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2013 Model Practices (Public)

Application Name: 2013 Model Practices (Public) : Walton County Health Department : PACE EH and MAPP = Walton Community Health Improvement Partnership(WCHIP)
Applicant Name: Mrs. Ewa L. Bearden
Application Title:
PACE EH and MAPP = Walton Community Health Improvement Partnership(WCHIP)
Please enter email addresses you would like your confirmation to be sent to.
ewa_bearden@doh.state.fl.us
Practice Title
PACE EH and MAPP = Walton Community Health Improvement Partnership(WCHIP)
Submitting LHD/Agency/Organization
Walton County Health Department/Environemtanl Health/ Florida Department of Health
Head of LHD/Agency/Organization
Holly Holt - Walton County Health Department Administrator
Street Address
362 State Hwy 83
City
DeFuniak Springs
State
FL
Zip
32433
Phone
850-892-8021
Fax
850-892-8025
Practice Contact Person
Ewa Bearden
Title
Senior Sanitation and Safety Specialist

Email Address

ewa_bearden@doh.state.fl.us
Submitting LHD/Agency/Organization Web Address (if applicable)
http://www.doh.state.fl.us/chdwalton/index.html

Provide a brief summary of the practice in this section. This overview will be used to introduce the model or promising practice in the Model Practices Database. Although this section is not judged, the judges use it to get an overall idea about your practice. You must include answers to the following questions in your response:

• Size of population in your health department’s jurisdiction
• Who is your target population/audience, what is the size of your intended population/audience for this practice and what percent of your target population did you reach?
•Provide the demographics of your target population (i.e. age, gender, race/ethnicity, socio-economic status) 
• Describe the nature and gravity of the public health issue addressed
• List the goal’s and objective(s) of the practice and clearly link them to the problem or issue the practice is addressing.
• Describe the potential public health impact of the practice, and the likely effectiveness of the practice being implemented as intended, and the ease of adoption of the practice by other LHDs.

In your description, also address the following
• When (month and year) the practice was implemented.
• Briefly describe how the practice was implemented, what were major activities, and any start-up and in-kind costs and funding services.
• Outcomes of practice (list process milestones and intended/actual outcomes and impacts.
• Were all of the objectives met? 
• What specific factors led to the success of this practice?

A Healthy Walton Begins Today! Join the Movement!” Integration of the PACE EH and MAPP processes into a larger health improvement initiative is the model practice submitted. In 2011, community partners in Walton County met to conduct the Environmental Public Health Performance Standards assessment. In 2012, the Walton County Health Department (WCHD) received funding from the Florida Department of Health to integrate Environmental Public Health activities with the Walton Community Health Improvement Partnership (WCHIP). The Walton Environmental Public Health Council used the Protocol for Assessing Community Excellence in Environmental Health (PACE EH) model and process to further engage our community to identify health concerns, take action on environmental health problems and improve the health and quality of life in Walton County. WCHD combined key components of the PACE EH process with the Mobilizing for Action through Planning and Partnerships (MAPP) model for community health improvement. The Walton Community Health Improvement Partnership grew from the community contacts initiated during the 2011 completion of the Environmental Public Health Performance Standards assessment. Walton County, founded in 1824, is located in Northwest Florida. The county is 1,238 square miles. Walton County has a population of 55,043. The population density is only 53.0 people per square mile, which is nearly six times lower than the state average. The majority of Walton County residents live outside the incorporated cities of DeFuniak Springs, Paxton, Santa Rosa Beach and Freeport. The majority of Walton residents are between the ages of 25 and 64 with an average age of 41.8. Walton County residents are predominately white; blacks make up 6.7 percent of the population; and the remaining 2.2 percent of the population consist of other minorities. Females account for 48.7 percent of the population and more than 22 percent of the county population is younger than 19 years of age. The median household income is approximately $47,273. The poverty level is 14.6 percent; 8.5 percent of the population exists at 50 percent of the Federal Poverty Level. The total number of Walton school students eligible to participate in the free or reduced lunch program is 4,042 students or 55.1 percent of the total school enrollment. Comprehensive community health improvement planning and stakeholder engagement is essential for a Healthier Walton! Without full community support and engagement in health improvement planning, the health of Walton County suffers. In the summer of 2011, WCHD invited representatives from community agencies, service providers and the community at large to complete the Environmental Public Health System Assessments. Environmental public health stakeholders assisted in the completion of the assessment and met to address environmental health issues and concerns. Funding to support an environmental staff member to build community relationships and complete the PACE EH tasks resulted in a stable and committed group of community members. The staff member developed a list of community partners and community resources. Identifying partners was not the challenge; getting them to meet, stay engaged and stay focused on a plan of action has proven to be most difficult.

