LiveWell Colorado | Building a Strong Foundation for Community-Based Collaborative Sustainability
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Presented by Leslie Levine, Technical Assistance & Research Manager, LiveWell Colorado, at the American Public Health Association's 2016 conference in Denver, CO.
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LiveWell Colorado | Building a Strong Foundation for Community-Based Collaborative Sustainability
- 1. Building a Strong Foundation for Community-Based Collaborative Sustainability Leslie Levine Technical Assistance & Research Manager LiveWell Colorado
- 2. Presenter Disclosures Leslie Levine No relationships to disclose 2
- 3. Our History Funding initiative launched in March 2007 Vision and innovative partnership of: – Colorado Health Foundation – Colorado Dept of Public Health & Environment – Kaiser Permanente Established as a nonprofit in 2009 To reduce barriers preventing healthy eating and active living (HEAL) behaviors in Colorado 3
- 4. 4
- 5. Integrating Sustainability into Community Partnerships Sustainability Planning implemented in 2011 Financial Institutional Cultural 5
- 6. Financial Sustainability What funding is needed to effectively implement planned interventions (short, intermediate, and long-term)? What funding sources are available that have an interest in HEAL in a specific community? What actions need to be taken in the near future to leverage LWC funding into additional resources? What assets does a community have, and will it need, in order to ensure financial sustainability of this HEAL movement? 6
- 7. Institutional Sustainability Which organizational structures need to adopt policies and values in order to sustain the HEAL movement? Which individuals that are a part of our coalition can drive institutional sustainability within their organization or community group? Who are we missing? What current efforts need to be sustained and which ones are no longer necessary? What are the indicators of institutional sustainability and how will we measure it? 7
- 8. Cultural Sustainability What would cultural sustainability look like in our community? How would organizations, the media, educators, politicians, and residents behave if HEAL became a cultural norm? What existing cultural barriers do we have the capacity to influence? What are some pre-existing examples of culture change our community has witnessed and what can we learn from them? What is going to be our most significant contribution to integrating HEAL into our community’s culture(s)? 8
- 9. Theory of Impact Low-income Colorado families don’t have opportunities to live healthy lives Coloradans are healthier Coloradans are better educated Coloradans are more economically prosperous Problem ImpactCatalyzer Community Voice Improved Physical Environment Culture of Entrepreneurship Communities lack places for people to play Schools can’t offer healthy options Communities don’t have healthy and affordable food Communities aren’t safe enough for healthy behaviors
- 10. Paths Toward Success Needs Assessment Leadership Development Supportive Fiscal Agent Quality Staff Participative Governance 10
- 11. Lessons & Challenges The path to obesity prevention is not obesity prevention… Nonprofits, government and foundations must organize their efforts before they enter a community… Community champions are at the very center of impact, invest in them… A holistically vibrant community has many definitions, find out how local leaders define success… 11
- 12. Park Hill/City & County of Denver Embraced Community Voice Improved Physical Environment Culture of Entrepreneurship 12
- 13. Thank you Leslie Levine LIveWell Colorado 720-573-3617 leslielevine@livewellcolorado.org www.livewellcolorado.org 13
Editor's Notes
- I want to start by sharing about the history of our organization so that you can understand how we were formed and how we have evolved over time to become a sustainable organization. Colorado received funding from the CDC for our statewide obesity prevention program. At the same time, Kaiser Permanente was funding coalition efforts to address obesity in communities in the Denver Metro region. The Colorado Health Foundation was funding community strategies to address obesity prevention, and the state had also received a Steps to a Healthier US grant that provided funding for 4 rural counties to address obesity among other risk factors and chronic conditions. In 2007, the Colorado Physical Activity and Nutrition program, partnered with Kaiser Permanente and the Colorado Health Foundation to streamline financial management, technical assistance and evaluation of grants to address obesity prevention. LiveWell Colorado (LWC), while initially a funding initiative, became a 501c3 to enable the necessary advocacy to address systems and policy changes. Today, we are a statewide nonprofit organization addressing the barriers to healthy eating and physical activity through policy at the local, state and federal level and shifting systems to make the healthy choice the easy choice. When the nonprofit organization was launched in 2009, we understood from our key funders – KP and TCHF – that we needed to diversify our funding. I thought it would be helpful to share some of our funding sources over the years. Foundation and KP funding still in place Cultivating individual donors such as a $1 million donation for our LiveWell@School Food Initiative that works with school districts to transition their school meal program from processed to scratch cooking. Additionally, through an annual fundraising luncheon, we have received many smaller donations from individuals. We have had a number of business sector partnerships, especially when our focus was on individual behavior change as opposed to the systems work that we now emphasize. We have received both sponsorships and grants from businesses based in Colorado and in other parts of the country. –BellCo Credit Union and Slimgenics sponsored what was called a Get Movin Mobile that was used to raise awareness about the importance of physical activity and nutrition at community events such as 5K runs and festivals. Glaxo Smith Klein awarded a $500,000 grant to address barriers to youth recreation in NE Denver through a collective impact process. We have received government grants at the state and federal level, most recently we were awarded a grant from the USDA for the Food Insecurity Nutrition Incentive program that will provide $20 vouchers to SNAP participants to purchase Colorado produce at farmers markets and more traditional food retail outlets.
