Improving Community Access to Nutrition and Physical Activity: On the Web and in the Garden

Improving Community Access to

Nutrition and Physical Activity: On the Web and in the Garden

On the Web:

Carrie Bergstralh, Rochester Healthy Community Partnership, Minnesota, U.S.

In the Garden:

Nadine Braunstein, Towson University, Maryland, U.S.

Development of an Interactive Web- Based Physical Activity and Nutrition

Asset Map to Reduce Health Access Barriers for Refugees and Immigrants

Carrie Bergstralh

Rochester Healthy Community Partnership, Rochester, MN, U.S.

Objectives

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Rochester Healthy Community Partnership (RHCP) Mission

Promote health and well-being among the Rochester population through:

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to achieve health for all.

Community-Based

Participatory Research (CBPR)

• A collaborative process of research.

-Engages community members.

-Employs local knowledge to understand health problems and design interventions.

-Invests community members in the processes and products of research.

• Goal: Reduce health disparities.

~Agency for Healthcare Research & Quality

RHCP CBPR Principles

Social Action Outcome

Long-term Sustainability

Joint

Ownership Varied Methods

Process Oriented

Equitable

Capacity Building Community

initiation, relevance

Asset-based Iterative

Rochester Healthy Community Partnership Beginnings

• Started in 2004 between Hawthorne Education Center and Mayo Clinic

• Initial health concern/research topic:

Tuberculosis at Hawthorne

• Hawthorne Education Center

-Rochester Adult and Family Literacy

-2,000 adult learners from Sub-Saharan Africa, Latin America, Southeast Asia and Southeast Minnesota -70 different languages spoken at home

-85% live below federal poverty level

RHCP Today

• Mayo Clinic

• University of Minnesota Rochester

• Winona State University Rochester

• Olmsted Medical Center

• Rochester Community and Technical College

Academic

• Hawthorne Education Center

• Church of St. John

• Somali Community Resettlement Services

• Association of Chicanos, Hispanics and Latin Americans

• Cambodian Association of Rochester Minnesota

• Cambodian Buddhist Temple

• Multicultural Learning Center

• New Sudan American Hope

• Boys and Girls Club of Rochester

• Rochester Area YMCA

• Olmsted County Public Health Services

• Vision Church

Community

RHCP Programs and activities

Building capacity for community-based qualitative research infrastructure.

•Let’s Talk about TB

Tuberculosis at Hawthorne Education Center

•Let’s Talk

Community-based Health Literacy Initiative

•Club Fit

A formative study of wellness programming at Boys & Girls Club of Rochester

•Diabetes Storytelling

Improving Diabetes Care among immigrants and refugees

•Healthy Immigrant Families (HIF)

Working Together to Move More and to Eat Well

HIF Beginnings:

Women’s Fitness Program

• Community-informed fitness pilot for immigrant and refugee women.

-6 week program with twice weekly classes.

-60 minutes exercise.

-30 minutes nutrition education.

• Evaluated with 34 women.

-Improved health behaviors, attitudes, and biometrics.

• Obtained preliminary data for NIH grant application to improve physical activity and dietary quality among immigrant and

refugee families.

Wieland, ML., et al. Women's Health Issues , 2012, 22(2):225-32.

Funding: Mayo Clinic Center for Translational Science Activities (CTSA)

What do you think is the greatest barrier to accessing physical activities in your

community? (Choose 1) 1.

environments

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5.

6.

7.

Healthy Immigrant Families Beginnings

Health Access Barriers Identified through the Women’s Fitness Program:

1. Childcare 2. Cost

3. Socio-cultural sensitivity 4. Transportation

Healthy Immigrant Families

Working together to move more and to eat well

Healthy Immigrant Families

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1: Develop a physical activity and nutrition intervention

2: Evaluate intervention efficacy

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Somali, Hispanic, Cambodian, Sudanese

Healthy Immigrant Families

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1º: Community-based, individualized, family-focused behavior-change intervention.

-Informed by evidence-based resources and focus group results

-Delivered by Family Health Promoters 2º: Group fitness opportunities

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1º: Physical activity; Dietary quality

2º: Weight, body composition, blood pressure, waist- hip ratio, survey questions

Healthy Immigrant Families Workgroups

Asset-Based Community Development

Group Fitness

Graduate Nursing Family

Health Promoter

Qualitative Analysis

Family Intervention Communication

Why Asset Mapping?

Encourage use of existing community nutrition and physical activity resource assets by

increasing awareness, working with families to find solutions to barriers, and increasing

participant self-efficacy through “family learning sessions”

Interactive Web-Based Asset Map

Family Intervention

Asset-Based Community Development

Graduate Nursing Family

Health Promoter

Qualitative Analysis

Group Fitness Communication

Development of an interactive web-based community asset map featuring existing physical activity and nutrition resources in

Rochester, Minnesota

Development of an interactive web-based community asset map featuring existing physical activity and nutrition resources in

Rochester, Minnesota

Attributes

•Easily accessible

•Family friendly

•Ability to filter results based on personal preferences

Attributes

•Easily accessible

•Family friendly

•Ability to filter results based on personal preferences

Which of the following do you think are most important to your communities when

choosing physical activity opportunities?

(Rank your top 3)

1. Women only or Men only

2. Family oriented

3. Group oriented

4. Indoor

5. Outdoor

6. Cost

7. Childcare availability

8. Proximity to home

9. Type of physical activity

10. Other

Interactive Web-Based Asset Map

Community Assets

Individual Community and Research Volunteers

Met in a weekly workgroup to discuss, plan the features and capabilities, and develop the asset map

Existing Physical Assets

Worked together to identify existing physical activity and nutrition resources

Institutional and Individual Consultations

Utilized both formal and informal networks to determine individuals who could assist with technical aspects of the project (i.e. data survey collection

instruments for sustainability and software development)

Community Feedback

Asset map layout presented to the larger community via a “Project Summit,”

where community leaders and members provided feedback and recommendations to ensure cultural and social acceptability

Asset Map Components

Physical Activity

•Socio-cultural: Women Only, Men Only, Co-Ed

•Family friendly: Adults, Teens, Adolescents, Youth, Family Oriented, Group

•Weather: Indoor, Outdoor

•Seasonal: Winter, Spring, Summer, Fall

•Cost: Fees (if any), Memberships, Scholarships

•Childcare Availability and Cost

•Search by Activities Nutrition

•Socio-cultural: Ethnic Groceries with Fresh Produce

•Cost: Farmers Market

Food Shelves/Food Pantries Community Gardens

Accepts EBT or WIC

•Dietetic services available

Healthy Immigrant Families Beginnings

Health Access Barriers Identified:

1. Childcare 2. Cost

3. Socio-cultural sensitivity 4. Transportation

Asset Map Components

Community assets addressing childcare, cost, and cultural sensitivity.

Insert screen shot of category options

This is a store with fresh produce:

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Asset Map Components

Community nutrition assets addressing cost and cultural acceptance.

Insert screen shot of category options– nutrition

Exhibit categories selected, and show screen shots

Healthy Immigrant Families Beginnings

Health Access Barriers Identified:

1. Childcare 2. Cost

3. Community

4. Transportation

Asset Map Components

Addressing transportation barriers– bus routes, bike routes, and walking friendly routes to come.

Insert screen shot of category options

Asset Mapping Sustainability

By using an asset-based approach, and

connecting participants to existing community resources, we hope to foster sustainable barrier reduction to health access beyond the end of the study and for the community at large.

Questions?

Thank You!

RHCP would like to honor all the

volunteers and individual members who have dedicated time to the asset map.

Healthy Immigrant Families Spring Summit