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Two Rivers’ patients participate in doctoral research study on stroke-risk reduction
Two Rivers  ribbon cutting
In this file photo from June celebrating the official opening of the Two Rivers Health Clinic are, from left: Rep. Buddy Carter, Dr. Frances Decker, Vicki Renfroe, RN; and Dr. Amber Fordham, executive director of Two Rivers Health Clinic. (Barbara Augsdorfer/Effingham Herald.)

By Barbara Augsdorfer, Editor for the Effingham Herald

Two Rivers Health Clinic serves a population that generally “falls through the cracks” – people between the ages of 18-64, the “working poor” who may work minimum-wage jobs and who may be uninsured or underinsured.

After several years of operating in doctors’ offices after hours, the clinic recently opened its own facility and continues to serve this population with free health screenings and medication.

It also helped a doctoral student complete research and earn her doctor of nursing practice (DNP) degree.

Dr. Sequoyah Brown worked as a volunteer nurse practitioner with Two Rivers in 2016-2017. When she decided to go back to school to earn the DNP, she found she could obtain grants to fund her research, which also benefitted the clinic.

She recalls talking with Dr. Frances Decker -- who also volunteers at the clinic -- about going back to school for her doctorate, but it was just an idea at the time.

“Dr. Decker and I got along really well,” Dr. Brown said. “I said, ‘Hey, I’m thinking about going back to school and that’s going to require research and that may get some grant funding going on. Keep me in mind for later.”

Later came in 2020, and Dr. Brown recalls her conversation with Dr. Decker, “I don’t know if you remember this conversation, and she said, ‘We’re in absolutely,’ and it went from there.”

Sequoyah Brown, DNP
Dr. Sequoyah Brown
Dr. Brown’s research centered about stroke reduction in Two Rivers’ patients, noting that the various factors in the patient population – tobacco use, diabetes, being overweight, high blood pressure – all contributed to a higher likelihood of experiencing a stroke. By helping patients reduce or quit tobacco use, make healthier food choices, and exercise more, her research showed a reduction in hypertension (blood pressure), and thus, stroke risk, in the patients.

“We did what we call a chart audit, (which) is basically assessing the gap that exists in healthcare,” Dr. Brown explained. “We tailored the research around stroke-risk reduction. How can we prevent stroke? We decided to prevent stroke by targeting all of those things individually.”

Her initial audit identified 100% of the patients were at risk for a stroke. And nearly 42% of them had stage 2 hypertension. “The way to attack all those elements for stroke-risk reduction was through lifestyle changes, which were initiated and followed for 90 days,” she said.

At the end of those 90 days, “We had improvement all around,” Dr. Brown explained. “(We had) blood pressure reduction. We had weight reduction. We had better lab numbers. We had folks who stopped smoking. We had weight loss (that) was probably the most significant part of it because some of the interventions were physical in nature.

“Teaching people how to eat better. Folks were educated on how to do that. We talked about recipes and sharing information and that was absolutely wonderful,” Dr. Brown said. The participants were enthusiastic about their progress and would come in to get weighed even if they didn’t have an appointment.

“We would do BMI (body mass index) measurements and say, ‘All right, your BMI is down. Keep up the good work!’” Dr. Brown added.

Additionally, Dr. Brown reported 98% of “My Healthy Plate” participants demonstrated healthy portion control, “Race Against the Risks” participants collectively walked nearly 282 miles. “Results validated the relationship between interventions and blood pressure reduction,” Dr. Brown wrote in her dissertation.

Dr. Brown added her praise for the Two Rivers staff – volunteers who give of themselves to serve a vulnerable population, especially Dr. Decker.

“Indigent care is not for the faint of heart and (Dr. Decker) has been there and she treats them like human beings,” Dr. Brown said. “These are people and they're not being treated like people. They don't have very many other options (and) they deal with it. Dr. Decker exhibited such humanity on a daily basis. It was just amazing, and that's why her patients love her.”

Dr. Brown completed her DNP at Frontier Nursing University in Versailles, Kentucky, in 2021. Now she works in occupational medicine at International Paper in Savannah.

Donations are always welcome for Two Rivers Health Clinic, and Effingham County residents age 18-64 who meet federal poverty-level guidelines are encouraged to apply as patients. For more information, click on their website at: