2015-2019 Community Health Improvement Plan Crow Wing County Community Services- Health Division

With a population of just over 63,000 (US Census estimate, 2013) Crow Wing County

is centrally located in the heart of Minnesota. It is a region with a diverse economic base, high

quality educational systems, and unparalleled natural beauty and recreational opportunities.

Brainerd, the county seat, can be found along the banks of the Mississippi River, in the heart of

Minnesota about two hours north of the Twin Cities, and nestled among more than 500 area

lakes. Brainerd and Baxter cities serve as the region’s hub for many governmental, health care,

and retail services. The region is home to nearly 100,000 year-round residents and thousands

more seasonal residents and visitors. Health care, information technology, construction, and

hospitality lead the list of large industry sectors.1

The state of the county’s health is attributed to many factors. In the 2014 County Health

Rankings report, released by the University of Wisconsin Population Health Institute and the

Robert Wood Johnson Foundation, Crow Wing County ranked 48 of 87 in health outcomes – the

measures of how long we live and how well we live.

The Rankings are based on a model of population health that emphasizes the many factors that,

if improved, can help make communities healthier places to live, learn, work and play. Building

on the work of America's Health Rankings, the University of Wisconsin Population Health

Institute has used this model to rank the health of Wisconsin’s counties every year since 2003.

Health outcomes in the County Health Rankings represent how healthy a county is. We measure two types of

health outcomes: how long people live (length of life) and how healthy people feel while alive (quality of life).

Health factors in the County Health Rankings represent what influences the health of a county. We measure

four types of health factors: health behaviors, clinical care, social and economic, and physical environment

factors.

53

67

62

50 48

60

70

59

44

51

0

10

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50

60

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80

2010 2011 2012 2013 2014

Health Outcomes Health Factors

CWC Health Rankings | out of 87 MN counties

2010-2014 Health Factors & Outcomes Data Trends

45

63

42

59

66 68

51

82

47

56

66

84

44

78

19

44

66

82

26

80

18

34

66

12

26

81

26 25

69

57

0

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20

30

40

50

60

70

80

90

Length of Life Quality of Life Health Behaviors Clinical Care Social and Economic Factors

Physical Environment

2010 2011 2012 2013 2014

CWC Health Rankings| out of 87 MN counties

2010-2014 Health Factors Data Trends

During the fall of 2012, Crow Wing County conducted a community wide health

assessment. The purpose of this survey was to gather information which will help Crow Wing

County provide services more relevant and responsive to the community’s needs.

The Community Health Assessment was an opinion based survey that was sent to 2,360 random

homes in Crow Wing County.

The survey was designed for individuals age 18 and over. In order to get a mix of the population,

it was asked that the survey be given to the adult household member who has had the most

recent birthday. The survey was completely voluntary and all answers were strictly confidential.

The survey identified the following problem areas:

The top 10 health areas of focus resulting from that survey are as follows-

• Pregnancy and Birth

• Child Growth and

Development

• Adult Disability and Aging

• Environment

• Alcohol, Tobacco, and

Other Drugs

• Mental Health

• Chronic Health Problems

• Infectious Disease

• Injury

• Violence

• Environment Economics

• Service Delivery Systems

The individual taking the survey was asked to rate the problem areas as to how much of a problem they felt that area was in Crow Wing County.

☐ No Problem ☐ Minor Problem

☐ Moderate Problem

☐ Serious Problem

The survey also asked for information such as the individuals, education, annual household income, number of members in household, how many months out of the year do they live in CWC, city/township, and whether or not there were any issues they felt were not addressed within the survey.

Of the 2,360 surveys mailed out, 723 were returned. We had 30% participation.

