Collaboration with Cooperative Extension and SNAPEducation the Indiana
Collaboration with Cooperative Extension and SNAPEducation, the Indiana Example Dennis Savaiano, Ph. D Virginia Meredith Professor of Nutrition, Purdue University Director North Central Nutrition Education Center of Excellence Associate Director Indiana CTSI Community Health Partnerships (CHe. P) ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH www. indianactsi. org
Back Home in Indiana • • • • Overall health ranking Obesity (32. 2% in adults) Smoking Physical inactivity Vegetables consumed Fruits consumed Diabetes % adults Cardiovascular deaths Cancer deaths Teen birth rate Infant mortality Air pollution Public Health Funding 41 / 50 44 44 41 38 33 32 39 42 35 36 47 48 Source: United Health Foundation 2015 ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH www. indianactsi. org
The evolution of health partnerships in IN • • • • Home Economics reorganizations w/health components-Nutrition long history Purdue Health and Human Sciences reorganization National Extension focus on health-NHOC Extension IBAT Extension Community Development Extension SNAP-Ed PSE emphasis / 40 CWCs in IN Jump. IN example w/CWCs NCNECE USDA national investment NEP/SNAP-Ed evaluation CTSI CHe. P CHCDP BC 3 CDC obesity prevention ISDH IHWI RWJF/4 -H Extension Partnership ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH www. indianactsi. org
ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH www. indianactsi. org
Cooperative Extension Service • National network of colleges, universities and USDA • One of largest providers of research-based information and education • Serving communities and counties in every state and territory ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH www. indianactsi. org
National Health Outreach Conference - since 1993 ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH www. indianactsi. org
Purdue HHS Extension • Deliver educational programs reaching more than 1 million residents that improve quality of life for individuals and families • Specialty areas: – Foods and Nutrition – Human Development – Family Resource Management – Health and Wellness ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH www. indianactsi. org
• SNAP-Ed and EFNEP to improve nutrition and health of limited resource audiences • Nutrition Education/SNAP-Ed – Free nutrition education to youth and adults in schools and community groups • Community Wellness Coordinators – Help make healthy choice easy choice – Focus on policy, system and environmental change ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH www. indianactsi. org
Community Wellness Coordinators • Forty full time BA/BS level health workers • Assigned to low income communities • Work solely on PSE initiatives: Health coalitions Community gardens School and workplace wellness Healthy corner stores Trails and parks Farm to school Farmers markets Active living Food access Food pantries ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH www. indianactsi. org
ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH www. indianactsi. org
• Social Network Analysis of environments of SNAP-Ed and EFNEP participants • Perceptions of SNAP-Ed and EFNEP participants of their food and exercise environment • Using photo-voice to inform healthy food environments • PSE and Nutr Ed interventions with low income home child care • Summer weight gain and PSE interventions • SNAP-Ed effectiveness on food security in rural and urban environments ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH www. indianactsi. org
ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH www. indianactsi. org
Background: Community Health Coalition Capacity Building Team (2012) • Goals: – Strengthen Purdue Extension role in health coalitions – Maximize effectiveness of coalitions • Team members: – Indiana State Department of Health; Communities Partnerships, and Nutrition and Physical Activity – Fairbanks School of Public Health, IUPUI – IU Health Hospital Bloomington – Purdue Extension: HHS Extension Educators with variety of tenure and experiences with coalitions Purdue University Cooperative Extension Service is an equal access/equal opportunity institution.
2015 Indiana Coalition Activity 35 Number of Coalitions 30 25 2010 20 2015 15 2020 10 5 0 No coalition present Conteplating starting a coalition Coalition formed, No information no goals set planning interventions ongoing with Coalition Stage evaluations Purdue University Cooperative Extension Service is an equal access/equal opportunity institution.
Statewide Purdue Extension Partnerships ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH www. indianactsi. org
Community Health Partnerships (CHe. P) and Purdue Extension Dennis Savaiano Donna Vandergraff February 2017 Nutrition Science Faculty Meeting Purdue University Cooperative Extension Service is an equal access/equal opportunity institution.
NIH CTSA Program Goals: • Train and cultivate the translational science workforce; • Engage patients and communities in every phase of the translational process; • Promote the integration of special and underserved populations in translational research across the human lifespan; • Innovate processes to increase the quality and efficiency of translational research, particularly of multisite trials; • Advance the use of cutting-edge informatics. Purdue University Cooperative Extension Service is an equal access/equal opportunity institution.
Future theme for the Indiana CTSI 3. 0 • Two Key Challenges in Health Care Today: 1. Precision Health 2. Population Health • There is inherent tension between these two concepts and scales • How do we create an integrated approach to address this challenge? Purdue University Cooperative Extension Service is an equal access/equal opportunity institution.
Indiana’s unique opportunity • Build a collaborative medical, public health and land grant college initiative to engage local communities deliver health promotion efforts – Utilize the community-based strength of Purdue Extension – Utilize and grow the health promotion infrastructure in and partnerships in Indiana counties – Utilize the combined research and outreach infrastructure of IUSM, Purdue, IUPUI and ND Purdue University Cooperative Extension Service is an equal access/equal opportunity institution.
