Doing Well in Wenham: A Local Wellness Check Program During COVID
by Ilana Cliffer
I relish any opportunity to apply knowledge gained throughout my studies in public health to resolve a real-world conundrum. When I learned that SARS-CoV-2 was spreading rapidly within our country and that it could overwhelm our health systems, I admittedly became obsessed. I read every pre-print that came out, whipped up my own spreadsheets to track the numbers, and cheered on epidemiologists who spun out passionate feeds on #epitwitter.
Fortunately, this relatively unproductive fascination turned into something impactful. A friend called and asked if I wanted join the Academic Public Health Volunteer Corps (APHVC) to strengthen the capacity of local boards of health (LBOH) of Massachusetts in their responsive to the outbreak. Since that call, I have been managing a team of 15 volunteers for the town of Wenham, collaborating on a wellness check-in program for older adults.
Wenham is a small town in the North Shore of Massachusetts. Of the 5,000 residents, approximately 1,200 are over 60 years old. During a consult meeting to partner with the town, I met with Jackie Bresnahan, the Director of Administrative Services for the town. She told me that they only had seven cases at the time and were on top of the contact tracing. However, Jackie was justly worried about older residents in her community who were impacted by the social distancing required by the pandemic. She put me in touch with Jim Reynolds, the local Council on Aging (COA) Director; Jenn Flynn, the coordinator of Marketing and Outreach; and Maribeth Ting, the Public Health Nurse to organize a support project.
They had an idea. Jim Reynolds, having recently completed a graduate degree in Gerontology, has a special interest in reducing isolation of the aging community, which was considered to be a public health epidemic by the former US Surgeon General even prior to COVID-19. They had recently completed a needs assessment about making the town more age-friendly, becoming only the 20th of the 351 Massachusetts municipalities to do so. Focusing on the population of older adults was their priority.
Wellness Check-in Calls
They asked for help in reaching out to these residents with wellness-check calls, during which a volunteer asks if the resident has everything they need, physically and emotionally, in this wholly unprecedented time. The purpose is twofold: communicate accurate information about COVID-19 and serve as an anti-isolation remedy.
My team dove in at full force and started making calls with a 9-question script put together by the Wenham COA, inquiring if they have access to groceries, medications, and thermometers; if they have someone checking in on them; and if they want a follow-up call. If needs are identified, the volunteer takes note, and the COA helps connect the person with services that can address those needs. If someone is not feeling well physically, Maribeth is informed so that she can keep track of what is going on in the community and follow-up with that person as indicated.
Wellness Call Results
Of the 403 residents the volunteers were able to reach in the first couple weeks, almost a quarter requested follow-up calls, and most of those who did not want follow-up calls expressed much gratitude for the call. According to reports from the volunteers, most first-round calls were relatively short– usually no more than 10 minutes- but follow-up calls often lasted 45 minutes to an hour. People want to talk. They have questions and concerns and they appreciate the opportunity to be seen and heard.
While these metrics alone convincingly demonstrate the utility of these calls, the metric that really struck me was that 5% of those reached did not have a single person checking in on them. For me, reaching this 5% of the population, who have no one else to turn to in these incredibly isolating and challenging times, is enough to consider these calls to be critical.
Scaling Up Beyond Wenham
As a team, we are learning every day how to make these calls even more effective, adapting the questions we ask of people as the situation changes, improving the monitoring and evaluation of the calls, and increasing support to the volunteers making the calls to protect their mental health. We are putting systems in place to streamline the feedback process that gets important information from the citizens back to Jim and Jenn of the COA, and to Maribeth and Jackie with the town.
We’re also looking to take this project beyond Wenham. We are working with others in the volunteer corps to scale up this service to other towns in Massachusetts. There is a lot of potential in leveraging these calls to improve the overall physical and mental health of the population during this time, and it will be exciting to see how the program expands.
Recently on a zoom call with my extended family, I shared how I’ve been doing. I talked about how volunteering has actually made me better at concentrating on my dissertation work. I’m no longer spending my days distracted by numbers and graphs and tweets (fine, maybe sometimes I am, but much less often), because I have something real and productive to contribute instead. What we’re doing in Wenham involves no complex models, but it is the definition of a gritty public health intervention aimed at increasing the well-being of a struggling population.
When I finished telling my family about the calls, my 85-year-old grandmother had an important question: “How come I didn’t get one of those calls!? Tell them they need to do that in Arizona, too!”
Ilana Cliffer is a doctoral student in the Food and Nutrition Policy and Programs division at the Tufts’ Friedman School of Nutrition Science and Policy. Primary research interests include food systems, global health, and nutrition policy specifically aimed at prevention and treatment of malnutrition in children. Dissertation work focuses on using longitudinal data to assess the timing of growth faltering among children and environmental influencers of growth. Methods include epidemiology, econometrics, statistics, and decision science.