives

Ongoing Initiatives: • Target the uninsured and underinsured with free screening days. • Actively pursue grant funding in order to increase our community outreach initiatives. • Target minority populations in our community. • Continue our focus on breast and lung cancer screenings and make them available

throughout the year. • Provide resources to the community on screening guidelines and insurance coverage.

New Initiatives:

Improve colon screening by implementing fecal immunohistochemoical testing instead of fecal occult blood methods.

Consider partnerships with GI practices to provide colonoscopy screenings.

Enhance tracking of screening patients to measure outcomes of our screening event.

66


Cancer Screening Events

Number of Individuals Screened: 176 Number of Screenings: 332

Number of Cancers Diagnosed: 1

Screening Event

Date Targeted Community

Need/Initiative

Evidence- based


# Served Process for

Evaluation/Follow- up


or Partnership

Free Evening Breast Screening Clinic Participants provided with clinical breast exam, mammogram, and education on cancer prevention and screening guidelines.

2/26 Access and affordability of health care.




Educate the public on cancer prevention with evidence-based strategies.

Target the uninsured and underinsured with free screening days.

Continue our focus on breast and lung cancer screenings and make them available throughout the year.

Provide resources to the community on screening guidelines and insurance coverage.

NCCN, ACS, ACOS, ASBS

15 1 abnormal mammogram 0 cancers diagnosed All patients followed by the breast navigator. Patient is notified of results and primary physician if the patient has one. Navigator facilitates follow-up for all abnormal results and documents in navigation software. Screening reminder letters are sent annually.

Aultman Health Foundation Educational Fund of America- grant

Saturday Breast Screening Clinic Participants provided with clinical breast exam, mammogram, and education on cancer prevention and screening guidelines.










15 3 abnormal mammograms 0 cancers All patients followed by the breast navigator. Patient is notified of results and primary physician if the patient has one. Navigator facilitates follow-up for all abnormal results and documents in navigation software. Screening reminder letters are sent annually.


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Screening Event


Need/Initiative

Evidence- based





or Partnership

Cancer Screening Day Free community screening event. Breast, lung, cervix, colon, head and neck, skin and prostate screenings offered. Prevention education offered including smoking cessation, colon prevention, healthy lifestyle choices and skin sun safety.









NCCN, ACS, ACOS, ASBS, AAB

80 patients 195 screenings 32 counseled on smoking cessation

2 cancers diagnosed Cancer navigators, cancer program APRN and physicians reviewed all abnormal results. Results sent to patient and primary physician, if listed. Navigators facilitated follow-up for all abnormal results. Annual reminders will be sent to all breast screening participants.

Aultman Health Foundation Stark County Physician Multispecialty volunteers

Breast Cancer Screening (Links Grant) Screening event targeted at minority, homeless and underserved Participants provided with clinical breast exam, mammogram, and education on cancer prevention and screening guidelines.

8/25 Target minority populations in our community.

Access and affordability of health care.









16 clinical breast exams 6 mammograms

1 abnormal mammogram 0 cancers diagnosed All patients followed by the breast navigator. Patient is notified of results and primary physician, if the patient has one. Navigator facilitates follow-up for all abnormal results and documents in navigation software. Screening reminder letters are sent annually.

Aultman Health Foundation Links Kent chapter - grant

Breast Cancer Screening -Evening Clinic (EFA grant) Participants provided with clinical breast exam, mammogram, and education on cancer prevention and screening guidelines.

8/25/15 Access and affordability of health care.







15 2 abnormal mammograms 0 cancers diagnosed All patients followed by the breast navigator. Patient is notified of results and primary physician if the patient has one.


68


Screening Event


Need/Initiative

Evidence- based





or Partnership



Navigator facilitates follow-up for all abnormal results and documents in navigation software. Screening reminder letters are sent annually.

Breast Cancer Screening -Evening Clinic (EFA grant) Participants provided with clinical breast exam, mammogram, and education on cancer prevention and screening guidelines.

9/1/15 Access and affordability of health care.









