Makin' chli


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  • Makin' chli

    1. 1. Making CHLI: Ingredients Ellen Zavisca Use of the Community Healthy Living Index as a Tool for Neighborhood Assessment and Community Engagement Overview
    2. 2. Presentation overview <ul><li>What is CHLI </li></ul><ul><li>Our experience with CHLI </li></ul><ul><li>Lessons learned </li></ul>
    3. 3. What is CHLI <ul><li>Developed by YMCA </li></ul><ul><li>Recommended to Knox County by RWJF/Healthy Kids, Healthy Communities </li></ul><ul><li>A qualitative tool for assessing physical activity and food environments </li></ul>
    4. 4. What is CHLI <ul><li>5 environmental assessment tools </li></ul><ul><ul><li>Afterschool child care site </li></ul></ul><ul><ul><li>Neighborhood </li></ul></ul><ul><ul><li>School </li></ul></ul><ul><ul><li>Work site </li></ul></ul><ul><ul><li>Community at large </li></ul></ul>
    5. 5. CHLI requirements <ul><li>Organized leadership </li></ul><ul><li>A multi-disciplinary team </li></ul><ul><li>Community volunteers </li></ul>
    6. 6. Some CHLI questions
    7. 11. Making CHLI: Taste Test Marsha Spence, Amber Dalton, Kristen Eppig, Mona Habibi, Miranda Huston, Zixin Lou, Alviony Pangloli, Pratsani Srikan The Pilot
    8. 12. Pilot Assessment <ul><li>Collaboration with: </li></ul><ul><li>The University of Tennessee, Knoxville </li></ul><ul><li>Department of Nutrition </li></ul><ul><li>Public Health Nutrition (PHN) Program </li></ul><ul><li>Knox County Health Department </li></ul><ul><li>Healthy Kids, Healthy Communities </li></ul><ul><li>Robert Wood Johnson Foundation </li></ul><ul><li>YMCA, Knoxville </li></ul><ul><li>Community Healthy Living Index </li></ul>
    9. 13. Purpose of Project <ul><li>Pilot the Community Healthy Living Index (CHLI) for feasibility of use for Healthy Kids, Healthy Communities Project </li></ul><ul><li>Perform a Nutrition & Physical Activity Environmental Audit of The University of Tennessee Neighborhood </li></ul>
    10. 14. The Neighborhood Zip code: 37916
    11. 15. Participants <ul><li>Participants were recruited by PHN graduate students via: </li></ul><ul><ul><li>direct contact with peers & community members </li></ul></ul><ul><ul><li>flyers distributed around campus </li></ul></ul><ul><ul><li>emails </li></ul></ul>
    12. 16. Participant Meetings <ul><li>Purpose: </li></ul><ul><ul><li>Explained CHLI & it’s purpose </li></ul></ul><ul><ul><li>Reviewed consent form & confidentiality </li></ul></ul><ul><ul><li>Assigned sectors & scheduled times to conduct audits </li></ul></ul>
    13. 17. CHLI <ul><li>PHN students: </li></ul><ul><ul><li>completed the General Information section of CHLI using data from US Census & other Internet & Library Sources </li></ul></ul><ul><ul><li>escorted participants through sectors of the community to complete the Programs, Physical Environment, Promotion, & Policy sections of the CHLI </li></ul></ul>
    14. 18. Results <ul><li>Neighborhood Design </li></ul>
    15. 19. Results <ul><li>Environment Related to Physical Activity </li></ul>
    16. 20. Results <ul><li>Environment Related to Food & Nutrition </li></ul>
    17. 21. Results <ul><li>Safety </li></ul>
    18. 22. Usability of CHLI <ul><li>Most participants reported CHLI was feasible & could help make positive changes in neighborhoods. </li></ul><ul><li>It took most participants between 2-3 hours to complete sector audits. </li></ul><ul><li>Participants need to be familiar with the neighborhood & the CHLI form to increase ease of completion. </li></ul>
    19. 23. Recommendations <ul><li>Distribute CHLI forms before scheduled audits </li></ul><ul><li>Decide neighborhood perimeters beforehand </li></ul><ul><ul><li>Give several maps & markers to each participant </li></ul></ul><ul><ul><li>Decide whether or not to access all areas of neighborhoods (every road; every store/restaurant) </li></ul></ul>2007. 01
