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Role of State and Local Public Health

Many local public health programs are already taking action in their communities. We offer these examples and recommendations as a menu of possibilities, to highlight opportunities to build on what is already working well, look for opportunities to enhance or expand efforts, and promote the exchange of ideas for what works at local levels. State public health programs can provide support to the development of an integrated public health system of stakeholders working together to improve the health of Oregonians.

Strategy State Public Health Activities Local Public Health Activities Desired Outcomes
Conduct state and community level needs assessments to understand community priorities, identify barriers, strategies, and solutions, and engage local support.

Develop environmental scan tool to assess local MCH staff.

Review Healthy Communities assessment data (Change tool).

Analyze and compile state and local data to inform state and local action steps.

Review and incorporate existing state childhood obesity plans and reports.

Identify local opportunities and partners for the collection of assessment data.

Use assessment data to build local partnerships and plans for child obesity prevention.

State and community level needs, resources and opportunities for child obesity prevention work are identified.

State and community level assessment data is available to support planning and infrastructure development.

Conduct surveillance to monitor trends, (obesity rates, risk and protective factors, and health outcomes), describe child obesity, and identify disparities (including racial/ethnic, geographic, socioeconomic, mental health, and special health care needs).

Identify surveillance questions relevant to childhood obesity (including PRAMS and PRAMS-2, other primary data collection).

Identify gaps in surveillance and assessment for child obesity, risks, and protective factors.

Identify opportunities to expand population-level surveillance.

Partner with state for data collection.

Engage local partners in child obesity surveillance and data collection.

The scope and impact of childhood obesity in Oregon will be better understood.

Ongoing surveillance will identify trends and emerging needs related to childhood obesity.

Review regulations and licensing standards for schools, early care and education, and provider settings related to obesity.

Identify current regulation and licensing landscape. Identify best practice policies from other states.

Compile findings to describe opportunities for policy development.

Disseminate findings to state and local partners.

Disseminate findings to state and local partners. Identify discrete opportunities to improve Oregon’s school, early care and education, and provider policies for health
Support research and demonstration projects.

Identify opportunities to expand research and implement best practices.

Serve as resource and capacity support for local partners.

Seek funding and/or other support as needed.

Identify opportunities to engage with local and state partners.

Seek funding and/or other support as needed.

Needed research will be supported.

Best practices will be implemented in Oregon.

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Strategy

State Public Health Role

Local Public Health Role

Desired Outcomes

Inform and educate the public and stakeholders about population-based, upstream obesity prevention and the financial/community costs of the obesity crisis.

Identify resources and supports to conduct the work.

Identify partners to collaborate and support delivery of message or program.

Identify opportunities to conduct social marketing.  Include Early Head Start, Head Start, and school/early care and education media advocacy.

Establish web-presence that is user-friendly and informative.

Identify resources and supports to conduct the work.

Identify partners at state and/or local level to collaborate and support delivery of message or program.  Examples include Let’s Move campaign, and WeCan initiative.

Increased public understanding of obesity prevention and costs.

Increased public presence of obesity prevention messages.

Promote active peer-to-peer support in communities.

Identify opportunities to promote peer-to-peer support such as via existing programs, through WIC breastfeeding support  in communities, or Centering Pregnancy.

Adopt and promote peer-to-peer support programs.

Expansion of peer-to-peer support opportunities across Oregon

Provide evidence-based health promotion, education, and interventions through MCH programs and services

Identify specific MCH programs and services, such as home visiting, client services, and early learning and care, to enhance interventions.

Conduct continuous quality improvement cycle (plan, do, study, act) with 1-3 teaching topics for Babies First! Program.

Promote effective parenting practices.

Adopt evidence-based interventions with support from state MCH staff.

Adoption of evidence-based interventions in programs.

Promote parents as partners for healthy weight and development in childhood.

Identify opportunities in public health programs.

