Christina Welter

Policy, Systems, and Environmentally Oriented School-Based Obesity Prevention: Opportunities and Challenges

Public health is increasingly emphasizing policy, systems, and environmental (PSE) change as a key strategy for population-level health promotion and disease prevention. When applied to childhood obesity, this strategy typically involves school systems, since children spend large portions of their days in school and are heavily influenced by this environment. While most school systems have implemented nutrition education and physical activity programs for some time, their understanding and use of PSE approaches to obesity prevention is accelerating based on several large federally funded initiatives. As part of one initiatives evaluation, key informant interviews reveal the specific obesity prevention PSE strategies schools are attempting and the corresponding barriers and facilitators to their implementation. These evaluation findings raise several fundamental issues regarding school-based obesity prevention, including the potential role of school personnel, the influence of grant funding on school health initiatives, and the fit between public health and educational priorities.

Partnering with community institutions to increase access to healthful foods across municipalities.

Background Low-income and minority communities have higher rates of nutrition-related chronic diseases than do high-income and nonminority communities and often have reduced availability to healthful foods. Corner store initiatives have been proposed as a strategy to improve access to healthful foods in these communities, yet few studies evaluating these initiatives have been published. Community Context Suburban Cook County, Illinois, encompasses 125 municipalities with a population of more than 2 million. From 2000 through 2009, the percentage of low-income suburban Cook County residents increased 41%; African-American populations increased 20%, and Hispanic populations increased 44%. A 2012 report found that access to stores selling healthful foods was low in several areas of the county. Methods Beginning in March 2011, the Cook County Department of Public Health recruited community institutions (ie, local governments, nonprofit organizations, faith-based institutions) who recruited corner stores to participate in the initiative. Corner stores were asked to add new, healthful foods (May–June 2011) to become eligible to receive new equipment, marketing materials, and enhanced community outreach (July 2011–February 2012). Outcomes Nine community institutions participated. Of the 53 corner stores approached, 25 (47%) participated in the trial phase, which included offering 6 healthful foods in their stores. Of those, 21 (84%) completed the conversion phase, which included expansion of healthful foods through additional equipment and marketing and promotional activities. Interpretation Community institutions can play a key role in identifying and engaging corner stores across jurisdictions that are willing and able to implement a retail environment initiative to improve access to healthful foods in their communities.

Building Capacity for Collective Action to Address Population Health Improvement Through Communities of Practice: A Distance-Based Education Pilot

Improving population health requires a comprehensive array of interventions across individual, organizational, and community levels. Integrating primary care and public health strategies through partnerships is one type of intervention. Workforce development can facilitate this type of integration; however, models and modalities of workforce training primarily focus on individual skill building and may not build the capacity needed for collective action. A collaborative and strategic learning approach, communities of practice, fosters primary care and public health integration to address population health. A Health Resources and Services Administration–funded multistate regional Public Health Training Center (PHTC), the Great Lakes PHTC, undertook an action learning process to develop and pilot a workforce development initiative to promote ongoing learning toward shared goals. Great Lakes PHTC facilitated 11 discussions throughout the region with a total of 100 participants from primary care and governmental public health communities to better understand perceptions, gaps, barriers, and opportunities for integration and training. Findings indicated that a regional, coordinated model to workforce development provided a process for improved, ongoing learning that uncovered gaps in adapting distance-based approaches that can be addressed in future programming efforts. In addition, the process revealed that addressing population health issues through integrated partnerships requires training beyond content and discipline that incorporates multiple modalities and models.

Model communities: a vital strategy to implementing policy and environmental change for active living and addressing health equity in Suburban Cook County, Illinois.

Active Living Research awarded the sixth annual Translating Research to Policy Award to the Model Communities Initiative of Suburban Cook County, Illinois (SCC). Model Communities is a local strategy designed and implemented to address obesity in SCC. The purpose of the award is to recognize innovative teams or individuals representing research, policy, or advocacy who have had success in catalyzing policy or environmental change of relevance to youth physical activity, sedentary behavior, and obesity prevention. The goal is to celebrate achievements, understand how success occurs, and share these stories so others will be inspired to improve the use of research in policymaking. The commentary that follows describes the work that is recognized by the award. Active Living Research commends the awardees on their successful participation in the policy process, and we recommend their approach as a model to others.

The university of illinois at chicago school of public health doctor of public health program: An innovative approach to doctoral-level practice leadership development

The University of Illinois at Chicago, School of Public Health, Doctor of Public Health degree is designed to build leadership skills and an ability to contribute to the evidence base of practice. The competency-based, distance-format, doctoral-level program for midcareer professionals features an action learning approach in which students apply leadership principles from the virtual classroom to real-world problems at their work sites. Students demonstrate mastery of the competencies and readiness to advance to the dissertation stage through completing a portfolio by using a process of systematic reflection. The practice-oriented dissertation demonstrates the ability to contribute to the evidence base of public health practice in an area of emphasis. Preliminary evaluation data indicate that the program is meeting its intended purposes.

Inclusion Wheel: Tool for Building Capacity and Public Health Leaders to Serve People With Disabilities

Public health leaders need to influence change to serve underserved populations, such as people who have a disability. Action research was conducted with a community of practice (CoP) from Ohio to examine readiness, capacity building, and capacity factors needed for public health partners to more fully include people who have a disability (PWD) in state smoking cessation efforts. Five conditions fostered readiness, capacity building, and capacity among public health partners to include PWD: (1) successful timing of effort, (2) facilitation of discussions, (3) systematic reflection, (4) sufficient support, and (5) personal commitment of participants. Nine factors of readiness, capacity building, and capacity influenced inclusion of PWD: (1) positive perception and quality interactions with partners, (2) contact with organizations, (3) recognition of need to coordinate, (4) engagement in a network, (5) practical collaboration experience, (6) continuing education, (7), critical reflection time, (8) dedicated staff, and (9) knowledge of priority population. Readiness, capacity, and capacity building were interconnected and supported inclusion of PWD in public health efforts. Ohio public health partners used these factors and conditions to achieve the first mandatory disability awareness training for all National Jewish Health Quitline counselors. Future efforts addressing other specific demographic groups that experience health disparities can use these findings.