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(1) Go Walk Houston: A Multi-Sector, City-Wide Walking Campaign to Increase Physical Activity

Debra Maxwell, MPH – Health Planner, Houston Health Department

Rita Cromartie – Grant Project Manager ,Office of Chronic Disease Health Education & Wellness, Houston Health Department


The City of Houston Health Department (HHD), in partnership with the Go Healthy Houston (GHH) Task Force and the Houston Parks and Recreation Department, developed and launched the city-wide walking campaign, Go Walk Houston in April 2018, adapted from the Surgeon General’s National Step It Up Campaign. The launch day kickoff “Go Walk Houston Day”, April 4, was recognized by a signed proclamation by City of Houston Mayor Sylvester Turner in 2018. This multi-sector collaboration successfully leveraged resources including in-kind hours, grant resources, and connections (including the sports and fitness community) to develop a Houston-specific messaging campaign to promote walking across the entire city as a cultural norm. The Go Walk Houston messaging campaign was developed with digital and print promotions including radio ads, electronic billboards, a Go Walk Houston Call to Action, a Go Walk Houston website, hashtag, registration forms, a social media toolkit, and additional outreach strategies and activities to promote walking in Houston. The Go Walk Houston campaign continues to encourage all Houstonians to “step it up” and “Go Walk Houston” and provides resources to support individuals in their quest for healthy, active living. The Go Walk Houston Call to Action provides a guide to how partners across all sectors can work together to improve walking and walkability for all Houstonians.



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(4) Data Linkages To Support A Mening B Outbreak

Danelle Wallace, MPH – SDIR Manager/Epidemiologist, County of San Diego HHSA


Between June and September 2018, three cases of serogroup B meningococcal disease in students at a local university were reported to the County of San Diego Health and Human Services Agency (HHSA). In response to the outbreak, increased public health efforts were undertaken to protect those at-risk, including mass vaccination clinics, residential hall vaccination events, and education and outreach activities. The County of San Diego partnered with the university as well as local pharmacies and health care providers to increase immunization status among students attending the university. Vaccination efforts targeted undergraduate students living on-campus in traditional residence halls and non-traditional residential settings as well as other groups considered at higher risk for transmission such as Greek life participants and varsity athletes. Multiple student rosters provided by the university were combined into a master roster that included variables indicating information about at-risk group membership, which was electronically queried against the San Diego Immunization Registry (SDIR) and the California Immunization Registry (CAIR) to assess individual vaccination status. From October 5 through November 15, 2018, 4,364 meningococcal serogroup B vaccinations were administered at campus events. By November 15, 30% of undergraduates age 23 and under had received at least one dose. Immunization Information Systems (IIS) may be used in public health emergencies to assist with mass vaccination campaigns, targeting at-risk individuals and preventing unnecessary vaccinations. Data linkages and coordination between public and private entities in San Diego County were essential to the efforts to vaccinate students at-risk for meningococcal serogroup B disease.



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(5) Health in All Policies in the Imagine 2040 Tampa Comprehensive Plan: An integrative review

Pedro Parra, BA – Principal Planner, Hillsborough County City-County (Planning Commission)

Ayesha Johnson, PhD – Senior Health Researcher, Florida Department of Health in hillsborough County


