Online Program

JUAs or Not: A Question in Rural Counties

Tuesday, November 5, 2013 : 3:10 p.m. - 3:30 p.m.

William Baldyga, DrPH, MA, Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, Chicago, IL
Anna Stein, JD, MPH, Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, NC
A key CTG strategy for promoting physical activity (PA) participation is the development of joint use agreements (JUAs). JUAs have proven successful in increasing PA participation in urban and suburban communities. For CTG implementation states with large rural areas like Illinois and North Carolina, JUA development has proven particularly difficult due to the requirements of JUA agreements, resource constraints, existing arrangements and other factors. Early lessons learned in these two states will assist others in understanding unique barriers to JUA development in rural areas. In Illinois and North Carolina, field reports over the past 12 months consistently identify unanticipated difficulties in locating, informing and negotiating with potential JUA participants. Qualitative performance monitoring data has identified specific challenges to JUA development. Field staff report significant challenges in using JUA templates to increase access to PA, particularly in rural areas. The requirement for a two-party agreement is particularly problematic, as often only one party determines accessibility policy to spaces for PA. In addition, reports indicate strong resistance to “formalization” of long-standing organizational practices. Field staff report more success using other strategies to open access to spaces for PA. Successful strategies to increase access to spaces for PA, particularly in rural areas, require more flexibility than incorporated in the traditional JUA template. Public health practitioners will be more successful in increasing PA opportunities with a broader set of strategies than just increasing the number of joint use agreements. It is important to share alternative strategies for opening access to spaces for PA participation.

Learning Areas:

Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
Describe the implementation of joint use agreements as defined by CDC for the purpose of the Community Transformation Grants. Define the challenges to implementing joint use agreements in rural counties as experienced by Illinois and North Carolina. Discuss alternative strategies for increasing physical activity opportunities in under-resourced, rural communities.

Keyword(s): Physical Activity, Rural Communities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a principal or co- investigator of multiple federal, state and foundation funded initiatives on a wide range of public health related issues including physical activity participation, diabetes, aging, breast cancer, etc. I have conducted multiple evaluation projects of national, state and local initiatives not limited to oral health, aging issues diabetes prevention, and public health workforce among other evaluation studies
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.