Building Effective Partnerships Between Pediatrics and Public Health

Building Effective Partnerships
between Pediatrics and Public Health:
Lessons Learned from the Practical Playbook &
the American Academy of Pediatrics
July 27, 2016
@PracPlaybook

Tia Simmons, DrPH, MCHES,
Senior Project Manager,
The Practical Playbook
Courtney Bartlett, MPH, CPH,
CHES, Project Planner,
The Practical Playbook

Objectives:
 Describe tools and resources for AAP members to
assist in finding and partnering with public health
professionals.
 Share tangible examples of primary care/public
health partnerships.
 Discuss challenges/barriers, and tips for successful
partnering.

Jacqueline Dougé, MD, MPH,
FAAP, Medical Director of Bureau
of Child Health, Howard County
Health Department
Amanda D. Castel, MD, MPH,
AAHIVS, Associate Professor and
Co-Director MSPHMEID Program,
George Washington University

AAP Prevention and Public Health Special
Interest Group
• The SIG hosts a quarterly webinar series focused on children’s public health issues,
and opportunities for collaboration between pediatricians and public health
professionals.
SIG Co-Chairs:
Jacqueline Dougé MD, MPH, FAAP
Amanda Castel MD, MPH, FAAP
The Prevention and Public Health SIG:
• Promotes public health approaches to child health
• Promotes collaborations between pediatricians and public
health professionals
• Provides a network for pediatricians to develop strategies
that integrate clinical medicine and public health
• The SIG is jointly managed by the AAP Section on
Epidemiology, Public Health, and Evidence and the AAP
Council on Community Pediatrics.
• Contact: cocp@aap.org to join the SIG.

How Can The Practical Playbook Help?

Get started with Fundamentals.

Phyllis Agran, MD, MPH,
FAAP, Executive/Medical
Director, Clinic in the Park

Health Collaborative of
Pediatricians, Community, Academic,
Public and Private Organizations &
Individuals providing
Health and Wellness Services
This project is supported, in part, by Grant # H17MC26778
from the U.S. Department of Health and Human Services,
Health Resources and Services Administration, Maternal501(c)3 nonprofit fiscal
Connect • Screen • Educate
Using Public Space for Health at the
OC Great Park & Neighborhoods

Faculty Disclosure Information
In the past 12 months, we have no relevant financial relationships
with the manufacturer(s) of any commercial product(s) and/or
provider(s) of commercial services discussed in this CME activity.
We do not intend to discuss an unapproved/investigative use of a
commercial product/device in my presentation.
Phyllis Agran, MD, MPH
Sandra Murray, MD
Herlinda Guzman, BA
John Billimek, PhD.
Clinic in the Park 2015
www.clinicinthepark.org

American Academy of Pediatrics
Resources
This project is supported, in part, by Grant # H17MC26778
from the U.S. Department of Health and Human Services,
Health Resources and Services Administration, Maternal501(c)3 nonprofit fiscal

Poverty in Orange
County
A Tale of Two Cities
(PBS Documentary)
1/5 live in poverty
(>30% in some areas)
1/3 overweight/obese
1/3 untreated dental disease.
(>30% in some areas)
54% Food Insecurity; up to 98%
School Lunch Program
Poor Health Translates to Poor
Academic Performance

2016-2019 Goals
•Access to health services in
community public venues (parks;
schools; resource centers)
This project is supported, in part, by Grant # H17MC26778 from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and
Child Health Bureau.
Connect • Screen • Educate
•Venue(s) where health
organizations, public,
private and academic
institutions/organizations
and individuals collaborate
to provide services in
neighborhoods.
○One Stop Shop
○Greater impact - refer
and cross refer
○Replicate model
•Sustainable community
resource in underserved
communities
•Demonstrate economic
benefit

A Fiscally
Sponsored Project
of OneOC*

Establishing Sustainable Partnerships
•Children’s Health
-Needs
•Aligned Mission(s)
-Optimal Health
•Leadership
-Credible, uniform messages
-AAP
•Diverse Collaborative
-Community non-profits
-Academic institutions
-Families
-Public Policy Makers
-Public and Private orgs
•Policies and Procedures
-Goals
-LOI
-MOU
•Sustainability
-Diverse Revenues
-Leverage
•Data Sharing
-Provide Results
•Evaluate
-Remodel; Reassess; QI
-Engage Partners

