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WACO, Texas (April XX, 2023) – Healthcare systems are beginning to engage with social and relational supports through trained community-based volunteers to address issues impacting the health of the communities they serve, according to a preliminary study of a unique partnership between The MetroHealth System and an organization called Open Table, a relational capital training program, by Baylor University’s Program on Prosocial Behavior released today.
Scholars from the Baylor University conducted a case study evaluation of the MetroHealth/Open Table collaboration program in Cleveland, Ohio involving the recruitment and engagement of close to 150 community-based volunteers, a third of which were MetroHealth employees, providing social and relational support to patients and others referred to the program based on the health risks of social isolation and other social determinants of health. The case study involved interviewing MetroHealth and Open Table staff, community volunteers, and the individuals and young families they served.
This case study is published through Baylor’s Institute for the Studies of Religion (https://www.baylorisr.org/publications/case-studies/).
“The Open Table program worked with MetroHealth to train community-based volunteers to provide relational and social supports through weekly meetings with individuals referred to the program facing a variety of needs and challenges for themselves and their children” said Byron Johnson, Ph.D., Distinguished Professor of Social Sciences and founding director of Baylor’s Institute for Studies of Religion. “This is accomplished not through social workers or health clinics, but instead through the development of familial-type relationships, something that is often in scarce supply for these individuals.”
“What this case study evaluation helped us to discover is a way for healthcare systems such as MetroHealth to engage those in need within the very communities they serve in a less clinical, episodic fashion, by helping to recruit and train volunteers to give of themselves in a more personal and direct manner. MetroHealth, in partnership with Open Table, has taken this model and customized the intensive training process to help volunteers seeking this type of opportunity in areas such as active listening and supporting an individual’s need to develop their own life plan.”
MetroHealth, through its Institute for H.O.P.E., maintains a strong commitment to identifying and addressing the social drivers of health through a comprehensive, coordinated approach. According to Karen Cook, Director, Healthy Families & Thriving Communities, “The partnership with Open Table has provided us with a model that brings our employees and community members into circles of support with patients who are experiencing poverty and other life challenges. The power of relationship is critical to the positive life changes that result.”
MetroHealth was founded in 1837 and was originally referred to as City Hospital, with a primary focus on the city’s population experiencing poverty. Since 2013, MetroHealth has been working toward a goal of transforming how and where healthcare services are delivered. Health system leadership recognized the critical importance of providing health care before people became sick, considering a whole person approach that looked at more than just a patient’s medical condition but also considered a variety of factors that impact a person’s health.
Open Table is a unique mutual support model, established in 2005, whereby trained volunteers, identified as Table Members, come alongside a family or individual in need, referred to as a Friend.[1] By giving of themselves relationally, Table Members invest themselves in the lives of Friends. Table Members commit to meeting once a week for a year with their Friend, providing support by helping them develop and implement their own plan, with the Table Members ‘tapping into’ their own social networks in support of that plan.
In this Q&A, co-authors Johnson and ISR non-resident fellow William Wubbenhorst explain the unique and distinct elements of Open Table they discovered through the case study development.
Q: How are Open Table engagements different from how these individuals are currently served and supported through healthcare providers such as MetroHealth?
Wubbenhorst: The MetroHealth/Open Table collaboration is, in part, based on the growing interest of, and research into, so-called social determinants of health (SDOH), which refer to conditions in which people live and work that have an impact on their physical and mental health. The increased attention on SDOH is part of a shift in the healthcare system from a medical model, whereby health services is in a reactive mode, with a focus on serving sick patients, to a population health/public health model, characterized by a more proactive approach that seeks to address factors that negatively impact health through non-health factors.
Open Table Members have the opportunity to engage their ‘Friends’ in a more personal and consistent manner than is possible for healthcare providers, who often deal with large patient caseloads, and tend to be limited in their ability to personally engage with those they are serving.
Q: What kind of outcomes and impact did you observe from the eight participating Table ‘Friends’ included in your study a year later?
Wubbenhorst: The unique nature of the Open Table Model, in which the Friend being served specifies the particular outcomes (e.g., housing, employment, etc.) for their Table, is a particular challenge for evaluation purposes. In the future, when the MetroHealth/Open Table initiative has a larger sampling of Table Friends served, it will be possible to conduct a more rigorous evaluation to capture some of the longer-term impacts of Table interventions in a more quantitative fashion.
Based on previous research on similar Open Table initiatives, there was an estimated $915,806 in future public program costs avoided and additional tax revenues generated through increased lifetime earnings. Compared to an estimated annual cost of $44,300 for Open Table implementation and administration, this results in an estimated ROI of $20.07 for every $1.00 invested in the Open Table program.
Q: Will you do future research related directly to social support programs like Open Table?
JOHNSON: Yes, we hope to revisit MetroHealth and other Open Table partnerships with healthcare providers, insurers and family medical practices, to determine whether there are any correlations between patient participation in an Open Table and reduced health costs. People need people, and those lacking in social capital gain friends and a sort of family with their Table Members and, we believe, also experience better health outcomes as a result.
ABOUT THE INSTITUTE FOR STUDIES OF RELIGION
Launched in August 2004, The Baylor Institute for Studies of Religion (ISR) exists to initiate, support, and conduct research on religion, involving scholars and projects spanning the intellectual spectrum: history, psychology, sociology, economics, anthropology, political science, philosophy, epidemiology, theology, and religious studies. Our mandate extends to all religions, everywhere, and throughout history. It also embraces the study of religious effects on such things as prosocial behavior, family life, population health, economic development, and social conflict. While always striving for appropriate scientific objectivity, our scholars treat religion with the respect that sacred matters require and deserve.
ABOUT BAYLOR UNIVERSITY
Baylor University is a private Christian University and a nationally ranked research institution. The University provides a vibrant campus community for more than 18,000 students by blending interdisciplinary research with an international reputation for educational excellence and a faculty commitment to teaching and scholarship. Chartered in 1845 by the Republic of Texas through efforts of Baptist pioneers, Baylor is the oldest continually operating University in Texas. Located in Waco, Baylor welcomes students from all 50 states and more than 90 countries to study a broad range of degrees among its 12 nationally recognized academic divisions.
[1] In some instances, Friends are referred to as ‘Brother’ or ‘Sister’.
