Petersburg Healthy Options Partnerships will prioritize and address health-related clinical and social needs through community action to reduce chronic diseases in children in Petersburg, Virginia - The project will be implemented through five strategies and associated activities. Strategy 1: Engagement and Coalition Building - Establish and convene a multidisciplinary community coalition with active community engagement. Activities: ●Convene coalition of community members, families, and community partners to design and review community health assessments and findings, provide feedback on an anchor condition, and develop appropriate interventions ●Establish a Community Advisory Board (CAB) to provide guidance and direction to the community health assessment, interventions and formative, process, and outcome evaluations. ●Craft a coalition membership engagement and communication plan for two-way communication with coalition partners to share regular updates via materials designed to communicate assessment, intervention, and evaluation results with the community. Strategy 2: Community Health Assessment and Priority Setting - Compile census-tract-level secondary data; engage coalition in assessment; identify disease incidence and prevalence, social, nutritional and, environmental triggers; assess Medicaid utilization in children. Activities: ●Using the PRECEDE-PROCEDE Model and coalition and CAB feedback, design community surveys and focus groups in each of the eleven Petersburg census tracts to supplement outcome data in the Community Dashboard. ●Conduct formative evaluation for feedback on the current built environment and policy, systems, and environmental initiatives to learn more about facilitators, challenges, and new interventions needed in priority neighborhoods. Strategy 3: Data Infrastructure and Dashboard Development - Aggregate secondary data; deploy data monitoring dashboard; establish data governance processes. ●Census-tract level data on coalition/CAB determined anchor condition and other social drivers of health will be aggregated, visualized and regularly update on a Community Dashboard hosted by HealthLandscape Virginia Strategy 4: Intervention Implementation - Implement evidence-based interventions across clinical, nutrition, physical activity, family support, and policy domains. ●The Community Coalition and CAB will advise and guide appropriate interventions to address the anchor condition. ●Implement evidence-based interventions that address the full spectrum of factors influencing the health outcomes in Petersburg, including clinical and healthcare access, nutrition and food access, physical activity and healthy environments, family and community support, and policy, systems, and environmental changes. ●Many of these interventions will build, in scope and scale, on pilot initiatives implemented during VT CPHPR/VCE’s prior work through PHOPs in Petersburg, including Road Safety and Walk/Bike Audits, indoor farm market at the Petersburg Public Library, food hub to source local food for community food access programs, community health worker network, and the PHOPs model with workgroups to support effective implementation. Strategy 5: Evaluation and Continuous Quality Improvement - conduct ongoing monitoring; share findings with the community; document lessons learned ●Implement formative, process, and outcome evaluation based on prescribed outcomes and performance measures in the NOFO and additional process and outcome measures tailored to the Petersburg community and its chosen interventions. ●Community-tailored communication tools (infographics, one-pagers, newsletters) which engage and solicit feedback from the coalition and CAB will be used to promote and disseminate the resources, programs, and health environmental changes implemented to the Petersburg community members. Intermediate outcomes will include a real-time data dashboard for decision-making, reduced Medicaid costs associated with the anchor condition in Petersburg, and Increased social connectedness and mutual investment in community health.
