Learn about Amoskeag Health's School-Based Health Centers, offering primary care and mental health services directly in Manchester schools. Our program includes nurse practitioners for on-site medical care and weekly mental health counseling, ensuring students' well-being and academic success. HEALTHCARE IN SCHOOLS Our goal is to meet children where they are for their health and wellness needs—that’s why we work with Manchester School District to deliver health care directly in the schools. ABOUT THE PROGRAM We provide weekly mental health counseling and mentorship to K-12 students in Manchester School District’s participating elementary, middle, and high schools. Each partnering school has a dedicated Community Health Worker (CHW) who can work with your family to assess your needs and help you connect with these services and any necessary supports outside of the school district. The School-based Counseling Program provides full mental health assessments and treatment planning with a goal to enhance the overall physical, emotional, and educational well-being of children. We continually foster opportunities to build strong and meaningful connections with their families, schools, and communities. We're fully integrated into the Manchester School District and its "Multi-Tiered System of Support for Behavioral Health and Wellness" (MTSS-B), which provides a comprehensive system of social, emotional, and behavioral supports to promote student wellness and improve engagement in learning . Through this integration and collaboration, the School-Based Counseling Program develops individualized treatment plans and provides interventions to support success. By working with the school district and incorporating elements of MTSS-B, school-based BHCs work within the school to promote improved behaviors and functioning for students in need of additional school support. School-Based Counseling Program HOW DOES THE PROGRAM WORK? Our Amoskeag Health school-based clinicians meet one-on-one with students weekly (for about 20-50 minutes, depending on the level of services required) to provide brief counseling, individualized support, and/or mentoring. They also help coordinate community resources to help students reach their goals, improve their mental health, and their overall health and well-being. Our clinicians stay in touch with Manchester School District! They work directly with the students’ teachers to schedule sessions around their classes. If it’s more convenient, our school-based clinicians can also meet with your child, at Amoskeag Health, summer programs, or via telehealth. The goal of this program is to follow your child through graduation, as research tells us that long-term, supportive relationships increase a child’s chance for success; however, the length of counseling treatment is ultimately based on the individual needs of each participant. THIS SOUNDS LIKE A GOOD FIT – NOW WHAT? Great! Students who want to be a part of the program do not need to be patients at Amoskeag Health, but they must obtain parental/guardian consent. If you would like your child to participate, please call 603-626-9500 and mention that you're interested in school-based counseling at your child's school. The representative will coordinate next steps with you. School-Based Vision Program Amoskeag Health’s Family Eye Care Center partners with Beech Street and Gossler Street Elementary Schools in the Manchester School District to provide eye care for students. Nurses complete a vision screening and refer students to our Eye Care Center for further care. We can offer services to students even if they don’t have a primary care provider at Amoskeag Health. A sliding fee scale is available to make our services affordable, transportation can be arranged if needed, and some students may qualify for free glasses. Our goal is to help every student see clearly, so they can do their best in school. Important Note About Insurance: If your child is currently enrolled in an insurance plan, the health plan will be billed for these services, and you might owe a co-pay or deductible depending on the plan’s benefits. If your child is not insured, Amoskeag Health can help you identify insurance options or determine a discounted fee using our income-based sliding fee scale.

