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Nursing Professor Helps Young People Build Resiliency

Genevieve Chandler

Genevieve Chandler
Dani Fine Photography

James Bowe Jr. had a few full-scholarship offers come his way during his senior year of high school in Miami, Fla.

But at 180 pounds, most of the elite football programs considered him too small to excel at his position — outside linebacker.

He chose to accept an offer from a school that he said stuck by him when others didn’t — UMass Amherst — but was soon to discover that being undersized was only one of many stress-inducing challenges he would encounter on and off the practice fields outside McGuirk Alumni Stadium after arriving in 2015.

“The biggest change for me coming out of high school was the speed of the game and how much you had to learn — we had to develop quickly, because there’s a lot of different plays and a lot of terminology you have to learn,” he said. “And along with my practice schedule, I had my classes and everything else; it was a lot for me to handle, and that affected me in the classroom.”

And there was still more that he needed to cope with, whether he knew it or not.

Indeed, as he would discover, the death of his sister not long before he arrived at UMass had left scars that hadn’t fully healed — there were feelings he needed to get off his chest and emotions that he had to confront.

And confront them he did, while also putting a huge dent in his stress level, thanks in large part to a unique program blueprinted by Genevieve Chandler, associate professor of Nursing at UMass Amherst. It’s called Changing Minds Changing Lives (CMCL), and it was created and piloted by Chandler on the basic premise that resiliency is something that can and should be taught, developed, and built.

“It’s long been thought that people were resilient or they were not resilient,” said Chandler, who so impressed the judges with her work on this subject to date that she became one of two winners in the category of Innovation in Healthcare. “But researchers concluded that everyone has resilience; the question is how much and what we can do about it. Researchers realized that we not only carried something inside, but we needed access to resources outside to build that resilience.”

Elaborating, Chandler said much of her career’s work has been in the realm of creating such resources, especially as they relate to adverse childhood experiences, or ACEs, as they’re called.

It’s not about what you don’t know, it’s about what you do know, and that makes it different from most classes. It’s not about deficits, it’s about strengths. I can’t teach you about you; you’re going to have to teach me about you.”

These include physical abuse, sexual abuse, emotional abuse, and the broad category of household dysfunction, which includes everything from substance abuse to incarceration; from domestic violence to divorce or death of a loved one.

That’s a long list, and a host of studies have concluded that perhaps 60% of the population has an ACE, or several, in their background, said Chandler, adding that studies have also shown direct links between these experiences and physical and mental illness.

Her work, and especially the CMCL initiative, is aimed not only at focusing attention on ACEs and their impact, but also at helping individuals move past these ACEs by teaching them resiliency.

How? Through a broad course of study that includes everything from deep-breathing exercises and yoga to group writing (lots of that, as we’ll see later) and storytelling.

These elements and this mindset came together in the pilot program, what Chandler called a “strengths” class offered at the university, one that attracted a broad mix of students, and, later, an expansion of the initiative to include those involved with Holyoke Community College’s Gateway Program for students who had dropped out of high school.

These successes caught the attention of Jim Helling, athletic counselor for the university, which led to a program involving incoming football players, all of whom, like Bowe, were dealing with a host of challenges and experiencing high levels of stress.

And Bowe is just one of many who can testify that CMCL has certainly helped in that regard.

“This class helped me get adapted to college, and taught me a lot of different ways to handle stress; it taught me to just breathe,” he said, saying that last word slowly for special emphasis. “We were taught to breathe and calm down during stressful situations. That next semester, after I took this class, I was able to get my GPA back to where I needed it to be.”

Breathing is just one of the lessons Bowe and teammate Martin Mangram, a safety from Buford, Ga., imparted upon a group of Springfield Central High School football players they mentored as they took essentially the same class offered to the incoming players at UMass in the latest, and apparently successful, expansion of the CMCL initiative.

Genevieve Chandler, seen here with incoming UMass football players

Genevieve Chandler, seen here with incoming UMass football players, says resiliency is something that can be taught or developed.

