Faculty, residents, staff, community partners and Teen Medical Academy participants listen to a speaker at the department of family and community medicine’s Community-Oriented Primary Care celebration June 23.
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It’s called “Community-Oriented Primary Care” (COPC) in the department of family and community medicine at The University of Texas Health Science Center at San Antonio. COPC is a year-round effort to intervene in the lives of individuals with the goal of treating the whole community.

The issues range from parent and child health to diabetes awareness and prevention to youth development. The four COPC projects have been going for several years and involve the collective talent of family and community medicine residents, teaching physicians and non-M.D. faculty. At a COPC celebration June 23 at University Health Center Downtown, residents described:

helping a charter school that educates young people the public schools can no longer handle;

holding support groups on early prenatal care and education for pregnant girls;

offering diabetes education and screening at a neighborhood church;

providing an early childhood fair at a school;

surveying households about health issues;

presenting a lecture series for seventh-graders about diabetes; and

offering a Teen Medical Academy for high school students.

“All the projects are great projects,” said Miguel Ramirez-Colon, M.D., M.P.H., director of the family and community medicine residency program.

Third-year resident Joseph Gonzalez, M.D., discussed his interaction with a group called “Circulo” at the Por Vida Academy charter school. The group, convened by a member of the Por Vida Academy faculty, brings adult role models to talk to young men who are at risk for substance abuse, promiscuity and other problems.

“My involvement with this group is to slowly develop myself as a positive role model for the young men,” Dr. Gonzalez said. “I am a young father myself.”

He is part of the COPC Parent and Child Health Project. Team members are Drs. Gonzalez, Jeannette Ross, Dinah George, Monica Hill, Cynthia Stone, Zohra Jahed and Cliff White. Team leaders are Sandra Burge, Ph.D., Sally Dunlap, Ph.D., and Margaret Mann-Zeballos, M.D.

The Old Pearsall Road COPC Project targets an area of Southwest San Antonio where 30 percent of residents are below poverty level, domestic violence is higher than anywhere in the city, 8 percent of residents have college degrees, and few hospitals or clinics are located.

“Each year we have strengthened our ties with this community,” said resident Sapna Jaiswal, M.D. “We had a lot of facts and figures about how this area is but we thought residents should also have firsthand knowledge, so we initiated a door-to-door household survey.”

This survey targeted 79 families living in the west sector of District 4, south of the former Kelly Air Force Base. Respondents indicated where they see the doctor, medications they take, medical problems they have, and concerns about social problems such as crime. Old Pearsall Road Project team members are Drs. Jaiswal, Ramin Poursani, Esmatullah Hatamy, Jose Lopez, Maria Montenegro, Maria Munoz, Susan Moon and Mariana Munante. Team leaders are Mary Garza and David Schneider, M.D.

Team members of the COPC Diabetes Awareness and Prevention Project selected Christa McAuliffe Junior High School in the Southwest Independent School District as the site of intensive diabetes education. Of the 693 students enrolled at McAuliffe, 640 are Hispanic (92 percent), said Andrine Grant, M.D. The statewide average in schools is 43 percent. A disturbing 12 percent of McAuliffe students have acanthosis nigrans, a dark area on the neck that is an indicator of a predisposition toward type 2 diabetes. Eight percent of McAuliffe students are obese, another diabetes danger marker.

The team presented a lecture series for McAuliffe seventh-graders, held a poster contest and developed a questionnaire to test knowledge of diabetes facts and complications. The residents administered the questionnaire to 250 of the students. A pre-test showed 69 percent of the students had knowledge of diabetic complications. That figure improved to 84 percent in the post-test. The pre-test showed 52 percent understood the benefit of staying physically active; 63 percent understood the benefit on the post-test.

The Diabetes Awareness and Prevention Project team members are Drs. Andrine Grant, Debra Krieg, Smita Saraf, Joe Deng, Shakil Khan, Vadean Jackson and Carlos Licon. Team leaders are Anne Larme, Ph.D., and Dr. Ramirez-Colon.

The COPC Youth Development Project, which began in 2000 with the goal of promoting health careers among adolescents, has reached 500 young students through Teen Health Camps and an outstanding Teen Medical Academy. The Teen Medical Academy was offered on six Saturdays this past school year and explored various topics, including sessions on cardiology, fractures, laceration repair, splints, asthma and abdominal ultrasound. It took place at Edison High School with the cooperation of teachers there.

“What you have is high school students getting up, going to Edison by 8 a.m. on a day they usually have off,” resident Tina Flores, M.D., said.

Of the 36 students who completed the 2003-2004 Academy, 22 have agreed to serve as peer facilitators for other youth. Pre- and post-testing of the students’ knowledge base indicated a dramatic increase in knowledge. For example, before the session on ankle fractures, the mean score for knowledge about this common injury by participants was 39. After the session, that figure rose to 80 percent.

Youth Development Project team members are Drs. Flores, Adeeba Ahktar, Joy Emko, Robert Morin, Yveth Soza, Suhaib Haq, Monika Kapur, Nancy Santana, Saima Siddiqui, Philippa Augustin, Emmanuel Lee and Syed Mahboob. Team leaders are Dolores Flores, Elia Ortiz and Manuel Oscos-Sanchez, M.D.

All physicians who enter the family and community medicine residency program join one of the project teams, which means the projects will continue to gain momentum in the years to come.