Building Effective Partnerships

between Pediatrics and Public Health: Lessons Learned from the Practical Playbook &

the American Academy of Pediatrics

July 27, 2016

@PracPlaybook

Tia Simmons, DrPH, MCHES,

Senior Project Manager,

The Practical Playbook

Courtney Bartlett, MPH, CPH,

CHES, Project Planner,

The Practical Playbook

Objectives:

Describe tools and resources for AAP members to assist in finding and partnering with public health professionals.

Share tangible examples of primary care/public health partnerships.

Discuss challenges/barriers, and tips for successful partnering.

Jacqueline Dougé, MD, MPH,

FAAP, Medical Director of Bureau

of Child Health, Howard County

Health Department

Amanda D. Castel, MD, MPH,

AAHIVS, Associate Professor and

Co-Director MSPHMEID Program,

George Washington University

AAP Prevention and Public Health Special Interest Group

• The SIG hosts a quarterly webinar series focused on children’s public health issues, and opportunities for collaboration between pediatricians and public health

professionals.

SIG Co-Chairs:Jacqueline Dougé MD, MPH, FAAP

Amanda Castel MD, MPH, FAAP

The Prevention and Public Health SIG:• Promotes public health approaches to child health• Promotes collaborations between pediatricians and public

health professionals• Provides a network for pediatricians to develop strategies

that integrate clinical medicine and public health• The SIG is jointly managed by the AAP Section on

Epidemiology, Public Health, and Evidence and the AAP Council on Community Pediatrics.

• Contact: cocp@aap.org to join the SIG.

How Can The Practical Playbook Help?

Get started with Fundamentals.

Turn Knowledge into Action.

Read Expert Perspectives.

Learn from Others.

Phyllis Agran, MD, MPH,

FAAP, Executive/Medical

Director, Clinic in the Park

Health Collaborative of Pediatricians, Community, Academic,

Public and Private Organizations &Individuals providing

Health and Wellness Services

This project is supported, in part, by Grant # H17MC26778 from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal

and Child Health Bureau.501(c)3 nonprofit fiscal

sponsor

Connect • Screen • Educate

Using Public Space for Health at the OC Great Park & Neighborhoods

Faculty Disclosure Information

In the past 12 months, we have no relevant financial relationships with the manufacturer(s) of any commercial product(s) and/or

provider(s) of commercial services discussed in this CME activity.

We do not intend to discuss an unapproved/investigative use of a commercial product/device in my presentation.

Phyllis Agran, MD, MPH

Sandra Murray, MD

Herlinda Guzman, BA

John Billimek, PhD.

Clinic in the Park 2015

www.clinicinthepark.org

16

American Academy of Pediatrics Resources

This project is supported, in part, by Grant # H17MC26778 from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal

and Child Health Bureau.501(c)3 nonprofit fiscal

sponsor

Poverty in Orange

County

A Tale of Two Cities(PBS Documentary)

1/5 live in poverty

(>30% in some areas)

1/3 overweight/obese

1/3 untreated dental disease.

(>30% in some areas)

54% Food Insecurity; up to 98%

School Lunch Program

Poor Health Translates to Poor

Academic Performance

2016-2019 Goals

•Access to health services in community public venues (parks; schools; resource centers)

This project is supported, in part, by Grant # H17MC26778 from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau.

Connect • Screen • Educate

•Venue(s) where health

organizations, public,

private and academic

institutions/organizations

and individuals collaborate

to provide services in

neighborhoods.

○One Stop Shop

○Greater impact - refer

and cross refer

○Replicate model

•Sustainable community

resource in underserved

communities

•Demonstrate economic

benefit

A Fiscally

Sponsored Project

of OneOC*

Establishing Sustainable Partnerships

•Children’s Health -Needs

•Aligned Mission(s)

