Running head: PRACTICUM FINAL PAPER 1 MPH Practicum Final...
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Running head: PRACTICUM FINAL PAPER 1
MPH Practicum Final Paper
Erika McKenzie
Texas Department of State Health Services- Region 8
7430 Louis Pasteur
San Antonio, TX 78229
Dr. Katherine Velasquez
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Abstract
I spent my practicum hours at the Texas State Department of Health Services (DSHS) working
on their work place wellness program. During my time there I worked to improve several aspects
of their wellness program including connecting DSHS to other wellness resources in the
community, addressing employee health needs through informational centers, and conducting a
lunch and learn as well as coaching employees regarding their health goals. I employed
knowledge and skills gained from various courses taken for the Master of Public Health program
at Concordia University to further my understanding of public health practice and reach my
practicum goals.
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MPH Practicum Final Paper
Wellness is a growing area of public health. Many workplaces are developing work place
wellness programs in order to address the health needs of their employees. Employees spend so
many waking hours in the work place that it presents a great opportunity to encourage healthy
behaviors and promote wellness. I spent 75 hours over three weeks working at the Texas State
Department of Health Services (DSHS) in the region eight headquarters helping to improve and
build their work place wellness program. I reviewed health assessments to identify employee
demographics, health needs, and barriers to healthy changes to tailor program components and
health promotions to those needs through developing various educational resources, facilitating a
lunch and learn, and coaching employees as needed to assist them in reaching their health goals.
The mission of DSHS is to improve health and well-being in Region eight of Texas
(Department of State Health Services- Health Service Region 8, 2015). This region covers 28
counties, includes seven local public health departments, and fifteen region eight offices in south
central Texas serving a combined population of three million people (Department of State Health
Services- Health Service Region 8, 2015). Their headquarters are located in San Antonio, TX
where I spent my hours. Most offices within region eight provide services to include
immunizations, tuberculosis treatment and contact investigation, health and community
education, HIV and STD testing and treatment, and communicable disease investigation and case
management. Other services and programs offered throughout region eight pertain to birth
defects epidemiology and surveillance, border health, cancer epidemiology and surveillance,
consumer safety, emergency medical service compliance, environmental groups, family health
services, food establishment groups, food safety, meat safety assurance, oral health, sanitation,
emergency preparedness, radiation control, spinal screening, tobacco prevention and control,
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vision and hearing screening, zoonosis control, and specialized health and social work services
(Department of State Health Services- Health Service Region 8, 2015).
I worked with the Specialized Health Care and Social Work Services Department
manager, Dr. Katherine Velasquez. Dr. Velasquez founded the Wellness Committee and the
Employee Wellness Program out of sheer love for wellness and on a volunteer basis.
DSHS is federally funded, but they do not have a paid position for workplace wellness.
Since DSHS works to serve the community and their health needs in various ways, Dr.
Velasquez thought it was important to provide wellness resources and programs for their
employees in order to practice what they preach as well as to put their best self into their work
and the services they provide. The development of the wellness program and committee aligns
with the organization’s mission of improving health and well-being in region eight by starting
with themselves. The wellness program serves all counties and employees in region eight.
Although DSHS receives federal funding for their programs to support health efforts in the
community, they do not have funding to support wellness in the workplace. Therefore, all
wellness efforts are financially supported by fundraising, donations, and volunteer efforts in this
region.
Discussion
Throughout my time at DSHS I worked on several projects and was involved in various
activities. The first week of my practicum was spent getting acquainted with my surroundings
and coworkers, as well as learning the background and starting point of the wellness program by
reviewing various materials to bring myself up to speed with where the current program was at. I
ran into several barriers this first week as I was not able to have a workspace and computer set
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up until the last day of the week due to technology issues. This was a real drawback when I had
limited time to work on projects, so I worked from home two days and thoroughly reviewed
every single material that the wellness program had previously used, as well as brainstormed
potential projects and ideas to discuss with my supervisor. Once getting back in the office my
supervisor and I set forth an action plan and narrowed down some goals with regards to the time
constraints I had. I also developed flyers and a schedule for the Farm to Work program during
my first week which they had just put in place.
The Farm to Work Program is a program that allows employees to order fresh produce
twice a month from local farmers markets that gets delivered to the office. Dr. Velasquez had
made it a priority to get this program rolling right when I started, so I helped raise awareness and
promote the program by developing the flyers. The flyers can be found in the appendices of this
paper. These flyers informed employees of the correct week to place orders, as well as the days
each month that their orders would be delivered. I also added reminders for this program to the
Wellness Outlook Calendar which could be accessed by employees. We also discussed where to
strategically distribute the flyers so that they would easily be seen and noticed by employees in
order to utilize the program.