Top 10 Problem Areas Identified

% of individuals who felt this was a

moderate or serious problem

Q59. Obesity and overweight Adults

88.4%

Q58. Lack of Exercise

87.1%

Q60. Obesity Overweight among Children

84.8%

Q57. Unhealthy Eating Habits

82.2%

Q37. Alcohol Use by Underage

76.9%

Q10. Parents with Inadequate Poor Parenting Skills

76.1%

Q41. Use of Illegal Drugs

75.6%

Q92. Unemployment

75.3%

Q14. Adolescents becoming sexually active

75.1%

Q35. Tobacco Use by Youth

73.9%

Crow Wing County’s Statewide Health Improvement Project kicked off

in Crosslake, MN, on February 20th, 2014. The purpose behind the

summit was to begin a great movement, a movement within Crow

Wing County to improve the health of its citizens and communities.

The idea was to bring together multiple stakeholders who would

collaborate together to seek sustainable solutions to improve health

and wellness within our communities. At this summit, both Crow Wing

Counties Community Health Assessment data was shared alongside

Essentia Health’s Community Needs Health Assessment data. This data

helped to demonstrate where the greatest need within the community

is for change. These community stakeholders would also sit on the

Community Leadership Team (CLT) who is the steering committee for

our grant funding. This team of stakeholders meets regularly to guide

the Goal Groups and make funding decisions as they relate to the ‘mini

grants’. The CLT was then divided into four main goal groups that

would help implement ideas and vision all while being driven by

partnerships within the collaborating goal groups: Healthy Choices,

Mental Fitness, Workplace Wellness & Community Connections (which

pertain to the identified areas of concern as stated within for CWC CHA

and Essentia Health’s CHNA). Together, we identified assets and

barriers within our community for each of the goal groups. The

purpose of meeting within our Goal Groups was, and is to, ‘dig deeper’

and have a more powerful impact within the community both by

creating collaborations amongst stake holders and by bringing

together those within the community who have a passion and desire to

make Crow Wing County a healthier community. During this time, a

Community Leadership Team (CLT) was formed Thus, Crow Wing

Energized was born!

CLT Members:

Gwen Anderson Crow Wing County

HSSD Division Manager

Nathan Bertram Crow Wing County

Healthy Adults

Shari Nelson Crow Wing County

WIC Coordinator

Steph Callahan Crow Wing County

Healthy Families

Sherry Hutchins Crow Wing County

HSSD- Administrative Assistant

Adam Rees Essentia Health

President Central Region

Miranda Anderson Essentia Health

Marketing & Comm. Relations

Cassie Carey Crow Wing County & Essentia Health

SHIP Coordinator

Randy Klinger Brainerd YMCA

Gayle Nielsen Essentia Health Care Coordinator

Jennifer Smith

United Way Executive Director

Karen Peterson Essentia Health

Nurse Manager

Marc Ostgarden City of Brainerd

City Planner

Matt Kilian Brainerd Lakes Chamber

CEO

Aimee Jambor Brainerd School District

Health Services

Alicia Bauman CentraCare

Crave the Change

Laura Perdue University of MN

Extension

Sarah Speer Good Samaritan Society

Marketing

Strategic Priorities Crow Wing County

Mission: To promote and protect the health, well-being and self- sufficiency of all residents of Crow Wing County. Aligning Health Division Strategic Priorities:

Priority Goals Expected Results

Prevention & Preservation

Collaborate with Community Partners and stakeholders [ongoing] Provide joint educational opportunities both internally and externally [ongoing]. Educate the public by taking part in community events to represent Public Health all the while empowering individuals to initiate change [ongoing].

Educated community partners and stakeholders regarding our programs and interventions available. Collaboration both internally and externally with consistent practices from both entities. Sustainable community change powered by Crow Wing Energized (SHIP). Involvement within various community events.

Results Based

Sit down as a multi-disciplinary collaborative team to review our Community Health Improvement Plan in December 2015 and yearly after that [ongoing].

To confirm we are on track and to make modifications and adjustments where necessary to ensure the plans effectiveness.

Strategic Priorities continued Aligning Community Services Strategic Priorities:

Vision Statement Priority Goals

Serve Well

Enhancing the Customer

Experience

Coordination of services

Deliver Value

Prevention & Preservation

Increase stability in the family and individual Less deep end services Get ahead of the problem Connect the community to resources

Drive Results

Results Based

Improved service to clients

Recommendation from the 10-09-12 Community Services Assessment: #6 Create a community health focus to identify and effectively address health related barriers to independence.

