Derm Clinic: Connie Huffine (right) and students re-stocking medications for the Dermatology Clinic.

I. The Dermatology Clinic for Homeless Men and Women
II. Youth Mentoring Projects

IIa. Hamilton Middle School Mentoring for English Language Learners (ELL)
IIb. Street Youth Health Projects

III. Sports Medicine Clinic
IV. Diabetic Foot Care Clinic
V. Mary's Place Health Fair
VI. Perinatal Support Project
VII. Educational Seminars

I. The Dermatology Clinic for Homeless Men and Women

Through participation in the dermatology clinic, students learn and practice a set of clinical and interviewing skills as well as becoming familiar with the special health challenges of homelessness, including limited access to health care, mental health services, and basic amenities such as water and toilet facilities. Student coordinators and student care providers attend quarterly seminars taught by Sharon Dobie, M.D. and Nancy Sugg, M.D. on topics relating directly to special problems of Seattle's homeless population. All students also attend an orientation at the Downtown Emergency Service Center. Since 1994, the Dermatology clinic has provided dermatology care for more than 2,000 persons on two Wednesday evenings each month at the Downtown Emergency Service Center (DESC), a shelter for more than 200 adult men and women. Dermatological problems are common in the homeless community, but often go untreated in the presence of more serious medical and social concerns. Ten student coordinators share leadership responsibility, scheduling students and attending physicians, ensuring that supplies are stocked and supervising each clinic session. Care is delivered by a medical student team that consists of a pre-clinical (first or second year) and a clinical (third or fourth year) medical student. The teams are precepted by a volunteer attending physician.

II. Youth Mentoring and Health Education Projects

Participation in the youth mentoring projects offers students the opportunity to develop skills for addressing the specific health needs of two unique groups of adolescents: Immigrant and refugee youth and homeless youth. Student participants receive ongoing training throughout the school year provided by both CHAP staff and our community partners. Sharon Dobie, M.D provides training regarding adolescent health. Staff from the Seattle Public Schools Health Education Department address teaching and group facilitation skills, skills for working with sensitive subjects, as well as providing training on working with English Language Learning (ELL) youth. Ian Maki and Rachel Lazzar also work with Seattle Public Schools staff to insure presentations are culturally and linguistically appropriate and provide cultural competency training when needed. Debriefing, evaluating presentations, and reflection are strong educational components of these programs. Orion participants receive an additional orientation at the drop-in center.

IIa. Hamilton Middle School English Language Learner (ELL) Classes

Since April 1997 CHAP has been working at Hamilton Middle School in Seattle providing a Youth Mentoring Project for middle school students. This project has grown to include 6th, 7th, and 8th grade students in two English Language Learner (ELL) classrooms. The mentoring team consists of 16-20 students representing health sciences programs such as medicine, nursing, pharmacy, public health, social work, and physician assistant training. CHAP works closely with Seattle Schools Health Education Department as well as with several teachers. Our students provide presentations to increase the emotional and social health of these young adolescents, focusing on topics such as smoking prevention, positive body image, and media literacy. Then, they participate in small group mentoring sessions each week. The mentoring program consists of approximately six mentoring sessions per quarter for three-quarters a year. Mentors and students stay together throughout the year.

IIb. Street Youth Health Projects: YouthCare's Orion Center

Since 1996, CHAP has provided health education and tutoring at Orion Center. This multipurpose drop-in center provides meals, educational opportunities, recreational programs, mentoring and other services for homeless youth, ages 12 to 19. Orion Center is associated with Seattle Public Schools, aiding students in obtaining a high school diploma or GED. UW student mentors provide health education presentations throughout the school year on topics ranging from the brain to body piercing. In addition, one-on-one tutoring is provided in the classroom. UW mentors at the Orion Center not only cover academics; they also build trust by doing creative art projects, going on field trips and most of all, listening to the voices of the students.

III. Sports Medicine Clinics

Students have another opportunity for developing skills for working with youth through participation in the Sports Medicine Clinics. Students receive training both on the special health needs of adolescents as well as clinical and interviewing skills. Since 1985, CHAP has offered a free, one-day, pre-athletics sports medicine clinic for student athletes at a Seattle Public School in an underserved community. Four medical students organize, implement and evaluate this one-day event. This clinic provides pre-athletic physicals for student athletes who plan to play on middle school teams. Athletes are examined by these specially trained medical student teams precepted by volunteer community physicians. Student leaders have recently worked to expand this program to an additional site. As a result of their diligence and creativity, the Sports Physical Clinic was held at two sites in Spring 2008, and will continue at both sites in 2009.

IV. Diabetic Foot Care

Students who participate in CHAP Foot Care Clinic develop a toolkit of both clinical and health promotion skills for working with the homeless community, for whom quality foot care can be a potential life-saver. Prior to each clinic, students attend a two-hour seminar by Sharon Dobie, M.D. which teaches students principles of diabetic pathophysiology and foot care management, in addition to health education techniques and strategies for encouraging positive health behaviors by low-income diabetic clients. During quarterly clinics for individuals affected by homelessness, students work one-on-one with clients providing foot examinations and foot care while providing relevant health education.

VI. Perinatal Support Project

CHAP's Perinatal Support Project helps address the needs of underserved pregnant women. This project offers the opportunity for medical students to experience pregnancy and delivery from the non-practitioner perspective. Additionally, they provide advocacy and emotional support for possibly at-risk mothers-to-be; encouraging use of prenatal services; and acting as approachable liaisons between the women and the medical community. The project is designed to pair medical students with pregnant women who would benefit from additional support throughout their pregnancies. The medical students attend prenatal care visits and are present at births if possible. Exit interviews are included in post-birth meetings.

VII. Educational Seminars

CHAP has provided educational seminars since the program's inception in 1980. These sessions traditionally were held in the evening hours or as "brown bag" lunches featuring speakers qualified to address the health care needs of underserved communities, particularly those served by CHAP programs, such as those with substance abuse issues, persons with AIDS, homeless youth, and immigrant and refugee populations. In years past, CHAP has collaborated with the SPARX program to coordinate a wide variety of educational events, ranging from a lecture series on homeless youth, panels on domestic violence, to daylong workshops on multicultural competency.