John D. Disher, MSIndiana University Health East Central Region Community Outreach ManagerIU Health Ball Memorial Hospital Foundation

https://connect.iu.edu/ph-insights-innovation/

Action Area 2: Fostering a Cross-Sector Collaboration to Improve Well-BeingPart I of II

Learning Objectives

IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH

Participants will be able to 1) identify quality partnerships and 2) invest in cross-sector collaboration.

Part I of a II Part session

Learning ObjectivesAt the conclusion of this program, participants should be able to: • Identify quality partnerships• Invest in cross-sector collaboration

Accreditation StatementIndiana University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation Statement Indiana University School of Medicine designates this live activity for a maximum of 1.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Faculty Disclosure StatementIn accordance with the Accreditation Council for Continuing Medical Education (ACCME) Standards for Commercial Support, educational programssponsored by Indiana University School of Medicine (IUSM) must demonstrate balance, independence, objectivity, and scientific rigor. All faculty, authors,editors, and planning committee members participating in an IUSM-sponsored activity are required to disclose any relevant financial interest or otherrelationship with the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial services that are discussed in an educational activity.

CME Learner Information

Disclosure SummaryThe following planning committee and those in a position to control the content of this activity have disclosed no relevant financial relationships:

JoBeth McCarthy-Jean, MPHJoan Duwve, MD, MPH

Carol Kacius, PhDJohn D. Disher, MS

CME credit will be awarded and certificates emailed within 3 weeks. The course evaluation will be sent immediately following theactivity. For questions and concerns, please contact IU School of Medicine, Division of Continuing Medical Education at 317-274-

0104 or cme@iu.edu

Please note: CME credit will not be awarded for viewing the recording of this live activity.

CME Learner Information - Continued

CEU Information

The Indiana Society of Public Health Educators (InSOPHE) has approved this session for 1.0 CEUs. If you are a member of InSOPHE and wish to receive credit for this webinar, please email Tiffany King at president.elect@insophe.org to receive the CEU evaluation.

CEUs can only be issued from the live webinar.

IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH

Building a Cultureof Health in Indiana

Action Area 2: Fostering Cross-Sector Collaboration to Improve Well-Being (Part I of II)

Framework and Action Area 1: https://connect.iu.edu/p94lf4bfyq3/?launcher=false&fcsContent=true&pbMode=normal

Action Area2

Fostering Cross-Sector Collaboration

to Improve Well-Being

Number and Quality of

Partnerships

Investment in Cross-Sector

Collaboration

IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH

Number and Quality of PartnershipsQuality cross-sector collaboration increases adoption of equitable policies and practices to support health.Indicators:Backbone organization (Turner, et al, 2012) – LHDs are ideal.Shared goalsStrong community relationshipsShared accountability thru metrics

Image source: www.momscleanairforce.org

IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH

Factors Influencing Partnership Development and Quality

Level Factors• Individual leadership styles

• Organizational reputation, history of collaboration• Resource quality and need from each

organization• Trust in organization role• Shared accountability• Policies that evaluate/require specific

collaboration quality

Individual

Organizational/community

Decision environment/policies

IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH

Investment in Cross-Sector Collaboration

Community investments (both directand indirect) should be tracked to reflect the quality of collaboration, resource alignment with shared goals, and value.

By tracking investments with health outcomes, additional resources can be leveraged.

Quality Collaboration

IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH

Factors Influencing Investment in Cross Sector CollaborationLevel Factors

• Expectation that sectors are contributing to health

• Sector contribution level and type, as well as link to health

• Sector interests and prioritization of health outcomes (for employees, constituents, and community members)

• Incentives or rewards for sector investment in health

• Policies that outline sector investment strategies

Individual

Organizational/community

Decision environment/policies

Cross-Sector Collaboration:Building a Collective Impact Model Health Coalition in Delaware and Blackford Counties

IU Health Ball Memorial Hospital• Muncie and Delaware County, IN. • Also serves 6 surrounding counties.• More than 18,000 inpatient admissions and

330,000 outpatient visits annually.• 384 beds• 2,600 team members• 45 medical specialties- cancer, cardiology,

orthopedics.• IU Health Ball Memorial Hospital has been

recognized as a Platinum-Level Fit-Friendly Worksite by the American Heart Association.