    20. 24. Recommendations <ul><li>Meet with participants before & after audits </li></ul><ul><li>Collect demographic information about participants </li></ul><ul><li>Address concerns & clarify any areas of confusion prior to completing audits </li></ul><ul><li>Take photographs of areas that are strengths or barriers in the neighborhood </li></ul>
    21. 25. Conclusions <ul><li>CHLI: </li></ul><ul><ul><li>Successful tool to assess neighborhood nutrition & physical activity environments </li></ul></ul><ul><ul><li>Capable of identifying barriers & strengths in neighborhoods </li></ul></ul><ul><ul><li>May be used to plan programs & make changes in the neighborhood </li></ul></ul>
    22. 26. Making CHLI: Main Course Ben Epperson Process, Findings, Thoughts How CHLI Worked for Us The Project
    23. 27. <ul><li>National program of Robert Wood Johnson Foundation </li></ul><ul><li>Supporting Community Action to Prevent Childhood Obesity </li></ul><ul><li>Goal: Implement active living and healthy eating initiatives to reduce childhood obesity </li></ul><ul><li>Funding must be used to build and sustain systems, policies and environmental changes </li></ul>HKHC
    24. 29. Our Purpose <ul><li>Address the needs of vulnerable populations and communities </li></ul><ul><li>Identify and engage: </li></ul><ul><ul><li>populations at greatest risk for childhood obesity </li></ul></ul><ul><ul><li>influential community members with experience and commitment to advancing active living and healthy eating </li></ul></ul><ul><ul><li>Broad-based political support </li></ul></ul><ul><li>Create something that can be replicated </li></ul>
    25. 30. Our HKHC Partnership <ul><li>East TN Children’s Hospital </li></ul><ul><li>– Childhood Obesity Coalition </li></ul><ul><li>Knoxville Regional Transportation Planning Organization </li></ul><ul><li>Knox County Schools Coordinated School Health Program </li></ul><ul><li>Fountain City Connections </li></ul><ul><li>Key faculty from UT-Knoxville: </li></ul><ul><ul><li>Center for Public Health </li></ul></ul><ul><ul><li>Obesity Research Center </li></ul></ul><ul><ul><li>Department of Nutrition </li></ul></ul>
    26. 31. “Target” Neighborhoods <ul><li>Three neighborhoods in year one, selected based on: </li></ul><ul><ul><li>Prevalence rates of childhood obesity </li></ul></ul><ul><ul><li>Socioeconomic, policy, and environmental factors </li></ul></ul><ul><ul><li>Assets and opportunities for success </li></ul></ul><ul><ul><li>A mixture of urban, rural and suburban communities </li></ul></ul><ul><li>Lonsdale, Inskip, Mascot </li></ul>
    27. 32. Our Assessments <ul><li>Key informant interviews </li></ul><ul><li>Focus groups </li></ul><ul><li>YMCA Activate America </li></ul><ul><li>Community Healthy Living Index: </li></ul><ul><ul><li>Neighborhood assessment </li></ul></ul>
    28. 33. CHLI <ul><li>Purpose </li></ul><ul><ul><li>Engage community members in a process of identifying environmental barriers and assets related to active living and healthy eating </li></ul></ul><ul><ul><li>Identify priority issues at the neighborhood level </li></ul></ul><ul><ul><li>Collect data that can ultimately be used to inform policy decisions at the systems level </li></ul></ul>
    29. 34. <ul><li>Identify and convene community </li></ul><ul><li>members and stakeholders </li></ul><ul><li>Assign 5 assessment routes within each neighborhood </li></ul><ul><li>Assist students/community members in scheduling assessment </li></ul><ul><li>Be present at assessments </li></ul><ul><li>Facilitate discussion, planning and implementation </li></ul>HKHC Staff
