Why It’s Useful to Show the Incidence Rate per 10K or per 100K Population Instead of Just Number of Cases

Incidence rates, or the rates of new cases of a disease, are often shown as the rate per either 100,000 population or per 10,000 population, and provide valuable additional insight to the number of new cases of the disease.

In scenarios when comparing the incidence of a disease across different localities that have varying different sizes in population, looking at the incidence rate of that disease per 10,000 or per 100,000 population helps to show a more complete picture than would only looking at the number of new cases alone.

Examples are given in the quick, 3 minute video below to further illustrate this point.

In conclusion, showing the incidence rate per 10,000 or per 100,000 population provides additional valuable insight in addition to showing the number of new cases of the disease. This is especially true when comparing the incidence rate of the disease across different localities that have varying sizes in populations. In addition, looking at the incidence rate per population is essential when comparing that rate to a state or national average for that disease or comparing it to a benchmark or goal that is in the format of an incidence rate per population.

Three Good Places to Look for Re-opening Checklists or Information on Re-opening During the COVID-19 Pandemic

Having good, accurate, and useful checklists for re-opening during the COVID-19 pandemic, or after any infectious disease outbreak that required closing or changing your organizations operations, makes it easier to communicate with everyone involved in your organization’s re-opening. 

Note that it is important to use your own critical thinking skills to assess whether the source of the re-opening checklist or information about re-opening is a good, reliable source for this kind of information. 

It is also important to use your critical thinking skills to assess whether the re-opening checklist or information about re-opening complies with state and local laws, ordinances in relation to re-opening in the localities in which your organization operates and for the type of industry that your organization works in. 

For more about what critical thinking is or ways that you can help others improve their critical thinking skills, see our article on this topic

The video below, part of RILLIAN’s 3 Minute Tuesday videos, mentions 3 good places to look for re-opening checklists or information on re-opening.

As mentioned in the above video, the first good source for kind information to develop a re-opening checklist is the Centers for Disease Control and Prevention (CDC) for those in the U.S. or a similar governmental health authority in your country for those outside the U.S.

The CDC has a website to provide essential information in relation to the COVID-19 pandemic, including information on re-opening for many different types of organizations.

The link to that website is: https://www.cdc.gov/coronavirus/2019-ncov/index.html 

A second good source for re-opening checklists and information are the state and local health departments or boards of health for the locality or localities in which your organization operates. Some localities may call them health departments some may call them boards of health or other similar names. These sources provide information specific to your state or locality. 

A third good place to look for re-opening checklists or information on re-opening is professional industry specific organizations or associations for the industry that your organization works in. These types of organizations may have re-opening checklists or information on re-opening that were adapted from information on re-opening from a source such as the CDC or state & local health departments and customized to be specific to that particular industry or profession.

There are more than the 3 good places to look for re-opening checklists or information on re-opening, such as OSHA, the FDA, Department of Agriculture, and many others. We only mentioned 3 of them in this short video. 

What sources for re-opening checklists or information on re-opening during infectious disease outbreaks, such as the COVID-19 pandemic, have you found to be helpful for your organization?

What is contact tracing?

Contact tracing is a process of figuring out who has been in contact with a person who has been diagnosed with a communicable, infectious disease, such as COVID-19, contacting them to let them know they may have come into contact with a person who has the communicable, infectious disease, and informing them of their options for testing, treatment, care, and follow up.

This process is typically carried out through phone calls, although in the past as well as in some cases or reaching people who do not have phones it may have involved in person visits.

The person doing the contact tracing, called a contact tracer, informs the person they are calling or otherwise contacting, of testing options so that they can get tested to see if they have the disease. That is if testing is available for the disease in question. 

The contact tracer also provides the person with how to prevent spreading the disease to others, information on where to get treatment — if treatment is available for that disease– and help the person understand the next steps that they should take with testing, preventing spreading the disease to others, and treatment.

For example, in the case of a COVID-19 exposure, this would include the contact tracer providing the person with instructions and support on how to self-isolate or self-quarantine, how to get tested if testing is available, and recommending what to do if their symptoms get worse, such as seeking medical care.

What should you do if a contact tracer calls or contacts you? By responding to them as quickly as you can, you can reduce the time it takes per person. If you have questions for them, such as if something they said was not clear to you, ask them. If they ask you questions, answer them as accurately as you can. Listen to and follow their instructions for testing, next steps, and preventing spreading the disease to others.

What if you’re looking for a job right now and you’re interested in becoming a contact tracer? A first step could be to learn more about the contact tracing process and make yourself more competitive when applying for a contact tracing job, such as by taking a free online course, such as the one offered by Johns Hopkins University’s Bloomberg School of Public Health, available at https://www.coursera.org/learn/covid-19-contact-tracing?edocomorp=covid-19-contact-tracing .

Good places to look for contact tracing jobs are state and local health departments websites, under the jobs or careers section, since contact tracing is conducted by these entities in most places in the U.S. In some localities, or in instances of large outbreaks of infectious diseases, some localities may outsource contact tracing to other organizations that have experience in this kind of public health work. If you know of an organization like this in your community, you could also check their website for job openings.

RILLIAN does not have any job openings for contact tracers. We did not get any contracts to be involved in the contact tracing or case investigation process.

