Recognizing the importance of developing leaders in community health, global heath and advocacy, we developed curricular experiences to allow interested residents to further develop skills in these areas. Our residents can apply in their first year of residency, with dedicated pathway months in the R2 and R3 years.
REACH Pathway (Community Advocacy and Global Health)
Our REACH (Resident Education and Advocacy for Child Health) Pathway (including REACH–Toppenish, REACH–Kisii and REACH-Seattle) train residents to look beyond the walls of the clinic and hospital to understand child health in a community context. Residents in REACH explore fundamental questions related to child health. For example:
- How do families, schools, neighborhoods and communities shape child health for better or for worse?
- Why are some children healthy while others are not?
- How does experience in childhood impact health and wellbeing across the lifespan?
- And, most importantly, what can physicians do to improve the health of children by working outside the clinic walls?
This approach to understanding health and well-being at a community level is part of a paradigm shift in the medical profession. At the same time, working closely with local partners, we hope to benefit the communities, by bringing our time, talents and energy to bear on local issues.
The REACH Pathway provides experiences in integrating public health, community partnerships, and advocacy in addressing child health needs. The goal is to understand and influence determinants of child health and health disparities at the community level. In the R2 year, all REACH residents participate in a month-long curriculum with REACH-Seattle residents from Nairobi (described below), learning about the social determinants of health, health policy, practical advocacy, and strategies for developing, evaluating and sustaining interventions to improve child health in the community.
During a second month, residents learn to conduct a community health needs assessment, which encompasses developing skills in data collection, interpretation and reporting. After this R2 year the REACH pathway diverges to REACH-Toppenish, and REACH-Kisii.
The REACH pathway is grounded in principles of parity and sustainability, and as such, we offer the REACH–Seattle experience for residents from the University of Nairobi. Pediatric residents from the University of Nairobi spend five weeks in Seattle. The REACH–Seattle Pathway is an opportunity for University of Nairobi residents interested in global health to achieve more training in public health, clinical service and research. The goal is to understand and influence determinants of child health and health disparities at the community level.
REACH–Seattle participants join REACH–Kisii and REACH–Toppenish residents during their R2 year to participate in their month-long curriculum, described above.
In the R3 year, each REACH–Toppenish resident spends 8 weeks in Toppenish, Washington, to learn from and about the community and its health and healthcare needs. With just half a day per week working clinically at the Yakima Valley Farm Workers Clinic, the remainder of residents' time is available to work with community organizations serving the children and youth of the Lower Yakima Valley. Residents partner with local community members, the REACH-Toppenish program coordinator, and the Community Advisory Board to design relevant and impactful projects. Each resident's activities evolve in response to community needs and residents’ unique learning goals and strengths. Residents are encouraged to explore experiences that expose them to role models and career options in community pediatrics and advocacy.
Some projects have included:
- Understanding child health from the parent's perspective through surveys and focus groups and applying social network analysis to community needs
- Conducting a needs assessment on access to adolescent services and adolescent medical home
- Developing afterschool programs and mentorship for local youth
- Supporting expectant parents with group support and resources through “baby showers”
- Expanding hands-on training opportunities for local youth interested in healthcare careers
- Leading high school students in developing educational videos for peers
- Partnering with high school teachers and staff to develop and teach health curricula, and “Ask the Doc’ sessions in classrooms
The REACH–Kisii Pathway is an opportunity for those residents interested in global health to achieve more training in public health, community advocacy and global partnership. In the R3 year REACH–Kisii Pathway residents participate in an 8-week experiential learning program in Kenya. Residents are exposed to pediatric health services through clinical experience at a 40-bed pediatric ward of a provincial hospital in rural Kisii, Kenya. The bulk of their time, however, is spent conducting community-based child health assessments and interventions working with the Kisii public health network that is headquartered at Kisii Teaching and Referral Hospital. The specific focus of these activities changes over time based on local priorities, but residents are encouraged to develop and meet individual learning goals while enjoying exposure to role models and career options in global health.
Our REACH–Kisii program is unique in that our residents are paired with pediatric residents from the University of Nairobi for their time in Kisii. The pairs live and work together for the entire experience. The goal is to look upstream at the determinants of child health in Kenyan communities. This pairing allows for support and sharing of expertise between residents and promotes a more in-depth understanding of Kenyan culture and medical training. With each resident pairing, the program makes further inroads into building a sustainable partnership with the larger Kisii community.