community roundtables - George Washington University School of ...

COMMUNITY ROUNDTABLES Year 3 Preliminary Report: Bridging Cancer and Chronic Disease

October 2017

1

CONTENTS Introduction .................................................................................................................................................. 1 Background .............................................................................................................................................. 1 Methods and Roundtable Structure ........................................................................................................ 3 Policy, Systems and Environmental Approaches ..................................................................................... 3 Evaluation ................................................................................................................................................ 3 Northeast Kentucky Regional Community Roundtable ............................................................................... 5 Champlain Valley Healthy Lifestyles Collaborative (Vermont) ................................................................... 11 Florida Community Roundtable ................................................................................................................. 17 Final Conclusion .......................................................................................................................................... 23 Appendices ................................................................................................................................................. 24 Appendix A: Facilitation Guide .............................................................................................................. 24 Appendix B: Workgroup Activity Plan Worksheet ................................................................................. 26 Appendix C: Collaboration Multiplier Tool ............................................................................................. 29 INTRODUCTION This Community Roundtables Year 3 Report: Bridging Cancer and Chronic Disease was developed to highlight successes and challenges of the third and final annual Community Roundtables that brought cancer, chronic disease and community stakeholders together to integrate efforts in three states in May 2017. Key highlights reported during Year 3 of the Community Roundtables include the following:  

 

The Northeast Kentucky Community Roundtable Radon Workgroup members formed the Step Up to Reduce Radon Alliance, which won the EnviroHealthLink Mini-Grant from the Kentucky Department of Public Health. The Northeast Kentucky Community Roundtable Workforce/Certified Tobacco Treatment Specialist Workgroup developed the Bridging Research Efforts and Advocacy Toward Healthy Environments (BREATHE) Tobacco Treatment Specialist Training, which provides 27 hours of online training and includes content consistent with the Core Competencies established by the Association for the Treatment of Tobacco Use and Dependence (ATTUD). The Champlain Valley Healthy Lifestyles Collaborative’s Promoting Health Lifestyles with 3-4-50 Workgroup members partnered with three health district offices to incorporate 3-4-50 into their worksite wellness efforts. The Florida Community Roundtable’s Federally Qualified Health Center (FQHC) Referrals Workgroup reported that a member organization hired a community patient navigator to assist community members through the health system and refer them to resources.

Materials used at the roundtables are included in the Appendices in hopes that they will be useful to comprehensive cancer control programs and coalitions that seek to replicate the Community Roundtables. BACKGROUND The Institute for Patient-Centered Initiatives and Health Equity at the George Washington University (GW) Cancer Center is working with three Area Health Education Centers (AHECs) around the country to organize roundtables to integrate cancer and chronic disease prevention efforts by convening key stakeholders and strengthening relationships at the state or regional levels. The roundtables give participants the opportunity to develop a collaborative approach to address a specific risk factor for cancer and chronic disease over a three-year period. Participants at the roundtables may include representatives from comprehensive cancer control coalitions or programs, state and local departments of health, cancer and chronic disease programs, universities, clinics or other groups working toward reduction of cancer and chronic disease in the state or region. This report is a summary of procedures of the third of three roundtables which were held in 2017. The report from the first roundtable, held in 2015, and the report from the second roundtable, held in 2016, are also available. Goal of the Community Roundtables: To promote increased integration of cancer and chronic disease efforts by convening key stakeholders and strengthening relationships at the state or regional level.

2

Intended Outcomes of the Third Community Roundtables: 1. Deeper and common understanding of how chronic disease and cancer efforts can be integrated. 2. Commitments from AHECs, chronic disease groups and community stakeholders in implementing strategies to address cancer and chronic disease risk factors in the state or region. 3. Consensus on an action plan to build on successes in years 1 and 2 to improve cancer and chronic disease outcomes in the state or region. Partnering AHECs were selected through a competitive application process in 2014 to host these roundtables due to their strong community-level history and connections. They are well-positioned to bring diverse stakeholders to the roundtables and facilitate dialogue and collaboration toward common health outcomes. In 2015, the following four AHECs were chosen to host the roundtables between 2015 and 2017; however, South Dakota did not hold a third roundtable in 2017: 1. 2. 3. 4.

