Healthier Lives initiative delivers training, addresses needs

Dr. Melenis Lopez, left, translates for a family at a health assessment clinic in Duplin County.

Health care providers of East Carolina University’s Healthier Lives initiative in the Brody School of Medicine continue to use the program to address health care needs for children in rural eastern North Carolina counties and are finding pathways to expand access to care at schools in Duplin County and beyond.

The Healthier Lives at School & Beyond Telemedicine Program originally launched in 2018 to deliver interdisciplinary services virtually to rural school children, staff and faculty during the school day. In response to COVID-19, the program continued to address health care needs for children and expanded access while students were learning remotely.

Since the fall of 2020, the program has used an ECU Transit bus to visit schools in Duplin, Jones and Sampson (Clinton City Schools) counties to provide high-quality health appointments. The retrofitted motorcoach has been used to provide screenings for 303 students, with additional visits planned for existing program partnerships and newly established ones.

The initiative was recognized recently by the Mid-Atlantic Telehealth Resource Center with the Breaking Barriers Through Telehealth Award in the category for small, rural and safety net organizations. During the 2024 Rural Health Symposium, a presentation on Healthier Lives – On the Road Again: Rolling to Reduce School Suspension – was awarded first place in innovations panel.

Experiential learning

Delivering care in the community is also delivering learning opportunities for ECU students. Third- and fourth-year medical students and medical residents participate in clinic days, gaining hands-on experience providing health care to rural populations.
Recent Brody graduate Dr. Melenis Lopez said the Healthier Lives clinics demonstrate that service is truly ECU’s mission. During a school clinic in the fall, Lopez applied pediatric learning experience as a care provider. She collected patient history and assisted in making plans for children that could be passed on to the school.

“Providing care in a place that is convenient to the community can be lifesaving,” Lopez said. “Offering physicals can uncover developmental delays and health problems. Children can’t stay in school without these physicals and proof of vaccinations, so I’m happy we were able to be there for the kids.”

Lopez and her ECU cohort guided elementary students and their families through clinic stations to take vitals, check vision and hearing, and perform physical exams. Students could meet with mental health and nutritional professionals for additional screening when needed.
Lopez used her ability to speak Spanish to help the children feel comfortable and ease the burden on families who may not understand the forms or instructions from the care provider.

Rural health care

Dr. Krissy Simeonsson, associate professor for pediatrics and public health and the medical director for the program, is proud that Healthier Lives is giving ECU students the opportunity to experience health care in a rural setting.

Dr. Jenelle Brison takes vitals of a Rose Hill-Magnolia Elementary student as part of a Healthier Lives health assessment in Duplin County. (Photos by Patricia Earnhardt Tyndall)

“Students can see that they can help,” Simeonsson said. “Most students and residents we’ve had have that ‘aha’ moment and can see themselves in primary care. They realize they can succeed out here.”
Jill Jennings, ECU’s Healthier Lives program manager, said the hybrid approach of on-site clinics and telehealth makes it easier for the medical providers to communicate with parents in person and more readily make referrals for any nutrition or behavioral health follow-up virtual care.

A $1.2 million grant from the Health Resources and Services Administration funded the first four years of the program. Funding now comes primarily from Anonymous Trust, a private North Carolina foundation, and has been provided by the Harold H. Bate Foundation, the ECU Health Foundation, and the North Carolina Department of Health and Human Services Office of Rural Health.

“There are many opportunities for institutions such as ECU to leverage their resources to address community needs,” said Debbie Aiken, executive director of Anonymous Trust. “This initiative is a wonderful example of ECU recognizing health care disparities, and in partnership with a local school district, serving children who might otherwise not receive the care that they deserve.”

Aiken witnessed a program clinic in action at Rose Hill-Magnolia Elementary School in Duplin County. ECU medical students and residents, health sciences undergraduate and graduate students, Healthier Lives team members and partners from the school system and Duplin Health Department screened 47 students who otherwise would have been suspended for not having a health assessment completed by a medical provider.

“These partnerships should be happening across the state,” Aiken said. “Seeing it helps you truly understand the disparities in our rural communities. If more school systems understood that this is available, they would want to participate.”

Community engagement

Dr. Jenelle Brison ’24 said Healthier Lives provided an opportunity for community engagement for medical students. Brison encouraged fellow Brody students to participate.

“It’s so nice to interact with the little kids,” Brison said. “Events like this help break down barriers and offer unique training for students.”

While Brison ultimately hopes to focus on obstetrics and women’s health, she was at ease helping children with vision screenings and demonstrating a blood pressure cuff before taking vitals.

Dr. Bolu Aluko ’24, a Tiana Nicole Williams Scholar at Brody, was drawn to the opportunity for community engagement provided by Healthier Lives.

“Coming into the community is incredibly enriching,” Bolu said. “Every med student should do this. It’s a fantastic way to serve and practice our clinical training.”

Through an interpreter, the family of one student said they had received a call from the school that their son would not be able to return to class because he had not had a physical or proof of vaccinations. They had just moved from Mexico to Warsaw, North Carolina. Without the availability of a Healthier Lives clinic at the school, they would not have had access to a health screening for their son in time to meet the state-mandated deadline.

The family sat with an interpreter and was provided a nutritional referral and a connection to a primary care clinic in Warsaw to establish a medical home. “We’re grateful to know he’s healthy,” his mother said through the interpreter.

“You have to meet people where they are,” Simeonsson said. “A lot of families trust the school. When you see the families getting help for their children, you know the program is living up to expectations.”