makin' chli
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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