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Connecting the RtI Process to Public Health
The Department of Health implemented a campaign to educate the public on strategies to maintain a healthy lifestyle. A local health clinic wants to identify the most frequent health concerns expressed by its patients. Analyzing initial complaints from patients, the clinic discovers that a good portion of their patients frequently experience cold and flu symptoms. Instead of meeting with each patient separately and developing an individualized plan, the clinic targets those patients’ needs all at once by providing a group-oriented intervention (a Tier 2 intervention). The clinic decides to share brochures on how to prevent spreading germs (e.g., washing hands frequently, covering mouth when coughing), passes out free hand sanitizer to those patients and to community venues (e.g., local grocery stores, coffee shops), and provides an on-call nurse to field questions for those individuals who have cold symptoms. In this scenario, the clinic analyzed common areas of need at the group level among its patients needing “Tier 2,” without investing major resources in analyzing individual patients’ complaints.
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Some patients are still sick. Now what?
At Tier 3, the clinic would focus on one particular patient. Imagine that one patient has a recurring cough and the typical “first line” of treatment (the Tier 2 example described above) did not work. From there, the clinic may draw blood to pinpoint a more aggressive approach. The clinic may also conduct an interview with the patient, asking questions about the patient’s day-to-day activities, and observe the patient taking deep breaths. The results of such a diagnostic evaluation would inform the doctors about the individualized course of action to take. In our case, the patient with a recurring cough had a bacterial infection. Low and behold, a round of intense antibiotics has gotten this patient back to full health. With RTI, the goal is similar: to get students back to full educational health.