Overflow: Please finish the response to the question above by using this text area.  Please be mindful of the word limits.

After completing the assessment, the Environmental Health Council met to discuss priorities for community improvement. The EH Council coordinator met with the WCHD Administrator to discuss integration of the council and PACE EH partners with a larger community partnership. Thus began the development of the Walton Community Health Improvement Partnership. The EH Council is now a standing workgroup within the larger partnership and all are committed to a healthier Walton. The project goal to establish and maintain a strong community partnership capable through integration of the PACE EH and MAPP processes into a larger health improvement initiative has empowered community members to enhance their community and to pool resources to improve the health of the community. The EH Council modeled effective strategies to build and sustain stakeholder engagement to solve community identified issues which lead to the establishment of a larger community partnership. This partnership has successfully focused on two objectives: 1. Increase community partnership engagement. 2. Increase the number of health education classes and outreach activities related to nutrition and physical activity. Focusing on community gardens and garden in a bucket strategies addresses obesity issues and takes us from Garden in a Bucket to Uniting a Community!
You may provide no more than two supplement materials to support your application. These may include but are not limited to graphs, images, photos, newspaper articles, etc.
Describe the public health issue that this practice addresses. (350 word limit)
Cardiovascular disease is the leading cause of preventable death in Florida and Walton County. Education, outreach, and community involvement which emphasize healthy eating, smoking cessation, increased activity and routine clinic visits are keys to the reduction of death and illness from cardiovascular disease. Some studies indicate that environmental factors are directly linked to chronic disease. Early in our community health improvement process, WCHD recognized the need for environmental health participation. Consequently, environmental health strategies to address public and environmental concerns were initiated. By showing people how to garden in a bucket or plant community gardens, we are helping to create a built environment where people are taught healthy and sustainable living habits. “Gardening in a Bucket” is a fun way to increase activity, improve nutrition and learn about water conservation, food safety, and recycling. An added benefit to this project has been the increase in dialogue between the health department and public thus promoting healthy lifestyle choices that will ultimately lead to a decrease in cardiovascular disease.
What process was used to determine the relevancy of the public health issue to the community? (350 word limit)
The Environmental Public Health System Assessment was the first local assessment to be accomplished. Shortly thereafter the following assessments were completed: Community Themes and Strengths Assessment Summary, Local Public Health System Assessment, Community Themes and Strengths Assessment, and Forces of Change Assessment. Information from these assessments were used to complete the Walton County Community Health Profile Report and to initiate the Walton County Community Health Improvement Plan. In March 2012, WCHD hosted a Health Summit meeting to develop a vision for Walton County. Holly Holt, WCHD Administrator led the Walton Community Health Improvement Partnership through a visioning process by asking three questions: “What does a healthy community mean to you?” "What are important characteristics of a healthy Community?” What are the key behaviors required of partners to achieve the vision?” Attendees unanimously voted on the following vision: “A Healthy Walton Begins Today! Join the Movement!” Now, each goal, objective, project and workgroup will align efforts with this vision.
How does the practice address the issue? (350 word limit)
Overall the Walton Community Health Improvement Partnership is using the MAPP process while the Environmental Health Council is using PACE EH. Integration of the PACE EH and MAPP processes into a larger health improvement initiative has been successfully implemented in Walton County. Strategic issues have been identified and a Community Health Improvement Plan developed with goals, objectives and strategies. Integration of the PACE EH and MAPP processes into a larger health improvement initiative is a practice that will allow Walton County to address public health challenges and leading causes of death and disability in Walton County. WCHD will steer the partnership to the CDC Winnable Battles framework for nutrition, physical activity, obesity and food safety.
Does this practice address any of the CDC Winnable Battles? If yes, select from the following
Please list any evidence based strategies used in developing this practice. (Provide links or other materials for support)
Without successful partnerships and effective planning, limited resources are duplicated; unfunded (but successful) programs disappear; and barriers to effective public health and healthcare services result in poor health outcomes. Integration of the EPHPS self-assessment, PACE EH and the Community Health Improvement Partnership is a novel concept that the Florida Department of Health (FDOH) supports. Walton County was one of the first health departments in the state and country to undertake such an initiative. Utilizing the PACE EH methodology as a vehicle to mobilize the community from defining issues to implementing action plans was a key element to the integration of the processes. The EPHPS self-assessment provided essential data and service gaps that allowed the health department to focus on defined deficiencies, but within a community and environmental public health scope. Data and action plans were then correlated and incorporated into the larger CHIP.
Is the practice new to the field of public health? If so, answer the following questions.
Yes

