Community Impact Through Data-Driven Action Teams

Community Impact Through Data-Driven Action Teams

Who is in the room?

The Heart of New Ulm Project What if we could eliminate heart attacks in an entire community?

New Ulm

Primary Objective Improve the proportion of 56073 zip code residents (age 40-79 years; active Allina health record) with controlled modifiable heart disease risk factors over 5 years.* 1. Elevated blood lipids (i.e., total/ldl/hdl cholesterol, triglycerides) 2. High blood pressure 3. Uncontrolled glucose (i.e., type 2 diabetes, pre-diabetes) 4. Obesity 5. Tobacco use 6. Physical inactivity 7. Low fruit/vegetable consumption 8. Uncontrolled stress 9. Medication underutilization/non-adherence

Initial Partnerships Established

2009 Community Diagnosis New Ulm 41% Obese 35% Overweight 38% Metabolic syndrome 17% Consumed 5 fruits and vegetables a day

10-Year+ Project Health Care Worksite Community

Continuous Cycle

Intervention Strategy Smoking policies, Complete Streets Policy, City Comprehensive Plan Program partnerships, community events, community-wide health challenges, social marketing campaigns Interventions delivered through health care, employers, restaurants, grocery stores, convenience stores and schools Interventions provide social connection opportunities, business leader engagement opportunities Phone coaching, provider education and training, lipid clinic

Lifestyle Behavior Changes Among Screening Participants Age 40-79 Measure 2009 (n = 3123) 2011 (n = 1976) 2014/15 (n = 1008) Smoking 7.9 7.4 5.5 Physical Activity (at least 150 minutes a week) Fruit and Vegetables (5 or more servings a day) 63.9 73.1 76.2 16.3 26.6 30.2 Screening analysis is age and gender adjusted to account for differential age and gender distributions in each screening time period.

New Ulm vs. Comparison Community Managed better: Blood pressure Total cholesterol Triglycerides

Small Group Discussion What data are you currently collecting? What data are you currently missing?

Data Collection Strategy Community Needs Resident surveys Focus groups CNA Environmental assessments Built environment Nutrition environment Policy and environmental assessment Screening data Behavioral Health-related data Data Integration Plan for assessment, monitoring and communication Electronic health record Risk factors MI Demographics National/State/ Local Data MI Police Public health Desired Impact

Community-Based Participatory Research

Leadership Engagement: Steering Committee Trucking Company News paper Radio Station Ancillary Services Park & Rec. City Public Health Physicians Foundation Business Family Services Employers Hospital Chamber Electeds Community Members Schools College Grocery Store

Improving community health will require new models of collaboration

Leadership Team Community Public Health Grocery Store Business NUMC Foundation Heart of New Ulm City College Allina Health Schools Chamber

Small Group Discussion How are you aligning priorities? 20

Food Environ ment Walking & Biking Mental Health Communi -cations Safe Routes to School HONU Action Teams Health Equity Down town Worksite Wellness Funding

Small Group Discussion What new partners will you engage?

Comprehensive Communications Strategy FLYERS POSTERS

Neighborhood Health Profiles

Community Input = Community Engagement

Neighborhood Surveys

Small Group Discussion When was the last time you shared data? How did you share it? If you had your ideal data, what would you do with it?

Comparison of HONU Changes to NHANES NHANES 2009-10 NHANES 2011-12 NHANES Change HONU 2008-09 HONU 2012-13 HONU Change BP at goal (<140/90 mmhg) 83.1% 82.5% -0.6 79.3% 86.0% +6.7 BP medication 35.2% 36.8% +1.6 38.3% 47.6% +9.3 LDL cholesterol at goal (<130 mg/dl) Cholesterol at goal (<200 mg/dl) Not obese (BMI <30) 64.3% 63.7% -0.6 68.0% 72.0% +4.0 47.5% 46.9% -0.6 58.3% 65.1% +6.8 62.5% 62.3% -0.2 55.9% 55.2% -0.7 NHANES data selected for participants age 40-79, white non-hispanic to provide a comparison group similar to New Ulm resident demographics, sample weights applied for analysis

Neighborhood Survey Results

Data Driven Action Teams

Action Team Mission Develop and support policies and practices that improve the access, availability and identification of healthy foods in venues throughout the community.

Aligning Priorities

Safe Routes to School

Distance Convenience of driving Time Child's before or after-school Speed of traffic along route Amount of traffic along route No Adults to walk or bike with Sidewalks or pathways Safety of intersections No Crossing guards Violence or crime Weather or climate Parent Survey 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% What of the following issues affected your decision to allow, or not allow, your child to walk or bike to/from school? (Select ALL that apply)

Student Density Map Justification for pedestrian activated light

City Council Transportation Fact Sheet

Restaurant Program

2015 Restaurant Perceptions Survey Question n=482 It s important to me that restaurants have healthy options When eating at a restaurant, it s easy to order healthy options It s important to me that I can find healthful choices in vending machines It is important to me that school or sporting event concessions provide healthful choices on their menu. 97% 55% 57% 73%

Healthy Practice Outcomes n = 28 restaurants 500% 450% 400% 350% 300% 250% 200% 150% 100% 50% 0% 2011 2013 2018

Healthy Practice Outcomes n = 28 restaurants Healthy Practice Availability 2011 2013 2018 Non-fried vegetables 61% 89% 64% Fruit 39% 54% 32% Smaller portions 29% 71% 57% Whole grain bread 21% 29% 21% Vegetable/salad as default side 21% 43% 18%

Healthy Practice Outcomes n = 28 restaurants Healthy Practice Availability 2011 2013 2018 100% fruit juice 61% 54% 64% Low-fat milk 71% 71% 61% Low-fat or fat free salad dressing 79% 68% 71% Trans fat free frying oil * N/A 75% 100% *Among restaurants that use frying oil 1 Restaurant use of trans fat free frying oil was not measured in 2011

Food Environment Tour

Building Capacity and Networks Minnesota Food Charter Network UMN Extension Leadership Training Public Health Law Center Food Policy Training Second Harvest Heartland Community Marketing Skills

Sustainability Revised Restaurant Program City Comprehensive Plan input Marketing materials Collaborative network Community ownership

Small Group Discussion Which action are you going to do when you get back: Identification Collection Sharing 47

Contact Us: Derek Hersch, MPH Project Leader, Population Health Minneapolis Heart Institute Foundation P: 612-863-6016 dhersch@mhif.org Cindy Winters Manager, Heart of New Ulm Project Minneapolis Heart Institute Foundation P: 507-217-5548 cindy.winters@allina.com MHIF Population Health Work www.mhifpopulationhealth.org @PopHealthMHIF @derekhersch @ckwinters