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Building and Sustaining Community and State Capacity for Policy, Environmental, and Infrastructure ChangeNational Association of Chronic Disease Directors General Member CallJune 23, 2011 3:00-4:00pm ET

1AgendaTimeTopicSpeaker3:00 3:10Welcome and Introductions Opening Remarks

John Robitscher, MPH CEO, NACDDJennie Hefelfinger, MS Project Director, ACHIEVE3:10 3:15Overview of ACHIEVE as a successful model to build state and community capacity for policy, environmental and infrastructure change

Jennie Hefelfinger3:15 3:35Learning from Successful Communities and States:Multnomah, ORSalamanca, NYAllentown, PAOregon State Health Department

Rachael Banks, 2009 CoachDeb Nichols, 2008 CoachTina Amato, 2008 CoachLuci Longoria, State Health Department Expert Advisor3:35 3:45Building in Sustainability through:Peer Learning/MentoringEvaluationSocial MediaAli Patty, MSPH, CHES Project Coordinator, ACHIEVEAnn Ussery-Hall, MPH, CHES Project Evaluator, ACHIEVEJaclyn King, MPH, CHES Project Coordinator3:45 3:55Question and Answer SessionALL3:55 -- 4:00Closing CommentsJennie Hefelfinger2Welcome and IntroductionsJohn Robitscher,NACDD Chief Executive OfficerJennie Hefelfinger, ACHIEVE Project Director

3NACDD ACHIEVE StaffAli Patty,Project CoordinatorAnn Ussery-Hall,Project Evaluator

Jaclyn King,Project Coordinator

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What is ACHIEVE?Action Communities for Health, Innovation and EnVironmental ChangE

National and state partnership that provides training and technical assistance to empower communities to find local solutions and to take local action to prevent and control chronic disease.5Communities working in partnership to create healthier places where people live, work and play.Focusing on promoting and implementing policies, systems and environmental changes that support and sustain healthy living.What is ACHIEVE?

6123 communities creating local solutions to change the landscape to improve health and the environment

7NACDD ACHIEVE TEAMSOver 3,328,000 people now have increased access to lead healthy lifestyles

$10,000,000 leveraged in additional funds over the past two years to support community efforts

53 strategies now in communities to support people being healthy (08 only)

(2008, 2009 and 2010 teams)

8Partnerships are Critical to Success and SustainabilityNationalNACDD, Y-USA, NRPA, NACCHO, SOPHE, and CDCState Heath Department Chronic Disease Prevention ProgramsCommunity Coalitions-- CHARTs

9Five-phase ModelCommitment (Coalition Building)AssessmentPlanningImplementationEvaluation10NACDD Supports Communities through:Training and skill development to help make the healthy choice the easy choice

Linkages to national and state resources and expertise

Funding to support collaboration and partnership

Referrals to other resources and funding opportunities

11Creating Healthy Communities: Success Stories from ACHIEVETo read this and moreNACDD Success Storiesplease visit NACDD website.

http://www.chronicdisease.org/policy/state-success-stories

Successes Where they liveHealthy CommunitiesOver 35,000 residents now live in communities with Complete Streets policies in placeBike racks have been added to communities, allowing 7,000 community members to chose biking over drivingOver 7,000 people have better access to fresh fruits and vegetables because their local farmers markets accept senior and WIC vouchers 200,000 people live in a community where healthy choices are now highlighted on restaurants menus

13Successes Where they learnHealthy Schools17,000 students can safely walk to school because their communities have implemented Safe Routes to School effortsOver 1,000 students are receiving an extra 50 minutes of physical activity weeklyOver 4,000 students now attend schools that have an active recess policy, 1,230 students have healthy smoothies and healthy meals-to-go options to purchase at school

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Successes Where they workHealthy Worksites15,000 employees have healthier items to chose from in the vending machines at work4,000 workers have physical activity options at their workplaceMore than 4,000 employees have indoor and/or outdoor walking paths where they can safely be physically active 1,500 county employees are protected from second-hand smoke by a tobacco-free workplace policy

15Lessons from the fieldMultnomah, OR

Salamanca, NY

Allentown, PA

Oregon State Health Department

16ACHIEVE: Multnomah County Health Department2009 ACHIEVE CommunityPortland, Oregon

Rachael Banks,Program SupervisorCommunity Wellness and Prevention ProgramMultnomah County Health Department(503) 988-3663 ext. 22975rachael.m.banks@multco.ushttp://www.multco-itstartshere.org

Yugen Rashadyugen.rashad@multco.us503 988-3663 Ext. 27205 17County covers 6 cities, 8 school districts and many diverse communties.Examples of Nutrition Policy EffortsFaith-based settings