- For this presentation, I will be focusing on the LiveWell Colorado Community Investment Initiative that originally had funding through the CDC Division of Nutrition, Physical Activity and Obesity. Over the years, LWC has funded communities across the state. While our model has evolved, communities received about $1 million over 9 years to address programs, policies, environmental and systems change. The scale of communities ranged from a cluster of neighborhoods in Denver, to cities along our front range, to entire counties in our rural communities. Each community hired a community coordinator and formed a multi-sector coalition that included government agencies, organizations, businesses, residents, and schools and has folks experienced in public health, economic development, transportation planning, education, environmental issues, agriculture, parks and trails, food insecurity and many more content areas. The emphasis was on multi-sector coalitions and each community determined which players were essential for their local conversation. Initially, our investment had a duration of 7 years. As the initial cohort of LW communities came to the end of their funding cycle, there was a lot of conversation about being just on the cusp of significant change. After much discussion, we were able to add another 2 years to the funding relationship so that communities had the time and resources to focus on sustaining their community initiative. In some cases, the initiative was sustained through the creation of a new nonprofit organization. In others, the coordinator was able to obtain funding from other sources to cover their salary, to continue funding strategies, and to keep the coalition in place. Together, we learned that sustainability needed to be addressed as the community initiative was being created. It is so easy to focus on the here and now and forgo planning into the future.
- In 2011, LWC incorporated sustainability planning into the mobilization and planning phase acknowledging that the primary purpose of LWC’s investment is to create a sustainable movement that will continue to have a positive impact long after our funding has ended. We understand that our investment can only be a piece of what is needed to create change. A community’s capacity to raise and leverage additional dollars, institutionalize interventions within agencies and organizations, and build cultural expectations around healthy eating and active living will be essential. LWC acknowledges that early on a sustainability plan may be more conceptual than concrete. Communities were required to address 3 components of sustainability: financial, institutional and cultural
- Financial What funding is needed to effectively implement planned interventions (short, intermediate, and long-term)? What funding sources are available that have an interest in healthy eating, activity living or obesity prevention directly or indirectly in a specific community? What actions need to be taken in the near future to leverage LWC funding into additional resources? What assets does a community have, and will it need, in order to ensure financial sustainability of this movement? One example is a municipality providing funding to a local non-profit organization to fund staff time to coordinate a community led coalition to address obesity prevention. Another community created a nonprofit organization to be able to accept donations from the community and to have the appropriate tax status for grant writing. We have provided a lot of technical assistance to our communities to address financial sustainability and most recently in 2015, on average our LiveWell communities were able to leverage our investment 9:1.
- Institutional sustainability is the integration of the movement into the various partner organizations. Examples include incorporating language about access to healthy eating and physical activity into policies that influence community design, or having a position on a non-public health oriented board or commission that is specifically allocated to obesity prevention, or modifying a job description to include healthy eating or physical activity components such as school district transportation planner being responsible for bicycle and pedestrian access to a school in addition to school bus routes. Some questions that communities considered when thinking about institutional sustainability include: Which organizational structures need to adopt policies and values in order to sustain the movement? Which individuals that are a part of our coalition can drive institutional sustainability within their organization or community group? Who are we missing? What current efforts need to be sustained and which ones are no longer necessary? What are the indicators of institutional sustainability and how will we measure it? Some examples of indicators of institutional sustainability are Modified job descriptions, and changing a community process such that youth are included in the creation of community recreation plan.
- Cultural sustainability is what can keep a community initiative in place once partners have long since taken ownership of programmatic strategies and implementation of policies that guide future changes to the built environment. It is definitely the least tangible of the 3 elements of sustainability per our definition. What would cultural sustainability look like in our community? How would organizations, the media, educators, politicians, and residents behave if healthy eating and active living became a cultural norm? What existing cultural barriers do we have the capacity to influence? What are some pre-existing examples of culture change our community has witnessed and what can we learn from them? What is going to be our most significant contribution to integrating healthy eating and active living into our community’s culture(s)? We think culture sustainability could mean political candidates including healthy eating and active living in their policy platform. It could mean an expectation that members from minority communities serve on board and advisory committees so that they are at the table from beginning of community change process.