However, we did create an activity tracker back in April 2020, to help reduce contact tracing time per person by logging symptoms, activities, and persons in close and frequent contact with. It is available for free from https://mailchi.mp/18d93948e8bc/rillian_activity_tracker_for_contact_tracing

Activity Tracker COVID-19 Contact Tracing

RILLIAN has developed a tool to reduce contact tracing time per person. You can download it here or by clicking the image above.

Let us know if you have any suggestions for topics in the areas of Research & Insights Leading to Learning, Innovation And actionN (R.I.L.L.I.A.N) that you would like to see us cover in our Three Minute Tuesday video series!

Email your suggestions to Jillian.Regan@RILLIANConsulting.com



bicycle rent renting bike Charlottesville Virginia

Enjoy Bike Month Safely: Bicycling Safety Considerations To Keep in Mind from Recent Injury Prevention Research

Enjoy Bike Month Safely:

Bicycling Safety Considerations To Keep in Mind from Recent Injury Prevention Research

bicycle rent renting bike Charlottesville Virginia

Bicycling is a fun form of active transportation or a leisure activity that many people enjoy. The bicycle in this photo is for rent in Charlottesville, VA through Jill + Ian’s bicycle rentals. Photo © Jillian Regan 2018. 

Bicycling is an enjoyable form of physical activity for many people. Most people (89.8%) in a recent survey have ridden a bicycle at one point in their life.1 People ride bicycles for a variety of different reasons. A recent survey found that most survey respondents (76%) ride bicycles for fun and almost half (47%) also ride bicycles for exercise.1 Many (22%) ride bicycles to ride with friends, family, or coworkers who ride bicycles as well to commute to work or school (27%).1 Only a few people say they ride bicycles to help the environment (18%), run errands (6%), for bicycling competitions (2%) or do not ride bicycles at all (6%).1

The month of May is National Bike Month in the U.S. Celebrate Bike Month safely by taking into consideration recent bicycling safety research when riding a bicycle.

bike rentals renting for rent Charlottesville Virginia bicycle safety public health injury prevention

Wearing a bicycle helmet reduces the risk of head injuries. Many bicycle rental services, such as Jill + Ian’s bicycle rentals, also rent helmets in addition to bicycles. Photo © Jillian Regan 2018

Wearing bicycling helmets has been proved to be effective in reducing head injuries as well as fatalities. Specifically, wearing helmets were found to reduce head injuries by 48%, serious head injuries by 60%, and traumatic brain injuries by 53% by a recent meta-analysis study.2 In addition, wearing bicycling helmets has been found to be protective against facial injuries, including facial fractures, as well as reduced hospitalization costs for those involved in a bicycling accident while wearing a bicycle helmet compared to those not wearing a helmet. 2,3,4 

While wearing a bicycle helmet is definitely recommended, it is also important to note that the design of bicycle helmets is continuously improving and that not all bicycle helmets have the same level of protection against head injuries.5 It could be a good idea to get a new bicycle helmet every few years as well as more thoroughly research the safety, design, and customer reviews of different kinds of bicycling helmets before purchasing one.

bike rentals renting for rent Charlottesville Virginia bicycle safety injury prevention

A relatively new bicycle helmet. This helmet is for rent in Charlottesville, Virginia through Jill + Ian’s bicycle rentals. Photo © Jillian Regan 2018

It is important to keep in mind that bicycle helmets do not protect other areas of the body in case of a collision or other bicycling accident. For example, shoulder injuries, some of which can be quite serious, can occur from bicycling accidents and there is not yet any protective gear designed specifically for protecting the shoulders in case of an accident while riding a bicycle.6 This could be a great new market for the entrepreneurial minded looking to design a type of shoulder protective gear or adapt designs from other sports to be used for shoulder protection for bicyclists. For those who simply ride bicycles and are interested in designing gear to protect their shoulders, this can be a reminder to follow other safe practices for riding bicycles, such as following the rules of the road and not riding a bicycle while under the influence of alcohol or other substances, in addition to wearing a helmet and to not ride more recklessly just because a helmet is being worn.

bike rentals renting for rent Charlottesville Virginia Safety injury prevention

Reflective bicycling safety vests with detachable lights can improve the visibility of the bicyclist to motor vehicles as well as to pedestrians. This particular reflective vest is available for rent through Jill + Ian’s Bicycle Rentals. Photo © Jillian Regan 2018

Visibility of the bicyclist on the road or on the trail is also an important safety factor to take into consideration. Using at least one visibility aid, such as a flashing light or reflective clothing while bicycling can reduce the chance of hospitalization from a motor vehicle collision.Wearing light colored clothing on the upper body to improve visibility while bicycling in the daytime, not just at night, is also important in reducing the risk of collision with motor vehicles.

bike rentals renting for rent Charlottesville Virginia bicycle safety bicycle month injury prevention

A red, rechargeable, battery operated tail light that can be attached to a bicycle’s seat post is another way to improve visibility of the bicyclist to motor vehicles, other bicyclists, and pedestrian. This tail light is available for rent in Charlottesville, VA through Jill + Ian’s Bicycle Rentals. Photo © Jillian Regan 2018

Attaching reflective tape to the back of the bicycle frame was founded to greatly increase the visibility of the bicycle at night and is a method highly recommended by the researchers,although may not be a popular idea with bicyclists who are concerned about the appearance of their bicycle and the risk of damaging the bicycle’s paint with reflective tape. Attaching reflective tape to the bicycle pedals was also found to improve bicycle visibility at night, but not as much as attaching the tape to the back of the bicycle frame.8

Another way of improving safety while bicycling can be through bicycling specific safety training specific. In a study of evidence based hazard perception training used with young elementary school aged bicyclists found that after the training, the young bicyclists detected more hazards and reacted more quickly than a control group of young bicyclist who did not receive the training.9 Focusing on safety when learning to ride a bicycle at a young age may help reduce bicycling accidents.