“We feel it was very successful,” Tad Tokarz, the school’s principal, said of the study, which involved a handful of players. “And speaking to students, they would tell you they’ve grown, and they can tell you how they’ve improved in recognizing emotions and building resilience.”

Course of Action

Helling, a psychiatric social worker as well as athletic counselor at UMass Amherst, was one of those offering instruction and insight to those football players at Springfield Central this summer.

And he said he started one of his presentations by putting up a picture of Charles Darwin on the screen at the front of the room and then focusing the conversation on the naturalist’s theory of ‘survival of the fittest’ — and in a way that hits at the heart of the CMCL initiative.

“The fittest does not mean the physically strongest,” Helling told BusinessWest. “The fittest means the best fit; it’s not the strongest or the biggest or the smartest that survives. The ones who survive are the ones who fit in best in their environment and meet the challenges that their environment presents to them.”

Helping young individuals become far more fit — in this respect — has become the focus of Chandler’s research, and life, in recent years. And this work in resiliency (technically defined as one’s response to adversity) continues what she said is a career-long focus on mental-health nursing, and, more specifically, what she called the “health and strengths aspects of one’s life, rather than the illness aspects.”

Elaborating, her approach has long been to focus on an individual’s strengths, rather than their problems, especially within the realm of ACEs, something she’s been studying for decades.

“I’m committed to using the notion of resilience to respond to the effects of adverse childhood experiences,” she told BusinessWest. “And I’ve learned how much ACE effects physical illnesses such as chronic lung disease, heart disease, anxiety, depression, and cancer; the higher the score for adverse childhood experiences, the higher the likelihood of biological and psychological illness.”

The resilience course Chandler has developed, number N297T in the university’s database, is officially called “Torchbearer: Stress Buster or Strength Builder.” (Actually, it likely does both).

The syllabus comes complete with a stated rationale — “identifying inherent strengths, developing agency, and managing stress to develop social connections and build resilience, promotes health and leads to success in college, community, and career” — as well as a course description, which reads:

“Build individual strengths to empower stress management and increase resilience. Research, mindfulness, and focused writing are applied to increase awareness of emotional responses to life’s challenges and facilitate social connections to increase leadership capacity.”

There are also several formal objectives. Indeed, upon completion of the course, the syllabus reads, the student will able to:

• Analyze individual strengths;

• Utilize health-promoting stress-management strategies;

• Foster a sense of community across lines of difference;

• Promote individual resilience;

• Negotiate a social-support network of mentors, role models, and peers; and

• Demonstrate strategies to facilitate individual leadership capacity.

The required text is just one thing, by Rick Hansen, subtitled “developing a Buddha brain one simple practice at a time.”

This is a different kind of college course in many ways, said Chandler, who explained what she meant by that.

“It’s not about what you don’t know, it’s about what you do know, and that makes it different from most classes,” she explained. “It’s not about deficits, it’s about strengths. I can’t teach you about you; you’re going to have to teach me about you, and that’s how we set up the class.”

Exercise in Resilience

Slicing through all that’s in the syllabus, Chandler said those taking this course essentially teach themselves how to become more resilient.

They do so through creation of a ‘strength plan,’ through a focus on what she called the ABCs of resilience:

• Active Coping, which could include exercise, medication, or yoga;

• Building Strength, which she said means focusing on one’s strengths and not one’s weaknesses or problems;

• Cognitive Awareness. “This means being aware of our thinking,” she explained. “So often, we get caught up in catastrophic ways of thinking, like ‘I’m going to fail a quiz’ or ‘I’m not going to be able to make a car payment;’” and

• Social Support, which, she said, involves understanding that people should call on their lifelines much sooner and build their social support so they have people they can lean on.

“Those are the ABCs, and that’s what we teach,” she told BusinessWest, adding that the course was first taught to essentially any student who wanted to take it four years ago, while the program for the incoming football players was started two years ago.

And that latter initiative is already registering measurable results, she went on.

“Half the incoming football players took it, and half didn’t. And then we measured what happened, and we saw a difference in their resilience, in their stress management, and emotional awareness — a big difference,” she said, adding that the results of that study were published, and the outcomes of a study on the second class of players were in the process of being sent to the Journal of American College Health.

