Healthy Eating Active Living (Collaborative Name) HEAL Zone (Event/meeting info or presenter/contact info)

What is the HEAL Zone? The (name) HEAL Zone is: A network of community partners working together to help make healthy choices the easy choice for (community name). HEAL Zone partners include: (list) Kaiser Permanente Community residents Part of a larger obesity prevention effort started by Kaiser Permanente in 2004. There are currently seven HEAL Zones across Northern California.

(Collaborative Name) HEAL Zone: Vision: Our vision is that the (###) people in (location) community will be able to: Eat better Move more As a part of daily life

(Collaborative Name) HEAL Zone Overall Objective: By making healthy choices accessible to more people, the (name) HEAL Zone will help prevent diseases such as diabetes and hypertension that often result from obesity.

Large Single Point Slide Why do we need a HEAL Zone? Obesity is a national epidemic: One in three U.S. adults is overweight or obese More than half of all California adults One in 3 California teens One in 9 California children In (name of community) (Stats from CAP) Annual costs for treating overweight and obesity-related illnesses are an estimated: $78 billion nationally $7.7 billion in California (over 9% of all health care spending) Studies show that our health and well-being are directly linked to the social and physical environments in our communities. Large Single Point Slide

What will the HEAL Zone do? Over the next three years, the (name) HEAL Zone will focus on these four goals: Decrease calorie consumption Increase fresh fruits and vegetables consumption Increase physical activity in community settings, such as parks, safe routes for working and biking Increase physical activity in institutional settings, such as schools and the workplace With these goals, our plan is to saturate the whole community with multiple, evidence-based strategies to impact physical and social environments. Simply put, people need to eat better and move more, but there are many complex personal and environmental factors that influence these behaviors. Given these multi-dimensional factors, the HEAL Zones Initiative focuses on saturating a particular geographic area and transforming both physical and social environments into places that support and encourage healthy eating and active living among residents.

(name) HEAL Zone strategies Effective “high dose” strategies will help us make lasting change in our community: Dose Reach Strength Reach: Number of people exposed Strength: Impact (i.e., change in lifestyle) for each person reached

How it all connects Vision Goals Strategies Decrease calories (soda, sugar sweetened beverages, portion sizes, snacking) Community Infrastructure Policy Development Organizational Practices Systems Change Built Environment Levers: Affordability, Accessibility, Availability, Safety People eat better and move more as part of daily life. Increase fresh fruits and vegetables Increase physical activity in community settings (safe walking and biking routes, parks, joint use agreements) Education Individual Skills and Knowledge Community Norms Change Levers: Perceptions, Knowledge, Skills, Attitudes Increase physical activity in institutional settings (schools, after school, workplace)

(name) HEAL Zone 2011-2012 In the next year, the (name) HEAL Zone will focus on: Description of strategy/activity, who it will impact and how

Looking ahead What does the (name) HEAL Zone mean to you? Opportunities for engaging in healthy behaviors include: Walking or riding bikes on safe routes Buying affordable fresh fruits and vegetables close to home Exercising in neighborhood parks Children participating in active after-school programs (or include tangible outcomes from your CAP)

The future of HEAL HEAL has been on the forefront of a growing national movement, including: The American Recovery and Reinvestment Acts (ARRA) Communities Putting Prevention to Work grants The First Lady's Let's Move campaign The movement is growing! Partnership for a Healthier America

To find out how you or your organization can get involved, call (###) ###-#### or visit www.xxxx.com

HEAL Context and History Slides Other slide options HEAL Context and History Slides

The beginning of HEAL Kaiser Permanente recognized that clinical care alone can not reverse the growing trend of obesity, and expanded its approach MEDICAL OFFICE VISIT INTERVENTIONS BMI screening Physician counseling Patient education materials Referral and follow up WEIGHT MANAGEMENT INTERVENTIONS Individual Counseling Group programs Intensive programs Internet resources Back in 2004, Kaiser Permanente recognized that clinical care alone will not stop or reverse the growing trends of obesity. KP developed a 3-pronged approach that married the medical office interventions with weight management interventions and efforts to change environments and policy. ENVIRONMENTAL CHANGES School Programs Worksite programs Community programs Legislation and partnerships

HEAL evolution: pre-Zones Year Highlights 2004 “HEAL” launches with small, one-year Local Partnership Grants (LPGs). 2005 KP participates as partner, funder, and technical assistance provider in The California Endowment’s statewide Healthy Eating, Active Communities Initiative. 2006 HEAL-CHI launches in 3 NCAL sites: Modesto, Richmond and Santa Rosa - $1.5m commitment over 5 years (EBCF). Includes evaluation, technical assistance, and CB Manager engagement. 2007 HEAL support includes 3 HEAL-CHIs, 13 targeted 2-year LPGs, technicial assistance, evaluation, Regional and Statewide Community Based Organizations working on systems, policy, and environmental changes. KP founding partner of CA Convergence – includes communities, funders, evaluators and advocates statewide. 2008 HEAL portfolio expands to address community needs including violence and food security. CA Convergence expands to 40 communities statewide. 2009 HEAL-CHI continues, 6 LPGs are ongoing, South Sacramento Trauma Center opens with violence intervention program anticipated to launch 2010, “Healthy Eating in Hard Times”: addresses economically hard times, CA Convergence helps counties apply for ARRA funds. 2004 to 2009 KP’s leadership grows – from weight management guidelines and farmers’ markets, to menu labeling in cafeterias, healthy picks vending and environmental stewardship. 2010 KP becomes founding member of Partnership for a Healthier America (First Lady’s Let’s Move Campaign) , next phase of strategic planning underway.