In addition to adolescents, older adults are another population who may be more at risk for bicycling injuries. While bicycling has many health benefits for older adults, such as maintaining balance control and coordination through regular bicycling which can help the risk of falling while walking, it is especially important that older adult bicyclists follow all safety precautions and only bicycle under safe conditions to avoid potentially debilitating injuries.10,11

bike for rent rentals renting Charlottesville Virginia bike month bicycle safety injury prevention

A bicycle headlight on the handlebars of a bicycle. This headlight and bicycle are available for rent through Jill + Ian’s bicycle rentals. Photo © Jillian Regan 2018

Conclusion

Reviewing recent injury prevention research on different aspects of bicycling safety can give insight as how to take these ideas into consideration when celebrating National Bike Month in the month of May in the U.S. and enjoying a safe ride on a bicycle.

What recent bicycling safety research have you heard of that I didn’t include in this article? Share a link to it in the comments below!

Jillian Regan, MPH is a consultant at Rillian. She enjoys helping organizations find new ways or evaluate improve existing community health improvement efforts, so that the organization can better serve its community members, clients, customers, patients, or other stakeholders. Connect with her by email at Jillian.Regan@RillianConsulting.com or Twitter (@JillianReganMPH) or LinkedIn

Follow Rillian on Facebook to get updates on articles like this one or updates about current projects, like a bicycling survey!

This post was created in collaboration with two of Rillian’s affiliated businesses, Jillian Regan Photography and Jill + Ian. Rillian conducted research and development for a bicycle rental service that Jill + Ian now runs. Jillian Regan Photography provides photography and photos for Rillian.

Sources:
1. Regan J. Not yet published preliminary results from recent bicycling survey. 2018.

2. Høye A. Bicycle helmets – To wear or not to wear? A meta-analyses of the effects of bicycle helmets on injuries. Accid Anal Prev. 2018 Apr 17;117:85-97. doi: 10.1016/j.aap.2018.03.026.

3. Fitzpatrick DG, Goh M, Howlett DC, Williams M. Bicycle helmets are protective against facial injuries, including facial fractures: a meta-analysis. Int J Oral Maxillofac Surg. 2018 Apr 2. Pii: S0901-5027(18)30077-8. doi: 10.1016/j.ijom.2018.03.005.

4. Michael PD, Davenport DL, Draus JM Jr. Bicycle Helmets Save More than Heads: Experience from a Pediatric Level I Trauma Hospital. Am Surg. 2017 Sep 1; 83(9): 1007-1011.http://www.ingentaconnect.com/content/sesc/tas/2017/00000083/00000009/ art00039;jsessionid=34vhu1ejf2uao.x-ic-live-01

 

5. Bland ML, Zuby DS, Mueller BC, Rowson S. Differences in the protective capabilities of bicycle helmets in real-world and standard-specified impact scenarios. Traffic Inj Prev. 2018 Feb 28;19(sup1):S158-S163. doi: 10.1080/15389588.2017.1388915.

6. Goldstein Y, Dolkart O, Kaufman E, Amar E, Sharfman ZT, Rath E, Mozes G, Maman E. Bicycle-Related Shoulder Injuries: Etiology and the Need for Protective Gear. Isr Med Assoc J. 2016 Jan;18(1):23-6.

7. Hagel BE, Romanow NT, Morgunov N, Embree T, Couperthwaite AB, Voaklander D, Rowe BH. The relationship between visibility aid use and motor vehicle related injuries among bicyclists presenting to emergency departments. Accid Anal Prev. 2014 Apr; 65:85-96. doi: 10.1016/j.aap.2013.12.014. Epub 2014 Jan 3.

8. Costa M, Bonetti L, Bellelli M, Lantieri C, Vignali V, Simone A. Reflective Tape Applied to Bicycle Frame and Conspicuity Enhancement at Night. Hum Factors. 2017 May; 59(3): 485-500. Doi: 10.1177/0018720816677145. Epub 2016 Dec 6.

9. Zeuwts LHRH, Vansteenkiste P, Deconinck FJA, Cardon G, Lenoir M. Hazard perception training in young bicyclists improves early detection of risk: A cluster-randomized controlled trial. Accid Anal Prev. 2017 Nov;108:112-121. doi: 10.1016/j.aap.2017.08.024. Epub 2017 Sep 1

10. Ikpeze, TC,Glaun, G, McCalla, D ,Elfar, J. Geriatric Cyclists: Assessing Risks, Safety, and Benefits. Geriatr Orthop Surg Rehabil. 2018 Jan 23;9:2151458517748742. doi: 10.1177/2151458517748742. eCollection 2018.