“It’s incredible how fast 17- and 18-year-olds put this into their life,” she said of the football players and their embrace of the ABCs of resilience. “Most of them don’t sleep very well, and in two nights, they’re sleeping better.”

Mangram is among those getting more and better rest at night. He told BusinessWest that the class enabled him to respond better to adversity and to deal with stress, rather than let it accumulate, as he did before CLCM.

“This class really helped me realize that I’m not crazy for stressing, and it’s not abnormal to be going through what I’m going through,” he explained. “And it gave me ways to release stress rather than just recognize it, which is what I did in high school — just carrying it over day by day where it’s constantly pounding you down; this helps me start fresh every day.”

And while she spent a good deal of time talking about college football players and their efforts to build resilience, Chandler said the same theory, and the same practice, applies to just about everyone.

“People will say, ‘I’m taking deeper breaths now, and I don’t react as fast; I now respond to things instead,’” she told BusinessWest. “They say, ‘I think about things a little more, and I talk to a friend about things first about what’s going on with me.’ And this is resilience, and then they can thrive in college and in life.”

Gaining Ground

This has been accomplished through the combination of everything in the CMCL playbook, if you will, from deep-breathing exercises (something the Central students were taught as well) to the yoga poses, to the writing assignments and the discussions that followed.

Indeed, writing has become a big part of the CMCL blueprint, said those we spoke with, adding that these exercises ultimately help individuals open up, share challenges and emotions with others going through most of the same things, and, ultimately, release some of the stress that’s been accumulating.

Chandler said she has long been a strong advocate of the Amherst Writers & Artists (AWA) Method, developed by Pat Schneider, author of the book Writing Alone and with Others.

Jim Helling

Jim Helling evokes Charles Darwin as he talks about survival of the fittest from the perspective of being able to respond to adversity.

The ‘method’ is to encourage writing and provide a safe environment in which individuals can experiment, learn, and develop their craft through practice and helpful response from other writers.

Chandler has used the method in many classes she’s taught over the years. Participants generally write to a specific topic at each class, and in most all cases, the results have surprised and encouraged her, while providing more evidence that resilience can indeed be taught and built.

“In one class, they were asked to write about something they had as a child, but don’t have now,” she told BusinessWest, referring to a program at Springfield’s Putnam High School. “Two-thirds of the students wrote about their father. I thought they’d write about a bike or a toy. But that’s how fast people take to writing about what’s important to them.”

The same has proven true with those taking the Torchbearer course, she said, adding that the opportunity to write and then gain support from those who hear what you’ve written has proven to be a powerful force in efforts to become a stress buster or strength builder.

“What’s interesting is that, when you give people the opportunity to write about strengths,” she said, “they feel safe enough to write about problems, which we don’t ask for, but we listen to and focus our feedback on moment of strength within the problems that arise.”

The upshot of all this, when it comes to the football team, is that the players are bonding in a way they didn’t before, said Chandler, and they’ve become more supportive.

“They’ve said that this gets them to know each other better,” she went on. “And that builds a stronger team — they all believe they have each other’s back.”

Bowe concurred. “A lot of people are afraid to talk about stuff they’ve been holding onto for a while,” he said, adding that, for him, the death of his sister certainly fell into that category, and writing about her and then sharing what he wrote with others certainly helped in the healing process.

“When I wrote about that … it was very hard for me to do,” he told BusinessWest. “But we were asked to write about a time when we had to overcome adversity, and that’s what I chose to write about.

“None of my teammates knew about it, and that’s how they found out — that allowed me to get that off my chest,” he went on. “After that, my teammates came to me and comforted me at a time when I needed it most.”

In his recent role as mentor to the Central High School students, he said his unofficial assignment was to help the students open up as he did, and, in the process of doing so, cope with ACEs, focus on strengths, and become more resilient.

“I’m here to let them know that it’s OK to open up,” he explained, “and make it clear that are other people here who are going through the same things that they are.”

