Partnerships | CRI Life Enhancement Program |
CRI LEP at Urban Health Plan in the South Bronx, NY

The Life Enhancement Program (LEP) originated at Canyon Ranch more than 20 years ago as a dynamic program designed to help people achieve optimal health and joyful living through commitment and long-term change.

In January 2007, Canyon Ranch Institute (CRI) pledged 10 scholarships for Urban Health Plan (UHP) health and wellness professionals to attend the Canyon Ranch Life Enhancement Program. After experiencing the Canyon Ranch LEP in Tucson, Arizona, the UHP professionals shared their feedback about what they learned. They shared with CRI that the best practices of Canyon Ranch could be translated in a culturally competent manner to the UHP patient population through the establishment of a CRI LEP at UHP. This idea launched the development of the first CRI LEP.

UHP is recognized as a premier community health center, serving over 27,000 patients in the South Bronx, New York.

The Urban Health Plan, Inc. Health & Wellness Center, in Partnership with Canyon Ranch Institute — El Centro de Salud y Bienestar, en Cooperación con Canyon Ranch Institute
As participation is a central value of the CRI approach to partnership, a participatory planning process involving CRI staff, UHP staff, and LEP participants identified the need and design for a wellness space at UHP.

By involving staff and participants in an iterative design process, UHP and CRI remodeled a 20-by-40-foot room at UHP that had been used for multiple purposes by UHP patients and staff. That multi-purpose room was redesigned into a wellness space that is the ideal setting for UHP patients to experience the LEP. The wellness center includes state-of-the-art fitness equipment; as well as space and equipment for yoga, meditation, and relaxation.

CRI and UHP celebrated the opening of the Health & Wellness Center with a ribbon cutting ceremony on October 29, 2009.

Learn more about the event

Program Launch
At the initial launch of the first class, more UHP patients arrived ready to participate in the CRI LEP at UHP than were initially recruited, reflecting the continuing high levels of interest in this integrative health and wellness program.

Starting June 16, 2009, UHP health professionals – including a physician, nutritionist, physical therapist, social worker, registered nurse, and pastor – facilitated the CRI LEP curriculum and program sessions with participants through informational lectures, group fitness and stress-management activities, a grocery-shopping excursion, and numerous planning sessions for setting health-related goals. The CRI LEP at UHP occurred two mornings per week for six weeks in the newly designed CRI LEP Wellness Center at UHP.

What’s Happening Today
Four classes have graduated from the six-week CRI LEP at UHP program, which is taught in both Spanish and English. Three classes took place in 2009, and the most recent class graduated on July 8, 2010. The all-women fourth class called themselves Las Dinamicas, which in Spanish means “the dynamic ladies.” Participants reported experiencing a number of healthy changes, including socializing more, exercising at home, feeling less pain, increased ability to manage stress, relaxing and meditating, eating healthier foods and healthier portions, and feeling less depressed.

Evaluation
The CRI LEP at UHP Demonstration Project is being evaluated in two important areas:

1. Whether the CRI LEP helped participants to learn about ways to become healthier, make changes in health-related behaviors, and become healthier in measurable ways (outcome evaluation) and
2. The CRI LEP’s strengths and challenges, with the goal of improving the experience and outcomes for future participants (process evaluation).

CRI team member Rainy Dawn Warf, M.P.H., CHES was on hand at UHP during the final week of each of the classes to facilitate focus group and individual conversations that engaged the CRI LEP at UHP participants and the core team in the further refinement of the program content and materials for future CRI LEP classes.

CRI is still interpolating data from the most recent classes, however, data from the first class of 17 participants shows that participants lost weight, are less depressed, and increased their health literacy. While CRI’s analysis of the data is ongoing, early data revealed:

• Participants lost an average of 3.37 pounds, with the highest individual weight loss of 11 pounds.
• Using the validated PHQ-9 depression screening scale (0-28 points possible), participants’ scores dropped 6.1 points on average, indicating a reduction in depression.
• Participants experienced an average drop in blood pressure of 7.8/2.3 mm Hg. For participants with hypertension or in the pre-hypertensive range before the program started, the average drop in blood pressure was 12/7.5 mm Hg.
• Qualitative analysis revealed that participants developed the desire and abilities to learn more about their health – the program increased their health literacy.

