Background and Purpose
The Healthy Communities Research Group (HCRG) was created by Dr. David M. Compton while at Indiana University, to help position parks, recreation, and related community agencies as public health providers.  The purpose is to develop and test the Surveillance and Management Toolkit - a step by step systematic assessment that allows communities to determine the key factors, indicators, and  actions necessary to help reduce obesity and increase physical activity. The testing is currently focused on ages 10 - 14 in the community but the Toolkit can be used to identify factors for all ages. Funding currently comes from GP RED, a 501(c)(3) public charity that provides research, education, and development for health, recreation, and land management agencies, with community funding support for hard costs, along with alliances and support from East Carolina University, and direction from the HCRG Director, Teresa Penbrooke, currently a PhD student at North Carolina State University.

Description
Since 2009, the GP RED Healthy Communities Research Group (HCRG) has been working to develop and test the Healthy Communities Surveillance and Management Toolkit. The project targets the community aspects that influence obesity and active living, specifically targeting ages 10 to 14, and helps to position parks and recreation agencies and partners as key public health providers. The initial “alpha project” with Indiana University in Bloomington, Indiana in 2010 was successful, and the methods are now being integrated into a training process and toolkit and applied to additional “beta” site communities for further refinement, testing, and implementation in the future. South Bend, IN, is just completing Year Three of the project, and Liberty, MO is finishing Year One.  Other communities are in funding stages. This presentation will cover methodology, outcomes, and evaluation of the Toolkit and its applications.

The Surveillance and Management Toolkit helps parks, recreation, and related departments and agencies assess, analyze, document, and evaluate five systematic elements related to the re-positioning of parks and recreation as a primary preventative community public health provider:

1. Convening Community Stakeholders and Champions – Residents? Partners? Providers?
2. Creating a Warrant for Agency Action – Why? Who? What is the Impact?
3. Policies, Laws, and Procedures – What is influencing obesity and/or active living?
4. Fiscal Resources and Distribution – What funds? How should they be allocated?
5. Inventory of Assets and Affordances – Programs? Parks? Facilities? Food?

From an inventory and quantitative and qualitative analysis of these elements, the project moves to creation of a systems portfolio, strategic concepts for improvement, and future modeling for the purposes of articulation, prioritization, management, and surveillance of outcomes over time. The process utilizes a specially designed Multi-Attribute Utilities Theory (MAUT) process to quantitatively determine evidence-based indicators, and as a tool for discerning consensus on healthy contributors in any community. Using current best practices for management, along with Composite-Values Method (CVM) for Level of Service Analysis, the process compiles a complete inventory of GIS-based relevant assets and affordances. This information was then integrated into the five-element analysis, including policy, fiscal, environmental, and Stella® implementation modeling, with evaluation and outcomes determined for each year.

Lessons Learned
The Surveillance and Management Toolkit has been created over a three-year development and testing phase. The Toolkit and process has been modified through implementation of three different communities, and still undergoing additional testing. Adjustments have been made for all inventory templates to ensure   practitioner and agency management ease of use, along with modifications to the MAUT process and Stella Modeling process to ensure accuracy and relevant results.

Conclusions and Implications
A step by step standardized but flexible systematic assessment process has been needed by public agencies and their community partners to help ascertain accurate factors and indicators to help reduce obesity and increase active living, and to position parks and recreation as key public health providers. This Surveillance and Management Toolkit has been successfully utilized and is being tested, and is now ready for peer review and refinement for broad community implementation to address these issues.

Next Steps
The intention is to identify up to 10 Beta site communities of various demographic profiles around the U.S., continue testing and validation, and then to publish the Surveillance and Management Toolkit for broad-based practitioner and community implementation and application.

References

1. Centers for Disease Control and Prevention (2010). Obesity: Halting the Epidemic by making health easier. Retrieved at http://www.cdc.gov/chronicdisease.
2. Compton, D.M., Muehlenbein, M., Penbrooke, T.L. (2010) Healthy Communities: Repositioning public park and recreation agencies as catalysts for healthy people. Unpublished workbook, Indiana University.
3. Crompton, J.L.(2010). Measuring the Economic Impact of park and recreation services. National Recreation and Park Association Research Series, Arlington, VA
4. International City/County Management Association (2005). Active Living and Social Equity – Creating Healthy Communities for all Residents, Washington DC.

Support / Funding Source
Support provided by GP RED, East Carolina University, Indiana University, and North Carolina State University.