11. Batcir S, Melzer I. Daily Bicycling in Older Adults May Be Effective to Reduce Fall Risks – A Case Control Study. J Aging Phys Act. 2018 Jan 18:1-21. doi: 10.1123/japa.2017-0263

social media management public health accreditation community research

#HDTweets: Ways In Which Twitter Can Be Used by Health Departments

social media management public health accreditation community research

A screenshot of the author’s Twitter profile as shown on a computer screen, taken on 3/27/2018.

Twitter is a social media platform with 330 million active monthly users as of 2017 for sharing posts of up to 280 characters–as of November 2017; prior to November, the character limit was 140 characters–that can also include images, links to articles, and short video clips.

Twitter is useful for health departments because it is low cost. Unlike running an ad in a newspaper or on the radio–there is no cost to share a post (called “Tweeting”), reply or share other users’ posts (called “Retweeting”), or like or otherwise engage with Tweets. The only costs are staff time and resources dedicated to creating the content to post, posting the content, engaging with the Twitter audience, and to post paid advertisements on Twitter.

Health departments can use Twitter as part of their overall communications strategy, participating in or hosting Twitter chats, to research barriers to accessing programs or services or to meet Public Health Accreditation Board (PHAB) standards and measures.

As part of the overall communications strategy

Some health departments (approximately 217 as of 2012)(1) use Twitter as part of their communications strategy. They communicate information with the community, the media, and other partner organizations and stakeholders about public health issues, health education topics, current public health related events like health fairs or an ongoing community health assessment, and other related topics.

When using Twitter as part of a communications strategy often in conjunction with using other forms of social media, it is important to keep in mind adapting the message for the format (240 characters with option to add photos and video clips) and audience using Twitter, which is slightly different than other social media platforms.

Also the time of day when the target audience will be active on Twitter is important to consider since that time of day may not coincide with the hours the person managing the health department’s Twitter account will be at work and posting on the Twitter account.

One way to handle this is by scheduling posts using an online social media manager like Hootsuite or Buffer. Whichever social media management system is used, it should include a way to schedule posts for each type of social media account, including Twitter, and not just one post with the exact same wording pushed to all social media accounts. While social media like Facebook and Instagram can handle long posts, Twitter posts are limited to 240 characters, so these posts need to be short and sweet and leave room for a couple hashtags.

Also, while the posts may be scheduled to be posted at optimal times for when the health department’s target audience is on Twitter, it is still important to have someone engaging with the audience on the platform by liking, responding to comments, and retweeting posts during that time, which may be outside of normal working hours. Some social media management agencies who have some staff with a background in both social media management and public health or a public health focused consulting agency might be able to assist a health department with managing their social media presence including Twitter.

social media management public health accreditation board phab mph research community

A screenshot of a Tweet announcing a community health assessment (CHA) meeting, screenshot taken in 3/2018.

Twitter Chats

Hosting or participating in Twitter chats — scheduled conversations on a certain topic or event– is another way of using Twitter to communicate and engage with an audience on the platform.

For example a recent study found that there was moderate engagement and a measure called return on engagement between the organizers of the Twitter Chat and the chat participants for a Twitter chat #LiveFitNOLA on health and wellness topics in New Orleans, Louisiana.(2)  The Twitter chat is organized and hosted by the Tulane Prevention Research Center (@TulanePRC), a university-based research and education center, and the City of New Orleans Health Department’s Fit NOLA Initiative (@FitNOLA). The authors noted that the level of engagement as two communication between the host organization or organizations depends on a variety of factors including the audience, context, scope, scale, and goal of the Twitter chat. It also depends on what other organized hashtag-based communications the organization or host already has on Twitter.(2)

To Research Barriers to Participating in Programs or Services

Twitter can also be used for researching barriers to participating in programs or services by searching specific hashtags in a local area. For example a recent study examined the barriers to CPR training in Pennsylvania using four years of Twitter data. The barriers were found to be time, duration, and location of the training.(3) A similar method might be able to be used by a health department or a research organization or consulting agency in partnership with the health department to find barriers to attending or participating in the health department’s services and programs.

social media management public health board accreditation community research mph

A screenshot of Franklin County Health Department’s Twitter feed, taken in 3/2018.

To meet Public Health Accreditation Board (PHAB) Standards and Measures

Some health departments were early adopters of using Twitter, starting to use the platform in 2009(1), while others have only begun to use it more recently to use it or are just now considering using it. As more health departments are becoming Public Health Accreditation Board (PHAB) accredited or are in the process of PHAB accreditation or getting reaccredited, they are incorporating social media usage, such as Twitter as well as other social media platforms like Facebook, into their communications strategy to meet PHAB standards and measures in domains, such as Domain 3 (Inform and educate about public health issues and functions).

Depending on how the health department uses Twitter, its Twitter strategy and usage could be used as examples to meet other measures in other domains such as Domain 4 (engage with the community to identify and address health problems). Some health departments have even used Twitter in their community health assessment (CHA) and/or community health improvement (CHIP) process — tweeting links to an online survey as part of the CHA or letting people know about and inviting them to their CHA or CHIP meetings.

social media management public health board accreditation phab mph research community

A screenshot of a Tweet including a link to a CHA survey, screenshot taken in 3/2018.

