In 2007 the Center introduced an access to healthcare component at four fatherhood program sites. New curriculum was added integrating material aimed at men's health; and, The Center hired a nurse practitioner to provide one-on-one services to fathers and to develop community resources to provide treatment and medical homes for the fathers.
Low-income men are among the most vulnerable when it comes to health and healthcare. Very few, if any, safety nets exist for unemployed, non-custodial fathers over the age of 21. Most are in survival mode weighted down by a series of poor choices including being poorly educated, having little to no job skills, unstable work histories, multiple partner, unprotected sexual relations often resulting in unplanned pregnancies, mounting child support debt, substance abuse and encounters with law enforcement frequently culminating in incarceration. Many suffer from depression and medical conditions exacerbated by the multiple stressors of unemployment, threats of incarceration for non-payment of child support, and in many cases, prohibited from seeing their children.
Community-based fatherhood programs provide excellent, non-traditional environments for low-income fathers to learn about being healthy in a trusted, accessible and familiar environment which becomes a catalyst for improving their health and health care behaviors. In a survey of 890 low-income fathers, trusting health care workers was ranked more important than available, low-cost exams/screening when they sought health care services. The difference was statistically significant (mean score 4.24 versus 3.75 with 5 being extremely important).
By integrating the health care component into the overall fatherhood program, the aim is to normalize health and healthcare for the men within the context of daily living rather than only viewing it as something to be attended to exclusively in the presence of illness. Thus, as fathers seek to improve their lives and acquire knowledge and skills about parenting, healthy relationships, job readiness and employment, navigating formal systems, and increasing their self- esteem, they will be able to learn about proper men's health practices for themselves as responsible fathers. Equipped to practice positive health behaviors as a normal part of life fathers can readily model positive health behaviors for their children to witness and embrace. The Men's Health Curriculum, which is presented in peer support sessions, provides information to help fathers change health behaviors. In addition to providing men's health education, the nurse practitioner meets one-on-one with the men to complete initial assessments of health behaviors, administer baseline health screenings, discuss issues or concerns, set up referrals, provide treatment, and assist with prescription services. Collaborative community health partners are essential to helping fathers connect with existing community resources and to find a medical home base.
In 2010 the following occurred:
- 322 fathers received health services of which 211 were first encounters with the nurse practitioner.
- The nurse practitioner experienced 1329 contacts with the 322 fathers who indicated that their issues needed on-going attention and that a trusting relationship had developed encouraging them to seek on-going help.
- The nurse practitioner saw fathers for 59 acute/sick visits that would have been inappropriately handled in a local emergency room or ignored until a more severe medical problem occurred. The nurse practitioner was also able to provide 61 prescriptions for participants needing medication.
- Blood pressure problems were the most frequent health issue observed by the nurse practitioner; and, participants were either treated or referred to appropriate community health resources for continuation of care. Depression was also very frequently identified and, either treated or referred to outside resources for continued care, if needed.
- 40 fathers were referred and received vision care and 33 fathers for dental care.
- 55 fathers were able to obtain free flu vaccinations through a supply given by Providence Hospitals and with the nurse practitioner giving injections at individual fatherhood program sites.
- 147 intensive health screenings were conducted through Providence Hospital and the nurse practitioner. The nurse practitioner summarized findings for each father counseling one-on-one in regard to their health needs dialoguing about realistic solutions to health issues which may have been uncovered.
- The nurse practitioner assisted in 190 incidences where participants needed help with past medical bills, acquiring charity care or compassionate care from a health institution, or securing low/no cost medical care or services.
- The nurse practitioner made 110 referrals for fathers bridging them to community health resources for medical, dental, and visual needs; 67 of these referrals assisted individuals in establishing a local medical home.