Identify tested messages that target parents such as the Food and Nutrition Services Core Messages, Let’s Move messages, Head Start BodyStart, Eat Well/Play Hard.

Identify opportunities in public health programs.

Promote target messages through programs.

Partner with primary care providers to promote messages.

Consistent obesity prevention messages that target parents are promoted through public health programs.

Identify gaps in health education in communities, to include culturally and linguistically appropriate materials and programs; identify gaps in provider practice

Using state and community assessments, and other resources, identify needs for more culturally responsive materials and programs.

Identify best practice strategies to address needs from other states and localities.

Develop and disseminate recommendations.

Identify resources and supports to conduct the work.

Identify partners at state and/or local level to collaborate and support delivery of message or program. 

Oregon’s public health programs, services, and messages promote health equity.

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Strategy

State Public Health Activities

Local Public Health Activities

Desired Outcomes

Engage community leadership through participation in prevention-focused coalitions and networks (county and/or regional).

Support local efforts to engage community leadership.

Identify community leaders to engage in coalitions and networks.

Actively seek participation of leaders and community members of perse race, ethnicity, culture, and ability.

Community coalitions or networks engage local leadership.

Coordinate and collaborate with State and Local programs and system partners to support and/or expand upstream prevention strategies.

Identify and recruit partners to collaborate on objectives.

Develop strategies to support health in all policies.

Develop and implement strategies to support obesity prevention and health promotion efforts with school-based health centers and early care and education settings.

Support partners and agency in focusing on child obesity as a public health priority.

Support local primary care providers in community in standards of practice for child obesity prevention.

Support local school-based health centers and early care and education providers in obesity prevention and health promotion efforts.

State and local public health and partners collaborate on upstream prevention strategies.

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Strategy

State Public Health Activities

Local Public Health Activities

Desired Outcomes

Identify and/or develop parent resources and supports for a network of referrals to programs that address early childhood obesity issues and promote healthy weight in children, with a special focus on populations experiencing disparities.

Conduct assessment of available resources and supports.

Identify gaps.

Make or review recommendations to improve and/or expand network.

Disseminate findings to partners and stakeholders.

 

Conduct assessment of available resources and supports.

Identify gaps.

Make or review recommendations to improve and/or expand network. Disseminate findings in communities.

A network of parent resources and supports to promote healthy weight and development is known to families in Oregon.

Describe the effect of adverse childhood experiences on obesity, and connect families with needed support.

 

Identify resources and supports to address adverse childhood experiences, and disseminate findings to partners and stakeholders.

Identify resources and supports to address adverse childhood experiences, and disseminate findings in communities.

Increased understanding of adverse childhood experiences, and a network of parent resources and supports is known to families in Oregon.

Assure linkages and continuity of care through health homes with a focus on preventive services for pregnant women with gestational diabetes or history of diabetes, and children at risk for obesity.

 

Develop and support relationships with provider communities.

Identify opportunities to support providers in evidence-based technical assistance, professional guidance and training.

 

Develop and support relationships with provider communities.

Identify opportunities to support providers in  evidence-based technical assistance, professional guidance and training.

Local providers are supported in providing obesity prevention services and interventions as recommended by the USPSTF.

Seek participation of leaders and community members of diverse race, ethnicity, culture, and ability.

Develop and support relationships with members of diverse communities.

Invite participation and feedback from a widespread, diverse group of stakeholders.

Develop and support relationships with members of diverse communities.

Invite participation and feedback from a widespread, diverse group of stakeholders.

At the state and local levels, partners and stakeholders represent a thoughtful cross-section of the diverse community.

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Strategy

State Public Health Activities

Local Public Health Activities

Desired Outcomes

Educate State and local policy makers about primary prevention of childhood obesity from a life course perspective for health and learning.

Explore opportunities to educate policy makers about child obesity.

Conduct effective communications.

Evaluate success of strategy.

Explore opportunities to educate policy makers about child obesity.

