Bonnie Broderick MPH, RDBonnie Broderick MPH, RD

Mary Foley von Ploennies MS, RDMary Foley von Ploennies MS, RD

Communities of Excellence in Nutrition, Communities of Excellence in Nutrition,

Physical Activity and Obesity Prevention (CXPhysical Activity and Obesity Prevention (CX33))

Santa Clara County: Santa Clara County: Mapping to MobilizationMapping to Mobilization

Santa Clara County Public Health DepartmentSanta Clara County Public Health DepartmentNutrition & WellnessNutrition & Wellness

OutlineOutline

BackgroundBackground

Approach and Implementation Approach and Implementation

Neighborhood SnapshotsNeighborhood Snapshots

Implications and BenefitsImplications and Benefits

Focus on WashingtonFocus on Washington

Background onSanta Clara County

and CX3

Size of Santa Clara CountySize of Santa Clara County

Land area of 1,315 square miles.Land area of 1,315 square miles.

As of July 1, 2006, the county’s populationAs of July 1, 2006, the county’s population was approximately 1.73 million, making it the was approximately 1.73 million, making it the largest of the nine Bay Area counties. largest of the nine Bay Area counties.

What is CXWhat is CX33??

Powerful tool to see how community “measures up”Powerful tool to see how community “measures up”

Identifies areas in need of improvementIdentifies areas in need of improvement

Community itself has a critical role to playCommunity itself has a critical role to play

Obesity prevention benchmarks – indicators andObesity prevention benchmarks – indicators and assets assets

CXCX33 indicators and assets set standards of “excellence” indicators and assets set standards of “excellence”

Defines what a community itself should look like inDefines what a community itself should look like in order to prevent chronic diseases order to prevent chronic diseases

Goal of CXGoal of CX33

Compile localized data to evaluate a community’sCompile localized data to evaluate a community’s strengths and weaknesses in relation to CX strengths and weaknesses in relation to CX33 indicators and assets. indicators and assets.

Set priorities based on local assessment data. Set priorities based on local assessment data.

Implement strategic, community-focused actionImplement strategic, community-focused action plans. plans.

Evaluate progress over time Evaluate progress over time

CXCX33 Focus on Neighborhood Focus on Neighborhood EnvironmentEnvironment

12 indicators used to paint a picture of the overall12 indicators used to paint a picture of the overall quality of nutrition and physical activity within a quality of nutrition and physical activity within a neighborhood. neighborhood.

Are healthy food choices available and accessible toAre healthy food choices available and accessible to residents of low-income neighborhood? residents of low-income neighborhood?

What is the density of fast food outlets in theWhat is the density of fast food outlets in the neighborhood and around schools? neighborhood and around schools?

How much and what type of nutrition marketingHow much and what type of nutrition marketing messages are around schools? messages are around schools?

Benefits to Santa Clara CountyBenefits to Santa Clara County

Places Santa Clara County neighborhoods in the forefront of obesity prevention.

Provides standardized indicators that can be used by other local neighborhoods and by other communities throughout the state.

Provides local communities with and objective, systematic, method to evaluate themselves.

Engages local residents in advancing community change.

Approach and

Implementation

SCC PHDNutrition & Wellness

Steps Leadership

Team

City of SJ Strong

Neighborhoods Initiative

The Health Trust

Kaiser (HEAL Grant)

Community Groups

Coalitions & Collaboratives

Partnerships & CollaborationsN & W Grants & Activities

How did we choose our neighborhoods?How did we choose our neighborhoods?

Gilroy Nutrition Project

Network

Short and long-term goals: reasons we areShort and long-term goals: reasons we are

doing CX doing CX33 and what we want to do with the and what we want to do with the data. data.

Focus on low-income neighborhoods inFocus on low-income neighborhoods in SCC that meet USDA FSNE eligibility SCC that meet USDA FSNE eligibility (census tracts 50% at or below 185% FPL). (census tracts 50% at or below 185% FPL).

How did we choose our neighborhoods?How did we choose our neighborhoods?