Mangram agreed.

“I enjoy being a mentor,” he noted. “It’s a fun experience and a very eye-opening experience. I think I’m making a difference with them — even if they don’t realize it right now.

Tackling Life’s Challenges

Bowe said he managed to get on the field for a few special plays during his first season with the Minutemen, and he’s looking to hear his number (13) called a lot more this coming season.

He’s put some weight on his 6-foot frame and is now officially listed at 192 pounds on the team’s roster. That’s still a little undersized for a linebacker in the FBS Division.

But as he copes with that challenge and the many others he faces, Bowe is certainly more fit than he was a few years ago — as Charles Darwin might say.

And as Genevieve Chandler would say. She’s the architect of the CMCL initiative, and a true hero when it comes to innovation in healthcare.

George O’Brien can be reached at [email protected]

Healthcare Heroes

Partnership Brightens the Picture in a Springfield Neighborhood

The Healthy Hill Initiative

The Healthy Hill Initiative
Dani Fine Photography

Helen Caulton-Harris described Donna Blake as a pioneer of sorts.

Indeed, she was one of the first African-American women to take an administrative role with the city of Springfield. But beyond that, she was extremely active within the community, working at the Urban League for decades, serving as a parks commissioner, and always advocating on behalf of children and their well-being.

“She was a staple in the community,” said Caulton-Harris, commissioner of the Division of Health and Human Services in Springfield. “Everyone in the city went to Donna Blake for advice and guidance.”

So it’s only fitting, then, that the small park named in her honor has become a symbol of sorts for turnaround efforts in the Old Hill Neighborhood of the city, and one of the focal points of a multi-faceted initiative called Healthy Hill.

Not long ago, Donna Blake Park was a place to avoid — unless you were looking for drugs or trouble, which you could find easily and in large quantities. As a result, parents didn’t want their kids playing there. The park became a flash point, a symbol of everything that was wrong with that neighborhood, one of the poorest in the city — and the state.

Today, though, the park is, well, what it was created to be — a resource, a gathering spot, a place to exercise, a haven within the neighborhood, especially for its young people.

And it became all this largely because of the Healthy Hill Initiative, or HHI, as it’s known, an endeavor that epitomizes the term ‘collaboration,’ and was the clear winner in that specific Healthcare Heroes category.

HHI is one of 18 sites funded by the BUILD (Bold, Upstream, Integrated, Local, and Data-driven initiatives) Health Challenge, a national grant program created to improve health and well-being in low-income communities. With $2.5 million awarded over five years to the coalition, as well as matching grants, the Healthy Hill Initiative has been working to change the health landscape in Old Hill by focusing on what Frank Robinson, vice president of Public Health and Community Relations at Baystate Health and one of the initiative’s architects, called “the dynamic intersection of two social determinants of health — public safety and access to physical activity.”

It does this through a number of initiatives, from indoor fitness activities for seniors through a collaboration with the YMCA of Greater Springfield and the Springfield Housing Authority, to C3 police efforts designed to build trust and supportive relationships, to a hugely successful program called Let’s Play that has involved more than 65 young people who participate in physical-fitness activities at Donna Blake Park at least two Saturdays a month.

“Let’s Play has been really exciting,” said Sarah Page, senior vice president of Community Building & Engagement for Way Finders, one of the collaborating entities. “Lots of kids come out and play, and the police often come and play with them. And the police feel they’re building wonderful relationships with those young people, which can really make a difference.“

“Years ago, you felt that you were pretty much safer if you just stayed home. But over the years, things have changed, and the neighborhood is transforming itself.”

HHI is a large, very involved collaborative effort, with more than a dozen players. In addition to Way Finders (formerly HAPHousing), which took a lead role in the initiative, as did Partners for a Healthy Community, participating entities include Mercy Medical Center, Baystate Health, Revitalize CDC, the Old Hill Neighborhood Council, and six city departments, including Health and Human Services and the Police Department.

These agencies were all working toward improving Old Hill before HHI was launched, said Caulton-Harris and others we spoke with. But this endeavor took them out of their respective silos and brought them into the same room — literally — and the same fight for better outcomes.