When a comprehensive plan is developed for the community, the impacts to human health are sometimes overlooked. To promote equitable development, sustainable communities and longevity, the unintended impacts of plans and policies should be explored before they are implemented. The Office of Health Equity (OHE) at the Florida Department of Health in Hillsborough County (DOH-Hillsborough) has sought to empower other public facing agencies to understand the health impacts of plans and policies that are implemented. Since 2015, OHE has collaborated on many projects with Plan Hillsborough, the umbrella organization responsible for transportation and land use planning in Hillsborough County, Florida. The partnership’s history includes conducting a health impact assessment on a complete streets plan, establishing community gardens to promote healthier communities, working to reduce traffic deaths to “0” and participating in several inter-agency committees and workgroups. DOH-Hillsborough has also participated in collaborations on various other community projects, including work to adopt a Health in All Policies (HiAP) planning approach intended to formalize the consideration of health into transportation planning decisions. Key HiAP principles include promoting health, equity and sustainability; supporting inter-sectoral collaboration; benefitting multiple partners; engaging stakeholders; and creating structural or procedural change. From ongoing HiAP work with Plan Hillsborough’s Metropolitan Planning Organization, a health priorities matrix was developed which highlighted agency cross-sectoral alignments. In early 2018, Plan Hillsborough’s Planning Commission undertook a qualitative review of the Imagine 2040 Tampa Comprehensive Plan (TCP), adopted by Tampa City Council, to assess the plan’s alignment with state and local health priorities established. This review identified no less than 153 policies and objectives that directly or indirectly addressed one or more of the state and local health departments’ priority areas. To follow this work in identifying alignment, the Planning Commission requested that DOH - Hillsborough further analyze the TCP and make health recommendations about the plan to the Tampa City Council. The review was intended to be through a HiAP lens to build on prior work. The problem statement for this collaborative project was to develop a suitable framework to evaluate health in comprehensive plans and policies. Problem Statement: Identifying a framework to evaluate health in comprehensive plans and policies. Methods: To address the problem, OHE staff searched the literature for frameworks to evaluate a comprehensive plan for how it addresses health and identified a few. These included conducting health impact assessments (HIA) on individual level comprehensive plan policies, using AARP’s Age Friendly Community Program standards, evaluating the policies for HiAP, and using ChangleLab Solution’s Healthy Comprehensive Plan Assessment Tool (HCPAT). The TCP contains more than 400 pages of text and more than 1,000 goals, objectives and policies (GOPs). For this reason, an actual HIA on individual level policies was not feasible. The team chose ChangeLab Solution’s framework to evaluate the TCP. The tool calls for implementing keyword searches within health-related domains. Researchers also compared the TCP to the Orlando Growth Management Plan (OGMP) as Orlando is a municipality similar in size and demographics to Tampa. Results: The review found that the TCP performs stronger in some health-related domains and weaker in others. The TCP performed similarly to the OGMP in the various health-related domains. This review conducted was able to determine that the TCP contains health-related terms and references. However, the review cannot say that the plan sufficiently includes health. This would require more in-depth analysis. However, this is a beginning step to incorporate health into comprehensive planning and can serve to help other “non-health” sectors to evaluate policies for their impact on human health. It is also a reasonable undertaking in terms of time, staff commitment and resources available to a local health department. Recommendations: To further advance the comprehensive plan effectiveness in addressing health the authors recommend: using a quasi-health impact assessment approach. This would be supplementing the HCPAT review with exploring a few of the individual level comprehensive plan policies that were identified as containing health-related references, for how they impact human health; and adopting an evidence-based measurement platform for gauging plan effectiveness, explicitly highlighting health in plan brochures and introductions, and evaluating intersectoral collaborations in plan development.

 



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(7) Chronic Disease Management in Illinois