Crow Wing Energized Guiding Principles:

• We seek to create and sustain a united approach to improving health and wellness in our community and surrounding area.

• We seek collaboration towards solutions with multiple stakeholders (e.g. schools, worksites, medical centers,) to improve community engagement and commitment focused on improving community health.

• We seek to prioritize evidence based efforts around greatest community good that can be achieved through our available resources.

Aligning our Strategic Priorities

o How can we work together as a community to improve the health of

our citizens and prevent health disparities? o How can we utilize evidence based efforts around the greatest

community good? o How can we promote change in a positive light and be the support

that is needed for the community?

We all find ourselves asking the same questions, let us work together as a unified front to address the barriers in our community that are affecting the health of our citizens and empower personal lifestyle change!

1. Find similarities amongst the Health Assessment data.

2. Do they overlap?

3. How do the findings overlap with the CWE strategies?

How should we prioritize?

1. Obesity and overweight Adults 2. Lack of Exercise 3. Obesity Overweight among Children 4. Unhealthy Eating Habits 5. Alcohol Use by Underage 6. Parents with Inadequate Poor Parenting Skills 7. Use of Illegal Drugs 8. Unemployment 9. Adolescents becoming sexually active 10. Tobacco Use by Youth

Crow Wing County 2012 Community Health Assessment

1. Obesity, physical activity, and nutrition as risk factors for chronic diseases, such as type 1 diabetes. 2. Reduction of excessive/binge drinking. 3. Tobacco use primary prevention/cessation

Essentia Health Community Health Needs Assessment

1. Schools

2. Community

3. Workplace

4. Healthcare

Minnesota Department of Health Statewide Health Improvement Plan

Similarities

• Obesity amongst both adults and children.

• Poor Nutrition & Unhealthy Eating Habits.

• Lack of Physical Activity.

• Mental Health Issues & Access.

• Excessive Alcohol Use.

• Tobacco Use.

• Behavioral Health.

Obesity is a huge public health concern both within Minnesota and across the nation. Obesity increases ones risk for developing chronic diseases.

Poor Nutrition and Eating habits as well as Lack of Physical Activity also contribute to obesity.

Rising rates of obesity also indicates rising healthcare costs!

Why are these areas of similarities important?

• For the most recent year available, the economic costs associated with alcohol use in Minnesota are an estimated $5.06 billion.

• Alcohol, Tobacco and other

drugs contribute to chronic disease, cause intentional and unintentional injuries, and social and family disruption.

• Alcohol use increases mortality and morbidity, unplanned pregnancy, poor birth outcomes, child development, mental health, and violence.

All of the area’s identified are important. They all play a

role in personal health and wellness as well as our

community and states. They all are intertwined in one

way or another so if we can work to create a change in

one area, for example, poor nutrition and eating habits,

than we can assume we will see a change in obesity!

Assets & Challenges Within Our Communities: AS

SETS

• Community Gardens

• Bike and walking trails

• Health Apps

• Fitness resources

• Golf Courses

• Supply of foods within the stores

• Parks

• Farmer’s Market

• Pequot Lakes Gymnasium and facilities

Healthy Choices

• Efforts that need to include the

high elderly population in the

county

• Ability to access services

• Poverty level increase

• % of female Head of Households

• Availability of a therapy pool

• Walking in the winter time –

weather

• Availability to keep the money

within our own county

• Pregnancy women and education

• Smoking related issues

• Combatting the marijuana use and

legalization

• Gapping the bridge of all ages –

KIDS through SENIORS

• Extra’s with garden left overs –

Cannery

• Transportation

• Motivation

• Short growing season

• Schedule of farmer’s markets

• Economic

• Elimination of Physical Education

in schools

• Insurances that cover

memberships to fitness centers

• Boxed foods vs fresh foods

• Motivation

• Mental health issues

• Internet electronic devices –

vaccination education… etc.

