CX3 for APHA-final

							Communities of Excellence3
  A Blueprint for Community Action

  Valerie Quinn, M.Ed.
  Cancer Prevention & Nutrition Section
  California Department of Health Services
  APHA, December 2005
Picture of traffic,
  sprawl
Schools
FOOD DESERTS

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Role for Public Health
   Provide data
   Convene interested parties
   Conduct needs assessments &
   evaluation
   Educate public
   Advocate for specific policy and
   environmental change
Policy and Environmental Change: New Directions for Public Health,
   ASTDHPPHE & CDC, 2001
Technology Transfer
Built environment
Healthy foods
Physical activity
Reduce TV viewing
Reduce hunger/food
insecurity
Breastfeeding
Health care
CX3 Defined
  A planning model that involves assessing
  communities in relation to a variety of obesity
  prevention benchmarks known as community
  indicators and assets.
   3 = nutrition, physical activity and obesity

  prevention
  Standardized indicators & assets – big plus!
Key Vision
CX3 Goal
  Empower communities!!!
     Assess a community’s strengths, assets,
      gaps & weaknesses
     Set priorities based on data
     Strategic local data-driven action plans
     Broaden participation
     Evaluate progress
Indicators & Assets
Community Indicators
 Specific, observable characteristics
  of a community’s environments &
  norms.


Example
“Supermarkets and grocery stores offering
   healthy, affordable food choices are
   located in low-income neighborhoods
   and readily accessible to residents.”
Indicators & Assets
Assets
A community’s “readiness”
  for addressing policy and
  environmental change.


Example
“Extent of local officials who
   advocate for local government
   action to promote
   environments that support
   healthy eating… “
Creating      CX3

Gather all possible
 indicators &
 assets. Refine.

Total:
 151 Indicators
 44 Assets
Creating       CX3

  Indicators   organized   Assets   organized into:
  in 6 Community
  Environments:
                              Health department
     Neighborhood             infrastructure
     Preschool               Political will
     School                  Community
     After-school             infrastructure
     Worksite
     Government
Creating   CX3
Creating                                                CX3 -- Cont.
                                      Raters by Type of Organization
                                                 (n=142)
                                                                                              Local Health Department

                    30                                                                        School

                                                                                              State Government
                    25   23.9
                                                                                              Non profit/Community Based
                                                                                              Organization
Percent of Raters




                                                                                              Other*
                    20
                                16.216.2                                                      Community Clinics/Hospital

                    15                                                                        University

                                           10.6                                               UC Cooperative Extension

                    10                            7.7                                         Federal Government
                                                        6.3
                                                              4.9 4.9                         Advocacy Organization
                                                                        4.2
                    5
                                                                              2.1 2.1         Voluntary Health Organization
                                                                                        0.7
                                                                                              Faith Based Organization
                    0
                                           Organization Type
CX3 Top Picks
Community Indicators               Community Assets
Neighborhood: 12 indicators        Local Health Dept.
  (42 total)
                                    Infrastructure: 3 assets    (14
Preschool: 5 indicators (14 total)  total)

School: XX indicators (45 total) Political Will: 3 assets (10 total)
After-school: 6 indicators (11 Community Infrastructure:
   total)
                                   11 assets (20 total)
Worksite: 6 indicators (20 total)
Government: 4 indicators (19
  total)
CX3 Focus
Neighborhood Environment
     Supermarkets in low income neighborhoods
                If not, do small neighborhood stores offer healthy food?
          Transportation available
          CA 5 a Day program
          Nutrition info provided
          Limit unhealthy advertising & displays aimed at kids
     Food banks provide healthy food
     Farmers’ markets accept EBT cards
     Alternative sources of health food available
     Density of FF outlets restricted
     Outdoor “unhealthy” advertising restricted
     Neighborhoods safe and walk-able
CX3 Focus – Cont.
Community Assets:
Local Health Department Infrastructure
  Obesity prevention… formal or expressed dept
  priority (Report Card)
  Actively develops collaborative relationships
  Dedicated staff with expertise
Political Will
  Local elected officials supportive
  Extent of supportive media coverage
  State/federal elected officials supportive
CX3 – What’s Next?
1. Assessment tools; strategies outlined
     Start: Focus within Neighborhood, Local Health
      Dept, Political Will
     Eventually -- all Top Picks in all environments
CX3 – What’s Next?
1. Assessment tools; strategies outlined
2. Pilot Projects test tools
CX3 – What’s Next?
1. Assessment tools; strategies outlined
2. Pilot Projects
3. Materials/training provided &
   implemented by local health
   departments and others
CX3 – What’s Next?
1. Assessment tools; strategies outlined
2. Pilot Projects
3. Implemented by local health
   departments and others
4. Breastfeeding indicators and WIC assets
   coming soon
Benefits to Participation
  Advances local policy change – Proven!
  Puts local groups at forefront for
  obesity prevention
  Gives standardized indicators for ALL
  types of work in obesity prevention
  Appealing to funders
Challenges – so far…
  Dynamic environment – build to grow
  Growing research base + limitations
  Narrowing the “Top Picks”
  Funding changes
  ID instruments – practical for local
  level, limited resources
    Change the
    environment,
    do not try to
     change the
       person.
Buckminister Fuller, architect, engineer,
        mathematician, poet and
               cosmologist.
For more information
List of Top Picks, etc.:
Valerie Quinn
vquinn@dhs.ca.gov
916-552-9908