Leadership Council Meeting Minutes 9.13.10
Attendees: Adrienne Yancey, Cheri Fidler, Cheryl Moder, Christine Edwards, Christine Lafontant, Christine Wood, Dana Richardson, Deirdre Kleske, Howard Taras, Jill Monroe, JuliAnna Arnett, Katie Shultz, Kristin Garrett, Leslie Linton, Melanie Cohn, Naomi Butler, Nick Yphantides, Paige Metz, Paula Ingrum, Randall Marks, Tracy Delaney, Wilma Wooten, Sandra Parkington
Welcome/Introductions
I. Discussion: Enhanced Evaluation of Domain Activities Chris Edwards/Leslie Linton
· Leslie opened the discussion by announcing that SDSU Research Foundation has been awarded the Active Living Research (ALR) grant, for which COI will be a subcontractor.
i. The COI will use funds to evaluate the Youth Engagement & Action for Health (YEAH!) program. She reported that they are looking to work with 10 to 12 groups of youth to evaluate the effectiveness of the training and projects, with COI providing technical assistance.
ii. COI developed the YEAH! manual late last year and held two corresponding trainings with Jenna Kirschenman of Live Well Initiative serving as a consultant. The trainings are developed to teach community leaders how to use the manual and tips for coordinating community improvement projects to engage youth and adult volunteers to work for and advocate for changes to improve communities. From these trainings, several attendees expressed interest and intended commitment to develop a youth engagement project.
iii. Chris and Leslie explained that COI is currently looking for additional funding to staff an adult leader as a way to support existing resources. They posed the idea to the Council about attracting local funders to fulfill this need. Tracy said that when she was involved in the CX3 projects in Chula Vista and La Mesa, which are similar to YEAH!, the projects found sustainability in the partnerships that were formed with like-minded organizations, such as HEAC. The youth in La Mesa were funded by Grossmont Healthcare, and Tanya Rovira-Osterwalder of HEAC worked as the site coordinator in Chula Vista.
iv. Chris Wood said that she has a contact with Kinesiology students who want to learn more about nutrition education and community work involving elementary-school aged kids. These students could be used as adult leaders and would not need to be funded.
v. Cheri Fidler added that the Health Champions program administered through Rady Children’s Hospital Center for Healthier Communities is run this way. Adult leaders are chosen on the basis of location, available funding and current partners. Cheri reported that they are currently developing a web-based curriculum and providing technical assistance, in hopes that it will make the program more user-friendly; Rady has some funding from Souplantation to do this.
vi. Leslie continued with some information on the ALR funding—the budget includes incentive money for participants. The challenge ahead lies in getting adult leaders to invest in the youth engagement project. Cheri said that for her youth engagement through Health Champions, they are having a few hundred dollars allocated per project, and hope that by putting some of it online, costs will decrease and the program will be sustainable.
· Chris and Leslie moved on to a list of domain-specific enhanced evaluation projects that they worked on in the last year, and explained that they need the Leadership Council’s input on what projects they can focus on with the remaining funding they have through June 2011. Projects completed to date include:
a. Youth Engagement & Action for Health (YEAH!) manual and supplemental trainings: The Community domain has created a training manual for youth engagement projects focusing on improvements to neighborhood nutrition and physical activity environments. Two training workshops were held in North County and East County, respectively, in February 2010. Chris and Leslie designed and implemented a training evaluation tool for participants who attended those trainings. The instrument provided information on how the training was received, potential advocacy projects under consideration, types of future support needed by trainees, and readiness to move forward with advocacy projects. SDSU has submitted a proposal in partnership with COI to the Robert Wood Johnson Foundation’s Active Living Research funding program for ongoing evaluation of projects implemented post-training.
