Program Planning: Community Nutrition Assessment

1. Program Planning: Community Nutrition Assessment 2005

2. Program Planning Basics • Systematic process • Continual feedback and evaluation • Cyclical: based on increasing understandings of the true nature of the situation and the effectiveness of interventions. • Starts with an assessment of the current situation

3. Process Evaluation & Adjustment Assessment Prioritize Analyze problem and propose model to address Develop Intervention goals, objectives, implementation plan Outcome evaluation

4. Why Do Assessment?

5. Community Nutrition Assessment: • Anchors program/intervention in the reality of the community • Essential part of ongoing process: • Needs assessment • Designing and implementing services • Evaluation • Improving programs and services • Includes community and stakeholders as fully active participants

6. Community Nutrition Assessment: • Based on assets more than deficits • Helps to integrate nutrition programs into community-based health programs and plans

7. Successful Community Assessment Includes: • Understanding current conditions of families and individuals • Evaluating local capacities for supporting health and nutrition needs • Building community support for implementing changes

8. Models and Protocols for Community Assessment • Planned Approaches to Community Health (PATCH) – CDC • Assessment Protocol for Excellence in Public Health (APEXPH) – NACHO (National Association of County Health Officials) • Moving to the Future: Developing Community Based Nutrition Services – ASTPHND (Association of State and Territorial Public Health Nutrition Directors)

9. Strategic Planning for Initiatives to Address Local Health Efforts • Community Assessment • Organize a community planning group • Define community boundaries • Gather information • Statistical profile • Qualitative data • Community Resources Agency for Health Care Policy and Research

10. Strategic Planning, cont. • Analyze Information • Common issues • High risk individuals • Unmet needs • Prioritize • Develop and implement community health plan • Monitor and evaluate community health plan

11. Steps to Assessment • Convene a planning group • Define community • Identify Community Assets • Identify Perceived Needs • Build Demographic Profile • Analyze Community Health Status • Analyze Community Nutrition Status • Identify Community Resources and Service Utilization • Identify common issues and unmet needs • Prioritize

12. Community Nutrition Planning Group: Responsibilities • Collect data and information • Identify health needs and gaps in service • Set priorities • Develop a plan • Help to implement interventions • Assist in evaluation • Of assessment, planning, and intervention process • Of impact of intervention

13. Community Nutrition Planning Group: Potential Members • Community leaders • Consumers • Health and Nutrition Service providers • Health organizations • Schools • Political office holders or their staff • Fitness professionals • Representatives from greater community health planning groups

14. Define the Parameters • Public Health Nutrition: Assuring conditions in which people can be nutritionally healthy • Community: “A community is any group sharing something in common” Community Tool Box

15. Community Description • Geographic boundaries • General history • Key people and leaders • Demographics • Financial & economic information • Important issues • Morale and involvement levels • Key allies and rivals • Unspoken rules and norms • Attitudes and opinions • Strengths and shortcomings

16. Identify Community Assets • Physical structure, place, business • Concerned citizens • History of successful efforts • Organizations • Individual and group skills • Communications systems • Relationships

17. Identify Perceived Needs • WHY? • To understand public opinion • To become aware of needs the planning group doesn’t know about • To gather support & expand group expertise • To make decisions about priorities • To plan programs in ways that will be acceptable to stakeholders

18. How do we assess perceived needs? • Listening sessions • Public forums • Key informant interviews • Needs assessment survey or survey of concerns

19. Demographic Profile • Economic status: income, employment, % below poverty • Education levels • Age and gender • Race & ethnicity • Social factors: homelessness, immigration status, family composition, TANF utilization

20. Community Health Status • Causes of Mortality • Hospital discharge data • Disease prevalence data • Food bourne illness reports • Years of potential life lost • Infant mortality

21. Community Nutritional Status • Pregnancy related: • weight gain in pregnancy • Pre-pregnancy weight • Anemia • Disease prevalence: HIV/AIDS, cardiovascular disease, diabetes • Activity levels (BRFSS) • Food intake: fat, fruits & vegetables (BRFSS) • Dental health • Food/dieting related behaviors (YRBS) • Food Security (BRFSS)

22. Community Resources & Service Utilization • What resources are available? • To what extent are people using them? • Sources of Information: • Citizens • Service providers • Tools • Existing data • Interviews • Surveys

23. Examples of Community Nutrition Resources • Food assistance programs (WIC, Basic Food, etc.) • Grocery stores with high quality produce • Food Service with health promoting food options • Educational programs • Media • Profession and non-profit organizations • Nutrition counseling

24. Criteria for defining/prioritizing community problems • Frequency • Duration • Scope or range • Severity • Perceptions • Root causes (“but why?”) & ability to impact root causes (effectiveness of interventions) • Barriers to resolutions • Political and financial support

25. Group Work: Roles • Assign roles within a breakout group: • Mayor who has lead the charge for a comprehensive strategic plan for economic development that includes recreation and attracting active retirees. • County Health Officer: a family practice MD who is a strong advocate for breastfeeding • Bicycle Alliance member • Anti hunger and farmers market advocate • School administrator • Nutritionist from the local health department

26. Group Work: Develop Problem List • Brainstorm nutrition & physical activity related issues & problems that arise from these data • Choose 5 issues that are of interest to all stakeholders • Prioritize these issues using criteria in these slides • Establish the one issue or problem that all stakeholders will be comfortable working on for the next two weeks