What process was used to determine that the practice is new to the field of public health? Please provide any supporting evidence you may have, e.g. literature review.

The full integration of EPHPS, PACE EH, and the WCHIP is a new concept. Public Health accreditation standards and measures specify community assessment, engagement and improvement and require county health departments to have a Community Health Improvement Plan. The FDOH felt strongly that EPHPS and PACE EH bolstered Domain 4 of these requirements and should be part of the community health improvement planning. Although container gardening is not a new concept or practice, the Walton County Health Department has found a new way of using this practice to open communication barriers with the public. This practice has given us the opportunity to inform, educate and empower our stakeholders on public health issues such as obesity, chronic disease, food safety, water conservation, et Empowering the community to experience and learn a hands on (literally) activity that can sustain and improve their health is exactly the objective WCHD aimed to accomplish. Developing and executing action plans to produce such activities as bucket gardening demonstrates the success of the integration, which can be replicated easily.
How does this practice differ from other approaches used to address the public health issue?
This practice is community driven from the environmental health aspect. By informing and educating the community on how to garden in a container we have empowered them to make to make healthier lifestyle choices in a fun and creative way. We have been able to link them with needed resources not only for the gardening but other aspects of their lives. This practice has opened the line of communication between the Health Department and the community. We have been able to mobilize community partners to help identify new strategies to help meet the needs of the community. With the lines of communication open we are able to monitor environmental and public health problems more readily. With monitoring increased the health department is more quickly able to diagnose and investigate health problems and issues in the community.
Is the practice a creative use of an existing tool or practice? If so, answer the following questions.
Yes
What process was used to determine that the practice is a creative use of an existing tool or practice?  Please provide any supporting evidence you may have, for example, literature review.
A literature review was used to search for similar programs in environmental health fields or delivered through local health departments. We found many different programs for community gardening, such as gardening in a bucket. We also found information supporting the need for nutritional programs. The programs that were located had children or the public having taste-testing, hands on gardening in the classroom and some recipe preparation. We could not find any programs to inform, educate and empower the public in a similar way to this project.

What tool or practice (e.g., APC development tool, The Guide to Community Preventive Services, HP 2020, MAPP, PACE EH, etc.); did you use in a creative way to create your practice?  (if applicable) (300 word limit total)
a. Is it in NACCHO’s Toolbox; (if not, have you uploaded it in the Toolbox)?
b. If you used a tool or practice to implement your practice, how was your approach to implementing the tool unique and innovative for your target area/population?

The Walton County Health Department used MAPP and PACE EH tools and processes to assess the needs of the citizens in Walton County. The EPHPS self-assessment was performed on the local environmental public health system. The integration of data collected and the formulation of action plans are examples of how existing tools were creatively adapted to maximize efficiency and impact. The community picked gardening in a bucket which was a creative adaptation of community gardening. Garden in a bucket is a strategy that the partnership initially used to increase the number of classes and outreach activities. This strategy has been extremely successful in increasing community partner engagement. What began as an environmental health improvement project has morphed into county-wide improvement and partnerships.

How does this practice differ from other approaches used to address the public health issue? 