-Optimal Health

•Leadership

-Credible, uniform messages

-AAP

•Diverse Collaborative

-Community non-profits

-Academic institutions

-Families

-Public Policy Makers

-Public and Private orgs

•Policies and Procedures

-Goals

-LOI

-MOU

•Sustainability

-Diverse Revenues

-Leverage

•Data Sharing

-Provide Results

•Evaluate

-Remodel; Reassess; QI

-Engage Partners

Clinic in the Park 2012

www.clinicinthepark.org

• American Academy of Pediatrics*• Allergy & Asthma Associates of Southern CA• Be Aware Foundation• Blind Children’s Learning Center• California Highway Patrol• Cal Optima (County Medicaid)• Catholic Charities of Orange County • Child Abuse Prevention Center*• Children & Families Commission of OC• CHOC: Children’s Community Education Dept.• City of Irvine & Great Park Corp. • Coalition of OC Community Health Centers• Community Health Initiative of OC• Dietitian, Katherine Bennett• Great Park Farm and Farmer’s Market• Head Start • Healthy Smiles for Kids of OC*• Hurtt Family Health Center (FQHC)• Irvine High School• Irvine Parks and Rec: Mobile Rec Unit• Irvine Police Department• Latino Health Access*• Legal Aid Society of OC*• MOMS (Maternal Outreach & Management

Services) OC*• National Ovarian Cancer Coalition

• OC Dept. of Education: Center for Healthy Kids & Schools

• OC Social Services• OC Health Care Agency Family Health & Health

Promotion Divisions*• OC Children’s Therapeutic Arts Center• Orangewood Foundation, Bridges for Newborns• Providence Speech & Hearing• Raise Foundation*• Regional Center OC• Safe Kids OC• THINK Together, Early Literacy*• Tustin Unified School District

Beswick & Veeh Elementary SchoolsCurrie-Thorman School

• UC Irvine: Health, School of Medicine, Trauma and Injury Prevention Services, Nursing Program*, Institute for Clinical & Translational Science, Population Health/Public Health, Burn Center, Pediatric Exercise Research Center, Pediatrics,

• Emergency Medicine, Informatics• Student Organizations. • Woodbridge High School• 2110C• Craig Anderson, PhD. DrPH*• Elaine King, MD* Farrouk Shadab, MD*• Sandra Murray, MD* Shahram Lotfipour, MD*• Zhijun Wang, MD*• Phyllis Agran, MD, MPH*

* Founding Faculty

Clinic Collaborators

Clinic in the Park Total Key Services 6/2012-5/2015at Great Park Hub and SatellitesEstimated Total Visitors: 19,000

Types of Services Provided Year 1 Year 2 Year 3 Total

Jun 2012-May 2015 Jun 2012 - May 2013 Jun 2013 - May 2014 Jun 2014 - May 2015 Jun 2012 - May 2015

(#Visitors = 5,481) (#Visitors = 9,164)(#Visitors = 3,603+290)

Allergy and Asthma 400 277 N/A 4219

Child Development 438 820 627 2285

Child/Adolescent Safety 1902 2171 1317 2972

Connections to Services 2204 1022 1226 4307

Dental Services 467 1491 466 1152

Early Literacy 1493 1599 1215 1883

Emotional Health 717 1152 988 689

First Aid / CPR N/A 389 399 3366

Health Chats 612 246 294 2493

Hearing and Speech 225 305 133 1117

Legal Information/Resources 488 412 217 5446

Medical Services 119 455 115 663

Nutrition 981 1129 1449 677

Parenting Skills 978 837 678 2802

Physical Activity 848 767 861 731

Prevention 638 1891 1036 2392

Total Services to Date 12510 14963 11021 37194

HealthyTomorrows.Thisprojectissupported,inpart,byGrant#H17MC26778fromtheU.S.DepartmentofHealthandHumanServices,HealthResourcesandServicesAdministration,MaternalandChildHealthBureau.*OneOCisa501(c)(3)nonprofit

organization

AFiscallySponsored

ProjectofOneOC*

COMMUNITYNEEDSASSESSMENT

(FULLRESULTSAVAILABLE)

Community

AnnualIncome<$23,000

68%

Jobless 30%

ServiceNeedsBicycleHelmet37%HealthyEatingTools27%ChildCarSeats20%

HealthCare

Dentist37%

Doctor31%MedicalHome27%HealthInsurance25%

IMPACT:

ATOTALOF492VISITORSOFALLAGESRECEIVED3,264DISCRETESERVICESAND200POUNDSOFFREE,FRESHPRODUCE.

