NWTEC 2016 Survey Results Presented by: Nanette Star Yandell, MPH Project Director & Epidemiologist nyandell@npaihb.org

Introduction Survey conducted in Fall 2015 Completed by 26 Tribes Purpose: Feedback for EpiCenter Health Priorities Public Health Policies Northwest Portland Area Indian Health Board

What is the EpiCenter doing well? Data reports http://www.npaihb.org/resource-lib/ Public health information – general Grants, financial assistance Responsive and friendly staff Data reports can be found on the NPAIHB website- Resource Library link Northwest Portland Area Indian Health Board

What can we improve? More outreach to programs outside of administrative Tribal government public health policy Provide best practices, esp. tribally adapted & culturally appropriate Tribal data warehouse Technical Assistance for NextGen Better communication of what the EpiCenter does Quotes for bullet one: “More hands-on site visits by EpiCenter personnel rather than just paper information. Sometimes the medical department has needs or concerns that differ from our administrative concerns. They don't always bring them forward until they are placed in a meeting with experts.” “I just don't think the information and availability of help reaches all the people it needs to. It probably doesn't get past the health director who doesn't know of needs” “Perhaps outreach to individual tribal programs once or twice a year and ask what's going on and whether the EPICenter might be of assistance” Northwest Portland Area Indian Health Board

Epicenter Services Data products such as fact sheets and health profiles were the most commonly used Trainings were the least used services, and we need to do a better job of getting the word out about our trainings and mini-grants. Northwest Portland Area Indian Health Board

Top Three Health Priorities Overweight and obesity (10) Substance Abuse (7) Mental health (6) These three areas were the most commonly chosen when respondents were asked to choose their top 3 priorities, and also high on the list of topics they would like to see the EpiCenter doing more about. Note that some of the issues that folks felt were a priority, about which they’d like to see the EpiCenter doing more, fell out of the top rankings when forced to prioritize the top 3. Specifically this included MCH, nutrition (although this aligns closely with overweight and obesity), asthma and arthritis. Northwest Portland Area Indian Health Board

EpiCenter could do more about… These were the 7 health topics for which more than half of the respondents said “the EpiCenter should be doing more” Northwest Portland Area Indian Health Board 11/7/2018

EpiCenter is doing well to address… These were the top 12 topics for which more than half of respondents said “the EpiCenter is doing the right amount”. Only one topic was considered “not a pressing priority” for the majority of tribes – Occupational Health Northwest Portland Area Indian Health Board

Top Sexual Health Priorities Note: Respondents ranked priority level on a scale of 1 to 7; this shows the mean ranking for each. Northwest Portland Area Indian Health Board

Policy, Systems & Environment Policy passing of or change to a law, ordinance, resolution, regulation or rule designed to guide or influence behavior System involves change made to organizational procedures Environment change made to the physical surroundings PSE APPROACHES TO PUBLIC HEALTH What PSEs are now in place/being considered to address the topics below: Nutrition Physical Activity Health Systems Data Use/Planning Emergency Preparedness

Top 5 Physical Activity PSEs Top 5 physical activity PSEs either in-process or in-place Many have recreation space and activities available in their community Northwest Portland Area Indian Health Board

Identified Opportunities Physical activity Rx, bikes, and standards for children are emerging concerns Top 3 physical activity PSEs identified as an issue but not yet in-process. Note that a few were on both “top” lists – a pretty even split between those who have them already and those who are considering them. For example, access to transportation, community rec/fitness center Talk about ( Physical activity Rx, bikes, and standards for children are emerging concerns) Percent reporting “identified as issue but not yet in-process” Northwest Portland Area Indian Health Board

Top 5 Food & Nutrition PSEs About 30% had cooking classes currently, about 30% were in progress. Similarly, farmers markets policies were split between in-place and in-progress Northwest Portland Area Indian Health Board

Identified Opportunities Percent responding “Identified as an issue but not currently in-process/place”. Opportu (Identified Opportunities to address food systems changes such as marketing, procurement (Identified opportunitnity here to support Tribes who are looking to develop these kinds of policies.) NWTEC Can assist: Percent reporting “identified as issue but not yet in-process” Northwest Portland Area Indian Health Board

Top 5 Commercial Tobacco PSEs Top 5 tobacco PSEs either in-place or in-process Most clinics offer a variety of tobacco cessation services, and non-smoking areas are the norm Northwest Portland Area Indian Health Board

Identified Opportunities Note – not too many in the “identified but not yet in process” category for tobacco. Similar situation to physical activity – split between those who had cessation counseling and those who want it. Some are considering smoke-free policies and restrictions on tobacco marketing Percent reporting “identified as issue but not yet in-process” Northwest Portland Area Indian Health Board

Top 5 Health System PSEs Top 5 health system PSEs. Patient education, lifestyle programs are available in most clinics Northwest Portland Area Indian Health Board

Identified Opportunities More have these items in-place than don’t – but less than half. About a quarter are ready to move toward regular monitoring and protocols in the clinic Percent reporting “identified as issue but not yet in-process” Northwest Portland Area Indian Health Board

Northwest Portland Area Indian Health Board Thank you! Indian Leadership for Indian Health Northwest Tribal Epidemiology Center Northwest Portland Area Indian Health Board