Purdue and CHe. P • Purdue Liaison (Vandergraff) and Associate Director (Savaiano) • CHe. P network – Over 600 members – Over 30 Extension educators plus campus – Schools, Hospitals, Minority Health, Health Depts. , Community Groups, etc. • Purdue Extension Educators – Working with coalitions – IN Recruitment Registry Purdue University Cooperative Extension Service is an equal access/equal opportunity institution.
Statewide reach built on statewide partnerships Liaisons: – Heidi Beidinger-Burnett (ND) – Silvia Bigatti (IUPUI) – Carrie Lawrence (IUB) – Donna Vandergraff (Purdue) Purdue University Cooperative Extension Service is an equal access/equal opportunity institution.
Exemplary “Best Practices” Healthy Communities of Clinton County Coalition • Tobacco ITPC reporting 2008 to 2013 – Adult smokers prevalence 29% to 19% • County Health Rankings 2010 to 2012 – Poor/fair health: 19% to 16% – Overall health status: 51 to 31 out of 92 co’s • General approach leading to this success: – Changes in policy, systems, and environment Purdue University Cooperative Extension Service is an equal access/equal opportunity institution.
Profile of Clinton County, IN • Rural county in Central IN • Population: 33, 104 • Farming – manufacturing • 30 -35% Growing Latino pop. • 40% of students Latino • 75% - 80% free & reduced lunch program • Smoking rate is 19% • Obesity rate is 29% Purdue University Cooperative Extension Service is an equal access/equal opportunity institution.
Clinton County Health Trends: County Health Rankings
Top Successes and Factors to Sustain Involvement in the Healthy Communities of Clinton County (HCCC) • • • ACHIEVE Grant Walking Paths Tobacco Cessation Efforts Complete Streets Ordinance Collective actions to raise awareness of health issues • Cooperative partnerships working to improve health • Improved county rankings • Strong leadership and working relationships • Continued partnership with major community organizations • Continued educational opportunities • Regular and convenient meetings • Visible outcomes and recognition • Grant opportunities Purdue University Cooperative Extension Service is an equal access/equal opportunity institution.
Coalition Capacity Building § Community Health Coalition Development Program (CHCDP) § 4 counties § Purdue Extension Community Health Coalition Capacity Building Team Coalitions reported Purdue University Cooperative Extension Service is an equal access/equal opportunity institution.
CDC High Obesity Prevention Grant Jackson and Lawrence Counties L Coalitions reported Purdue University Cooperative Extension Service is an equal access/equal opportunity institution. J
Community Health Coalition Development Program (CHCDP) • Goal: Improve health of Indiana through regionalized self-learning networks and communityacademic partnerships • Stage 1: Evaluate a successful coalition • Stage 2: Experimental trial among 4 rural coalitions with controls • Stage 3: Disseminate step-wise across Indiana 2 2 1 3 3 2 2 3 3 ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH www. indianactsi. org
Intervention Locations by Area Northeast West/Central Southwest Southeast 29 Purdue University Cooperative Extension Service is an equal access/equal opportunity institution.
Findings in CHCDP Phase 1 • Key ingredients for creating, stabilizing, and sustaining the coalition – Form: build the initial coalition – Implement: design & implementation of initial programs – Stabilize: programs and organization – Sustain success, maintain momentum, expand reach ** Flexibility important as key ingredients differ (& can conflict) • Challenges – Throughout entire county, immigrant populations, youth • Main foci: policy, system, & environment ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH www. indianactsi. org
Top Successes and Factors to Sustain Involvement in the Healthy Communities of Clinton County (HCCC) • • • ACHIEVE Grant Walking Paths Tobacco Cessation Efforts Complete Streets Ordinance Collective actions to raise awareness of health issues • Cooperative partnerships working to improve health • Improved county rankings • Strong leadership and working relationships • Continued partnership with major community organizations • Continued educational opportunities • Regular and convenient meetings • Visible outcomes and recognition • Grant opportunities ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH www. indianactsi. org
CHCDP Phase 2 Trial • Sample – 21 similar rural counties in 4 regions: 4 intervention counties, 17 control counties • Intervention – Mentoring by skilled coalition leader – Technical and other assistance from Purdue Extension • Measures – Process: key informant interviews & surveys – Outcome: ISDH and IPHA health/health risk measures Phase 2 leans into next phases of dissemination, networking, & learning communities ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH www. indianactsi. org
CHCDP Phases 3 and 4 • Social Network Analysis of coalitions and comparator counties • Factor analysis of SNA compared to intermediate outcomes (programs) • Long-term factor analysis of SNA and health outcomes ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH www. indianactsi. org
Cooperative Extension System and Robert Wood Johnson Foundation Partnership Initiative ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH www. indianactsi. org
Questions? ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH www. indianactsi. org
ACCELERATING CLINICAL AND TRANSLATIONAL RESEARCH www. indianactsi. org
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