• American Academy of Pediatrics*
• Allergy & Asthma Associates of Southern CA
• Be Aware Foundation
• Blind Children’s Learning Center
• California Highway Patrol
• Cal Optima (County Medicaid)
• Catholic Charities of Orange County
• Child Abuse Prevention Center*
• Children & Families Commission of OC
• CHOC: Children’s Community Education Dept.
• City of Irvine & Great Park Corp.
• Coalition of OC Community Health Centers
• Community Health Initiative of OC
• Dietitian, Katherine Bennett
• Great Park Farm and Farmer’s Market
• Head Start
• Healthy Smiles for Kids of OC*
• Hurtt Family Health Center (FQHC)
• Irvine High School
• Irvine Parks and Rec: Mobile Rec Unit
• Irvine Police Department
• Latino Health Access*
• Legal Aid Society of OC*
• MOMS (Maternal Outreach & Management
Services) OC*
• National Ovarian Cancer Coalition
• OC Dept. of Education: Center for Healthy Kids &
Schools
• OC Social Services
• OC Health Care Agency Family Health & Health
Promotion Divisions*
• OC Children’s Therapeutic Arts Center
• Orangewood Foundation, Bridges for Newborns
• Providence Speech & Hearing
• Raise Foundation*
• Regional Center OC
• Safe Kids OC
• THINK Together, Early Literacy*
• Tustin Unified School District
Beswick & Veeh Elementary Schools
Currie-Thorman School
• UC Irvine: Health, School of Medicine, Trauma
and Injury Prevention Services, Nursing
Program*, Institute for Clinical & Translational
Science, Population Health/Public Health, Burn
Center, Pediatric Exercise Research Center,
Pediatrics,
• Emergency Medicine, Informatics
• Student Organizations.
• Woodbridge High School
• 2110C
• Craig Anderson, PhD. DrPH*
• Elaine King, MD* Farrouk Shadab, MD*
• Sandra Murray, MD* Shahram Lotfipour, MD*
• Zhijun Wang, MD*
• Phyllis Agran, MD, MPH*
* Founding Faculty
Clinic Collaborators

Clinic in the Park Total Key Services 6/2012-5/2015
at Great Park Hub and Satellites
Estimated Total Visitors: 19,000
Types of Services Provided Year 1 Year 2 Year 3 Total
Jun 2012-May 2015 Jun 2012 - May 2013 Jun 2013 - May 2014 Jun 2014 - May 2015 Jun 2012 - May 2015
(#Visitors = 5,481) (#Visitors = 9,164)
(#Visitors =
3,603+290)
Allergy and Asthma 400 277 N/A 4219
Child Development 438 820 627 2285
Child/Adolescent Safety 1902 2171 1317 2972
Connections to Services 2204 1022 1226 4307
Dental Services 467 1491 466 1152
Early Literacy 1493 1599 1215 1883
Emotional Health 717 1152 988 689
First Aid / CPR N/A 389 399 3366
Health Chats 612 246 294 2493
Hearing and Speech 225 305 133 1117
Legal Information/Resources 488 412 217 5446
Medical Services 119 455 115 663
Nutrition 981 1129 1449 677
Parenting Skills 978 837 678 2802
Physical Activity 848 767 861 731
Prevention 638 1891 1036 2392
Total Services to Date 12510 14963 11021 37194

