Six years ago, Teresa Bogado's life changed for the
better after she attended a “charla”
at Zufall Health
Center (ZHC) in Dover, NJ. The charla (Spanish word
for “talk”), which focused on healthy
living and weight management, motivated Bogado to make
significant changes in her lifestyle and home meal
preparation, resulting in a 40-pound weight loss for her
and lower medication dosages for her diabetic husband.
ZHC, a federally qualified health center (FQHC), includes
lifestyle and weight management counseling, and oral and
behavioral health assessments as part of every patient's
primary care exam.
Bogado, who teaches Zumba classes at ZHC now, inspires
other women to make good health a priority. ZHC's
long-term efforts to help patients improve lifestyle and
weight management contributed to its selection as one of
50 locations participating in the Healthy
Weight Collaborative, a HRSA-funded national effort
to develop and share evidence-based clinical
interventions to prevent and treat obesity in children
ZHC primary care providers do weight management
assessments on patients of all ages. They provide
nutrition education, teach patients the
Plate Method, help patients set healthy weight goals
and equip them with self-management tools to use at home.
Parents receive coaching that teaches them the importance
of helping children adopt better habits, such as
increased physical activity and healthier snacking.
In addition to weight loss and exercise, outreach
programs target special populations. BD Direct
Relief awarded ZHC a $100,000 grant in recognition of
its innovative approach to treating diabetes. ZHC's
participation in the Patient Safety and Clinical Pharmacy
Services Collaborative (Link no longer available)
affiliated with the Alliance for Integrated Medication
Management resulted in 67 percent of ZHC patients
with diabetes demonstrating improved medication and
lifestyle management. Seventy percent of patients with
elevated cholesterol levels and 58 percent with high
blood pressure also demonstrated significant
improvements. A pharmacist and diabetes educator
coordinated the program and worked with patients.
ZHC's mobile medical van brings dental care and chronic
disease management assistance to area senior public
housing sites. For the last three years, ZHC has
participated in National Rural Health Day
by offering free physical and behavioral health
screenings and on-site dental care. Community dentists
and hygienists volunteer their time to the cause.
The FQHC serves underprivileged, at-risk residents living
in Dover, Morristown and rural communities in Morris,
Sussex, Hunterdon, Somerset and Warren counties.
Farmworkers are a primary patient population in the rural
counties, said Director of Special Populations Michelle
Blanchfield. Obesity, poor oral health and depression are
common among patients and these conditions are often
culturally influenced, according to Blanchfield, who gave
as one example the Hispanic viewpoint that babies' and
children's chubbiness is a sign of good health.
“Cultural differences, along with language and
literacy barriers, make it more challenging to
effectively change patient misconceptions related to
illness prevention and benefits of having a continuum of
care,” Blanchfield said. “These
really impact our patients in ways most of us don't
realize. Our immigrant population walked everywhere they
went, ate out of the fields with their families, and were
a support system for each other in their homelands. Once
here, they lose that family support. They often are
working two jobs and they've never exercised just to stay
physically active. They end up eating cheaper, prepared
foods that are less healthy. Social issues related to
experiences like crossing the border or what they
experienced in their homeland contribute to depression
and anxiety levels. It's such a drastic lifestyle change.
Many gain weight and develop chronic diseases.”
Zufall Health Center became a fully licensed FQHC in 2004
after having operated as a privately owned clinic since
1990. Founder Dr. Robert Zufall, a retired urologist,
opened the clinic to meet the needs of underprivileged
families. His wife, Kathryn, handled administrative
duties and a handful of volunteers assisted them. (Dr.
Zufall now serves on the Center's board and writes a
column in its Be Well Newsletter entitled
“Ask Dr. Bob”). Today ZHC continues
that mission of serving patient needs regardless of
income or insurance status.