1. CX 3 Orientation December 1, 2010 Presented by: Valerie Quinn & Alyssa Ghirardelli

2. AGENDA Welcome Background & Orientation to CX 3 - Background, review CX 3 indicators and assets - The CX 3 process & steps Strategizing, Lessons Learned Resources & Timeline

3. Metro Atlanta has Removed 58 acres of forest per day for the last 25 years Georgia Department of Natural Resources Bog box store TOXIC ENVIRONMENT

6. Food Marketing: $9 million every day in California

7. Food deserts Food Deserts Food “Swamps”

10. How do you assess it? How do you change it?

11. TECHNOLOGY TRANSFER…

12. Context Real world information/data a must for planning nutrition education programs Local, Local, Local Relevant to surroundings, tailored to issues, persuasive, empowering!

13. Defined CX 3 is a planning framework that involves evaluating communities in relation to a variety of benchmarks knows as community indicators and assets. –Standardized indicators –Community strengths, assets, gaps and weaknesses –Develop local action plans for promoting policy, systems and environmental change –Strengthen evaluation of local efforts

14. CX 3 Communities of Excellence in Nutrition, Physical Activity and Obesity Prevention (CX 3 ) C = Communities X = Excellence 3 = 1 (nutrition) + 2 (PA) + 3 (obesity prevention)

15. Key Vision

16. CX 3 Goal Promote healthy communities!!! Educate & empower consumers!!! –Strengths, assets, gaps & weaknesses –Set priorities based on data –Strategic local data-driven action plans –Broaden participation –Evaluate progress

17. Indicators & Assets Community Indicators Specific, observable characteristics of a community’s environments & norms. Example “Supermarkets and grocery stores offering healthy, affordable food choices are located in low-income neighborhoods and readily accessible to residents.”

18. Indicators & Assets Assets A community’s “readiness” for addressing environmental change. Example “Extent of local media coverage that is supportive of role of communities and government in addressing obesity prevention, not just a matter of “individual choice.”

19. back in time... The CX 3 formulation (Circa 2004 & 2005)

20. Creating CX 3 Gather all possible indicators & assets. Refine. Total: 151 Indicators 44 Assets

21. Indicators Community Indicators: Criteria for including… –Environmental or community level measures (e.g., policies) –Possible to change by community –Addresses an intermediate goal –Items are stated neutrally

22. Creating CX 3 – cont. Indicators organized in 6 Community Environments: –Neighborhood –Preschool –School –After-school –Worksite –Government Nutrition and Activity Assets organized into: –Health department infrastructure –Political will –Community infrastructure

23. Creating CX 3 – cont.

25. CX 3 Top Picks Indicators Neighborhood: 18 indicators (42 total) Preschool: 5 indicators (14 total) School: 20 indicators (45 total) After-school: 6 indicators (11 total) Worksite: 6 indicators (20 total) Government: 4 indicators (19 total) Community Assets Local Health Dept. Infrastructure: 3 assets (14 total) Political Will: 3 assets (10 total) Community Infrastructure: 11 assets (20 total)

26. FSNE restrictions late summer 2005 Rules of the road changed… FSNE restrictions, late summer 2005.

27. How can we do this? #1. Program planning, proportionality Health departments are responsible for community’s health Multi-year contracts, small portion Complete neighborhood nutrition picture #9. & 10. Improve access to healthier foods in low-income communities within the context of nutrition education Neighborhoods, not institutions/schools. Empower FSNE population to become advocates for change.

28. CX 3 Focus: Neighborhoods Research: Clear connection between neighborhood factors and health outcomes

29. Neighborhoods Matter

30. Neighborhood Nutrition Data Look at nutrition in the broadest sense: All about understanding how consumers are influenced in their food choices. –Are healthy food choices available and accessible to residents of low-income neighborhoods? –How many fast food outlets are in neighborhood and around schools? What’s the proportion to large grocery stores? –How much and what are the types of nutrition marketing messages around schools? At stores? –Safely walk to store? Is it accessible? –And more!