Sharing information on Twitter can also make it easy for the health department’s partner organizations and other stakeholders who may be involved in the CHA / CHIP or are partners for other health department programs to share their message by simply clicking the button below the post to like and another to “retweet” it.

social media management public health accreditation board accreditation mph research community

A screenshot of tweets about the hashtag #communityhealthassessment, screenshot taken in March 2018.

Tracking engagement & results

As more health departments use or are thinking of starting to use Twitter, it is important to measure and track metrics related to Twitter usage. Tracking metrics and results is a way that the health department can know if the resources they have put into using Twitter are getting the desired results.  

Also, tracking metrics for engagement is important, not just of how many tweets they post or retweet a month, but how many followers they have and how engaged those followers are with the content the post, such as the number of likes, replies, and retweets the Tweets get. Tracking the results, as well as measuring if there’s any difference over time or for tracking a specific health promotion campaign can also provide valuable insights into how the health department can improve their Twitter usage to communicate with their target audience.

Having a dedicated staff role of public information officer

Having a dedicated staff role of public information officer (PIO), either as a separate position or as part of a role of another staff position at the health department is one way to manage social media, including Twitter, usage. Having a PIO role has been found to be associated with a health department having a larger number of Twitter followers who are local, or in other words are part of the local community that the health department is trying to reach.(1)

Having a PIO role is also one of the requirements for PHAB accreditation (PHAB measure 3.3). Although, as noted in the cited study, determining the locality of Twitter users is not very precise, due to many individuals using Twitter not including location information on their Twitter profile pages, whereas most Twitter accounts for businesses and organizations do include location information in their profiles.

Conclusion

Health departments can use Twitter as part of their overall communications strategy to engage with their audience, participating in or hosting Twitter chats, to research barriers to accessing programs or services or to meet Public Health Accreditation Board (PHAB) standards and measures.

Tracking metrics, including engagement, and results of Twitter usage is essential to know if the resources being put into using Twitter to engage with the health department’s audience and communicate information are effective in doing so. Working with a social media agency that has staff with a public health background in addition to social media management skills or a public health focused consulting agency is one way to help create content, manage posts, and/or measure metrics and results from Twitter usage by the health department. Having a PIO role either as a separate position or as part of a role of another staff position has been found to be associated with a health department having a larger number of Twitter followers who are local.(1)

Do you know of a health department who’s active on Twitter? How do they use Twitter, do they post content, or participate in Twitter chats, or use Twitter for researching barriers or do they use it in another way? Share in the comments below!

Jillian Regan, MPH is a consultant at Rillian. She enjoys helping organizations find new ways or evaluate improve existing community health improvement efforts, so that the organization can better serve its community members, clients, customers, patients, or other stakeholders. Connect with her by email at Jillian.Regan@RillianConsulting.com or Twitter (@JillianReganMPH) or LinkedIn

Follow Rillian on Facebook to get updates on articles like this one or updates about current projects, like a bicycling survey!

Sources:

  1. Harris, JK, Choucair, B, Maier, RC, Jolani, N, and Bernhardt, JM. Are Public Health Organizations Tweeting to the Choir? Understanding Local Health Department Twitter Followership. J Med Internet Res. 2014; 16(2): e31. doi:  10.2196/jmir.2972
  2. Rabarison, KM, Croston, MA, Englar, NK, Bish, CL, Flynn, SM, and Johnson, CC. Measuring Audience Engagement for Public Health Twitter Chats: Insights From #LiveFitNOLA. JMIR Public Health Surveill. 2017; 3(2):e34. doi:10.2196/publichealth.7181
  3. McGovern, SK, Blewer, AL, Murray, A, Leary, M, Abella, BS, and Merchant, RM. Characterizing barriers to CPR training attainment using Twitter. Resuscitation. 2018; pii: S0300-9572 (18) 30118-7. doi: 10.1016/j.resuscitation.2018.03.010
public health accreditation board healthy food programs systems health equity

Community Driven Population Health Improvement Efforts with Health Equity & Cultural Competence: Healthy Food Programs in Sitka, Alaska

public health accreditation board healthy food programs systems health equity

Shoppers, vendors, and fresh produce at a Farmer’s Market. Photo © Jillian Regan 2017 courtesy of Jillian Regan Photography, LLC.

Community driven population health improvement efforts that include a health equity lens as well as cultural competence in their programs and initiative work to address population health issues. Through a community driven, collaborative approach, essential stakeholders as well individual citizens provide valuable insight, data, research, ideas for ways to address the population health issues, funding, and gives the stakeholders more of a stake and ownership of the programs and initiative. When  health equity is taken into account, programs and initiatives can be designed to provide additional help those who may be at a higher risk of a certain issue or at more of a disadvantage in some way than others in the same community. Looking at examples of real-world examples of a community driven, health equity focused population health improvement efforts can provide better understanding of and ideas for practical ways to do this in one’s own community.

The Sitka Health Summit’s healthy food programs are a one example to of a community driven population health improvement programs that include a health equity lens.

healthy food programs systems community health public health accreditation board health equity

Eggplants and vendor at table at a farmer’s market. Photo © Jillian Regan 2017. courtesy of Jillian Regan Photography, LLC.

