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Descriptions Oct 14
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MPHA Annual Business Meeting and Conference- Descriptions of Keynotes and Breakouts- October 14, 2015

8:00 – 9:00 am 

Why Clinical Medicine Can Not Fix the Health System Alone  Greg Holzman MD, MPH

As healthcare cost continue to skyrocketing, while national health indicators slip further behind other developed countries, many are looking towards new and innovative ways to address these issues. New models within the healthcare system are being promoted such as Patient-Centered Medical Home (PCMH), Pay for Performance (PFP) and Accountable Care Organizations (ACO). However, many of the health problems facing our nation are complex and beyond the reach of our clinics and hospitals. Solving these issues will require the expertise, cooperation and involvement of many disciplines. 

Core Competencies for Public Health-
            Communication 
              Community Dimensions of Practice 
              Leadership and Systems Thinking 


9:15 – 10:15 am sessions        

 Diving Deeper with Greg Holzman

This facilitated session will allow meeting attendees to have deeper conversation following his keynote address with Greg Holzman new State Medical Officer, Public Health and Safety Division, Montana DPHHS. Attendees are encouraged to bring their own questions and participate actively in this discussion.  

 Home Visiting - It Takes a Village- Ashley Peters BSN and Lillian Adams-Custer BSN

Many have heard the saying ‘it takes a village to raise a child,’ but what constitutes that proverbial village? Although today’s communities look very different from when that saying was coined, families continue to grapple with how to best raise their children, and in what ways their ‘village’ can support them. Enter home visiting – a model of support that utilizes evidence-based practice to help children and families in all stages of development. The Flathead City-County Health Department would like to share our Home Visiting Partnership’s ongoing journey to discovering the strengths and limitations of our programs, and how our successes and failures can help your communities build a better network of support for children and families. From basic essential services to state documentation systems, this presentation seeks to illustrate how the complex web of evidence-based programs and funding sources can be organized and utilized to their full potential. Furthermore, by describing our difficulties and program problem areas we hope to demonstrate how true community collaboration comes with its own unique set of difficulties. You will also gain a better understanding of what services are currently available in the Flathead Valley, and how community organization structure helps dictate how resources are utilized. Although complex, we will discuss our program’s unique referral structure, our involvement with our health department’s accreditation journey and how this has impacted our home visiting services, and we will also touch on our home visiting program’s sustainability efforts and how this process will affect home visiting in the future as we potentially face additional funding cuts to home visiting programs. But more important than the what or how of program logistics and implementation, is the why. Why should healthcare providers and non-medical organizations care about home visiting programs? Why should existing service providers form home visiting partnerships? It all circles back to creating that proverbial village. If we believe that every child needs a ‘village’ to support him or her, then we, as public health representatives, must also take responsibility for creating and sustaining it. Join the Flathead City-County Home Visiting Partnership in navigating the complexities of our own village, and how home visiting services have helped improve the health and well-being of our community. 

Core Competencies for Public Health-
            Policy Development/Program Planning 

 Enhancing our Capacity to Deliver Culturally-Competent Public Health Services – Melissa Henderson MPH, CPH,  Yasmin Odowa  and Shawn Hinz  BS

The mission of RiverStone Health is to improve the life, health and safety of our community members, but how can we ensure that we are doing so in a culturally and linguistically sensitive manner? In 2014, our organization began an intentional process of reflecting on and directing our ability to provide culturally competent services in Yellowstone County. This presentation will provide an overview of steps taken to enhance our cultural competence including examples of self-assessment tools, action plan development, and implementation techniques. As cultural competence is an ongoing process without a fixed endpoint, the session will also highlight the importance of integrating ongoing systems thinking and consideration of community dimensions of practice within this work. Time will also be devoted to sharing how this work can not only enhance your ability to serve your community, but also support the accreditation process. A small panel of reTHINK committee members, from a variety of RiverStone Health programs, will conclude this presentation by sharing their perspectives.

Core Competencies for Public Health-
            Cultural Competency 
            Community Dimensions of Practice 


11:15 am – 12:15 pm sessions

 Local Gardeners' Market uses Policy, System, and Environmental Change to Increase Fruit and Vegetable Consumption in Yellowstone County - TommiLee Gallup BS, CHEC and Maia Dickerson BS

Yellowstone County has an estimated population of 154,162 residents (Us Census, 2013) located in 2,633 square miles. During the 2014 Community Health Needs Assessment, Yellowstone County residents were asked about their accessibility to affordable, fresh fruits and vegetables. A total of 23.5% of those surveyed stated they find it very or somewhat difficult to access affordable, fresh fruits and vegetables, of that population 40.5% lives in a lower income area. The Healthy By Design Gardeners’ Market aims to expand access to healthy, fresh, local fruits and vegetables on the Southside of Billings, Montana—a designated food desert. A food desert is defined as urban neighborhoods and rural towns without ready access to fresh, healthy, and affordable food (USDA). 