b. Farmers’ market use of POS terminals: The COI has purchased and installed Point-of-Service (POS) terminals for 4 farmers’ markets in San Diego County. These POS terminals accept EBT, credit and debit cards. The San Diego Farm Bureau, which manages these markets, has agreed to provide the COI with sales data for one year prior to installation of terminals, and one year post-installation to determine if data suggest that debit/credit POS terminals may be associated with increased sales at farmers’ markets. An MOU is already in place between the COI and the San Diego Farm Bureau in order to interface and provide support through the project’s conclusion. Research was conducted on previous farmers’ markets studies, and an evaluation plan developed to understand the impact of debit /credit POS terminals at farmers’ markets should the COI decided to put future funds towards this effort.
c. Government Domain Case Study: A case study was designed to document the unique efforts of COI’s government domain to support and enact policy change at multiple levels of government to create healthy environments. A specific goal was to study and highlight the multidisciplinary partnerships that have developed in working for policy change and to investigate the factors that have contributed to and challenged partnership success. Overall, the case study found the COI’s government domain has successfully embraced the ecological model at multiple levels, created vibrant new partnerships, enjoyed significant early policy change successes, and laid the groundwork for significant future impact through solid, synergistic partnership relationships. A full report is available.
d. Breakfast in the Classroom: The federally funded Breakfast in the Classroom (BIC) program allows all children in participating elementary schools to have a healthy breakfast each morning at the beginning of the school day. San Diego Unified School District began implementing the BIC program in 2007 in 4 schools. Currently, 32 SDUSD schools participate. The San Diego Unified School District is a member of the COI’s Schools Domain and representatives of the District’s Food Services department related facts and observations about the implementation of the program at domain meetings in 2009 as an example of a policy with the potential to impact childhood obesity in the County. The evaluators met with the SDUSD Food Services staff to discuss implementing an evaluation of BIC. We discussed at length the potential difficulty of detecting an effect of the program because data were aggregated and available only at the school level, with no individual level data at our disposal, combined with the fact that there were no “comparison” schools available to analyze. However, the school district elected to have the evaluators pursue analysis to try to determine whether there was a correlation between the initiation of the BIC program and an increase in test scores. Overall, the evaluation indicated that while the clear majority of schools had higher test scores after implementation of the BIC program, the analysis could not infer a BIC program effect. A full report is available.
· Chris explained that they need the Leadership Council’s input on what projects they can focus on with the remaining $20,000 in funding they have through June 2011. Options are included but not limited to those included on the handout that they distributed with new potential domain-enhanced evaluation ideas.
i. Evaluation of vending machine and concessions food policy changes at Department of Parks and Recreation. In 2006, San Diego County enacted a Healthy Choice Options in Vending Machines on County Property ordinance. The ordinance originated from a similar policy adopted by the Department of Parks & Rec. The evaluation would focus on the efficacy of the vending policy, including audits of sample sites to determine whether or not policy is enforced; review and analysis of sales data to determine sales trends; and if feasible, analysis of policy compliance by concessionaires under contract with County DPR.
o Christine Lafontant said that she gets a lot of inquiries about evaluation of this policy, but currently she does not have that data, so this would be helpful if selected. This project would also look at sales trends to see if consumers are selecting the healthy options from vending machines. Deirdre Kleske mentioned that there is software called “Sunbeams” developed by Samuels & Associates, which is designed to evaluate sales trends of vending products. Chris and Leslie will look into this.
ii. Early Childhood domain wellness policy survey. The EC domain developed wellness policies and conducted a number of trainings with providers to instruct and guide them on content and implementation. It is not known how many providers trained have gone on to implement policies. This evaluation would survey a sample of childcare providers who have received training to see whether or not policy has been implemented, process, barriers, successes, parent feedback, etc.
o Wilma suggested that perhaps attention should be focused elsewhere, since this domain would likely conduct a survey either way.
iii. Government domain case study update and publication. In August, HPCG completed a case study focused on a number of recent activities / work plans of the government domain. The study report of the study, titled, “Shared Agendas and Common Solutions: Engaging Non-Traditional Health Partners in Policy Change to Create Active Living Environments” is in a format that could be adapted for submission to a scientific journal or another publication with a public health practitioner readership. If evaluation were to continue, they would update the case study findings through supplemental interviews / document review to reflect continued activities of the domain and submit the paper to a scientific journal.
