1. Upstream Approaches to Improving Community Health
2015 Minnesota Cancer Alliance Working Meeting
May 7, 10 am-2pm
Presented By:
Maria Regan Gonzalez
Bloomington Public Health

2. How upstream is our work?
Very upstream….
Conditions that create health (SDOH)

3. One of Many Upstream Approaches
Latino Childcare Provider Network
Nutrition and PA, school readiness, licensing, workforce development
Comfort Inn Worksite Wellness
Transportation and income
Healthy Living Hub
Cultivation of community leaders, culturally appropriate & accessible HP activities
In-house 3 year old preschool screening services in identified communities
Bridging barriers to preschool screening and services
Bridging cultural barriers to healthy food access (Fare for All)
Workforce development, environmental change, relationship building with community
Bridging cultural barriers to participating in youth and adult programming provided by the school districts
Workforce development, bridging cultural and religious barrie
If there is success and need, they will incorporate and expand into programming
Explain how upstream our approaches are to all three projects…very upstream. Focus on SDOH or the conditions that create health.

4. The Why: Barriers to Health for the Latino Community
Youth obesity
Adult chronic disease
Childhood poverty
School readiness
Free and reduced lunch
Home ownership
Employment and income
Health insurance coverage
4-year high school graduation

5. How the Project Started
Listening to the community (over 2 years)
Childcare was a top concern
Barriers to healthy children
Physical inactivity
Poor nutrition
Poverty
Barriers to becoming licensed providers
Cultural beliefs around childcare
Barriers to education
Isolation
Funding: UCare and SHIP

6. The What and How

7. What has been done to date?
providers from around the metro area
Mostly unlicensed providers
Average of 4 kids x provider (~480 children)
2. 20 trainings since 2013
Nutrition
Physical activity
Licensing requirements and resources for providers
School readiness & CPR
Toy making workshop (school readiness)
Community resources for providers
3. Opportunity for social connection and support
4. Identification of individuals to become trainers (in-progress)
5. Connections to support becoming licensed
6. Providing information to those within the system about the network and population

8. http://www. preventioninstitute

9. The 5 C’s 1. Content Expertise and 2. Collaboration Skills
Cross sector collaboration with experts in the field of childcare
Church of the Assumption
Latina childcare providers
Early Childhood & Family Education
Fairview Southdale Hospital
University of Minnesota Extension
MN Department of Health
Develop
Think Small
Hennepin County Licensing
Hennepin County Child Care Assistance Program
Minnesota Department of Education
Help Me Grow Program
Child Care Aware
Church of the Assumption
a. Lead the project, recruit participants, populate database, collect information, host trainings
Latina childcare providers
Participant Recruitment
Early Childhood & Family Education
Co-sponsor some training
Space for trainings
Info about school readiness
Fairview Southdale Hospital
Provide educational opportunities for the kids in childcare while adults are in the training
University of Minnesota Extension
Provided training support
MN Department of Health
Funding for physical activity and nutrition workshops
Spanish resources around PA and Nut
Technical assistance
Develop (Org. that approves trainers and trainings)
Ta to make sure trainings we are offered and are approved
Think Small
Info session about licensing requirements and process
Promoted with our network with their contacts
Sent our contacts to them
Provided TA in understanding the barriers and requirements to licensing
Hennepin County Licensing
TA about licensing process for providers
Hennepin County Child Care Assistance Program
TA about licensing interested providers
With Somali community, they provided list of FFN providers in Somali community in our area
Minnesota Department of Education
Information about the Child and Adult Care Food Program, figure out requirements
Spanish resources for school readiness
Help Me Grow Program
TA to provide school readiness materials and resources in Spanish
Child Care Aware
Discussion and attempts to incorporate PA and nutrition into required trainings for licensed providers

10. From the 2014 Advancing Health Equity Legislative Report
The 5 C’s
3. Systems Change Literacy
Addressing childhood obesity is not as simple as teaching parents and childcare providers about healthy eating and physical activity
Change the way we (public health) works
Support the community’s literacy and action in systems change
From the 2014 Advancing Health Equity Legislative Report

11. The 5 C’s 4. Strategic Communications
Grassroots communication strategy
Word of mouth, church bulletin, in-person, texts
Listening to the community
Understanding our role within the context of power dynamics
Language, meeting format and times
Bi-cultural, bi-lingual BPH staff person, resident of the community as staff lead

12. The 5 C’s 5. Cultural Competency Build relationship & trust
Culturally appropriate services
Bi-cultural, bi-lingual staff
Community-led work
Cultural perspectives on childcare, communication and education
Culturally appropriate communication
Addressing community’s barriers to health

13. 12 Guiding Principles for our Partnerships with Communities
The number one beneficiary of collaboration is the community it serves;
Partners must commit to humility when collaborating and begin by learning from the community before it can share the knowledge and resources it brings to the community;
Partnerships will utilize the wisdom and expertise of the community to build capacity and leadership from within;
The community partner will lead the development and implementation of the work plan;
Organizational partners will follow the leadership of the community;
The collaboration will adapt to the community’s work style;

14. Guiding Principles Cont.
7. Partners will work with the community, not for the community;
8. Existing history, work and partnerships will be honored;
9. Educational activities will be done in a language the community
understands;
10. Culture, tradition and flexibility are considered valuable assets;
11. Partnering organizations will provide connections, resources and
support to the community and the community will decide how
partners can contribute in way that is effective and meaningful; and
12. Collaborations and partners will not duplicate existing efforts.

15. Successes and Barriers
Expanding our reach, quickly via word of mouth
Multifaceted approach to addressing barriers to health
Reaching an isolated community
Creating networks and connections
Identifying gaps in the system
Building community leadership
Informing key partners who can make changes
Barriers
Funding has not caught up to the reality of the community
Need to start limiting promotion and registration
Many systemic barriers identified
Little to know culturally appropriate staff within system
Systems, systems, systems barriers

16. Pictures
We need to think about our heal

17. Closing Remarks
“Those who profess to favor freedom and yet depreciate agitation, are people who want crops without ploughing the ground; they want rain without thunder and lightning; they want the ocean without the roar of its many waters. The struggle may be a moral one, or it may be a physical one, or it may be both. But it must be a struggle. Power concedes nothing without a demand. It never did and it never will.”- Frederick Douglass
In order to effectively advance health equity and address the conditions that create health, we need to work at the intersections. Intersections of PSE, spectrum of prevention, community organizing and empowerment, and SDOH.
There needs to be a fundamental change in the way we do this work….1. funding needs to change, 2. workforce needs to change, 3. relationship and power dynamics with communities need to change

18. Thank You María Regan González Health Specialist City of Bloomington Public Health Division   1900 W. Old Shakopee Road Bloomington, MN PH: