1. Assessment of Community Perception of Policy and Environmental Barriers as a Stimulus for Change Presented by: Sue D’Isabel, MPH Formerly with the Missouri Department of Health and Senior Services, Cardiovascular Health Program CVH Program Manager: Diana Hawkins, MEd, CHES

2. Tools The MO CVH program created a package of materials for local public health agencies that included: –p/e inventory –prioritization process –strategies to address barriers –guidance to develop and evaluate a small p/e change

3. Overview of Process Phase I: RFA to all LPHAs to pilot assessment/planning materials and make a small p/e change. Mini-grants ($1000) awarded to 16 counties. Phase II: Counties successfully completing Phase I invited to reapply for additional funding ($4000) to continue with Phase I projects or address a new barrier. 6 counties completed Phase II. Phase III (final): 6 initial phase II counties complete last year of implementation.

4. Overview of Process: Revision of P/E Inventory Package Evaluation of pgm materials after Phase I: –counties were surveyed regarding their satisfaction with the materials –feedback on materials and the program process provided in small group settings –review of county completion of program components –assessment of types of technical assistance needed

5. Community Policy and Environmental Inventory Not applicable/ Yes No Not sure Thinking about traffic, is it safe to walk, run or bike in your community?    Thinking about criminal activity, is it safe to walk, run or bike in your community?    Are fresh fruits and vegetables readily available in the community year-round?    Are fruits and vegetables affordable?    Sample Questions Out of all the questions to which you answered “no,” circle the number of the one you would most like to see addressed in the community. Please circle only one.

6. Inventory Summary NoPriority Questions Safe to exercise--traffic Walking/biking trails Public outdoor facilities F&V available year-round 13 2 101 98 55 94 26 17 Sample Data Grid

7. Sample Objectives/Evaluation Additional Process Objectives As Necessary

8. Phase I Results Community P/E Change# Counties Walking Paths (mile & trail markers, improvements, etc.) School Policy Changes Indoor Facility for PA Nutrition-related Interventions 5 2 1 4

9. Phase II Results Community P/E Change# Counties Establishment of a Walking Trail Improvements to Existing Trails School Policy Changes Community Garden 2 2 1 1 Community P/E Change # Counties Walking Trails (Establishment, extension, maintenance, etc.) School Policy Changes Park (soccer & baseball fields) 4 1 1 Phase III Results

10. Sidewalk improvement along a newly designated city walking trail

11. Bulldozed walking trail around site of future city park

12. Community garden involving senior citizens and high school students

13. Results from “New” Phase I Community P/E Change # Counties* Walking Trails (establishment, safety/lighting, beautification, etc.) School Policy Change Community Garden 6 1 1 Restaurant Menu Choices Church Exercise Facility 1 1 *7 counties have completed the assessment process with the revised materials, however some have chosen to work on multiple projects.

14. MISSOURI CARDIOVASCULAR HEALTH PROGRAM Diana Hawkins, Program Mgr hawkid@dhss.state.mo.us 1-800-316-0935 573-522-2896