1. Public Health for Dummies Kristin McCartney, MPH, RD, LD Extension Specialist-Public Health Family Nutrition Program

2. Objectives: Define “public health” in terms of community programming and describe how it can be integrated into direct education efforts. Describe steps for initiating a public health program including: Identification of need Determination of stakeholders & target audience Project development (Activities, Outcome, Outputs) Evaluation Dissemination Participants will identify a public health need/opportunity in their community and work with other participants to develop a project outline.

3. The Social-Ecological Model Individual What I Eat How much I exercise Genetics How sedentary I am Interpersonal (peer, family, classroom, religion, clubs/sports, parenting) Organizational (school system, medical institutions, media, community) Community (cultural values, economics, norms, social conditions) Public policy

4. The most EFFICIENT and EFFECTIVE way to educate the PUBLIC is NOT one person at a time.

5. Obesity: Complex but Conquerable Improve the Physical Activity Environment Improve the Food and Beverage Environment Improve the Messaging Environment Improve Health Care and Worksites Improve School and Child Care Environments

6. Steps for Developing a Public Health Outreach Project 1.Identify NEED 2.Identify TARGET POPULATION (adults, youth, low-income, diabetics, etc.) 3.Identify OUTCOMES (change in behavior, health outcomes or environment, long term and short term) 4.Determine ACTIVITIES that need to take place to result in desired outcomes (step by step description of what is to occur) 5.Determine what OUTPUTS are expected (countable/tangible results, number of volunteers, participants, classes, etc.) 6.Identify needed RESOURCES (funding, volunteers, equipment, time)

7. Step 1: Identify Need Mandate from an organization’s national office or from a federal agency Section 9007 of the Patient Protection and Affordable Care adds requirements that a nonprofit hospital must conduct a community health needs assessment and adopt an implementation strategy to meet the community needs identified. Results of a community needs assessmentcommunity needs assessment Research findings Community leader or coalition Availability of funding for new programs Government policy

8. Step 2: Identify Target Population & Stakeholders Efforts using SNAP funding must target low-income participants or those living in an area (neighborhood, town, county, school district) which is considered to be low-income. Narrowly defining target population 10-12 year olds Adults 18-25 3 rd graders at West Side Elementary Seniors at Ravenswood Care Center Children in after care at Kids Korner day care

9. Step 2: Identify Target Population & Stakeholders What are Stakeholders? Who would be “stakeholders” in a program targeting children at an elementary school? Who would be stakeholders in a program targeting breastfeeding mothers? Why are stakeholders important?

10. Goals with those in Pre-Contemplation and Contemplation stages different then with those in Preparation, Action and Maintenance.  Pre-contemplation – individual unaware of or not interested in making a change  Contemplation – individual is thinking about making a change within the near future  Preparation – individual actively decides to change and plans a change very soon  Action – individual is trying to make the desired change and has been working at it for less than 6 months  Maintenance – individual sustains change for six months or longer Step 3: Identify Outcome (Stages of Change)

11. Step 3: Identify Outcome Level I: Building awareness Change attitudes and beliefs, increase knowledge of risk factors Seldom results in behavior change Level II: Changing lifestyles Successful with small changes over time. Uses combination of behavior modification and education Level III: Creating supportive environment for change Create environments that support behavior changes made by individuals

12. Step 3: Identify Outcome Our Long Term Goal is to prevent obesity in low income adults and youth in West Virginia. Is this something we can achieve in the scope of 1 project or 1 year? Our Short Term Goal will be specific to our current project and will represent a small step towards our Long Term Goal. For Example: The goal of this walking program is to increase physical activity pre/post in 10-12 year old children participating in “Show Me Nutrition” nutrition education classes.

13. Step 5: Identify Activities  Start with the intended outcome in mind. You must include a way to track outcome and outputs. For example: The goal of this walking program is to increase physical activity pre/post in 10-12 year old children participating in “Show Me Nutrition” nutrition education classes. Must have a way to measure physical activity. (pedometer, self-report, paper logs/computer logs) How will participants be recruited? Will you need permission of teachers or parents? What will the “walking program” consist of and how will it be implemented?  Once you have answered those questions, you can start breaking the activities down into achievable steps: Gain support of stakeholders (principal, teacher, parent) Select and order pedometers. Research logging software appropriate for children.  Each of the activities outline should be connected to an output:  Activity: Gain support of stakeholders  Output: 3 Meetings with PTA members and staff

14. Evaluating Public Health Programs Why Do We Evaluate? Determine Effectiveness (Impact Evaluation) Did our program increase physical activity in 10-12 year old students To Improve Program (Process Evaluation) Paper physical activity logs were not filled out by students To determine if program’s impact is worth cost of implementing (Cost-Benefit Evaluation) Test elements of a program before implementing (Formative Evaluation) Have students review paper logs prior to program to determine if they will be used Program documentation required by supporting agency Justify program’s continued funding or expansion

15. Dissemination??? What is Dissemination? To spread information about your work to others. Methods: Mass media (TV, radio) Press release Summary documents (reports, facts sheets) Flyers, posters, brochures Newsletters List-servs Community meetings, conferences, seminars Letter of thanks Need to match the appropriate dissemination method to the stakeholder group.

16. Steps for Developing a Public Health Outreach Project 1.Identify NEED 2.Identify TARGET POPULATION (adults, youth, low-income, diabetics, etc.) 3.Identify OUTCOMES (change in behavior, health outcomes or environment, long term and short term) 4.Determine ACTIVITIES that need to take place to result in desired outcomes (step by step description of what is to occur) 5.Determine what OUTPUTS are expected (countable/tangible results, number of volunteers, participants, classes, etc.) 6.Identify needed RESOURCES (funding, volunteers, equipment, time)