Transcript Public Health for Dummies - West Virginia University

Public Health for Dummies
Kristin McCartney, MPH, RD, LD
Extension Specialist-Public Health
Family Nutrition Program
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.
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
The most EFFICIENT and EFFECTIVE
way to educate the PUBLIC is NOT
one person at a time.
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
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)
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 assessment
• Research findings
• Community leader or coalition
• Availability of funding for new programs
• Government policy
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
•
3rd graders at West Side Elementary
•
Seniors at Ravenswood Care Center
•
Children in after care at Kids Korner day care
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?
Step 3: Identify Outcome (Stages of Change)

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
Goals with those in Pre-Contemplation and Contemplation
stages different then with those in Preparation, Action
and Maintenance.
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
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.
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
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
Dissemination???
What is Dissemination?
To spread information about your work to others.
Methods:
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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.
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)
Public Health
Youth
Focus groups
Key Informant Interviews
Social Marketing Campaign
Evaluation


Target Audience:
 Pre-School
 Elementary age
Curriculum:
 Eating Smart,
Being Active
 Teen Cuisine
 NEAT
School Gardens
Community
Gardens
Farm to School
Curriculum:
Show Me Nutrition
Nutritious, Delicious
Garden
Adult
Farm to Backpack
SNAP at the
Farmers Market
NAP-SACC
Target Audience:
 Moms
 Adults
 Teens
Farm to Food
Pantry
Healthy Concessions
Smarter Lunchrooms
Environments:
 High Schools
 Food Pantries
 Farmers
Markets
Environments:
 Schools
 Summer
Camps
Outcomes:

Outcomes:
Increase intake of fruits and vegetables

Increase in healthy snack consumption.

Limit calorie intake from foods/beverages
with added sugar.

Increased SNAP participation in Farmers Markets.

Increased availability of fruits and vegetables in low
income households

Increased policy support and advocacy for healthy food
financing initiatives.

Increased participation in gardening in low income
children and adults.

Increased access to healthy foods in daycares, schools
and concession stands.
Outcomes:

Increase intake of fruits and
vegetables

Increase the minutes of moderate
intensity physical activity.

Limit calorie intake from
foods/beverages with added sugar.