23 2 abnormal mammograms 0 cancers diagnosed All patients followed by the breast navigator. Patient is notified of results and primary physician, if the patient has one. Navigator facilitates follow-up for all abnormal results and documents in navigation software. Screening reminder letters are sent annually.

Aultman Health Foundation Educational Fund of America - grant

Carrollton Screening Event Health event for men and women offering breast, cervix, prostate, colon and skin screenings, and education on cancer prevention and screening guidelines.









NCCN, ACS, ACOS, ASBS, AAB

22 patients 63 screenings

0 cancers diagnosed Cancer navigators and screening physician reviewed all abnormal results. Results sent to patient and primary physician, if listed. Navigators facilitated follow-up for all abnormal results.


69


Evaluation of Effectiveness of Screening Activities Our cancer program places a high priority on continuing to provide the community with access to low-cost or free screening. We were able to provide 332 screenings to 176 individuals, which is an increase from 2014. We target the uninsured population through collaboration with our health department and clinics and by directed marketing in underserved areas of our community. This continues to be effective as over 50 percent of those who participated in our screening events were uninsured. We are continuing to provide free screenings at our events to insured individuals because we have found that many of them do not participate in screening outside of these events due to accessibility and inconvenience. A survey of our screening event participants in 2015 indicated that many attend our events annually because they don’t have a primary care physician, they have insurance but the plan does not pay for specialists, access is easier when they are able to get all of their screenings at one time, and long waits to see specialists inhibit their ability to get their screening in a timely manner. One way that we evaluated the results of our annual multisite screening this year was by comparing the participants in the last five years with our cancer registry data. We found that ten cancers were diagnosed in those individuals within six months of our screening. This further supports the success of our screening program.

We were fortunate to receive a grant through the Educational Fund of America which made it possible to provide four additional breast screening events to our community. We found that events held at our facility in the Massillon area are in higher demand. Surrounding ZIP codes in this area have been identified as high relative need areas so we will continue to have events at this facility. The grant through the Educational Fund of America continues into 2016 and will allow us to again provide these four additional screening events. Although no cancers have been diagnosed from these screening events in 2015, we have diagnosed three through breast screening-focused events in the last three years. We continue to consider these additional screenings to be an integral part of our outreach since screening is a proven means to finding cancers early when they are most treatable.

In 2014, we expanded our screening event at Carrollton to include cervical and skin in addition to breast screening for women. Our organization was willing to expand this screening event again in 2015 to offer prostate, skin and colon screening to men and add colon screening (through FIT) for women. We screened 22 individuals this year versus nineteen in 2014. Only two of the participants were men, which was disappointing. In 2016, we may consider a change in marketing the event and/or considering alternate times, days that may be more accessible.

Although our collaborative relationship with the Links, Inc. group is only at its beginning stages, we were able to attend a community event focused on the homeless or near homeless. We offered clinical breast exams and education at the event and then scheduled the women for a mammogram and provided gas cards or bus passes to get to the hospital. Unfortunately, the follow-through rate was low. Out of the 14 women who scheduled for a mammogram, only six actually showed for the appointment. We will continue to look for ways to reach out successfully to this underserved area of our population and establish new community relationships through the Links, Inc. collaboration.

Our initiative to improve colon screening options will continue into 2016. Although we successfully implemented FIT testing at our main screening and Carrollton, we were unable to accomplish our goal of GI collaboration for colonoscopy screening options for the uninsured. Our commitment to partner with the American Cancer Society in an effort to increase CRC screening to 80 percent by 2018 will be a strong focus in the coming year.

70


Our lung screening program continues to be a success. Since its inception in 2013, we have enrolled 245 patients in the screening program and diagnosed seven cancers; five were stage I or II (early stage), one was stage III and one stage IV. We have provided these screenings at a low cost ($99) until insurance coverage was available. In 2015, some commercial insurance plans started paying for this screening and Medicare will provide coverage to high risk individuals in 2016. We have also been committed to offering free LDCT screening to our free screening day participants who meet high-risk criteria. In 2015 we performed eight free screenings which was the same number as in 2014. We will continue to offer this free screening to uninsured individuals at our cancer screening day and will explore grant options in an effort to offer more free screenings throughout the year.

