Power Point Presentation from PartnerSHIP 4 Health for NDSU Health Master's Class

1. May 4, 2015 - NDSU MPH-Health Promotion Class
Karen Nitzkorski
PartnerSHIP 4 Health - School and Worksite Coordinator

2.  The Problem
 Factors that influence Health
 The Minnesota Solution
 Statewide Health Improvement Program
 PartnerSHIP 4 Health
 The Federal Solution
 CDC 1422 Community Wellness Grant
 Life in the Grant World
Tonight’s Roadmap

3. The Problem: Chronic illness
accounts for four of the top seven causes of
death in MN…

4. The Problem: The “real” causes of
these deaths are behaviors that are preventable,
such as tobacco use/exposure, poor diet, and
sedentary living…

5. Obesity is epidemic in Minnesota.
• Nearly 2/3 of adults
are overweight or
obese
• Only one out of four
adults eats enough
fruits and vegetables
• Only slightly more than
half of Minnesota
adults get at least a
moderate level of
exercise
Percent of Minnesota Adults Obese

6. Tobacco continues to be a problem in
Minnesota.
• 14.4% of adults
smoke, and many
others are
subjected to
secondhand smoke.
• Over a quarter of
high school
students used
tobacco in the past
30 days. www.mnadulttobaccosurvey.org

7. All contributing to rising health care costs…

8. What Influences Our Health?
• Socio-Ecological Model:
– Individual: knowledge, attitudes,
beliefs
– Interpersonal: family, peers, social
networks
– Organizational: employers, schools,
etc.
– Community: social norms and
standards
– Policy: a law, rule at an employer,
college, or multi-unit housing
Wherewe’vetraditionallyspentourefforts

9. What Influences Our Health?
• Socio-Ecological Model:
– Individual: knowledge, attitudes,
beliefs
– Interpersonal: family, peers, social
networks
– Organizational: employers, schools,
etc.
– Community: social norms and
standards
– Policy: a law, rule at an employer,
college, or multi-unit housing
Wherewe’vetraditionallyspentourefforts
Whatismosteffective

10.  2009 - present day
 https://www.youtube.com/watch?v=SMymFKsix6A
 Making the Healthy Choice the Easy Choice
Statewide Health
Improvement Program
(SHIP)

11. The Policy, Systems and
Environmental Approach
• Support social norm changes
• Support individual behavior change
• Widespread results
• Long-term impact

12. What is Policy Change?
• Policies include laws, ordinances,
resolutions, mandates,
regulations, or rules (both formal
and informal)
– Policy change includes the passing of
laws, ordinances, resolutions,
mandates, regulations, or rules
– Example: organizational policy that
allows the use of flex-time to
accommodate physical activity

13. What is System Change?
• Systems impact all elements of an
organization, institution, or system
– Systems change impacts all elements
of an organization and often focuses
on changing infrastructure within a
school, park, worksite or healthcare
setting
– Example: Implementation of the WHO
10 Steps to Successful Breastfeeding
and becoming a baby-friendly hospital
system

14. What is Environmental
Change?
• The environment involves physical
or material elements of the
economic, social, or physical
environment
– Environmental change is a change
made to the physical or material
elements
– Example: Incorporating sidewalks,
paths, and/or recreation areas into
community design

15. Policy, systems, and environmental changes…
supporting healthy individual behaviors…
How it
works
• work with schools to serve more
locally grown produce
Rather than just telling
kids about good
nutrition
• help employers build
opportunities into the day
Rather than just telling
people to get more
physical activity
• help college campuses become
smoke-free
Rather than just telling
students to avoid
second-hand smoke

16. PartnerSHIP 4 Health
 Community and public health partners in Becker,
Clay, Otter Tail and Wilkin counties working
together to create an environment that supports
improved health for all
 Anchored in the Statewide Health Improvement
Program (SHIP)

17. Our Goals
•Improve population health
• Increase healthy weight adults
by 9%
• Reduce young adult tobacco
use by 9%
•Decrease medical costs

18. Our
Objectives
Increase
Healthy
Eating
Increase
Physical
Activity
Decrease
Tobacco Use
And Exposure

19. Walking Alongside Our Partners…
• Human Service Organizations
• Schools
• Worksites
• Communities
• Healthcare
• Childcare
Impacting Policies, Systems, and the
Environment to Create Sustainable Changes
Environment
Policy
System

20. It Takes a Team
• Multi-agency, multi-county, multi-disciplinary staff
• The right people doing the right work
• Supported by decision-makers
• Multiple funding partners

21. Complete Streets Active Transportation Safe Routes to School
Active School Day:
Active Recess and
Active Classrooms
Comprehensive School
Physical Activity Programs:
Bike Fleet
Worksite Wellness
INCREASING PHYSICAL ACTIVITY FOR ALL

22. Worksite Wellness:
Lactation Room
Farmers Markets
Fresh Connect Food Hub
and Farm to School
Human Service
Organizations
Community Gardens Healthy Food Pantry
Donations
INCREASING HEALTHY FOOD ACCESS FOR ALL

23. Smoke-Free Multi-Housing
Units
Clinical Guideline
Implementation
Tobacco-Free Worksites and
Secondary Campuses
Counter Marketing and
Point of Sale
Increase Access to Tobacco
Cessation Services
Smoke-free Childcare and
Foster Care
DECREASING TOBACCO USE AND EXPOSURE