Healthy Worksites

Healthy Retail Initiative

18Healthy Food in Faith Settings: Nutrition policies and/or kitchen modifications in 3 faith-based settings reaching 100,000 peopleCHART worked with community partners (e.g., EMO) to increase availability of fresh fruits and vegetables to churches/mosques through membership in buyers clubs and other strategiesDevelopment of community gardensHealthy Worksites: Adoption of Multnomah County Worksite Wellness ResolutionDevelopment of policies including: nutrition standards, procurement, healthy meetings, and water promotionPromotion of chronic disease self management, tobacco-free worksites and flexible wellness-time policies to local bargaining unitCommercial Retail: Branding of Healthy Retail Initiative: voluntary agreements with retailersExploring farm-to-store and farm-to-church strategiesCommunities Putting Prevention to Work5 CHART agencies funded to implement policy in community-at-large and other sectorsHealthy Active Multnomah County It Starts Here campaignSelected as case study site: studying impact of policy on African Americans and low-income populations.Keys to SuccessBuild on past efforts

Engage community

Coordinate with other coalitions and initiatives

Focus on policy; link to other efforts

Build a legacy and have fun!

191- honor past work and link to future plan. utilize existing data (especially if community has been studied a lot).Utilize expertise of CHART, staff and community members. Listen to people in a way that they want to share. This is not always the same way that were prepared to collect or document information.Working with FPC, PAALF, EMO interfaith, etc. These groups have provided policy ideas, reviewed processes, helped conduct assessments and surveys and have representatives participate in CHART meetings.CHART can focus on policy while linking to others who provide education or other forms of supports.This is life-changing work that can build. Spend time documenting your work and talking it upACHIEVE: Cattaraugus County Health Department2008 ACHIEVE CommunitySalamanca, NY

Deb NicholsPublic Health Educator, Public Information OfficerCattaraugus County Health Departmentdjnichols@cattco.org

20County covers 6 cities, 8 school districts and many diverse communties.Salamanca, NY DemographicsAmerican Indian 15% Hispanic 3%African American 1% Asian 1%2 or more races 3%White 77%6.2 square miles (city) 43.7 square miles (Res)

22.2% residents below poverty level compared to 14.6% NYS41.7% children living below poverty level compared to 19.1% NYSMedian family income = $32,004 compared to $56,003 NYS Salamanca HS ranked 120 out of 133 schools in WNY

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Salamanca ACHIEVE PROJECTS:

Youth Possession of Tobacco ProductsProhibits use of tob products by minorsTob products are confiscated/destroyedNO arrests or penalties; education only

Young Lungs @ Play (YLAP)NO smoking allowed in public parksSelf-enforced

Reclamation of the PENNSY TrailAnnual Clean-up DayAdopt-a-Trail programBrochures project

22ACHIEVE: Allentown, PA Health Bureau2008 ACHIEVE CommunityAllentown, PA

Tina Amato,Nutrition and Physical Activity ManagerChronic Disease Programs Allentown Health Bureauamato@allentowncity.org

23County covers 6 cities, 8 school districts and many diverse communties.

Supplemental ACHIEVE Grant Funding

2424And fortunately the ACHIEVE grant funding was able to provide the teacher inservice for the entire school district including curriculum manuals and instructional materials. When Allentown received this ACHIEVE grant funding in the amount of $50,000, it was really to implement the CDCAction Guide sort of a how to guide. SPARK was mentioned as one of the instructional models that we went with.

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27Overall Positive ChangesLesson length increased at all three (3) schoolsActive Time(MVPA) increased in 2 of 3 schoolsIncorporating activity into the roll-taking processChanged their warm-upsIntroducing more co-ed activities at the upper levelsStopped using "elimination games

Common BarriersSpace/FacilitiesClass SizeSeparation of Grade Levels (high schools)Scheduling

2828Lesson length increased - that means the teacher is doing a better job of less management so the class lesson starts sooner and goes longer

Sheridan did not increase active time at the post observation. This is no way reflective on how much Josh embraced and practiced the SPARK concepts. Its just that it would have been hard to top the class activity you did in the beginning (1 mile walk/run). If it had been flipped, we would have seen success. Walking to field alone diminished all down time.

Co-ed activities at the upper levels which enables them to offer a greater variety of games to enhance participation.Stopped using elimination games which ensuring that all students stay active for longer periods of time.

Physical education must devote at least 50% of class time to MVPAOregon State Health Department Expert

ACHIEVE supports state and local coordination as key to successACHIEVE complements existing efforts for local capacity building for policy advocacyACHIEVE develops leadership in public health staff and partnersACHIEVE reinforces effectiveness and accountability in engagement, assessment, planning, policy development, and sustainability

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State and local public health partnership is critical to achieving outcomes. We need to work together to show the benefit of this investment, and help assure policymakers maintain investment in our movement.

HPCDP helps local partners by providing statewide coordination, conducting surveillance, support regional and statewide priority setting, help build partner capacity to do work effectively, and assure program effectiveness and accountability.

In Oregon, weve helped ACHIEVE communities (weve got four! Multnomah, Jefferson, Lane and Columbia-NACCHO) by supporting coordination with existing TPEP and Healthy Communities programs, participating in assessment and planning meetings, speaking at CHART kickoffs, reviewing actions plans and providing feedback on strategies and resources, creating opportunities to share successes with each other and other programs statewide.

