Coquille Indian Tribe

Healthy Communities Project

M7572

Healthy Places, Healthy People: A Framework for Oregon*

Together heart disease, stroke, diabetes and chronic respiratory disease account for three of five deaths in Oregon. 61% of adults have one of the following: arthritis,

asthma, diabetes, heart disease, high blood pressure, high cholesterol and stroke.

89% have one of the risk factors for these conditions: current smoker, overweight or obese, physical inactivity or consumption of too few fruits and vegetables.

*Healthy Places Healthy People: A Framework for Oregon; OR DHS, Public Health Division, Health Promotion Chronic Disease Prevention. December 2008

Healthy Places, Healthy People: A Framework for Oregon

Oregon Health Promotion Chronic Disease Prevention Program Vision 2020: All People in Oregon live, work, play and learn

in communities that support health and optimal quality of life. Mission: To advance policies, environments and systems

that promote health, and prevent and manage chronic disease.

Work together to reduce exposure to tobacco products and secondhand smoke, make it easier to access healthy foods and be physically active, and assure people can easily manage their chronic diseases.

Coquille Indian Tribe Healthy Communities Project

The Healthy Communities Project: Gathering partners and stakeholders to access the

environmental and policy factors that affect the health of the community and the chronic disease environment.

Identify community health strengths and needs of the Coquille Indian Tribe.

Develop a multi-year plan focused on improvements to help community members be as healthy as possible.

Purpose Reduce the incidence of chronic disease most closely linked

to tobacco use, physical inactivity , and poor nutrition. Improvements to policy and environmental factors, policies,

social norm and best practices to improve healthy behaviors.

Coquille Indian Tribe Healthy Communities Project

Examples Tobacco Free Worksite Policy

Examples of Health Policy that are now expectation: New York City Tenements Sanitation Indian Health Service

Water and Sanitation Tobacco Use

Surgeon General’s Report 1964 Seat Belts and Car Seats

Coquille Indian Tribe Healthy Communities Project

OR Health Authority Health Promotion Chronic Disease Prevention (H.P.C.D.P.) Tobacco Prevention Education Program (T.P.E.P.) “Healthy Communities” Funding

Conduct Community Health Assessment based on CDC CHANGE (Community Health Assessment and Group Evaluation) Tool Modified to meet the needs of the Coquille Indian Tribal

Community

T.P.E.P. Stakeholders

Health and Human Services Administrator Assistant Health and Human Services

Administrator Tribal Council Representative Elders Program Coordinator Community Health Representative Coquille Indian Tribe Police Representative Coquille Indian Tribe Housing Authority Human Resources Director Prevention Coordinator Health Advisory Board Representative

Coquille Indian Tribe Healthy Communities Project

Environmental Changes: physical, social, economic factors that influence practices

Examples Walking path around the

Kilkich Community Nasomah Healthy

Traditions Incentive

Policy Changes: laws, regulations, rules, protocols that guide behavior

Examples Policies that require

healthy food choices be offered at meetings

Policies Smoke Free Tribal Events

Framework

C.H.A.N.G.E.

Sample Questions

Community-At-Large Sector Physical Activity To what extent does the

Tribe encourage walking by developing, maintaining, and/or promoting walking routes to, from and around tribal properties?

To what extent does the tribe offer, promote, or provide access to traditional cultural physical activities like dancing?

Leadership Does the Tribe have a health

promotion budget?

Nutrition To what extent does the

Tribe use locally grown and traditional foods at Tribal restaurants and events?

Tobacco To what extent does the

Tribe prohibit commercial tobacco use for outdoor public places?

Chronic Disease Management

To what extent does the Tribe educate Tribal members about obesity prevention?

C.H.A.N.G.E. Sample Questions

Health Care Sector

Physical Activity To what extent do health care

providers assess patients’ physical activity during routine office visits?

Nutrition To what extent do the health

care facilities provide free or low cost weight management or nutrition programs?