• Fear of predators

• TV

CHAL

LEN

GES

Assets & Challenges Within Our Communities: AS

SETS

• Emergency preparedness – Red Cross, fire and rescue, EMT’s

• Crisis Line- mobile crisis • Telemedicine • Strong community

• Lutheran Social Services, Bridges of Hope, Nystrom’s & Northern Pines

• Central Lakes College & Saint Scholastica

• Mental Health Initiative • Stress and Anxiety within our

work environment – Trust, direct honest respectful

• Public education – Mental health professionals

• Community based services that will go to the homes

• Partnerships with providers and mental health professionals

Mental Fitness

• Stigma with Mental Health • Transportation – difficult

because of availability and financial

• Availability of the actual Mental Health services – long waits in the past (1 week out)

• Awareness of programs, and lack of some programs

• Technology – referrals by technology– slow contact

• Fragmented in regard to Providers giving a referral

• Accessing and having parents or adults feel that there can be more local services

CHAL

LEN

GES

Assets & Challenges Within Our Communities: AS

SETS

• Incentives – prizes, insurance

benefits, health club

discounts

• Fitness equipment on site

• Health fairs

• Health assessments – screenings

• Wellness Committees

• Large employers (School, Health systems) Modeling

programs possibly

• Strong business connections for sharing programs

• Health insurance companies

Workplace Wellness

• Celebrations – healthy food choices?

• Food costs – need better in workplace

• Knowledge and training gap within the

workforce

• What works for incentivizing

• Schedules and time conflicts

• NO sidewalks in Baxter

• Need showering facilities in the

workplace

• Economic

• Understanding the economic benefit

from providing more healthy choices for

their employees

• Small business employers run into

challenges.

CHAL

LEN

GES

Assets & Challenges Within Our Communities: AS

SETS

• Wealth of resources within the community

• Northland Arboretum – miles of trails and free

access

• This program – being public/private partnership

COLLABORATION!

• Partnerships and networking

• Senior Linkage Line

• Kinship Partners

• Knowledgeable and professional

nurses and medical providers

Community Connections

• Lack of knowledge about the resources

• Veterans – reintegration back into

community after being deployed

• Lack of communication in marketing

• Getting access to the population that we

want to reach

• How do we find the ways to motivate that

particular group?

• Turnover – from organizations and

individual companies

• Technology

• Stigma – in terms of being afraid to

ask for help

• Tourism – play and unhealthy choices

• Competition amongst businesses CHAL

LEN

GES

Community Engagement

• Filled out Community Health Needs Assessment!

• Invited to attend Crow Wing County’s SHIP Summit to kickoff Crow Wing Energized!

• Goal Group Involvement!

Each of the 4 Goal Groups is made up of community stakeholders and leaders from various organizations as well as community members who feel a calling to help change our health.

Each Goal Group meets monthly and sub committees meet at an as needed basis.

The Community Leadership Team (CLT) meets monthly and serves as Crow Wing Energized steering committee for our grant funding. This team of stakeholders meets regularly to guide the Goal Groups and make funding decisions as they relate to the ‘mini grants’

Crow Wing Energized Community Partners: 1st Lutheran Church

A.C.T.

AmericInn

Bethlehem Lutheran Church

Brainerd Jaycees

Brainerd Lakes Area Early

Childhood Coalition

Brainerd Lakes Chamber

Brainerd Public School

District

Brainerd VA Clinic

Breezy Point Police

Department

Breezy Point Resort

Camp Vanasek

Central MN Council on

Aging

Child Care Aware

City of Brainerd

City of Crosby

City of Pequot Lakes

Country Financial

Crisis Line & Referral

Service

Crosslake Community

School

Crosslake Lutheran Church

Crow Wing County

Licensed Family Child Care

Association

Crow Wing Power

CTC

Cuyuna Regional Medical

Center

Cycle Path and Paddle

Discovery Horse

Dragonfly Healing Arts, LLC

Eagle View School –

Pequot Lakes

Early Childhood Coalition

ECFE

Good Samaritan Society

Graphic Packaging

Hallett Center

Happy Dancing Turtle &

Hunt Utilities Group

ISD #181 Youth

Connections & Recover

Health

Kiwanis of Baxter

Landis & Gyr

Minnesota Licensed Family

Child Care Association

Minnesota Teen Challenge

– MNTC

New Pathways

Northern Pines Mental

Health Center

Northland Arboretum

Nystrom & Assoc.

