Navigating the Road to Community Change: Evidence-Based Public Health Interventions

1. Navigating the Road to Community Change: Evidence-Based Public Health Interventions KHI Mini-Grant Workshop March 21, 2011 Our Vision – Healthier Kansans living in safe and sustainable environments.

2. Change Survival Tips Tip #1 : You must know your current location to guide future direction Tip #2 : Create a roadmap that most effectively helps you arrive at your destination Tip #3 : Once you’ve arrived at your destination point, take time to reflect on how you got there Tip #4 : Plan future destination points Our Vision – Healthier Kansans living in safe and sustainable environments.

3. Tip #1 : You must know your current location to guide future direction Our Vision – Healthier Kansans living in safe and sustainable environments.

4. Assessing where you are: Community Health Assessment • Community Health Assessments: • Important to assess community needs to build a framework for where you are • Help develop a community action plan for improving and supporting healthy lifestyles • Map out a course for using specifically targeted action to make positive and sustainable changes in their communities. Our Vision – Healthier Kansans living in safe and sustainable environments.

5. Now that you know what your community needs… Have you found yourself asking Which program and policy interventions have been proven effective? Are there effective interventions that are right for my community? What might effective interventions cost; what is the likely return on investment? Our Vision – Healthier Kansans living in safe and sustainable environments.

6. Tip #2 : Create a roadmap that most effectively helps you arrive at your destination Our Vision – Healthier Kansans living in safe and sustainable environments.

7. Public Health Impact: Policies, Systems, and Environment Changes Our Vision – Healthier Kansans living in safe and sustainable environments.

8. Create Direction: The Community Preventive Services Guide • Health and Human Services/CDC Resource providing on-going recommendations on evidence-based interventions to improve public health • Developed by a team of community guide staff – federal and non-federal experts in research, practice, and policy • Based on systematic reviews of all available research Our Vision – Healthier Kansans living in safe and sustainable environments.

9. The Community Preventive Services Guide The Community Guide provides answers to commonly asked questions about public health interventions: What interventions have and have not worked? In which populations and settings has the intervention worked or not worked? What might the intervention cost? What should I expect for my investment? Does the intervention lead to any other benefits or harms? Our Vision – Healthier Kansans living in safe and sustainable environments.

10. Community Guide Continued ● The Community Guide has assessed the effectiveness of more than 210 public health interventions in 18 topic areas and settings designed to: -Promote healthy behaviors/reduce unhealthy behaviors -Reduce specific diseases, injuries, or impairments -Promote healthy behaviors in community settings (e.g., schools, worksites) Our Vision – Healthier Kansans living in safe and sustainable environments.

11. So, based on what we know about Policies, Systems, and Environment Changes & the Community Guide…. Our Vision – Healthier Kansans living in safe and sustainable environments.

12. Taking the Community Guide/PSE to the next level: MAPPS Strategies • Evidenced-based interventions • Drawn from peer-reviewed literature • Synthesized directly from the Community Guide • Improve health outcomes at a Policies, Systems, and Environment Level Our Vision – Healthier Kansans living in safe and sustainable environments.

13. MAPPS Strategies Media Access Point of Decision Price Social Support/Services

14. Media • Physical Activity • Promote increased physical activity • Promote use of public transit • Promote active transportation (bicycling and walking for commuting and leisure activities) • Counter-advertising for screen time • Nutrition • Media and advertising restrictions consistent with federal law • Promote healthy food/drink choices • Counter-advertising for unhealthy choices

15. Access • Physical Activity • Safe, attractive accessible places for activity • City planning, zoning and transportation • Require daily quality PE in schools • Require daily physical activity in afterschool/childcare settings • Restrict screen time (afterschool, daycare) • Nutrition • Healthy food/drink availability • Limit unhealthy food/drink availability • Reduce density of fast food establishments • Eliminate transfat through purchasing actions, labeling initiatives, restaurant standards • Reduce sodium through purchasing actions, labeling initiatives, restaurant standards • Procurement policies and practices • Farm to institution, including schools, worksites, hospitals, and other community institutions

16. Point of Decision Information • Physical Activity • Signage for neighborhood destinations in walkable/mixed-use areas (library, park, shops, etc) • Signage for public transportation, bike lanes/boulevards • Nutrition • Signage for healthy vs. less healthy items • Product placement & attractiveness • Menu labeling

17. Price • Physical Activity • Reduced price for park/facility use • Incentives for active transit • Subsidized memberships to recreational facilities • Nutrition • Changing relative prices of healthy vs. unhealthy items (i.e., through bulk purchase/procurement/competitive pricing)

18. Social Support/Services • Physical Activity • Safe routes to school • Workplace, faith, park, neighborhood activity groups (e.g., walking hiking, biking) • Nutrition • Support breastfeeding through policy change and maternity care practices

19. MAPPS Strategies in Action in the Worksite Setting Important note: Worksite strategies are most effective as part of a comprehensive worksite wellness program that addresses a variety of health issues • Changing cafeteria and vending machine options to provide healthy alternatives • Providing on-site facilities for exercise • Worksite walking groups • Stair prompts • Providing employees health insurance benefits around preventative care Our Vision – Healthier Kansans living in safe and sustainable environments.

20. Tip #3 : Once you’ve arrive at your destination point, take time to reflect on how you got there Our Vision – Healthier Kansans living in safe and sustainable environments.

21. Northeast Kansas Examples • Heartland Healthy Neighborhoods/Topeka City Council: Passage of “Complete Streets” Ordinance in November 2009 • Heartland Healthy Neighborhood Shunga Trail Connection • Douglas County Farmer’s Market: Electronic Benefits Transfer to increase access Our Vision – Healthier Kansans living in safe and sustainable environments.

22. Tip #4: Plan Future Destination Points Our Vision – Healthier Kansans living in safe and sustainable environments.

23. Future Funding Opportunities • ACHIEVE • Chronic Disease Risk Reduction • Kansas Coordinated School Health • Kansas Health Foundation Our Vision – Healthier Kansans living in safe and sustainable environments.

24. Questions? Our Vision – Healthier Kansans living in safe and sustainable environments.

25. Contact Information: Dr. Candace Ayars Director Chronic Disease Risk Reduction cayars@kdheks.gov Liesl Hays Northeast Outreach Coordinator Chronic Disease Risk Reduction lhays@kdheks.gov Our Vision – Healthier Kansans living in safe and sustainable environments.

26. www.kdheks.gov Our Vision – Healthier Kansans living in safe and sustainable environments.