• Operates IU Health Blackford Hospital in Hartford City (15 bed Critical Access Hospital)

IU Health Ball Community Outreach• Part of IU Health Ball Memorial Hospital Foundation• Community Benefit Tracking• Community Health Needs Assessment• Development and implementation of strategies to address identified health

needs• Connect hospital experts to community

• Health improvement projects• Speakers Bureau• Community service projects

Delaware and Blackford Counties

Blackford CountyHartford City, IN

Pop. 12,400

Delaware County, Muncie, IN Pop. 117,000Home of Ball State University

Delaware County is a Health Program and Asset-Rich Area• 62 Mile Paved Cardinal Greenway (rail to trail project)• Large number of parks, outdoor rec areas• Muncie is a Bronze Bicycle Friendly Community - League of American Bicyclists

• 4 YMCA facilities• University immersion programming, nationally recognized Fisher

Institute for Wellness• Multitudes of programming related to diet, exercise, tobacco use

offered by community organizations. • Multiple health and wellness organizations, committees and coalitions• Engaged media partners• Farmers Markets• 5K run/walk opportunities throughout the year

Health Status• Delaware County (DE) is ranked 87th and Blackford

(BL) 64th out of 92 Indiana counties for overall health outcomes. –RWJ County Health Rankings

• Adult smoking rates are 22.6% (DE) and 20.3% (BL)*• Adult obesity rates are 31.7% (DE) and 35.5% (BL)**• Preschool obesity 14.4% (DE) and 13.7% (BL)***• Physical inactivity 31.3% (DE) and 31% (BL)**• Diabetes rates 12.8% (DE) and 13.3% (BL)***County Health Rankings**Centers for Disease Control and Prevention*** U.S. Department of Agriculture - Food Environment Atlas

Collaboration Background• 2011-2012 Community Health Needs Assessment process.• IUHBMH Foundation Community Outreach Committee

formed to prioritize needs and develop strategies to address:• Obesity Prevention• Access to Care• Behavioral Health• Infant Health Factors• Smoking/Tobacco

• Outreach Committee composition was health and wellness oriented

Community Outreach Committee 2013-2014

Gov’t, Economic, EducationHealth and Wellness

• IU Health Ball & Blackford (hospitals)

• YMCA• Open Door Health (FQHC)

• Blackford Co. Health Dept.• Delaware Co. Health Dept.• Minority Health Coalition• Family Physician • Retired Pathologist

• Retired Banker• Retired Schoolteacher

Local collaborations• 2013-2015 Developed and

supported initiatives to address needs identified in CHNA

Collaboration Background• 2014- “Can we do more?”

• Broader reach• Align efforts to leverage other community programs and assets• Change the culture

• 2014- Committee studied collective impact coalition Top 10 by 2025 in Indianapolis.

Top 10• Mission: “To be a catalyst for individual, policy, system and environmental

change by aligning stakeholder’s individual strengths into a collective power for improved community health.”

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23

Top 10• Collective Impact Model – common agenda, shared measurement, continuous

communication, mutually reinforcing activities among participants.

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24

Article: John Kania and Mark Kramer, Stanford Review

Key Attributes –Top 10 Coalition• Common Vision• Common Goals• Common Measurement• “If we (coalition partners) are all saying 60 minutes of

physical activity every day, then that’s what the community will hear.” –Ann Graves

• Speak as a common voice for policy change• Celebrate success when it occurs

Committee Consensus 2014• The time is right to form a new collective impact model health coalition in our

area.

Coalition Model• Scope-Delaware and Blackford Counties

• 3 Priority Areas with impact on chronic disease states• Increased physical activity• Improved nutrition• Reduced tobacco use

• Basic Components• Steering Committee• Broader Coalition Membership• Work groups around 3 priority areas plus

communication/measurement• Backbone Organization (IU Health Ball Memorial Hospital)• Technology platform for communication and data measurement

IU Health Ball Memorial Hospital• Backbone organization for Community Health Coalition

• Financial Support • Coordination, Facilitation and Communication Support

• Emphasis on ‘community initiative’ to facilitate community buy-in, ownership and accountability

• Strategy- Curve 2 positioning• Chronic Disease Trends Rising

• Lack of exercise or physical activity • Poor nutrition• Tobacco use

Formation of Steering Committee• Individuals in key community roles, insight into issues• Organizations with resources, broad audiences, policy influence

Community Outreach Committee 2013-2014

Gov’t, Economic, EducationHealth and Wellness

• IU Health Ball & Blackford (hospitals)

• YMCA• Open Door Health (FQHC)

• Blackford Co. Health Dept.• Delaware Co. Health Dept.• Minority Health Coalition• Family Physician • Retired Pathologist

• Retired Banker• Retired Schoolteacher

Coalition Steering Committee 2015A Cross Sectional Composition of Stakeholders

Gov’t, Economic, EducationHealth and Wellness

• IU Health Ball & Blackford (hospitals)

• YMCA• Open Door Health (FQHC)

• Meridian Health (Behavioral Health)

• Blackford Co. Health Dept.• Delaware Co. Health Dept.• Central IN Orthopedics• Tobacco Free Coalition• Minority Health Coalition• Wellness Professional Coalition• Family Physician • Retired Pathologist • Physician/County Health Officer