Tobacco To what extent do health care

providers provide regular counseling about the harm of commercial tobacco use and exposure during routine office visits?

Chronic Disease Management To what extent do the health

care facilities have a systematic approach to diabetes care?

Leadership To what extent do the health

care facilities provide access to medical services outside of regular working hours ?

C.H.A.N.G.E. 20-40 Questions in each sector

Major Community Events, Health Care, Education, Tribal Government, Work Site

Score Policy

1 - Not identified as a problem 3 – Policy formulation and adoption 5 – Policy evaluation and enforcement

Environment 1 – Elements not in place 3 – Some elements in place 5 – All elements in place

C.H.A.N.G.E. Findings

Chronic Disease Management Received high scores except Major Community Events

had scores less than 3 Reason: No onsite preventative medical

screenings and chronic disease management education and prevention

Education (Afterschool/Summer Programs/ Head Start and Tutoring)

Lower score due to inconsistent engaging of parents in chronic disease prevention for Tribal youth

Tribal Community low scores for use of traditional wellness to address chronic disease

CHANGE Findings

Nutrition Low policy scores but high environmental.

Many evaluated a 2 for policy and a 3 for environmental support. Indicating support from some but not consistent enough for policy.

Examples: nutrition labeling of foods at Tribal events, healthy options at all Tribal events, healthy vending machines, access to refrigeration for staff, weight loss programs, promotion and education regarding traditional foods, programming to support community gardens, etc.

C.H.A.N.G.E. Findings

Physical Activity Most differences between sectors

For Example: Education and Tribal Community had only one score below 3 but worksite had many 1 and 2 scores.

The environmental score for traditional cultural physical activities was 4 however, the policy score was 1.

Midwinter gathering and Restoration Celebration had both scored low for policy but high in environmental.

C.H.A.N.G.E. Findings -Physical Activity

CHANGE Findings - Physical Activity

CHANGE Findings

Commercial Tobacco Use Overall the Tribe’s policies and environmental

support for commercial tobacco cessation received high scores.

Access to commercial tobacco cessation products and services was indentified as particularity strong.

Three questions scored low: Education sector scored a 2 for referring

participants for tobacco cessation. Tribal Community received a 1 for

environmental elements in place to prohibit commercial tobacco promotions, and prizes.

CHANGE Findings – Commercial Tobacco

Healthy Communities Discussion Draft: Community Health Action Plan

Goal: To support Tribal members and Tribal employees making

healthy choices, improving their health and well-being.

Strategies: Develop policies and programs that make it easier for Tribal

members and employees to: Choose to eat healthy foods Engage in physical activity Self-manage chronic disease Reduce, quit, or never start using commercial tobacco

products

Coquille Indian Tribe Sample Strategies

Policy Actions: Healthy Foods Develop a “Healthy Food” policy for all Tribe-

hosted events and meetings with food that requires: Healthy food choice alternatives at all events and

meetings with food. Traditional food options, with labeling that describes

the food and its nutritional value, be available at all Tribe-hosted events and meetings with food.

Smaller or half portions and “tasting options” with serving size labeling to be offered at all Tribe-hosted events and meetings with food.

Coquille Indian Tribe Sample Strategies

Program Activities Physical Activity Develop informational materials about walking

trails on Kilkich community land. Create maps or brochures of walking trails, include

mileage information, elevation gain, and level of difficulty.

Funding Opportunity

Next Steps

Currently in the Process of Completing the Healthy Communities Action Plan.

Goal to complete 6-30-12.

Gain support and approval through the appropriate Coquille Tribal Channels.

RFP “Oregon Healthy Communities Implementation Program”.

Healthy Tribal Communities

Contact: Kelle Little, RD, CDE

Health and Human Services Administrator

Coquille Indian Tribe Community Health Center

kellelittle@coquilletribe.org

541-888-9494 , ext: 20217