The Well Community Project: Moving Beyond Health
Creating Communities of Wellness and Resilience Where Children & Families Flourish
Goal
- Empower vulnerable communities with an evidence-based framework, metrics and other tools supportive of community policy and decision-making processesforcommunitywellness and resilience;
- Inform and positively impact national health policiesfor improving community health, quality of life, and for enhancing community prevention and wellness.
Significance and rationale
Health decision-making is a complex process influenced by personal, cultural, economic, and environmental factors, in addition to the individual’s own knowledge and motivation as well as their peers opinions and behaviors.[1][2][3] Information alone is not enough to change behavior – however, providing behavioral change tools, including information, healthy experiences and improving the social environment (i.e. community) supports individuals and the community in making healthy choices.[4][5][6] This builds both individual and community wellness, productivity and resilience.
Community Wellness and Resilience (CWAR) is a collaboration among Samueli Institute, the Institute for Alternative Futures (IAF), and CommonHealth ACTION. Made possible through funding by the W.K. Kellogg Foundation, CWAR seeks to answer the following questions that pertain directly to community needs and the national effort to reduce disparities in health outcomes and access to the health care system:
- What are community wellness and community resilience, their determining factors and components?
- How do these concepts relate to traditional public health constructs, such as health promotion and disease prevention?
- What is needed to empower and support leaders in vulnerable communities to make decisions about policy, program selection and resource allocation related to community wellness and resilience?
- What are the community outcomes of primary interest to leaders of vulnerable communities?
- How can community leaders measure these outcomes in a useful, rigorous and ongoing manner?
- How do we link individual to community-level efforts and to national policy decision-making and programs, such as Healthy People 2010/2020, the National Prevention Strategy[7], and Total Force Fitness[8]?
Outcomes and Products
National framework and tools
Informed by community participation, the NPT will produce a Whole Community Wellness and Resilienceframework and supportive tools that can be used by communities to enhance planning, monitoring, and adjusting of local policies and programs focused on vulnerable children.
Report on community capacity
The NPT will provide a report on the process of providing technical assistance to the participating communities throughout the project, and in building capacity in these communities after the project term.
Cost assessment tool
In collaboration with a renowned health economist, the NPT will produce a tool for conducting cost assessments of community wellness initiatives. This tool will be tailored for use by community leaders, with input from community participants.
Expansion to additional communities
Leveraging the framework and community engagement process, the NPT will create opportunities for expansion of these efforts to additional communities that can fund their own participation.
Policy
The NPT will support the National Prevention Council by reviewing their efforts to provide wellness education tools (e.g., apps and other online tools) to local communities and creating an “opportunity map” on policies for health promotion.
Benefit to communities
Each community elected to participate will receive a modest grant to participate in the national process and to test the national framework and tools locally through community wellness systems planning and advocacy. Technical support will focus on:
- Analyzing the current public policy environment and mapping the existing community systems that are meant to protect and improve the public’s health;
- Assessing health equity issues and social determinants of health;
- Applying whole health and wellness perspectives to local public health systems and policy;
- Supporting effective collaborative processes required to participate in the project;
- Gaining knowledge and skills for conducting a wellness impact assessment in their community; and,
- Facilitating peer learning across participating sites and assisting communities in documenting processes and lessons learned.
- Fostering sustainability by building communities’ capacity to apply holistic health and wellness planning and advocacy principlesin the long term
Background and related efforts
Samueli Institute, a non-profit research organization supporting the scientific investigation of healing and healing and its role in medicine and health care, has worked closely with the current Administration, the Integrated Healthcare Policy Consortium, and other visionary healthcare leadersduring the last five years on several initiatives, which are described in the next section.
Wellness Initiative for the Nation (WIN)
The purpose of WIN is to proactively prevent disease and illness, promote health and productivity, and create well‐being and flourishing for the American people. Available for download[9], the WIN concept paper addresses strategies for creating health, saving costs, and enhancing wellness through a concerted focus on self-care, lifestyle and integrative health care practices.
Integrative Medicine and Health Disparities Research Program
Samueli Institute’s research initiative on Integrative Medicine and Health Disparities aims to synthesize what is currently known about the use of integrative medicine (IM) in low income and underserved populations and by their health care providers; explore how this integration of IM can be incorporated into the quality improvement of outpatient primary health care; andenable community health centers to use evidence based, cost effective, and culturally appropriate IM modalities in their practice in order to enhance health. Samueli Institute convened a one-day meeting in April 2008 on IM and Health Disparities to explore how to create greater awareness of IM in low income and underserved populations. A full report has been published.[10]
Health Policy Efforts
In collaboration with the Systems Wellness Advancement Team (SWAT), a group of leading health and policy experts,Samueli Institute convened a Health Care Community Discussion[11] on December 29, 2008 in response to a call for input on health reform by then-President-elect Obama. Over 150 professionals from a wide variety of disciplines participated, either in person or via teleconference.Their feedback was compiled into a group report on health care reform that was submitted to the Transition Health Policy Team.