Healthy Tomorrows. This project is supported, in part, by Grant # H17MC26778 from the U.S. Department of Health and Human
A Fiscally Sponsored
Project of OneOC*
COMMUNITY NEEDS ASSESSMENT
(FULL RESULTS AVAILABLE)
Community
Annual Income
<$23,000
68%
Jobless 30%
Service Needs
Bicycle Helmet 37%
Healthy Eating Tools 27%
Child Car Seats 20%
Health Care
Dentist 37%
Doctor 31%
Medical Home 27%
Health Insurance 25%
IMPACT:
A TOTAL OF 492 VISITORS OF ALL AGES RECEIVED 3,264
DISCRETE SERVICES AND 200 POUNDS OF FREE, FRESH
PRODUCE.
· OF ADULTS WHO WERE SCREENED, 2 IMMEDIATELY
REFERRED TO THE COMMUNITY CLINIC
· REQUESTS FOR MORE BOOSTER SEATS AND BICYCLE
HELMETS
· 55 CHILDREN RECEIVED FREE ORAL SCREENING
INCLUDING FLUORIDE VARNISH
COMMENTS AND OBSERVATIONS:
“IT IS A MUCH NEEDED SERVICE… WITHOUT THE CLINIC
[A PARENT] WOULDN’T HAVE KNOWN SHE HAD A
HEALTH ISSUE”
– LISA SOLOMON, PRINCIPAL, MADISON ELEMENTARY
KEY OUTCOMES
(FULL REPORT AVAILABLE)
COST SAVINGS:
· $15/BOOSTER SEAT SAVES $2700 IN COST SAVINGS
· $1/FLUORIDE TREATMENT SAVES $38 IN DENTAL COSTS
· $1 INVESTED IN NUTRITION EDUCATION REDUCES HEALTH
CARE COSTS BY $10
Services
Child/Adolescent Safety
Education
235
Free Bicycle Helmets
Free Booster Seats
19
15
Early Literacy:
Free Books 250
Dental Services:
Education/Referrals
Fluoride treatment
150
55
Hands Only CPR Skills 178
Emotional Health 179
Medical Services 106
Nutrition Education 580
Clinic in the Park at Madison
March 26, 2016
Impact
LEAD PARTNERS/HOSTS: • Clinic in the Park • Madison Park Neighborhood
Association • GREEN Project • Madison Elementary School
COMMUNITY PARTNERS: 14 ORGANIZATIONS, 168 IN-KIND HOURS

I haven’t had an
exam in 3 years
because I do not
have health
insurance and
now I will get
medical care.
My son and I learn
new things each
month, especially
today when Dr.
Malger spoke at the
health chat and your
dietitian were there to
speak directly with
my son. Sometimes
kids have to hear it
from someone other
than a parent.
Healthy
Smiles
found a
cavity in my
daughter’s
mouth. My children
were given
booster seats. I
didn’t know
they outgrew
their car seats!
It was great
meeting
Bobby Grich
and hearing
him talk
about
health.
We love
the
Adventure
Farm Tour
and fresh
produce.
(Tom
Larson
hosts the
Tour)
The Clinic is
very friendly.
They talk to
you, give
useful
information
and help us.
They are very
patient and
answer all of
our questions.
They are not
rushed like a
doctor’s office.
Our kids like
the activities
and like to talk
to the doctors
too. We like
the fruit!
Visitor
Comments

Volunteer Opportunities
● Visit a Clinic
● Marketing/Branding
○ Refresh Marketing Video (www.clinicinthepark.org)
○ Increase Social Media Presence/Followers
○ Need Mobile Unit (SUV, Mini Van for storage and transport to
satellites
● Assist with Child Safety Station
○ Booster Seats, Bicycle Helmets, Kids in Hot Cars
○ Burn, Poison, Drowning Prevention
● Assist with Sponsor Donations
○ Fresh Produce
○ Book Bags & School Supplies
○ General Funding
● Volunteer
○ Assist with Clinic setup and teardown
○ E-mail clinicinthepark@gmail.com
○ Bring your ideas

Benefits of Clinic in Park
• Provide evidence-based AAP messages
• Time for chats
• Provide education to extended family
• Educational tools
• Safety Equipment
• Venue for Collaborators
• One-Stop Shop
• Promotes cross-referrals
• Replicable Model

Safe to Sleep Station
Presented at American Academy of
Pediatrics 2015
.

Research Agenda
•Can public space for health enhance access to
community resources and education?
•What is the impact of a large community health
collaborative providing one stop shop for health?
•Can health education be effective outside of the
traditional medical home/office visit?
•Is the Clinic model replicable and sustainable?