iv. Farmers’ markets credit/debit POS terminals evaluation. Chris and Leslie reported that they have looked into a case study approach to have an in-depth look at the benefits and barriers (perceived and real) to Point-of-Service (POS) terminal implementation at farmers’ markets. POS terminal installation would expand the payment options at markets so that consumers can pay with debit/credit, and EBT if applicable. The San Diego Farm Bureau, which operates 4 markets in the region, has agreed to make sales data available in order to evaluate if the credit/debit POS system has an effect on sales trends. Continued attention to this project would track this sales data for 1 to 3 markets, accounting for pres/post design, seasonal trends, costs to vendors and markets associated with the use of POS terminals, etc.
v. Healthcare Domain—OB/GYN provider survey. The healthcare domain has established a group known as “Partnership for Primary Prevention” (P3) – a group of researchers, clinicians and community health leaders representing RCH, UCSD, SDSU who meet regularly with the goal of identifying opportunities to collaborate on a primary prevention initiative focused on the 0-5 age group and addressing the childbirth continuum (prenatal through postpartum). Recognizing the importance of engaging pregnant mothers and delivering timely information about prevention of childhood obesity, the domain is interested in surveying county OB/GYN providers to identify current barriers to delivering these services, types/ forms of information, tools, and support they need in order to do so effectively, and the types of messages they believe will most effective. Evaluation efforts could consist of assistance with baseline survey development, data analysis and report.
o Wilma commented that this survey, if developed, should also be directed to family practitioners because they do prenatal work as well.
vi. Healthy community indicators. The COI’s overall evaluation plan calls for periodic measurement and review of community health indicators that reflect progress in creating communities with evidence-based environments supportive of healthy eating and active living. Over the last year, the evaluation subcommittee has worked with the County’s Health Statistics Unit to identify indicators for which there are existing data. The subcommittee identified and prioritized measures and the Health Statistics Unit is in the process of organizing and mapping available data. Per the urging of COI’s evaluation subcommittee, the extended project would leverage opportunities to see if COI domains can incorporate indicators into their work; identify potential opportunities for making this information more accessible to community members and COI partners; it will also enable COI to be part of the national conversation surrounding measures of community success.
o Wilma mentioned the HHSA Health Strategy Agenda Community Forums, which will gauge ways to leverage overall strategies belonging to HHSA, CPPW, and COI. These forums will be held in all 6 health service regions, but have not all been scheduled.
o Chris pointed out that this option is broad and not domain-specific, but still up for decision.
o Tracy Delaney reported that SANDAG has hired a contractor to look at indicators as well, as a part of the CPPW work. If this project is selected, it may be a good opportunity to collaborate.
vii. Masters’ thesis students supervision. Several professors from SDSU and UCSD have suggested that masters level students may be interested in participating in evaluation of COI projects, with the caveat that supervision will be necessary. To make this a rewarding process for both the thesis student and the COI, staff or consultant time is needed in order coordinate and monitor progress of the student and evaluation design itself.
o The group agreed that this would only be worthwhile if a clear plan is developed both for the COI and for the student. Anyone that would be involved with overseeing this project would have to understand it would involve a lot of work.
o Howard Taras said that if professors at SDSU and UCSD could be engaged to see this as a long-term research project, there could be buy-in to make it sustainable. Howard will check with his associates.
o Leslie mentioned the Core Evaluation Committee discussion on 8/19 surrounding this idea. The group talked about possibly developing a practicum course on COI evaluation that could serve as a ground for this work in the university setting. This would require more resources than are currently available. Cheryl added that Katherine Keir of San Ysidro Health Center, who participated in that discussion, has a colleague who would be interested in this work.
· The group was asked to vote on the 7 ideas. The two ideas that received the most support from the Council were the vending policy evaluation and the farmers’ market evaluation.