IMPORTANT UPDATE At Amoskeag Health, we are committed to providing the best possible care for our patients while making strategic decisions for our future. As part of our commitment to improving and streamlining services, we will close our McGregor Street location on Friday, November 22, 2024. This closure is part of a temporary consolidation of our locations, as we look ahead to the future opening of the Mark Stebbins Community Center on the West Side of Manchester. McGregor Street Location Closure The McGregor Street site is our smallest location and has played an important role over the years. During the pandemic, it served as our only acute care site, allowing us to deliver essential services safely. However, since early 2023, McGregor has only been open part-time, focusing primarily on wellness visits due to its limited size. Since March 2020, many of our patients from the west side have been receiving their care at our three other locations on Hollis Street, Elm Street, and Tarrytown Road. These larger sites offer a wider range of services, allowing us to meet patient needs more effectively. The closure of McGregor will allow us to strengthen and focus our care at these larger facilities. Why Are We Closing McGregor? While McGregor is closing, this decision is part of a larger plan for the future. We are preparing for the development of the Mark Stebbins Community Center, which will provide expanded facilities and services with easy access for residents on the West Side. We are very excited about plans for the Mark Stebbins Community Center and the opportunities it will bring. Plans for the Future The McGregor Street location will close on Friday, November 22, 2024. As we approach the closure date, patients with appointments scheduled at McGregor will be contacted to reschedule their appointments at one of our other locations. Moving forward, all future appointments will also take place at these sites, where patients can continue to see their regular provider. If transportation to any of the three locations is a concern, we will help arrange transportation to ensure care remains uninterrupted. Next Steps for Patients Closing the McGregor site allows us to allocate resources more effectively and continue delivering comprehensive care at our larger locations. This decision supports our ongoing efforts to provide high-quality care and ensures the financial sustainability of our services as we prepare for the future. If you have any questions or concerns, please do not hesitate to contact us. You can reach us at (603) 626-9500. Thank you for your support as we work to strengthen integrated healthcare services to our community. Supporting Quality Care

Visit the Family Eye Care Center at Amoskeag Health for comprehensive eye care services. Our team offers eye exams, vision correction, and treatment for various eye conditions, ensuring the best care for your family’s eye health. FAMILY EYE CARE CENTER Optometry is health care related to your eyes and vision. It's important to have eye exams even if you don't have trouble reading signs or books. In some cases, an eye exam can be lifesaving. Did you know that some health conditions can be visible in your eye and caught by an optometrist (eye doctor)? Illnesses that can be detected during an eye exam include: Glaucoma (damage to the optic nerve) Potential stroke Diabetes High blood pressure Autoimmune diseases Sexually transmitted diseases Some cancers What is Optometry? At Amoskeag Health's Family Eye Care Center, we can see patients of any age. We will evaluate your eye and vision health and may r ecommend glasses. Please call 603-626-9500 to schedule an appointment. Types of Eye Exams Annual Eye exams can be performed on patients of all ages—even infants—to prevent permanent changes in vision. If needed, the patient may be referred to a specialist to provide further evaluation and testing. We can also fit patients for glasses right in our Family Eye Care Center! Annual Eye Exam These exams are for patients who have acute eye issues. These can be made for same-day or scheduled appointments based on conditions such as: infections, sudden changes in vision, or injuries – but not for glasses. Acute Eye Exam As part of a Diabetic Eye exam, you will have medicated eye drops used to widen your pupils. Using a special magnifying lens, the eye doctor will be able to view the entire inside of your eye, looking for any changes that might develop from Diabetes and other conditions. Diabetic Eye Exam

