Making CHLI: Ingredients

Ellen Zavisca

Use of the Community Healthy Living Index

as a Tool for Neighborhood Assessment

and Community Engagement

Overview

Presentation overview

• What is CHLI

• Our experience with CHLI

• Lessons learned

What is CHLI

• Developed by YMCA

• Recommended to Knox County by RWJF/Healthy Kids, Healthy Communities

• A qualitative tool for assessing physical activity and food environments

What is CHLI

• 5 environmental assessment tools

o Afterschool child care site

o Neighborhood

o School

o Work site

o Community at large

CHLI requirements

• Organized leadership

• A multi-disciplinary team

• Community volunteers

Some CHLI questions

Making CHLI: Taste Test

Marsha Spence,

Amber Dalton, Kristen Eppig,

Mona Habibi, Miranda Huston, Zixin Lou, Alviony Pangloli, Pratsani Srikan

The Pilot

Pilot Assessment• Collaboration with:• The University of Tennessee, Knoxville

Department of Nutrition

Public Health Nutrition (PHN) Program

• Knox County Health Department

Healthy Kids, Healthy Communities

Robert Wood Johnson Foundation

• YMCA, Knoxville

Community Healthy Living Index

Purpose of Project• Pilot the Community Healthy Living Index (CHLI)

for feasibility of use for Healthy Kids, Healthy Communities Project

• Perform a Nutrition & Physical Activity Environmental Audit of The University of Tennessee Neighborhood

The Neighborhood

Zip code: 37916

Participants• Participants were recruited by PHN graduate

students via:

– direct contact with peers & community members

– flyers distributed around campus

– emails

Participant Meetings• Purpose:

– Explained CHLI & it’s purpose

– Reviewed consent form & confidentiality

– Assigned sectors & scheduled times to conduct audits

CHLI• PHN students:

– completed the General Information section of CHLI using data from US Census & other Internet & Library Sources

– escorted participants through sectors of the community to complete the Programs, Physical Environment, Promotion, & Policy sections of the CHLI

Results• Neighborhood Design

Results• Environment Related to Physical Activity

Results• Environment Related to Food & Nutrition

Results• Safety

Usability of CHLI

• Most participants reported CHLI was feasible & could help make positive changes in neighborhoods.

• It took most participants between 2-3 hours to complete sector audits.

• Participants need to be familiar with the neighborhood & the CHLI form to increase ease of completion.

2007. 01

Recommendations • Distribute CHLI forms before scheduled audits

• Decide neighborhood perimeters beforehand– Give several maps & markers to each participant– Decide whether or not to access all areas of

neighborhoods (every road; every store/restaurant)

Recommendations• Meet with participants before & after audits• Collect demographic information about

participants• Address concerns & clarify any areas of

confusion prior to completing audits• Take photographs of areas that are strengths or

barriers in the neighborhood

Conclusions• CHLI:

– Successful tool to assess neighborhood nutrition & physical activity environments

– Capable of identifying barriers & strengths in neighborhoods

– May be used to plan programs & make changes in the neighborhood

Making CHLI: Main Course

Ben Epperson

Process, Findings, Thoughts

How CHLI Worked for Us

The Project

• National program of Robert Wood Johnson Foundation• Supporting Community Action to Prevent Childhood Obesity• Goal: Implement active living and healthy eating initiatives to reduce childhood obesity • Funding must be used to build and sustain systems, policies and environmental changes

HKHC

Our Purpose• Address the needs of vulnerable populations

and communities• Identify and engage:

– populations at greatest risk for childhood obesity

– influential community members with experience and commitment to advancing active living and healthy eating

– Broad-based political support• Create something that can be replicated

Our HKHC Partnership• East TN Children’s Hospital

– Childhood Obesity Coalition• Knoxville Regional Transportation Planning

Organization• Knox County Schools Coordinated School Health

Program• Fountain City Connections• Key faculty from UT-Knoxville:

– Center for Public Health– Obesity Research Center– Department of Nutrition

“Target” Neighborhoods• Three neighborhoods in year one,

selected based on:– Prevalence rates of childhood obesity– Socioeconomic, policy, and

environmental factors– Assets and opportunities for success– A mixture of urban, rural and suburban

communities • Lonsdale, Inskip, Mascot

Our Assessments• Key informant interviews• Focus groups• YMCA Activate America

Community Healthy Living Index:– Neighborhood assessment

CHLI• Purpose

– Engage community members in a process of identifying environmental barriers and assets related to active living and healthy eating

– Identify priority issues at the neighborhood level

– Collect data that can ultimately be used to inform policy decisions at the systems level

• Identify and convene community members and stakeholders

• Assign 5 assessment routes within each neighborhood

• Assist students/community members in scheduling assessment

• Be present at assessments• Facilitate discussion, planning and

implementation

HKHC Staff

Community Members• Answer the assessment questions

based on instructions, direct observation and perception

• Participate in discussion, planning and implementation

• Understand the CHLI Neighborhood Assessment tool

• Facilitate use of the tool by neighborhood/community stakeholders

• Accompany stakeholders on the assessment; assure consistent assessment process used; provide clarification, if needed; record responses

• Enter data• Provide report

MPH Student Role

MPH Methodology

• Data Collection– Student designated walking route– 1-2 CHLI tools per audit– Student, HKHC staff, community

member– Additional participant comments

noted– Pics/Video taken by HKHC staff

• Neighborhood Design– 1 well-maintained park and 1 Rec

center

but– Poor walkability– Few sidewalks, trails, greenways– Narrowness, uneven surfaces,

uncovered small utility holes

MPH Report Example

• Safety (concern among community)– Large crime rate, prostitution, and

suspicions of gang activity – Poor lighting throughout neighborhood– High-traffic areas with high-speed

drivers– “City does not pay attention” to area– Substantial efforts to reduce loitering– Neighborhood Watch Association

MPH Report Example

• Physical Activity Environment– Abundant green space…but much unused – Swimming pool (“very popular”), baseball

and soccer fields, tennis courts, and playground

– No basketball court, golf course, facilities open for walkers during off-hours, water or winter sport areas

– No street safety measures to support walking and biking

MPH Report Example

MPH Report Example

• Community Engagement– Social Capitol split between two views

• Familiarity among long term residents

but• Public housing residents and new

immigrants viewed as outsiders• No known community organizations• Boy’s and Girls Club (fee)• After school program (fee)

CHLI Next Steps

• Assessment results as a “Stage of Development”

• From Seeds to an Orchard:– Planting the Seeds– Nurturing for Growth– Nourishing the Roots– Cultivating Healthy Fruit– Harvesting the Rewards

HKHC Next Steps

• Sociometrics

• Key Informants

• Group Visioning

• Prioritization

• MPC audit

• Community Action Teams

• Trainings

Thoughts

• Strengths:– “Ground Truthing” tool– Engages community– Neighborhood crash course– Full assessment strengthens communication

• Weaknesses:– Lacks specificity– No community development model