Evelyn Whitmer with Charlotte Taylor Rhegan Derfus Actually Improving Lives, Communities and the Economy with Long-Term Impacts Evelyn Whitmer with Charlotte Taylor Rhegan Derfus

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http://www. americanfitnessindex http://www.americanfitnessindex.org/infographic-path-to-a-culture-of-health/ E

Breaking Apart “Buzz Phrases” EVENTS PROGRAMS PSE’S SUSTAINABILITY IMPACT When talking about PSE’s, we often hear these words. What do they actually mean? Can you give me some examples? Write on stickies! Breaking Apart “Buzz Phrases” R

R Events Characteristics of Event or Program One time Additive: often results in only short‐term behavior change Individual level Not part of ongoing plan Short term Non‐sustaining Events R

Programs R Characteristics of Event or Program One time Additive: often results in only short‐term behavior change Individual level Not part of ongoing plan Short term Non‐sustaining R

R Policy Changes “Little p” and “Big P” Policy “Little p” and “Big P” Policy: Paths to Improve Our Food System https://communityfoodstrategies.com/2017/04/27/little-p-and-big-p-policy/ “Little p” policies are typically at an institution, department or agency level and generally influence organizational practices. One example of a “little p” policy is a healthy vending machine requirement. The Board of Directors for a hospital can make a decision to only stock vending machines with healthy food and beverage choices. This policy could have an immediate impact on what kinds of foods hospital visitors are consuming. These types of policy changes can actually create quick wins and can sometimes lead to larger changes that typically are not as labor-intensive as “big P” Policy changes. “Big P” policies, like state or federal law, city ordinances and comprehensive plans, typically need elected officials’ approval and are generally more difficult to influence than “little p” policies. We typically hear about these policy changes more often because they receive lots of media attention or take a long time to pass. The farm bill is the strongest example of a “big P” policy in the fields of agriculture and food security.  Policy Changes R “Little p” and “Big P” Policy

R Systems Changes ORGANIZATIONS, INSTITUTIONS, AND NETWORKS GW Cancer Center, Action 4 PSE Change http://action4psechange.org/about-pse-change/systems/ Organizations can continually adapt and improve to fit the needs and wants of stakeholders who are impacted by these systems. Examples of a systems change? Eliminating soda from vending machines…worksite wellness program… http://healthtrust.org/wp-content/uploads/2013/11/2012-12-28-Policy_Systems_and_Environmental_Change.pdf Changing rules and infrastructure Systems Changes R ORGANIZATIONS, INSTITUTIONS, AND NETWORKS

R Environments Changes ECONOMIC, SOCIAL, OR PHYSICAL http://healthtrust.org/wp-content/uploads/2013/11/2012-12-28-Policy_Systems_and_Environmental_Change.pdf Physical (Structural changes or programs or service), social (a positive change in attitudes or behavior about policies that promote health or an increase in supportive attitudes regarding a health practice), and economic factors (presence of financial disincentives or incentives to encourage a desired behavior) influence people’s practices and behaviors Bigger- impacting whole populations   Charging higher prices for less healthy products to decrease their use. Environments Changes R ECONOMIC, SOCIAL, OR PHYSICAL

Policy, systems and environmental change approaches seek to go beyond programming and into the systems that create the structures in which we work, live and play. These approaches often work hand‐in‐hand where, for example, an environmental change may be furthered by a policy or system change. Similarly a policy could be put in place that results in additional environmental changes. The process is not linear. Source: Healthtrust.org R

Short Medium Long Term Goals and Outcomes E

Outcomes What results for individuals, families, communities… SHORT-Learning MEDIUM-Action LONG-Conditions Changes in Awareness Behavior Conditions Knowledge Decision-making Social (well-being) Attitudes Policies Health Skills Social Action Economic Opinion Civic Aspirations Environmental Motivation Behavioral intent Chain of outcomes E (University of Wisconsin-Extension, Program Development and Evaluation (Logic Model), Retrieved Aug-2019)

PSE’s: REAL WORLD EXAMPLES REFLECT TO GROUP. WHAT DO YOU SEE? C

PSE’s: REAL WORLD EXAMPLES Policies are in place in Cochise County to promote healthy eating and active living and to prevent the onset of obesity and diabetes Community and school systems have incorporated health into their daily operations The environment in Cochise County is more supportive of healthy eating and active living through increased community buy-in and infrastructure changes The Healthy Community Committees become self-sustaining, able to maintain consistent action through ongoing recruitment of volunteers and ability to seek out and acquire funding Graduates of the Leadership Academy attain leadership positions at the local, county, or state level to sustain the PSE changes in Cochise County Cochise County residents have greater access to opportunities for physical activity Cochise County residents eat healthier and are more physically active Cochise County residents have reduced rates of obesity and type II diabetes C

BREAK

Is your community ready? Gearing up for PSE change

Outreach vs. Engagement Doing things FOR the community. Using ‘us’ and ‘them’ Engagement Doing things WITH the community. Turning ‘us’ and ‘them’ into ‘all of us together’.

LEVEL OF OUTREACH = LEVEL OF COMMITTMENT 1. Inform: provide information 2. Consult: offer opportunities 3. Involve: allow influence on the decision 4. Collaborate: partner on options and decisions 5. Empower: implement community’s will LEVEL OF OUTREACH = LEVEL OF COMMITTMENT

ENGAGE WITH YOUR COMMUNITY Assess your community for the following: Current needs and conditions – what are some areas of concern Assets – focus on the positive and build from it Opinions and Values – can be your stepping stones or the weight that holds you back Readiness to Change – “You can lead a horse to water, but you can’t make it drink.” ENGAGE WITH YOUR COMMUNITY

WHY? Why should you take the time to systematically seek out information about and from the community?

WHY? Why should you take the time to systematically seek out information about and from the community? To make decisions in the best way possible to achieve the goals of your work. To gain ‘buy-in’/cooperation from the community.

1 2 3 KNOW YOUR SCOPE Identify Team Learn and adjust Identify your scope – no right or wrong answers 2 Team Team approach – involve partners from multiple sectors and settings 3 Learn and adjust Learn and adjust as you go Continually gather information about current conditions

TOOLS Community Forums/Meetings Surveys Focus Groups Interviews Photovoice One-on-ones strategic planning Create a a goal statement Identify champions

Moving Forward to Bigger and Better Questions to Ask: Is this help helping? Is this meeting community needs? Who will benefit from this? What are the potential consequences of this? What is the impact? Who is being left out? What are the short-medium-long term goals? What will data collection present? Is this sustainable?

ACTIVITY TO PUT IDEAS INTO PRACTICE Vitalyst form