,!j$JRGEON GENERAL WORKSHOP ON $ELF-HELP AND PUBLIC HEALTH Los Angeles, California September 20.22. 1987 U.S DEPARTMENT OF HEALTH 6 HUMAN SERVCES PU~IK: twm ~etv~e Health Reswrces and Services Admikbatmn Bureau of Malemal and CM Heal& and Resarce -enI I believe in self-help as an effective way of dealing with problems, stress, hardhip, and pain . . . Mend- ing people, curing them, is no longer enough: it 15 only part of the total health care that most people require. C. Everett Koop, M.D., Sc.D. Surgeon General, U.S. Public Health Service 224250 - 88 - I . . . ill ACKNOWLEDGEMENTS The Surgeon General's Workshop on Self-Help and Public Health was supported by grants from the following organizations: The Office of Mater& and ChiId Health Bureau of Maternal and Child Health and Resources Development Health Resources and services Administration U.S. Public Health Service U.S. Department of Health and Human Services The W. Clement and Jessie V. Stone Foundation The California State Department of Mental Health The Exxon Corporation GTE of California Kaiser Permanente of Southern California The workshop was conducted under the direction of Heddy Hubbard, R.N., M.P.H., Office of Maternal and Child Health, U.S. Public Health Service. Mark Mayeda of the California Self-Help Center was chairman of the planning committee and modera- tor of the workshop. Overall workshop coordination was by Marilyn Ruiz and Annette Nussbaum of the Illinois Self-Help Center. Site coordination at the University of California, Los Angeles, was directed by Carol Eisman and Nerissa Leonardo of the California Self-Help Center. This report was prepared by Peter L. P&r&is, Ph.D., M.P.H., Life Sciences Editorial Service, Annapolis, Maryland. V -~~ ~~ MEMBERS OF THE WORKSHOP STEERING COMMITTEE Faye G. AbdelIah, R.N., Ed.D., D.Sc. Deputy Surgeon General U.S. Public Health Service Heddy D. Hubbard, R.N., M.P.H. Bureau of Maternal and Child Health and Resources Development U.S. Public Health Service Mark M. Mayeda California Self-Help Center Daryl H. Isenberg, Ph.D. Illinois Self-Help Center Frances Jemmott Dory New York City Self-Help Clearinghouse Barbara E. Giloth American Hospital Association Ronald C. Brand Wilder Mutual Help Resource Center vi MEMBERSOFTHE WORKSHOP PLANNING COMMllTEE Faye G. AbdeIIah R.N., Ed.D., D.Sc. Deputy Surgeon General Chief Nurse Officer U.S. Public Health Service Parklawn Building, Room 18-67 5600 Fishers Lane RockviIle, MD 20857 John Ahegrante, Ph.D. Department of Heahh Education Teachers College Columbia University 525 West 120th Street New York, NY 10027 Thomasina J. Borkman, Ph.D. Associate Professor George Mason University Fairfax, VA 22030 Ronald C. Brand Project Coordinator Consuhant Minnesota Mutual Help Resource Center Wilder Foundation c/o Community Care Unit 919 Lafond Avenue St. Paul, MN 55105 Maree G. Bullock Executive Director W. Clement and Jessie V. Stone Foundation 111 E. Wacker Drive, Suite 510 Chicago, IL 60601 Fran= Jemmott-Dory Executive Director New York City Self-Help clearinghouse, Inc. 1012 8th Avenue Brooklyn, NY 11215 Jean K. Elder, Ph.D. Assistant Secretary for Human Development Services U.S. Department of Health and Human services Room 309F 200 Independence Avenue S. W. Washington, DC 20201 Barbara E. Giloth Manager Patient Education American Hospital Association 840 North Lake Shore Drive Chicago, IL 60611 Hannah L. Hedrick, Ph.D. Director Information Analysis and Publications Division of Alhed Health American Medical Association 535 North Dearborn Street cbicago, IL 60610 Janet Heimich American Nurses Association 1101 14th street NW Washington, DC 20201 vii Mary Jean Houde Manager National Community Relations Sears Roebuck and Co. Sears Tower 40-08 Chicago, IL 60684 Heddy D. Hubbard, R.N., M.P.H. Program Analyst Division of Maternal and Child Health U.S. Public Health Service ParkIawn Building, Room 6-40 5600 Fishers Lane Rockville, MD 20857 Vince Hutchins, M.D. Maternal and Child Health Division Bureau of Health Care Delivery and Assistance U.S. Public Health Service Parklawn Building, Room 6-05 5600 Fishers Lane Rockville, MD 