• Ball State University- Building Better Neighborhoods

• Blackford Community Schools• Muncie Community Schools• City of Muncie• County Planning Commission • Energize ECI (economic development)

• Purdue Extension• Chamber of Commerce• IUH Ball Memorial Hospital

Foundation• Retired Banker• Retired Schoolteacher

S.C. Launched Feb. 2015• Presented the need• Illustrated the ‘siloed’ nature of our current efforts• Described the desired health and economic benefits• Shared the proposed coalition model

Community Partners (Spheres of Influence)

5/31/2016 33

Muncie Action Plan

Health Department

HospitalPlanning Commission

Mayor’s Office

School Systems

YMCA

Parks Department

Meridian Health Services

Open Door Health Services

Banks

Little Red Door

Chamber of Commerce

Cardinal Greenway

Ball State University

Workplaces

Purdue Extension

Newspaper

Radio Station

Minority Health Coalition2nd Harvest Food Bank

Private Citizens

Women of INFluenceChild Day Care

Prevent Child AbusePrevent Child AbuseCommunity Centers

Senior Center

Sphere of Influence

5/31/2016 34

What is a “sphere of influence?””An area or region over which a state or organization has significant cultural, economic, military or political influence”-Wikipedia

-In our collective impact model, it’s the ability of our partners to persuade others to make good decisions by about nutrition, physical activity and tobacco use.

Coalition Model

5/31/2016 35

IUH BMHFCommunity

Outreach Committee

Coalition Steering Committee

Coalition Model

5/31/2016 36

IUH BMHFCommunity

Outreach Committee

Coalition Steering Committee

Coalition Member

Nutrition Physical Activity TobaccoWork Teams

Coalition Model

5/31/2016 37

IUH BMHFCommunity

Outreach Committee

Coalition Steering Committee

Coalition Member

Metrics

CollectiveImpact

Grants and Funding

Improved HealthReduced Chronic Disease

Nutrition Physical Activity TobaccoWork Teams

What our collective impact coalition doesn’t intend to do….• “Create a BIG program” A collective impact coalition is not about starting new

programs and initiatives...Our role is to be a catalyst…to align initiatives…to foster mutually supporting activities among partners that are aligned with our goals, objectives and measurements.

Building the Framework• Name, logo• Mission, value statements• Charter• Goals• Web platform with goal-

related metrics• Communications materials• Partner recruitment strategy

Phases• Organizational structure development QTRS 1,2,3 2015• Web platform development QTRS 2,3 2015• Targeted partner recruitment beginning December, 2015• Community launch April, 2016• Work group formation QTR 3 2016

Name, Logo and Mission• “The mission of the Healthy Community Alliance of Delaware and Blackford

Counties is to improve the health and well-being of the communities we serve.”

We Value• Community involvement• Aligning people and organizations for maximum health impact• Community assets and resources• Personal accountability and practical approaches to good health habits• Measuring and sharing results

Healthy Community Alliance Overall Goal• Improve the health of the

population in Delaware and Blackford Counties, thereby lessening the impact of chronic disease.

Three Goal Areas5/31/2016 44

Goal 1: Increase Physical Activity

•Increase the percentage of adults who meet the recommended amounts of physical activity per day.

•Increase the percentage of youth who meet the recommended amounts of physical activity per day.

•Increase the percent of individuals who maintain a healthy body weight.

•Increase the proportion of trips made by walking.

•Increase the proportion of trips made by bicycling.

•Increase legislative, administrative and institutional policies for the built environment that enhance access to and availability of physical activity opportunities.

Goal 2: Improve Nutrition

•Increase the percentage of adults who eat the recommended amounts of fruits and vegetables per day.

•Increase daily consumption of fruits and vegetables.

•Increase the percentage of youth who eat the recommended amounts of fruits and vegetables per day.

•Increase the percentage of individuals who are at a healthy body weight.

•Decrease the amount of fast food consumption by adults and children.

Goal 3: Decrease Tobacco Use

•Reduce tobacco use by adults.

•Reduce tobacco use by youth.

•Increase the state tax on tobacco products.

•Reduce exposure to secondhand smoke.

•Law enforcement of age requirements.

Web Platform to support collaborationprovided by Xerox Community Health Solutions healthycommunitiesinstitute.com

5/31/2016 45

Partner Recruitment• Approached key potential partners first

• City Governments- Muncie, Hartford City, Montpelier• School Systems- Muncie, Blackford County• Existing Coalitions- Tobacco, Minority Health, Wellness

Professionals• Ball State University• Media Outlets

• Public Launch April 2016• 250 invitations mailed• 75 attendees

Alliance Partner Commitment• Partnership agreement• Designate a representative• Select one or more priority areas to promote in your ‘sphere of influence’• Participate in a priority area workgroup to develop tactics, share best

practices, etc. • Participate in quarterly Alliance Partner meetings (phone participation

available)• Commit to strategies/best practices within areas of influence for a priority area.

