Advancing California Opportunities to Renew Native health Systems (ACORNS) Funded by the Centers for disease control and Prevention’s (CDC) Good Health and Wellness in Indian country (GHWIC) Cooperative agreement 9/21/2018

CDC’s Good Health and Wellness in Indian Country (GHWIC) & ACORNS Goals: Increase chronic disease prevention Create sustained policy, system and environment (PSEs) improvements Increase community and clinical linkages within California Increase team-based systems of care through culturally competent interventions in Native communities. As a GHWIC grantee, California Rural Indian Health Board’s (CRIHB) Research and Public Health staff provide: funding, training, and technical assistance to Tribes and Tribal Health Programs (THPs) in California to implement such programs, through ACORNS. 9/21/2018

ACORNS Funding GHWIC is a 5 year grant (2014 – 2019) awarded to CRIHB and funding was open to all California Tribes and THPs through two phases as sub-awardees. Phase I – Community Health Assessment (CHA): Funds were allocated for Tribes to conduct a comprehensive CHA and develop an assessment-based Community Action Plan (CAP) that address community-specific health needs. Phase II – Program implementation: Funding to implement effective, community chosen and culturally adapted policies, systems, and environmental changes to address commercial tobacco use, access to healthful nutrition, physical activity, and strengthen team-based care and community-clinical linkages. California Indian Tobacco Education (CITE): Additional supplemental funding for activities that focus on the reduction of commercial tobacco use and exposure. 9/21/2018

Phase I AWARDEES: Assembled a “Community Team” Produced a CAP to guide implementation of policy, systems, and environment changes Produced a community assessment Gathered information on community Assembled a “Community Team” (Representatives of the community, health care, school, & work site sectors) 9/21/2018

Phase II AWARDEES are: Implementing community action plans aimed to address one or more of the following: Prevent commercial tobacco use & exposure Increase physical activity Increase access & consumption of healthy foods Strengthen clinical-community linkages Promote breastfeeding 9/21/2018

ACORNS Program Approach ACORNS supports sustainable chronic disease prevention through policy, systems, and environmental (PSE) changes. Policy Written statement of organizational position, decision or course of action, such as ordinances, resolutions, mandates, guidelines, or rules. System Changes in organizational procedures such as, personnel, resource allocation, programs. Environment Physical, observable changes in the built, economic, and/or social environment. 9/21/2018

Health Promotion vs. PSE Changes Setting Program/Event PSE Change School Have an event or assembly promoting healthy food Establish a school garden Community Host a community walk Establish and maintain a walking trail in your community Worksite Have a physical fitness challenge Implement a policy which encourages and allows employees to engage in physical activity during work breaks Clinics Hold free breastfeeding courses for new moms Designate a breastfeeding room for nursing mothers 9/21/2018

ACORNS/CITE Example program strategies The community garden at Cold Springs Rancheria where they are planting vegetables, traditional plants, and fruit trees. The greenhouse for Bridgeport Indian Colony’s community garden. Greenville Rancheria’s healthy vending machine. Tule River Indian Health Center’s new vending machine for healthy snacks. Institute healthy food and beverage options in vending machines Establishing community gardens 9/21/2018

ACORNS/CITE Example program strategies No smoking signage outside of Cloverdale Rancheria’s Tribal Office. Indian Child and Family Preservation Program has made their Wellness garden smoke free. Bridgeport Indian Colony’s bikes from their bike-share program. Big Pine Paiute Tribe of the Owens Valley’s bike-share program. Institute a smoke-free policy for outdoor public places Institute a bike sharing program 9/21/2018

ACORNS/CITE Example program strategies Round Valley Indian Health Center’s garden trailhead. Bishop Paiute Tribe’s Wellness Center. Bridgeport Indian Colony’s community walking trail. Cold Springs Rancheria’s Wellness Center. Maintain a network of walking routes or nature trails Big Pine Paiute Tribe’s Wellness Center. Provide access to public recreation facilities for people of all abilities Bishop Paiute Tribe’s walking trail. 9/21/2018

ACORNS/CITE Other example program strategies Implementing wellness and healthy eating policies Developing referral systems linking clinical and community services Developing community partnerships which increase access to nutritious food or physical activity Developing culturally competent communications promoting health 9/21/2018

ACORNS/CITE Awardees Reach: 40 CA Tribes or THPs have completed Phase I Currently, 27 Tribes and THPs are implementing funded Phase II programs Since 2015, 52 CA Tribes have been reached through Phase II programing Setting: Rural and urban Tribes, clinics, and health programs 9/21/2018

(Insert Tribe/THPS name here) ACORNS Program Completed Phase I Community Health Assessment in (add month and year). Our CHA results showed: List some of the major findings of your CHA Insert finding here Based off those results, we developed an action plan focusing on (Insert program focus areas: commercial tobacco, healthy foods/nutrition, community clinical linkages, physical activity). Phase II program implementation began (Insert Phase II start date). Insert photo taken during Phase I or of your CHA 9/21/2018

(Insert Tribe/THPS name here) ACORNS Program Team (Add names, roles, and photos of the ACORNS team, office etc.) 9/21/2018

ACORNS Phase II Work Plan (add work plan year) Overall goal: (Write program goal here) Objective 1: (Write objective here) Activity 1: (Insert supporting activities) Activity 2 Activity 3 Objective 2: Activity 1 Insert photo of work plan/work/goals 9/21/2018

ACORNS Program Evaluation (Insert information about how you are measuring or plan to measure your program success) 9/21/2018

ACORNS Program Progress (Insert information about your project’s progress… - What activities have you completed? How many people have you reached? # of policies implemented # of referrals made # of physical activity opportunities provided # people who have quit smoking # of MOUs written or partnerships developed # of gardens established Add photos, videos, survey results etc. This could be several slides. 9/21/2018

Greatest Successes (Use this space to talk about some of the successes of your work and why you are committed to this program or work) (Using pictures, stories, videos, etc. are good ways to share this) 9/21/2018

Biggest Challenges (Use this space to talk about some of the past and current challenges of your work and how you will or did overcome them) (Using pictures, stories, videos, etc. are good ways to share this) 9/21/2018

The future of ACORNS (What is your vision for the future of the ACORNS program ?) (How do you plan to make these program efforts sustainable?) (Why is this work important to continue?) 9/21/2018

Your Role (This could be a slide for informing the people watching the presentation how they could be a part of this program ) (Who are you presenting this to and what do you need from them to support your work?) Donate their time or resources Implement/pass a policy Enter into a partnership with you Endorse the program Participate in program activities Contribute ideas for program growth or improvement 9/21/2018

Questions? 9/21/2018

(Insert name and contact information here) 9/21/2018