The Walton County Health Department used the PACE EH and MAPP processes to engage the community and to assess the needs of the citizens in Walton County. The environmental self-assessment was performed on the local environmental public health system. The integration of data collected and the formulation of action plans from all the partners is an example of how existing tools were creatively adapted to maximize efficiency and impact. Members of the partnership selected gardening in a bucket as a creative way to bring community partners together to work for the overall and individual good of the public.
If this practice is similar to an existing model practice in NACCHO’s Model Practices Database (www.naccho.org/topics/modelpractices/database), how does your practice differ? (if, applicable)
Although there are community and gardening projects as well as integration projects in the NACCHO database, there were none found that compared to our project. Combining the PACE EH and MAPP processes and using the community-driven strategy for container gardening has enabled the development of a strong partnership that will effectively address both public health and environmental health priorities in the months and years to come.
Who were the primary stakeholders in the practice?
A community health improvement plan is the culmination of a focused collaborative process between the local health department and the community. Using PACE EH and the EPHPS self-assessment data enabled the health department to interject valuable environmental health actions in the CHIP. Primary stakeholders or participants in our community partnership are too numerous to list. WCHD has taken a lead role in the practice by inviting well over 250 known associates, caregivers and providers to the table. These have included traditional public health partners such as the hospitals, law enforcement, local and state government, educational institutions, etc. By including partners from the environmental perspective, community leaders, residents, and businesses have been added to the mix to achieve a much larger group of stakeholders. The health department first selected a large number of potential participants that represented a variety of groups and sectors. Agency and program leads are invited and at every invitation, agencies are asked to make sure they have a representative present. Invitations to participate are sent to residents and consumers of services; service providers; governmental agencies; medical care providers; members of local schools and colleges; law enforcement; environmental organizations; faith-based community; and business community partners. All of these entities are part of a much larger public health system in Walton County. EMS, Hospitals, doctors, community health centers, schools, neighborhood organizations, law enforcement, local employers, civic groups, non-profit organizations, nursing homes, community centers, home health, mental health, fire, transportation, elected officials, faith-based institutions.
What is the LHD's role in this practice?
The Walton County Health Department is the lead agent for development of a community health improvement plan. The primary role of the local health department staff is facilitator. An essential role has been to get the participants to the table and to engage them in substantial discussion. Other public health roles include: planning; meeting organizer and leader; workgroup leader; health educator; public information officer; and data collector.
What is the role of stakeholders/partners in the planning and implementation of the practice?
Active and engaged community partners are essential to the success of the overall partnership and its improvement efforts. Not only are the stakeholders and partners essential to improvement, these people are the eyes and ears of the community. Without their input, public health interventions are less likely to be effective and delivered to the area of need. Community residents, stakeholders and partners have been engaged in both the planning and implementation of the WCHIP and gardening in a bucket. For the Garden in a Bucket initiative, partners plan, gather supplies, coordinate events, provide resources, and attend. Partners and stakeholders completed multiple assessments and brainstorming exercises and participated directly in formulating action plans for the overall community health improvement plan.

What does the LHD do to foster collaboration with community shareholders?
Describe the relationship(s) and how it furthers the practice's goals.