The Sitka Health Summit, is an ongoing, community driven population health improvement annual event that started in 2008 in the small, coastal town of Sitka, Alaska (population 8,863 as of 2015). The Summit was began through a partnership between Sitka’s two hospitals. Local citizens identify and decide on two health initiatives to work on in the next year during the Summit. Each initiative is then funded with a $2,000 grant with the funding for the grant provided by the two hospitals as well as other community organizations. At many of the Summits, health issues relating to lack of access to and consumption of healthy food was recognized as a major challenge.

Factors such as Sitka’s relatively remote location in a cold climate meant that a lot of foods had to be imported in, thus increasing the cost of healthy foods like oranges as well as food overall. For example the average family food cost per week in Sitka is higher than in other communities in Alaska such as Juneau and Anchorage, as well as higher than that of the US average.  As a result, several healthy food programs were developed, beginning with the Sitka Local Foods Network. Several interesting and innovative healthy foods programs have come out of the Sitka Health Summit’s annual initiatives.

The healthy food programs include finding ways to improve access to both healthy, fresh locally -grown foods as well as traditional, healthy Tlingit food because of their focus on food as important for nutrition as well as having cultural importance. The Tlingit are the Alaska native people who have inhabited the Sitka, Alaska area for a long time. The healthy food programs in Sitka include The Sitka Local Foods Network, St. Peter’s Fellowship Farm, Sitka Farmer’s Market, Garden Mentoring Program, Sick-A-Waste Sitka Composting Project, the Sitka Kich, serving local fish in school lunches, Stream to Plate Fish to School Classroom Lessons, and an annual Sitka Seafood Festival.

Sitka Local Foods Network

This is a nonprofit organization whose mission is to increase the amount of locally produced and harvested food in the diets of Southeast Alaskans that began as a result of the first Sitka Health Summit in 2008 as a way to tie two, healthy food initiatives together: creation of a community garden and greenhouse as well as a farmer’s market. It has since then expanded it’s programs to include expanding community and family gardens, providing educational opportunities, technical expertise and encouragement, Promoting the responsible and sustainable use of traditional foods, also called subsistence foods, and conducting a community food needs assessment in 2012.

Throughout their programs, the food network takes into consideration health equity as well as cultural competence. For example, they try to provide assistance so that those in the community who may be at a economic disadvantage can also participate in and purchase healthy, local produce. Also, their promotion of sustainable use of traditional or subsistence foods includes collaborating with the Alaska Native communities to promote foods such as local salmon, halibut, cod, herring eggs, deer, berries, seaweeds and other foods that were traditionally consumed by the Tlingít, Haida and Tsimshian diets before non-Native Alaskans arrived in Sitka.

healthy food programs systems public health accreditation board phab community health population health

Fresh, organic produce at a farmer’s market. Photo © Jillian Regan 2017 courtesy of Jillian Regan Photography, LLC.

St. Peter’s Fellowship Farm

This community farm was created in partnership with the Sitka Local Foods Network and St. Peter’s By-The-Sea Episcopal Church. Community members organized by the Sitka Local Foods Network built raised garden beds on the church’s land. Local contractors provided the soil. Engaging people from all different sectors of the community was an important aspect of the project, involving different groups, like elementary school students who were involved with planting, weeding, harvesting some of the crops. Celebrated. The opening of the farm was celebrated a big community potluck, featuring healthy produce from the gardens.

Sitka Farmer’s Market

This farmer’s market was created and operated by the Sitka Local Foods Network initially as a way to sell off the extra produce from the St. Peter’s Fellowship Farm. Over time it grew to include other local vendors as well as vendors from other parts of the region. One interesting aspect of this program is that it partnered with the Alaska Native Brotherhood and the Alaska Native Sisterhood to use part of their building and parking lot for the farmer’s market. Another is how it was adapted to accept SNAP benefits to help those at a economic disadvantage being able to purchasing healthy foods from the farmers market.

Later on the Farmer’s Market added an additional program, Quest cards, once the program realized that even with SNAP benefits, the healthy produce at the farmer’s market was too expensive. Quest cards are a Sitka initiative to encourage families who qualify for SNAP to buy healthy food from the farmer’s market. The Quest card gives the participants $1 for every dollar spent on purchase of healthy foods at the farmer’s market to encourage and enable them to buy fresh, healthy produce from the farmer’s market instead of buying unhealthy foods from convenience stores.

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An outdoor farmer’s market. Photo © Jillian Regan 2017 courtesy of Jillian Regan Photography, LLC.

Garden Mentoring Program

This program run by the Sitka Local Foods Network provides education, training, and technical assistance to local organizations or citizens who want to grow their own gardens to increase the amount of food grown and harvested locally. This helps provide those without previous experience gardening with valuable resources.

Sick-A-Waste Sitka Composting Project

As a companion project to the Garden Mentoring Program and St. Peter’s Fellowship Farm, this initiative by the Sitka Local Foods Network was to create a community compost with contributions of compostable waste by community members that could be turned into compost used in community and family gardens.

Sitka Kich

A commercial kitchen for community members to use for for processing and canning the food grown, harvested, farmed, or caught locally was created through the Sitka Local Food Network partnering with: the Sitka Conservation Society, the Sitka Health Summit, the First Presbyterian Church, the Sitka Food Co-op, the Sustainable Southeast Partnership and the University of Alaska-Southeast Cooperative Extension.