By: Laura Fry, MD January is Cervical Cancer Awareness Month! Many of you know me as the “queen of everything cervical,” so with that title, let’s dive into some information that might help all of us work together to prevent and treat this disease. Why Does Cervical Cancer Awareness Matter? Cervical cancer is a type of cancer that begins in the cells of the cervix, which is the lower part of the uterus that connects to the vagina. On a global scale, cervical cancer is the fourth most common cancer in women, with 604,000 new cases leading to 342,000 deaths annually. However, cervical cancer affects people around the world very differently. In 2020, almost 90% of the deaths occurred in countries with lower incomes due to delays in getting vaccines, screenings, and treatment. In the United States, there are about 11,500 new cervical cancer cases per year and 4,000 deaths linked to this cancer. Cervical cancer usually develops slowly over many years. Early signs of cervical cancer include abnormal changes in the cells of the cervix, which is not noticeable from the outside. However, these changes can be detected through tests at your doctor’s office. If abnormal cells are left untreated, they can progress to become cancerous. So, it’s important to be seen regularly by someone like me! What Causes Cervical Cancer? Nearly 100% of cervical cancer cases are caused by the Human Papilloma Virus (HPV), mostly through sexual intercourse. HPV has many subtypes, and over 11 of them are considered “high risk” types. Globally, about 40% of women were unaware that HPV causes most cervical cancers. Can Cervical Cancer Be Prevented? YES! Primary prevention (preventing a disease before it occurs) can be done through HPV vaccines. These vaccines are given in the US to girls and boys preferably before the age of 15. Two doses are recommended. Secondary Prevention (identifying disease at its earlies stages) is done through a pap test and HPV testing. Testing should start at age 21 and be done every three years, with HPV added at age 30 and repeated every 5 years for women who do not test positive. Paps and HPV testing can detect pre-cancerous conditions, which can often be treated easily and can prevent progression to invasive cervical cancer. WHO’s Global Efforts to Reduce Cervical Cancer There is a global campaign from the World Health Organization (WHO) called “90-70-90” by the year 2030. This campaign has three goals: 90% of girls worldwide will be vaccinated against HPV by age 15. 70% of women will have been screened by a high-quality screening method at age 35 and 45. 90% of women with invasive or pre-invasive disease will receive treatment. Now, What Can You Do to Protect Yourself and Your Family from Cervical Cancer? If you have not been vaccinated and are below the age of 24 – GET IT DONE! There are some situations in which you can be vaccinated later than age 24. Talk to your provider at your next appointment about your options. Make sure your children are vaccinated. There are lots of parents who don’t think it’s needed, or they think that giving the vaccine will give their children permission to start having sex younger. This has been proven NOT to be the case! Get screening done for yourself if you’re assigned female at birth. Talk to any of the providers or nurses here at Amoskeag Health if you have questions. Spread the news and help us dispel myths and misinformation about vaccines, screenings, and treatment. Think about it this way: we have a cancer that is very effectively prevented through a vaccine! How cool is that? Let’s eliminate cancer one cervix at a time! If you’re interested in the HPV vaccine or are overdue for a screening, we can help! To schedule an appointment with an Amoskeag Health provider, please call 603-626-9500.

By: Katherine-Starr Goodwin Managing blood sugar levels is very important for overall health, especially for those with diabetes. The Glycemic Index (GI) is a valuable tool that helps us choose foods wisely to keep blood sugar stable. Here’s how you can use the Glycemic Index, along with portion control, to make healthier choices. What is the Glycemic Index (GI)? The Glycemic Index ranks foods based on how quickly they raise blood sugar levels. Foods with a high GI (70 or more) cause a rapid spike in blood sugar, while those with a low GI (55 or less) cause a slower, more gradual rise. Using the Glycemic Index to Make Better Choices: Green (Go): Choose low GI foods (55 or less) most often. These include items like whole grains, legumes, and many fruits. See a list of low Glycemic Index foods here. Yellow (Caution): Moderate GI foods (56 to 69) should be eaten less frequently. These include some fruits, whole wheat products, and couscous. See a list of moderate Glycemic Index foods here. Red (Stop and think): High GI foods (70 or more) should be limited. These include white bread, sugary cereals, and some types of potatoes. See a list of high Glycemic Index foods here. By opting for more foods with a lower GI, you can help manage blood sugar levels more effectively, reducing the risk of complications from diabetes and promoting better weight management. Portion Control and Diabetes Management Watching portion sizes can help manage diabetes. We suggest a balanced approach to portioning meals: Fill half your plate with vegetables and fruits: Choose more vegetables than fruits, as most vegetables have less sugar. This helps control calorie intake and provides essential nutrients. Divide the other half of your plate: Distribute this portion between protein-rich foods and whole grains. Examples include lean meats, fish, beans, whole wheat pasta, and brown rice. Combining GI and Portion Control Understanding the Glycemic Index and practicing portion control can significantly impact your health outcomes, particularly if you have diabetes or are aiming for better overall well-being. By choosing low GI