Conduct effective communications .

Evaluate success of strategy.

State and local policy makers are informed about public health prevention from a life course perspective, and life course programs and interventions, in order to prevent child obesity.

Promote health in all policies, using partnership, collaboration, and health impact assessment efforts.  Assure special focus on built environment in policies and plans.

Explore ways to educate internal and external stakeholders about health in all policies.

Convene stakeholders to identify low hanging possibilities and win-win scenarios.

Support state and local efforts for health in all policies through health impact assessment and rapid assessment trainings.

Explore ways to educate internal and external stakeholders about health in all policies.

Convene stakeholders to identify low hanging possibilities and win-win scenarios.

Convene and participate in health impact assessment and rapid assessment trainings.

State and local policy makers identify win-win scenarios; policies are developed that maximize positive health impacts and reduce health consequences.

Advance key selected state and local policies to support healthy weight and development in childhood and prevention of child obesity.

Perform review of state and local policies.

Identify policies yielding outcomes of interest for Oregon.

Identify key stakeholders to help advance policy initiative.

Perform review of policies.

Identify policies yielding outcomes of interest for community.

Identify key stakeholders to help advance policy initiative.

State and local public health identify key policies to support for population health improvements.  Policy makers identify win-win scenarios; policies are developed that maximize positive health impacts and reduce health consequences.

Collaborate and promote Healthy Communities objectives.

Develop and support relationships with chronic disease and Healthy Communities staff.

Identify shared opportunities intraining and technical assistance, messaging, assurance, etc.

Identify opportunities for win-wins for community health.

Develop and support relationships with chronic disease and Healthy Communities staff.

Identify shared opportunities in training and technical assistance, messaging, assurance, etc.

Identify opportunities for win-wins for community health.

State and Local Maternal and Child Health programs and staff are recognized as key partners for chronic disease efforts, and are integrated within Healthy Communities efforts.

Strengthen place-based obesity prevention policies and practices that address nutrition, physical activity, screen time and breastfeeding.

 

Promote Baby Friendly Hospital designation and adoption of 10 Steps in hospitals and birthing centers.

Educate the public and partners about Oregon’s breastfeeding laws and regulations.

Explore other policies and practices that would increase public and provider support, initiation, duration, and exclusivity of breastfeeding.

Conduct comprehensive needs assessment related to obesity prevention practices in child care settings

Advocate for changes to Oregon licensing standards that align with best practices.

Assure statewide training related to best practices for licensing training credit.

Develop and implement recognition system linked to the training system for early care professionals.

Promote Baby Friendly Hospital designation and adoption of 10 Steps.

Educate the public and partners about Oregon’s breastfeeding laws and regulations.

Explore other policies and practices that would increase public and provider support, initiation, duration, and exclusivity of breastfeeding.

Advocate for changes to Oregon licensing standards that align with best practices.

Support training related to best practices for licensing credit.

Promote recognition system linked to the training system for early care professionals.

Mother’s infant feeding decisions are supported and protected in a variety of settings.

Early learning and care settings are supported to improve nutrition, physical activity, breastfeeding and screen time policies and practices for health.

Promote healthy worksites through awareness of organizational policies and practices.

Enforce laws and regulations that promote healthy weight and development in childhood.

Perform review of state and local worksite policies and practices.

Identify key stakeholders to help advance policy and practice initiatives.

Pilot implementation of selected practices and policies.

Develop promotional/educational campaign for the public and partners about Oregon’s breastfeeding law and other laws and regulations that influence child obesity.

Review worksite policies and practices.

Identify key stakeholders to help advance policy and practice initiatives.

Pilot implementation of selected practices and policies.

Develop promotional/educational campaign for the public and partners about Oregon’s breastfeeding law and other laws and regulations that influence child obesity.

The public is aware of laws and regulations that influence child obesity.

State and local public health departments are models in their communities of healthy organizational and worksite practices and policies.

