The Community Free Clinic provides medical services at no cost to low income, uninsured residents of Cabarrus County, North Carolina diagnosed with chronic health conditions. The Clinic, founded in 1994, has part- and full-time staff that includes physicians, nurses, pharmacists, lab technicians, and hundreds of volunteers. Although the Community Free Clinic has changed over the years, their mission to “Keep People Healthy” has always remained the same. The Clinic serves the needs of patients who have no provision for healthcare under the Affordable Care Act due to lack of Medicaid expansion in our North Carolina. Among those served by the Clinic are adults who have high blood pressure, diabetes, heart disease, and other chronic health conditions.
In an effort to better serve their patients and local community, the Community Free Clinic began partnering with the Cabarrus Health Alliance (CHA) in 2010. Through this partnership, the CHA offered a 15-week lifestyle modification program focused on physical activity and healthy eating for the staff, and any interested patients, at the Community Free Clinic. The goal of the program was twofold; one, to improve the health of the staff, but also to promote a culture of health and wellness that would lead to greater physical activity and dietary counselling efforts with their patients in the future. Fifteen staff attended the training with nearly all of them reporting greater levels of fruit and vegetable consumption and physical activity levels at the end of the program. At the end of the program, CHA staff continued providing weekly exercise classes and educational opportunities at the Community Free Clinic.
In 2014, the CHA expanded their efforts at the Community Free Clinic after receiving a “Racial and Ethnic Approaches to Community Health” (REACH) grant from the U.S. Centers for Disease Control and Prevention (CDC). Under this award, the CHA worked with the Community Free Clinic to adopt parts of the EIM Solution. Clinic leadership and medical staff received training on assessing patient physical activity levels, providing physical activity counselling, and connecting patients to a database of resources (their Network of Care Service Directory) that the CHA had catalogued throughout the county. Further, the CHA helped customize an “exercise prescription pad” for use by Clinic practitioners. EIM was launched in the second half of 2014 and aspects of this initiative are still in use at the Community Free Clinic today.
An evaluation of medical records between August 2015 and July 2016 revealed that the Community Free Clinic served 523 patients over the course of 2790 visits to their Chronic Care Clinic program. During this time, 43.6% of patients discussed physical activity with their healthcare provider and received a written exercise prescription. Across all patients, a net weight loss of 0.25 pounds was observed, a remarkable feat considering that most adults experience weight gain over time and that the greatest levels of overweight and obesity are often observed in underserved populations. The efforts made by the Community Free Clinic, with assistance from the CHA, shows just how critical the promotion of physical activity and a healthy lifestyle can be in positively impacting the health of our uninsured and underserved populations!