In Santa Clara County, there were threeIn Santa Clara County, there were three

CX CX33 pilot neighborhoods chosen pilot neighborhoods chosen

All urban neighborhoodsAll urban neighborhoods

CXCX33 Neighborhoods Neighborhoods

California Nutrition Network California Nutrition Network GIS MapGIS Map Washington Neighborhood (San Jose)Washington Neighborhood (San Jose)

2 Census Tracts2 Census Tracts

California Nutrition Network California Nutrition Network GIS MapGIS Map University Neighborhood (San Jose)University Neighborhood (San Jose)

4 Census Tracts4 Census Tracts

California Nutrition Network California Nutrition Network GIS MapGIS MapChestnut Neighborhood (Gilroy)Chestnut Neighborhood (Gilroy)

1 Census Tract1 Census Tract

Engaged the community in the CXEngaged the community in the CX33 process by process by recruiting the help of Promotoras orrecruiting the help of Promotoras or“community health educators” from two local “community health educators” from two local CBOsCBOs

SCC staff and Promotores each concentrated on SCC staff and Promotores each concentrated on their strengths in the division of labortheir strengths in the division of labor

How did we approach the How did we approach the surveying and data collection?surveying and data collection?

PromotorasPromotoras

Food Availability & MarketingFood Availability & Marketing

Walkability Walkability

Fast Food AdvertisingFast Food Advertising

Outdoor AdvertisingOutdoor Advertising

Surveying and Data CollectionSurveying and Data Collection

Role and Responsibilities of:Role and Responsibilities of:

SCC PHD StaffSCC PHD Staff

Supermarket Access Supermarket Access and Transitand Transit

Crime StatisticsCrime Statistics

Farmers’ MarketFarmers’ Market

Food BanksFood Banks

Alternative Food OutletsAlternative Food Outlets

Neighborhood Snapshots

Field survey data sent to State CXField survey data sent to State CX33 Nutrition Nutrition Network staff for analysis. Network staff for analysis.

Analysis results translated into Spanish forAnalysis results translated into Spanish for dissemination back to community. dissemination back to community.

Attention given to language of results so that itAttention given to language of results so that it was made more accessible to community was made more accessible to community members. members.

Data and TranslationData and Translation

• Population: 10,608

• Number of census tracts: 2

• 1 supermarket

• Most of the stores are small

• 7 out of 10 stores sell alcoholic beverages

• More than half of the stores (55.5%) have 50 – 100% of their windows covered with unhealthy advertising

• Most (83.3%) of fast food outlets <100 feet from the schools/parks

WASHINGTON

• Population: 18,155

• Number of census tracts: 4

• 2 supermarkets

• Most of the stores are small stores or liquor stores

• More than half of all the stores (55.6%) have unhealthy ads or promotions at the checkout| counter

• Most stores (86%) sell 3 or fewer types of fruit

UNIVERSITY

• Population: 8,543

• Number of census tracts: 1

• 3 supermarkets

• 25% of the stores were convenience stores, chain convenience

• More than half of all the stores (64.3%) have unhealthy ads or promotions at the checkout counter

• Had the second highest ratio of fast food outlets to population (1:777)

CHESTNUT

STRENGTHS

• Transportation to supermarkets are available and convenient.

• High percentage of supermarkets and other stores were food stamp vendors.

• The Food Bank serves all 3 neighborhoods and distributes fresh produce and canned fruit and vegetables every day.

Neighborhood SnapshotsNeighborhood Snapshots

Washington University Chestnut

WEAKNESSES:

• High percentage of stores had unhealthy advertisements and promotions around check-out counter, below check-out level, on floor and hanging from the ceiling.

• Most of the fruits and vegetables were of mixed quality, but more poor than good.

• No outdoor advertising for healthy foods items or physical activity.

• No Farmers’ Markets in either of the neighborhoods.

Neighborhood Profile SnapshotsNeighborhood Profile Snapshots

Washington University Chestnut

Implications / Benefits

Benefits and Value of Participating in CXBenefits and Value of Participating in CX33

The maps and surveys provide hard The maps and surveys provide hard evidence to support what we may know evidence to support what we may know intuitively about the relationship intuitively about the relationship between food access, marketing and between food access, marketing and media and poverty in the communitymedia and poverty in the community

Opens door to other opportunities & Opens door to other opportunities & enhances partnershipsenhances partnerships

Presentation of neighborhood profiles Presentation of neighborhood profiles and data back to all the Promotoresand data back to all the Promotores

Has allowed for the creation of more effective Has allowed for the creation of more effective scope of works and tailored nutrition education scope of works and tailored nutrition education

planning to improve effectiveness of planning to improve effectiveness of interventionsinterventions

Gilroy Nutrition Project

Information being used for program planningInformation being used for program planning

Steps to a Healthier Santa Clara County City of SJ Strong Neighborhoods Initiative

CX3 Data – San Jose (University & Washington)

