Presentation to KC-CDC April 24, 2004 Work Group on Health Promotion and Community Development

1. Documenting and Evaluating Community Efforts to Reduce Health Disparities in Kansas City, MO:Second Year Results Presentation to KC-CDC April 24, 2004 Work Group on Health Promotion and Community Development University of Kansas

2. KC-CDC’s Logic Model to Reduce Disparities Community Change (and Change Agents) Widespread Behavior Change & Reduced Health Disparities Targeted Community Action & Intervention Collaborative Planning & Capacity Building Community Change & Change Agents Health care agencies Business/Labor Unions Faith Groups State/Local Gov’t Social Services Community Action Plan identified 98 changes to be sought, using 5 strategies for change Create new or modified: 1. Programs 2. Practices 3. Policies Reduction in risk behaviors Reduction in CVD and diabetes

3. What factors affect the rate of community change? • A clear vision and mission • Leadership • Action planning • Mobilizers • Technical assistance and support • Documentation and feedback on change • Making outcome matter

4. Vision Excellent health for all   Mission Improve health outcomes for diabetes and CVD by promoting access to quality health care, healthy environments, and lifestyles through integrated, affordable, culturally sensitive, accountable, community-based healthcare and prevention services.

5. Efforts to Develop Action Plan • Following the phase II action planning meeting in Nov 2001, a revised plan was approved by KC-CDC for year I priority CC’s January 2002 • In Dec 2002 the community to rate the feasibility and importance of proposed changes for year II and priority CC’s were set for year II • May of 2004 community change goals will be assessed and prioritized

6. KC-CDC Action Plan • Personal Healthy Habit • 1. Disseminate information about the risk factors and consequences of having diabetes and CVD, in addition to local resources for treatment and support • Compile information about existing services • Identify methods of dissemination that are most suitable for the neighborhoods • Getting Help from the Medical Community • 1. Develop common protocols and best practices for treating diabetes, CVD, and related disorders. • Identify existing methods of establishing protocols • Select protocols affecting KC-CDC focus efforts

7. Targeted Objectives 1. Increase the number residents who can identify a personal doctor/healthcare provider by 35% 2. 90% of residents diagnosed with diabetes will have their HbA1C measured in the last 12 months 3. Residents reporting eating fruits and vegetables will increase by 30%

8. Targeted Objectives (Cont.) 4. Increase number of residents who engage in physical activity will increase by 30% 5. 30% of residents report people in their neighborhood working together to improve their neighborhoods.

9. Efforts to Secure and Provide Technical Assistance and Financial Resources • Grants • REACH 2010 planning grant, implementation grant tentatively through 2007 • Aetna grant for screening supplies and piloting a patient navigator program • In kind resources • Printing and graphic arts support by MO Dept of Health & Senior Services • Sponsorship of Fox’s weekly “Healthy Habits Food Segment” by University of MO Extension Office • Educational Materials • MO Dept of Health & Senior Services, American Diabetes Assoc, American Heart Association, Assoc of Black Cardiologists, Pfizer Pharmaceuticals, Office of National Women’s Health (DHHS), Aetna, others

10. Efforts to Make Outcome Matter • Possible strategies • celebrate successes • recognize good partners • provide incentives for success

11. Documenting Accomplishments—Implementing the Documentation System • Initial steps • Challenges • Plans for adjustment • What are we accomplishing

12. Key Questions--For the KC-CDC 1.Is the initiative serving as a catalyst for change? 2. What factors contribute to the initiative’s effectiveness as a catalyst for change? 3. Is the initiative making a difference? 4. How is the initiative contributing to effort?

13. 1. Is the initiative serving as a catalyst?

14. KC-CDC Initiative: Illustrative Community Changes January 2002 – January 2004 • Information about factors affecting risk for CVD and diabetes was distributed through the Order Up Healthy Habits program – a monthly distribution of free materials available across the community • 30-thirty minute walking tours within the 11 zip code area were established and printed brochures of the routes, their length, difficulty, estimated walking time, and points of interest on the route were distributed throughout the neighborhoods

15. AdditionalIllustrative CC’s • In partnership with the MO Dept of Health & Senior Services, mini grants were distributed to 15 neighborhood organizations to support efforts to implement their action plans. 13 additional faith organizations will receive mini-grants in Feb 2003. • As a result of mini grants, neighborhood organizations: • Started walking clubs in their community • Installed new playground equipment and cleaned up parks • Created monthly health forums for seniors and women • Modeled healthy eating choices at board and community meetings

19. 2. What factors contribute to the partnership’s effectiveness as a catalyst for change?

20. HIP makes grants Neighborhood Network grantees implement Pick 6 Order Up Healthy Habits Program starts Nurses in KCMO SD receive health promotion and prevention training MO DHHS begins making neighborhood grants Hired Mobilizers

21. 3. Is the initiative making a difference?

22. Linking Our Efforts to Widespread Behavior Change • REACH 2010 Risk Factor Survey • How long since seen Dr. for routine check up? • # of days/wk walking for >10 min.s at a time? • # of days/wk do moderate activities? • Consumption of fruit, green salads, nonfried/ unprocessed potatoes, carrots, other vegetables? • Reducing risk for heart disease and stroke through changes in fat consumption, physical activity levels, eating more fruits and vegetables?

23. Illustrative Community-Level Indicators for KC-CDC Diabetes: Prevalence and Incidence of Diabetes among African American and Hispanic populations in KCMO CardiovascularPrevalence and Incidence of Disease: Heart Disease among African American and Hispanic populations in KCMO

24. 4. How is the initiative contributing to the effort?

25. Working Hypothesis—Conditions Under Which Community Change is Associated with Improvement in Community-Level Indicators More Distal Outcomes Community Change (Intermediate Outcome) • Amount (by goal) • Intensity of strategy • Duration • Penetration/Exposure— • Target • Sector • Place

26. Community Changes by Goal 2004

27. Community Changes by Goal 2003

28. Community Change by Duration 2002

29. Community Change by Duration 2003

30. Community Change by Sector 2002

31. Community Change by Sector 2003

32. Community Change by Strategy 2002

33. Community Change by Strategy 2003

36. Using the Data • Potential uses by KC-CDC • Potential uses by support organizations • Potential uses by MPCA

37. Learning with Partners • Reviewing accomplishments, challenges, and success stories • Making adjustments • Selecting lessons learned to communicate to others • Honoring champions

38. Using Technology to Build Capacity • Online documentation system • Online indicator system • Web support page

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