Mobilizing Teens & Young Adults in Lifelong Community Engagement through Service-Learning, Empathy, and Social Innovation
What if we become proactive for good health? What if we face the social determinants of health head on? What if we collaborate with adolescents who live in communities the most impacted by health inequity, and what if we listen to this population who knows inequity so well? Let's let them be the sole source of Glories hats for sick children, let's let them see and feel the value they create. Let's use this value creation to show them that they can innovate solutions to the social determinants of health. and above all, let's let them become self-reliant yet collaborative agents of change.
Systemic root causes of health inequities in the United States will take considerable time and effort from all the actors in the community—business, state and local government, anchor institutions, and other community residents — to change the narrative and promote health equity.
In an effort to advance this discussion to adolescents and young adults, the Glories HATS Project® (GHP®) asked "Can disadvantaged youth create value when they direct happy thoughts and generosity of spirit through the Glories hat as a symbol of peer-support to hospitalized children?" And "can this new engagement helping sick children impact their individual choices in personal responsibility for their health, their desire for purpose in their career path, and their motivation to serve to mitigate the unhealthy conditions in their own neighborhoods.
Our experience shows the value added is measurable in several areas: patient well-being, patient experience, compliance, doctor-patient communication, and patient outcomes. In addition, could we align youth from health deserts or areas of high incidence in the project to increase their levels of health literacy, workforce readiness and self-efficacy? Our experience shows that community collaboration is the key to health equity.
Since its inception, co-founders Susan and Alireza Khorsand have welcomed over 460,000 youth and young adults, joining forces in more than 3500 GHP® community events to make 685,000 Glories hats "filled with happy thoughts!" for hospitalized children in 23 hospitals across the United States. This experience frames the GHP® and Program Delivery Model as a replicable and scalable social innovation.
Our youth are not indifferent, their generosity of spirit and sense of justice is solid. GHP® believes that given the knowledge, skills and abilities gained over the course of the GHP® program, entire regions of youth and young adults will gain actionable knowledge, perspective, initiative and connectedness to bring on much needed community strategies to address the systemic root causes of health inequity.
The mission of Glories HATS Project® (GHP®), a 501 (c) 3 corporation, is to bring the healing power of peer-support to children isolated by hospitalization while delivering to adolescents and young adults living in underserved communities access to a thoughtful and positive youth development service-learning activity.
Through the combination of peer-support, tele-conferencing and a positive hospital feedback loop, GHP® is able to show participants and hospitalized children they matter; guiding them through compassion towards self-reliance, increased feelings of self-efficacy, personal agency, initiative, and health literacy. GHP's® vision is to see our nation value marginalized youth as a resource where their value and potential is recognized and actualized. Our nation's adolescents need for hope is great and this demand can be met by the very children and their parents whom they serve.
GHP® is a service-learning initiative where youth "Make Glories hats and fill them with happy thoughts!” They then present the hats to patient care teams for hospitalized children as an act of compassion. The skill-building involved in the hands-on process of organizing and managing Glories hats production workshops (soft-skills and teamwork), along with increased awareness of how social, economic and physical environments impact our health, strengthen their sense of compassion and build the foundation of their critical thinking and greater capacity for innovation. Questions such as why does the hospital need so many hats, why are so many children sick, what determines health, what are the social determinants of health in our district, and how can I join efforts that address these issues. Preparing adolescents and young adults (14-24) for success in an age of dynamic change requires a systemic recalibration in existing beliefs, both in our expectations of youth and in how they perceive themselves, but also the presentation of translational research to inspire them in successfully fulfilling their integration into the economy.
GHP® is a bridge between adolescents in communities of high risk and hospitalized children via pediatric patient care teams. GHP® participants create value by supplying Glories hats (peer-support) to healthcare staff, while staff, in turn, utilize this therapeutic resource to improve patient experience, well-being, compliance, and patient outcomes. In regularly scheduled video-communication sessions, physicians, nurses and technicians explain to GHP® participants how much their efforts soften the environment in often fearful and traumatic interventions for their patients. This exchange increases hospital outreach and community presence; allows them to serve as role/career models and message healthy behaviors. GHP's® positive and reciprocal connection serves to increase health awareness and build health literacy in high-risk communities. Studies show that those with knowledge, rather than fear, of their health issues exhibit more rational behavior in terms of aligning their lifestyle and medication compliance with their physician’s recommendations.
Parents and their hospitalized children often share the joy Glories hats bring into their lives and their hospital experience. They provide photos and kind thank you notes for GHP® participants along with anecdotal stories from hospital staff (HIPPA compliant).