Focus on Washington

Washington NeighborhoodWashington Neighborhood

Focus on the Washington NeighborhoodFocus on the Washington Neighborhood

Goal to empower the community; help Goal to empower the community; help residents advocate for making their community residents advocate for making their community and neighborhood a healthier place to liveand neighborhood a healthier place to live

Set priorities based on the localizedSet priorities based on the localizedassessment dataassessment data

Implement strategic action plans to createImplement strategic action plans to createenvironmental change in the communityenvironmental change in the community

Network Network Case StudyCase Study

Community Engagement ProcessCommunity Engagement Process

Phase I:Phase I: Community Engagement Design Community Engagement Design (Feb 07)(Feb 07)

Phase II:Phase II: CXCX33 Data Review & Interpretation Data Review & Interpretation (Mar 07)(Mar 07)

Phase III:Phase III: Setting Priority Areas (Apr 07) Setting Priority Areas (Apr 07)

Phase IVPhase IV: Action Planning (current): Action Planning (current)

NetworkNetwork Case Study Timeline Case Study Timeline

Network Network Case Study: Phase ICase Study: Phase IDesignDesign

Community leaders and residents meet with Community leaders and residents meet with SCCPHD staff to inform and refine designSCCPHD staff to inform and refine design

Residents invited to participateResidents invited to participate

Draft community engagement process & Draft community engagement process & review with community membersreview with community members

Revise community engagement designRevise community engagement design

Develop mechanisms to maintain Develop mechanisms to maintain participation from stakeholdersparticipation from stakeholders

Network Network Case Study: Phase ICase Study: Phase I promotores in the Washington neighborhoodpromotores in the Washington neighborhood

Individual meetings with community leadersIndividual meetings with community leadersSIRENSIRENWashington United Youth CenterWashington United Youth CenterLa Biblioteca LatinoamericanaLa Biblioteca LatinoamericanaWashington Area Community CoalitionWashington Area Community CoalitionWashington Neighborhood AssociationWashington Neighborhood AssociationGardner Neighborhood AssociationGardner Neighborhood AssociationCatholic CharitiesCatholic Charities

Outreached to La Biblioteca Latinoamericana Outreached to La Biblioteca Latinoamericana to post and disseminate information about effortsto post and disseminate information about efforts

Network Network Case Study: Phase IICase Study: Phase IIData Review/InterpretationData Review/Interpretation

Developed data presentation for community Developed data presentation for community members that will engage them in the members that will engage them in the interpretation of the datainterpretation of the data

English & Spanish English & Spanish Assets & needsAssets & needsWhere, why, & whatWhere, why, & whatPictures & mapsPictures & maps

Network Network Case Study: Phase IICase Study: Phase II

Conducted community data presentations with Conducted community data presentations with various groups in Washington neighborhoodvarious groups in Washington neighborhood

Encouraged dialogueEncouraged dialogue

Developed list of participants interested in Developed list of participants interested in continuing involvementcontinuing involvement

Compiled the initial Compiled the initial responses to and responses to and interpretation of the data interpretation of the data

EmpowermentEmpowerment

Organizational & Community

SIREN

PHD

The Health Trust

Stanford Medical School

Catholic Charities

La Biblioteca Latinoamericana

City of San Jose Strong Neighborhoods

etc.

EmpowermentEmpowermentOrganizational & Community

City of SJ Strong

Neighborhoods Initiative

Washington United Youth

Center

Washington Neighborhood

NetworkLIA

The Health Trust

Stanford Medical

Students

Catholic Charities

Steps to a Healthier

SCC

SIREN

Kaiser HEAL grant

SCC PHDNutrition & Wellness

CX3 State

Chestnut University

Alma Senior Center

La Biblioteca

Gardner Community

Center

First 5

Lessons LearnedLessons LearnedTake time

Cultivate relationships

Gain trust

Additional small group meetings, perhaps prelude to community forum

Frame information

Fact sheets

Policy brief-share with policymakers

Attracts funders who can implement change

Lessons LearnedLessons Learned

Community participation (promotores) invaluable & empowering

Need to perceive data as personally motivating

Balance maintain conversation & momentum while evaluating process

Tap further into faith-based organizations and additional community leaders

Next StepsNext StepsTake additional time to attend meetings in community & engage additional community groups

Invite local church participation

More personal, one-to-one contact to elicit further input

Need to reframe initial priority for sustainability?

Communicate & collaborate on multiple levels

Share data with city & county government

ContactsContacts

Bonnie Broderick

Bonnie.Broderick@hhs.sccgov.org

Mary Foley von Ploennies

Mary.Foley@hhs.sccgov.org