Community Transformation Grant

HEART: Health Engagement and Action for Rochester’s Transformation

Thomas A. Pearson, MD, MPH, PhDChair, HEART Expert Team

Target Population: Monroe County, New York

• 2010 Population: 744,344– Demographics similar to U.S. including poverty, minorities.– Prevalence of deaf persons using sign language one of

highest in the world.• Economics

– Recovery from loss of dominant employer (Kodak)– Financial Times: One of world’s 50 strongest economies

for 2011, based on high technology, education, healthcare• Health Infrastructure

– Strong municipal health department– One medical school (Univ. of Rochester)– Three hospital systems– Two major health insurers

Federal Grants Supporting HEART Partners in Community-Wide

Prevention ProgramsGrant Program Funding

AgencyRecipient

Community Transformation Grant CDC URMC Center for Community Health/Monroe Co. Dept. of Public Health

Clinical and Translational Science Award Community Engagement Key Function

NIH/NCATS

URMC Center for Community Health

Prevention Research Center CDC URMC/Dept. of Public Health Sciences

Care Management/Payment Demonstration Grant

CMMI Finger Lakes Health Systems Agency

Preventive Medicine Residency HRSA URMC/Dept. of Public Health Sciences

Preventive Cardiology Training Grant NIH/NHLBI

URMC/Dept. of Public Health Sciences

Health

Engagement &

Action for

Rochester’s

Transformation

Transforming communities to make healthy living

EASY!

Figure 4. Conceptual framework for population-wide cardiovascular risk behavior change, showing three dimensions for consideration: the risk factor or risk behavior targeted for change, the community setting in which the intervention would be implemented; and the type of public health intervention or service used, including policy legislative strategies. Ref (11).

FOCUS POPULATIONS:Our efforts will reach Monroe County residents, with a focus on

Rochester’s “crescent”

The deaf communityFOUR KEY VENUES:CommunityWorksitesSchoolsHealth Care

Rochester’s Deaf Community in HEART

• Linguistic (American Sign Language) and cultural minority group

• Little prior engagement in public health programs• Inclusion in multiple HEART programs

– Coordinator for the Deaf Community – School Health Programs include Rochester School for

the Deaf– Deaf coaches for the Diabetes Prevention Program– Food hub creates first farmer’s market for deaf persons

• National model for community-based health promotion in Deaf persons

H.E.A.R.T.’s Core Principles: •Maximize health impact through prevention

•Advanced health equity and reduce health disparities

•Use and expand evidence base for implementing policy, environmental, and infrastructure change

HEART Overarching Goals1) Weight – 5% decrease in expected percentage of population who would be obese by 20162) Nutrition – 5% increase in average daily number of servings of fruits and vegetables3) Physical Activity – 5% increase in percentage of adults achieving 150 minutes/week4) Tobacco – 5% decrease in the prevalence of tobacco use5) High blood pressure – 5% increase in the percentage of adults with HBP at goal6) Cholesterol – 5% increase in the proportion of adults with hyperlipidemia at goal

H.E.A.R.T.’s Initiatives:

• Active Transportation• Breastfeeding Supportive

Policies • Coordinated School Health

Programs• Diabetes Prevention• Food Hub• High Blood Pressure

Ambassador Program• Safe Public Spaces• Tobacco Free Living• Virtual Clinician• Workplace Wellness

ACTIVE TRANSPORTATION

Identify needs and gaps, and improve

supports for active

transportation.

ACTIVE TRANSPORTATIONObjectives:

Increase the number of •municipalities with active transportation plans•municipalities that include active transportation plans in capital budgets •community active transportation events•bike racks for public use •schools with “safe routes to school” programs •signed walking routes and walking groups in Rochester

COORDINATED SCHOOL HEALTH PROGRAMS

Identify and engage schools to assess and improve health and wellness policies and

environments

COORDINATED SCHOOL HEALTH PROGRAMS

Objectives:

Rochester City Schools and School for the Deaf:

• Establish school health teams in 31 schools

• Create plan to improve health in each

• Implement plans• Implement District-wide

improvement plan

SAFE PUBLIC SPACES

Citizen/City teams create and enact plans to make “Crescent” parks and

play areas safe

SAFE PUBLIC SPACES

Objectives:• Train 29 City staff and

neighborhood leaders in Crime Prevention Through Environmental Design

• Form City/resident teams• Create safe plans for each

park/play space in Crescent• Implement plan

recommendations

DIABETES PREVENTIONTraining target

community members to deliver

evidence-based diabetes

prevention program

DIABETES PREVENTION

Objectives:• Double number of

Diabetes Prevention Program community coaches (13 to 29)

• Add 32 groups for pre-diabetic adults in Crescent and Deaf community

FOOD HUB

Provide start-up costs for a Food Hub to bring affordable, healthy food to the

Rochester Crescent and the Deaf Community.

FOOD HUB

Objectives:• Link local producers with

inner city consumers to increase markets for fresh, healthy, affordable food

• Build volume to achieve sustainability

HIGH BLOOD PRESSURE AMBASSADOR PROGRAM

Train volunteer outreach workers to promote self management of high blood

pressure in their organizations.

HIGH BLOOD PRESSURE AMBASSADOR PROGRAM

Objectives:• Recruit and train 150

community “High Blood Pressure Ambassadors”

• Create 900 blood pressure self-management plans for at-risk adults

TOBACCO FREE LIVING

Work to establish smoke free

policies at parks, beaches, college

campuses and multi-unit housing

TOBACCO FREE LIVING

Objectives:

Increase tobacco free policies in •multi-unit housing •outdoor spaces •college campuses

VIRTUAL CLINICIAN

Implement interactive

software program to deliver behavioral

counseling to patients in health

care settings serving the focus

populations

VIRTUAL CLINICIAN

Objectives:• Develop interactive computer

module to counsel patients with high cholesterol

• Adapt for African-American, Latino and deaf patients

• Place in community health center and deaf health practice to help patients make healthy behavior changes

WORKPLACE WELLNESS

Develop a web-based assessment tool for employers to assess, improve, and evaluate their

wellness efforts, and provide community recognition for companies that support workplace wellness.

WORKPLACE WELLNESS

Objectives:• Finalize employee

wellness assessment and improvement tool for companies

• Create links to local wellness resources

• Focuses on local health priorities

• Implement across the community

Future HEART Initiatives

• Evaluation of impact in partnership with Regional Health Information Organization

• Expert Team to implement Million Hearts– Engage healthcare community (payers, systems,

practices, providers)– Focus on the ABC’s– Three strategies

• Develop performance metrics • Utilize health information technologies• Innovate care models

– Support community-wide implementation of NHLBI Guidelines (ATP4, JNC8, Obesity2)

THE PARTNERS

Rochester, New Yorkhas

H.E.A.R.T.!