This feedback loop encourages GHP® participants to continue through all 25 GHP® learning sessions in the service-learning program. Youth understand that when small patients believe that entire communities of teenagers are thinking about them and making Glories hats "filled with happy thoughts!”, they know that teens "have their back." This also strengthens both patients and their families and GHP® participants belief that their collective effort adds to the growing voice to address health equity.
This positive exchange, between professional healthcare staff and community youth, generates respect and cultivates health awareness and prevention, both cornerstones of a strong value-based healthcare system and, in turn, a healthy, innovative and productive nation.
Youth and young adults need multiple opportunities for deepening their education, including accessible on-ramps that emphasize 'unlocking potential' rather than on 'skill deficit.' Through GHP®: Engaged students connect to address health inequity, as they develop crucial organizational management skills, interact with the community in a resource role, and understand the impact compassion and social innovation can have on quality of life as well as their career path.
Hospitalization can be a frightening experience for children. They report they are most afraid of their symptoms, the unfamiliar environment, separation from their friends and restriction of their self-determination and free choice.
GHP® bridges these two needs in a low-cost, high touch, high reach strategy that is highly replicable.
GHP® partners with dynamic children's hospitals. Together they review hospital discharge statistics by zip code and/or data points representing incidence clusters. By targeting "hot" spots as GHP® implementation sites, together they can determine priority health messaging. A collaboration is then established with GHP® site directors to develop a positive reciprocal connection between the GHP® sites, their students and professional healthcare staff. Using a production timeline, weekly production goals, quality control and a continuous virtual feedback loop from professional health care providers, GHP® engages students so they interact with the community in a resource role, develop organization management skills in order to produce the hats, and understand how social observation + compassion will increase social innovation and how these skills can and will enhance their career path.
Using a hub and spoke model, GHP® links to a local hospital and/or public health agency to create a HATS Network, multiple program sites across a region. These sites are placed in targeted high incidence neighborhoods and e-linked from the GHP ® site to the partnering hospital. Each site is provided with a HATS Headquarters® unit, an exportable “turn-key” mini-factory (cabinet) housed on-site. Hat production is based on an assembly-line, supply-chain, modular process that uses 12 steps to assemble and decorate Glories hats. The process is developmentally appropriate for youth and young adults (ages 13 - 24) and affords participants the responsibility to face productivity head-on, to meet production goals, and practice supply-chain analysis, teamwork, positive communication, self-discipline, and compassion. GHP® coordinates production with video conferencing that allows for regular, pre-scheduled hospital staff outreach to sites.
The financial burdens of preventable health problems in adolescence are large and include the long-term costs of chronic diseases that are a result of behaviors beginning in adolescence.
Youth and young adults (13-24) make-up 21% of our nation's population. There are 300+ children's hospitals across the United States.
With a developmentally appropriate approach and collaboration, GHP® is a platform for all adolescents to experience the strength of collaboration to face systemic challenges while, at the same time, increase their feelings of self-efficacy and personal agency.
Currently hospitals and healthcare systems are grappling with improving population health and compliance. These institutions hold powerful brain trusts. GHP® is an opportunity for them to invest their knowledge into the community while the adolescent community provides them back with the powerful therapeutic resource contained in Glories hats.
GHP® builds skills through practice. The 25 sessions are divided into blocks of five, each with specific learning goals.
GHP® partners provide scheduled video sessions with health professionals who provide branded, customized health information that is integrated into each of the 25 sessions in GHP® sites, injecting relevant curriculum into targeted populations. Participant surveys and essays make up GHP's® evaluation tools and are administered from the GHP® Cloud.
There are two areas GHP® evaluates: Operational which is the impact on community adolescents and young adults, and in the Hospital and Healthcare Environment
GHP® starts program evaluation with outputs, •Glories HATS made •Glories HATS delivered to hospitals •Glories HATS dispensed to patients
Then to Outcomes, •Community Connectedness, Improved self-efficacy •Effect of Peer-support, Improved patient well-being•Compliance, Staff efficiency, and patient visibility
With the final evaluation on Impact •Increased health literacy, healthcare career awareness, and workforce readiness, •Improved patient experience, •Improved patient outcomes and Compliance
GHP® changes health literacy environments. Adolescence is a pivotal time to "learn by doing." As adolescents move toward young adulthood, they begin to make independent health decisions and manage their own health. The health habits, knowledge, and skills needed to make those decisions are established during adolescence, and will shape medical care and overall health throughout life (Giedd et al., 1999; Sawyer et al., 2012; Wolf et al., 2009). Efforts to improve quality, reduce disparities and reduce costs cannot succeed without improving health literacy.