· OFADULTSWHOWERESCREENED,2IMMEDIATELY

REFERREDTOTHECOMMUNITYCLINIC

· REQUESTSFORMOREBOOSTERSEATSANDBICYCLE

HELMETS

· 55CHILDRENRECEIVEDFREEORALSCREENINGINCLUDINGFLUORIDEVARNISH

COMMENTSANDOBSERVATIONS:“ITISAMUCHNEEDEDSERVICE…WITHOUTTHECLINIC

[APARENT]WOULDN’THAVEKNOWNSHEHADA

HEALTHISSUE”

–LISASOLOMON,PRINCIPAL,MADISONELEMENTARY

KEYOUTCOMES

(FULLREPORTAVAILABLE)

COSTSAVINGS:

· $15/BOOSTERSEATSAVES$2700INCOSTSAVINGS

· $1/FLUORIDETREATMENTSAVES$38INDENTALCOSTS

· $1INVESTEDINNUTRITIONEDUCATIONREDUCESHEALTHCARECOSTSBY$10

Services

Child/AdolescentSafetyEducation

235

FreeBicycleHelmetsFreeBoosterSeats

1915

EarlyLiteracy:FreeBooks

250

DentalServices:

Education/ReferralsFluoridetreatment

15055

HandsOnlyCPRSkills 178

EmotionalHealth 179

MedicalServices 106

NutritionEducation 580

ClinicintheParkatMadisonMarch26,2016

Impact

LEADPARTNERS/HOSTS:•ClinicinthePark•MadisonParkNeighborhoodAssociation•GREENProject•MadisonElementarySchoolCOMMUNITYPARTNERS:14ORGANIZATIONS,168IN-KINDHOURS

I haven’t had an

exam in 3 years

because I do not

have health

insurance and

now I will get

medical care.

My son and I learn

new things each

month, especially

today when Dr.

Malger spoke at the

health chat and your

dietitian were there to

speak directly with

my son. Sometimes

kids have to hear it

from someone other

than a parent.

Healthy

Smiles

found a

cavity in my

daughter’s

mouth. My children

were given

booster seats. I

didn’t know

they outgrew

their car seats!

It was great

meeting

Bobby Grich

and hearing

him talk

about

health.

We love

the

Adventure

Farm Tour

and fresh

produce.

(Tom

Larson

hosts the

Tour)

The Clinic is

very friendly.

They talk to

you, give

useful

information

and help us.

They are very

patient and

answer all of

our questions.

They are not

rushed like a

doctor’s office.

Our kids like

the activities

and like to talk

to the doctors

too. We like

the fruit!

Visitor Comments

Volunteer Opportunities● Visit a Clinic

● Marketing/Branding

○ Refresh Marketing Video (www.clinicinthepark.org)

○ Increase Social Media Presence/Followers

○ Need Mobile Unit (SUV, Mini Van for storage and transport to

satellites

● Assist with Child Safety Station

○ Booster Seats, Bicycle Helmets, Kids in Hot Cars

○ Burn, Poison, Drowning Prevention

● Assist with Sponsor Donations

○ Fresh Produce

○ Book Bags & School Supplies

○ General Funding

● Volunteer

○ Assist with Clinic setup and teardown

○ E-mail clinicinthepark@gmail.com

○ Bring your ideas

Benefits of Clinic in Park

• Provide evidence-based AAP messages

• Time for chats

• Provide education to extended family

• Educational tools

• Safety Equipment

• Venue for Collaborators

• One-Stop Shop

• Promotes cross-referrals

• Replicable ModelClinic in the Park 2015

www.clinicinthepark.org

Safe to Sleep StationPresented at American Academy of

Pediatrics 2015

.

Research Agenda

•Can public space for health enhance access to community resources and education?

•What is the impact of a large community health collaborative providing one stop shop for health?

•Can health education be effective outside of the traditional medical home/office visit?

•Is the Clinic model replicable and sustainable?

