February 2012

From Director Anna Schenck

Anna SchenckPublic health is a team sport. By its very nature, public health requires teamwork, partnerships and collaborative effort. Earlier this year, when the NC State Health Director's Conference was held in Raleigh, the theme was "Expanding Partnerships to Transform Health Outcomes." We heard inspiring presentations from Buncombe County leaders and others about improving health and the environment through partnerships. In this edition of Impact, you will find several articles illustrating the importance of teamwork and partnerships.

You can see it in the efforts to reduce childhood obesity in Moore and Montgomery Counties. This effort involves partners spanning multiple sectors in the community, including health care, municipal governments, volunteer groups, schools, and others. Their plan involves collaboration with additional partners in the area, including those in agriculture and recreation. The director for the project credits partnerships as the primary mechanism for how this group plans to accomplish their goals.

You can also see the importance of teamwork in the articles on quality improvement efforts featured in the recent Journal of Public Health and Management Practice. These articles, accessible online, provide great examples of teams in NC and beyond accomplishing improvements in ways that would not have been possible for a single person acting alone. Services targeted for improvement span those provided by public health, from the delivery of a flu awareness campaign, to standardization of environmental health processes, to increasing breast feeding among new moms, to improved scheduling for home care nurses. There are many other examples of quality improvement efforts in the Journal, all of which feature cross-functional teamwork.

Other examples in this edition of Impact highlighting the value of teamwork include the story on Management Academy teams, our own internal quality improvement team that works on improving our continuing education processes, and the partnerships that make the NC Telehealth Network possible.

At NCIPH, we are honored to partner with many organizations working to improve public health in their communities, across the state and beyond. Thank you for including us in your efforts!

Anna Schenck, PhD, MSPH
Associate Dean for Public Health Practice,
UNC Gillings School of Global Public Health
Director, Public Health Leadership Program & NCIPH



33rd Annual Minority Health Conference

Minority Health Conference brochure coverThe 33rd  Annual Minority Health Conference is scheduled for February 24, 2012, at the Friday Continuing Education Center in Chapel Hill. It will be on "Translational Research--The Road from Efficacy to Equity."

The conference is the largest and longest-running student-led health conference in the country. It regularly attracts over 500 students, faculty, researchers, public health and human services professionals, and community leaders from North Carolina and surrounding states, with at least as many throughout the country viewing the keynote lecture by broadcast or on DVD.

Keynote speakers this year are Ana Diez-Roux, MD, PhD, MPH, and Nina Wallerstein, DrPH, MPH.

Dr. Diez-Roux is director of the Center for Integrative Approaches to Health Disparities and director of the Center for Social Epidemiology and Population Health at the University of Michigan. She is an international leader in the investigation of the social determinants of health, the application of multilevel analysis in health research, and the study of neighborhood health effects. Dr. Diez-Roux's presentation will be broadcast live over the Internet.

Dr. Wallerstein is a professor and director of the Center for Participatory Research at the University of New Mexico. For over 25 years, she has been involved in empowerment/popular education, and participatory research with youth, women, tribes, and community building efforts. Her research focuses on community capacity and health development, culturally appropriate translational intervention research to reduce health disparities, evaluation, and community-based research processes and outcomes.

Get more information and register for the conference.



Journal of Public Health Management and PracticeNC quality improvement featured in JPHMP

North Carolina's outstanding public health quality improvement work is featured in the January/February issue of the Journal of Public Health Management and Practice. The issue is entirely focused on quality improvement in public health. Seven of the issue's articles are written by and/or about North Carolina public health departments and their QI leaders. Several NCIPH staffers contributed articles to the issue. Mary Davis and Elizabeth Mahanna are authors on an article on evaluation of quality improvement training offerings, and Gene Mathews and Milissa Markiewicz are authors on an article examining legal frameworks that support public health department accreditation.

NCIPH, the NC Center for Public Health Quality, and East Carolina University have partnered to make this issue available free online. Read it now.



NCIPH QI team tackles course management

NCIPH learned first-hand about the value of quality improvement by sending a team to the Quality Improvement 101 course offered by the NC Center for Public Health Quality (CPHQ).

The team's challenge was to review the Office of Continuing Education's current course management system and to come up with a more streamlined system. The aim, developed over many months, was to improve the course reporting system to insure timeliness, accuracy, and thoroughness. The team held a four-day working session with guidance from the CPHQ in October and presented outcomes in Raleigh in January.

"Participating in QI 101 helped us to successfully improve the old system," says Steve Orton, NCIPH QI team leader.

Some accomplishments to date:

  • Decreased the number of process steps required from the start to finish of a course. Three different forms have been combined into one.
  • Developed live on-site check-in via the Internet. This streamlines participant check-in at conferences and eliminates the need for manual reconciliation of check-in lists after programs.
  • Eliminated course reporting backlog from 2011.
  • Moved to completely electronic archiving going forward.
  • Prepared 20 shelf-feet of paper archives for University storage.