Champlain Valley AHEC (Vermont) Gulfcoast South AHEC (Florida) Northeast Kentucky AHEC Northeast South Dakota AHEC

The roundtable locations selected represent different Centers for Disease Control and Prevention (CDC) National Center for Chronic Disease Prevention and Health Promotion Regions (Figure 1). Each Community Roundtable convened once a year between 2015 and 2017 in-person followed by sixmonth follow-up calls. The roundtables selected one chronic disease risk factor that remained constant throughout the three years and one strategy that changed each year to advance cancer and chronic disease integration efforts in a comprehensive manner Figure 1. The AHEC roundtable hosts selected in 2014 represent (Figure 2). four different CDC National Center for Chronic Disease Prevention and Health Promotion Regions

It should be noted that following the 2016 Northeast South Dakota Community Roundtable meeting and subsequent conversations regarding uncertainties with Medicaid expansion and changing definitions and training requirements for Community Health Workers and Patient Navigators, GW Cancer Center and South Dakota AHEC

Figure 2. The roundtables selected one chronic disease risk factor that remains constant throughout the three years and one strategy that changes each year

3

mutually agreed to discontinue the roundtable. METHODS AND ROUNDTABLE STRUCTURE The third of three Community Roundtables took place in May 2017 (Figure 3). Chronic disease risk factor topics remained the same from 2015. Florida, Vermont and Kentucky all chose the same year 3 strategy: PSE approaches, which differs from their year 2 strategies, as intended. The number of attendees was kept small, ranging from 21 to 29, to foster meaningful relationship-building (Figure 4). Kentucky and Vermont concentrated their efforts on the AHEC regions: Northeast Kentucky and Champlain Valley, respectively, while Florida continued on a state-level roundtable with wider reach. All three roundtables created a planning committee to help organize the roundtable meeting, provide insights and perspectives to choose roundtable strategies, brainstorm potential attendees and speakers and facilitate the roundtable meeting and activities. Planning committee members in Kentucky and Vermont also led workgroup discussions during the in-person meeting. Vermont uniquely conducted pre-roundtable work with partners to populate the Prevention Institute’s Collaboration Multiplier Tool, which they used to highlight opportunities for collaboration. All roundtables followed a general structure of presentations by experts in the morning to understand the current landscape of cancer and chronic disease in the region or state, best practices and current community activities. Participants then broke out into workgroups in the afternoon. Florida and Vermont decided to convene in a single workgroup to facilitate relationship-building across all stakeholders, and they identified workgroup topics onsite. Kentucky, on the other hand, chose to split into three workgroups focusing on three different topics, which were predetermined by the planning committee. Workgroup leaders and GW Cancer Center representatives facilitated the conversations using the Facilitation Guide (Appendix A) and noted key points and planned activities using the Workgroup Activity Plan Worksheet (Appendix B). Roundtable participants will also attend respective six-month follow-up calls to celebrate progress, discuss challenges and troubleshoot. These follow-up meetings will take place in October and November 2017. POLICY, SYSTEMS AND ENVIRONMENTAL APPROACHES Policy, systems and environmental (PSE) approaches are public health changes that increase access to healthy options and allow the healthy choice to become the easy choice (Truss, 2013). PSE change can address cancer-related health disparities at the population and community levels. Changing policy, systems or the environment is achieved through: 