foods and controlling portion sizes, you can better manage blood sugar levels, support weight loss efforts, and improve your overall health. Remember, consult with a healthcare professional or Registered Dietitian to tailor these principles to your individual needs and health goals. Each small step towards healthier eating habits contributes to a more balanced and fulfilling lifestyle. Low Glycemic Index (55 or less) Foods. Choose these most often! Grains and Starches Breads: Heavy Mixed Grain Breads Spelt Bread Sourdough Bread Tortilla (Whole Grain) Cereal: All-Bran™ Cereal Oat Bran Oats (Steel Cut) Grains: Barley Bulgur Mung Bean Noodles Pasta (Al Dente, Firm) Pulse Flours Quinoa Rice (Converted, Parboiled) Other: Peas* Popcorn Sweet Potato* Winter Squash* *Most starchy/sweet vegetables (e.g. peas, parsnip, winter squash) provide 15 g or more carbohydrate per 1 cup serving Fruits Apple Apricot (Fresh, Dried) Banana (Green, Unripe) Berries Cantaloupe Grapefruit Honeydew Melon Mango Orange Peach Pear Plum Pomegranate Prunes Milk and Milk Alternatives Almond Milk Cow Milk (Skim, 1%, 2%, Whole) Frozen Yogurt (An occasional food) Greek Yogurt Soy Milk Yogurt (Skim, 1%, 2%, Whole) * Milk, alternatives, and other beverages listed include flavored (e.g. chocolate), sweetened and unsweetened varieties Meat and Alternatives Baked Beans Chickpeas Kidney Beans Lentils Mung Beans Romano Beans Soybeans/Edamame Split Peas * Poultry and fish do not have a GI because they do not contain carbohydrates Moderate Glycemic Index (56 to 69) Foods. Choose LESS often! Grains and Starches Breads: Chapati (White, Whole Wheat) Flaxseed/Linseed Bread Pita Bread (White, Whole Wheat) Pumpernickel Bread Roti (White, Whole Wheat) Rye Bread (Light, Dark, Whole Grain) Stone Ground Whole Wheat Bread Whole Grain Wheat Bread Cereal: Cream of Wheat™ (Regular) Oats (Instant) Oats (Large Flake) Oats (Quick) Grains: Basmati Rice Brown Rice Cornmeal Couscous (Regular, Whole Wheat) Rice Noodles White Rice (Short, Long Grain) Wild Rice Other: Beets Corn French Fries (An occasional food) Parsnip Potato (Red, White, Cooled) Rye Crisp Crackers Fruits Banana (Ripe, Yellow) Cherries (Bottled) Cherries (Fresh) Cranberries (Dried) Figs (Fresh, Dried) Grapes Kiwi Lychee Pineapple Raisins Meat and Alternatives Lentil Soup (ready-made) Split Pea Soup (ready-made) *Poultry and fish do not have a GI because they do not contain carbohydrates High Glycemic Index (70 or more) Foods. Choose LEAST often! Grains and Starches Breads: Bread (White, Whole Wheat) Naan (White, Whole Wheat) Cereal: All-Bran Flakes™ Cereal Corn Flakes™ Cereal Cream of Wheat™ (Instant) Puffed Wheat Cereal Rice Krispies™ Cereal Special K™ Cereal Grains: Jasmine Rice Millet Sticky Rice White Rice (Instant) Other: Carrots Potato (Instant Mashed) Potato (Red, White, Hot) Pretzels Rice Cakes Soda Crackers Fruits Banana (Brown, Overripe) Watermelon Milk and Milk Alternatives Rice Milk *Milk, alternatives, and other beverages listed include flavored (e.g. chocolate), sweetened and unsweetened varieties Want to learn more to help manage your blood sugar and feel your best? Schedule an appointment with an Amoskeag Health provider today by calling 603-626-9500.

Colorectal cancer is the second most common cancer that affects both men and women. With routine screening and early detection, we are able to significantly reduce the risk that you might develop colorectal cancer in the future. New Recommendations for Screening New guidelines recommend starting colorectal cancer screening at 45 years old. If you’re 45 or older and have not been screened or referred for screening, talk to your healthcare provider about one of several screening options. Screening Options There are several screening tests available, a couple of which are painless and non-invasive. Depending on your insurance status, family history or other risk factors, one of these tests may be appropriate for you. Fecal Immunochemical Test (FIT): Collect a stool sample at home and it will be evaluated for blood which could be indicative of cancer. This test is good for a year. Cologuard® Multi-Targeted Stool DNA Test: Collect a stool sample at home to check for cancer-related DNA changes and blood. This test is good for three years. Colonoscopy: A gastroenterologist uses a camera to examine the colon and rectum for polyps and cancer and is able to biopsy any polyps or changes that are found during the procedure. If normal, this may be sufficient for ten years. Symptoms to Watch For Be aware of these potential symptoms of colorectal cancer: Unexplained abdominal pains Blood in your stool Changes in bowel habits Unexplained weight loss If you are currently experiencing any of these symptoms, please contact your healthcare provider immediately. Don’t Wait for Symptoms Don’t wait for symptoms before getting screened. By the time symptoms appear, cancer may be more advanced and harder to treat. Routine screening can catch problems early, potentially preventing cancer and if found it may be more treatable. Take Action Don't wait, get screened! Is it time to schedule your colorectal screening? Schedule an appointment with an Amoskeag Health provider by calling 603-626-9500.