Accomplishments
Clinic Satellites
Anaheim; Santa Ana;
Tustin; Costa Mesa
New Collaborators
Madison Park
Neighborhood Assoc.
Newport Mesa USD &
Hoag Center for
Community Health;
Collaboration to Assist
Motel Families; UCI/CHOC
Pediatric Residents
• Transportation Program.
Veeh; Project Access
• Presentations.
AAP, Safe Kids, UCI
• New Funders
• HRSA
Region IX
Director:
Melissa
Stafford
Jones
hosted a
health chat

Clinic in the Park –
2016 CDPH Innovation Award Finalist

www.clinicinthepark.org (949) 385-3067)
pagran@uci.edu

Roderick K. King MD, MPH
Chief Executive Officer,
Florida Institute for Health
Innovation

Working Collaboratively for Results
Liberty City Collaborative for Change:
Build Health Challenge
Roderick King, MD, MPH, Florida Institute for Health Innovation

Overview
Participants will learn about:
• Liberty City Collaborative for Change: Build Health Challenge
• Best practices for mobilizing leaders
• Role and leadership of pediatricians

The Florida Institute for Health Innovation
38
Health In All Policies
Collective Impact for
Healthy Communities
Research Evaluation
and Training
(Health Impact Assessment Work)

Liberty City Collaborative for
Change: Build Health Challenge
Miami, Florida
Building a Healthy
and Resilient
Liberty City

Result: A Safe and Healthy Liberty City
40

Story of Liberty City
• 1933 Liberty Square Housing Project
developed in response to deteriorating
housing conditions in Overtown
• “The Wall” along 12th avenue signified the
divide between Blacks and White
communities

0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
35.00%
40.00%
45.00%
33127 33142 33147 33150 Miami-Dade
County
Percentage of Families Below
Poverty in Liberty City Zip
Codes (2015)
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
35.00%
40.00%
45.00%
50.00%
33127 33142 33147 33150 Miami-Dade
County
Percentage of Homeowners in
Liberty City Zip Codes (2009-
2013)

What does it take for population
health level changes?
“Real” adaptive work for communities

Rooted in a Theory of Change
45
Collaborative Leadership
Competencies
Urgency and
Public
Accountability
Focus on Results
Population level changes are most likely to occur if a group of
leaders come together across sectors and agencies and focus their
efforts on achieving a desired result
Results Based Leadership Framework
Results Based
Accountability
Interest Based-
Negotiation
Action Commitments and
Accountability
Jolie Bain
Pillsbury

Key: Leadership Capacity
Building

Engagement
• Diversity of stakeholders
• Inclusiveness – everyone at table has a voice
• Looked within community for residents and community partners first
• Known and respected leadership from LC agencies / organizations
Medical Professionals, Criminal Justice & Law enforcement, Youth and family program providers,
School system, government agencies
• Meeting location is central and neutral
Carrot – all involved have a vested interest in Liberty City

Role of pediatricians
• Challenges facing communities often require a life course approach
• Pediatricians work and see children along the life spectrum (cradle to
college)- 14 WCC visit by 4 years old
– Unique opportunity to educate, identify and intervene/refer (1 on1)
– Child health population expert
– Credible voice (for community, for funders and for other health care
providers
• Challenge: Which role(s) best fit my skills and capacity that will support the
work of the community?
48

Q&A
Please post questions in the chat box.
Dr. King
Chief Executive Officer
Florida Institute for Health Innovation
Dr. Agran
Executive/Medical Director
Clinic in the Park

Thank you!
Practical Playbook:
• Tia Simmons tia.simmons@duke.edu
• Courtney Bartlett Courtney.Bartlett@duke.edu
American Academy of Pediatrics:
• Jackie Dougé jdouge@howardcountymd.gov
• Amanda Castel acastel@email.gwu.edu
Clinic in the Park: http://www.clinicinthepark.org/
BUILD Health Challenge: http://buildhealthchallenge.org/
https://practicalplaybook.org/

Let’s stay in touch! Visit our website to sign up
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Building Effective Partnerships Between Pediatrics and Public Health

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