Improving effective policy advocacy and mastering the art of community mobilization are goals shared by a host of sectors that often operate in isolation from one another, with different approaches, distinct incentives and varying definitions of successful outcomes. Led by the Institute for Public Strategies, this workshop will focus on implementation of a dynamic five-pronged, non-linear, implementation model proven to break down sector silos for effective advocacy. Working within the social-ecological model, this strategy has a strong track record for creating change at the community and policy levels and improving the social determinants of health in those communities.

The ACT Model (Approach to Community Transformation) focuses on five interrelated strategies: Data and research, which identifies problems and notes changes over time; community organizing, which ensures those most affected are involved in the process; media advocacy, which raises awareness of the problem; policy advocacy to implement solutions; and sustainability which ensures solutions are implemented for the long-term. Together, these activities improve neighborhood empowerment and sustainable improvements for the community.

The session will include several examples of the model in action, including a border project focused on reducing alcohol-related harms, and the revitalization of a small community east of San Diego. Participants will come away with skills and knowledge to help their organization utilize this model in their work for sustainable community change.

By the end of the workshop, participants will be able to:

• Define and measure community readiness,
• Define the five strategies of the ACT model,
• Utilize the strategies of the model for planning of prevention campaigns.

There has been a growing recognition that social determinants – the conditions in which we are born, grow, live, work and age – are influenced by many policies thought to be unrelated to health, but which may have important health consequences (both positive and negative). Failure to consider health consequences of policies can result in unintended harm or in lost opportunity to improve health. To respond to these needs, the public health field developed a Health Impact Assessment (HIA). Despite the effectiveness of HIAs in informing and improving decision-making, the resources required (time and funding) to conduct HIAs present challenge to using this tool during decision-making processes that involve quick turnaround time. This presentation will describe an alternative approach to an HIA. A new tool, the Health Impact Checklist (HI-C), developed by the Kansas Health Institute was designed to inform decisions at many levels (e.g., organizational, city, county and state). It asks a series of questions and uses a combination of check boxes and written responses to connect potential changes in social, economic and environmental conditions with potential health impacts. The tool guides users as they create practical recommendations to maximize potential positive health impacts and mitigate potential negative health impacts. The HI-C also includes a template for a one-page summary that provides a high-level snapshot of findings. Pilot projects with several cities and counties across Kansas will be completed during Summer 2020 to implement the HI-C tool on local policies. The pilot projects will result in insights for utilizing the HI-C in practice to improve planning and decision making across sectors. The HI-C will be presented at the National Network of Public Health Institutes (NNPHI) 2020 Annual Conference in a round-table format with a focus on how this tool can be use by public health institutes. This presentation will have a different focus - development, value and implementation of the HI-C tool. The following learning objectives will be achieved: 1) Participants will be able to describe the goals of the HI-C; and 2) Participants will be able to describe the potential benefits of using the HI-C to inform policy decisions.

Fullerton, California, is one of the largest and most diverse cities in Orange County. In the predominantly Latinx and immigrant Richman neighborhood of South Fullerton, existing health disparities continue to impact the overall health of residents. Compared to North Fullerton, life expectancy is 7.1 years less (77.1 v. 84.2 years). Almost one-fourth (23.2%) of residents is uninsured (v. 4.4%), and 14.9% report mental distress (v. 8.1%). Almost half (41.5%) of children live below the poverty level (v. 2.8%), and less than one-third are prepared for kindergarten (about 50% less than children in North Fullerton). Between 2018-2019, the number of aggravated assaults and homicides increased.

The Center for Healthy Neighborhoods was established in the Richman neighborhood with the purpose of providing social services and developing resident-based capacity to determine and implement positive change in the community. Utilizing a community organizing and participatory model, efforts were made to create a safe environment to engage local residents in Center activities and events, decision-making, and leadership. Resident leaders who have the capacity to assume leadership roles in their neighborhood and to represent it to external decision makers were identified.

Since 2016, over 2,600 individuals have attended meetings and/or trainings at the Center, which allow them to identify and mobilize around community issues. A total of 29 resident leaders have been trained and participated in community events, which help to foster trust and a sense of community among predominantly low-income Spanish-speaking residents. Additionally, 16 adults completed a Resident Leadership Academy that empowered these residents with knowledge, tools, strategies, and commitment to make positive changes at the neighborhood level. Residents have identified lack of affordable and quality housing, poor school readiness, unmaintained built environment, and crime and violence as pressing neighborhood issues.

The collaboration between the Center’s public health professionals and core team of community resident leaders will work to determine and address structural difficulties that contribute to community distress. The team have identified key partners (e.g., law enforcement, school administrators, city officials) who can create sustainable, policy-level changes. Achieving social cohesion has the potential to address community problems and effect change at the community level.

Evidence shows that health disparities in the U.S. are serious, persistent, and even increasing. Many other countries also face health equity gaps based on geography, race and ethnicity, income, and other socioeconomic factors. We conducted a systematic review and case study comparison of public and private sector strategies, policies, and programs designed to improve equity implemented by other countries to identify potentially promising practices for consideration in the U.S. We used comparative sociological methods to analyze secondary data related to health equity to narrow our selection of countries for in-depth qualitative case study analysis; these countries included Australia, Brazil, Czech Republic, Northern Ireland, Indonesia, Singapore, and South Africa. For the comparative case study analysis, we collated publicly available data for a thematic analysis from government reports, news articles, peer-reviewed and grey literature and key informant interviews. In this presentation we focus on three countries that share with the U.S. a history of settler colonialism; relatively large, heterogeneous populations; and democratic governance: Australia, South Africa, and Brazil. We identified and compared approaches across several domains, including housing, education, and reducing bias and discrimination. Analysis revealed several cross-cutting themes, including government-led acknowledgement of structural racism in South Africa and Australia; integrated, multisectoral planning approaches to improving equity in all three countries, including through asset transfer programs in Brazil and South Africa; utilization of population-based monitoring mechanisms to gauge changes in discrimination, equity, and social cohesion in South Africa and Australia; and use of participatory, place-based approaches to engaging communities in policy making, program implementation, and evaluation in all three countries. We suggest possible extensions to the U.S. For instance, formalized reconciliation processes and resulting policies and interventions applied at sub-national and community-levels in Australia and South Africa may inform state and municipal planning to address historic disparities across multiple social determinants of health. Participatory approaches applied to xenophobia toward labor migrants in South Africa and Australia, slum or shantytown upgrading in Brazil and South Africa, and inclusive curricula development in South Africa and Australia may also be of relevance for incorporating health equity principles in active community partnerships in the U.S.