Walton County Health Department coordinates quarterly partnership meetings. Individual workgroups utilize health department staff members as group leads or facilitators and these workgroups often meet more frequently to complete specific action plans. Health department staff are routinely in contact by phone and email with county stakeholders to discuss issues, needs, and to develop solutions. All participants are given the opportunity to provide agency updates at the quarterly meetings. Specific agencies (based on partnership feedback and requests) provide a program or agency presentation to the overall partnership each quarter. Contact information is shared as needed with the community at large when local initiatives outside the partnership host events of interest. Examples include tobacco cessation initiatives, health and preparedness fairs, and continuing education for health care providers. Increased opportunities for sharing information resulted in increased knowledge of and access to resources in our county thus linking people to needed services. As we link more people we are assuring a competent workforce and educating, informing, and empowering people to make a change.
Describe lessons learned and barriers to developing collaborations.
Attempts to develop a community-wide, community-driven health improvement plan in Walton County have been tenuous at best. Community engagement and commitment is sporadic and there is no centralized location for people to get assistance for social and medical needs. Many Walton agencies and programs function independently. After the initial environmental assessments, there was not a definite plan for the Environmental Public Health Council. Being a part of the overall Walton Community Health Improvement Partnership contributed to the development of achievable goals, objectives and strategies. Most successful was the Gardening in a Bucket strategy, in that it united the community in a straightforward and hands-on manner. We did not plan for this project to be so successful so fast! Initially the project was to be for school aged children in one high school. Then, there were presentations to larger groups, including the School Health Advisory Committee, health department employees, classrooms and parent teacher organizations. Obtaining supplies for large groups became a problem. Unbelievably, adequate supplies of dirt and seeds were difficult to obtain. Not only did we not have the finances to get dirt we did not have the means to move it. Containers (buckets) went fast. So, we developed even more partnerships within the county to get supplies. Resources were provided in coordination with the local correctional facility (containers) and Rembrandt foods provided containers that they were going to take to the landfill. We worked with the county extension office; we collaborated with the master gardeners and with the local 4H leader. We worked with science teachers and principals developing programs for the schools. Lessons learned included: many hours of preparation for each garden in a bucket demonstration were needed. We were not prepared for the number of presentations requested. Community partners could have been used more effectively rather than using health department staff. Ultimately though, Garden in a Bucket was a great way to meet and educate the community and to learn more about specific issues.

Evaluation assesses the value of the practice and the potential worth it has to other LHDs and the populations they serve. It is also an effective means to assess the credibility of the practice. Evaluation helps public health practice maintain standards and improves practice.


Two types of evaluation are process and outcome. Process evaluation assesses the effectiveness of the steps taken to achieve the desired practice outcomes. Outcome evaluation summarizes the results of the practice efforts. Results may be long-term, such as an improvement in health status, or short-term, such as an improvement in knowledge/awareness, a policy change, an increase in numbers reached, etc. Results may be quantitative (empirical data such as percentages or numerical counts) and/or qualitative (e.g., focus group results, in-depth interviews, or anecdotal evidence).

List up to three primary objectives for the practice. For each objective, provide the following information:  (750 word limit per objective)

• Performance measures used to evaluate the practice: List the performance measures used in your evaluation. Depending on the type of evaluation conducted, these might be measures of processes (e.g., number of meetings held, number of partners contacted), program outputs (e.g., number of clients served, number of informational flyers distributed), or program outcomes (e.g., policy change, change in knowledge or attitude, change in a health indicator)
• Data: List secondary and primary data sources used for the evaluation.  Describe what primary data, if any were collected for each performance measure, who collected them, and how.
• Evaluation results: Summarize what the LHD learned from the process and/or outcome evaluation. To what extent did the LHD successfully implement the activities that supported that objective? To what extent was the objective achieved?
• Feedback:  List who received the evaluation results, what lessons were learned, and what modifications, if any, were made to the practice as a result of the data findings.


 

The two major objectives for our project are 1. To increase community partnership engagement and 2. To increase the number of health education classes and outreach activities related to nutrition and physical (including community gardens and garden in a bucket demonstrations.) Essential to the health of our community is our ability to successfully establish and sustain a community partnership which uses proven processes. Committed and active partnerships allow us to leverage support and resources to address public health issues in Walton County.

• Performance measures used to evaluate the practice: List the performance measures used in your evaluation. Depending on the type of evaluation conducted, these might be measures of processes (e.g., number of meetings held, number of partners contacted), program outputs (e.g., number of clients served, number of informational flyers distributed), or program outcomes (e.g., policy change, change in knowledge or attitude, change in a health indicator)
• Data: List secondary and primary data sources used for the evaluation.  Describe what primary data, if any were collected for each performance measure, who collected them, and how.
• Evaluation results: Summarize what the LHD learned from the process and/or outcome evaluation. To what extent did the LHD successfully implement the activities that supported that objective? To what extent was the objective achieved?
• Feedback:  List who received the evaluation results, what lessons were learned, and what modifications, if any, were made to the practice as a result of the data findings.