More recently, legislation developed in the Patient Protection and Affordable Care Act (PPACA)[12] based on the WIN effort has produced the National Prevention Health Promotion and Public Health Council (“Council”), charged with providing coordination and leadership at the Federal level with respect to prevention, wellness, health promotion practices, the public health system and integrative health care.
Samueli Institute has conducted several strategic meetings with Dr. Regina Benjamin, U.S. Surgeon General and Council Chair, related to rollout of the National Prevention Strategy (NPS), development of a website on health.gov to include evidence based practices that individuals and communities can access to support efforts towards prevention and wellness, and potential collaboration efforts to develop a National Leadership Summit on the NPS.The NPS’s goal is to increase the number of Americans who are healthy at every stage of life. The NPS has four strategic directions, for the purpose of this program our efforts are focused on strategy #3:
- Healthy and Safe Community Environments: Create, sustain, and recognize communities that promote health and wellness through prevention.
- Clinical and Community Preventive Services: Ensure that prevention-focused health care and community prevention efforts are available, integrated, and mutually reinforcing.
- Empowered People: Support people in making healthy choices.
- Elimination of Health Disparities: Eliminate disparities, improving the quality of life for all Americans.
Summary of Program Phases
Initial Phase(July to December 2010)
The institute developed a plan to support the Counciland its Advisory Group to promote the breadth, effectiveness and longevity of their actions, developed and implemented plans and strategies to pursue support and engagement of the highest level ofthe Administration, and outlined a strategy and process for developing, implementing and evaluating a comprehensive healthmodel for the Nation, with particular emphasis on underserved populations who experience disparitiesin health care and outcomes.
Phase One(May 2011- November 2012)
Aim 1: Review and summarize national policy efforts in community wellness and resilience
- Unique Focus and Contribution: Link the development of a Whole Community Wellness and Resilience Framework to national policy efforts, by liaising with the US Surgeon General, the membership of the NPC and its Advisory Board, and other government and non-government groups.
- Outcomes and Deliverables: Summary and map identifying opportunities to impact national decision-making by highlighting the potential role for whole community wellness and resilience approaches to positively impact health and wellness, with a particular focus on vulnerable children.
Aim 2: Building a Framework for Community Use and Community Scoping Meeting
- Unique Focus and Contribution: Develop (1) a pragmatic whole systems framework that empowers and adds value to communities’ policy and resource decision-making processes to enhance planning, monitoring, and adjusting of local programs focused on vulnerable children; (2) a review of tools to create a Wellness Impact Assessment (WIA); and (3) vetted criteria to select 3-4 communities to participate in a scoping meeting to discuss the framework.
- Outcomes and Deliverables: Publications that establish the scientific, economic, and cultural case for resilience communities, identifies best practices by taking a whole systems approach for vulnerable children.
Phase Two: National Framework and Tools
(Nov. 2012- April 2014)
In collaboration with national partners, SI will continue to develop a national framework and tools for developing Whole Community Wellness and Resilience. Additionally, the team will continue to develop a WIA for enterprise-level resource discussion and individual- and community-level tracking of health and wellness. Lastly, the team will convene a national grantee meeting, in which selected community leaders and stakeholders will discuss and revise the framework.
Literature Cited
[1] Lau R.R. et al. Development and change of young adults’ preventive health beliefs and behavior: Influence from parents and peers. J Health SocBehav. 1990;31:240–59.
[2] Patrick H. et al. A Review of Family and Social Determinants of Children’s Eating Patterns and Diet Quality. J Am Col Nutr 2005;24( 2): 83–92.
[3]Kelder S.D. et al. Longitudinal tracking of adolescent smoking, physical activity, and food choice behaviors. Am J Pub Health 1994;84:1121–6.
[4]Singh G.K. et al. Neighborhood socioeconomic conditions, built environments, and childhood obesity.Health Aff. 2010;29(3), 503-12.
[5] Wisdom J. et al. Promoting Healthy Choices: Information versus Convenience. American Economic Journal: Applied Economics 2010;2, 164–78.
[6]Yarcheski A et al. A meta-analysis of predictors of positive health practices. J NursScholarsh. 2004;36:102-108
[7] National Prevention Council, National Prevention Strategy, Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General, 2011.
[8]Total Force Fitness for the 21st Century, A New Paradigm. Supplement to Military Medicine: Volume 175, No. 8. August 2010.
[9] Wellness Initiative for the Nation (2009), is available at
[10]Fritts M, Calvo A, Jonas W, Bezold C. Integrative medicine and health disparities. Explore (NY). 2009 Jul-Aug;5(4):228-41.
[11]A full report is available at
[12] Public Law 111-148, 124 Statute 119,