Through a song-filled puppet show, Susan Lee's Senior Innovative group helped teach toddlers about diabetes.

Each year, senior nursing students at Emory are required to do something no other student at the university is: complete a community service project as a prerequisite for graduation. Working in small groups with a modest $150 budget, they are asked to identify the health needs of a specific group and then address those needs through the planning, implementation, and evaluation of a community-based Senior Innovative Project.

"In addition to helping people in the community," says faculty coordinator Darla Ura, "students learn to develop a proposal, construct a budget, and write an abstract," skills that will be vital to their success in the workplace and in graduate school.

This year's projects, 27 in all, range from educating elderly Russian immigrants about hypertension to encouraging low-income mothers to breast-feed their babies--from helping senior citizens understand how foods interact with drugs to preventing teenage suicide.

Here's a look at three of this year's projects.

This is the way we wash our hands

For their Senior Innovative Project, Lilabet Choate, Susan Eldred, Marjorie Dunne, Rochelle Mack, and Lois Wright took a "hands-on" approach to hygiene. As a result, kids at Winnona Park Elementary School in Decatur are scrubbing their hands a little longer and more often these days.

"We talked to 10- and 11-year-olds in two fifth-grade classes about the difference between transient and resident microorganisms," says Choate, "about how germs get from your hands to your mouth and how washing your hands gets rid of most of those germs. We demonstrated what we were talking about by culturing bacteria from their hands."

The children were asked to swab their dirty hands and under their fingernails and put the material on an agar plate. The kids were then taken to the school restrooms and taught how to properly cleanse their hands--wetting them first, scrubbing for ten seconds with soap, drying with paper towels, and turning the water off with a paper towel.

"They all walked back to the room holding up their hands like surgeons," Choate recalls with a laugh. "Then we recultured their clean hands."

Two days later, the Emory students returned with the two culture plates so the youngsters could compare the difference in bacteria growth between the "clean" and "dirty" cultures. The nursing students also showed the children a culture made from school restroom faucets.

"We were able to get E. coli from the faucets. That gave us an opportunity to discuss with the kids how bacteria get on their hands when they wipe their bodies and how, if they touch the faucet after washing, it goes right back on their hands and into their mouths," says Choate. "There were a lot of 'yucks!' and 'that's gross!' but we certainly got the message across."

Using puppets to teach poppets

They looked like examples of carefree childhood fun--lively, colorful puppets ready for a song-filled show. But there was a serious mission behind all the fun, a Senior Innovative Project designed by Jennifer Capell, Susan Lee, and Laura Leidel to help educate 3- to 5-year old patients at the diabetes clinic at Egleston Children's Hospital.

"This is a hard age group to reach, but we think early education about their disease is important," says Lee. "We felt the best way to reach these kids was to use something fun, like our puppets, and songs they can identify with."

Among the characters they invented was a large arm puppet with explosively curly hair and two smaller wormlike sock puppets. "We used the puppets to communicate to the children the symptoms of hypoglycemia that they need to recognize and make their parents aware of," says Lee. Why this particular project?

"We see in our clinical orientation just how far-reaching diabetes is in adulthood," she says. "If we can educate people earlier, then maybe down the line it will be beneficial. We wanted to give back to the community and help families. We think we found a creative way to do that."

Where do you go for help?

Imagine this scenario: You are 15 and afraid you have a sexually transmitted disease (STD). You live in the inner city, you have no insurance, and you have no money. Where do you go for help? Nursing seniors Jennifer Duggan, Meg Grant, Jason Smith, and Amy Thom know there is health care available for such youngsters, but the problem lies in telling teens how to access it. To tackle that problem, the students developed health resource materials for a class of about 50 ninth- through 11th-graders at Atlanta's inner-city Booker T. Washington High School.

"Adolescents are in particular need of health care," says Thom. "They are in flux--not children and not adults--yet they are at risk for STDs, accidents, and other serious problems. We wanted to find a way to help instill good health practices at this critical time in their lives."

"There are several clinics in the downtown area," says Duggan. "Grady Hospital has an adolescent clinic, for example. We want these kids to know where help is and how to get it. We also want them to understand that prevention is the best way to go and not to let a problem get to a crisis point." The group not only presented this information to the students, they also compiled a teen-friendly reference guide.

"In addition to information about the location of health clinics, we included numbers for advice lines staffed by nurses," Duggan says. "We addressed issues of confidentiality--when do teens have to obtain their parents' consent to seek treatment?

We even addressed how to get things done using an automated phone system: how to listen and be patient, how not to lose your cool when trying to get information or set up an appointment."

The group has received enthusiastic support, Duggan says.

"The community is excited we have put all this information together. It's never been done before, and we believe the project is touching people's lives. You can read a book all day long, but turning a concept into a concrete reality is different. That's what the Senior Innovative Projects are all about."

For more general information on The Robert W. Woodruff Health Sciences Center, call Health Sciences News and Information at 404-727-5686, or send e-mail to hsnews@emory.edu.