Pivotal Partnerships Community Collaboration Washington State Diabetes Network March 14, 2006

1. Pivotal Partnerships & Community CollaborationWashington State Diabetes NetworkMarch 14, 2006 Barbe West Executive Director Community Choices 2010

2. Community Choices 2010Mission: A Catalyst for a Healthy Livable Clark County Data Driven Awareness Building Objective Convener Collaborator Early Prevention Community Choices 2010 is a data-driven community-based non-profit organization whose mission is to be a catalyst for a healthy livable Clark County. Every three years CC2010 publishes a report card on the health of our community. Our organization�s guiding principles are: To be data-driven and use this information to build awareness of community health issues. To be an objective convener of community partners To be a collaborator with organizations and To focus on early prevention strategies. Community Choices 2010 is a data-driven community-based non-profit organization whose mission is to be a catalyst for a healthy livable Clark County. Every three years CC2010 publishes a report card on the health of our community. Our organization�s guiding principles are: To be data-driven and use this information to build awareness of community health issues. To be an objective convener of community partners To be a collaborator with organizations and To focus on early prevention strategies.

3. Data in our 2003 Report Card, indicated a significant increase in over weight and obesity in Clark County Adults. Data in our 2003 Report Card, indicated a significant increase in over weight and obesity in Clark County Adults.

4. In fact, our obesity rates were higher than the State of Washington and the United States. In fact, our obesity rates were higher than the State of Washington and the United States.

5. And Diabetes among adults was increasing.And Diabetes among adults was increasing.

6. Less than 25% of Clark County adults were eating 5 servings of fruits and vegetables per day.Less than 25% of Clark County adults were eating 5 servings of fruits and vegetables per day.

7. And half of the adults met the national physical activity requirements (30 minutes or more at least 5 days per week of moderate activity).And half of the adults met the national physical activity requirements (30 minutes or more at least 5 days per week of moderate activity).

8. When a significant trend is identified in the Report Card, our organization will convene community partners to present the data and ask if the community needs to respond to the issue (s) through early prevention strategies. In planning this initial meeting, we think strategically about who to engage in these major health issues. We use the Socio-Ecological Model as a tool to think through who we might want involved at each of the levels.When a significant trend is identified in the Report Card, our organization will convene community partners to present the data and ask if the community needs to respond to the issue (s) through early prevention strategies. In planning this initial meeting, we think strategically about who to engage in these major health issues. We use the Socio-Ecological Model as a tool to think through who we might want involved at each of the levels.

9. Community Coalition Look for natural partners aligned with common goals (hospitals, health systems, public health) Identify partners who should be concerned (school districts, employers, Parks and Recreation, restaurants) Identify unusual partners (grocery stores, faith-based community, insurers, transportation, Chamber of Commerce) Seek partners who disagree with goals (parent groups, businesses)Look for natural partners aligned with common goals (hospitals, health systems, public health) Identify partners who should be concerned (school districts, employers, Parks and Recreation, restaurants) Identify unusual partners (grocery stores, faith-based community, insurers, transportation, Chamber of Commerce) Seek partners who disagree with goals (parent groups, businesses)

10. Steps Risk Factors & Disease So where are we today? We have a community-based coalition (Steps to a Healthier Clark County) which is addressing obesity, diabetes, and asthma and the associated risk factors of physical inactivity, poor nutrition and exposure to second-hand smoke.So where are we today? We have a community-based coalition (Steps to a Healthier Clark County) which is addressing obesity, diabetes, and asthma and the associated risk factors of physical inactivity, poor nutrition and exposure to second-hand smoke.

11. Steps to a Healthier Clark County This coalition includes leaders from Worksites, Schools, Health Systems, Government, and the broader community. Each of these venues is addressing the aforementioned risk factors and in some cases treatment of the diseases. Membership on the actual teams is voluntary and there is always active recruiting to bring new members to the teams.This coalition includes leaders from Worksites, Schools, Health Systems, Government, and the broader community. Each of these venues is addressing the aforementioned risk factors and in some cases treatment of the diseases. Membership on the actual teams is voluntary and there is always active recruiting to bring new members to the teams.