Policy: Changing laws, regulations, resolutions, ordinances or rules



Systems: Changing processes or rules of an organization, institution or system



Environment: Changing the physical environment

In March 2017, GW Cancer Center developed and released the Action for PSE Change Tool, an online platform to help comprehensive cancer control professionals, coalitions and communities improve health across the cancer continuum through PSE changes. The platform offers basic information on PSE approaches and resources on where to find and how to use cancer data and other resources to advance PSE change efforts. The GW Cancer Center staff introduced this tool during the roundtables and workgroups were encouraged to use it to help develop specific, measurable, achievable, realistic and time-bound (SMART) workgroup goals. EVALUATION Evaluation of the roundtables is ongoing to continuously assess areas for improvement. As part of this effort, GW Cancer Center administered the following before the roundtable: 1. An online survey using REDCap collecting demographic information and assessing baseline levels of participants’ perceived capability to address the chronic disease risk factor topic; expectations of the roundtable; belief that they will be able to make a difference in the field; perceived support and reinforcement of their activities; and confidence in the capability of the roundtable to make a differencei

4

2. An online survey collecting social network data, including how often participants contact other participants, to compare with baseline data collected before the first roundtable in 2015 The GW Cancer Center administered the following after the roundtable: 1. A paper survey to assess process outcomes and satisfaction levels 2. An online survey assessing changes in participants’ perceived capability to address the chronic disease risk factor topic; expectations of the roundtable; belief that they will be able to make a difference in the field; perceived support and reinforcement of their activities; and confidence in the capability of the roundtable to make a differencei Data collected in 2015, 2016 and 2017 will be compared to determine whether the year 1 roundtables were successful in creating stronger ties between cancer and chronic disease professionals and advancing integration of efforts. 2015 2016 2017 Chronic disease risk roundtable roundtable roundtable Year 1 strategy factor topic date date date Northeast Kentucky

Champlain Valley (Vermont)

Gulfcoast South (Florida)

Northeast South Dakota

April 30

May 9

Year 2 strategy

Year 3 strategy

Area

Workforce improvement

PSE approaches

Regional

Communication, Nutrition, physical education and activity and obesity training

Communication, education and PSE approaches training (no change)

Regional

Nutrition, physical Communityactivity and obesity clinical linkages

Coordination between health PSE approaches care professionals

State

May 18 Tobacco

9am-4pm

9am-4pm

9am-4pm

May 12

May 24

May 23

8:45am3:30pm

8:45am3:30pm

8:45am3:30pm

June 10

May 3

May 2

9am-2pm

9am-2pm

9am-2pm

July 28

July 26

12:30pm4:30pm

12:30pm4:30pm

N/A

Health services access and utilization

Prevention and detection

Communityclinical linkages

Communityclinical linkages (no change)

N/A

State

Figure 3. Summary of roundtable dates, time and length of meetings, chronic disease risk factor topic, strategy and area of focus

Number of 2015 attendees



Planning committee

Collaboration Multiplier Tool

Table set up

Breakout rooms

Northeast Kentucky

32

34

29

Yes

No

Roundtables

Yes

Champlain Valley (Vermont)

30

29

21

Yes

Yes

Horseshoe

Yes

Gulfcoast South (Florida)

28

31

21

Yes

Yes

Horseshoe

Yes (room dividers)

Northeast South Dakota

20

22

N/A

No

No

N/A

No

Figure 4. Summary of the number of attendees at the 2015, 2016 and 2017 roundtables, use of planning committees, Collaboration Multiplier Tool, tables and breakout rooms

Truss, M. (2013). Policy, Systems and Environmental Change in Cancer Control. [PowerPoint slides]. Retrieved from http://phpa.dhmh.maryland.gov/cancer/ cancerplan/SiteAssets/SitePages/publications/PSE%20Presentation%20FINAL.pps i

Development of this survey was made possible by partial support from Award Number UL1TR001876 from the National Institutes of Health (NIH) National Center for Advancing Translational Sciences. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Center for Advancing Translational Sciences or NIH.

5

NORTHEAST KENTUCKY REGIONAL COMMUNITY ROUNDTABLE

Goal:

Description and Overview

To promote increased integration of cancer and chronic disease efforts by convening key stakeholders and strengthening relationships at the regional level.

