1. Community Transformation Grant HEART: Health Engagement and Action for Rochester’s Transformation Thomas A. Pearson, MD, MPH, PhD Chair, HEART Expert Team

3. Target Population: Monroe County, New York 2010 Population: 744,344 –Demographics similar to U.S. including poverty, minorities. –Prevalence of deaf persons using sign language one of highest in the world. Economics –Recovery from loss of dominant employer (Kodak) –Financial Times: One of world’s 50 strongest economies for 2011, based on high technology, education, healthcare Health Infrastructure –Strong municipal health department –One medical school (Univ. of Rochester) –Three hospital systems –Two major health insurers

4. Federal Grants Supporting HEART Partners in Community-Wide Prevention Programs Grant ProgramFunding Agency Recipient Community Transformation GrantCDCURMC Center for Community Health/Monroe Co. Dept. of Public Health Clinical and Translational Science Award Community Engagement Key Function NIH/ NCATS URMC Center for Community Health Prevention Research CenterCDCURMC/Dept. of Public Health Sciences Care Management/Payment Demonstration Grant CMMIFinger Lakes Health Systems Agency Preventive Medicine ResidencyHRSAURMC/Dept. of Public Health Sciences Preventive Cardiology Training GrantNIH/ NHLBI URMC/Dept. of Public Health Sciences

5. Transforming communities to make healthy living EASY!

6. Figure 4. Conceptual framework for population-wide cardiovascular risk behavior change, showing three dimensions for consideration: the risk factor or risk behavior targeted for change, the community setting in which the intervention would be implemented; and the type of public health intervention or service used, including policy legislative strategies. Ref (11).

7. FOCUS POPULATIONS: Our efforts will reach Monroe County residents, with a focus on  Rochester’s “crescent”  The deaf community FOUR KEY VENUES:  Community  Worksites  Schools  Health Care

8. Rochester’s Deaf Community in HEART Linguistic (American Sign Language) and cultural minority group Little prior engagement in public health programs Inclusion in multiple HEART programs –Coordinator for the Deaf Community –School Health Programs include Rochester School for the Deaf –Deaf coaches for the Diabetes Prevention Program –Food hub creates first farmer’s market for deaf persons National model for community-based health promotion in Deaf persons

9. H.E.A.R.T.’s Core Principles: Maximize health impact through prevention Advanced health equity and reduce health disparities Use and expand evidence base for implementing policy, environmental, and infrastructure change

10. HEART Overarching Goals 1) Weight – 5% decrease in expected percentage of population who would be obese by 2016 2) Nutrition – 5% increase in average daily number of servings of fruits and vegetables 3) Physical Activity – 5% increase in percentage of adults achieving 150 minutes/week 4) Tobacco – 5% decrease in the prevalence of tobacco use 5) High blood pressure – 5% increase in the percentage of adults with HBP at goal 6) Cholesterol – 5% increase in the proportion of adults with hyperlipidemia at goal

12. H.E.A.R.T.’s Initiatives: Active Transportation Breastfeeding Supportive Policies Coordinated School Health Programs Diabetes Prevention Food Hub High Blood Pressure Ambassador Program Safe Public Spaces Tobacco Free Living Virtual Clinician Workplace Wellness

13. ACTIVE TRANSPORTATION Identify needs and gaps, and improve supports for active transportation.

14. ACTIVE TRANSPORTATION Objectives: Increase the number of municipalities with active transportation plans municipalities that include active transportation plans in capital budgets community active transportation events bike racks for public use schools with “safe routes to school” programs signed walking routes and walking groups in Rochester

15. COORDINATED SCHOOL HEALTH PROGRAMS Identify and engage schools to assess and improve health and wellness policies and environments

16. COORDINATED SCHOOL HEALTH PROGRAMS Objectives: Rochester City Schools and School for the Deaf: Establish school health teams in 31 schools Create plan to improve health in each Implement plans Implement District-wide improvement plan

17. SAFE PUBLIC SPACES Citizen/City teams create and enact plans to make “Crescent” parks and play areas safe

18. SAFE PUBLIC SPACES Objectives: Train 29 City staff and neighborhood leaders in Crime Prevention Through Environmental Design Form City/resident teams Create safe plans for each park/play space in Crescent Implement plan recommendations

19. DIABETES PREVENTION Training target community members to deliver evidence-based diabetes prevention program

20. DIABETES PREVENTION Objectives: Double number of Diabetes Prevention Program community coaches (13 to 29) Add 32 groups for pre-diabetic adults in Crescent and Deaf community

21. FOOD HUB Provide start-up costs for a Food Hub to bring affordable, healthy food to the Rochester Crescent and the Deaf Community.

22. FOOD HUB Objectives: Link local producers with inner city consumers to increase markets for fresh, healthy, affordable food Build volume to achieve sustainability

23. HIGH BLOOD PRESSURE AMBASSADOR PROGRAM Train volunteer outreach workers to promote self management of high blood pressure in their organizations.

24. HIGH BLOOD PRESSURE AMBASSADOR PROGRAM Objectives: Recruit and train 150 community “High Blood Pressure Ambassadors” Create 900 blood pressure self- management plans for at-risk adults

25. TOBACCO FREE LIVING Work to establish smoke free policies at parks, beaches, college campuses and multi-unit housing

26. TOBACCO FREE LIVING Objectives: Increase tobacco free policies in multi-unit housing outdoor spaces college campuses

27. VIRTUAL CLINICIAN Implement interactive software program to deliver behavioral counseling to patients in health care settings serving the focus populations

28. VIRTUAL CLINICIAN Objectives: Develop interactive computer module to counsel patients with high cholesterol Adapt for African-American, Latino and deaf patients Place in community health center and deaf health practice to help patients make healthy behavior changes

29. WORKPLACE WELLNESS Develop a web-based assessment tool for employers to assess, improve, and evaluate their wellness efforts, and provide community recognition for companies that support workplace wellness.

30. WORKPLACE WELLNESS Objectives: Finalize employee wellness assessment and improvement tool for companies Create links to local wellness resources Focuses on local health priorities Implement across the community

31. Future HEART Initiatives Evaluation of impact in partnership with Regional Health Information Organization Expert Team to implement Million Hearts –Engage healthcare community (payers, systems, practices, providers) –Focus on the ABC’s –Three strategies Develop performance metrics Utilize health information technologies Innovate care models –Support community-wide implementation of NHLBI Guidelines (ATP4, JNC8, Obesity2)

32. THE PARTNERS

33. Rochester, New York has H.E.A.R.T.!