1. Funded by the Centers for Disease Control and Prevention Good Heath and Wellness in Indian Country Major Activities PHASE I Annually award $5,000 - $15,000 to 20 - 55 tribes and tribal health programs to conduct community health assessments based on local data. PHASE II Annually award $20,000 - $30,000 to 20-50 tribes and tribal health programs to create and sustain policy, systems, and environmental health interventions (years 2-5). Goals Increase chronic disease prevention Create sustained policy, system and environment (PSEs) improvements Increase community and clinical linkages within California Increase team-based systems of care CRIHB Research and Public Health staff provides: training, funding, and technical assistance to tribes and tribal organizations in California. Advancing California Opportunities to Renew Native health Systems (ACORNS)

2. CRIHB Awarded “Good Health & Wellness in Indian Country” Sept. 2014 Call for Proposals to tribes and tribal health programs to develop Community Health Assessments Released: December 1, 2014 Amounts: $5,000-$15,000 Award 20-50 Community Health Assessment Awards 02/01/2015 Community Health Assessments Completed and Community Action Plans Developed 08/31/15 Release Annual Call for Proposals to address needs identified in Community Action Plans Due Every Fall Amounts: $20,000-30,000 Award 15-20 tribal grantees to address policy, systems, environmental changes focused on promoting health Complete comprehensive evaluation and share best practices developed from grantees. 2019 Year 1 Years 2-4 Year 5 Program Objectives: * Increase chronic disease prevention * Sustained policy, system and environment improvements * Increase community and clinical linkages within California * Increase team-based systems of care Training & Technical Assistance Training & Technical Assistance Training & Technical Assistance

3. Produce a Community Action Plan (CAP) to address Policy, Systems and Environment Produce a Community Assessment Gather information on community Assemble a “Community Team” (Representative of the Community Sector, Health Care Sector, School Sector & Work Site Sector)

4. Implement a Community Action Plan aimed to address one or more of the following Tobacco use & exposure prevention Physical activity & healthy eating Chronic disease prevention & related risk factors

5.  Support costs related to team meetings  Support costs related to data collection  Support costs related to staff time dedicated to the identified intervention  Intervention Supplies:  ex. Exercise equipment  ex. Gardening supplies & equipment

6. Policy Written statement of organizational position, decision or course of action. (such as ordinances, resolutions, mandates, guidelines, or rules) System Changes in organizational procedures. (such as personnel, resource allocation, programs) Environment Physical, observable changes in the built, economic, and/or social environment.

7. University of Colorado, REACH, 2013 Health Promotion Program PSE Strategies Education on dental careAdd fluoride to water system Smoking cessation education No-smoking policies for public places Healthy nutrition classes Adding calorie information to menus

8. SettingProgram/EventPSE Change SchoolCelebrate national nutrition month Add fruits and vegetables to cafeteria lunch options CommunityHost a community bike rideImplement a Complete Streets policy to ensure community roads are safe for biking, walking, and driving WorksiteHold a health fair for staffImplement a healthy vending machine policy that offers healthy, affordable snacks Radiology FacilityHold a low-cost mammography event Change operating hours to include night and weekend appointments HospitalHold free breastfeeding courses for new moms Implement WHO 10 Steps to Successful Breastfeeding Adapted from http://www.cookcountypublichealth.org/files/CPPW/PSE%20Change.pdf

9. Policy Amends codes and policies to define farmers markets. System Create new permitting processes for farmers markets, food options at school. Environment Community gardens, healthy concessions, healthy options on menu at local diners, improved food options at stores. https://www.ihs.gov/healthyweight/documents/Tools4H ealthyTribes.pdf

10. Holistic approach to population health and wellness. Purpose To assist Awardees with creating a framework for their process and outcome assessments, action plan, and project development. Evaluation Tools CDC CHANGE Tool (Community Health Assessment and Group Evaluation) Culturally Responsive Evaluation Indigenous Evaluation Framework Empowerment Evaluation

11. Grounding Telling the Story Planning Creating Knowledge Interpretation or Analysis Sharing and Using Knowledge “Tribal public health infrastructure is strengthened when each tribe adopts local strategies to meet its public health challenges. Interventions are tailored to the cultural beliefs and practices of the population; ultimately leading to decreased morbidity, decreased early mortality and improved quality of life.” – CDC

12. Questions? Comments? Website http://www.crihbacorns.org/ CRIHB Contacts Virginia Hedrick (Yurok/Karuk) Program Manager (916) 929-9761 ex 1518 virginia.hedrick@crihb.org Nanette Yandell Program Evaluator (916) 929-9761 ex 1515 nanette.yandell@crihb.org