University of Vermont

Office of Community-University Partnerships & Service Learning

Promoting Public Health in Marginalized Communities

Physical therapy students lend vital support to underserved populations and the organizations they rely on

The Vermont SledCats, pictured here at a scrimmage with UVM Men’s Hockey. (Photo: Nich Hall)

The World Health Organization tells us that health promotion is the process of enabling people to increase their own control over their health. Put into practice, this encompasses a wide range of social and environmental interventions, combined with education, to support public health and wellness.

So how does one actually tackle the task of promoting public health?

This can be a deceptively difficult project, as student Alex Linde discovered in Professor Nancy Gell’s PT 303: Health Promotion and Disease Prevention service-learning course. The responsibility of promoting public health goes far beyond simply providing tips and recommendations, Linde explains. “At the beginning of the project I thought it would be easy to create a few flyers and handouts … after countless meetings and group discussions, however, I now have a much different understanding of how hard it is to put together a simple public outreach program.”

Prof. Gell’s students tackled a variety of community-based projects this Spring. The class worked in small groups that focused on a particular organizations and populations, designing and implementing seven different health promotion interventions over the course of the semester. Students collaborated with a range of local partners — often working directly with the communities they serve to deliver initiatives that meet their needs.

As a physical therapist with an M.P.H. in health behavior and education and a Ph.D. in exercise science, Professor Nancy Gell is well-equipped to provide her Doctor of Physical Therapy (DPT) students with the skills and knowledge necessary to practice health promotion out in the real world.

In this course, students partnered with Stay Steady Vermont and physical therapists at UVM Medical Center to strengthen fall prevention programs for senior citizens, a community of Special Olympics coaches, three Northeast Disabled Athletic Association (NDAA) sports teams, and the Bridges to Health Program with UVM Extension to serve migrant dairy farmworkers. By supporting these ongoing community programs, they were able to contribute to the sustainability of long-term health promotion projects in the local area.

As a service-learning course, PT 303 has worked with Stay Steady Fall Prevention for the past two years. The initiative is a volunteer effort led by physical therapists across the state of Vermont; this semester, student Rachel de Simone’s group aided the volunteers by creating a new algorithm for the physical therapists to use on-site when conducting fall risk screenings. Another group partnered with physical therapists at the UVM Medical Center to develop community exercise programs for these older adults identified to be at-risk of falling.

As de Simone notes, these programs are especially important for a state “with Vermont’s growing elderly population. These initiatives are increasingly vital … we all hope to live long and healthy lives, and projects like Stay Steady allow people to do so.”

The class formed a new partnership with Vermont Special Olympics, after the organization requested to work with DPT students at UVM. Students created content for the volunteer coaches of Special Olympics — the essential point of contact for the athletes — providing everything from sports psychology to conditioning tips for specific sports.

Three groups of students also partnered with three different sports programs in the NDAA: adaptive sailing, sled hockey, and powerchair soccer. These projects included promotion and recruitment videos (see below) as well as strength and conditioning programs for the athletes.

Students Jason Oziemina and Christine Ninh worked with Vermont’s competitive sled hockey team — the SledCats — to develop off-season, pre-season, and in-season workout programs and a series of YouTube tutorials.

The contributions of service-learning students fills a gap in the ongoing work of these programs, lending vital support to underserved communities and the organizations they rely on. The class often reaches out to communities that are ‘not typical PT populations,’ to broaden the scope of physical therapy practice. Student Jasmine Braman explains that by expanding the role of physical therapy in health promotion, PT 303 students are able to ensure that physical therapy is more inclusive of all populations.

This is perhaps most apparent in the new collaboration to bring injury prevention programs to migrant farmworkers in Vermont. Jasmine Braman and Vanessa Matos’ group worked with Bridges to Health to conduct a needs assessment, focusing on the risk of musculoskeletal injury. Though many have upper extremity pain and disorders from the nature of their work, it is difficult for migrant dairy workers in the state to access medical care — especially physical therapy.

The group traveled to three different Vermont farms to observe the jobs, interview workers, and talk with a health promoter from UVM Extension. Matos describes the project as a “blank canvas” explaining that the group started the work with the goal of “connecting to find out how we may support them … we needed to figure out in what ways we could help this population, and most importantly, to find out how they wanted to be helped.”

She continues: “They work long, hard hours and rarely have the time or resources to access the healthcare that they need.” The group explored methods of injury treatment versus injury prevention, settling on the project to provide preventive care. Through working directly with a migrant dairy worker and the health promoter, the group was able to create physical therapy care and education materials, translate them into Spanish, and distribute them through communication channels used by the workers.

Professor Gell is most proud of the great results from these kinds of community-engaged student efforts. “They value these real life projects where they can contribute and interact with the community. They are filling a gap for the community partners that would otherwise be difficult to address.” Through these service-learning collaborations, both partners and students are exposed to the valuable role of physical therapists in health promotion, a role that is not always clear.

As de Simone reflects, “these projects allowed both our group and our partner to learn more about the contributions of physical therapy in creating healthy communities … This class helped me to see that physical therapy plays a big role in health promotion and public health, these type of efforts really do lead to a healthier population.”

In learning how physical therapists can contribute to health promotion in public health, students are motivated to continue these type of volunteer efforts as they enter their professional careers.

Professor Gell knows that the time requirement of these service-learning projects can be tough for full-time graduate students. Yet students note that this experience has shown them that, despite their busy schedules, “it’s doable to make time to volunteer.

Said Matos, “Everybody knows it’s important to be involved in the community, it’s wonderful to have actually had exposure to that before we’ve had our first job … to realize that it is possible to find the time and energy to be involved in volunteer projects as we begin our professional life as physical therapists.”