Bur rather than talk about how it all came together and why, those involved were clearly more interested in discussing the many forms of progress it has yielded.

Awilda Sanchez, vice president of the Old Hill Neighborhood Council and a 25-year resident of that area, said the changes are palpable.

“Years ago, you felt that you were pretty much safer if you just stayed home,” she recalled. “I didn’t go out at night, and my children did not play in the public parks. But over the years, things have changed, and the neighborhood is transforming itself.”

Certainly one of the more poignant measures of improvement is the relationship between young people and the police, as related by Beatrice Dewberry, manager of Way Finders.

“Initially, when the police first began to interact with some of the kids who live in a public housing unit on Pendleton Avenue, a boy walked up to the sergeant and said, ‘I don’t like police; you guys arrested a family member and put him in jail for a long time, so I don’t like you guys,’” she recalled. “Now, each week, when we play, the same kid says to the police, ‘when are you guys coming?’ He can’t wait to connect and engage with the officers.”

Defining Moments

Webster defines collaboration as a willingness to “work jointly with others, especially in an intellectual endeavor.”

Those last few words take on new meaning in an age when the health- and wellness-related problems in society are large in scale, complex in nature, and require collaborative efforts if they are to be effectively addressed.

So much so that, as BusinessWest talked with a large and distinguished panel of advisors as it was bringing the Healthcare Heroes program to reality, those individuals made it clear that a category devoted to collaborative efforts should be established.

One was, and it drew a large and diverse mix of projects, all of which drive home the point that, when groups with common goals and ample amounts of energy, imagination, and persistence come together, powerful things can happen.

Nowhere is that more evident than in Springfield’s Old Hill neighborhood, a once-proud (it’s getting back there) enclave of roughly 4,300 residents.

Like many of Springfield’s neighborhoods, Old Hill, largely populated by Hispanics and African-Americans, has experienced years of disinvestment and complex challenges ranging from higher rates of poverty, lower graduation rates, an active drug trade, gang activity, higher rates of violent crime, and increased incidences of chronic disease and obesity, said Robinson. These matters were further complicated by the fact that the June 1, 2011 tornado tore across parts of Old Hill, causing considerable damage.

With an eye toward addressing health- and wellness-related issues in Old Hill, a host of local agencies and city departments came together behind a common vision, he went on, adding that, in many ways, Peter Gagliardi, president and CEO of Way Finders, was the catalyst by bringing attention to the direct correlation between housing and health and essentially inspiring a call for action.

Sarah Page

Sarah Page says the Let’s Play initiative has brought children — and adults — back to Donna Blake Park, which for decades had been a place to avoid.

“He pulled together 40 to 50 people in his office to talk about this connection,” said Caulton-Harris. “There was a recognition of the need to address this intersection of health and housing.

“There was work going on in that neighborhood involving housing and health,” she went on. “But they were separate initiatives; this effort brought them together.”

The effort she referred to took the form of a proposal for the BUILD Health Challenge that was worthy of all those adjectives that make up that acronym (again, they’re ‘bold,’ ‘upstream,’ ‘integrated,’ ‘local,’ and ‘data-driven’).

By way of clarification, those with the BUILD Health Challenge define ‘upstream’ this way: “partnerships that focus on the social, environmental, and economic factors that have the greatest influence on the health of a community, rather than on access or care delivery.”

And the Healthy Hill Initiative certainly fits that description, said Page, noting that the HHI was clearly focused on those social factors, including everything from housing to public safety to neighborhood infrastructure and facilities — or the lack thereof.

And the application efforts were certainly helped by the fact that there were already initiatives in place to help revitalize Old Hill, including a five-year strategic plan created after the tornado as well as Revitalize CDC’s plan to revitalize 10 blocks of the neighborhood over a 10-year period, an endeavor launched in 2012.

The initiative is also data-driven, said Jessica Collins, executive director of Partners for a Healthier Community, adding that her agency and others involved could look at maps of Old Hill and identify blocks where there were high incidences of asthma, obesity, and other problems.