Operation Sandwich

Parent Aware

Pequot Lakes PTA

Pequot Lakes School

District

Prince of Peace Lutheran

Church

Recover Health

Rural Minnesota CEP

Smile Again Ministries

SNAP Fitness – Pequot

Lakes

The Farm on St. Mathias –

Arlene Jones

The Nature Center

United Way of Crow Wing &

Southern Cass

University of MN- Extension

Veteran’s Assistance

Services

YMCA – Brainerd

Healthy Choices PURPOSE: To develop sustainable strategies that encourages the population of Crow Wing County to make healthy choices.

GENERAL DESIRED OUTCOMES: 1. Increase access to healthy food choices. 2. Increase active living opportunities and active lifestyles. 3. Promote and support healthy environments.

FOCUS AREAS:

• Healthy Food in the Community o This group is looking at how we can improve our food shelves and provide more nutritious foods, teach

individuals how to prepare this foods, and have hours of operation that work well for those they serve. o How can we make our farmers markets more available to working individuals? Currently, many markets

are held during business hours. Is it possible to have a weekend farmers market and have a central location for this? Also, let’s look at the addition of EBT use at these markets as well.

o In SHIP 1, city gardens were implemented and maintained! We are looking to grow in this area during the CWE movement as well!

• Active Living

o We are working to become a Walkable & Bikeable Community. Brainerd City Counsel established a strategic goal to create more walkable and bikeable neighborhoods. Current projects include putting in bike lanes and more sidewalks within our communities!

o Looking at a Safe Routes to School Plan and sidewalk construction.

o Region V bicycle racks grant to be implemented!

o In partnership with CWE, the Northland Arboretum is designing and building and outside Accessible

Wellness Fitness Trail that will promote the health and well-being of individuals of all ages within our community. The trail will have check points where you can engage in various types of exercise. The Accessible Wellness Fitness Trail’s goal will be to promote healthy lifestyles, encourage weight loss, and improve mental and physical wellness.

o Community individuals are becoming training in the Lifestyle Coach/National Diabetes Prevention

Program curriculum through CWE! The purpose of this program is to work with those who have a diagnosis of pre-diabetes or a BMI >24. Measures and indicators of progress include BMI and a weight loss of 7% of their starting weight.

• Smoke-free Housing

o Working to make multi-unit housing in CWC smoke free. CWE has held luncheons for those individuals with rental properties to converse with a lawyer around the laws related to smoke free housing and how to go about starting the movement.

• Childhood

o CWE hosted a Providers Choice training for 31 child care providers within our communities. At this training they learned new ways to engage children in play and activity, the importance of healthy meals and serving family style meals, as well as breastfeeding education, practice, and promotion. Each individual wrote up an action plan for each of the areas: active play, healthy eating, and breastfeeding practices.

o In the process of creating a hub or central location for all providers to swap recipes, active play ideas, and just meet and learn from one another. Currently trialing a Basecamp for Crow Wing child care providers powered by CWE!

o Two local child care providers are participating in the Certified Lactation Counselor training in March. How awesome to bring this support to our local child care!

• Healthy School Food Day

o Looking at how we can offer healthier choices at more convenient locations such as concessions stands and vending machines.

o Continuing to look at and grow our Farm to School programs that allow our students to be eating fresh, farm grown foods!

o Forestview Middle School Earth Diggers, is utilizing CWE funds to start a youth garden and a junior Master Gardener Club. This will be maintained by students, staff, families, community volunteers and businesses.