20857 Daryl H. Isenberg, Ph.D. Executive Director The Self-Help Center 1600 Dodge Avenue, Suite S-122 I Evanston, IL 60201 Gini Laurie Founder and Chairman International Polio Network 4502 Maryland Avenue St. Louis, MO 63108 Robert F. Lepp Program Director Psychosocial Services Courage Center 3915 Golden Valley Road Golden Valley, MN 55422 Rita A. McGaughey Director of External Affairs National Easter Seal Society 2023 W. Ogden Avenue Chicago, IL 60612 Carlos J.M. Martini, M.D. Vice-President Medical Education American Medical Association 535 North Dearborn Street Chicago, IL 60610 Mark M. Mayeda Deputy Director California Self-Help Center Psychology Department University of California 405 Hilgard Avenue Los Angeles, CA 90024 Leonore MilIer President SHARE, Inc. 68-37 Yellowstone Boulevard Forest His, NY 11375 Gladys W. Neu Widowed Persons Services American Association of Retired Persons 1313 Casa Verde Corpus C&i, TX 78411 Charles E. Roppel Chief Office of Prevention California Department of Mental He&h 2340 Irving Street, Suite 108 San Francisco, CA 94122 S. Denise Rouse Member, Board of Directors National Black Women's Health Project Department of Health and Human Services ParkIawn Building, Room 7A-30 5600 Fishers Lane RockvilIe, MD 20857 . . . Vlll Paul J. Scriffignano Executive Director International Association of Laryngectomees 49 Pleasant Avenue West Caldwell, NY 07006 Judith F. Sultan President Valley Parents Support Group 5641 Tobias Avenue Van Nuys, CA 91411 Helen G. Teisher Member, Board of Directors National Alliance of the Mentally Ill 5820 Yorkshire Avenue La Mesa, CA 92042 Laura P. Zeitlin Twelve Step Program 2214 Churchill Lane Highland Park, IL 60035 ix WORKSHOP AGENDA Opening Plenary Session Presiding: Heddy Hubbard, Workshop Project Officer, U.S. Public Health Service Greetings: Mark Mayeda, Chairman and Workshop Moderator, California Self-Help Center Jeanne Bradner, Director of the IIlinois Governor's Office of Voluntary Action Clifford L. Allenby, Secretary of the California Health and Welfare Agency Introduction of the Surgeon General Faye G. Abdellah, Deputy Surgeon General of the U.S. Public Health Service Keynote Address C. Everett Koop, M.D., D.&z., Surgeon General of the U.S. Public Health Service Panel Presentation Frances J. Dory, Moderator, New York City Self-Help Clearinghouse Panel Members: Leonore Miller, President of SHARE, Inc. Edward J. Madara, Director of the Self-Help Clearinghouse of St. Clares- Riverside Medical Center S. Denise Rouse, Member of the Board of Directors of the National Black Women's Health Project Irving K. ZoIa, Professor of Sociology, Brandeis University X CONTENTS Introduction Self-Help and Health Self-Help and Public Health: Steps Toward Partnership Chapter I Organization of the Surgeon General's Workshop on Self-Help and Public Health Chapter II Welcome and Charge to the Participants C. Everett Koop, M.D. Surgeon General of the U.S. Public Health Service Remarks of the Honorable James R. Thompson Governor bf Illinois Remarks of the Honorable George Deukmajian Governor of California Welcoming Address by the Workshop Moderator Mark Mayeda California Self-Help Center Who Was Invited Here-and Why Frances J. Dory Selection Subcommittee Member What Health Professionals Can Learn from Breast Cancer Patients Leonore Miller President of SHARE, Inc. The Role of Self-Help Clearinghouses Edward Madara Director, The Self-Help Clearinghouse St. Clares-Riverside Medical Center Self-Help for Health Professionals S. Denise Rouse National Black Women's Health Project The Politics of Self-Help Irving K. Zola Professor of Sociology Brandeis University xi 1 2 4 10 11 12 13 15 18 22 25 Chapter III Overview of the Workshop Process The Modified Delphi Technique Small-Group Deliberations Chapter IV Recommendations to the Surgeon General Chapter V The Surgeon General's Response Closing Remarks Appendix A Background Readings Appendix B Suggested Strategies for Implementing Workshop Recommendations Appendix C Participants in the Surgeon General's Workshop on Self-Help and Public Health 28 28 28 30 33 38 39 41 49 xii