Curriculum emphasizes natural supports

Discussing our bodies and our sexuality with strangers in the medical profession can be difficult for anyone. For women with developmental disabilities, it can be even harder.

But with the help of a new curriculum and respectful training, women with disabilities in Montana are learning to talk about their reproductive health and benefit from medical practices that could save their lives.

“Being so uncomfortable with their bodies and sexuality, we have a hard time moving forward, practicing and talking about the subject,” said Angel Nordquist, outreach educator for Planned Parenthood of Montana, one of two groups that has adopted the Women Be Healthy curriculum developed by the University of North Carolina and in use across the United States. The curriculum has been taught in a series of workshops in Montana.

Lessons in the curriculum address the fear and anxiety associated with receiving reproductive screenings and other healthcare visits, as well as techniques of advocating for oneself in a healthcare setting through assertiveness training,” Nordquist said.

The first step, however, is getting women to feel comfortable talking about their bodies.

“The evaluations women completed after the workshops indicate that women are often uncomfortable talking about their bodies,” Nordquist said. “So, this workshop may be the first time they’ve had the opportunity to talk about their bodies and reproductive health.”

The Montana Disability and Health (MTDH) program has copies of the facilitator curriculum available to those who have been trained by a master trainer to facilitate the workshops, said Tracy Boehm, Living Well Coordinator Research and Training Center on Disability in Rural Communities at the The University of Montana Rural Institute: Center for Excellence in Disability Education, Research and Services in Missoula.

“MTDH does not currently have the capacity to support the implementation of WBH monetarily, so our partners have agreed to implement the program within their capacity,” Boehm said. For example, she said, Planned Parenthood of Montana has an agreement with Special Friends Advocates in Kalispell to provide technical assistance to conduct workshops in that community.

Facilitators who were trained at a 2008 master training at the University of Montana teach the curriculum.

Currently, Planned Parenthood staff in Missoula and Great Falls, as well as Bridger Clinic in Bozeman, have facilitators. Special Friends Advocates in Kalispell has two staff trained by a previous Planned Parenthood master trainer. Targeted participants are adult women age 18 and older with intellectual and developmental disabilities.

The course lasts eight weeks or longer, depending on how it needs to be structured to meet the needs of participants.

The Women Be Healthy curriculum enables women with developmental disabilities to become more active participants in their health care. Its primary emphasis is on early detection of breast and cervical cancer. Initially, Women Be Healthy was designed for women who had difficulty with gynecological and breast examinations or who had never had an exam.

It was immediately apparent, however, that the topics covered were relevant to any woman interested in increasing her knowledge about and becoming more comfortable with women’s health issues. The curriculum focuses on three components to help women become better health advocates:

1. Health Education
Women learn about general health concerns, their bodies, hygiene, breast self-examinations, as well as the procedures of a gynecological exam and mammogram. Facilitators educate the women through verbal instruction, pictures, video, and hands-on experience.

2. Anxiety Reduction
Anxiety about visiting the doctor is reduced through progressive exposure to the medical exam instruments, procedures, and setting. In addition, women exchange and learn effective ways of coping with mild discomfort or pain that they might experience during a gynecological exam. Relaxation techniques are practiced throughout the curriculum.

3. Assertiveness and Empowerment Training
Women are given the opportunity to role-play various women’s health situations in which they must assert themselves (e.g., asking the doctor a health-related question, describing their symptoms to a trusted person). In this manner, they gain confidence and learn to identify health-related problems and possible solutions to those problems.

The curriculum places emphasis on the importance of natural supports for women with developmental disabilities.

Therefore, women with disabilities are encouraged to attend group meetings with a female staff or family member. In addition to providing support during group meetings, these people serve an essential role in helping the women practice the skills learned within sessions.

Any female advocate who is comfortable being part of the group and who understand issues of confidentiality can be a valuable support so long as they are involved on a regular basis with the woman they support. Most importantly, the same support people should consistently attend each week as sensitive topics are discussed and group members need to feel that they are in a safe and confidential environment.

For more information on Women Be Healthy, contact the partners listed in the box above, or Tracy Boehm, program coordinator, program coordinator 406/243-5741; or boehm@ruralinstitute.umt.edu.

Women Be Healthy Partners
Contact these agencies for Women Be Health workshop schedules

Planned Parenthood of Montana
211 9th Street South
Great Falls, MT 59405
(P) 406/454-3432
(F) 406/454-3433
Jill Baker, Education Director
Jill.Baker@ppmontana.org

Planned Parenthood of Montana
219 East Main Street
Missoula, MT 59802
(P) 406/728-5490
(F) 406/728-5497
Angel Nordquist, Outreach Educator
Angel.Nordquist@ppmontana.org

Bridger Clinic, Inc.
300 N. Willson, Suite 2001
Bozeman MT 59715
406/587-0681 ext. 13
Laura Mentch, Health Educator
lauramentch@qwestoffice.net
laura@creekfarm.net

Special Friends Advocacy
313 2nd Ave W
Kalispell, Montana 59901
406/756-5488

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