Practice Title: Better Together Hennepin Health Mentor Model
Department: Hennepin County Public Health
Size: Large (Population of 500,000+ people)
State: Minnesota
Summary of Practice:
Hennepin County Public Health (HCPH) is the largest public health department in Minnesota. Its vision is for all people who live, work, and play in Hennepin County (HC) to experience optimal health grounded in health and racial equity. HCPH takes a comprehensive approach that strives to respond to the unique and important needs of all residents. Its dynamic programs promote physical and mental health, reduce chronic diseases, and prevent illnesses and injury associated with communicable diseases and environmental conditions. Better Together Hennepin (BTH) is HCPH’s adolescent health team.
HC is Minnesota’s largest county, with 1.27 million people, or about 23% of the state’s population. HC is rich with diverse cultures, dynamic immigrant groups, arts, and civic engagement. HC also struggles with institutional and historic racism and classism, with the 2020 murder of George Floyd in Minneapolis bringing local inequities to the national lens. The county’s population is 0.5% American Indian/Alaska Native, 3.9% two or more races, 6.9% Hispanic/Latino, 7.1% Asian, 13% Black/African American, and 67.9% White (Source: 2020 ACS 5-year estimate). HC is home to over 75,000 adolescents, ages 15-19.
During adolescence young people experience significant physical, mental, and emotional changes including increased risk-taking behaviors. Sexual risk behaviors can lead to HIV, sexually transmitted infections, and unintended pregnancy. Adolescents experience stress, anxiety, and trauma that impacts their general health and specifically their sexual and reproductive health. Community and school leaders, parents, health professionals and youth have identified that there is a current mental well-being crisis among youth. Public data supports that concern.
In partnership with local clinics and schools, BTH created the Health Mentor Model to provide a public health response to the above identified issue. The Health Mentor Model embeds a full-time sexual health educator called a health mentor in a school site. Health mentors are employed by adolescent-friendly clinics.
BTH provides funding, guides vision and strategy, monitors and evaluates programming, supports aligned activities, mobilizes resources, creates shared measurements, and provides training and technical assistance to the Health Mentor Model. Clinic and site partners coordinate activities to meet specific community needs and maximize resources and impact.
Health mentors provide four tiers of support: one-to-one education; small groups; classroom education; and systems work. Additionally, Health mentors facilitate youth leadership councils that inform program approaches and mobilize young people at the site.
This tiered approach supports all students with evidence-based classroom sexual health education. The focus on systems work addresses the needs of all by striving to create safe and supportive environments, while being responsive to specific community needs. Small group and 1 to 1 interventions offer a directed approach for young people who have higher or more individualized needs, and support mental well-being. With any tier, adolescents may be referred to adolescent-friendly health care and other supportive services. Because the health mentor is employed by a local clinic, warm referrals are easy to make.
The goal of the Health Mentor Model is to improve adolescent health and well-being, reduce health disparities and advance health equity in HC communities with the greatest needs and disparities.
The Health Mentor Model promotes health equity by prioritizing sites in communities with the greatest inequities. Priority communities are identified by a range of data indicators. They may be geographical or specific populations of young people, i.e., groups experiencing racial inequities, LGBTQ+ youth, etc.
Partner clinics strive to hire health mentors that reflect the communities they serve and train them to provide trauma-informed, culturally, and linguistically responsive, age-appropriate, inclusive, and medically accurate programming.
Assessment data confirms that the Health Mentor Model addresses needs identified by young people, parents, community stakeholders, and adolescent health professionals. Evaluation activities identify that programming reflects strategies the community determined to be important, especially the inclusion of well-being with sexual health promotion.
The Health Mentor Model is successful due to strong partnerships. BTH contracts with seven clinic organizations that are trusted by youth. These organizations have MOUs with 17 sites to host the health mentor, facilitate implementation of all tiers the model, collect required data, and commit to improving the sexual health and well-being of young people. Each site has a youth leadership council that engages with the health mentor to guide and inform the work. Parent and community engagement are also key to the success of the model, and a community advisory group guides and informs all BTH’s work. On the IAP2 Spectrum of Public Participation, the HMM falls under the “collaborate” pillar.
The Health Mentor Model is unique because it: Meets young people where they’re at, literally and figuratively; offers education, youth development and support services; Implements evidence-based practice informed by community wisdom; Partners schools, clinics, and local public health; Addresses adolescent sexual health holistically, understanding that it is not just about behaviors and decision making; Uses a systems thinking approach to identify leverage points to create systemic changs; Responds to the diverse needs of young people in the environment; Addresses the intersection between well-being and sexual health; and Prioritizes communities with the greatest needs.
Having an accessible, safe, and supportive adult ready to address sensitive topics is a unique and valuable addition to local schools. The following quotes demonstrate the impact this has on young people and school staff:
“She gave me time to think carefully and gave me important info I needed” -1 to 1 participant
“She really didn’t judge she just helped. she made me feel comfortable about my situation honestly.” - 1 to 1 participant
“I learned not be afraid to communicate to a trusted adult and don't be afraid to ask questions” – classroom participant
“I learned about my own body and others and how they work and how to protect myself.” – classroom participant
“The HM understands the barriers that our community faces day to day. They meet the students where they are and give them what they need.” – school staff
“Best program I've experienced in over a decade working in schools.” – school staff
Information about HCPH and BTH can be found at the following links:
HCPH: https://www.hennepin.us/publichealth
BTH: https://www.hennepin.us/bettertogether
Better Together Hennepin Health Mentor Model
Category
Maternal, Child, and Adolescent Health
Description