Another initiative that Dr. Velasquez and I agreed I would work on was their
informational centers. The informational centers included Bits and Tips and wellness bulletin
board materials. The Bits and Tips were once-a-month informational posters that were to be
hung up in the bathroom stalls of each health department location. Since I did not have adequate
time to run an assessment of employee health issues and challenges, I reviewed the previous
assessment that had been done nearly two years ago. I studied the results of this assessment to
develop a theme for each month that would address employees’ relevant health needs. The needs
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assessment told me that employees at DSHS primarily struggled with their weight, healthy
eating, and exercise. Employees had indicated that they would be more receptive to
informational centers as opposed to coaching/mentoring. They had also disclosed that they
struggled with accountability and staying motivated. They listed relevant barriers to changing
their habits as time, money, lack of energy and sleep, and stress.
Based on these results I developed four months of informational centers. I set themes for
each month to include motivation, emotional eating and portion control, stress management, and
sleep. Each month had one of the aforementioned themes. I developed my own Bits and Tips for
each theme, and found relevant credible information on each subject to be printed off each month
for the bulletin boards. Each Bits and Tips can be found in the appendices. I also compiled
multiple resources on other subjects from credible sources for future use. I organized each of the
months and materials into folders to be easily printed off and distributed for each month. After
previously reviewing the older Bits and Tips that had already been used, I decided that ‘less was
more’ and to try to make them less wordy, more succinct, and more visually appealing. I varied
the style on each Bits and Tips with the intention of being able to grab people’s attention with a
new visual appeal. I tried to make it less wordy than before so that people wouldn’t feel
overwhelmed with reading and could more easily read an article quickly. I worked on the
informational centers throughout the entire span of my practicum.
Another main project I worked on was developing a Lunch and Learn. For this project I
developed marketing materials, facilitated the lunch and learn, and evaluated it with Dr.
Velasquez. In my previous job as a Health Coach I had found that it was difficult for people to
focus on making long term sustainable changes. The benefits of making a lifestyle change versus
a quick fix (regardless of the goal) are vast, so I planned my Lunch and Learn on making
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sustainable changes and named it “Make it a Way of Life.” I discussed with some coworkers and
my supervisor their thoughts on this subject and they confirmed that it would interest them and
seemed relevant. The promotional materials I developed to market the lunch and learn are
attached in the appendices as well as the PowerPoint used and two handouts given. I tried to
make all of these materials visually appealing and attention-grabbing to garner interest,
attendance, and participation for my lunch and learn. My turn out was high, the presentation
interactive, and the participants engaged. My supervisor and I evaluated the lunch and learn
afterwards, and she told me she had heard good feedback about it and thought it went well. We
also discussed some areas for slight improvement if given another similar opportunity down the
road.
During my practicum I also had the opportunity to attend the New Employee Orientation.
This was an all-day event where speakers from each department came and talked to us and
explained their role within DSHS. I learned more about emergency preparedness, vaccinations,
infectious diseases, social services, and children and pregnant women with regard to their
various respective programs offered through DSHS. This was very interesting to me to learn how
each department helps to address different but important health issues, and also how they all
work together to achieve the mission of DSHS.
I also spent several hours completing required trainings of new employees. These
trainings were on subjects including harassment in the workplace, HIPAA, computer usage,
workplace violence awareness, and civil rights. While I had previously completed much similar
training for other employment opportunities in the past, it was interesting to see how DSHS
tailored these trainings to their specific workplace and responsibilities.
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Additionally, I had the opportunity to attend a meeting with members of the United States
Air force collaborating with members of DSHS on emergency preparedness issues. This meeting
was enlightening in several ways. I learned about the importance of collaboration between
parties during the event of an emergency, and also the importance of having a plan in place and
anticipating potential challenges as much as possible. It was also interesting to learn how each
department of DSHS has a role in responding to an emergency.
Furthermore, I filled out the application for DSHS to join the Veg Out SA competition
put on by the City of San Antonio. This competition was designed to promote healthy
workplaces through incorporating more fruits and vegetables into employees’ healthy eating
plans. I had to review what DSHS was already doing along these lines to see if we would be
eligible to participate, and explain why we wanted to join. This application was submitted right
before I finished my hours.
Throughout my practicum I also updated the Wellness Outlook Calendar with reminders
and activities. I attended a group work out with some colleagues, and provided healthy recipes
and health coaching to those who were interested.
