Community Health Promotion Can Work… It takes a long time, but ‘Yes We Can’ create healthier communities!
by Jacqui Shumway
In 2005, I was asked to become a part of a community health promotion project attempting to promote healthy lifestyles in the my economically diverse Park Hill Denver neighborhood. The “Park Hill Thriving Communities Summary Report Progress and Accomplishments 2006-2011” was released in 2012 and shows that community based programs can be effective in increasing physical activity and healthier lifestyles over the long haul. A recent discussion on a neighborhood social media site made me realize now many of my new neighbors do not know the history of efforts to make Park Hill the thriving and vibrant community it is today.
So, what was the social media discussion about? After 10 years, they are finally installing a second island crosswalk that is known to calm traffic and folks are excited! The original one was put in around 2007 at Dahlia and Montview Blvd. Montview Blvd. traffic greatly increased as Stapleton Airport and Fitzsimmons were being redeveloped. From the Denver Museum of Nature and Science east to the Aurora City Limit, Montview Blvd. has numerous schools, daycares, churches and bicyclists in the bike lanes! I am hoping that some of our other healthier community ideas from the 2006-2011 project will begin to come to fruition as well. Island crosswalks AND slowing all traffic to 25mph along Montview Blvd. are two environmental changes that have both been proven to reduce pedestrian and bicyclist injuries from motor vehicle collisions. Below are the findings our report. Below is a summary of one of my papers I presented at Oxford University in England in 2006 and 2013.
Community Health Promotion and Park Hill Thriving Communities
Park Hill Thriving Communities (PHTC) funded by Kaiser Permanente/Thriving Communities and Live Well Colorado was designed to promote healthy eating and active living (HEAL) in the Park Hill neighborhoods in Denver Colorado. The total population in the three Park Hill neighborhoods is approximately 26,000. about half of the residents are Latino or African American and the median household income is low in Northeast Park Hill, in comparison to Park Hill as a whole, and the household income is higher in South Park Hill.
Over 38 organizations and numerous community leaders were involved with PHTC. I, Jacqui Shumway (then Vice President of the Colorado Governor’s Council on Physical Fitness), our daughter, Josie Brady (coordinating the Bikes Together Bike Camp this summer) and the Tai Chi Project were amongst those involved. Other stakeholders included Denver Public Schools, Northeast Park Hill Coalition, Greater Park Hill Community, Inc, Denver Department of Environmental Health and Denver Parks and Recreation.
Community Change Strategies and Accomplishments
The PHTC mission was to improve health promotion in Park Hill neighborhoods by providing equal access to healthy eating and active living opportunities, primarily though community level neighborhood and school approaches. Using an extensive resident engagement strategy, they identified program, policy and environmental changes that were supported by the community. Together they engaged in extensive advocacy, often using Photovoice pictures, to bring new services and features to the neighborhood thus making it easier to eat well and engage in regular physical activity in a safe, inviting environment. Photovoice was also used as city-wide advocacy that launched HEAL efforts in other areas. This included the Denver Safe Routes to School Coalition, the Denver Living Streets Initiative and the Denver Healthy Foods Task Force. In the end, they worked closely with key partners to implement organizational changes that were both high dose (i.e. reaching large numbers of people with interventions of sufficient strength) and sustainable beyond the period of grant funding.
Two of the neighborhood strategies made lasting changes to the built environment—the Bike Depot (expanded and renamed Bikes Together in 2015) and the City of Axum Park at Dahlia and MLK Blvd. The City of Axum Park renovation included a playground, covered picnic pavilions with grills, new basketball court, paved walkway through the park, multi-use perimeter trail, chess/game tables, a painted mural and an obelisk climbing structure. The Bike Depot (Bikes Together), a newly established nonprofit located in a commercial zone in North Park Hill, provided free bikes from donated sources to residents and is exploring youth job training opportunities in green jobs (bicycle repair) through police and city bicycle maintenance contracts. The Bike Depot (Bikes Together) has an “earn-a-bike” wait list and successful summer bike camps for which scholarships are available for those with less available funds. These neighborhood amenities remain sustainable.
PHTC put in place a model for promoting healthy eating and active living in the Park Hill neighborhood. In all, over 1,300 children were reached by the school-based interventions and about a quarter of the neighborhood residents (6,300) were touched by HEAL programs and changes to the neighborhood environment. If the changes are sustained and more people are reached by them, measurable improvements in nutrition and physical activity behaviors are likely in the future.
Community Health Promotion Can Work!
“All real behavior change is local and personal” ~ Walter Bortz M.D.
Joe Brady, my partner, and I were invited to lecture at Oxford University on the Park Hill Thriving Communities and other community based health promotion programs in 2006.
As health care costs continue to skyrocket, the need for new approaches in preventive medicine increases. Results of a survey on health promotion programs in Denver were reviewed and potential solutions debated by 28 leading experts from Medical Schools and Universities in 8 countries at the 10th Annual International Conference on Health, Nursing, Aging and Nutrition held at Harris Manchester College in the University of Oxford. The purpose of these debates is to bridge the gap between world class research and local community health promotion efforts and find solutions to the problems in community health promotion. The study noted here is an attempt to test the effectiveness of those recommendations and improve the impact of health promotion efforts in the community.
The evidence is strong for the effectiveness of community-wide health promotion campaigns. This report and many other studies show that communities and health promotion partnerships can create an environment that supports the physical, emotional, and spiritual well-being of everyone in the community. It has been argued, however, that when used as a single strategy, such campaigns do not generally result in sizable changes in health behavior. Although community-wide campaigns have wide reach and potentially greater benefit than less comprehensive interventions, they are also more resource-intensive and require ongoing social marketing knowledge and resources to achieve sustainable changes in major health risk factors, such as physical inactivity, tobacco, mental health, violence prevention and unhealthy diets. Community-wide campaigns are not short-term interventions, but must be sustained over time to change the knowledge, attitudes, and behaviors of the intended audiences.
What were some of the research questions?
- What is needed to inspire people to take control of their own health?
- What is needed to help heath promotion organizations get the word out about their programs?
Barefoot Doctor’s Journal: Healthier Communities Resource Guide made available
Clear evidence suggests that enhancing access to opportunities for physical activity, lifelong learning and health education is effective at increasing healthy lifestyles. By publishing an online Community Resource Guide to help organizations get their message out on the streets and by pooling resources between organizations and agencies, we are attempting to provide easy access to information not otherwise readily available. Health care providers find resource guides to be a potentially useful adjunct to physical activity counseling.
World class programs and teachers establish a quality speakers bureau
People benefit tremendously from working with experienced and educated professionals. Providing accurate, credible health information in an inspiring way is not a common talent and the quality of health promotion programs is very teacher-specific. The Resource Guide will provide organizations and individuals with access to world-class teachers and programs. Physicians are more likely to refer patients to programs if they are aware of the expertise of the teacher running the program. The speakers bureau will provide speakers and teachers for keynote lectures, group seminars, one on one tutorials, classes and other learning resources dedicated to the needs of adult learners.We will also provide organizations with updated lists of community resources that directly benefit and solve some of their staff and volunteer needs.
Support valuable research, become a part of the Oxford Study and the Barefoot Doctor’s community of health.
Want to be on “The Cutting Edge”?
The project is maintaining meaningful partnerships by connecting local organizations with world class research and “best practices” from around the world. Give us your e-mail if you want updates on research and access to tools, information and resources to improve health promotion in your community. We also offer input on future directions for health promotion and lifelong learning in Denver and at the University of Oxford.