Bernalillo County Community Health Council Albuquerque, Nuevo Mexico

Partner Organizations Presbyterian Healthcare Services – Community Health APS - Health & Wellness Bernalillo County Community Health Council NM DOH - Health Promotion International District Healthy Communities Coalition First Choice Community Healthcare – South Valley Community Commons UNM - Pathways to a Healthy Bernalillo County

Our SCALE Team Michelle Skrupskis Regional Community Health Improvement Liaison, NM Dept of Health Marsha McMurray-Avila (CHILA2) Coordinator, Bernalillo County Community Health Council Leigh Caswell (CHILA2) Manager of Community Health, Presbyterian Healthcare Services Daryl Smith Program Manager, UNM – Pathways to a Healthy Bernalillo County Jeanne Forrester District Wellness Manager, APS Michelle Melendez Development Director, First Choice Community Healthcare Enrique Cardiel (CHILA2) Facilitator, International District Healthy Communities Coalition

Since the last CHILA, we are excited to share what we are most proud of…. In July 2015, the pilot for the Mobile Market, an initiative of our CDC-funded Healthy Here: Communities Leading Healthy Change, was launched to increase access to healthy food in the International District and the South Valley. This “farmer’s market on wheels”, brings fresh local fruit and vegetables every Tuesday to 2 locations in 1 of the 2 target communities. All the produce is grown by local farmers who are paid their full price. Purchases are subsidized by our partners with Presbyterian Healthcare Services to keep prices low for the consumer. The Mobile Market accepts cash, credit, EBT Cash Card & SNAP. Samples of recipes are free!

A story about something we learned since CHILA1…. Everything we do can benefit from what we’re learning through SCALE. Every time we turn around there’s an initiative that could benefit from a driver diagram or a rider-elephant-path analysis. Here we used the driver diagram to see how all our initiatives interconnect…

What we learned about engaging community members with lived experience Our partner, First Choice Community Healthcare, is working with partners to develop a comprehensive health commons surrounding their South Valley clinic. They have held several design workshops with community members from the neighborhood to involve them in the planning for various components: wellness center, early childhood development center, charter high school, walking trails, community garden and farm to table restaurant. By providing incentives for the first sessions, they have been able to generate enthusiasm for ongoing volunteers to help with future design, construction and implementation. They report a very successful co-design experience!

What we learned about engaging the BROADER community in developing our aim It’s hard! This summer in particular has been hard to schedule additional meetings specifically for this discussion, due to life, health, work and vacation conflicts. We have tried scheduling opportunities into other meetings to discuss our aim, but the other agenda items always run over and there’s never enough time for the full discussion. Hoping for success in the fall!!

Our aim for SCALE is….. By 2016, increase the # of active community participants with lived experience in the implementation of BCCHC's Healthy Here initiatives focused on addressing obesity in the International District and the South Valley. We believe that increasing involvement and leadership of community members with lived experience will result in better health outcomes for them, as well as better outcomes overall for the Healthy Here projects related to healthy eating and physical activity.

We still have a lot of work to do and questions to ask ourselves about our driver diagram. For example, one big question is: Is it enough to aim for starting with improving the health of the community members with lived experience due to both the program in which they’re involved and the “empowerment effect” of being in a leadership role?

Metrics we are considering to our track progress Potential process measures for tracking increased involvement of community members with lived experience: Numbers of new community members involved in implementation of each initiative related to healthy eating or physical activity Quality of their experience (measured through surveys) Potential outcome measures for increased access to healthy food and physical activity: Fruit/vegetable consumption Fruit/vegetable expenditures Steps or miles walked per week

What we learned from “Switch” Rider: People need to focus on the bright spots or they get too caught up in negative thinking which messes with the brain (e.g., “It can’t be done!) Elephant: When people lose the joy for their work, the negative emotions take on the weight of an elephant! Path: Clear the brush! Obstacles in bureaucratic systems are particularly thorny.

Top two things we learned from other communities since CHILA1 Learned that we’re not the only ones with a full “portfolio” of initiatives, trying to figure out how to focus in on one without losing the buy-in of partners working on other pieces. 2. Learned from observing the metrics experts walk through another community’s driver diagram – areas we need to refine and work on. 3. Have begun learning about the ABLe Change Framework from Michigan State University (that’s three things, but oh well…)

Our biggest challenge(s) right now are….. TIME – Trying to herd the cats (who are all meeting-ed out and doing 2-3 people’s jobs) into coherent discussions where we can motivate them to take on the discipline required for doing this work well. PRACTICE – Still trying to integrate all these wonderful tools we’re learning into a flow that makes sense and get others to take that journey with us.

We hope to learn this at CHILA2… More about the ReThink Health modeling More about how to refine our aim and driver diagram More about using a “Switch” analysis to determine action More about Transformational Leadership More about what other communities are learning and doing, especially with regard to engaging community members with lived experience More about how to find and keep the joy!

Best way to contact us: Marsha McMurray-Avila (Local Improvement Advisor) mcavila.bcchc@comcast.net Leigh Caswell (Coalition Lead) lcaswell@phs.org Enrique Cardiel (Community Champion) ecardiel@bernco.gov