The Missouri Foundation for Health is investing in nonprofit subgrantees working in low-income communities across the state to reduce risk factors and the prevalence of two preventable causes of chronic disease and death: tobacco use and obesity. The project draws on an integrated community change model blending two transformative models of prevention on obesity and tobacco control.
This SIF grant supports Missouri Foundation for Health (MFH) efforts to implement the Strategic Innovation in Missouri (SIM) project. The project is investing in nonprofit subgrantees working in targeted low-income and high-need communities in the state. The goal of SIM is to improve the health of Missourians by reducing risk factors and prevalence of the two most preventable causes of chronic disease and death: tobacco use and obesity. To achieve this goal, a team of qualified MFH staff is administering a competitive application process based on the expansion and replication of the Community Health Improvement (CHI) model across Missouri. CHI is an integrated community change model blending two transformative models of prevention on obesity and tobacco control. Potential innovations to be funded as a result of the project include farm-to-school food programs, workplace changes supporting physical activity and tobacco cessation, and campaigns promoting nutrition and reduction of tobacco use, point-of-sale advertising of tobacco products and smoke-free policies.
The potential impacts of the project on individuals and communities include:
- Short-term: Increase in access to services for community residents; increase in local health policy changes in targeted communities; increase in understanding of health effects and preventive activities and expansion of CHI into identified sub-grantee communities;
- Intermediate-term: Decrease in current smoking rates and exposure to indoor tobacco smoke; increase in physical activity and higher rates of consumption of five fruits and vegetables per day; and
- Long-term: Decrease in rates of diabetes, asthma, high blood pressure and reports of fair or poor health status; replication of CHI in additional Missouri communities.
Track Record before Social Innovation Fund Grant:
- The Foundation has implemented two related funding programs – Healthy & Active Communities, and Tobacco Prevention and Cessation Initiative – in more than 50 communities in Missouri. As a result, more than 250,000 Missourians have been reached and 215 local policies have been changed.
- Existing grantees include long-established local coalitions, multi-tiered community health centers serving multi-county areas, major university systems, local public health departments, hospitals, and small independent nonprofits providing critical health services not typically reimbursed by third parties.
- Community partners are diverse and include major universities and research centers (Washington University in St. Louis, University of Missouri-Columbia, University of Missouri-St. Louis, RAND Corporation), statewide coalitions (Missouri Convergence Partnership, Missouri Council for Activity and Nutrition, Tobacco-Free Missouri), governmental bodies (Missouri Department of Health and Senior Services) and other area foundations (Incarnate Word Foundation, Healthcare Foundation of Greater Kansas City, Gateway Center for Giving, Deaconess Foundation).
- Missouri Foundation for Health selected seven subgrantees across five regions of Missouri to implement proposed strategies for addressing tobacco-use and obesity prevention;
- Through their partners Trailnet and Americans for Nonsmokers’ Rights, Missouri has provided technical assistance to grantees to ensure they have the skills necessary to successful implement the Community Health Improvement model; and
- Missouri Foundation for Health’s Coalition Leader Core Competencies Checklist has been adopted by both the County Health Rankings and Roadmaps site and the Robert Wood Johnson Foundation for its Roadmaps to Health funding program.
- Subgrantees have implemented numerous health program and policy changes across the seven counties in which they work. Most recent changes include:
- Nine businesses went smoke free in two counties,
- The State Board of Education approved a comprehensive school wellness policy,
- Developing and implementing a customized school curriculum for tobacco awareness for students in Jennings, MO, and
- Expanding the Active and Healthy Schools program to six school districts in Knox county.
Nonprofits Receiving Social Innovation Fund Awards from Missouri Foundation for Health
|Health Care Coalition of Lafayette County||Ozarks Regional YMCA|
|Heartland Foundation||Putnam County Health Department|
|Independence City Health Department|
|Missouri Foundation for Health|
Health Care Coalition of Lafayette County
Initial Award Amount: $130,601
The Health Care Coalition of Lafayette County proposes to improve the county's overall health by decreasing tobacco use and exposure to tobacco; increasing access to healthy, fresh food; and encouraging active and healthy lifestyles. Project goals include: increased access to locally grown food, increased physical activity to improve health and reduce obesity, new trails and sidewalks, and more tobacco prevention/cessation classes. Short-term outcomes include increased access to locally grown food for low-income residents and schools; greater understanding of the need to increase physical activity to improve health and reduce obesity; development and implementation of community plans for trails and sidewalks; and more tobacco prevention/cessation classes for children and adults throughout the 3 county. Lafayette County, with 33,000 residents, has four main population centers: Lexington, Higginsville, Odessa and Concordia. The project expands existing programs in the county, as many of the initiatives are currently in their infancy, and awareness of these programs is low due to limited resources for promotion. The proposed intervention through the SIF grant will help develop a comprehensive action plan for healthy lifestyles in the county. Qualitative analyses of outcome data will yield a description of key themes as community partners implement and evaluate community-based programs.
St. Joseph, Missouri
Initial Award Amount: $176,271
Heartland Foundation will use an integrated strategy to address food access and physical activity at the elementary school level, focusing on Title 1 schools and promoting and expanding the use of trails, hiking and biking routes and other outdoor recreation facilities. These include completing trail segments, facility upgrades, trail documentation, addition of mile markers, path signage, access points, bike racks, messaging, and recognition events and youth programs. Partners will support workplace, school and community policies that support healthy eating, and active and tobacco-free living. The target community is St. Joseph, with a priority of serving individuals living below 200% of the poverty level; low-income children and families; and individuals at risk of chronic health problems. The project proposes to increase access to the built environment, and make outdoor public places smoke-free in St. Joseph.