- As previously mentioned, communities in Colorado have been addressing obesity prevention in a comprehensive manner as early as 2004. That said, we have had a lot of time to study and assess what success looks like and the necessary elements to bring about that success. What we’ve learned is that much of what prevents healthy behaviors in lower income communities has a lot to do with what people can or can’t access. LWC has to understand our role as a state-level organization in making sure people can engage in healthy behaviors. We have to keep top of mind the more significant, deeply rooted issues of poverty, poor education, unsupportive physical environment, safety, unhealthy food options, and overall lack of resources. People face all kinds of issues that get in way of making healthy choices. We have learned that equity must be central to our work and that equity is about the opportunity to make the healthy choice. Our efforts, our guidance and our resources try to remove barriers and then contribute to bigger issues like economic prosperity that we believe leads to thriving communities. This slide shows our equity theory. The problem is one that is not unique to Colorado. While success varies and looks very different by community, there are trends that lead to progress. We have learned the value of Community Voice – While it is a slow process to build, having an organized and inclusive agenda brought forward by community leaders is key to sustainable community change. As a funder, we understood the value of investing in this process and early on lengthened the time frame for communities during their planning process to build those necessary relationships. Leading with the community voice also allows a community to redefine their image or their “brand” from one that was impoverished and inundated with challenges to a community rich with culture and full of assets. For years, improving the physical environment has been deemed essential in addressing obesity. Infrastructure changes such as roads that support pedestrians and bicycle travel in addition to cars, parks in close proximity to homes, trails that connect homes to community assets are all important components of a healthy community. We have learned that a community can have the conditions in place that support healthy behaviors, but unless you have a big and visual win that rallies the entire community and propels further action, sustainability is more challenging. Culture of entrepreneurship – This is part of the re-branding of a community. This is the focus on shifting community norms so that there is an emphasis on and support for trying new ideas, creating a new way of doing things and building on assets in innovative ways. This shift to a culture of entrepreneurship means that confidence is building among a community’s residents and that optimism is growing. Residents begin to see the possibilities in their community and not just the problems. Residents believe they bring value to their community.
- We get a lot of questions from state and local partners around the country wanting to understand how we address community investment. Beyond the theoretical, here are some other important elements to consider when forming a community based initiative. Needs Assessment is the cornerstone of any community initiative. We value data informed community plans We encourage try new methods to reach and engage new community members. In one of our metro area communities under Mondi’s leadership, they used walkability and bikeability assessments to collect data, engage residents and partners in an active assessment process, and educate them about active transportation issues. Leadership development – Invest in your coalition Give residents the opportunity to be leaders. Provide leadership training. In another LW community, each committee is co-chaired by a community organization and a resident Supportive fiscal agent – Where a community initiative is housed, whether in a local health authority, community benefit department of a hospital, or a local non-profit organization, a coalition needs to be thoughtful about choosing a home for their initiative. How entrenched is the organization in the community? How are they viewed in the community by a variety of residents/organizations/agencies? What is the fiscal agent hoping to achieve by housing the initiative? Staff – I can’t emphasize enough the importance of having a paid coalition convener or director. If funding is available for a full time position, especially if the initiative is at the scale of our LW communities, it is worth the investment. It takes a lot of time to build a coalition, foster and deepen relationships, conduct strategic planning, oversee strategy implementation, fundraising and evaluation. Having a paid position is essential to sustainability of a movement. We used to try to create a sample job description for a community coordinator. While skills to do things like fundraising and evaluation are important, what is essential is that the coordinator embraces the elements discussed on the theory of impact slide – community voice, understanding how to build a movement in partnership with a community, and the value of a culture of entrepreneurship. Participative Governance –The coordinator or director shouldn’t be doing all of the work. All partners need to be at the table actively contributing to the work of the community initiative, actively participating in decisions big and small, committing to implementing the strategies, helping with assessment, evaluation, communication – all facets of the work.
- I have a few parting thoughts before I pass the baton to Mondi. I am lucky to have been with LiveWell Colorado since its inception as a funding initiative. Over the years, we have stepped back to take a mile high view (ha ha) and I want to share some of the lessons we’ve learned. Traditional obesity reduction strategies are important aspects of our work. However, taking a community asset approach and addressing the prosperity and upward mobility of individual residents and the community as a whole are two essential elements of community change. We see this all the time. Institutions from outside of a community come in to “fix” a community’s problems. It is imperative that nonprofits, government agencies and foundations be open to guidance from community leaders to determine what the problems are that a community is facing and how to effectively address those problems. Champions are the strength of a community and through their capacity, change happens. Invest in them What does success look like in community? Help a community discover its own voice. Directly and tangibly remove the physical and social barriers to thriving communities. Foster innovation. It is contagious!
- Next, you will hear about our partners in the City and County of Denver who started with a community initiative in the Park Hill neighborhood. This initiative embraced the elements that I have previously described as those that lead to sustainable change in a community.
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