In addition to offering the use of a commercial kitchen, they hold classes teaching people how to can foods such as salmon and vegetables, with the idea of encouraging individuals in the community to create a cottage food industry of healthy, locally sourced foods.

A commercial kitchen is great for supporting healthy food programs because food safety is an important aspect of healthy food, that is sometimes overlooked when healthy food programs solely focus on nutritional value and healthy diet. Without proper equipment when preparing large batches of food for sale, there is a much higher risk of contamination of the food with pathogens, leading to an increased risk of contracting a foodborne illness for those who consume the food.

Serving local fish in school lunches

Local schools in Sitka now serve locally harvested fish once a week in the school cafeterias along with a coordinating educational program for the elementary school students that came to be as a result of a partnership between the Sitka Conservation Society, local schools, commercial fishermen, local seafood processors, the school food service provider, Sitka Native Education Program (SNEP), the Alaska Department of Fish and Game (ADF&G) and the National Park Service.

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Filets of freshly caught fish at a market. Photo © Jillian Regan 2010 courtesy of Jillian Regan Photography, LLC

A Guide to Serving Local Fish in School Cafeterias

This guide was created to help other schools in similar communities, such as those in Southeast Alaska, adopt similar programs. It provides details on the organizations and process involved with getting local fish to be served in school cafeterias as well as getting the students interested in and excited about eating the  

Stream to Plate Fish to School Classroom Lessons

This document includes lesson plans, worksheets, and picture cards for teaching a program called “Stream to Plate” about the local fishing industry to get young students excited about and interested in learning more about the fish they’re eating in the cafeteria for lunch. The lessons are geared towards 2nd to 5th grade elementary school students.

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Fresh seafood at a market. Photo © Jillian Regan 2010 courtesy of Jillian Regan Photography, LLC

Sitka Seafood Festival

Held every year to celebrate local seafood, this festival includes a contest where people make a fish dish and judges award prizes, such as Alaska Airline tickets. Including locally harvested seafood as well as celebrating the different cultures within the community helps to emphasize the cultural importance of seafood as well as its nutritional, environmental, and economic importance.

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A seafood dish. Photo © Jillian Regan 2011 courtesy of Jillian Regan Photography, LLC

Sharing

In addition to having some very interesting healthy food programs including a focus on health equity, the Sitka Health Summit shares information about their programs in order to inspire and inform other communities looking to start, grow, or improve their healthy food programs. One way they share about their healthy food programs is through Live Stories. LiveStories is an all-in-one data platform makes it easy to analyze local data, get benchmarks, and create interactive stories. The Sitka Health Summit’s Live Story on their healthy food programs includes interactive graphs of data such as the difference between food costs in Sitka compared to the US average, two other cities in Alaska–Juneau  and Anchorage–, and two cities in mainland US — Seattle, WA, and Portland. Check out the Sitka Health Summit LiveStories page to take a look at these data visualizations and narratives.

Another way Sitka’s healthy food programs get shared with others in the public health or community development field is through discussing their healthy food programs in online webinars. Loyd Platson, with Sitka Counseling and who is on the board of the Sitka Health Summit recently told the story of and shared details about Sitka’s healthy food programs on LiveStories webinar on the topic of Healthy Food Access on February 13, 2018.

healthy food programs systems public health accreditation board community health assessment

A customer buying fresh produce from a vendor at a farmer’s market. Photo © Jillian Regan 2017 courtesy of Jillian Regan Photography, LLC.

Conclusion

Partnerships with a multitude of organizations in a collaborative, community driven process, that includes a focus on health equity have created innovative healthy food programs to increase access to healthy foods in Sitka, Alaska. By looking at the example of the Sitka Health Summit’s healthy food programs other communities may be able to use ideas, lessons learned from these programs in Sitka and find ways that will help create or improve on existing healthy food initiatives in their own community in ways that may provide additional resources to those most at risk or at a disadvantage compared to the rest of the community so that more of the community can access and benefit from the healthy food programs.

Are there healthy food programs similar to these in your community?

Share a link below to a website, article, about the healthy food program so everyone reading the comments can check them out!

Jillian Regan, MPH is a consultant at Rillian. She enjoys helping organizations find new ways or evaluate improve existing community health improvement efforts, so that the organization can better serve its community members, clients, customers, patients, or other stakeholders. Connect with her by email at Jillian.Regan@RillianConsulting.com or Twitter (@JillianReganMPH) or LinkedIn.

Follow Rillian on Facebook to get updates on articles like this one or updates about current projects, like a bicycling survey!

 

public health partnerships

Cross Sector Collaborations Addressing Population Health Issues

Cross sector collaborations can be a great way to address population health issues. There are myriad ways and types of cross sector collaborations as well as a variety of types of organizations involved in cross sector collaborations. Here are a few examples of current or recent collaborations.

Examples

Engaging Youth in Building a Culture of Health — Collaboration between the National 4-H Council, the Robert Wood Johnson Foundation, the national Cooperative Extension System, and Local Health Councils

The National 4-H Council is partnering with the Robert Wood Johnson Foundation, the national Cooperative Extension System and local Health Councils in 1,000 different communities in the U.S. with a focus on engaging youth in to promote a culture of health in their communities. (1).