The team estimates that savings are roughly twice the cost of the training for the year.



Ripe for Change
Candor, NC

Candor is the peach capital of North Carolina. Decades ago, the small town was a booming pit stop for travelers on their way to Myrtle Beach. Today, Candor's vitality is diminished. Its only grocery store closed down more than 10 years ago. Residents are forced to travel to nearby towns for healthy food.

Some believe resident's lack of access to healthy food is related to Candor's high rate of childhood obesity--it's higher than the state and national averages. This would paint a bleak picture if it weren't for the efforts of residents who want to make Candor a better place to eat and live. These community members see a town ripe for change.

See more of Candor's story in this video.

Reducing obesity in Moore and Montgomery Counties

In Moore and Montgomery Counties, a project called Healthy Kids in the Carolinas will work in five communities in the largely rural area where overweight and obesity among elementary school students exceeds 50 percent at times.

The project is being led by FirstHealth of the Carolinas, a comprehensive health care system. The organization and its partners, namely the towns of Southern Pines, Aberdeen, Robbins, Mt. Gilead and Candor, aim to remove some of the barriers keeping these children from being active and eating right.

With funding through Healthy Kids, Healthy Communities, a program of the Robert Wood Johnson Foundation housed at Active Living by Design, the partnership initially will identify problems in the built environment that affect weight gain, from a rural area’s lack of infrastructure and recreational facilities to food-shopping limitations.

Then the problems will be tackled. geographic information system (GIS) mapping and analysis will be used to craft land use plans that promote sidewalk and trail development. “GIS mapping and other tools will show us where we need sidewalks and trails so that kids can walk safely to school,” explained project director Melissa Watford.

The project also will build on existing momentum and obesity prevention in the region, such as efforts to create more greenways and trails and to improve access to healthy food through farmers markets, community-supported agriculture, and community gardens that sell locally grown produce.

Distance, limited financial resources and a small pool of volunteers to tap are among the hurdles facing the project. But the partnership, which also includes the groups Sustainable Sandhills and Communities In Schools, doesn’t view the region’s high rate of obesity as an insurmountable obstacle. Rather, it’s a challenge that it has an obligation to meet.

“I think the health of our children is our future,” Watford said, adding: “We have strong partnerships here that will help us meet that challenge.”



Practica give students field experience

The North Carolina Public Health Leaders in Practice program gives residential graduate students in the Gillings  School of Global Public Health opportunities to gain practice experience via academic credit-bearing field practica in local public health agencies in North Carolina.

Local health departments from across the state will host students for 6-10 weeks in the summer between the students' first and second years of their graduate program. Students will be working on projects like:

  • Analyzing state and local teen pregnancy trends in the Hispanic population in Alamance County
  • Developing and implementing a campaign to reduce the incidence of tick borne illness in Chatham County
  • Conducting a Hatteras Island bike/pedestrian path study in Dare County
  • Developing, maintaining, and evaluating a youth advisory council to guide the improvement of family planning and STD clinics in Buncombe County.

This is the second year of the practica program. Meghan Lewis, one of last year's students, says of the program, "Being a part of that experience reminded me why I chose public health." Read more about her experience in Carolina Public Health magazine.

Student applications are being accepted through February 24 for this summer's practica. For more information, go to www.sph.unc.edu/nciph.



Accreditation Update

Congratulations to the following health departments who were granted Accreditation Status on December 16, 2011. There are now 64 accredited health departments in the state

Alamance County Health Department (re-accreditation)
Edgecombe County Health Department
Halifax County Health Department (re-accreditation)
Richmond County Health Department (re-accreditation)
Surry County Health & Nutrition Center (re-accreditation)
Swain County Health Department (re-accreditation)
Wake County Human Services
Warren County Health Department

Right: Wake County Human Services staff with Accreditation Site Visitors and Accreditation Staff, Brittan Wood and Rich Rosselli.





New online resource guide for vulnerable and at-risk populations

Vulnerable and at-risk populations resource guideRecently, at-risk populations have been incorporated into many of CDC's new public health preparedness capabilities, including community preparedness, emergency public information and warning, and medical countermeasure dispensing. However, one of the most challenging tasks when planning for at-risk groups is deciding how to define "at-risk." The North Carolina Preparedness and Emergency Response Research Center (NC PERRC) at the UNC Gillings School of Global Public Health has developed a quick online resource guide to provide a custom list of resources with accompanying jurisdictional maps to aide local health departments (LHDs) with preparedness planning for vulnerable and at-risk populations.

The Vulnerable and At-Risk Populations Resource Guide is intended to support LHDs' planning and preparedness activities by providing a filter for the extensive array of existing resources, templates, PowerPoint presentations, Memorandums of Understanding, and case studies. Based on individual responses to a short series of questions, the Guide provides links to population-specific resources and tools to help LHDs work with vulnerable population groups to build or maintain partnerships. The tips and resources contained in the Guide provide information related to:

  1. Identifying vulnerable and at-risk populations
  2. Planning for vulnerable and at-risk populations
  3. Building community partnerships

Custom maps using the CDC's Social Vulnerability Index help to illustrate each jurisdiction's vulnerable populations at the census tract level. Each tract is ranked according to its level of vulnerability in comparison to the average across the state. The automated guide allows LHDs instant feedback, thereby decreasing lag time to find information useful to planning and preparedness activities.