Twenty-nine cancer, chronic disease and community stakeholders convened on Thursday, May 18, 2017 in Morehead, Kentucky for the third of three annual Northeast Kentucky Regional Community Roundtables. The Northeast Kentucky region is highlighted in Figure 5.

Intended Outcomes of the Third Roundtable:

There were diverse professions and interests represented at the roundtable, including health educators, researchers and academics, public health professionals, and clinicians (Figure 8).

1. Deeper and common understanding of how chronic disease and cancer efforts can be integrated. 2. Commitments from Northeast Kentucky AHEC, Comprehensive Cancer Control stakeholders, chronic disease groups and community stakeholders in implementing prevention and early detection strategies to reduce the impact of tobacco on Northeast Kentuckians’ health. 3. Consensus on a continuing plan of action to address tobacco use and for integration and collaboration of efforts in Northeast Kentucky.

Figure 5. Northeast Kentucky region highlighted in yellow (Image courtesy of Northeast Kentucky AHEC)

Topic and Strategy Northeast Kentucky AHEC created a roundtable planning committee consisting of David Gross and Alexandra Stanley from Northeast Kentucky AHEC, Mary Horsley from St. Claire Regional Medical Center, Dr. Tony Weaver from University of Kentucky (UK) HealthCare and Trina Winter from the Kentucky Cancer Program. Informed by disease prevalence and risk factor data compiled by GW Cancer Center in years 1 and 2, the planning committee chose tobacco as the roundtable topic that remained constant across the three years of the initiative. The strategy was prevention and early detection for year 1, workforce improvement for year 2, and policy, systems and environmental approaches for year 3. Roundtable Meeting Summary The first half of the one-day meeting consisted of informative presentations from subject matter experts. After words of welcome and brief introductions from the AHEC, GW Cancer Center presented an introduction on PSE change to orient workgroup members less familiar with the roundtable strategy. Next, Dr. Ellen Hahn from UK College of Nursing/College of Public Health and Bobby Ratliff from Gateway District Health Department presented the continuation of the Radon Workgroup’s activities from year 1 through year 2. Based on the finding from year 1 that radon mitigation interventions were not accessible, the year 2 workgroup goals were to improve access to affordable mitigation for low- to middle-income property owners and create opportunities to increase awareness of the combined risk of radon and tobacco smoke exposure in Northeast Kentucky. Workgroup members formed the Step Up to Reduce Radon Alliance, which met four times during year 2. In February 2017, Step Up to Reduce Radon Alliance won the EnviroHealthLink MiniGrant from the Kentucky Department of Public Health. The funded project aims to

6

10 9 8 7 6 5 4 3 2 1 0

8

5

5 3 2 1

1

1

Figure 8. Self-identified professional representation of those in attendance** (n=20)

“increase radon testing and expand access to radon mitigation in the Gateway District service area.”1 Workgroup members, including Northeast Kentucky AHEC, are also involved in creating a paid and earned media awareness raising campaign and providing assistance with mitigation costs for residents with the “greatest combined risk and need based on radon level, smoking in the home and limited financial resources.”1 Dr. Audrey Darville from UK College of Nursing gave an overview of the Workforce/Certified Tobacco Treatment Specialist Workgroup’s activities in year 2. The workgroup goal was to develop a tobacco treatment specialist training to increase capacity for evidencebased treatment. The group developed the BREATHE Tobacco Treatment Specialist Training which provides 27 hours of online training and includes content consistent with core competencies established by ATTUD. At the time of the roundtable, the group was completing a pilot with 25 participants and testing the validity of synchronous versus asynchronous video conferencing evaluation. They plan to apply for accreditation with the Council for Tobacco Treatment Training Programs.

*Non-profit organization/non-governmental organization **Some respondents selected more than one option 1

Gateway District Health Department. (February 2017). EnviroHealthLink Mini-Grant Proposal.