Janae D. Price, MPH – Epidemiologist, Centers for Disease Control and Prevention


In the U.S., 75 million adults aged 20 and older have been told by a health care provider that they have hypertension (HTN), 30.2 million indicated being told they have type 2 diabetes (T2D), and an estimated 3 million indicate both, with the number of adults increasing. Interventions employed by health systems to address HTN, T2D and other chronic diseases have shifted in recent years toward using a population health management approach as interventions are more likely to be effective for hypertension and diabetes prevention given the current resource-constrained environment. As such, a comprehensive approach that incorporates a multi-disciplinary care team and point of care resources, within and outside of the health care walls, is critical to address the multiple co-morbidities and risk factors that are routinely addressed in the primary care setting. Given the variability of resources, organizational supports, community linkages and information technology (IT) infrastructure, the ability of health care systems to implement evidence-based interventions can vary widely. The aim of this study was to understand evidence-based interventions used to manage chronic diseases in Illinois using CDC Health Systems Scorecard (HSSC) results. In 2018, the CDC HSSC was deployed state-wide to >250 private and public health plans, hospitals, provider groups, federally qualified health centers, and independent practitioners. This study focused on evidence-based strategies and interventions used to manage 3 chronic conditions (high blood pressure, high blood cholesterol, and diabetes) across 7 domains. Policy, systems and processes (P/S/P) scores were generated based on the number of interventions the organization had in place for each strategy. Responses were direct-matched with the national clinical quality improvement (QI) measure scores for controlled high blood pressure, cholesterol management and hemoglobin A1c >9% (poor glycemic control). Clinical QI percent scores are national measures reported by health systems, to monitor and improve the quality of perinatal, chronic, and preventative care services. Descriptive statistics were generated as well as cumulative and within domain scores. Interventions were most common among Electronic Health Record Systems (67.5%), followed by team-based care (66.3%) and self-management (58.8%) The total number of interventions in place across all domains ranged from 5 – 37 (high blood pressure), 0 – 36 (high blood cholesterol), and 0 – 38 (diabetes) with a mean of 14.1 (95% CI 11.8, 16.4), 6.9 (95% CI 5.1, 8.7), and 11.3 (95% CI 8.6, 14.0) interventions, respectively. Preliminary results indicate a positive relationship between the number and type of interventions and overall clinical quality scores across health systems in Illinois. Within each intervention category, there was a positive association between the percent of health systems that had P/S/P's in place and met or exceeded the Healthy People 2020 target for all HTN, high cholesterol and diabetes. There is growing evidence that strategies such as use of P/S/P's across health systems to improve the quality of chronic care are effective and vital to improving health outcomes. Although this study focused on a sub-set of elements that address systematic supports for quality improvement, there are other elements that would benefit from being studied. These could include, but are not limited to; availability of community resources, the level of leadership and decision support, and systems of care design to ensure productive interactions between health systems, care teams and patients. In Illinois, assessments of organizational infrastructure and P/S/P's that support evidence-based interventions for chronic disease management is a novel concept. Evidence-based system-wide interventions for the management of HTN, high blood cholesterol and T2D are routinely reviewed and recommended by national organizations. Aligning these public health recommendations with clinical guidelines while accounting for the variability of cost, resources, partnerships, and patient engagement can be more of an art than a science for healthcare systems. Further study in this area would assist Illinois health systems with identifying universal and targeted interventions to improve QI strategies in support of HTN, high blood cholesterol and T2D prevention and control.

 



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(8) AIDSVu: Using Data Visualization to End HIV

Elizabeth Pembleton, MPH – Research Program Manager, Emory University

Chandni Jaggi, MPH – Public Health Program Associate, Emory University Rollins School of Public Health


AIDSVu is an interactive online mapping tool that visualizes the impact of the HIV epidemic on communities across the United States to increase disease awareness and promote data-driven public health decision-making. Utilizing data from Centers for Disease Control and Prevention, local health departments, and prescription analytics, AIDSVu allows users to explore the HIV epidemic at the state-, county-, and ZIP Code-levels. The map visualizes HIV-related data by race/ethnicity, sex, age and transmission category, and shows how HIV is related to various social determinants of health, such as high school education and poverty. AIDSVu allows users to locate services for HIV prevention, testing and care, and also includes NIH-funded HIV prevention, vaccine, and treatment trial locations. The site also has local data pages with profiles for 33 U.S. cities, 49 states, D.C., and Puerto Rico, offering easy-to-understand, printable snapshots that summarize the impact of HIV and other sexually transmitted diseases.



