AAIP PROJECT STAFF GARY LANKFORD – PROJECT DIRECTOR ECHO DUERKSEN – PROGRAM ASSISTANT EXPERT CONSULTANT NOELLE KLESZYNKSI, MPH WEDNESDAY OCTOBER 28, 2015 Healthy Active Native Communities Funding Opportunity Webinar

Purpose of Webinar Learn a little about AAIP Provide overview of the HANC funding opportunity Review allowable strategies Go over dates and application requirements Answer any questions you might have

Association of American Indian Physicians Founded in 1971 by 14 AI/AN physicians National Non-Profit Dedicated to providing support and services to AI/AN communities Physician member organization with over 400 members Organizational Goals 1. Recruit AI/AN youth to purse career in medicine and provide resources along the way 2. Improve AI/AN health through Public Health programs in Diabetes Capacity Building Program

Overview of Funding Opportunity In 2012 AAIP was awarded a 5 year CDC OSTLTS Cooperative Agreement – Capacity Building Assistance - to sustain and improve the performance of tribal public health systems Eleven projects funded  Healthy Active Natives Community Project  Data Into Action Training  Compendium of Success Stories  Tribal Grant Writing Workshop  Tribal Public Health Accreditation  Native public health course for Schools of Medicine Curriculum  STD and Colorectal Cancer Screening Programs  School Health Index  AI/AN Specimens Policy Development Project For more information contact John Stafford at

Healthy Active Native Communities Goal: Improve nutrition and physical activity and reduce obesity rates in AI/AN communities Objectives:  To increase knowledge of evidence-based, CDC-recommended obesity prevention strategies among AI/AN communities;  To facilitate the development and implementation of sustainable nutrition, physical activity, and obesity prevention efforts that have lasting effects in the reduction of obesity;  A great explanation of Policy, Systems, & Environmental Change df df  To promote and disseminate AI/AN obesity prevention efforts and share results, lessons learned, and cultural adaptation strategies with AI/AN communities and stakeholders nationwide.

HANC Activities HANC On-Line Resource Guide = Website Go live December 2015 HANC Website

HANC Activities National Dissemination Plan  Attend and present at national conferences  Share information virtually and handouts at events and conferences Promising Practices Brief  Little evidenced-based research & low dissemination of work in Native communities  Purpose: To share HANC communities accomplishments, challenges, lessons learned, cultural significance, impact, and promising practices  HANC reports, semi-structured interviews, and available research to develop content  Disseminate hard copy and PDF version available Spring 2016

HANC Mini-Awards What is AAIP looking to fund? Innovative, culturally appropriate, effective approaches to prevent obesity and improve nutrition and physical activity Tribal Health Departments – 3 at $5,000 each Applicants that propose CDC Winnable Battles and/or Community Guide Preventive Services recommended strategies Culturally adapt strategies for your community Well thought out applications that are not too wordy and follow guidelines

CDC Winnable Battles  Public health priorities with large-scale impact on health and with known, effective strategies to address them.  Based on the magnitude of the health problems and our ability to make significant progress in improving outcomes.  In addition to Obesity, Nutrition, and Physical Activity  Food Safety, HIV, Motor Vehicle Injuries, Teen pregnancy, health care associated infections, and tobacco  Systems, policy, environment, and programmatic interventions

Factors That Affect Health Counseling & Education Clinical Interventions Long-lasting Protective Interventions Socioeconomic Factors Changing the Context to make individuals’ default decisions healthy Eat healthy, be active Rx for diabetes, blood pressure, cholesterol Vaccines, brief intervention, tobacco cessation, colonoscopy Fluoridation, 0g trans fat, smoke free laws Poverty, education, housing, inequality Largest Impact Smallest Impact

Does the Environment Support Individual Behavior Change Efforts?

CDC Strategies To Improve Nutrition Strategy 1. Promote food policy councils as a way to improve the food environment at state and local levels Strategy 2. Improve access to retail stores that sell high-quality fruits and vegetables or increase the availability of high-quality fruits and vegetables at retail stores in underserved communities Strategy 3. Start or expand farm-to-institution programs in schools, hospitals, workplaces, and other institutions Strategy 4. Start or expand farmers’ markets in all settings Strategy 5. Start or expand community supported agriculture programs in all settings Strategy 6. Ensure access to fruits and vegetables in workplace cafeterias and other food service venues Strategy 7. Ensure access to fruits and vegetables at workplace meetings and events. Strategy 8. Support and promote community and home gardens Strategy 9. Establish policies to incorporate fruit and vegetable activities into schools as a way to increase consumption Strategy 10. Include fruits and vegetables in emergency food programs

CDC Strategies to Increase F and V CDC Strategies to Increase Fruit and Vegetable Consupmtion CDC Strategies to Increase Fruit and Vegetable Consupmtion  df df  Definition, rationale, evidence of effectiveness, key considerations, program examples, action steps, and resources Start or expand farm-to-institution programs  Kindergarten Initiative in Pennsylvania This program uses education, snacks from local farms, parent involvement, and community support to promote healthy eating. Nutrition concepts are integrated into the regular kindergarten classroom curriculum, and healthy fruit and vegetable snacks grown by local farmers are provided to the students.