12. Policy Guide � Years 3-5 As we have learned, Coalitions are not necessarily stable AND that is a good thing. In Clark County, as our Obesity, Diabetes and Asthma efforts continue, we are finding the need for new �players� in our work and in some cases, the need to coalesce venues around an issue rather than each of them working on it alone. Ex: Healthy Food Team to address vending machines in all venues. Now bringing vendors into mix Student Stores (DECA) Worksites/Farmer�s/Neighborhood � Farmer�s Market Ex: Support for non-motorized transit Community: Trails & Bikeway Plan Schools: Safe Routes to School Worksites: Trails and sidewalks adjacent to worksites Health Systems: Advocates for Physical Activity (bring rationale/data to table) As we have learned, Coalitions are not necessarily stable AND that is a good thing. In Clark County, as our Obesity, Diabetes and Asthma efforts continue, we are finding the need for new �players� in our work and in some cases, the need to coalesce venues around an issue rather than each of them working on it alone. Ex: Healthy Food Team to address vending machines in all venues. Now bringing vendors into mix Student Stores (DECA) Worksites/Farmer�s/Neighborhood � Farmer�s Market Ex: Support for non-motorized transit Community: Trails & Bikeway Plan Schools: Safe Routes to School Worksites: Trails and sidewalks adjacent to worksites Health Systems: Advocates for Physical Activity (bring rationale/data to table)

13. Two examples of how we have effectively used this network of community partners. In September 2004, the Washington State Diabetes Prevention and Control Program contacted us about the feasibility of conducting a diabetes media awareness campaign with specific focus in low-income population. Publicity and media tools were provided by Diabetes Prevention and Control Program while locally we utilized our community partners to quickly integrate the campaign into worksites, community organizations, and school districts. The Portland office of the American Diabetes Association agreed to field all inquiry calls from the campaign and make referrals to community health centers.Two examples of how we have effectively used this network of community partners. In September 2004, the Washington State Diabetes Prevention and Control Program contacted us about the feasibility of conducting a diabetes media awareness campaign with specific focus in low-income population. Publicity and media tools were provided by Diabetes Prevention and Control Program while locally we utilized our community partners to quickly integrate the campaign into worksites, community organizations, and school districts. The Portland office of the American Diabetes Association agreed to field all inquiry calls from the campaign and make referrals to community health centers.

14. The Health Care Coalition and our Communications Team, because of pre-established relationships, were able to reach out to all Clark County providers by sending them a letter and the �Small Steps, Big Rewards� provider toolkit.The Health Care Coalition and our Communications Team, because of pre-established relationships, were able to reach out to all Clark County providers by sending them a letter and the �Small Steps, Big Rewards� provider toolkit.

15. In April we will be providing a �walking guide� to health care providers, community organizations serving low-income, and worksites. Through our coalition structure we are developing processes to integrate this tool into the fiber of these organizations, i.e. health care providers � will introduce tool to pre-diabetic and diabetic patients; members of care team will work with patients to set up goals to use this tool. Through connection with realtors, these guides will be included in new home owner packets. In April we will be providing a �walking guide� to health care providers, community organizations serving low-income, and worksites. Through our coalition structure we are developing processes to integrate this tool into the fiber of these organizations, i.e. health care providers � will introduce tool to pre-diabetic and diabetic patients; members of care team will work with patients to set up goals to use this tool. Through connection with realtors, these guides will be included in new home owner packets.

16. Lessons Learned Inclusiveness vs. efficiency in a fast moving process Seek out the Naysayers Structures are not permanent Change is an iterative process � flexibility and adaptability are KEY! Learn to listen and lead When building a coalition, there is a tendency to identify and organize the players and then move forward. This is more efficient from a staffing standpoint. But reality and success requires you to find ways to add stakeholders as necessary and allow the process to be fluid. Working with those who challenge your goals and intentions is hard; often easier to exclude � DON�T. Work in a semi-permanent structure; be responsive to rebuilding coalitions based on changing needs. Listen, Listen, Listen and know when to lead. When building a coalition, there is a tendency to identify and organize the players and then move forward. This is more efficient from a staffing standpoint. But reality and success requires you to find ways to add stakeholders as necessary and allow the process to be fluid. Working with those who challenge your goals and intentions is hard; often easier to exclude � DON�T. Work in a semi-permanent structure; be responsive to rebuilding coalitions based on changing needs. Listen, Listen, Listen and know when to lead.