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(9) Exploring Health Education Documentation

Amy E. Morrison, D.H.Ed., CCC-SLP, CHES – Certified Health Education Specialist, A. T. Still University

Amy E. Morrison, D.H.Ed., CCC-SLP, CHES – Certified Health Education Specialist, A. T. Still University


This study explored a standard, yet seldom-examined, responsibility within the field of health education—documentation. Using symbolic interactionism as a theoretical framework and established criteria for high quality qualitative research, the following research questions were investigated: • What are the current documentation practices of health education specialists; and • What are the beliefs and attitudes of health education specialists regarding documentation? Individual, semi-structured interviews were conducted in person with 14 health education specialists working in county and state health departments in one southwestern state. Data were analyzed using constructivist grounded theory methodology with the assistance of ATLAS.ti 8 (Windows). Results revealed participants defined documentation broadly and engaged with a variety of documents across myriad tasks. In practice, participants reported using documentation for two main audiences—the public and professionals. Emerging from the data were a duality of nine factors health education specialists perceived as impacting documentation: • Politics; • Resources; • Communication; • Support; • Training/guidance; • Collaboration; • Approach; • Priority population; and • Power/voice. Generally, participants expressed positive attitudes toward documentation for public consumption, as those documents symbolized autonomy, and negative attitudes toward documentation for professional use, as they symbolized heteronomy. To reduce barriers to documentation, study participants described potential benefits of public-private partnerships including sharing resources, expediating procedural processes, improving technological tool development/use, and extending program reach. Findings suggested when health education professionals are supported in routine tasks such as documentation they are better able to realize their reported primary goal—making a positive impact on the communities they serve.



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(12) Getting the Community Fit Together- unique partnerships between the Florida Department of Health and private entities in Hillsborough County

Jennifer Waskovich, MS, RD, LDN, CLC – Senior Human Services Program Manager, Florida Department of Health in Hillsborough County

Kelsey Christian, MPH, CHES, CPH – Health Educator Consultant, Florida Department of Health in Hillsborough county


In 2007, the Florida Department of Health in Hillsborough County began a project to meet the wellness needs of communities that had rates of obesity higher than the state average. Through research and community involvement, the Department realized that people needed a simplistic, easy to understand program and guide to health and wellness. The Department also discovered that people are more likely to make long lasting behavior changes if the information was conveyed in a support group setting. Hence, the Get Into Fitness Today (GIFT) program was born. The GIFT program was developed by Registered Dietitians, Registered Nurses, and health educators with the goal that the program would be delivered by lay community health workers. The program is based off the Transtheoretical or Stages of Changes Model, which allows the program to meet the participants at where they are at in the behavior change process with the goal of moving them to make sustainable behavior changes. The program was also developed using Social Support Theory which allows the participants to interact in a support group setting to receive emotional, instrumental, informational, and appraisal support through GIFT which strengthens behavior changes that lead to weight loss. The materials were created to cover the basics of nutrition and wellness including: MyPlate, ways to lower sodium, healthy shopping education, fats, portion sizes, physical activity, and chronic disease prevention. The program can be delivered in 6 or 12 weeks with each class being at least 1 hour long. The outcome measures were weight loss (measured pre and post), increase in physical activity, and overall increase of fruit and vegetable intake. Originally in 2007 the program was created for lay community health workers to deliver the program within their communities. Then, as the program became more and more successful the Department hired these lay community health workers to offer the program in addition to health educators. Over the course of 11 years the program has expanded from initially being facilitated by lay community health workers to now being offered by many facets of the community including nurses, health educators, yoga instructors, employers, and church groups. In 2016, the Department offered a grant to organizations in the community who could facilitate the GIFT program for a year. That year, the grant recipient was a small business owner who ran a yoga studio with a strong emphasis on wellness. She delivered the program with her employees and the weight loss, physical activity, and fruit and vegetable intake were on par with what the Department’s health educators were seeing in the classes they offered. In 2017, the grant recipient was BayCare Health Systems, a large hospital system that covers 4 counties and is the 2nd largest employer in the Tampa Bay area. BayCare offered GIFT in small clinic settings, their fitness centers, recreation centers, and their own faith-based community groups within Hillsborough County. They too saw the same weight loss results, physical activity, and fruit and vegetable intake increases. When the grant ended in 2018, BayCare decided to continue the project through a grant and expand into Pinellas County. Currently, the Department has expanded the program even further into train the trainer sessions where a Department health educator will work with an employer so that they can use the GIFT program to create their own wellness program. During the GIFT program’s 11-year history, over 350 groups have been conducted throughout Hillsborough County with approximately 90% of participants indicating increases in physical activity and fruit and vegetable intake. Groups, whether conducted by the Department or community partners, indicate an average class weight loss of 2-4%. The Department will continue to expand the GIFT program through public and private partnerships in ways that best benefit the community to reduce the impact of obesity in Hillsborough County.

