Anne Arundel County Community Action Agency Final Practicum Report

Final Practicum Report

Name

Institution

Course Code: Title

November 30, 2023.

Final Practicum Report

Introduction

The practicum site was the Anne Arundel County Community Action Agency (AACCAA), which is the primary anti-poverty agency in the county. Created in 1965 as a result of Congress’ passage of the Economic Opportunity Act, the AACCAA is tasked with funding local communities to address disparities in healthcare, childcare, employment, and education. The agency’s primary purpose is to design and implement interventions to assist low-income residents to become self-sufficient (AACCAA Needs Assessment, 2021). The AACCAA envisions to “become the recognized leader in addressing poverty and improving the quality of life in the communities of Anne Arundel County” (AACCAA Needs Assessment, 2021, p.6). The agency serves the Anne Arundel community through six programs:

i) Youth Development Services – serves children and young people aged between 5 and 24 through educational, preventive and therapeutic services, workforce training, and behavioral health program (AACCAA Needs Assessment, 2021).

ii) Returning Citizens Program – supports ex-convicts to become productive community members through workforce training, psychosocial support, and access to rehabilitation services (AACCAA Needs Assessment, 2021).

iii) Health and Wellness Program – uses awareness and prevention initiatives to eliminate health disparities for low-income households (AACCAA Needs Assessment, 2021).

iv) Early Head Start – offers child care and hands-on education to toddlers aged between zero and three to foster positive development (AACCAA Needs Assessment, 2021).

v) Energy Assistance – serves eligible low-income households in the county by supporting them to reduce their electricity and heating bills (AACCAA Needs Assessment, 2021).

vi) Asset-building Initiative – empowers residents to achieve independent living through education programs around home ownership, employment, credit repair, banking, and budgeting (AACCAA Needs Assessment, 2021).

My overall goal for the practicum was to design a community-based resource guide that the agency could use to communicate information on essential services and resources to the public, and which community members could access on the agency’s website. The primary aim of the resource guide was to bridge the gap between community members and available services by centralizing information on available resources and services, leading to a healthier community.

In addition to designing the resource guide, I sought to accomplish two other deliverables. The first was developing an evaluation proposal that could be used to examine the efficacy and impact of the agency’s health and wellness program in reducing mental health among low-income individuals. An evaluation plan would indicate what aspects of the program worked, thus enhancing efficiency in resource allocation by allowing the program managers to commit resources in activities that work (Harris, 2016). Further, an evaluation plan would enhance the quality of the evaluation process, thus helping to build trust among community members and funders (Harris, 2016). The second was conducting a literature review of scholarly sources on the barriers that low-income families face in accessing education and child care. The findings of the literature review will go a long way towards identifying the community’s unique needs and designing programs that address the identified needs. To effectively deliver on my assignment during the practicum, I had to synthesize agency annual reports, collaborate with beneficiaries and staff, and conduct literature evaluations, all of which gave me a complete picture of the agency’s impact on the target community.

The public health problem that the practicum project addresses is mental health issues among low-income individuals and households in Anne Arundel County. Mental health remains a fundamental health concern in Maryland, particularly for low-income households without insurance coverage. Data from the National Alliance on Mental Illness (NAMI) shows that 20 percent of American adults experience a mental illness every year (NAMI, 2021). 2021 data indicates that 181, 000 adults and 1 in every 6 teenagers in the State of Maryland experienced a serious mental illness in that year alone (NAMI, 2021).

Unfortunately, access to mental healthcare services remains a serious challenge for the entire Maryland population. In 2021, for instance, less than 50 percent of adults suffering from mental illness in Maryland were able to access mental healthcare (NAMI, 2021). Cost was cited as the main barrier to access by 33.7 percent of adults who were unable to access mental healthcare services in the state (NAMI, 2021). The shortage of mental health professionals also limits access to care, particularly for low-income families. According to the AACCAA needs assessment report, Anne Arundel County had 1,180 mental health professionals in 2021 (AACCAA Needs Assessment, 2021). This translates to a patient-provider ratio of 490:1, which is lower than the state and country averages, which stand at 360:1 and 270:1 respectively (Brown, 2022). At the same time, the shortage of Spanish-speaking psychiatrists and counselors continues to pose access-related issues for non-English speaking households in the county, who make up 19 percent of the total population (Brown, 2022).