27. Community Inventory Moses Lake Factors that affect nutrition and physical activity choices June - August 2002

29. MosesLake • Agricultural community • Recreation destination • Population: 14,953 in 2000 census • Unemployment rate: 8.5% (2001) • 2,246 cases of food assistance ( MRDA, Oct 2001 ) • 33% population increase from 1990-2000 • Workforce: primarily agriculture; Increasing food processing and industrial manufacturing base • 48% school children eligible for free or reduced lunch

30. Ethnic Distribution

31. Interviews with Nutrition and Physical Activity Professionals

32. Top HealthConcerns • Obesity • Poor nutrition • Diabetes • Smoking • Unplanned pregnancy • Poor medical “compliance” among minorities

33. Perceived Barriers to Accessing Healthy Food and Physical Activity • Healthy food • Lack of education • Lack of recognition/concern for food choices • Cultural attitudes • TIME- easier to access fast/junk food • PA • Lack of awareness/perceived need • Difficult to get people interested/time factors • Poverty/poor nutrition • Language issues • Decreased emphasis on PE in school

34. Readiness for Change andLevel of Interest • Level of interest:medium-high interest • Awareness: strongly represented in need to educate through schools, starting early • Infrastructure- Moses Lake/Grant County have strong community health programs • Perceived readiness to change- medium to high • Community level exposure- festivals and summer recreation- based activities may reach large numbers

35. Solutions/Priorities for Change • Increase nutrition and PE curriculum requirements • Increase staffing to implement programming,especially In schools and existing food programs • Increase access for all members of community through “riverwalks”, lengthier bike paths, schools indoor walking programs (inclement weather) • Promote active lifestyles for families; “Free exercise” • Coordinate community resources to “make healthy lifestyle changes happen” (= coalition-building!) • Promote positive media campaigns

36. Interviews with Community Leaders

37. Is obesity a problem? • 5/10 reported that it was a visible problem • Not perceived as unique to ML • Due to sedentary lifestyle and fast foods • Concern because see in children in schools

38. Perceived Levels of Physical Activity • 9/10 believe that lack of physical activity is a problem in Moses Lake • Don’t see people exercising (but I do) • Fairly active community • Poor community & people don’t know that there are free opportunities for recreation here • There is a general lack of facilities in rural towns in general • Same as nation as a whole

39. Perceived Problems due to Poor Diet • 9/10 thing that poor diet is a problem in Moses Lake • Heavy use of fast foods (5) • Rushed lifestyle (3) • Poverty • People don’t know how to cook

40. Awareness of Nutrition and Physical Activity Programs in Community • 7/10 were aware of some • Private health clubs and weight loss programs • Hospital classes • School classes • City Parks and Recreation, skate park, pool, skating rink • Programs for Seniors

41. Community Inventory Goals • Assess factors which affect nutrition & physical activity choices in Moses Lake • Assist AC members to determine what project(s) are appropriate for the community

42. Healthy Communities, Healthy Living Planning Document Based on State Plan for Nutrition and Physical Activity • Enhanced opportunities for recreation & physical education • Increased access to healthy foods • Assurance that transportation, urban planning, & public safety systems support active lifestyles

43. Key Community Documents • City of Moses Lake: Planning Commission Recommended Comprehensive Plan • Parks, Recreation, & Open Space Plan • Community Streets & Utility Standards • Municipal Code for Major Subdivisions • “Just Data” Grant County Health District Community Assessment Data • Draft VISION 2020 Strategic Plan • A Description of Grant County: Population -- The Changing Face of Grant County -- August 2001

44. Community Resources • Police Department: http://www.moses-lake.com/police/ • Parks and Recreation: http://www.mlrec.com/ • School district: http://www.moseslakeschools.org/ • Chamber of Commerce: http://www.moseslakechamber.org/ • Moses Lake Information: http://www.moses-lake.com/ • Grant County Economic Development Council: http://www.grantedc.com/ • Samaritan Healthcare: http://www.samaritanhealthcare.com/ • Moses Lake Community Health: http://www.mlchc.org/ • Moses Lake Clinic: http://www.wvclinic.com/locations/MLC.asp • Port of Moses Lake: http://www.portofmoseslake.com/ • Columbia Basin Herald: http://www.columbiabasinherald.com/ • Aging and Adult Care of Central Washington: http://www.aaccw.org • Grant County: http://www.grantcounty-wa.com • Grant County Health District: http://www.granthealth.org/

45. Anne Henning Becky Meyer Bev Shuford Brenda Teals Caren Jacobson Dave Helms Debe Nuss Diana McKinsey Emily Dufault Fernando Alvarez Jane Kim Judi Ellis Laure Grammer Lori Barlow Lori Moholt Mary Falconer Mary Talcott Ryan Hopkins Spencer Grigg Teri Carpentier Tracy Fisher Tim Varney CI Committee Members

47. Methods Community Action Info / Training Development Pre-work Recruitment Sample audit • Walkability • Map of physical environment • Non-section specific research

48. Methods Community Action Info / Training Development Pre-work Recruitment Sample audit • Sample audit presented at 1st AC meeting • Call for volunteers to assist in finishing the section-specific audit • Follow-up recruitment post 1st AC meeting via phone / email

49. Methods Community Action Info / Training Development Pre-work Recruitment • Forms and instructions for assessment • Segmentation of ML • Technology for summarizing results • Information and training Sample audit

50. Methods Community Action Info / Training • Roll call • Segmentation of ML • Process overview • ‘Size’ of task Development Pre-work Recruitment Sample audit