• Active School day

o Looking at how we can better our Physical Education curriculum by engaging those most involved- PE teachers and staff. How can we help students be more active before and after school?

o Policy Change to accomplish health objectives of decreasing childhood obesity: Include

physical education every year throughout K-12, not just K-8.

*Current Minnesota law requires that instruction in physical education be provided to all students in grades K-8 every year and at least once in high school.

National Prevention Strategy- Empowering People

In this strategy, we are providing people with tools and information to

make healthy choices, promoting positive social interactions, and

supporting their decisions to make healthy choices.

FitnessMental PURPOSE: To encourage and equip citizens in achieving and maintaining mental fitness. GENERAL DESIRED OUTCOMES: 1. Build networks throughout the county to equip citizens in achieving resilience. 2. Increase the practice of intentional choices to reduce stress and anxiety. 3. Educate to increase the community knowledge on mental fitness so individuals can make positive choices regarding their overall health. FOCUS AREAS:

o The Northern Pines Mental Health is utilizing CWE funds to establish a smoking cessation and healthy living curriculum to be offered within the ACT program to individuals who are dealing with sever and persistent mental illness.

Use Rehabilitation education in a group format to assist clients understanding better choice making for healthy living alternatives including reducing smoking, increase physical exercise and eating healthier. Objectives include:

-Increasing individualized affordable choices related to healthy diet. and exercise. -Increase alternatives related to smoking cessation for action related coping strategies by teaching and practicing. Action orientated coping strategies to be use by participants, such as bicycling, walking, working out at YMCA. -Provide education on smoking cession following the manual recommended by the Minnesota Cancer Society for healthy living. -Use of electronic oximeter to measure physical changes for those who elect to reduce smoking.

-Inclusion of this group in formal mental health rehabilitation treatment plan. -Develop group format / materials (including the use of peer specialist) for continuing mental and physical health rehabilitation that can be utilized in the future to reach more consumers.

o At Brainerd Public Library, a display location will feature information relating to CWE program topics. Visitors may take promotional information and checkout books and materials associated with the program, encouraging healthy lifestyle choices.

Examples of programs would be:

Ways to Manage SAD (Seasonal Affective Disorder) Great Places to Bike in the Brainerd Lakes Area Learn How to Stop Smoking

o How can we bring the Make it OK campaign to our community? If we know

more, we can do more. Learning to fight the mental health stigma together!

WellnessWorkplace PURPOSE: To create a healthy and more productive workforce. GENERAL DESIRED OUTCOMES: 1. Achieve employee satisfaction. 2. To maximize productivity 3. To minimize absenteeism. 4. Reduce health care costs. FOCUS AREAS:

• Healthy Eating o Making healthy choices the easy choice- how can we make our vending machines

healthier? Let’s look at serving healthier food at meetings, too!

• Physical Activity o How can we add more activity to our work days? Advocating for and spreading

the word about walking meetings, strategic breaks, and how one can become more active during their work day!

o Working on a scalable workplace wellness resource kit to serve Crow Wing County businesses.

• Tobacco Free

o Starting the conversation and movement towards tobacco free campuses and businesses.

• Breastfeeding Practices

o Taking a look at employers and places of work— how can we help to support nursing mothers in their decision to breastfeed? Making the movement to provide all mothers with a location to nurse and place to store breast milk.

FOCUS AREAS:

o Billboards o Creating bold statements to catch the attention of our community members

on how important health and wellness is and the purpose behind CWE.

Example, 1 out of 4 adults in our county is obese. o CWE Website

o Offering highlights from each of our goal groups.

o How to get involved!

o A calendar of

community events.

o Resources for individuals.

Connection Community

PURPOSE: To connect Crow Wing County citizens to services, events, organizations and resources that promote healthy living. GENERAL DESIRED OUTCOMES: 1. Increase awareness on available services, programs, and events within Crow

Wing County. 2. Promote Crow Wing Energized movement and the citizen inspired programs

and events within the county.