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Strategy

State Public Health Activities

Local Public Health Activities

Desired Outcomes

Provide resources, support and education on evidence-based practices for childhood obesity prevention to inpiduals who interact with parents and children (including health care providers in the context of a health home, early care and learning and school personnel, and worksites).

Assess competency and need for training.

Inform about public health resources and supports.

Promote awareness about importance of preconception health for all women.

Promote awareness and use of evidence-based practices for childhood obesity prevention.

Promote use of BMI to screen and monitor childhood obesity.

Explore opportunity to focus on child obesity as third wave of START project.

Support and incentivize workforce training and assistance.

Inform about public health resources and supports.

Promote awareness about importance of preconception health for all women.

Promote awareness and use of evidence-based practices for childhood obesity prevention.

Promote use of BMI to screen and monitor childhood obesity.

Explore opportunity to focus on child obesity as third wave of START project.

Children, women, and families have health homes where they receive USPSTF clinical preventive services.  Providers are informed about public health resources and supports in communities.

Professionals who interact with children are informed about and utilize evidence-based practices for childhood obesity prevention.

Promote quality training for public health workforce on laws and regulations, and on evidence-based interventions   related to obesity prevention (including risk/protective factors).

Assess competency and need for training.

Develop an information campaign and/or training to inform the public health workforce about laws and regulations related to child obesity.

 Promote WIC Nutrition modules to non-WIC staff.

Promote Healthy Communities trainings to MCH and WIC staff.

Partner with Healthy Communities program staff to design and implement trainings that address MCH topics and a life course perspective.

Promote Health Impact Assessment trainings across public health programs.

Develop and promote a web-based toolbox

Develop and promote a web-based learning collaborative for local public health staff.

Develop evaluation and/or competencies.

Support and incentivize workforce training and assistance.

Develop an information campaign and/or training to inform the public health workforce about laws and regulations related to child obesity.

Develop evaluation and/or competencies.

Promote WIC Nutrition modules to non-WIC staff.

Promote Healthy Communities trainings to MCH and WIC staff.

Partner with Healthy Communities program staff to design and implement trainings that address MCH topics and a life course perspective.

Promote Health Impact Assessment trainings across public health programs.

Develop and promote a web-based toolbox

Develop and promote a web-based learning collaborative for local public health staff.

State and local public health staff are informed about laws and regulationss related to child obesity.

State and local public health staff working in different Offices and content areas have consistent information about evidence-based practices and programs for child obesity.

Support personnel achieving professional certification, International Board Certified Lactation Consultant (IBCLC).

Assess need for lactation consultants.

Identify target or priorities for support.

Identify means to support certification through public health clinics, WIC, and hospitals.

Assess need for lactation consultants.

Identify target or priorities for support.

Identify means to support certification through public health clinics, WIC, and hospitals.

Women who choose to breastfeed their infants have access to professionally certified support in their communities.

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Strategy

State Public Health Activities

Local Public Health Activities

Desired Outcomes

Identify public and private funding and support for work at State and Local levels.

Investigate grant opportunities.

Assess which opportunities align with MCH needs and goals.

Pursue grant funding opportunities as they arise.

Investigate grant opportunities.

Assess which opportunities align with MCH needs and goals.

Pursue grant funding opportunities as they arise.

Additional funding support garnered.

Identify successful programs and interventions for use as funding strategies.

Identify evidence-based or best practice interventions.

Identify evidence-based or best practice interventions.

Evidence-based and/or best practice programs and/or interventions identified and used in funding applications.

Provide/assure flexible funding to support community engagement and capacity (not tied to direct service) and to support coordination and collaboration efforts across programs.

Identify new or existing funding opportunities with potential for enhanced flexibility.

Identify new or existing funding opportunities with potential for enhanced flexibility.

Local public health receives flexible funding to support partnership, planning, and coordination efforts unrelated to direct service nursing.

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