Anticipated outcomes for the short term (2 years) include increasing access to built environment and services for community members; increasing understanding of the health outcomes of prevention; and increasing health policy changes. Intermediate-term goals (3-5 years) include increasing physical activity; increasing consumption of fruits/vegetables; and decreasing smoking rates and exposure to environmental tobacco smoke. Long-term goals (5 years) include decreasing rates of diabetes, asthma and high blood pressure; decreasing rates of poor health status; and decreasing financial burden of poor health status on employers and the community.
The Heartland Foundation will carry out a coordinated strategy in a resource-poor community which currently has no coordinated communication or central source of information to share obesity and 4 tobacco resources. This will influence policy and building opportunities that support personal mobility, healthy eating and clean air to achieve improved health outcomes over time. The evaluation plan includes quantitative and qualitative data with outcome, performance, and process measures, including retrospective analysis for certain components of the project.
Independence City Health Department
Initial Award Amount: $242,748
The Independence City Health Department (IHD) will work with city departments and community partners to increase accessibility, safety and healthy choices in high-risk, low-income areas of Independence. These collaborations will build on existing programs and policies, and expand access to safe places to be physically active, support positive health choices, and change the built environment to support activity and smoke-free air. The target population includes low-income and underserved residents residing in northwest and southwest 6 Independence, which have a high density of low-income and underserved populations.
Expected outcomes include an increase in the use of recreational facilities; increased safety and accessibility, with sidewalks and a complete street policy; increased consumption of fresh produce; increased nutrition education with menu labeling and healthier options; a decrease in tobacco use at parks and on trails; and greater promotion of tobacco reduction and smoking cessation programs. Building off several successful efforts, the Independence City Health Department will fill gaps in access and services, and carry out a comprehensive project that includes policy and environmental changes, along with social marketing and programming to support these changes.
Missouri Foundation for Health
2010 Social Innovation Fund Subgrantees
Knox County Community Center, Inc.
Initial Award Amount: $388,187
Knox County Community Center seeks funding to improve access to a healthy, physically active environment through the construction of a community center; creation of workplace wellness policies that support a healthier lifestyle; and increased community participation. The project's goal is to improve health through evidence-based physical activity, health promotion, and tobacco cessation intervention programs in an affordable and accessible manner. The target is rural northeast Missouri covering Knox County (population 3,981), and residents from the bordering counties of Scotland, Lewis, Adair, and Shelby (estimated 1,500 individuals).
As no resources are available in Knox County for recreational and guided physical activity, tobacco cessation, increasing physical activity or improving nutrition, the proposed intervention will fill a gap and provide a way for local partners to work toward the project's long-term sustainability. The project will enhance the work of a local "Smokebusters" group currently providing tobacco education and public engagement regarding city ordinances. It will involve worksite support for tobacco cessation programming, increase in public awareness, knowledge and behavior change, with the potential of increased advocacy, and augment a community movement toward a tobacco-free environment. The overall project evaluation will assess the effect in a rural community of changes in worksite wellness policies that support increased physical activity, improved nutrition and tobacco-free work places. It also will examine whether these can be replicated in other rural communities.
Ozarks Regional YMCA
Initial Award Amount: $107,676
The goal of Ozarks Regional YMCA (ORYMCA) and the Healthy Living Alliance (HLA) is to reduce obesity and tobacco use by collaborating with existing organizations to focus expertise and resources to build a sustainable culture of wellness in 15 low-income schools and work sites in the Springfield area. This project will rely on collaboration of community organizations working with an Advisory Committee to provide education, technical support for new policies, and increased access to nutritious food and physical activity. Tailored plans will be made for each target community using the Community Healthy Living Index (CHLI), which evaluates the individual and environment to identify areas for improvement in policy and administrative support, environment, and access to healthy living choices.
Strategies include increasing availability of farm fresh foods; point-ofsale nutrition labeling; restricting unhealthy food in public venues; supporting infrastructure improvements; Walking School Buses and incentive programs for employees to bike/walk to work; scholarships for YMCA memberships; worksite wellness policies; promotion of the tobacco Quitline; and implementation of smoke-free workplaces. The intent is to increase access and support, and encourage tobacco-free policy implementation and tobacco control by engaging the community and fostering policy change in the target population. The project will use a model that deploys existing resources in a coordinated way. It will help the schools and worksites create a replicable and a sustainable wellness program focused on physical activity, nutrition, tobacco-free policy implementation, and tobacco free policy.
Putnam County Health Department
Initial Award Amount: $100,000
Montgomery AIDS Outreach, Inc. (MAO) will install permanent telemedicine equipment in rural, satellite HIV clinics serving 47 of Alabama’s 67 counties. Targeting newly diagnosed people living with HIV/AIDS (PLWH/A), PLWH/A who have left care, and PLWH/A receiving suboptimal care who have no and/or little access to care, telemedicine services will provide Alabama a singular opportunity to elevate the standard and access of HIV-specific medical care in a poor, rural state. Telemedicine sites will be staffed with a nurse who can communicate with medical providers at the permanent sites and collaborate on a diagnosis via a camera and video screen, saving the patient and provider the burden and expense of traveling long distances to receive and administer vital HIV treatment. Collaborating partners include: AIDS Action Coalition of Huntsville and Whatley Health Services.