Roundtable participants listen to Dr. Ellen Hahn’s update on the Radon Workgroup’s year 2 progress

7 Northeast Kentucky Regional Community Roundtable

Amy Jeffers presents on county smoke-free ordinances

Ashley Gibson from St. Claire Regional Medical Center provided an overview of the E-Cigarettes Workgroup activities in year 2. The workgroup’s goal was to develop and disseminate education on electronic nicotine delivery system (also known as e-cigarettes) myths to adults in Northeast Kentucky by May 2017. They achieved this through internal education, with a presentation by Dr. Ellen Hahn to the workgroup in July 2016 and through participation in the Project E-Prevent workgroup in May 2017. These internal trainings consisted of an overview of the evidence-base surrounding e-cigarettes as well as clinician guidelines and regulations on the local and federal levels. Workgroup members then performed focus groups with current and former smokers and college students to measure knowledge and determine perceptions of e-cigarettes’ effects on health. This work is ongoing and will inform a social marketing campaign intended for adults in Northeast Kentucky. Workgroup updates were followed by presentations on the year 3 strategy: PSE approaches, with a focus on smoke-free policies. Greg Waters, owner of the Mount Sterling Dairy Queen presented on Smoke-free Businesses. Amy Jeffers of Pathways, Inc. presented on County Smoke-free Ordinances and Dr. Ellen Hahn spoke on Policy Alternatives for Radon and Tobacco. Roundtable organizers and participants were excited to have Kentucky Senator Ralph Alvarado as keynote speaker after lunch. Senator Alvarado presented An Overview of Statewide Smoke-free Efforts (Public Places, Schools, Etc.). The presence of this nationally visible policy maker made for an exciting afternoon of productive conversations and a platform for discussion on the state-level.

Senator Ralph Alvarado addresses the audience regarding Kentucky’s state-level smoke-free efforts

Equipped with knowledge of workgroups’ progress and current trends and priorities for policy to address tobacco-use in Kentucky, participants broke out into workgroups for the second half of the meeting. The workgroup topics pre-determined by the planning committee were:

8

  

Radon with five members Smoke-Free Ordinances with four members E-Cigarettes with seven members

Participants joined the workgroups in which they were most interested. Subject matter experts, at the invitation of Northeast Kentucky AHEC, served as workgroup leaders. The GW Cancer Center provided workgroup leaders a facilitation guide (Appendix A) and worksheet (Appendix B) to track key information and planned activities. Each of the three workgroups planned activities over the next year that will contribute to priorities and goals of all involved parties. Workgroups discussed common goals, shared resources and activities related to PSE change and reducing the health impact of tobacco in Kentucky. Planned activities included developing a social marketing campaign about e-cigarettes targeting health care providers, current smokers and adolescents; increasing financial assistance to current radon mitigation efforts; and developing and disseminating educational presentations to increase awareness of comprehensive smoke-free ordinances.

The E-Cigarette Workgroup discusses goals and tasks, led by work group lead Ashley Gibson

Workgroups committed to communicating and meeting as necessary, whether in-person or by conference call. Evaluation A paper survey was administered after the meeting to assess process outcomes, which showed positive results (Figure 9). Comments included: 

“It was a very profitable day—good information shared from different points of view and multiple disciplines.”



“Great workshop discussions.”

Roundtable participants were also asked to complete an online survey before and after the roundtable to assess changes in participants’ perceived capability to address tobacco; expectations of the roundtable; belief that they will be able to make a difference in the field; perceived support and reinforcement of their activities; and confidence in the capability to make a difference, which all showed positive outcomes (Figure 10). Comments included:

Renee Fox of University of Kentucky’s BREATHE and the Radon Policy Division reports out on the Radon Workgroup’s afternoon discussion

9 Northeast Kentucky Regional Community Roundtable



“Would have been nice to have the decision makers for the entities represented at the meeting (e.g., public health directors).”



“We have made great progress in some regions of the state but have a long way to go. It starts by not being afraid to have the conversation about tobacco control.”