The Gardeners’ Market, sponsored by RiverStone Health and supported by the Healthy By Design Coalition provides an outlet for residents to purchase fresh, local, and affordable produce. Local gardeners and farmers are not charged a fee to sell at the market, allowing for lower produce prices. Market staff trains vendors to accept Supplemental Nutrition Assistance Program (SNAP) benefits and Women, Infants and Children (WIC) Farm Direct benefits to increase payment options for the community.

The Market has experienced significant growth since its grassroots inception in 2011 with only a handful of participating vendors and customers; by 2014 there were an average of 14 vendors and 180 customers, and sales have tripled since 2012. Entering year five, the main goal of the market is still to increase consumption of fresh fruits and vegetables as well as to establish a community atmosphere that centers on the importance of healthy eating habits. As we continue to grow market vendors and activities, we hope to use the market as a key community strategy to increase consumption of fresh fruits and vegetables from 40% to 44%, a goal of the 2014-2017 Community Health Improvement Plan.

Using a policy, systems, and environmental change approach to health the Market strives to bring awareness, education, and a cultural of health to Southside residents in Billings, Montana.

In our presentation we will provide information regarding the decision to start the Gardeners’ Market and how we continue to grow it into a community hub of healthy eating and engagement. This presentation will be useful for a variety of Montana communities that are seeking ways to address food access issues and increase community involvement.

Core Competencies for Public Health-
            Policy Development/Program Planning 

 Improving Seasonal Influenza Vaccination in Long-Term Care Personnel- Theresa Majeski MPH

Healthy People 2020 set a goal of achieving 90% seasonal influenza vaccine coverage for health care personnel. Early data from the CDC for the 2014-2015 seasonal influenza season indicate a vaccination rate of 54% in long-term care facility staff. Montana Immunization Program data indicate that long-term care facility health care personnel seasonal influenza vaccination coverage was 62% for the 2011-2012 influenza season. Studies have shown that mandatory vaccination policies are effective at increasing health care personnel seasonal influenza vaccination rates.

Due to the Montana Immunization Program decision to no longer collect state-wide health care personnel influenza vaccination rates after the 2011-2012 influenza season, Flathead County decided to collect county-wide data. Flathead City-County Health Department conducted a survey during the 2014-2015 seasonal influenza season to determine current self-reported seasonal influenza vaccination coverage among health care personnel at long-term care and assisted living facilities, assess influenza vaccination beliefs among health care personnel at these facilities, and determine current health care personnel seasonal influenza vaccination policies.

This presentation will discuss the study method and results. Attendees will receive the toolkit created as a result of this study. The toolkit provides facilities with information supporting mandatory vaccination policies, sample vaccination policies, and strategies to increase vaccination rates. Attendees will also learn about the next steps the Flathead City-County Health Department will be undertaking to help increase seasonal influenza vaccination rates in long-term care and assisted living facility health care personnel. 

Core Competencies for Public Health-
            Analytic/Assessment 
            Policy Development/Program Planning 
            Community Dimensions of Practice 

 The Road to Tobacco Free Parks – Karen Lane M.Ed

Plenty of evidence points to the dangers of second hand smoke. And in 2006 the Surgeon General stated that there is no safe level of exposure to second hand smoke. Many of the outdoor public gatherings and events in Helena already had a tobacco free policy and the local tobacco use prevention program provided the tobacco free signage. [279]
On February 23, 2015 the City Commission of Helena passed a resolution to adopt a tobacco free policy in all of the city’s developed parks. That’s sixty parks! Helena is the first community in Montana to achieve this distinction. The Commissioners’ decision represented the culmination of over two years of effort by numerous partners to achieve this milestone. This presentation will highlight the steps, strategies, bumps and victories along the way. It is a how-to session with examples of tools used. 