Objective 1:

To increase community partnership engagement Community members continually reinforce the need for a strong partnership to address local public health issues. Integration of the PACE EH and MAPP processes into a larger health improvement initiative will utilize community input and decision-making to improve the health of Walton County. Not only are the WCHD Administrator and EH Manager keeping up with both processes but so are the Environmental and Community Health professionals at the Florida Department of Health in Tallahassee. Performance Measures: • Level of community engagement: number of agencies participating in quarterly meetings or community health improvement workgroups • Results and activities from each phase of PACE EH and MAPP Data: • Number of WCHIP meetings • Number of attendees and number of meeting evaluations received • Sound meeting management practices are used for the WCHIP meetings. Documentation includes agenda and handouts, minutes, sign-in roster and evaluation summary. Evaluations Results: • Lessons learned from the overall process management is to have a clear expectation of what is required for a full cycle and to fully document results from each step or task in the processes. • The integrated partnership, Walton Community Health Improvement Partnership is established and individual workgroups are addressing each objective of the overall Walton Community Health Improvement Plan. • Since December 2012, there have been four quarterly WCHIP meetings and one Health Summit for strategic planning. • January 2012 – introduced MAPP Timeline; completed Forces of Change Assessment; Environmental Health Council update. Ten attendees, ten evaluations; overall meeting rated good (30%) or excellent (70%). Opportunities for improvement: increase number of participants. Market community health initiative on local public websites. • March 2012 – First annual Walton County Health Summit; completed Steps 1 through 5 of the MAPP process; emerged with strategic priorities for community health improvement plan. 38 participants from 20 different entities; 23 evaluations; overall rating of excellent. Opportunities for improvement: increase time for workgroups; increase number of participants; include decision-makers in the process.

Overflow (Objective 1): Please finish the response to the question above by using this text area.  Please be mindful of the word limits.

• April 2012 – established workgroups for four strategic issues; workgroups met to formulated goals, objectives and strategies; completed Steps 5 and 6 of MAPP process. Environmental Health Council was one of the four workgroups and continued to work on issues and priorities established from environmental health assessments. 35 participants; 24 evaluations; overall meeting rated good (12.5%) or excellent (87.5%). • July 2012 – Walton County Community Health Profile Report and Community Health Improvement Plan documents presented to partnership; four workgroup breakout sessions met to further develop action plans. 33 attendees; 26 evaluations; overall meeting rated good (19%) or excellent (77%). Opportunities for improvement: list of key partners not in attendance developed. • October 2012 – local Tobacco Prevention program presentation as well as presentation from Gulf Region Health Outreach Project; four workgroup breakout sessions to monitor progress on action plans and modify based on data. 31 attendees; 15 evaluations; overall meeting rated good (20%) and excellent (73%). Opportunities for improvement: meet more often and expand the range of the group. Feedback: • The Environmental Health, Senior Sanitation and Safety Specialist (PACE EH lead) and the WCHD Community Health Liaison (MAPP lead) led efforts to complete processes for community health improvement. • The PACE EH process involves thirteen (13) tasks and the MAPP process involves eight (8) steps. Need to fully document completion of each task or step. • Each meeting evaluation is carefully reviewed to determine what went well and what could have gone better. Participants are asked to write down opportunities for improvement. The WCHD Core Workgroup for the process meets prior to the WCHIP meeting to review the suggestions and take action.

Objective 2:

To increase the number of health education classes and outreach activities related to nutrition and physical (including community gardens and garden in a bucket demonstrations.) Though there are a number of tools to evaluate the practice and project submitted, the overwhelming response of the communities throughout Walton County is perhaps the most convincing. Gardening in a Bucket and community gardening activities are the vehicle we used to drive a major increase in community partnerships and participation among diverse groups. Performance Measures: • Number of community gardens in Walton County. • Number of health education classes, including Garden in a Bucket demonstrations. • Overall satisfaction with health education and demonstration activities. Data: • Direct observation of community gardens grew from 10 to 18. Every public school in Walton County has created a student garden. • Completed presentations: 34 school-based presentations (includes Parent Teacher Organization); 7 local club presentations (Science Clubs, Boys and Girls Club); 16 community presentations (Extension Office classes, Valley View Community, Earth Day, Energy Conference, and Public Health Week); and 3 workplace presentations (Sheriff’s Office and County Health Department.) • Overall positive feedback from simple evaluations received from the Healthy Meals presentations done in conjunction with the extension office. Evaluation Results: • Continual requests received for more community gardens. No formal evaluation tool, but cannot accommodate current requests for community garden instructions and support with existing resources. • Science classes across all grade levels utilize on-site school gardens to demonstrate processes such as recycling, oxygenation, growth and development as well as many other scientific processes required by curricula. • The Walton Middle School Science Club doubled in size due to the integration of container gardening activities in the club. In addition to a community service project of establishing and maintaining the school’s garden, the Science Club will be sponsoring a garden at a local private school. • Container gardening was combined with Cooking with Kids night a local elementary school and health department staff have been invited back to present this again. The school itself garnered supplies from local business donations so all 350 students could have a container garden.