Roundtable participants also completed a survey to assess changes in social networks before the roundtable meeting in 2015, 2016 and 2017. These results will be shared in the cumulative three-year roundtable report to be released in early 2018, following the wrap-up of year 3 projects. Conclusion The third of three Northeast Kentucky Regional Community Roundtables convened key cancer and chronic disease stakeholders and has continued to leverage passionate stakeholders to advance its mission to reduce tobacco-related health effects. By taking a PSE approach, the roundtable is increasing radon mitigation in homes; awareness of the dangers of e-cigarettes; smoking cessation and screening; and the availability of tobacco cessation specialists.

Process Indicators

Post-roundtable average (n=11)

The roundtable was run efficiently

5.00

Communication leading up to the roundtable was sufficient

5.00

The facility where the roundtable was held was sufficient

5.00

Food and drinks provided at the roundtable were sufficient

4.82

I met my personal/professional goals for participating in the event

4.91

Figure 9. Post-roundtable process survey (1= strongly disagree; 5= strongly agree)

10

Success Indicators

PrePostroundtable roundtable average average (n=20) (n=14)

I have the knowledge to address tobacco

4.20

4.50

I have the skills and resources to address tobacco

4.15

4.36

I expect to expand/have expanded my network at this roundtable

4.20

4.36

I expect to learn/have learned new skills, resources and opportunities at this roundtable

4.00

4.21

This roundtable is addressing an important issue

4.55

4.79

I can make a difference in addressing tobacco

4.25

4.43

Making a difference in tobacco is within my control

4.20

4.29

Participation in this roundtable will empower/has empowered me to contribute to addressing tobacco

4.15

4.21

I have the support I need from the community in addressing tobacco

3.40

3.86

I have the support I need from local government entities in addressing tobacco

3.35

3.50

I have the support I need from state government entities in addressing tobacco

3.30

3.50

I have the support I need from national government entities in addressing tobacco

3.15

3.50

I have the support I need from academic entities in addressing tobacco

3.85

4.29

I have the support I need from health systems entities (e.g. hospitals, insurers) in addressing tobacco

3.90

4.00

I am confident in my ability to make a difference in tobacco

4.25

4.36

I am confident in the ability of the roundtable members to make a difference in tobacco

4.00

4.29

Addressing tobacco is an overwhelming task

3.55

3.36

Figure 10. Pre- and post-roundtable survey results (1= strongly disagree; 5=strongly agree)

Acknowledgements: Special thanks to Northeast Kentucky AHEC’s David Gross, Director and Alex Stanley, Educational Assistant, for coordinating the event. We would also like to thank presenters for sharing their expertise, and workgroup leaders: Mary Horsley, St. Claire Regional Medical Center; Kristian Wagner, Kentucky Cancer Consortium; Audrey Darville, UK HealthCare; and Ellen Hahn, UK College of Nursing/ College of Public Health.

11

CHAMPLAIN VALLEY HEALTHY LIFESTYLES COLLABORATIVE (VERMONT)

Goal:

Description and Overview

To promote increased integration of cancer and chronic disease efforts by convening key stakeholders and strengthening relationships at the regional level.

Twenty-one cancer, chronic disease and community stakeholders convened on Tuesday, May 23, 2017 in Colchester, Vermont for the third of three annual Champlain Valley Healthy Lifestyles Collaborative Roundtables. The Champlain Valley region is highlighted in Figure 11.

Intended Outcomes of the Third Roundtable: 1. Deeper and common understanding of how chronic disease and cancer efforts can be integrated. 2. Commitments from Champlain Valley AHEC, Comprehensive Cancer Control stakeholders, chronic disease groups and community stakeholders to implementing communication, education and training strategies to reduce the impact of obesity on Vermonters’ health. 3. Consensus on an initial plan of action to improve nutrition and physical activity and for integration and collaboration of efforts in Champlain Valley.