My initial proposal goals included revising and executing a new wellness program
assessment to develop a wellness room, wellness bulletin board materials, Bits and Tips, lending
library, and wellness calendar. Due to time constraints I was unable to revise and execute a new
wellness program assessment but overcame this challenge in the best way I could by using the
results from the previous one. I also was not able to develop the wellness room as Dr. Velasquez
had found a sponsor to do this for her instead who would provide equipment, paint the room, fix
it up and fund these changes. The remaining proposal goals stayed the same throughout the
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course of my practicum, with the addition of the lunch and learn and other activities and
initiatives like trainings, orientation, Farm to Work, and Veg out SA. The goals of my practicum
were appropriate in addressing the employee health problems at DSHS. The projects I worked on
aimed to make healthy living easier and more convenient, as well as inform and educate
employees about health issues and ways to overcome barriers and stay motivated while changing
the environment in the workplace to be one that is conducive to and supportive of healthy living.
Throughout my practicum I encountered several barriers and challenges. The main
challenge I faced was that I completed all my hours in such a short period of time. While the
number of hours completed was the same as my peers in the program, three weeks was fairly
limiting for what I could accomplish since other contingent things needed more time (ie:
employees to fill out a health and program assessment). Initially my practicum was intended to
be spanned over four weeks which would have allowed for slightly more time, but then I ran into
other challenges regarding paperwork and technology. Once I did begin my hours, there were
several hours that my computer either wasn’t set up or working, or I had some other
technological problem that sometimes limited my productivity. Barriers related to time and
technology were addressed by changing some of my goals to account for less time, and using an
old health assessment’s results instead of creating and distributing a new one. While this is not
ideal, my supervisor and I agreed that this was the best option given the circumstances.
Other challenges I encountered included a lack of resources for work place wellness from
DSHS. As previously mentioned, DSHS does not fund an actual wellness program, and therefore
all initiatives and efforts are volunteer-based and funded through donations and fundraising. This
was severely limiting as to what I could do and what initiatives for wellness were realistic. This
also affected program stability and consistency, as employees had other job responsibilities that
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often restricted their ability to put time and effort toward employee wellness initiatives. The
wellness committee was also voluntary, which made it difficult to know how serious employees
were about contributing to the wellness program and how reliable they would be. These barriers
were addressed by simply trying to be realistic with the situation and what I had to work with. In
three weeks I did not have time to plan fundraisers or raise money, so I researched wellness
program ideas and reviewed options that were less dependent on time, money, or resources and
tried to fit those ideas into my time constraints. I also discussed these challenges with Dr.
Velasquez for ideas and guidance regarding overcoming them.
Personal Assessment
My practicum experience has greatly contributed to an understanding of public health
practice. I began my hours wanting to completely redo the wellness program at DSHS and make
it the best it could be, but I quickly realized that I had to work within the confines of time and
resources and be realistic. I think this was a good representation of reality and how often times
when working in public health the circumstances are less than ideal. This experience helped me
to understand that public health programs often have limited resources and time, and one must do
the best one can with what there is to work with. Public health situations are rarely if ever ideal,
and it was helpful for me to be able to problem solve and try and work with the barriers I faced,
as opposed to fighting them in a situation that wasn’t realistic to do so.
I also had the opportunity to use many skills I learned in various classes. I employed
strategies learned in my Marketing in Public Health, Principles of Health Behavior, Community
Health, and Program Planning and Evaluation courses. I combined this knowledge with skills I
developed in my previous job as a Health Coach working on employee wellness programs to
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work on each of my initiatives for my practicum. My marketing class taught me how to develop
promotional pieces to a specific target audience, and I used this information when developing
promotional materials for the Farm to Work Program as well as my Lunch and Learn. I also used
some concepts from marketing when developing the Bits and Tips to keep them visually
appealing and succinct for my colleagues for whom they were intended. I also used various
models and theories of behavior change that I learned about from my health behavior course
when developing materials to try to influence healthy behaviors. I used constructs from the trans-
theoretical model of change, social learning theory, social cognitive theory, and theory of
planned behavior. I used strategies to increase self-efficacy with my health coaching at DSHS
and also during my lunch and learn. My community health and program planning classes gave
me the foundation to know how to gear program pieces to a specific audience as well as evaluate
their efficacy. Each of these classes paired with my previous employment experience guided me
throughout my practicum experience.
Several of the public health competencies were applied during my practicum experience.
I aimed to protect and promote the health of individuals within the DSHS employee community
through encouraging healthy behaviors and making sustainable lifestyle changes. I evaluated my
lunch and learn as well as previous wellness program efforts and designed and implemented
appropriate initiatives to address employee’s health needs. I also critically reviewed and
analyzed medical and public health literature and research findings for appropriateness in
addressing DSHS employee’s relevant health problems and barriers to change through the Bits
and Tips and wellness bulletin board materials. I also had to frequently consider ethical issues in
the work place pertaining to employee wellness and demonstrated an understanding of ethical
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reasoning to guide my decisions in not overstepping personal boundaries and rights within the
workplace.