Overflow (Objective 2): Please finish the response to the question above by using this text area.  Please be mindful of the word limits.

Feedback: • Feedback results channel through the Environmental Health, Senior Sanitation and Safety Specialist assigned to work on community health and the PACE EH project. Requests and feedback come from multiple points including local health department staff, community partners and leaders, and interested citizens. • Prior to January 2012, there were barriers to health education in schools and community organizations. Word of mouth successes of Garden in a Bucket presentations enabled increased opportunities to provide public health and environmental health education. • There are currently more requests for Garden in a Bucket demonstrations and community garden technical assistance than can be accommodated. In some areas, barriers to community gardens are being addressed. Formal classroom evaluations were not obtained since demonstrations and presentations did not occur in formal classrooms, but outside. Evaluations should still occur because they could help us improve our practice and assist us to identify barriers to healthy life style choices.
Objective 3:

Overflow (Objective 3): Please finish the response to the question above by using this text area.  Please be mindful of the word limits.

What are the specific tasks taken that achieve each goal and objective of the practice?
In January 2012, the need to inform and educate the public for health and environmental reasons came to the forefront and the concept (Gardening in a Bucket) was proposed to teach children how to create their own sustainable food source. Initially, local students were educated on the importance of healthy foods and learned how to grow ingredients for salsa. Immediately, requests for presentations on Gardening in a Bucket began. Not only were students and teachers interested in the project, but there were also opportunities to present to the School Health Advisory Committee, Walton Community Health Improvement Partnership, Sheriff’s Office, Healthy Start Clients, Boys and Girls Club, Science Clubs, Parent Teacher Organizations and more. Feedback: • Feedback results channel through the Environmental Health, Senior Sanitation and Safety Specialist assigned to work on community health and the PACE EH project. Requests and feedback come from multiple points including local health department staff, community partners and leaders, and interested citizens. • Prior to January 2012, there were barriers to health education in schools and community organizations. Word of mouth successes of Garden in a Bucket presentations enabled increased opportunities to provide public health and environmental health education. • There are currently more requests for Garden in a Bucket demonstrations and community garden technical assistance than can be accommodated. In some areas, barriers to community gardens are being addressed. Formal classroom evaluations were not obtained since demonstrations and presentations did not occur in formal classrooms, but outside. Evaluations should still occur because they could help us improve our practice and assist us to identify barriers to healthy life style choices.
What was the timeframe for carrying out these tasks?
The MAPP process will have completed one full cycle in calendar year 2012. Integration of PACE EH and MAPP was essentially complete by the second quarter of 2012.
Please provide a succinct outline of some basic steps taken in implementing your practice.
• Complete Environmental Public Health System Assessment. • Initiate thirteen PACE EH tasks. • Complete Local Public Health System Assessment. • Initiate eight MAPP steps for community health assessment and planning, including completion of MAPP assessments, i.e., Community Health Status Assessment, Community Themes and Strengths, and Forces of Change. • Continue activities from both PACE EH and MAPP processes.

What were some lessons learned as a part of your program's implementation process?

