Upstream Healthcare: Values Training for Low-Income Children Using Baccalaureate Nursing Students and Community Youth

Friday, 28 July 2017: 11:25 AM

Martha Martinez, MN
School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
Socorro Escandon, PhD, MSN, BSN
University of Texas Health Science Center at San Antonio, El Paso, TX, USA

Evidence now supports the idea that social determinants of health (SDH) are the biggest factors in influencing population and community health. Addressing one or more of these factors can have a positive impact on health. Efforts and investments should be directed at root causes of heath disparities to improve health outcomes. One of the core principles of Upstream Health Care is to focus beyond the walls of acute care settings and extend into the communities and collaborating agencies to address the root causes of health problems/issues including SDH. Community settings can provide an environment that supports and fosters character building and core values such as courage, good judgement, integrity, honesty, self-discipline and service. Focusing on SDH as part of nursing education and promoting healthcare at the community level enables nursing students to develop an expanded perception of nursing care that includes vulnerable populations. Students completed their Population-Focused Health clinical rotation at Jireh House, a faith-based community agency that provides services to residents living within a government subsidized low-income housing property. This area is known for increased health and educational disparities in San Antonio, Texas.

Moral qualities are valued by individuals, parents, and educators and are likely to benefit society as a whole. Experiences during childhood play a role in shaping an individual’s life and outcomes. Providing positive learning opportunities, supporting positive relationships and teaching core values to improve health outcomes. Children, as early as two years of age, demonstrate kindness and begin to develop collaboration and teamwork abilities which increase throughout early childhood. Community settings can provide an environment that supports and fosters character building and core ethical values such as courage, good judgement, integrity, honesty, self-discipline and service. Given that experiences during childhood play a big role in shaping future life outcomes, providing positive learning opportunities, supporting positive relationships, and teaching core values may improve health outcomes. Children relate to puppets from a very early age and puppet shows provide a way to use a story format to portray a variety of situations related to misconceptions, conflicts, and coping skills. The purpose of the Values Training Puppet Projectwas to provide senior nursing students, in their Population-Focused Health clinical rotation, the opportunity to develop mutually beneficial relationships with community service organizations in San Antonio, Texas. Nursing students worked side-by-side with youth ages 13-17 at Jireh House to create and produce puppet shows for school age children who lived in the nearby low-income housing. The goal was to foster citizenship and leadership skills for the nursing students and volunteer youth through character building activities and shared development of a values training project using puppet shows for school age children attending a youth program at Jireh House.

Prior to the beginning of the project, both the nursing students and volunteer youth at Jireh House completed the Values in Action Inventory (VIA)Survey of Character Strengths to identify their own personal strengths and values prior to implementing values training to the children. The VIA is a self-report questionnaire designed to identify individual strengths within six virtue clusters. One focus is to identify and strengthen moral core values that will guide life experiences and decisions. Before implementing the puppet shows, the students and community youth met separately to address their VIAs and discuss perceptions of the benefits of community collaboration. The two groups then met to share reflections from their VIAs. These reflections informed The Values Training Puppet Project which focused on: 1) Engagement, active participation, and positive learning experiences and 2) the concepts of honesty, self-control and integrity. The nursing students and youth volunteers worked together to introduce creativity and imagination and engagement into three different puppet shows. For example, one group incorporated music prior to the show. At the request of the children, the groups repeated two of the puppet shows twice.

At the conclusion of the project, the nursing students were again asked to reflect on their VIA identified strengths and relate them to their work during the project. Three themes emerged: 1) Strength of teamwork, 2) Fairness, and 3) Leadership. The students used their character strengths to inform their work with the volunteer youth group, the creation and implementation of the puppet shows and how to mentor youth. The students also discussed how this experience related to growth and development theory of young adolescents and their need to be creative, yet held accountable for their work. Using innovative teaching strategies to promote character building, mentorship, and values training for at risk youth and children is one approach to upstream health care and has the potential to decrease to health disparities and improve health outcomes.