Research in Social Cognitive Theory and positive youth development explain the importance of how feelings of community connectedness act as a strong factor in developing self-efficacy and personal agency. Furthermore, research shows the importance of how an “Arc of Effort” builds initiative in youth.
Over an “Arc” of 25 sessions and rooted in compassionate action GHP® participants show increased interest in their health and improvements in their perception of themselves, their empathy for others, realize they have something positive to contribute to their community while realizing that they can make a difference in the lives of others.
There are many aspects to health inequity; its power depends on maintaining systemic injustices while denying there is any problem at all. A person can do their best to take care of themselves, but still live in a toxic environment (poverty, toxic stress, neurotoxins, air quality, water pollution, homelessness, joblessness, etc.) that is slowly diminishing their health. Working for systemic change demands learning to think things through, to think critically, to identify common denominators in the pipeline of systemic injustices and innovate community level interventions to collectively address them. Translating these common denominators into health communications messages and corresponding community level actions can be momentous in alleviating the health determinant’s power. We live in resource restricted environments and the rules of the economy have changed. GHP® participants respect their social observations and understand today’s importance on self-reliance. Self-reliance is defined as relying on oneself or one's own efforts and abilities rather than those exerted or supplied by other people. Communities today are being asked to be self-reliant. GHP® believes that adolescents can add purpose, compassion and critical mass to move their communities forward and ultimely move our nation to action.
Participation in GHP® builds workforce readiness and soft skills. The hospital feedback loop builds participant self-efficacy and personal agency. These assets are rooted in participant's sense of purpose that only they can offer peer-support and finally, their sense of justice in that it’s not fair to be a kid and even worse to be a kid and be sick. Bridging shared needs and shared value leads to socially innovative solutions. GHP® empowers youth to identify and act on these steps to innovate community-level solutions addressing issues affecting health equity. Engaging adolescents and young adults now, as they are building life-long behaviors, making critical life, career and academic choices and when they see themselves as problem solvers and as part of the solution, can positively impact health literacy, STEM directions, and the overall health of our citizenry. Applying these concepts, GHP® participants execute the personal effectiveness and workplace competencies that frame the academic competencies necessary to follow career ladders of purpose ultimately bringing health justice to their communities. The vision of GHP® is collaboration with 300 children’s hospitals across our nation, engaging adolescents with purpose to tip our nation's balance to greater health equity.
The Glories HATS Project® is available to forge cross-sector collaboration in your community. We are happy to discuss your aims then, together we can determine your goals and scope in relation to the placement of GHP® program sites in medically under-served communities, discuss public health and prevention content, set-up evaluation tools to be delivered from our cloud, deliver hat-making materials, train the trainers, provide program support and guide implementation.
GHP® frames youth as a sole source of peer-support which is actualized through their production of Glories hats.
Patient care teams incorporate Glories hats as a high-value therapeutic resource. "Wear a Glories hat and think happy thoughts!'
Hospital patient care teams thank youth for their engagement and positive impact on patient well-being while health outreach professionals deliver prevention health strategies. This reciprocal connection creates value-added in two ways:
Population Health: Providing prevention health information into targeted communities, Recognizing youth as team partners in improving care for their patients, Increasing adolescent and young adult health literacy, Introducing health care careers and career ladders to achieve them.
Healthcare Environment: The improvement in patient compliance, well-being, and satisfaction generate an improved ward atmosphere and staff morale allowing caregivers and patients to benefit from enhanced doctor/patient communication.
GHP® is an actionable platform for hospitals to build comprehensive adolescent health outreach initiatives while improving their "Triple Aim."
This strategy is designed to rapidly increase children's and adolescent health awareness and target resources more efficiently to improve the social and physical environments promoting good health for all.
As youth and young adults understand that lifelong health should be available for everyone, the more they understand the value GHP® skill-building offers. They now possess the tools, at a time in their life where they can make individual, academic, and career decisions based on their feelings of self-efficacy and personal agency. Entering in to adulthood with a sense of compassion and desire for advancing health equity they can move our nation forward with their engagement and focus.
As hospital teams integrate the peer-support contained in Glories hats in a consistent, systematic process, the well-being of both hospitalized children and youth participants are accelerated which implies economic returns for hospitals and, in the long run, for the community as a whole.