    30. 35. Community Members <ul><li>Answer the assessment questions based on instructions, direct observation and perception </li></ul><ul><li>Participate in discussion, planning and implementation </li></ul>
    31. 36. <ul><li>Understand the CHLI Neighborhood Assessment tool </li></ul><ul><li>Facilitate use of the tool by neighborhood/community stakeholders </li></ul><ul><li>Accompany stakeholders on the assessment; assure consistent assessment process used; provide clarification, if needed; record responses </li></ul><ul><li>Enter data </li></ul><ul><li>Provide report </li></ul>MPH Student Role
    32. 37. MPH Methodology <ul><li>Data Collection </li></ul><ul><ul><li>Student designated walking route </li></ul></ul><ul><ul><li>1-2 CHLI tools per audit </li></ul></ul><ul><ul><li>Student, HKHC staff, community member </li></ul></ul><ul><ul><li>Additional participant comments noted </li></ul></ul><ul><ul><li>Pics/Video taken by HKHC staff </li></ul></ul>
    33. 38. MPH Report Example <ul><li>Neighborhood Design </li></ul><ul><ul><li>1 well-maintained park and 1 Rec center </li></ul></ul><ul><ul><li>but </li></ul></ul><ul><ul><li>Poor walkability </li></ul></ul><ul><ul><li>Few sidewalks, trails, greenways </li></ul></ul><ul><ul><li>Narrowness, uneven surfaces, uncovered small utility holes </li></ul></ul>
    34. 39. MPH Report Example <ul><li>Safety (concern among community) </li></ul><ul><ul><li>Large crime rate, prostitution, and suspicions of gang activity </li></ul></ul><ul><ul><li>Poor lighting throughout neighborhood </li></ul></ul><ul><ul><li>High-traffic areas with high-speed drivers </li></ul></ul><ul><ul><li>“ City does not pay attention” to area </li></ul></ul><ul><ul><li>Substantial efforts to reduce loitering </li></ul></ul><ul><ul><li>Neighborhood Watch Association </li></ul></ul>
    35. 40. MPH Report Example <ul><li>Physical Activity Environment </li></ul><ul><ul><li>Abundant green space…but much unused </li></ul></ul><ul><ul><li>Swimming pool (“very popular”), baseball and soccer fields, tennis courts, and playground </li></ul></ul><ul><ul><li>No basketball court, golf course, facilities open for walkers during off-hours, water or winter sport areas </li></ul></ul><ul><ul><li>No street safety measures to support walking and biking </li></ul></ul>
    36. 41. MPH Report Example <ul><li>Community Engagement </li></ul><ul><ul><li>Social Capitol split between two views </li></ul></ul><ul><ul><ul><li>Familiarity among long term residents </li></ul></ul></ul><ul><ul><ul><li>but </li></ul></ul></ul><ul><ul><ul><li>Public housing residents and new immigrants viewed as outsiders </li></ul></ul></ul><ul><li>No known community organizations </li></ul><ul><li>Boy’s and Girls Club (fee) </li></ul><ul><li>After school program (fee) </li></ul>
    37. 42. CHLI Next Steps <ul><li>Assessment results as a “Stage of Development” </li></ul><ul><li>From Seeds to an Orchard: </li></ul><ul><ul><li>Planting the Seeds </li></ul></ul><ul><ul><li>Nurturing for Growth </li></ul></ul><ul><ul><li>Nourishing the Roots </li></ul></ul><ul><ul><li>Cultivating Healthy Fruit </li></ul></ul><ul><ul><li>Harvesting the Rewards </li></ul></ul>
    38. 43. HKHC Next Steps <ul><li>Sociometrics </li></ul><ul><li>Key Informants </li></ul><ul><li>Group Visioning </li></ul><ul><li>Prioritization </li></ul><ul><li>MPC audit </li></ul><ul><li>Community Action Teams </li></ul><ul><li>Trainings </li></ul>
    39. 44. Thoughts <ul><li>Strengths: </li></ul><ul><ul><li>“ Ground Truthing” tool </li></ul></ul><ul><ul><li>Engages community </li></ul></ul><ul><ul><li>Neighborhood crash course </li></ul></ul><ul><ul><li>Full assessment strengthens communication </li></ul></ul><ul><li>Weaknesses: </li></ul><ul><ul><li>Lacks specificity </li></ul></ul><ul><ul><li>No community development model </li></ul></ul>