There were diverse professions and interests represented at the roundtable, including public health professionals, health educators, non-profit and nongovernmental organization professionals and community health workers (Figure 14). Topic and Strategy Figure 11. Champlain Valley

Champlain Valley AHEC created a roundtable planning region highlighted in yellow committee consisting of Judy Wechsler and Jane (Image courtesy of Champlain Nesbitt from Champlain Valley AHEC, Sharon Mallory Valley AHEC) from Vermont Department of Health’s Comprehensive Cancer Control Program, Judy Ashley from Vermont Department of Health St. Albans District, Pam Farnham from University of Vermont Medical Center and Blueprint for Health, Jessica French from Vermonters Taking Action Against Cancer (VTAAC) and Kim Dittus from Vermont Cancer Center and Vermont Center on Behavioral Health. The planning committee from year 1 chose nutrition, physical activity and obesity as the roundtable topic that remained constant across the three years of the initiative. The strategy for year 1 was communication, education and training, and the planning committee decided to keep the same strategy for year 2, as they had just gained momentum and wanted to continue with related workgroup activities. For year 3, the planning committee chose the strategy policy, systems and environmental approaches. Roundtable Meeting Summary After words of welcome from the AHEC and GW Cancer Center organizers and brief introductions, GW Cancer Center presented an introduction to PSE change to orient workgroup members less familiar with the roundtable strategy. The day resumed with brief updates on the two workgroups from year 2. Ed DeMott of Vermont Department of Health presented on the Promoting Healthy Lifestyles with 3-4-50 Workgroup activities from year 2. The workgroup’s goal was to support the 3-4-50 campaign at the local level by amplifying Health District Office efforts through engagement of community partners, messaging on social media, public presentations and dissemination of timely information. Workgroup members partnered with three

12

10 9 8 7 6 5 4 3 2 1 0

8

5

5 3 2 1

1

1


health district offices to incorporate 3-4-50 into their worksite wellness efforts. In Burlington and St. Albans health districts, the workgroup successfully identified a smallto medium-sized employer and obtained commitment from them to incorporate 3-450. In Middlebury health districts, workgroup members are working to identify an employer with the capacity and enthusiasm to sign onto a 3-4-50 worksite wellness partnership. Pam Farnham of the University of Vermont Medical Center and Blueprint for Health shared year 2 updates from the Providers and Referrals Workgroup. The workgroup’s goal was to increase awareness and referrals to a community-based self -management program, especially for diabetes prevention. The workgroup identified and tallied clinics with electronic health records with panel management abilities, and successfully increased referrals to these clinics through Vermont Department of Health mailings. The workgroup also circulated a diabetes prevention program toolkit to primary care practices throughout Vermont in fall 2016. This outreach is ongoing and the workgroup has partnered with Vermont YMCA’s diabetes prevention program to run two more programs in Chittenden County. *Non-profit organization/non-governmental organization **Some respondents selected more than one option

Judy Wechsler of Champlain Valley AHEC welcomes roundtable participants in the morning

13

Champlain Valley Healthy Lifestyles Collaborative (Vermont)

Workgroup updates were followed by informative presentations from subject matter experts. Ashwinee Kulkarni from Vermont Department of Health presented first on 3-4-50 and Challenges and Opportunities in Worksite Wellness Promotion. She spoke about the differences in health risk factors and chronic disease prevalence across occupations, as well as how to take a policy and environmental approach to developing worksite wellness programs, which aligns with the roundtable Roundtable attendees listen to informative presentations