 



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(13) An Ounce of Prevention - Literally

Terrence Ates, M.Ed., TTS – PIO / Director of Community Outreach, Northeast Texas Public Health District


How does a LHD continually retain community members, many of them they never even see, to continually participate in a free health challenge? In 2012, Fit City Tyler adapted "The Biggest Loser" concept and included the element of a random lottery. Persons would receive a "ticket" for the lottery drawing by completing a health challenge that would be available for a wide variety of populations to participate in their own way. The annual Lighten Up East Texas regional weight loss challenge has averaged 3,000 entrants yearly over the past 6 years who "weigh-in" during the months of January and February, and the percentage of entrants who "weigh-out" during the last week of April have increased every year. Entry locations have evolved since the first year, as LUET has enjoyed increased community support from public school districts and private businesses, as they integrate their existing workplace wellness initiatives with our annual challenge that easily relates with New Year's Day resolutions. Weighing locations are annually requested to recruit new weighing locations within their city/county, and they can choose to be a 'private weighing location' and just register their employees, or they can be a 'public weighing location' and have their community members to to register at their location. The wide variety of companies that have been private weighing locations include school nurse clinics, city government employees, police departments, county government employees, church recreation buildings, distribution centers, fire departments, doctors' offices, grocery stores, pharmacies, branch bank locations, restaurants, city halls, libraries and community centers. A company does not have to be a 'health-related business' in order to weigh their employees into Lighten Up East Texas. In addition, a weighing location can contribute prizes that are made available to our regional participants as mid-point incentives or reserved as prizes awarded at the end of the weight loss challenge. The donating organizations are then able to become advertised as a sponsor of Lighten Up East Texas, which equates to their company being included in our promotions that expand across 35 counties in East Texas. Entry is free and the bilingual registration forms are made available at public and private entry locations across a 35-county East Texas region. A person completes a registration form that requests demographic data (e.g., zip code, age, ethnicity, proximity to parks and fresh foods), preferences to receive health information (email, phone call, or text) and the creation of peer support networks (i.e., creating weight loss teams, enrolling within other locally-available community health challenges) & steps onto an approved weight scale during their "weigh-in". During the 3-month period of their "weigh-in" and their "weigh-out", proactive health messages and community resource navigation are communicated to all registered participants. For-profit and non-profit businesses benefit from their in-kind and financial prize contributions, for the non-health incentive of having the hope of possibility becoming one of our Grand Prize winners has sustained the annual growth of the number of entrants and the increase in the number of facilities who agree to serve as weighing locations. Of the 17,000+ participants who have entered over the past 6 years, over 6,400 East Texas residents have successfully conquered our annual challenge to "weigh-in", "weigh-out" and to maintain a weight loss over a 4-month period. The cumulative weight loss is over 52,000 pounds, and the continued support of local and regional partners have sustained the inertia of Lighten Up East Texas.

 



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(16) Bringing Design Innovation to Public Health Preparedness Outreach

Rachel M. Holder – Graphic Designer, Austin Public Health


This Poster will highlight how the use of graphic design principles, in addition to health behavior theories and health communication principles, can improve public health preparedness risk and prevention messaging. It will display practical examples of how to create engaging visual, tangible, and usable designs that can be brought home by community members attending outreach events. These innovative designs have the potential to reinforce public health preparedness messaging and provide cues to action and encourage the community to be proactive at home.