Communities bring together key partners to support norms change, promote dialogue about the best solutions to community health problems, identify strategies tailored to meet local needs, and assure policy strategies are prioritized and fulfilled. Local public health leadership and policy development: informs state and national policy, and raises the bar for statewide and national policyidentifies new policy horizons for chronic disease preventionoutpaces those that cause and perpetuate disease and death (tobacco industry, unhealthful foods, etc.)

29Health Promotion & Chronic Disease PreventionLuci Longoria, MPHCommunity Programs Team LeadOregon Public Health Division971-673-1064luci.longoria@state.or.us 30

30NACDD Services and ResourcesIn support, NACDD provides technical assistance and support for:Technical assistance and trainingCoalition development and maintenanceProject sustainability Peer to peer learning opportunitiesEvaluation strategiesCommunications and social media31Technical Assistance and TrainingFace to face meetings to provide training and technical assistance (Coaches Meeting and Action Institute)One on one conference callsGroup conference callsSite visits to communitiesWebinars

32Technical Assistance and TrainingTopics such as:Coalition development and maintenance Assessment and data collectionPolicy, systems and environmental strategiesDeveloping an Community Action Plan EvaluationCommunication planning Using Social MediaProject sustainability

33Peer Learning Network (PLN)For whom? Leaders/coaches working to support local Healthy Community effortsWhat? Opportunity to learn and share experiences and best practices with other leaders/coachesHow? Teams meet over facilitated conference call and are provided additional opportunities to connect over email and phone34NACDD: Evaluation ResourcesAssessment processes and toolsEvaluation plans Data analyses and reportingSharing data and results

35Assessment processes and toolsCHANGEPhotovoiceSurveysFocus groupsEnvironmental scans

36Other Assessments

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Evaluation PlansLogic modelsGoals and objectivesData sourcesReporting schedules

Implementation and outcome indicators38GoalBy December 2012, increase physical activity in 100% of schools from 30 to 150 minutes/week

StrategyActive recess policy

ObjectiveBy December 2011, increase the physical activity minutes from 30 to 150 in 10 elementary schools

Data sourceKentucky Department of Educations Nutrition and Physical Education Report Card Annual Report

Evaluation Plan: ExamplePractical, politically viable, cost effective39Data analyses and reportingProcess and outcomeProgress updatesSummary dataLocal, state and national data

40Sharing data and resultsSummary reportsSuccess storiesPresentationsAbstractsArticles

Analyzing quantitative and qualitative data and preparing reports and recommendations41Sustaining Your Efforts Through Social Media

42Why Use Social Media for Public Health?Fundamental shift in the way we communicateReach people when, where, and how they want to receive health messages Leverage social networks to encourage participation, conversation, and community Spread key messages and influence decision makingVariety of social media tools can be used as part of an integrated health communications plan

Source: CDC The Health Communicators Social Media Toolkit available at: http://www.cdc.gov/healthcommunication/ToolsTemplates/SocialMediaToolkit_BM.pdf

Communities and State Health Departments are advised to use social media to improve reach of health messages, increase access to their content, further participation with audiences and advance transparency to improve health communication efforts. 43NACDD ACHIEVE Expands Communication Strategy; Creates Social Media NetworkPodcasts

Facebook

Twitter

YouTube

Flickr

LinkedIn

Social media has rapidly become the core communication channel by which the majority of the population receives their information, and NACDD ACHIEVE is now on board.Under an evolving communications strategy, the NACDD ACHIEVE team has created several social media sites including: Facebook, Twitter, YouTube and Flickr, along with recorded podcasts available online and soon to come- LinkedIn! These social media channels are updated with timely health-related information, community photos, and videos highlighting ACHIEVE community efforts on a regular basis. 44

By joining these social media arenas, NACDD ACHIEVE is now connected to hundreds of national organizations, federal agencies, and other efforts similar to that of NACDD and ACHIEVE.45Communities Continue to Spread the ACHIEVE Message

In addition, many ACHIEVE communities have already started their own social media sites in order to sustain their efforts, and ACHIEVE is now able to share the impact of these efforts with a broad audience.46Where to Find Us: Watch: http://www.youtube.com/user/ACHIEVEingHealth

Share: https://www.facebook.com/ACHIEVENACDD

Follow: http://twitter.com/#!/NACDDACHIEVE

Listen: http://www.achievecast.com/

Connect:

http://www.linkedin.com/groups?about=&gid=3928586&trk=anet_ug_grppro

47NACDD is ready to assist you on Community Transformation GrantsCoalition/Capacity BuildingPeer Learning Networking and MentoringUsing Social Media to Build MomentumCommunity-based Evaluation StrategiesPolicy, Systems and Environmental Change Academy

State Technical Assistance and Review (STAR) Program State Success Stories EBPH State Based Program State Chronic Disease Academy Technical Assistance in Developing and Implementing Evaluation ProgramsQuestions??

49AdjournThank you for your participation today. For more information about ACHIEVE please visit:www.chronicdisease.orgwww.achievecommunities.orgwww.achievecasts.comwww.achievecasts.com/retro

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