“It was exciting for us to be able to look at that granular level of health data,” she explained, noting that it was necessary to apply for the grant. “We had never done that before.

“We had an amazing team working on data; information came from health clinics, the school system, and other sources, and then put through GIS,” she went on, adding that the Pioneer Valley Planning Commission and Baystate Health both worked to crunch the numbers.

And they revealed that considerable work needed to be done, Dewberry said, adding that the accumulated data was used, along with considerable feedback from the community, to develop specific strategic initiatives, especially in the realms of physical activity and getting young people back out in the parks.

Exercise in Collaboration

But for that to happen, residents had to be convinced that the park was safe, and this took some doing, said Sanchez, adding the park was known as a place for gang recruitment and a host of illegal activities.

Parental approval was required to get children to the park, she went on, adding that people went door to door to secure this approval.

The resurgence of the park has had a transformative effect on the rest of the neighborhood, said all those we spoke with, adding that the return of children playing, the interaction between young people and police, and other positive developments have helped convince Old Hill residents that change is in the air — and they should be out in that air.

“The playing, the physical activity, the public-safety piece, having a safe environment for children … those pieces are critical,” said Caulton-Harris. “And when people see activity in the neighborhood, it definitely makes residents feel it’s safe to come out of their houses, particularly the elderly.”

Dewberry agreed, and told BusinessWest that, beyond a greater overall feeling of safety, the various components of HHI have contributed to creating a neighborhood that is in many ways better connected, something it has certainly not been historically.

“We talk about social cohesion and building this unified, connected neighborhood,” she explained. “And a lot of what we’re doing with the Healthy Hill Initiative is working toward that end.

“Let’s Play is a great example of that,” she went on. “For example, an elderly couple that has custody of their grandkids, they didn’t let the kids come out, but now they do, and they come out as well, to engage with us and engage with the other kids. We have parents and guardians coming, as well as resident health advocates, who also come. We’re developing community and building that social cohesion that has proven to be effective in deterring crime and reporting crime.”

Meanwhile, Healthy Hill Initiative has become a leading-edge example of how healthcare providers, moving beyond a fee-for-service model and into an accountable-care model, are taking on new responsibilities with regard to the health of the communities, and embracing that role, said Doreen Fadus, executive director of Community Health and Well-being at Trinity Health of New England and Mercy Medical Center.

“From a hospital perspective, this initiative and others have changed the culture, especially of the leadership of the hospital,” she explained. “Instead of thinking that these are nice things that the hospital does, these are things we have a responsibility to do to make the neighborhood healthier.

“As we move away from fee for service and just treating people when they’re sick, the leadership is more focused on the social determinants of health. This is our mission; these are the things we should be doing in the community.”

As Sanchez surveys Old Hill today, she sees less blight, she told BusinessWest, a direct result of many of the initiatives taking place in that neighborhood to rebuild properties and clear vacant lots once used as dumping grounds.

But she also sees more green — in the form of flowers, new trees, and vegetable gardens — and, most importantly, more people, who obviously feel safe enough to walk, exercise, and get some fresh air.

And with all that, she’s seeing a lot of what she left behind when she moved here from Puerto Rico decades ago.

“In Puerto Rico, communities are people knowing each other on the block, helping each other … the kids are being cared for by everyone,” she explained. “That’s what I wanted to see in Old Hill, and we’re starting to see that. I can see the difference.”

It came about because of determination, imagination, and, most importantly, collaboration.

Developing Story

Returning to that story she told about the young boy living in the public housing project who once hated police but soon couldn’t wait to engage with them in the park, Dewberry said her agency has tons of pictures of police and young people playing together.

Perhaps more than anything else, these images tell the story of how Old Hill is experiencing change and progress. Not so long ago, this neighborhood, and the park that has been at the forefront of so much that has happened, were the picture of disinvestment, the picture of a neighborhood in crisis.

HHI has brought better times, and better health, into focus.

And Donna Blake would certainly be proud.

George O’Brien can be reached at [email protected]