Examples Ensure access to healthy fruits and vegetables in workplaces  Healthy Picks The Healthy Picks program at the Santa Rosa Medical Center in California is one of several programs implemented by the Kaiser Permanente Comprehensive Food Policy. The program provides healthier food options in the medical center’s vending machines and cafeteria. Healthy foods are labeled with Healthy Picks stickers. Hospital officials used detailed nutritional standards to choose the Healthy Picks food options, which include more vegetables. A team of nutrition and dining service professionals working at Kaiser Permanente implemented the program.  NIHB WORKSITE WELLNESS PROGRAM

Examples Establish policies to incorporate fruit and vegetable activities into schools as a way to increase consumption  Cooking with Kids This program engages elementary school children in hands-on learning that uses fresh, affordable foods from diverse cultures. Students are encouraged to use all of their senses to explore many varieties of foods, to have fun, and to exercise choice. The curriculum is aligned with the New Mexico Department of Education’s academic standards in math, science, social studies, language arts, and wellness, as well as with the National Health Education Standards. An evaluation of the program showed that the majority of children have shown a greater interest in eating healthy foods, including fruits and vegetables, at home.

CDC Strategies to Increase Physical Activity

CDC Guide to Increase Physical Activity Point of decision prompts to encourage use of stairs  CDC’s StairWELL to Better Health Program  Motivational signs were placed where people have the choice between stair and elevator use. Intervention messages were tested in focus groups to ensure that they were motivating to the audience. In addition to using point-of-decision prompts, CDC also enhanced the stairwell by adding carpet and rubber treading to each step to maximize safety. The walls were painted bright colors (each floor is a different color), and framed artwork that features nutritious foods, picturesque scenery, and people being active was added to each floor. The intervention also included a contest to choose employee artwork to be hung in the stairwell. In addition, music is provided through a digital satellite system that rotates a variety of musical genres, including classical, country, jazz, Latin, oldies, popular contemporary, and urban

Examples Enhanced school based physical education CATCH (Coordinated Approach to Child Health)  CATCH is a popular, evidence-based school health program. It includes activities that can be done in and out of the classroom, as well as home and after-school activities and a family component. CATCH is designed to promote physical activity and healthy food choices in children.  The YMCA of Greater Rochester integrated the philosophy of the CATCH program into the YMCA’s after-school child care program. Child care staff received training from a certified CATCH program director at the beginning of the school year, as well as booster training throughout the year.

Community Guide to Preventive Services The Guide to Community Preventive Services is a free resource to help you choose programs and policies to improve health and prevent disease in your community Based on a scientific systematic review process and answers questions critical to almost everyone interested in community health and well-being such as:systematic review process  What interventions have and have not worked?  In which populations and settings has the intervention worked or not worked?  What might the intervention cost? What should I expect for my investment?  Does the intervention lead to any other benefits or harms?  What interventions need more research before we know if they work or not?

Community Guide Preventive Services Recommended Strategies

Community Guide to Preventive Services

Examples Link to recommended obesity prevention strategies ngs.html ngs.html Behavioral interventions that aim to reduce recreational (i.e., neither school-related nor work-related) sedentary screen time teach behavioral self-management skills to initiate or maintain behavior change. Worksite wellness - Policy and environmental approaches aim to make healthy choices easier and target the entire workforce by changing physical or organizational structures. Examples of this include: Improving access to healthy foods (e.g. changing cafeteria options, vending machine content)Providing more opportunities to be physically active (e.g. providing on-site facilities for exercise)

Why Should We Adapt these Strategies? The recommended strategies have been tried and tested to be effective in addressing obesity, physical inactivity, and poor nutrition.  They draw on peer-reviewed literature and practice-based programs  utilizing these strategies will increase the likelihood of your program’s success. There are lots of strategies to choose from, so you have the opportunity to determine which strategy will best work in your community.  Since the majority of these strategies are not designed to be culturally specific for American Indian communities, you will be able to tailor the strategy to meet your community’s needs.

Important Dates All mini-grants applications must be received by November 20, :00 p.m. CDT. Grant recipients will be notified by November 30, Mandatory Awardee Webinar Thursday, December 3, 2015 at 1:00 PM CDT Funds will be distributed by December 4, 2015 Project period is December 1, 2015 to June 30, 2016 Mid-Project Check-in (Survey Monkey) is due March 15, 2016 Required group conference calls to share lessons learned, suggestions, and discuss any challenges End of Project Success Story and Photos due June 30, If funds allow, travel for one to present at AAIP Annual Meeting and Health Conference (July 2016)

Application Requirements Title Contacts for two people at THD include mailing address Brief description of THD Target Population Winnable Battle or Community Guide strategy Adapting Strategy to be Culturally Appropriate Description of Project & Workplan Partners Outcomes/Evaluation Budget

Objectives, Outputs, & Outcomes For example, I would like to see increased participation in our Kids fun and Fit center. I would like to do this by offering regularly scheduled group fitness classes. I expect to offer kids yoga, kids in motion and jump roping. I expect to have higher participation numbers. I plan to do this through purchases for additional equipment, marketing. Which is which? Objective, output and outcome?

Answer The objective would be something like "to provide X number of regularly scheduled fitness classes per month for X number of children ages (5-12?) at the Kids Fun and Fit Center” The output would be the classes offered - i.e. 5 jump rope classes, 3 yoga classes, etc. which you could show with sign in sheets or any ‘physical, tangible thing’ i.e. parent satisfaction surveys, reports, etc. The outcome would be "increase in physical activity of pediatric patients of the clinic"

Scoring Criteria – Total Eligible Points=40 Eligibility Requirements and Formatting Guidelines (5 points) Project Feasibility (5 points) Impact (10 points) Policy, System, and/or Environmental Change (10 points) Project Development (10 points)

Time for Q and A Submit application to Echo Duerksen at Questions? contact Noelle at or AAIP Staff Gary Lankford at THANK YOU!!