It is important to assess mental health issues because these issues affect individuals, communities, and families, impacting their quality of life (NAMI, 2021). Mental illness increases the risk of school non-completion, suicide, and involvement in crime (NAMI, 2021). High school students with depression are two times more likely than their peers to drop out of school, and people with a history of mental illness are three times more likely to be sent to prison than their peers (NAMI, 2021). In Maryland alone, over 180,000 adults reportedly had suicidal thoughts in 2021, and 650 lost their lives to suicide due to mental illness (NAMI, 2021).

The main topic addressed during the practicum period was the barriers that low-income families face in accessing education, healthcare, and child care. The reviewed literature identified the main barriers to effective healthcare utilization as lack of parental education, insurance-related complications, poor relationships with healthcare providers, and distrust in the healthcare system. Lazar and Davenport (2018) found that parents with low education levels were less likely to sacrifice resources to meet their families’ healthcare needs, particularly preventive care. DeVoe et al. (2021) also found that most low-income households faced challenges meeting the restrictive Medicaid strategy set by states, leaving most of them uninsured. Access to private insurance was also severely limited by the high deductibles, copayments, and annual premiums, all of which make the cost unaffordable (DeVoe et al., 2021).

Sources also identified lack of trust in the healthcare system as a barrier to healthcare utilization. According to DeVoe et al. (2021), low-income individuals do not often understand standard hospital procedures and may feel intimidated, which affects their willingness to seek healthcare services (DeVoe et al., 2021). The barriers to quality education for children from low-income families included lack of parental and familial support (social academic capital), lack of financial resources to purchase academic resources, restrictive institutional policies, and inadequate teacher support (Compton-Lilly & Delbridge, 2018).

Methods

The goal of the practicum was to design and develop a community-based resource guide that would provide community members with adequate information on how to find and access the agency’s essential resources and services. The primary aim of the guide was to foster a healthier and more robust community by bridging the gap between needy individuals and available agency programs, initiatives, and resources. The guide was to be hosted on the agency’s website and would centralize all information about the services it offers. This would give residents access to vital resources that address their unique needs and promote their well-being.

The first objective towards realizing this goal (objective 1.1) was to collect information about various local services, resources, and programs, including social support, education, employment assistance, housing, and healthcare by 12th September, 2023. Objective 1.2 was to collaborate with the agency’s partners, staff, and local organizations to gather up-to-date and accurate information on what to include in the guide by 25th September, 2023. Using the information obtained from these collaborations, objective 1.3 was to create by 23rd October 2023, a user-friendly and visually appealing resource guide that offers clear descriptions of services informed by different needs, with clear contact information that allows users to easily navigate and search for specific services based on their needs and preferences. The fourth objective (objective 1.4) was to pilot test the guide with a group of community members to test its effectiveness and usability and gather feedback to inform improvement. Finally, objective 1.5 was to promote the guide among community members using the agency website, social media, local newsletters, the county website, and community events as a means to increase its visibility.

In addition to the primary project goal, the practicum attracted two standalone deliverables. Deliverable 1 was an evaluation proposal for assessing the impact of the health and wellness program on the mental health of low-income residents in Anne Arundel County. The evaluation proposal will be beneficial in identifying the program’s areas of improvement, as well as strengths and weaknesses, thus enhancing efficiency in resource allocation (Harris, 2016). Deliverable 2 was a literature review of scholarly sources on the barriers that low-income families face in accessing education and child care services. The literature review points out the gaps or inconsistencies in the agency’s programs relative to the community’s needs, which ensures that interventions are efficient and impactful. It also build trust among funders and community members, who are more likely to support and trust the agency’s efforts if the same are informed by research (Harris, 2016). Thus, both deliverables contribute towards the agency’s dedication to address the needs of low-income residents through evidence-based decision making.