My practicum experience greatly contributed to my understanding of public health
practice. I had to apply the information I had learned and develop skills to put my knowledge
into practice. I also had to problem-solve and overcome typical barriers in public health while
still working to make a positive change in the DSHS work place. I believe my experience offered
me a hands-on, real-life opportunity to understand what public health work looks like in the real
world. I had to learn how to balance ideals with realism and budget and time restrictions which I
believe is crucial in learning how to practice public health outside of an educational setting.
Conclusions and Recommendations
I have several suggestions and recommendations for improving the work site wellness
program at DSHS in Texas. Since my practicum time was limited I was limited in how much I
could do in such a short period of time, but I left Dr. Velasquez with various other ideas that she
or a future intern could move forward with as well as laid the groundwork for the Farm to Work
Program and Veg Out SA competition.
After receiving feedback from my colleagues at DSHS I suggested to Dr. Velasquez that
the Bits and Tips continue on with themed months after I left. I left her with a theme for each
month for the remainder of the year, based off of health needs and barriers reported in the health
assessment. I also prepared various print outs for those themes to be displayed on the wellness
bulletin boards.
Additionally, I prepared a list of other wellness program ideas for Dr. Velasquez to
consider with more time and resources to act on the various ideas. I suggested further utilization
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of the Wellness Outlook Calendar to plan employee workouts, events, and reminders for other
initiatives that employees could have easy access to. I believe the wellness calendar is something
that has immense potential but was not properly utilized. I think that this calendar could even be
used for motivation or reminders for healthy living in addition to wellness activities.
I also suggested that DSHS run more fundraising campaigns. It is difficult to do much
more with the wellness program than what already exists with such limited funding. Raising
funds for wellness could be put toward pedometers for all employees, wellness challenges with
rewards, participation in group 5k’s or other fitness events, or more fitness equipment to go in
the wellness room once it is developed.
I also suggested that a future intern look into government sponsorships for gym
memberships, as many employees had mentioned the cost of membership to a gym as a barrier to
exercising. Developing a partnership with various local gyms could be helpful in terms of
reducing costs for membership (ie: offering group or discounted membership rates) as well as
having stakeholders in the community that support healthy living at DSHS.
During my time at DSHS I developed wellness bulletin board materials pertaining to
employee assistance program benefits. Many employees were not aware of the benefits they had
access to at no charge through the employee assistance program. Because many employees had
reported stress as a barrier to healthy living and the employee assistance program offers free
counseling from qualified therapists, I thought this could be a good option to help manage and
reduce the stress that employees experience and thereby improve wellness in the workplace.
One of the biggest recommendations I had for Dr. Velasquez was to develop and
distribute a new health assessment to give to employees that would quantify their health issues
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and barriers as well as satisfaction with current program initiatives to gauge efficacy. It is
difficult to gear program initiatives and activities toward the health needs of current employees
with a dated assessment. Dr. Velasquez said that there had been a good amount of turnover since
the last assessment was executed, although she suspected that new employees probably had
similar health issues to the older employees who were still at DSHS. Regardless, conducting a
new health assessment would provide very valuable insight as to how the current program is
working. Even if the health needs of the employee population has not drastically changed, an
assessment could measure what to put valuable time and resources into as opposed to what
initiatives may not be worth continuing.
I believe that moving forward the work site wellness program at DSHS in Texas will only
continue to improve. With a new assessment will come more clarity about where to spend
wellness efforts as well as how to address current employee health needs. When I began my
practicum the work site wellness program had just begun, but with continued development of
some of my ideas presented in conjunction with more time for employees to respond to wellness
efforts I believe that the health of employees at DSHS can be improved even more. I am thankful
for my time spent and learning experience gained through DSHS, and am happy to have been a
part of supporting employee health through their work site wellness program.
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Reference
Department of State Health Services- Health Service Region 8. (2015, June 11). Retrieved from
Texas Department of State Health Services:
http://www.dshs.state.tx.us/region8/default.shtm
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Appendix A
Farm to Work Flyers
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Appendix B
Farm to Work Schedule
Farm to Work Schedule 2015
Order Delivery (every first and third Wednesday between 2-4pm)
June 3
June 17
July 1
July 15
August 5
August 19
September 2
September 16
October 7
October 21
November 4
November 18
December 2
December 16
Order Submission (every 2nd and 4th week Mon-Fri)
May 25-20
June 8-12
June 22-26
July 6-10
July 27-31
August 10-14
August 24-28
September 7-11
September 28th-October 2
October 12-16
October 26-30
November 9-13
November 23-27
December 7-11
December 28-January 1
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Appendix C
Lunch and Learn Promotional Flyers
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Appendix D
Lunch and Learn Tips Sheet
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Appendix E
Bits and Tips June-September (see attachments in submission for better clarity)
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Appendix F
Evaluation (see attachments in assignment submission for a more clear document and included
comments from supervisor)
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