Core Competencies for Public Health-
            Analytic/Assessment 
            Policy Development/Program Planning 
            Communication 
            Community Dimensions of Practice


1:45 – 2:45 pm sessions

 Secondary Traumatic Stress and Public Health Professionals: Radical Self-Care to Thrive in Your Work – James Caringi MSW, Ph.D, LCSW 

Secondary Traumatic Stress (STS) is defined as, “the natural and consequent behaviors and emotions resulting from knowing about a traumatizing event experienced by a significant other, the stress resulting from helping or wanting to help a traumatized or suffering person” (Figley, 1995). Public health professionals frequently work with individuals, families, groups, and communities who have experienced multiple traumas and as a result, are at high risk for experiencing STS. Secondary Traumatic Stress can lead to personal health issues, loss of productivity, and turnover and therefore should be a concern for practitioners and administrators.

This presentation will address the causes of STS and offer ideas for both prevention and recovery. In addition, findings from empirical research projects examining STS, burnout, and peer support will be reviewed. Finally, the presenter will facilitate an action research process designed to enable participants to begin the development of self-care plans that they can use in their organizations. 

Core Competencies for Public Health-
               Analytic/Assessment 
            Policy Development/Program Planning 
            Communication 
            Public Health Science 
            Leadership and Systems Thinking 


3:00 – 4:00 pm sessions

Strategies for Preventing and Mitigating Secondary Trauma-  James Caringi MSW, Ph.D, LCSW and Bart Klika  MSW, PhD 

One essential, yet overlooked component of a trauma-informed system of care is a healthy and vibrant workforce. Continually listening to client accounts of trauma and adversity can lead workers to experience symptoms similar to post-traumatic stress disorder, a response referred to as secondary trauma. Absent strategies to manage these symptoms, workers can begin experiencing significant impairment in their professional and personal lives. Research demonstrates that secondary trauma is a significant contributor to high rates of burnout and staff turnover for individuals working within helping professions.
This hands-on presentation will introduce participants to personal, professional, and organizational strategies for preventing and managing secondary trauma. Presenters will integrate research on strategies for mitigating secondary trauma with models of reflective practice. 

Core Competencies for Public Health-
            Leadership and Systems Thinking 

 Benefiting from a Public/Private Partnership: Improving Your Immunization Rates and Outreach – Kristi Aklestad RN and Pete Nowakowski BA

The Blue Cross Blue Shield Care Van program and the Toole County Health Department will discuss leveraging private resources to achieve public health goals. Public agencies, such as small health departments, have limited financial and human resources. Partnering with a private entity, such as Blue Cross Blue Shield Care Van program, can help a local health department meet their goals of increasing access to immunizations for vulnerable populations utilizing private funding and resources. Healthcare is undergoing unprecedented change in the United States. Our hybrid public/private system makes these types of partnerships more common post-ACA. Finding mutual and neutral ground and working on a common cause means public and private entities can expand outreach in ways that neither could do alone. 

Core Competencies for Public Health-
            Policy Development/Program Planning 
            Communication 
            Leadership and Systems Thinking 

 Using Cultural Interventions to Prevent Tobacco Use among Montana’s American Indian Population - Janet Sucha BA, Dana Kingfisher AS, Charleena Penama and Quincy Bjornberg

As American Indians address historical trauma and come to understand how it shapes individual behaviors and choices in todays’ world, cross-generational members have an opportunity to come together to recognize and affirm their own natural resiliency and review their unique heritage. In doing so, youth and adults can rebuild lost cultural norms to better understand who they are and where they come from. In their attempt to diminish the disproportionately high use of commercial tobacco among Montana’s tribal members, MTUPP’s American Indian Tobacco Prevention Specialists (TPS) are working both collectively and independently to address historical trauma and promote cultural integrity. 

Along with following the Center for Disease Control’s four goal areas, objectives, and best practice activities, American Indian TPS look to cultural interventions (traditions, games, norms, rituals, beliefs and language) as effective prevention tools. In this presentation, we will provide an overview of MTUPP’s mission and practices; provide background knowledge on traditional tobacco and sacred herbs of MT tribes; share local successes using culturally relevant tools; and teach participants an interactive Native Game. As one TPS stated, “I feel very strongly that these games, if brought in the right way will help heal our people and strengthen our hoop. My children’s’ Great-Great -Grandfather always told us these games keep us connected to earth and Creator.”

The hope is that these techniques can facilitate in healing past wounds and move tribal communities forward to create a healthier future for all generations. As we saw in the Adverse Childhood Experiences Study, the greater the number of risks, the greater the likelihood of habitual commercial tobacco use, substance abuse, mental health issues and higher morbidity. For the American Indian population these numbers play true. Our presentation examines historical trauma, ACES and the high rate of commercial tobacco use and ways to combat it. 

Core Competencies for Public Health-
            Cultural Competency 

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