Creation of the program evaluation proposal aligns with competency GC1, which requires students to design a program evaluation, systematic review, or research study to address a public health issue. To demonstrate the identified competency, I created a detailed program evaluation proposal for assessing the impact and effectiveness of the AACCAA’s Health and Wellness Program in addressing mental health issues among low-income residents in the county. This complex procedure involved extensive report reading and literature, leading to the development of an insightful evaluation plan that details the evaluation questions, techniques, data collection instruments, and key performance indicators.

Designing and developing the resource guide aligns with competencies FC#9 and FC#19, which require students to design a population-based intervention, program or policy, and to effectively communicate public health content to a non-peer and non-academic audience. To demonstrate competency FC#9, I thoroughly reviewed the AACCAA’s needs assessment report and strategic plan and aligned my efforts with it. Increasing family and community involvement in the agency’s activities is a priority area in the AACCAA strategic plan. Towards this end, I developed a comprehensive resource guide that adequately communicates to community members the resources and essential services offered by the agency, thus increasing access to vital resources and developing a healthier community. To demonstrate competency FC#19, I piloted the resource guide to a number of non-peer and non-academic community members, from whom I managed to obtain feedback on areas of improvement. As part of developing the resource guide, I engaged with the agency’s partners, staff, and local community organizations to gather up-to-date and accurate information on what to include in the guide. This collaboration was in line with GC#3, which requires students to apply community engagement principles to create public health awareness.

The third deliverable, the literature review, aligned with FC#7, which requires students to assess population needs, capacities, and assets that affect the health of communities. To demonstrate this competency, I conducted a literature review to identify the barriers that low-income families face in accessing healthcare and childcare resources. The review of literature provided a means to understand the specific needs of, and limitations facing the Anne Arundel Community, which helps the agency design interventions that address the identified needs.

The evaluation adopts a specific logic model approach, which moves from outcomes, through outputs towards intended activities (Rural Health Innovations, 2016). The program’s long-term mental health goal is to improve the mental health of low-income residents in Anne Arundel County by reducing the incidence of mental illness and suicide by 30 percent and hospital stays by 5 days within five years. In the short-term, the evaluation proposal measures how well the program enhances beneficiaries’ mental health, how well the program reaches and engages critical populations, and how well the program has implemented planned activities. The specific methods, data, procedures, and performance indicators used to achieve this is summarized in table 1 below:

Table 1: Summary of Evaluation Proposal Data Collection Methods and Performance Indicators

Logic model Element

Evaluation Question

Data Source and

Data Collection Method

Performance Indicator

Program Goal

To improve the mental health of low-income residents in Anne Arundel County

Do individuals report improved mental health as a result of the health and wellness program?

Percentage of the resident population suffering from mental illness.

Suicide rates among low-income residents.

Hospitalization rates for mental disorders among residents.

Surveys to collect primary data among residents on the incidence of mental illness, suicide rates and hospitalization rates before and after the program was implemented. The chi-square and ANOVA will then be used to compare rates before and after program implementation

The incidence of mental illness and suicide among low-income residents in the county reduce by 30 percent within five years. Hospitalization rates as measured by the lengths of in-hospital stays among mentally ill residents reduces by 5 days on average within five years.

Outcomes

Short-term: Reduced stress levels among program participants

Do individuals report reduced stress levels as a result of participating in the health and wellness program?

Participants’ perceived stress scores as measured by the Perceived Stress Scale administered by agency counselors at intervals of 6 months (She, 2021).

Document Review: Reviewing records of a sample of participants selected randomly and comparing perceived stress scores over time.

80 percent of participants report reduced perceived stress scores after 6 months of participating in the health and wellness initiative