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(17) Developing a Harm Reduction Program through Community Partnerships and Collaborations

Michelle Perdue – Harm Reduction Coordinator, Cabell-Huntington Health Department


This poster will show how to use volunteers, educational opportunities, and contractual agreements with treatment providers to deliver collaborative services to an affected population. Harm reduction practitioners play a vital role in tackling the nation’s opioid crisis by addressing the adverse effects of drug use, including opioid-related overdose. Partnering with the harm reduction field can help substance use disorder prevention practitioners deepen the impact by providing critical links to populations at greatest risk. This poster explores how developing a cultural understanding of each viewpoint and type of work can facilitate healthy collaborations.



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(18) Building Community Health with Public and Private Partners

Diana Gomez, BS, MPH – Chief Health Officer/Director of Public Health, Yuma County Public Health Services District

Ying-Ying Goh, MD, MSHS – Director and Health Officer, City of Pasadena - Public Health Department

Lilian Bravo, BA, MPH – DIRECTOR OF PUBLIC HEALH PARTNERSHIPS, YAKIMA HEALTH DISTRICT

Janet L. Suttie, MA – Director National Program Office, NC Institute for Public Health


New strategies, partnerships, and funding sources are needed to create social and environmental change in communities impacted by complex health issues. Three local health department leaders, from both urban and rural areas, engaged public and private partners to collectively develop and implement strategic plans for making community health improvements that support the missions of each partner organization. Leaders will share lessons learned working with their partners to identify strategic priorities, explore opportunities for new funding sources, establish fiscal mechanisms that sustain long term efforts to improve the health environment, and leverage those partnerships in innovative ways.



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(19) Hispanic Health Assessment

Ellis E. Perez, MPH – Government Analyst iI, Florida department of Health


The Hispanic population is the largest colored population group in Orange County, FL, comprising 29.8% of the total population. The county has a rich variety of cultures which includes United States and Non-United States residents from Central America, South America, Mexico, Spain, and the Caribbean. Due to the increasing growth of Hispanic residents, it is essential to assess and gain understanding of the population’s overall health status and well being. This will allow for the provision of the most effective and most reliable form of care and service, with the hope of addressing and preventing any concerning health issues. The 2017 Hispanic Health Assessment (HHA) is the first population specific assessment developed to address the needs of a targeted population in the county. It is an example of the commitment the Florida Department of Health in Orange County has in utilizing best practices to improve the health of community residents. The HHA is an essential tool that answers questions that further explain the population, growth, change, characteristics, and health indicators among Hispanics. This tool can be used to engage community partners in improvement plans and enhance the spread of public health messages.



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(20) Healthy Eatonville

Veronica L. Smith, Bachelor of Arts – Executive Assistant, Town of Eadtonville

Audrey D. Alexander, BS – Senior Health Educator, Florida Department of Health in Orange County


The Historic Town of Eatonville, known as the Town that Freedom Built, celebrated its 130 years’ anniversary in 2017 and is recognized as the oldest black incorporated municipality in America. The Town of Eatonville is a small municipality with a geographic area of 0.99 square miles made of 665.8 acres. It has a population of 2,243 with 91.9% of its residents representing Black and Hispanic people (2013 Census data). Eatonville has a rich heritage and has played a big role in literary history with noted author, Zora Neal Hurston, as a former resident. The Town of Eatonville’s health improvement journey began after a baseline study was conducted in 2011 to ascertain the health of the community by the University of Central Florida (UCF) using the CDC’s Behavioral Risk Factor Surveillance System (BRFSS) survey tool. Survey results revealed an alarming diabetes rate of 24.2% which was nearly triple the national average and nearly double that of African Americans. Results also showed residents had high rates of hypertension, (49.8%), high cholesterol and smoking. This presentation will highlight how the Town of Eatonville was able to mobilize from the inside out to address its health crisis and the steps they took to make changes in its policies, infrastructure, activities and behavior.