For more information, visit cphp.sph.unc.edu/ncperrc/guide.html or contact Dr. Christine Bevc at bevc@email.unc.edu



NC Telehealth Network receives Public Leadership Award

The North Carolina Telehealth Network (NCTN) received the Public Leadership Award during the 21 Awards Gala hosted by the North Carolina Technology Association in Durham. Along with several partners, The North Carolina Institute for Public Health of the Gillings School of Global Public Health secured funding and coordinated the participation of NC health providers in the North Carolina Telehealth Network.

NCTN is a multi-phased project to provide dedicated, high-speed broadband services to the state's public health and healthcare providers. Funded by grants and contracts from the Federal Communications Commission, the North Carolina Division of Public Health, and the Golden Leaf Foundation, it provides broadband services that link health programs and sites across the state. Sites include clinics, community health centers, public health agencies, and non-profit hospitals. The largest number of participating providers are rural and/or have limited resources.

NCTN connectivity provides these institutions with the network infrastructure required to utilize a diverse set of telehealth and healthcare information applications. As healthcare comes to depend more on health information exchanges, electronic health records, and Internet-enabled research, the NCTN will directly serve the needs of health practitioners and researchers throughout North Carolina.

To date, 54 public health sites have been connected to the network. An additional four public health sites and 24 non-profit hospitals have subscribed to the project and are in the process of being connected. Nearly 20 additional non-profit hospital sites are expected be on board in the foreseeable future.

"This has been an exciting project, addressing a core need of many of our rural healthcare and public health service providers. It could not have succeeded without the dedicated and coordinated efforts of many partners throughout the state." noted John Graham, the project manager from NCIPH.

Get more information at nctelehealthnetwork.com.



Call for nominations: Craig Michalak Award for Excellence

In honor of former Accreditation Administrator Craig Michalak, the NC Institute for Public Health is accepting nominations for the Craig Michalak Award for Excellence. The award is given to individuals by the NC Institute for Public Health to recognize the efforts and support of the Local Health Department Accreditation system throughout NC. Please consider nominating someone you feel is deserving of this award. Nomination forms are due no later than March 31st.

To make a nomination, download nomination form and send the completed form to Debbie Andrews at deandrew@email.unc.edu.



Congratulations to Dr. Tavie Flanagan

Tavie FlanaganAfter six long years of course work, research, and writing, Tavie Flanagan, continuing education specialist with the Office of Continuing Education, completed her dissertation and received a doctorate from the UNC-CH School of Nursing.

Her dissertation, Cardiovascular Disease Prevention in Women Prisoners: The Stay Fit and Healthy Intervention, was a secondary analysis of a study which focused on the efficacy of a health promotion intervention, originally designed as a control group for the HOPE Project.

HOPE was a HIV prevention intervention clinical trial which studied the population of women prisoners. Stay Fit and Healthy Intervention (Stay Fit) was a nine session program which incorporated educational and behavioral strategies to increase healthy behaviors and decrease cardiovascular disease risk. Flanagan evaluated whether the Stay Fit program had any effect in decreasing cardiovascular risk. She compared the changes in cardiovascular-related healthy behaviors of the women who received Stay Fit with the women who received the primary intervention designed to reduce HIV risk behaviors.

Results show that women in the Stay Fit group limited more fast food intake three months after prison release than the control group. All healthy behaviors analyzed trended towards statistical significance at three months in the Stay Fit group, and smoking behavior improved in both groups following release.

Flanagan is hopeful that the results of her study emphasize the need for future interventions designed for incarcerated women in reducing their risk of developing cardiovascular disease.



New Management Academy online module

Steve OrtonManagement Academy director Steve Orton collaborated with the Northwest Center for Public Health Practice on a second self-paced module on business planning. The module launched in late December and is available free.

Find a link at maph.unc.edu or go to the NWCPHP website.

Management Academy teams graduate

Three teams from western Nebraska and three teams from the NC Division of Public Health recently completed business plans with the help of the Management Academy for Public Health.

NC Division of Public Health teams wrote or expanded business plans for the North Carolina Center for Public Health Quality; the Eat Smart, Move More, Weigh Less program; and the Diabetes Education Recognition Program. The final presentations were held in Raleigh.

Nebraska teams presented their plans on-line. District teams wrote business plans for expanding flu vaccine use, providing preventative dental care to school-age children, and building a food safety certification program.

In each case, the business plans are designed to show how programs can generate revenue to sustain effort over time.

The Management Academy program is a joint effort of the Institute for Public Health and the Kenan Institute at Kenan-Flagler Business School.