Over the course of the last year, we have learned many lessons during integration and implementation of a community health improvement initiative. Though there was significant public health leadership buy-in for the process, WCHD should have conducted capacity assessments (outlined in PACE EH) for both processes. Development of a clear path and measure for success of both processes was obvious, but documentation of the overall process goals and objectives should have been fully completed.
Provide a breakdown of the overall cost of implementation, including start-up and in-kind costs and funding services.
Grant funding in the amount of $21.600 was received to pay salary costs for one Environmental Health employee. These funds were tagged to complete the Environmental Health Assessment and PACE EH program. Other funding to support gardening presentations, health education and outreach activities came from established public health programs such as School Health and Healthy Start. In addition, community businesses and agencies donated materials and supplies for the outreach activities, i.e., dirt, plants and containers. Mini-grants were received for seeds, shovels, lip balm and sunscreen. In fiscal years 2011 – 2012, $5,000 salary dollars were received and applied to the Community Health Liaison salary to assist our rural health department to conduct the community needs assessments and implement community development activities. Meetings were held locally using WCHD resources. Printing costs were absorbed from general funding allocated to the Community Health program.
Is there sufficient stakeholder commitment to sustain the practice?  Describe how this commitment is ensured.
There is sufficient stakeholder commitment to sustain an integrated community health partnership and associated improvement activities. The first year of this partnership has been hugely successful. Local environmental and public health leaders have know for quite some time that reliance on funded agency initiatives will not do everything needed to improve the health of our community. This partnership has helped us to recognize the need for each partner to continue to focus on the activities and strategies specific to them while also noting the bigger community need. Development of a community wide, structured community health improvement plan focused on issues identified at the local level has provided the structure needed to continue to address improvement opportunities. Currently, the PACE EH project is addressing many of the Ten Essential EH Public Health Services to include: 1. Monitor environmental and health status to identify and solve community environmental public health problems, 2. Diagnose and investigate environmental public health problems and health hazards in the community, 3. Inform, educate, and empower people about environmental public health issues 4. Mobilize community partnerships and actions to identify and solve environmental concerns 7. Link people to needed environmental public health services and assure the provision of environmental public health services when otherwise unavailable 8. Assure a competent environmental public health workforce Gardening in a Bucket and the associated community participation and interaction are easy to duplicate and to sustain. Based on the response thus far, this initiative can only grow in Walton County. Gardening in a Bucket was the catalyst to unite a community focused on healthy behaviors. In addition to the physical activity of planting and working a garden and the ability to grow food, individuals are learning about larger public health and environmental issues and strategies to address these issues. Community engagement and Gardening in a Bucket is not expensive. WCHD has the ability to host meetings and has staff throughout the department to inform and educate.
Describe plans to sustain the practice over time and leverage resources.
Materials for the gardens are not expensive, i.e., use of existing or recycled containers and materials. “Free” seeds for the project were initially difficult to obtain. Through our partnerships with stakeholders in the community and Florida Department of Health (FDOH), buckets, seeds, shovels, sunscreen, educational material, and recipes were provided. This kept costs to a minimum. In order to sustain this practice over time, continuous community engagement is essential. Community members may come and go as will agency or individual participation, but it is apparent that there are more willing to be at the table than not. Walton County is not just a community that needs to improve, it is our home and with rare exception, the partnership members are also our neighbors, co-workers and friends. Community engagement and Gardening in a Bucket is not expensive. WCHD has the ability to host meetings and has staff throughout the department to inform and educate. Materials for the gardens are not expensive, i.e., use of existing or recycled containers and materials. “Free” seeds for the project were initially difficult to obtain. Through our partnerships with stakeholders in the community and Florida Department of Health (FDOH), buckets, seeds, shovels, sunscreen, educational material, and recipes were provided. This kept costs to a minimum. Use of the PACE EH and MAPP processes will likely continue and will move the health department closer to public health accreditation. Garden in a Bucket, though only one strategy, will continue to be a part of the health department strategic plan for education and outreach activities. WCHD will continue to strengthen relationships to find new and creative ways to assure that the vision continues. A Healthy Walton Begins Today! Join the Movement!
Practice Category Choice 1:
Environmental Health
Practice Category Choice 2:
Community Involvement
Practice Category Choice 3:
Community Assessment
Other?
No

Please Describe:

Check all that apply.
NACCHO Connect
Colleague in my health department

Other (please specify):

Are you a previous applicant?
No