Collective Impact for Neighborhood and County Health (CINCH)

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Goal • Create a healthier community by achieving positive changes

in: nutrition/weight physical activity tobacco use the built environment access to clinical preventive services (such as blood pressure

screening)

• Improve health and wellness of county residents through policy, environmental, programmatic, and infrastructure changes

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How?• Reduction in deaths and illnesses from heart disease,

diabetes, cancer, and asthma through policies that increase opportunities for:

physical activity and healthy eating healthy neighborhoods environments free of tobacco smoke

• Participatory Planning Approach Leadership, advisory teams and community input

• Research Policy Scan, Health Assessment, qualitative data

gathering

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Health Assessment Key Findings• Hispanics in Bernalillo County:

Have disproportionately high rates of death from Heart disease (men)Stroke (men and women)High blood pressure

Have high rates of obesity

High rates of poverty – 21.2%

High rates of smoking among high school students

• African Americans in Bernalillo County:

Have disproportionately high rates of death from Lung cancerHeart diseaseStroke

See higher rates of obesity than any other population group

Are most likely to encounter financial barriers to obtaining health care

Health Assessment Key Findings

Health Assessment Key Findings•American Indians in Bernalillo County:

Have disproportionately high rates of death from CancerDiabetes

See higher rates of overweight than any other population group

Are most likely to have no health insurance than any other group

Have highest rates of smoking among high school students and adults

Areas with highest concentration of families living in poverty have the highest rates of chronic disease

CINCH Community Engagement Focus group-style community

meetings Six communities identified in health

assessment Geographic – International District, South

Valley, I-25 Corridor Racial/Ethnic – African American, Native

American, Hispanic Two-hour meetings in community settings

(schools, community centers, etc.)

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CINCH Community Engagement• Key informant interviews

Fill in the gaps from community meetingsWho was not represented?

Community health workers, youth advocates, community center leaders

CINCH Community Engagement• Key findings - Healthy eating

Need increased access to affordable, quality fresh food

Need education about healthy food preparation

Wanted more fresh food in schools and at summer programs

Low price and easy access to fast food makes it difficult to eat well when time and money are constraints

CINCH Community Engagement• Key findings – Active Living

South Valley – need for safer streets and sidewalks

International District – concerns about crime

Supported increased access to school yards after hours

Expressed need for increased use of community centers for recreation opportunities

CINCH Community Engagement• Key findings - Tobacco

Difficult for smokers to quit – become defensive when regulations are proposed

Enforcement is lacking – smoking in public places as well as sales of tobacco to minors

Need to deal with larger issues of why people are smoking – stress, poverty

Living in a smoke-free environment is important, especially for children

CINCH Community Engagement• Key findings – Clinical Preventive Services

Hesitation to go for screening because costs are often unclear

Need more providers similar to the race and ethnicity of the communities they serve

Would like to see community health workers in non-clinical settingsSchools, community centers

Need to make people aware of free clinics and screening services

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Policy Change•Written policies at the state, local, and

institutional level (schools, workplaces)• Includes legislative, regulatory, and

organizational policies that promote population health

•Focus on prevention of heart disease, cancer, stroke, and diabetes

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Examples of Effective Policies•Tobacco-free school policies•Policies that increase opportunities for

physical activity in communities (e.g., joint use)

•Policies that support breast-feeding•Mixed-use zoning policies•Complete Streets policies•Training and technical assistance to

improve delivery of clinical preventive services

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The Community Transformation Implementation Plan

•CINCH’s two-year long planning process informed the development of a three-year implementation plan for Bernalillo County that focuses on prevention of chronic disease.

•The CINCH Planning Team met for six months to review results of the Health Assessment, Policy Scan, and focus groups, and to prioritize implementation activities.

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The Community Transformation Implementation Plan•Policy, environmental, programmatic, and

infrastructure changes consistent with CDC’s strategic directions

• Implementation activities must impact the entire population of Bernalillo County, as well as specific population subgroups with disproportionately high rates of health and social disparities

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The Community Transformation Implementation Plan• Submitted to CDC for

consideration in May 2013

• Implementation project period: October 1, 2013 – September 30, 2016

• If funded, activities will be carried out through contracts with community partners

• Seven objectives, each with an overarching goal and specific activities to accomplish the goal

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The Community Transformation Implementation PlanActive Living Project Goal: Increase the number of schools that are authorized to provide safe, inviting, accessible places for physical activity opportunities during non-school hours

Objectives: 1. Increase the number of district-wide joint

use agreements that facilitate the shared use of school property for physical activity purposes

2. Increase the number of schools that employ joint-use and shared-use practices

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The Community Transformation Implementation PlanHealthy EatingProject Goal: Increase the number of people in lower-income neighborhoods who have access to healthy, affordable food

Objectives: 1. Increase the number of people served by mobile produce vending

programs that link consumerswith fresh, locally grown fruits and vegetables

2. Increase the number of people served by healthy corner stores initiatives that facilitate access to fresh fruits and vegetables

3. increase the number of students served byinitiatives that provide schools with locallygrown fruits and vegetables

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The Community Transformation Implementation PlanTobacco-Free Living

Project Goal: Increase the number of people living in smoke-free multi-unit housing in Bernalillo County's International District

Objectives: 1. Increase the number of property owners/managers who

receive education, training, and outreach related to smoke-free housing

2. Increase the number of people exposed to smoke-free multi-unit housing messages

3. Increase the number of tenants receiving education and outreach related to smoke-free multi-unit housing in the International District

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The Community Transformation Implementation PlanTobacco-Free LivingProject Objective:Decrease the number of middle and high school students in priority neighborhoods with access to tobacco products

Goals: 1. Increase the number of community-based youth tobacco

compliance task forces2. Increase the number of tobacco merchants in priority

neighborhoods receiving education about tobacco sales to minors

3. Increase the number of community members in priority neighborhoods receiving education about enforcement and reporting of tobacco sales to minors

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The Community Transformation Implementation PlanHealthy and Safe Physical Environments

Project Objective: Increase the number of adopted land use/transportation plans, policies, or funded projects that incorporate Complete Streets design principles

Goals: 1. Increase the number of transportation engineers, planners, and

other stakeholders in Bernalillo County that are familiar with Complete Streets principles and proficient in applying Complete Streets design standards

2. Increase the number of adopted land use/transportation plans, policies, or funded projects that incorporate Complete Streets design principles

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The Community Transformation Implementation PlanClinical Preventive Services

Project Objective: Increase the number of people who receive health education and preventive services from community health workers who are representative of the target populations

Goals: 1. Increase the number of community health worker programs that have

sustainable funding sources2. Increase the number of Bernalillo County-based community health

workers participating in a formal learning collaborative3. Increase the number of certification programs that incorporate

community health worker core competency curriculum modules that focus on chronic disease, social determinants of health, and CTG strategies

4. Increase the number of community health workers placed in community settings

Thank you!Questions?