Follow-up for screening activities has effectively been accomplished through our navigation program. Previously, navigation nurses were involved in follow-up for breast and lung patients. However, in 2014, we expanded this to include the gynecologic screening patients and in 2015, we included all abnormal screenings. All screening results are reviewed and abnormal results are discussed with our cancer program APRN or the ordering/overseeing physician for the screening event. Normal results are provided to patients and their primary care physician (if provided by the patient), through letters. All patients with abnormal results are contacted by phone as well as provided a letter with recommendations for follow-up. Follow-up is facilitated by a navigator to ensure compliance. The nurse navigator also sends all abnormal results to primary care physicians as provided and facilitates referrals to specialists as needed. We have found a high rate of follow-up compliance using this process and will continue to involve the nurse navigator team in all cancer screening follow-up.

2015 Additional Community Outreach

Outreach Initiatives

New Initiatives: o Increase availability of mental health and supportive care access. o Focus on survivorship needs.

71


Additional Outreach Events:

Activity Date Type Evidence-based

guideline or intervention

# Attended

Process for Follow-up/ evaluation

Sponsoring Organization or

Partnership Cancer Education Series - Knowledge is Power - general cancer, treatment, side effect and support education for cancer patients and family members.

5 weekly sessions in January, April, July and October


Increase availability of mental health and supportive care access.

Focus on survivorship needs.

ACS, NCCN, ONS 11 Satisfaction survey Outreach Subcommittee review


Moving Forward - monthly survivorship support group/screening sessions with therapy, behavioral health, financial advocacy, dietary, and integrative therapy including massotherapy and Reiki.

Monthly – second Thursday




NCCN guidelines ASCO survivorship

10 monthly Satisfaction survey Outreach Subcommittee review


Relay for Life 6/6 Community outreach.


ACS 100 Aultman participants


Aultman Health Foundation American Cancer Society

Cancer Survivorship 6/10 Educate the public on cancer prevention with evidence-based strategies.



ACS, NCCN, ONS 4 Participant survey Outreach Subcommittee review


Activity Date Type

Evidence-based guideline or intervention

# Attended

Process for Follow-up/ evaluation

Sponsoring Organization or

Partnership

Survivorship Day Event 6/16 Focus on survivorship needs.

ACS, NCCN, ONS 125 survivor attendees 16 employee participants



Making Strides Against Breast Cancer

10/25 Community outreach.


ACS 75 Aultman participants


Aultman Health Foundation American Cancer Society

72


Evaluation of Effectiveness of Additional Outreach Events Additional community outreach needs identified through our community needs assessment included behavioral health and supportive care as well as survivorship. Our survivorship activities have been successful and also offer opportunities for behavioral health and supportive care intervention. A behavioral health APRN leads a session at our Moving Forward program and several of these participants have gained access into more advanced counseling services through this opportunity. This program is also supported through a grant from the Educational Fund of America. Approximately 10 participants every month have been able to meet individually with a behavioral therapy specialist, physical therapist, dietitian, financial counselor and integrative therapy specialist (Reiki and massotherapy), all free of charge. In evaluating this program, we have found that although participation is not as robust as we would like, it is beneficial for those who attend. Further evaluation needs to be done to determine how to better market this program and how to engage physicians in referring patients to this supportive care program.

Participation in our cancer education series - Knowledge is Power - has been low in 2015 and we will consider modifying this program in 2016. Although those who attend indicate a high level of satisfaction on their post- event survey, low attendance may indicate a barrier. One possibility is that the five-session design is prohibitive, and a better format may be a combined session with abbreviated content.

Participation and financial support of community events such as Relay for Life and Making Strides Against Breast Cancer confirms to our community that our cancer program is committed to cancer research and education. It also offers us another opportunity to be visible and active participants in our community. Participation at both of these events this year increased through the active engagement of all members of our cancer team.

