MOCAN Meeting October 24, 2013

Centers for Disease Control and Prevention, Prevention Research Center Program Special Interest Project: 5U48DP Physical Activity Policy Research Network (PAPRN) The communities who shared their time, stories and successes Kaiser Permanente LiveWell Colorado Wisconsin Department of Health Services Denver Environmental Health

What we know … Challenges we face … What are the changes we can make to live more actively?

Evaluate the effectiveness of collaborative groups to facilitate the adoption and implementation of policies and environmental changes at the community level that promote physical activity

Structures Social Processes Management Tactics and Activities Policy and Environmental Change

Phone interview Structures, leadership, tactics and activities Environmental and policy achievements Network survey Resources, trust, value Groups Invited Interview Sample Network Sample

Parks and Recreation Transit Streetscaping Street Improvement Children’s Play Areas Plazas Infill and Redevelopment Safe Routes to School.

*Source: BRFSS, 2008

Most groups involve partners from multiple sectors, including: Planners Elected officials Public health experts Private entities (e.g., health care organizations) Media Non- profit organizations

Greater policy and environmental change in groups that reported: Engaged in media communication Actively participated in the policy process Engaged with the broader community of stakeholders

Groups reported the most success in adopting policy in the areas of: Public plazas Street improvements Streetscaping Parks and recreation Complete Streets policy was frequently cited as a supporting policy for these areas Opportunities remain in other areas, including transit and infill and redevelopment

Age: years (44%)-MOCAN=9 years Size: 11 – 30 partners (44%)-MOCAN= >50 Focus: Place-based (66%) Funding status: < $200,000 (61%)-MOCAN= $350,000 Structures Staff: Paid (85%)-MOCAN=Paid Leadership: Has designated lead (76%)-MOCAN=Yes Coordinator: 1+ years experience (72%)-MOCAN=8 years Management Overall trust: 3.45/4-MOCAN=2.97 Overall value: 3.13/4-MOCAN=2.63 Social processes Population density: Mixed (49%) Geographic area: City/town/neighborhood (43%) Demographics

Environmental Change Group focus Activity Place-based a Advisory a Community events-MOCAN=3 Low a Medium High a Social media No a Yes a Policy Change Group focus Advisory a Activity Place-based a Age-MOCAN=9 years 1 – 3 years a 4 – 6 years years a Social marketing No a Yes a % Score

Environmental Change Engages in media advocacy Rarely a,b,c Sometimes a Often b Very frequently c Community leaders participate in or endorse events Sometimes/Rarely Often Frequently Policy Change Engages in media advocacy Rarely a,b Sometimes c,d Often b,c Very frequently a,d Offers testimony in hearings Rarely a,b Sometimes a Frequently b % Score

Contacted members of MOCAN to learn more about their experiences in this partnership Perceptions of those partners who took the PARTNER survey 11 partners identified 8 partners completed online survey 73% partner response rate

Social Network Analysis to map relationships (also known as ties) among members of the group Structural attributes of the group: Density-general level of cohesion-proportion of ties present in the network in relation to the number of possible ties in the entire network Degree centralization-the extent to which relationships are centered around specific group members-proportion of ties each member has in relation to other members

Most members recognized one another by name. There appears to be a core group of members in the center and others are organized around the periphery. Information flows through the core group to the periphery Density Score: 0.75 Degree Centralization: 0.31

Different network configurations work for different groups Groups can organize in a way that works best for their members and the context in which they are working. Groups can be effective with both tightly knit (i.e. high density) or loosely constructed (i.e. low density) configurations.

Collaborative’s most important outcome and whether the group as been successful in achieving their goals MOCAN: group has been somewhat successful in achieving their goals

Majority (50%) members selected changes to or formation of policy as the most important outcome of MOCAN

Trustworthiness-measured by reliability, mission congruence, and openness to discussion Organizational value-power and influence, level of involvement, and resource contribution

Member asked to identify their most important contribution to the collaborative Variety of contribution reduces redundancy and increases the group’s ability to work collaboratively toward a common goal

Insights into the: Structures and activities of collaborative groups Environmental and policy approaches they utilize to advance an active living agenda Suggests that active living collaboratives are translating the evidence on environmental and policy approaches to promote active living from research to practice Achieving environmental and policy change requires time, social and political connections, and financial resources.

Diverse, multi-sectoral collaborative expands the influence of the group and their ability to make decisions that move the work of the group forward. Groups who organize a greater variety of community events and use social media and social marketing achieve higher levels of environmental improvements and related policy change Groups most effective in making improvements to the built environment and changes to the policy landscape dedicate substantial resources to engage: Their memberships The broader community Decision-makers

Age: 9 years Size: >50 partners Funding status: $350,000 Structures Staff: Paid Leadership: Has designated lead Coordinator: 8 years experience Management Overall trust: 2.97/4 Overall value: 2.63/4 Social processes Population density: Mixed (49%) Geographic area: City/town/neighborhood (43%) Demographics

Environmental Change Policy Change Age Place-based * Hold Events 0.28* Offer testimony 0.48*** Engage in media 0.31** Overall model fit F-value Pr<F 0.001<.0001 R2R

Largest study of its kind to evaluate group effectiveness in advancing a policy and environmental change agenda to promote physical activity However, statistical analysis is limited by sample size of 59 groups This dataset is robust enough to look at the types of network structures and the quality of relationships within these structures as they relate to group effectiveness

Collaborative groups are translating the message about environment and policy approaches to advance the active living agenda into action Tactics and activities, as part of community engagement, are widely used but intensity of use varies All collaborative groups have attempted to make changes to local environments and most have attempted to improve or add policies

Dissemination Feedback sheets Interactive forum to facilitate exchange of information among groups ( ) Future work Social network analysis Case studies Key informant interviews Site visits Healthy eating module