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(21) Being Strategic with Health in All Policies and Governing for Racial Equity

Carmen Gil, MPA/HSA – Health in All Policies Manager, Monterey County Health Department

Elsa Jimenez, MPH – Director of Health, Monterey County Health Department

Krista Hanni, MS, PhD – Program Manager II, Monterey County Health Department


Local Health Departments are tasked to be the health strategists in the 21st century to address emerging health issues while also maintaining mandated services. This has necessitating developing new partnerships and may require new approaches. Health in All Policies (HiAP) provides a framework by which local health departments can position themselves with public and private partners to deepen efforts to address social health inequities and in turn create support for mandated services. Monterey County Health Department in California has used a Health in All Policies Framework for over seven years, informing work from developing its community health assessment through addressing emerging needs including housing, transportation, chronic disease, and opioid use reduction. HiAP in Monterey County has been an effective framework for educating new partners in public health and encouraging intersectoral work across numerous disciplines. Strategies have worked to increase understanding within the Health Department and with a variety of community partners. Surveys have indicated improved understanding of the concepts of health equity along with deeper understanding of strategic alignment across systems and with an overarching vision for health. The efforts were augmented by a variety of systems change and collaboration tools and approaches. These will be discussed and presented. They will include community engagement and empowerment tools, partner development stages and domains that have relevance for intersectoral action and implementation, and concepts and questions to be asked prior to and during implementation. In addition to HiAP a broader effort across county government and with community partners in Monterey County has included the use of Governing for Racial Equity (GRE). Similarities and complimentary aspects for both efforts will also be presented and methods for integrating GRE into a local Health Department’s HiAP efforts will also be presented and demonstrated as integral to the HiAP process. Participants will be provided opportunities to learn how to use the frameworks and tools and which to apply with different audiences.

 



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(22) Building a Culture of Quality Improvement through Storyboarding

Kariely Negron – Government Operations Consultant III, Florida Department of Health in Orange County

Vicente A. Araujo, MBA – Governemnt Analyst II, Florida Department of Health in orange County


Introduction to the process of storyboarding to increase the participation of staff in quality improvement efforts. By allowing staff to participate and submit their ideas anonymously, we reinforce the thinking of, "I am capable of contributing to positive change." This thinking contributes to the continued efforts of building a culture of quality improvement and increasing employee engagement within an organization. The Plan, Do, Check, Act model is used to guide the process.



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(23) Grab the brass ring: partnerships that use a racial equity lens to improve social determinants AND generate funds for staff

Kirsten Wysen, MHSA – Policy Analyst, Public Health - Seattle & King County


What are the benefits to local health departments of participating in multi-sector community-led public private partnerships aiming to create healthy communities? While the benefits to the focus communities respond to Community Health Needs Assessments, the advantages and disadvantages to the local health department can be less clear. This presentation will share surprisingly strong benefits for a large local health department including substantial increases in funds for chronic disease prevention staffing. Public Health – Seattle & King County launched a public private partnership with Seattle Foundation in 2014 called Communities of Opportunity. The initiative aims to create greater health, social, economic and racial equity in King County so that all people thrive and prosper, regardless of race or place. The partnership has resulted in scores of measurable process improvements in the funded neighborhoods and organizations. Supportive community leaders were instrumental in securing a new source of public revenue for the initiative from a voter-approved property tax increase. These levy funds have been used to invest at least $6.5 million more per year for six years to further support focus neighborhoods and 10% of the new funds have supported new chronic disease prevention staff with close ties to these neighborhoods. While neighborhood improvements and policy changes were hoped for goals of the work, the new staff have made unexpected and meaningful changes within the department since they’ve been hired and we look forward with anticipation to the results of work they accomplish during their careers with the department.