Throughout the program evaluation process, CRI is collaborating with a team at the Canyon Ranch Center for Health Promotion and Prevention, located within the University of Arizona’s Mel and Enid Zuckerman College of Public Health. This team is supporting CRI and UHP to ensure integrated planning, data collection, and data analysis. These evaluation results will help CRI and future partners to adapt the CRI LEP to other health care organizations and the communities they serve.

Potential next steps: Our evaluation of the CRI LEP at UHP Demonstration Project will inform the expansion of the partnership to include additional CRI LEP classes at UHP, as well as the addition of other partners and sites in order to reach more underserved communities who could benefit from an integrated approach to health and wellness. The CRI LEP at UHP experience will help inform design of an approach that allows adapting programming to the local community while maintaining the core elements of the CRI LEP.

CRI Receives Bronx Spirit Award from Urban Health Plan
CRI was honored with the Bronx Spirit Award from UHP on October 29, 2009. The award recognizes individuals or organizations that help to enhance the health and well-being of UHP patients and the Bronx community. The award was presented to CRI during an event celebrating the 35th anniversary of UHP and 80th birthday of UHP Founder Richard Izquierdo, M.D.

The first cohort of 17 CRI LEP at UHP participants graduated on July, 23. 2009. Participants and staff marked the occasion with dancing, cheering, and heartfelt testimonials about the value and positive impacts of the program. (July 23, 2009, South Bronx, New York, © 2009 Canyon Ranch Institute)

The Urban Health Plan, Inc. Health & Wellness Center, in partnership with Canyon Ranch Institute — El Centro de Salud y Bienestar, en cooperación con Canyon Ranch Institute, opened on June 16, 2009. The wellness center was designed to be the ideal setting for Urban Health Plan participants to experience the Canyon Ranch Institute Life Enhancement Program. The wellness center includes state-of-the-art fitness equipment, as well as space and equipment for yoga, meditation, and relaxation. (Photo of sign: November 12, 2009, South Bronx, NY, © 2009 Canyon Ranch Institute, photographer Andrew Pleasant. Photo of Health & Wellness Center: June 18, 2009, South Bronx, New York, © 2009 Canyon Ranch Institute, Andrew Pleasant photographer)

As part of the Canyon Ranch Institute Life Enhancement Program (CRI LEP), participants have the opportunity to participate in physical activity that they can include in their daily lives. Additionally, a licensed personal trainer (pictured) provides CRI LEP participants with direct instruction about how to use the fitness equipment in the wellness center at UHP. (June 18, 2009, South Bronx, New York, © 2009 Canyon Ranch Institute, Andrew Pleasant photographer)

During the Canyon Ranch Institute Life Enhancement Program, participants experience healthy eating firsthand. The curriculum also includes a group discussion led by a nutritionist (pictured). The discussion focuses on the many benefits of healthy eating, as well as affordable and fun ways to make healthy food choices (June 18, 2009, South Bronx, New York, © 2009 Canyon Ranch Institute, Andrew Pleasant photographer)

During the Canyon Ranch Institute Life Enhancement Program at Urban Health Plan (UHP), participants and health professionals are engaged in learning about integrative health and wellness. Participants experience group and individual sessions focused on healthy eating, physical activity, and stress-management. The group structure encourages participants and UHP health professionals to support each other in setting and meeting health-related goals. (June 18, 2009, South Bronx, New York, © 2009 Canyon Ranch Institute, Andrew Pleasant photographer)

• Click here to read about the CRI LEP at UHP poster presented by CRI at the Annual Meeting and Exposition of the American Public Health Association.
• Click here to read the CRI-UHP October 29, 2009 press release detailing the opening of the UHP Health & Wellness Center.
• Click here to read the January 23, 2007 CRI press release detailing CRI's scholarship pledge to UHP.
• Click here to visit the Urban Health Plan website.