1. NWTEC 2016 Survey Results Presented by: Nanette Star Yandell, MPH
Project Director & Epidemiologist

2. 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

3. What is the EpiCenter doing well?
Data reports
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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

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