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(24) Effective Integration of Community Resources for Co-Occurring Care

Monique Bourgeois, MPNA, LADC – Chief Community Relations Officer, NUWAY

Kenneth L. Roberts, MPS, LADC, LPCC – Chief Clinical Officer, NUWAY

Kenneth L. Roberts, MPS, LADC, LPCC – Chief Clinical Officer, NUWAY


Clients require a coordinated network of community-based services and supports beyond primary treatment to enhance sustained recovery outcomes. Recovery environments, peer support and effective care coordination continue be deficits in the care continuum. This session focuses on collaborative strategies for leveraging evidence-based community resources including recovery residences and peer support to fill gaps in ongoing client care. Session content includes a review of recovery residence regulation standards and access, an overview of recovery community organizations as resources for peer support development, strategies for organizational integration of identified community assets and effective data collection to demonstrate innovative integration efforts in a value-based context. The target audience for this presentation includes all levels of care providers with a focus on those responsible for agency evaluation, strategic planning and implementation.



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(25) Designating Medically Indigent Population (MIP) HPSAs in states without, or transitioning to, Medicaid Expansion: A Virginia case study

Anna Riggan, M.S – Social Epidemiologist, Virginia Department of Health


Prior to expanding Medicaid in January 2019, Virginia was one of almost 20 states that had not expanded Medicaid under the provisions of the Affordable Care Act. Furthermore, Virginia had among the most stringent Medicaid eligibility requirements. Almost 700,000 Virginians under the age of 65 were uninsured in 2016. In many cases, the working poor, defined as working individuals living at or below 200% FPL, rely on Sliding Fee Scale (SFS) services. A federally designated Health Professional Service Area (HPSA) can be transformative for a community. Not only does a competitive HPSA score (reflecting the degree of healthcare provider shortage) give practice sites access to student loan repayment or scholarship recruitment resources, but also requires that sites receiving these funds offer SFS payment options. This incentive to increase SFS services makes HPSAs a primary method to address the healthcare coverage gap. A Medically-Indigent Population HPSA (MIP HPSAs) is a special HPSA designation that examines only the uninsured population living between 139% and 200% of the Federal Poverty Level. However, MIP HPSA designations are rarely pursued due to complexity and data limitations. Using state-level data sources, Virginia has had two MIP HPSAs designated in the past 12 months.



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(26) Boston's Prevention and Wellness Trust Fund Pilot: A Clinical and Community Partnership Model for Pediatric Asthma, Hypertension and Elder Falls

Catherine Cairns – Chief of Staff, Boston Public Health Commission

Christine T. Vu, BA, MPA – Associate Division Director, Boston Public Health Commission

Margaret VanCleve-Rocchio, RN, MSN, FNP, NCSN – Senior Director, Health Services, Boston Public Schools


The Boston Public Health Commission (BPHC) will present an overview of the innovative Prevention and Wellness Trust Fund (PWTF) Boston Partnership model for effective cross-sector partnerships and public health initiatives. PWTF achieved its primary goals, which were to: 1.) Establish and optimize clinical and community linkages, 2.) Enhance comprehensive clinical care, and 3.) Advance health equity while addressing some of the state’s most prevalent and preventable health issues. These efforts specifically focused on Older Adult Falls, Pediatric Asthma, Hypertension, and Tobacco Control. The Prevention and Wellness Trust Fund was created through Massachusetts state legislation in 2012 as an integral part of the state’s multi-faceted approach to healthcare transformation through innovative partnerships. Under the leadership of the Massachusetts Department of Public Health, PWTF provided funding to 9 local municipalities, including Boston. Through invaluable strategic partnerships, PWTF established and leveraged a network of community providers, residents, leaders and existing initiatives to advance work in prevention and wellness.



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(28) Effective Process for Evaluation and Treatment of Tuberculosis in a College

Lisa GreenMills, RN, MPH

Indu Gupta, MD, MPH, MA, FACP – Commissioner of Health, Onondaga County Health Department


International students who are from high to moderate risk countries for tuberculosis often enroll at universities in the United States. These students are at risk of introducing tuberculosis, an airborne infection, into classrooms or dormitories and to the larger community. Screening for tuberculosis in this population requires close cooperation between the educational institution and the local health departments. This article demonstrates that reducing barriers to the evaluation and treatment can improve the rates of completed assessments and compliance with the treatment of LTBI in a college campus. This requires a collaborative working relationship with the college leadership and healthcare team.



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