Alliance Partner Benefits• Participate in proven promising practices that lower healthcare

costs among employees or other populations.• Learn about ways to support and implement policy and

environmental changes that can make our community more attractive for economic development.

• Access to continually updated data regarding health indicators.• Share your best practices with others through the Alliance

website and workgroups.• Learn about local and nationwide grant funding opportunities

for health and wellness initiatives.• Be a part of the solution to our community’s health challenges.

Current Alliance Partners• 104.1 WLBC/Woof Boom Radio Group• America Multi-Sport, Inc.• Ardagh Group• Arrowhead Plastic Engineering, Inc. • Ball Brothers Foundation• Ball State University• Blackford Community Foundation• Blackford Community Schools• Blackford County Health Department• Blackford County YMCA• Boys and Girls Club of Muncie• Cardinal Greenways• City of Hartford City• City of Montpelier• City of Muncie• Delaware County• Delaware County Health Department• Delaware County Wellness Professionals• Glad Tidings Church• Hartford City Kiwanis Club• Hearts with Integrity• Horizon Convention Center• IU Health Ball Memorial Hospital• IU Health Blackford Hospital• IUPUI-Fairbanks School of Public Health• Lifestream Services, Inc

• Meridian Health Services• Meridian-Tobacco Free Delaware Co.• Minnetrista• The Minority Health Coalition of Delaware County• Muncie Electrology Clinic• Muncie Community Schools• Muncie Delaware County Chamber of Commerce• NASH-FM 102.5• Northeast Indiana Area Health Education Center (AHEC)• Open Door Health Services• PAWS, Inc.• Purdue Extension-Delaware County• Red Tail Land Conservancy• Second Harvest Food Bank• Steve Perry Enterprises• Teamwork for Quality Living• The Community Foundation of Muncie and Delware

County, Inc. • The Star Press• The Waters of Muncie• Transition Resource Corporation (TRC Head Start)• United Way of Delaware County• Westminster Village• Youth Opportunity Center• YMCA of Muncie• YWCA of Muncie

Next Steps• Continue recruitment of broader coalition members.• Establishment of workgroups using member volunteers to develop tactics

around goal areas.• Goal area achievements and time frames defined by workgroups.• Member organizations commit to strategies/best practices within areas of

influence.

Questions?• John Disher

jdisher1@iuhealth.org765-747-3915

Questions, Comments?

Presenter:

IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH

Source: theconversation.com Source: seattlechildrens.org Source: theasianparent.com

Evaluation: http://survey.constantcontact.com/survey/a07ecpcaqa9iod0b3cs/start

John D. Disher, MSIndiana University Health East Central Region Community Outreach ManagerIU Health Ball Memorial Hospital Foundation

ResourcesTitle Description LinkRobert Wood Johnson’s Culture of Health

Building a culture of health https://www.cultureofhealth.org/

Building a National Culture of Health: Background, Action Framework, Measures, and Next Steps

A review of the framework, drivers,and metrics

http://www.rand.org/content/dam/rand/pubs/research_reports/RR1100/RR1199/RAND_RR1199.pdf

Indiana Indicators Indiana community data http://indianaindicators.org/

Collective Impact Forum A structured way to create and sustain social change.

https://collectiveimpactforum.org/what-collective-impact

Coalitions Work Practical tools for building coalitions and workgroups

http://coalitionswork.com/

IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH

New Insights & Innovation Series

SAVE THE DATE Camara Phyllis Jones, MD, MPH, PhD, American Public Health Association’s Executive Board President

Kerry Ann McGreary, MA, PhD, Robert Wood Johnson Foundation

The Future of Public Health: The Integration of Policy, Practice and Research

Sept 14 Pre-Conference Grant Writing AcademySept 15 Conference

IUPUI Campus CenterIndianapolis, IN

http://pbhealth.iupui.edu/events/indiana-public-health-conference

IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH

CultureOFHealth.ORG

IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH

Evaluation: http://survey.constantcontact.com/survey/a07ecpcaqa9iod0b3cs/start

Thank you!

For more information about INsights & INnovations, please contact:

JoBeth McCarthy, MPH, DirectorCenter for Public Health Practice, Indiana Public Health Training Center, and

Liaison, Public Health CORPS

Indiana UniversityRichard M. Fairbanks School of Public Health

Health Sciences Building1050 Wishard Blvd., Floors 5 and 6

Indianapolis IN 46202-2872Direct: 317-274-3178

Cell: 317-370-8757Fax: 317-274-3443jomccart@iupui.edu

www.pbhealth.iupui.edu