31. CX 3 – How does it work? Standardized Indicators Tools & Methods Real world data 4 STEPS 1.Compile localized real world data 2. Set priorities based on data 3. Implement strategic, community-focused action plan 4. Evaluate progress over time

32. CX 3 Tools & Methods Breaking new ground -- Tobacco & alcohol control (marketing elements, retail environment), nutrition, PA Best of PH tools available – GIS; powerful data layers Focus: Local Tools developed: Local involvement

33. CX 3 Data #1: Mapping (aka Tier 1) GIS, cutting-edge public health tool; Web searches –Time: 1 day training, up to 3 days for mapping –3 – 6 low income neighborhoods* –Selecting neighborhoods takes time to ponder & plan (up to 20 hours) * SNAP-Ed eligible: Comprised of census tracts where 50% of residents are at or below 185% FPL

34. CX 3 Data – Cont. #2: On-the-Ground (aka Tier 2) In-depth look (quality) at nutrition factors Foot work, people power User-friendly tools--Community members/youth Training –Time: 1 day training, 2 months for field work

35. Moving- Under construction

36. CX 3 Data – Cont. #3: Community Assets (aka Tier 3) Internal look at your department Media coverage – via web search

37. CX 3 : Localized Data Analysis

38. CX 3 Communications pieces

39. After Data Collection Share data with department leadership, community groups, neighborhood residents, etc. Get input! Prioritize actions –Network interventions vs. other groups pursue Implement strategic SoW activities based on data findings –Informal SoW revision may be needed

40. 61 local health departments Who’s doing it?

41. CX 3 Coming to scale FFY 2005: CDPH launched initiative FFY 2006: 6 pilot sites; 22 low-income neighborhoods Berkeley, Santa Clara, Alameda, Kern, San B, Riverside FFY 2007: 5 LIA health departments... + San Diego! Sacramento, Marin, Contra Costa, Ventura, Solano FFY 2008: 9 more LIAs Monterey, Sonoma, Stanislaus, Shasta, Yolo, Santa Barbara, Orange, Pasadena, Sierra Cascade LIA (CSU). FFY 2009: 3 more LIAs Tulare, Long Beach, San Mateo FFY 2010: 1 more Riverside (2010) FFY 2011: 2 more Humboldt & Yolo

42. And beyond... CCROP (2008) –Fresno, Merced, Kings, Tulare, Madera, Mariposa, Stanislaus and San Joaquin San Luis Obispo Network LIAs doing more neighborhoods –Santa Clara, Alameda, Riverside, Long Beach CX 3 Re-assessments begin next year!

43. How did they do it? From the Field… (refer to charts in binder) # of Neighborhoods # of Census tracts How Neighborhoods selected Tier 1 – Who mapped? Ease of use? Tier 2 – Who organized? Foot work? Key advise? Suggested resources Top benefit? Key local health department staff

44. Timeline… accelerated Tier 1/Mapping Training: -Dec. 3, 2011 Tier 2 Training: TBD -Late Jan/early Feb 2011 Monthly conference calls – for strategizing, reviewing tools, etc. Webinars used also.

45. Timeline & Next Steps (Cont.) Thinking ahead: –Which neighborhoods? –Field work-people power How can the Network help?

46. Questions? Strategizing…

47. Key to success: Community involvement

48. CX 3 Benefits Advances local change – Proven! Puts local groups at forefront for obesity prevention Standardized indicators, methods, tools Appealing to funders

49. Thank you! This material was produced by the California Department of Public Health’s Network for a Healthy California with funding from USDA SNAP, known in California as CalFresh (formerly Food Stamps). These institutions are equal opportunity providers and employers. CalFresh provides assistance to low-income households and can help buy nutritious foods for better health. For CalFresh information, call 1-877-847-3663. For important nutrition information, visit www.cachampionsforchange.net.