The 4-H organization is a youth development organization that focuses on empowering youth to by providing youth with experiences that help to develop critical life skills. The Robert Wood Johnson Foundation works to improve health and health care, with an emphasis on creating a culture of health.

This new partnership will focus on involving youth in addressing top public health priorities in cross-sector collaborations between the youth and community members, local public health organizations, businesses, government entities, and non-profit agencies. Three main focus areas of this partnership will be designing a network to promote health and wellness in communities, creating and disseminating tools for healthier communities, and launching a training curriculum for local community advocates. The network, tools, and curriculum created from this partnership will be able to be applied to other communities in the U.S. (1)

Opioid Addiction Treatment through Telemedicine in Rural Communities– a Cross-Disciplinary Team

The opioid addiction epidemic is a serious and severe population health issues. Many different organizations are working to address this issue. One way is through cross sector collaboration. An example is a cross disciplinary team of psychiatrists, a nurse practitioner, and a social worker from the University of Maryland School of Medicine and health system working with a non-profit organization to develop and implement opioid telemedicine programs in rural communities as part of Robert Wood Johnson Foundation’s Clinical Scholars program.(2)

Collaborators:

  • Eric Weintraub, MD, director of substance abuse services at University of Maryland School of Medicine (UMSOM)
  • Seth Himelhoch, MD, professor of psychiatry at UMSOM
  • Jewell Benford, LCSW-C, a lead social worker at UMSOM,
  • Marian Currens, director of chemical dependency, University of Maryland Medical System
  • Wells House, a non-profit providing recovery services to community members battling drug and alcohol dependencies in Hagerstown, MD

NACCHO – FDA – Health Departments Collaboration to offer a Mentorship program to improve and standardize Retail Food Regulatory programs

Having robust, standardized retail food protection programs can improve food safety inspections and help to reduce the risk and occurrence of foodborne illness outbreaks in retail food establishments.

The National Association of City and County Health Officials (NACCHO) and the Food and Drug Administration (FDA) connect retail food regulatory programs (RFRP) that are looking to improve and standardize their retail food protection services with mentors from RFRP’s that are already experienced with implementing the FDA’s Retail Food Regulatory Program standards.(3) The FDA’s RFRP standards are a set of 9 standards that focus on the improving the design and management of existing RFRP’s so that they can better provide their services to reduce risk factors that contribute to foodborne illnesses in their jurisdiction. (4)

In addition to facilitating the mentorship experience NACCHO and the FDA provide funding for both the mentee and the mentor RFRP’s. Other assistance is also provided, such as sharing of policies, procedures, tools, and technical assistance to help RFRP’s implement the FDA’s RFRP standards to better be able to improve food safety in their community or jurisdiction.(5)

Conclusion

Learning about different cross sector collaborations has hopefully given you some ideas for how your organization or an organization you work with can collaborate with other organizations in different sectors to address a population health issue.

Organizations collaborating in cross sector collaborations can come from a variety of industries, ranging from the federal government, national non-profits focused on supporting local health officials or creating a culture of health, university hospitals, health departments, and more. Cross sector collaborations can be a great way to address population health issues.

Do you have any examples of cross sector collaborations working to improve community health issues, or have you or your organization been a part of a cross sector collaboration that you would like to share about? Then leave a comment below!

Jillian Regan, MPH is a consultant at Rillian. She enjoys providing technical assistance to organizations, so that the organization can better serve its clients, customers, patients, or other stakeholders. Connect with her by email at Jillian.Regan@RillianConsulting.com or Twitter (@JillianReganMPH) or LinkedIn.

Follow Rillian on Facebook to get updates on articles like this one or updates about current projects, like a bicycling survey!



Sources:

  1. National 4-H Council and the Robert Wood Johnson Foundation Partner to Empower Youth in Creating Healthier Communities. Robert Wood Johnson Foundation. Retrieved 9/14/17 from https://www.rwjf.org/en/library/articles-and-news/2017/09/national-4-h-council-and-rwjf-partner-to-empower-youth-in-creating-healthier-communities.html
  2. Felix, K. New Leaders Use Telehealth—and Teamwork—to Tackle Opioid Use. Robert Wood Johnson Foundation. Retrieved 9/26/17 from https://www.rwjf.org/en/culture-of-health/2017/09/new-leaders-use-telehealth-to-tackle-opioid-use.html
  3. National Associated of City and County Health Officials (NACCHO). NACCHO Mentorship Program. Retrieved 11/5/17 from https://www.naccho.org/programs/environmental-health/hazards/food-safety/mentorship
  4. Food and Drug Administration (FDA). 2015. Voluntary National Retail Food Regulatory Program Standards – Introduction. Retrieved 11/5/17 from https://www.fda.gov/downloads/Food/GuidanceRegulation/RetailFoodProtection/ProgramStandards/UCM372399.pdf
  5. National Associated of City and County Health Officials (NACCHO). Retail Food Program Standards Flyer. Retrieved 11/5/17 from https://www.naccho.org/uploads/downloadable-resources/Retail-Program-Standards-Mentorship-Program-Flyer.pdf