Walking the talk In addition to its community investments, Kaiser Permanente applies and learns from HEAL strategies in its facilities and becomes a visible leader: 2001: Sponsors and participates in the California Childhood Obesity Conference 2002: Introduces Body Mass Index as a vital sign in clinical practices 2004: Introduces its Farmers’ Markets 2006: Receives National Recognition Awards for Health Care Programs Addressing Childhood Obesity 2007: Begins to implement comprehensive food policy and menu labeling in hospital cafeterias 2008: Launches “Take the Stairs” campaign 2010: Launches comprehensive Live Well Be Well worksite wellness program 2011: Introduces exercise as a vital sign in clinical practices

More about HEAL-CHI The HEAL Zones are a continuation of Kaiser Permanente's Healthy Eating Active Living Community Health Initiative (HEAL-CHI). HEAL-CHI was a five-year initiative that started in 2006 and empowered communities to promote: Healthy eating Active living Through community-driven policy and environmental change Let’s take a few minutes to hear from members of the HEAL-CHI communities: http://www.kpmmc.org/video/HEAL_V3.wmv

Examples of HEAL-CHI successes Modesto: Implemented new farmers’ market, youth growing and selling 900 lbs of fresh produce New walking path under development Walking School Bus program 19% increase in children exercising in after-school programs Richmond: Health elements included the General Plan Survey results used to advocate for improvements in parks Community Subsidized Agriculture (CSA), bringing produce to low-income residents 13% increase in children eating the school lunch, compared to control schools Santa Rosa: BMI screening in clinics Safe Routes to School environmental improvements Policy banning mobile junk-food vendors from schools 15% increase of residents recognizing health promoting community changes Significant improvements in healthy food behaviors through several worksites wellness programs

Picturing Success Before After Before After

Picturing Success Before After

HEAL-CHI learning applied to the Zones Structure Narrow Focus / Increase Dose Employ Range of Strategies Use Evidence Informed Strategies Allow Flexibility in Structure Consider Safety as an Important Component Process Strengthen Kaiser Permanente Engagement as a Partner Continue to Lead by Example Narrow Focus / Increase Dose: HEAL-CHI sites were spread very thin across a broad geography, four pre-defined “sectors”, and multiple objectives/strategies proving difficult to achieve synergy and impact. For this phase we have narrowed the geography to 10-20k people, removed the sectors and focused on creating greater “dose.” Employ Range of Strategies: Policy, organizational practice, and built environment change is hard and takes time. We will continue to focus on these longer-term changes, and also include community awareness and education strategies that complement the policy change, to impact the short term behavior change needed now. Use Evidence Informed Strategies: Whenever possible, we are directing action toward evidence-based strategies, and consider building our evaluation to track and monitor strategies where the evidence is not as developed. Allow Flexibility in Structure: While we required longstanding collaborative last round, we are allowing for a varied leadership organization and structure and require more formal relationships (including Memorandum of Understandings) and funding arrangements. Safety is an Important Component: Safety concerns/fear manifest differently in communities (e.g., gangs, stray dogs or pedestrian paths). All sites want to address safety in active living goals. Process Strengthen Engagement as a Partner: Communities appreciated KP’s involvement beyond funding. Better leverage and deploy our assets including Community Benefit Managers, facility staff and TPMG experts. Lead by Example: Continue to model the changes and behaviors we are asking in the community within our own facilities for members, staff, and physicians.

Network of Partners As a continuation of the HEAL CHI initiatives, the HEAL Zones bring together a robust coalition and network of partners in each site, including: Local public agencies Schools and school districts Community based organizations Employers and local businesses Faith-based organizations and Health care providers, including Kaiser Permanente Community residents

2011: HEAL Zones are launched HEAL Zones Detail: Continuing 3 HEAL-CHI Sites: Santa Rosa, Modesto, Richmond Adding 4 New Communities: South Sacramento, Madera, San Francisco (Bayview), Concord (Monument) Investing $1 million per site, over 3 years Investing additional funding for technical assistance and evaluation Focusing on smaller population (10-20k residents) and common goals, overlapping strategies in each Zone Increasing active engagement of area Community Benefit Managers and facility staff Engaging Center for Community Health and Evaluation team from the beginning Encouraging synergy in overlapping geography with other funders’ initiatives such as The California Endowment’s Building Healthy Communities

Additional HEAL work underway Kaiser Permanente is investing in programs that compliment and supplement the HEAL Zones, including: HEAL Local Partnership Grants: smaller, 1-2 year grants for “non-Zone” areas Continued investment in policy, built environment and programmatic grants Continued participation in California Convergence Continued investment and framing on the overlap between violence, safety and HEAL Since 2004, Kaiser Permanente has invested more than $21 million to support HEAL efforts in Northern California Local Partnership Grants (LPGs): Smaller, more focused HEAL projects, such as youth engagement in school wellness policy work, community engagement in city planning for safe routes for walking and biking and college campus changes. Policy, built environment and programmatic grants: Support for strategic partners for advocacy on HEAL policy changes, and to provide technical expertise to place-based (HEAL Zone) grantees. Partners include the California Center for Public Health Advocacy, Prevention Institute, California Convergence: Kaiser Permanente and The California Endowment are lead funders. Engages over 40 place-based HEAL sites in California to share experiences, best practices and common policy agenda. Violence Prevention/Intervention: Partners include City of Sacramento & Youth Alive for Violence Intervention Program (linked to Kaiser Permanente’s South Sacramento Trauma Center, Youth Radio and the MLK Jr. Freedom Center.

Questions?