24. Encourage
Clinical
Obesity and
Tobacco
Guidelines
Encourage
Worksite
Wellness to
Foster Healthy
Role Models
HEALTH CARE STRATEGY #1
ELEVEN PARTNERS
 Community Health
Service, Inc. (Migrant
Health)
 Family HealthCare
Center (FQHC)
 Orthopedic and Sports
Physical Therapy, Inc.
 Lake Region Healthcare,
Essentia Health,
Sanford Health, and
Perham Health Clinics
 Local Public Health
Departments

25. HEALTH CARE STRATEGY
Five Partners
• Essentia Health St.
Mary’s in Detroit Lakes
• Lake Region Healthcare
in Fergus Falls
• Perham Health in
Perham
• St. Francis in
Breckenridge
• Essentia Health and
Sanford Health in
Fargo-Moorhead
Participate with Local
Hospitals in their
Community Health Needs
Assessment and Strategic
Planning Process
Health Care Strategy #2

26. Multiple funding partners
• Statewide Health Improvement Program - SHIP
• SHIP Innovation
• CTG, CDC 1422 Community Wellness Grant
• ClearWay
• UCare
• Otto Bremer Foundation
• BCBS Foundation
• MN GreenCorps
• BCBS Center for Prevention
• NW Regional Sustainable Development
Sustaining the work in the future

27. Worksites
Healthcare
Human Service
Organizations
Community
Active
Transportation
Community
Healthy Foods
Childcare
School
Population Health

28. • Minnesota has outperformed nearby states by being the only one of its neighbors to bend
the curve on obesity rates, according to a recent MDH analysis of CDC data.
• Significant health care savings linked to 60,000 more Minnesotans at a healthy weight
U.S. and Regional Obesity Rates
Data source: CDC Behavioral Risk Factor Surveillance System
http://www.health.state.mn.us/news/pressrel/2015/ship042015.html
Minnesota Alone Trims Obesity Rates Among Upper Midwest States

29. CDC 1422
Community Wellness Grant
(2015)
Healthcare Reform: A vision for Minnesota
SHIP, CTG, and CWG

30. FUNDING TO PREVENT OBESITY, DIABETES,
AND HEART DISEASE AND STROKE
 The Minnesota Department of Health (MDH) has received new Centers for
Disease Control & Prevention (CDC) funding to support local communities to
improve health. This grant builds on current work to prevent and better
manage obesity, diabetes, heart disease, and stroke, at the same time
focusing on reducing health disparities.
 With this funding, FOUR selected communities in Minnesota will engage in
cross-cutting, creative approaches that can positively impact the health of
your residents, especially those with the greatest health needs.
 The key components and strategies of this grant will also enhance
communities’ current efforts through the Statewide Health Improvement
Program (SHIP), The Minnesota Accountable Health Model or SIM, and Health
Care Homes.

31. Promote Health and Support and Reinforce Healthy
Behavior through Environmental Change
1.1 Implement food and beverage guidelines including sodium
standards (i.e., food service guidelines for cafeterias and vending)
in public institutions, worksites and other key locations such as
hospitals
1.2 Strengthen healthier food access and sales in retail venues (e.g.,
grocery stores, supermarkets, chain restaurants, and markets) and
community venues (e.g., food banks) through increased availability
(e.g., fruit and vegetables and more low/no sodium options)
improved pricing, placement and promotion
1.3 Strengthen community promotion of physical activity through
signage, worksite policies, social support and joint-use agreements
1.4 Develop and/or implement transportation and community plans
that promote walking

32. Build Support for Healthy Lifestyle Changes, especially
for those at high risk for Type 2 Diabetes
1.5 Plan and execute strategic data-driven actions through a network of
partners and local organizations to build support for lifestyle change
1.6 Implement evidence–based engagement strategies (e.g., tailored
communications, incentives, etc.) to build support for lifestyle
change
1.7 Increase coverage for evidence-based supports for lifestyle change
by working with network partners

33. Improve the Quality of Health Systems, Care Systems, and Care
Delivery for People w/Hypertension and Pre-Diabetes Disparities
2.1 Increase electronic health records (EHR) adoption and the use of health information
technology (HIT) to improve performance (e.g., implement advanced Meaningful Use
data strategies to identify patient populations who experience CVD-related
disparities)
2.2 Increase the institutionalization and monitoring of aggregated/standardized quality
measures at the provider level (e.g., use dashboard measures to monitor healthcare
disparities and implement activities to eliminate healthcare disparities)
2.3 Increase engagement of non-physician team members (i.e., nurses, pharmacists,
nutritionists, physical therapists and patient navigators/community health workers)
in hypertension management in community health care systems
2.4 Increase use of self-measured blood pressure monitoring tied with clinical support
2.5 Implement systems to facilitate identification of patients with undiagnosed
hypertension and people with prediabetes

34. Link Clinical and Community Resources to Support
Heart Disease, Stroke and Type 2 Diabetes Prevention
2.6 Increase engagement of CHW’s (such as Community Paramedics) to
promote linkages between health systems and community resources
for adults with high blood pressure and adults with prediabetes or at
high risk for type 2 diabetes
2.7 Increase engagement of community pharmacists in the provision of
medication-self management for adults with high blood pressure
2.8 Implement systems to facilitate bi-directional referral between
community resources and health systems, including lifestyle change
programs (e.g., EHRs, 800 numbers, 211 referral systems, etc.)

35. Life in the Grant World

36. Questions?