This project is supported, in part, by Grant # H17MC26778 from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau.

Clinic in the Park 2016

Accomplishments

This project is supported, in part, by Grant # H17MC26778 from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau.

Clinic SatellitesAnaheim; Santa Ana; Tustin; Costa Mesa

New CollaboratorsMadison Park Neighborhood Assoc. Newport Mesa USD & Hoag Center for Community Health; Collaboration to Assist Motel Families; UCI/CHOC Pediatric Residents

• Transportation Program. Veeh; Project Access

• Presentations. AAP, Safe Kids, UCI

• New Funders

• HRSA Region IX Director: Melissa Stafford Jones hosted a health chat

Clinic in the Park –2016 CDPH Innovation Award Finalist

This project is supported, in part, by Grant # H17MC26778 from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau.

THANK YOU

www.clinicinthepark.org (949) 385-3067)pagran@uci.edu

Roderick K. King MD, MPH

Chief Executive Officer,

Florida Institute for Health

Innovation

Working Collaboratively for Results

Liberty City Collaborative for Change:

Build Health Challenge

Roderick King, MD, MPH, Florida Institute for Health Innovation

Overview

Participants will learn about:

• Liberty City Collaborative for Change: Build Health Challenge

• Best practices for mobilizing leaders

• Role and leadership of pediatricians

The Florida Institute for Health Innovation

38

Health In All Policies

Collective Impact for Healthy Communities

Research Evaluation and Training

(Health Impact Assessment Work)

Liberty City Collaborative for

Change: Build Health Challenge

Miami, Florida

Building a Healthy

and Resilient

Liberty City

Result: A Safe and Healthy Liberty City

40

Story of Liberty City• 1933 Liberty Square Housing Project

developed in response to deteriorating

housing conditions in Overtown

• “The Wall” along 12th avenue signified the

divide between Blacks and White

communities

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

45.00%

33127 33142 33147 33150 Miami-DadeCounty

Percentage of Families Below Poverty in Liberty City Zip

Codes (2015)

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

45.00%

50.00%

33127 33142 33147 33150 Miami-DadeCounty

Percentage of Homeowners in Liberty City Zip Codes (2009-

2013)

What does it take for population

health level changes?

“Real” adaptive work for communities

Rooted in a Theory of Change

45

Collaborative Leadership

Competencies

Urgency and

Public

Accountability

Focus on Results

Population level changes are most likely to occur if a group of

leaders come together across sectors and agencies and focus their

efforts on achieving a desired result

Results Based Leadership Framework

Results Based

Accountability

Interest Based-

Negotiation

Action Commitments and

Accountability

Jolie Bain

Pillsbury

Key: Leadership Capacity

Building

Engagement• Diversity of stakeholders

• Inclusiveness – everyone at table has a voice

• Looked within community for residents and community partners first

• Known and respected leadership from LC agencies / organizations

Medical Professionals, Criminal Justice & Law enforcement, Youth and family program providers,

School system, government agencies

• Meeting location is central and neutral

Carrot – all involved have a vested interest in Liberty City

Role of pediatricians

• Challenges facing communities often require a life course approach

• Pediatricians work and see children along the life spectrum (cradle to college)- 14 WCC visit by 4 years old

– Unique opportunity to educate, identify and intervene/refer (1 on1)

– Child health population expert

– Credible voice (for community, for funders and for other health care providers

• Challenge: Which role(s) best fit my skills and capacity that will support the work of the community?

48

Q&A

Please post questions in the chat box.

Dr. King

Chief Executive Officer

Florida Institute for Health Innovation

Dr. Agran

Executive/Medical Director

Clinic in the Park

Thank you!

Practical Playbook:

• Tia Simmons tia.simmons@duke.edu

• Courtney Bartlett Courtney.Bartlett@duke.edu

American Academy of Pediatrics:

• Jackie Dougé jdouge@howardcountymd.gov

• Amanda Castel acastel@email.gwu.edu

Clinic in the Park: http://www.clinicinthepark.org/

BUILD Health Challenge: http://buildhealthchallenge.org/

https://practicalplaybook.org/

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