Recommendations for 2016 Screening/Prevention/Community Outreach

Implement and expand youth cancer prevention education program. Middle school age youth are at a crucial time in development both in adoption of healthy vs. unhealthy lifestyle choices and exposure to known cancer risks. A survey of Stark County seventh- and eighth-graders indicated that the average age to start smoking is 14.3 years, with 7.6 percent of all surveyed indicating that they are regular smokers. Although lower than the national rate of 34.6 percent, 2009-2010 data showed that 34.1 percent of Stark County third-graders were classified as overweight or obese. This is an increase from 33.5 percent in 2004-2005 data. Adult obesity and smoking rates in Stark County are also higher than the national average. As an organization, we are committed to Leading Our Community to Improved Health. We feel that we can reduce future cancer incidence in our community through advancing awareness and education in our youth. Our partnership with the Stark County School System will provide opportunity for us to educate youth about the importance of cancer prevention strategies including healthy diet, exercise, avoidance of tobacco and alcohol, sun and UV ray exposure and HPV awareness.

This initiative will address our identified community need related to high-risk health behaviors.

Target lung cancer prevention and screening activities. As a program, we are committed to continuing our efforts toward lung cancer prevention. As the leading cause of cancer deaths, prevention and early detection are vital to improving outcomes. As stated previously, we found in our community needs assessment that tobacco use continues to be above national and state averages in our community. Data also shows that more of our cancers are found at later stages. We feel that it is an opportune time to continue to increase awareness of lung cancer screening guidelines and smoking cessation since screening is now covered by insurance. Physician and community education should be a focus in 2016.

73


We will also continue our partnership with the smoking cessation program and the Working on Wellness community outreach program in an effort to better combine our efforts for greater impact in our community.

This recommendation will address our identified community needs of cancer screening compliance and access, high-risk health behaviors and timely diagnosis and treatment.

Improve colorectal cancer (CRC) prevention and screening awareness in the community. A large focus of our screening and prevention initiatives for 2016 should focus on CRC cancer. We have partnered with the American Cancer Society’s initiative to increase screening to 80 percent by 2018. Although our community needs assessment showed that we have slowly declining rates of colon cancer, 22 Ohio counties fall into one of the “hotspot” areas for high CRC incidence and mortality. The current national average for CR screening is 65 percent, while Ohio has an estimated rate of 59-63 percent with some areas as low as 49 percent.

FIT screening annually for normal-risk individuals will be a focus; we should continue to explore options to offer low-cost or free colonoscopy to those at higher than average risk that are uninsured or underinsured. Screening for CRC using colonoscopy is also a preventive strategy, as polyps are removed that could later become CRC.

This recommendation will address our identified community needs of cancer screening compliance and access, timely diagnosis and treatment, as well as access and affordability of care.

Minority focused partnerships. Although we implemented a minority focused partnership in 2015 through our collaboration and grant with Links, Inc., this collective effort should be continued in 2016. We should increase our resource materials and education that is specific to this population, and focus our efforts on those cancers that are most prevalent or deadly to them such as prostate, colon and breast cancers.

This recommendation will focus on our identified community need of to address minority health disparities.

References American Cancer Society Cancer Facts and Figures, 2014 American Cancer Society 80% by 2018 Report Aultman Hospital Cancer Registry Aultman Cancer Center 2014 Community Health Needs Assessment Centers for Disease Control Komen Northeast Ohio 2014: Community Profile/Snapshots/Stark National Cancer Data Base

