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Marin County
Prevention Hub: A Story of Evolution,
Collaboration and Prevention
CARS Presentation
September 4, 2013
ObjectivesLearning
Attendees of this webinar will learn:
• How the Prevention Hub was conceptualized and created
• Major challenges and achievements of the Prevention Hub
• Lessons for other counties pursuing cross-system collaboration
is inequalitymaking us sick? - California Newsreel 2008
The choices
we makeare shaped by the choices
we have...
Marin vs Marin
• Healthiest county in California
• Healthiest county for young people in America
• High income inequality
• Alcohol consumption, particularly binge drinking across the age span, is in the top 5%
Cross-Divisional Work
Communication
Strategy
Restructuring
Effort
Professional Development
Streamlined
Resources
What is the Prevention Hub?
To work together to advance
effective prevention practices
to improve the health of
all people and communities
in Marin County
• Inclusive & Community-centered
• Cross Sector Collaboration
• Environmental Prevention
• Ingenuity & Innovation
• Adaptability
• Risk Taking
• Integrity
Principles& Values
ReStructuring
• Request to all departments to improve services with existing resources
• HHS assessed opportunities for collaboration
– All six HHS divisions had a prevention thread
• Identified key staff and assessed capacity and readiness of each division
• Communicated how the Prevention Hub adds value to division leads
ReStructuring
• Intentional Institutionalization
– Did not want this to be the “idea of the day”
– Identified two Co-Coordinators
– Recruited cross-divisional staff: not just what you do, but what skills can you bring to the table
– Developed a “virtual” Hub
• Agreed on common language & training needs
Drawbacks of the Past Approach
• No systematic way to coordinate and collaborate
• Services were often limited by grant requirements
• Divisions worked with similar providers and partners with little coordination
• Training and professional development opportunities were limited/siloed
Prevention Hub do?What does the
• Align internal HHS structure to support prevention and community engagement
• Train on specific competencies to build skills of partners and staff
• Cross system strategic planning/allows for synergy across divisions
• Mutually beneficial prevention projects
• Provides a learning community and an incubator for new ideas
• Acknowledged that:
– We have different working styles and cultures
– This was the first time collaborating across divisions
– Some divisions were not accustomed to collaboration
• Agreed to:
– Use direct communication
– Appreciate different styles and cultures
– Share successes and allow for mistakes
WorkingAgreement
Spectrum of Prevention
Influencing Policy and Legislation
Mobilizing Communities and Neighborhoods
Changing Organizational Practices
Fostering Coalitions and Networks
Educating Providers
Promoting Community Education
Strengthening Knowledge and Skills
Assuring access to quality health care
Strategic Direction:
Support Community Action on Prevention
Prevention Priority Area from the National Prevention Strategy –
Objective
(specific,
measureable,
achievable,
realistic, time
limited)
Activity
(specific steps and sub-
steps needed to achieve
the objective)
Individual
and Agency
Partners
(both
internal and
external)
Deliverable
(measures that
can be
specifically
quantified,
include by when)
• Interdepartmental Coordination
• Technical Assistance
• Community Policy Advocacy
• Promoting Evidence Based Practices
• Media & Communications
• Project Planning
Functions of thePrevention Hub
• Have a prevention focus
• Are linked to a priority community need
• Have clearly identified outcomes
• Address issues of equity
• Have synergy across HHS Divisions
• Fit within our values and guiding principles
CriteriaFor Projects
• Marin County Fair- Play Fair
– Policies: smoking, healthy food, alcohol advertising
– TA: responsible beverage services
– Health Promotion- kids run
– Online and social media posting
– Health Ambassadors
– Baby Sanctuary
– USDA SNAP Ed grant (1st in Nation)
Howdoes it work?
• Tobacco Policy Success
– Work with Smoke Free Marin Coalition
– Collaboration with Public Housing
– Municipalities to pass local ordinances
– Board of Supervisors
– San Rafael Ordinances passed
Howdoes it work?
• Rethink Your Drink/Obesity
– Community engagment through HEAL planning process
– Program doing community education
– Policy goal for no soda in County vending machines
– Video to promote
– Board of Supervisors resolution as advocacy opportunity
– Wellness Ambassadors
Howdoes it work?
• HEAL Framework is the first countywide, coordinated roadmap to improve healthy eating and active living in Marin
• Complex problem requires integrated solutions
• Focus on equity
Builds on community assets and brings together partners from different sectors
•Community Partners: Ag, food policy, Community Based Organizations, Food Bank, Safe Routes, Bike Coalition
•Social Services: CalFresh
•Parks and Open Space: Healthy People, Healthy Parks
•Public Works: Promotes walking and cycling
•Aging: Nutrition and physical activities for seniors
• The Hub’s Healthy Retail Campaign aims to improve the health of Marin County through changes to the retail environment
• Community will asses the availability and marketing of tobacco, alcohol and un/healthy food and beverages in 144 stores
• Partners with Cx3 Communities
This Campaign:
• focuses on upstream policy change
• integrates tobacco, alcohol, and healthy food policy objectives within the retail environment
• offers the opportunity to mobilize public health advocates around one environment and build critical mass to leverage social norm change
• Countywide Rx/OTC Abuse Initiative
• Intimate Partner Violence Prevention
• Senior Injury Prevention
• Community Coalitions
OtherProjects
Opportunities& ChallengesOpportunities
• Prevention staff collaborating on projects much more frequently
• Communication has increased
• Share information, resources and expertise
Challenges
• Give up old ways / different expectations
• Concern that priorities will disappear
• Information overload
• Figuring out the next steps
• Different funding timelines
Opportunities& ChallengesOpportunities
• County-wide and local leadership commitment
• View concerns in an integrated way
• Assess outcomes more closely
• Potential to expand stakeholders
Challenges
• “Just another request from the County”
• Struggle to move folks from “reflection” and process outcomes
• Time pressures and concerns about priorities
Opportunities& ChallengesOpportunities
• Partners eager to collaborate
• Focus on equity & social determinants of health
• A good solution solves many problems
Challenges
• Dwindling resources and changing priorities of funders
• Discomfort within a “privileged” county
• Healthiest county
Marin County
Prevention Hub
facebook.com/MarinHealthAndHumanServices
twitter.com/MarinHHS
youtube.com/MarinCountyHHS
Marincounty.org/hhs
Sparkie Spaeth – HHS Deputy [email protected]
Kristen Law, MA – Resource Development [email protected]