Community Case Management (CCM) was developed to identify open cases with multiple workers, bring these professionals together, identify areas of duplication, and establish unified goals and a plan moving forward. Three models have been developed: Track A, Original (for already open clients); Track B, New Referral; and Track C, “Just in Time”. A CCM will last about 30 minutes and during that time the team will speak about each of their concerns related to the client and what their individuals goals are. From there, we identify priorities for that client (parenting education? birth control? rehabilitation?) with a timeline for completion. One individual with the most involvement in that case is assigned to be ‘lead’ and are responsible for starting an email thread with all parties involved. This email thread will help keep communication consistent amongst each party and the outcome we are expecting is a more coordinated approach to the clients care.

WIC Breastfeeding Peer Counselor Program is a new adventure CWC WIC is about to take on. With

the help of a $20,000 UCare grant award, we are going to be developing and establishing a breastfeeding peer counselor group. Breastfeeding has been proven to reduce the risk of child obesity, development of allergies, and chronic disease as well as promote bonding and attachment between mother and baby (which closely relates to our prevention and preservation efforts). The healthy people 2020 goal for exclusive breastfeeding through 3 months is 46.2%. In 2013, the CDC Breastfeeding report card for Minnesota showed that exclusive breastfeeding through 3 months was 47.2%! However, despite this number, in 2012 our WIC program only had 33.9% of mothers exclusively breastfeeding through 3 months. When we ask ourselves the question of why, many trends come up such as this is a common time for mothers to return to the workplace, postpartum follow up visits are less frequent, and general support goes down. This program would allow us to have a Peer Counselor who can provide support and education to our nursing mothers on an as needed basis. This may consist of this individual spending time in the clinic on clinic days, making phone calls to nursing mothers to see how it is going, and by just meeting one on one with a mother who may be experiencing difficulty nursing and could use some extra support and education. By developing and starting this breastfeeding peer counselor program in WIC, our goals are to increase the rate of mothers who are exclusively breastfeeding at 3 months to the Health People 2020 goal of 46.2%.

61% of infants born in 2015 participating in Crow Wing County WIC services will be

being breastfed at 6 months.

Prevention & Preservation Strategies

Growing Great Kids (GGK) is an evidenced based curriculum that provides a “how to” guide, or

roadmap, for parents to develop positive parenting skills. It focuses on child social, emotional, and growth and development. Helps parents to understand cues and what empathy means as a parent and how to use that approach in raising their children. Tools such as E-Parenting, Character Builders, and 4 Steps to Success are taught to the parents by the home visitor that help them to learn about their child’s development and needs. The outcome for this program is to reduce child abuse and neglect within our community and be a support for parents who are struggling to help them become self-sufficient and positive parent role models. Currently, GGK is being offered to those families who score >25 on their Parent Survey. The Parent Survey is offered to first time parents in WIC and is completed with referrals we receive from Child Protection. We see a huge need for parenting education (as reflected in our CHA and in our Child Protection numbers for 2014

Of those families, without prior child protection case management, who have been enrolled with the Growing Great Kids curriculum for ≥3 months, ≥70% will not be opened for ongoing child

protection case management within 6 months.

*Currently we have 8 families ≥3 months enrollment with GGK. *Out of those 8 families, in the last six months, 25% (2 families) have undergone an assessment and

been opened for ongoing case management.

*Out of those 8 families, 25% (2 families) had open case management prior to enrollment in GGK. *Out of those 8 families, 50% (4 families) are currently open for ongoing case management. A strategic goal of CWC- Health Division is for county and community to be delivering unified education and support to families that are receiving home visits. A long term goal is for all community partners who have a home visiting program to be trained in the Growing Great Kids 0-3 curriculum.

National Prevention Strategy- Clinical and Community Preventive Services

In this strategy, we aim to support implementation of community-based preventative

services and enhance linkages with clinical care.

References & Sources

Minnesota Department of Health www.health.state.mn.us

Centers for Disease Control

www.cdc.gov

National Prevention Strategy www.surgeongeneral.gov/initiatives/prevention/strategy

County Health Rankings & Roadmaps

www.countyhealthrankings.org

Brainerd Lakes Chamber www.explorebrainerdlakes.com