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APPENDIX I

Infant Mortality Community Outreach

Community Outreach: Infant Mortality and Safe Sleep

Date Location # of adults

1/13/2014 Turnaround Community Outreach 15


2/19/2014 Library 7


4/21/2014 Library – Community Baby Shower 20



7/12/2014 WOW Hartville 50

7/17/2014 WOW Carroll County Fair 15

7/25/2014 WOW Rivertree Church: Teens 50

7/26/2014 WOW Canton Farmers Market 50

8/5/2014 WOW National Night Out: Target 10

8/8/2014 WOW United Church of Christ: Backpacks 50

8/9/2014 WOW Massillon Fun Feast 300


8/16/2014 WOW Canton Community Clinic 400

8/30/2014 WOW Nimisilla Park 15

9/6/2014 WOW Crooked River Powwow 10

9/7/2014 WOW Canton Carnival of Wheels 150


9/16/2014 WOW Canton Health Fair: Grandparents 30

9/18/2014 WOW Jackson Farmers Market 10

9/25/2014 WOW Health and Wellness Fair: Grandparents 36

9/27/2014 WOW Peace Lutheran 10

10/1/2014 HOF Senior Day: Grandparents 150

10/3/2014 WOW Women’s Wellness: Carrollton 20

10/11/2014 WOW Green Community Expo 20


10/15/2014 WOW Walsh Wellness 10

10/16/2014 WOW Trinity Dream Center 10

10/18/2014 WOW Jackson Health Fair 50

10/20/2014 WOW Hartville Flea Market 30

11/2/2014 St. Michael’s: Teens 50


11/15/2014 WOW JIT Food Ministry 10


1/9/2015 Habitat ReStore 6

TCO 15

1/18/2015 St. Stephen Lutheran Church 20

2/4/2015 Bedford Lobby 12

2/7/2015 H&R Block 4

2/10/2015 Total Living Center 12

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Date Location # of adults


TCO 15


2/28/2015 JIT Food Ministry 15

3/4/2015 Aultman Lobby 30

3/8/2015 Louisville YMCA 35

3/12/2015 Health Fair: Mahoning Road 30

3/13/2015 Stark County Fair Grounds 40

TCO 15

3/19/2015 Trinity Dream Center 25

3/21/2015 Timken Kindergarten Registration 30

3/26/2015 Health Fair: Louisville High School 150

3/27/2015 Community Drive: Cherry Ave. 25

3/28/2015 Fit and Family Fun Day 25

4/1/2015 Cultural Center Senior Health Fair 150


4/18/2015 Timken 50

TCO 20


4/25/2015 North Canton YMCA 170

4/27/2015 Library Baby Shower 40

5/2/2015 Fishers Health Fair 40

TCO 20

5/15/2015 Amherst Elementary Carnival 40

5/16/2015 Gentlebrook Wellness Event 25


6/4/2015 Community Development Day 120

TCO 20

6/11/2015 Jackson Farmers Market 40

6/13/2015 Massillon Farmers Market 50

6/23/2015 Adventist Wellness Fair 55



7/16/2015 Canal Fulton Farmers Market 16

7/18/2015 Canton Farmers Market 22

8/1/2015 Massillon Fun Fest 100

8/4/2015 National Night Out – Target 200


8/11/2015 Library Mom’s Club 18

8/13/2015 Jackson Farmers Market 40


8/15/2015 Lifecare 50

8/20/2015 Canal Fulton Farmers Market 6


9/2/2015 Aultman Lobby 25

9/4/2015 Stark County Fair Grounds 50

9/12/2015 Baby Tots – Belden 300

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Date Location # of Adults

9/13/2015 Canton Carnival of Wheels 100


9/24/2015 Health Fair Massillon 76

9/26/2015 Faith UMC 15

10/2/2015 Massillon YMCA 40

10/3/2015 Family Fun Day 15

10/7/2015 HOF Senior Day: Grandparents 125


10/8/2015 Church of Covenant 10

10/24/2015 Diversity Fair: Friendship Baptist Church 30

11/11/2015 Canton Calvary Mission 45

11/21/2015 Urban League of SC 18


12/11/2015 Canton South Wellness Fair 152


Total Outreach 4,772

Professional Outreach

Date Event/Location # of Attendees

8/6/2014 Clergy Breakfast 50

10/30/2014 Perinatal Symposium 105

Staff Engagement

Date Event

4/2/2014 5/1/2014

Skills Day – Birth Center Skills Day – NICU

7/14/2014 Halo Sleep Sack implementation

7/14/2014 Crib card revised

10/9/2014 OHA Safe Sleep Summit: presented

12/4/2014 OCPIM Infant Mortality Summit Skills Day – Birth Center

Documents

Aultman Hospital | Health Care in Canton Ohio - …...newborn care services, level 2 trauma services, hospice, long-term care, physical rehabilitation and psychiatric care. Aultman