1. The Children of Appalachia
Working toward success
2018 CELEBRATE KIDS! Conference
CASA for Children, Ohio
September 27, 2017, 1:15 to 2:45

2. Presenters
Pamela Salsberry PhD, RN, Professor OSU, College of Public Health; Program Director, Community Engagement, OSU Center for Clinical and Translational Science
Beverly Stringer, BS, Community Engagement Coordinator, OSU Center for Clinical and Translational Science

3. Learning Objectives
Discuss importance of context and life course approaches for optimal child development
Become familiar with Ohio Appalachian Region
Identify barriers and facilitators to children’s success within Ohio Appalachian Region.
Discuss programs and resources that are in place to improve child outcomes in the Ohio Appalachian region.

4. First …a few comments about optimizing child development
Optimizing child development- thinking across the life course and within context

5. Optimizing a child’s development
Think of as a trajectory that depends upon prior experiences, but always with the potential for change
Some periods particularly critical for child’s development….early childhood, start of school, school transitions
Family transitions and changes have significant long-term impact, importance of ‘buffers’

6. A Life Course Approach to Health Development
Good health
Poor Health
Birth
Adolescence
Infancy
Early
Childhood
Exclusive breastfeeding
Bottle fed; rapid weight gain
Safe Neighborhood; physical activity; sleep quality
Good family routine; exercise; good stress management
Lack of exercise; unsafe neighborhood; shortened sleep; disorganized family environment; poverty; stress
Healthy prenatal period
Prepregnancy health, genetic predisposition
Development of type 2 diabetes in youth.
Middle Childhood

7. One depiction of social ecological model

8. 3 Principles to Improve Outcomes for Children and Families
Support responsive relationships for children and adults.
Strengthen core life skills,
Reduce sources of stress in the lives of children and families.
From

9. Context matters…Knowing about Appalachia
Two …what are the contexts that matter?
Context matters…Knowing about Appalachia

10. Source #1

11. Report available at : Appalachian Regional Commission
Website, Source #2

12. The Appalachian region
An overview….
The Appalachian region

13. The Appalachian Region
States
All of West Virginia
Part of 12 other states:
Alabama
Georgia
Kentucky
Maryland
Mississippi
New York
North Carolina
Ohio
Pennsylvania
South Carolina
Tennessee
Virginia

14. Appalachian Sub regions

15. The Ohio Appalachian Region
Counties in Ohio
Adam Mahoning
Ashtabula Meigs
Athens Monroe
Belmont Morgan
Brown Muskingum
Carroll Noble
Clermont Perry
Columbiana Pike
Coshocton Ross
Gallia Scioto
Guernsey Trumbull
Harrison Tuscarawas
Highland Vinton
Hocking Washington
Holmes
Jackson
Jefferson
Lawrence

16. Appalachian Region…The Geography and Demographics are Unique

17. Persons per Square Mile
About ½ of the counties are less populated than US average. Population concentrations need large cities, Pittsburgh in Northeast, Cincinnati, southwest

18. Median Age of Persons in the Appalachian Region
North east portion of Ohio Appalachia older than US and other Appalachian areas;
Other counties at least at US median

19. % under 18 years, 2016
Much of the region has fewer children than the US Average.

20. Appalachian Region…The Social Determinants, that is the social and physical context that influence outcomes

21. Social Determinants: Per Capita Income
Most of the Ohio Appalachian region has a per capital income below the Appalachian average

22. The Social Determinants
Poverty by age group

23. An attempt to assess and delivery resources to those most challenged

25. The Social Determinants
Education
Total Pop % < High School HS Plus HS Degree Assoc. Degree Bachelor +
Ohio Appalachian has greater percent with less than high school, fewer with bachelor or higher degrees

26. Social Determinants: Employment

27. The Social Networks and Associations

28. Community Characteristics: Social Association
Ohio Appalachian region has high social association rate, compared with other areas, specifically true of the north east.

29. Community Characteristics:
Student-Teacher Ratio
Higher student-teacher ratio

30. Community Characteristics
Coalitions—all types!
Public Health Departments
Extension Offices
Local hospital/health care initiatives
Educational institutions

31. So in summary: Context matters: Rural, low resources, aging population
Community Strengths: Connected, widespread efforts to work with communities in ways that they define

32. Lifestyle and Health

33. Lifestyle: Physical activity

34. Lifestyle: Smoking

35. Lifestyle: Obesity

36. Health: Diabetes

37. Health: Physical Health, unhealthy days per month per person

38. Health: Mental Health, unhealthy days per month per person

39. But there are “bright spots” where health is better than expected!
Communities are working hard to turn things around.

40. A DEEPER LOOK AT THE BRIGHT SPOT COUNTIES
Each of the ten Bright Spot counties has its own particular health-related challenges, available resources for dealing with them, and different responses. But there are similarities in the solutions and strategies they employed. These fall into six broad categories:
Community leaders engaged in health initiatives
Cross-sector collaboration
Resource sharing of Transportation, Food, Shelter
Local healthcare providers committed to public health
Active faith community
Initiatives to combat substance abuse

41. In summary…..
Life style: Smoking, obesity, and physical activity reflect rates that need improved
Adult health: diabetes, physical and mental health challenges….partially from an aging population

42. Community Engagement of Southeast Ohio
Beverly Stringer, BS
Community Engagement Coordinator
OSU Center for Clinical and Translational Science
Appalachian Translational Research Network
Scioto County Welcome Center
342 Second Street, Portsmouth Ohio 45662

43. Community Engagement of Southeast Ohio:
Encourage community involvement:
Identifying and prioritizing problems;
Providing input into relevant research questions;
Contributing to research design and methods;
Developing culturally sensitive and ethical proposals;
Enhancing recruitment and retention of participants;
Implementing and disseminating research findings.

44. Community Partners
Communities have the capacity to participate as full partners….
Consulted about research priorities;
All stakeholders respected, valued, rewarded;
Effective implementation and dissemination strategies are developed;
Increase in public support for research, and
Ultimately, improved health and well-being of communities.

45. Research Collaboration
Researchers encouraged to go into the communities of southeast Ohio
Consult with community members
Seek community input/feedback
Support for researchers to be involved with communities
Grow partnerships

46. Extended Collaboration
Appalachian Translational Research Network – 9 universities
OSU, OU, UC, UK, WVU, Marshall, Penn State, ETSU, Wake Forest
SE-Ohio Community Advisory Board: meets quarterly
Franklin County Community Advisory Board: meets quarterly
Community Faculty Advisory Board: meets semi-annually
Education efforts

47. Projects Community Engagement
Sodabriety
Educational Literature Assessment
Hep C Study – mothers/babies
Planning to Be Active
My Plate
Yoga for Children – summer program
Training for professionals working with children
Opioid Project

48. An example: Community Engagement in SE Ohio
Problem identified from Community Advisory Board of SE Ohio—Hep C
Reach into OSU to find researchers interested in this problem
Researchers invited to Board meeting
Collaborations began between Dr. Jennifer Syvertsen and Scioto Community
R21 submitted, followed by larger U submission (Miller, PI)

49. Community Engagement of Southeast Ohio
Beverly Stringer, BS
Community Engagement Coordinator
OSU Center for Clinical and Translational Science
Appalachian Translational Research Network
Scioto County Welcome Center
342 Second Street, Portsmouth Ohio 45662

50. So in sum…
While the challenges for children in Appalachia are real, there are new efforts all across Appalachia to address these challenges with local efforts, that are community centric and sustainable.