Jonathan Billings of Northwestern Medical Center, Sharon Mallory of Vermont DOH, and Jessica French of VTAAC discuss incorporating 3-4-50 in worksite wellness programs

strategy of PSE change. Jonathan Billings from Northwestern Medical Center Lifestyle Medicine followed with a presentation on Evolving HealthyÜ: Using Wellness Navigation and Complementary Improvements to Reduce Spending Growth to “Zero Trend”… and How It All Ties to 3-450 and RiseVT. He spoke about Northwestern Medical Center’s employee wellness program, HealthyÜ, and a cost-benefit analysis of implementing their program. After lunch, the Collaborative reviewed the pre-completed Collaboration Multiplier Tool from the Prevention Institute (Appendix C). The roundtable speakers, representing organizations implementing nutrition and physical activity initiatives in Vermont were asked about: 1) their goals, 2) desired or achieved program results and outcomes and 3) key strategies implemented. Champlain Valley AHEC then mapped their answers in the Collaboration Multiplier Tool to identify common goals, outcomes and strategies that can be tackled as a Collaborative. Since several roundtable attendees were unable to stay for the workgroup portion of the meeting, important stakeholders were missing from the table. The group arrived at the consensus to create a singular workgroup to promote collaboration and cohesion between the various stakeholders present for the afternoon workshop. The topic of the workgroup, Worksite Wellness and 3-4-50, was determined through continued discussion among the 10 present participants of the priorities revealed through the Collaboration Multiplier. The GW Cancer Center facilitated workgroup discussions and Pam Farnham tracked key information and planned activities using the Workgroup Activity Plan Worksheet (Appendix B). The workgroup planned activities over the next year that will contribute to priorities and goals of all involved parties. The workgroup discussed common goals, shared resources and potential PSE approaches that could reduce

14

the health impact of diabetes in Champlain Valley. Planned activities included inviting key stakeholders missing from the meeting; identifying opportunities to work with industries that usually do not offer worksite wellness programs; creating educational materials and identifying platforms to disseminate information; and writing a 3-4-50 success story for GW Cancer Center’s Action for PSE Change Tool. Workgroups committed to communicating and meeting as necessary, whether in-person or by conference call. Finally, two student interns present at the meeting, Charity Ryan—a University of Vermont nursing student and Blueprint intern— and Shae Rowlandson—a University of Vermont Medical Center on Behavior and Health Research Assistant and medical student—volunteered to co-lead the workgroup’s efforts moving forward.

The workgroup plans activities to implement over the next year that will contribute to priorities and goals of all involved parties

Evaluation A paper survey was administered after the meeting to assess process outcomes, which showed positive results (Figure 15). Comments included: 

“Thank you! Wonderful day. Your efforts are much appreciated.”  “Well run day.” Roundtable participants were also asked to complete an online survey before and after the roundtable to assess changes in participants’ perceived capability to address nutrition, physical activity and obesity; expectations of the roundtable; belief that they will be able to make a difference in the field; perceived support and reinforcement of their activities; and confidence in the capability of the roundtable to make a difference, which showed mixed outcomes (Figure 16). Comments included: 

“Attendance was disappointing. Follow up steps not as clear as needed to make a difference. Seems like it may be business as usual and not necessarily anything new. Hopefully I'm wrong.”

Roundtable participants also completed a survey to assess changes in social networks before the roundtable meeting in 2015, 2016 and 2017. These results will be shared in the cumulative three-year roundtable report to be released in early 2018, following the wrap-up of year 3 projects.

Jane Nesbitt of Champlain Valley AHEC helps facilitate workgroup discussions

15 Champlain Valley Healthy Lifestyles Collaborative (Vermont)


Process Indicators The roundtable was run efficiently

4.36


4.66


5.00


4.82


4.20


Challenges and Lessons Learned The pre-roundtable work using the Collaboration Multiplier Tool required time from key stakeholders who contributed to populating the tool, but this process helped to narrow and focus discussions during the roundtable meeting. Low attendance at the afternoon workgroup discussion hindered progress towards developing a realistic action plan as certain stakeholders were missing from the group, which was reflected in post-roundtable evaluation results. However, the workgroup resolved to continue reaching out to those missing to gather their input and expertise. Additionally, the expected dissolution of Champlain Valley AHEC in November 2017 has slowed project progress and has led to skepticism about likely outcomes. A strong and sustained convener and leadership is a key factor for success of the roundtables. Roundtable members will discuss ways to sustain activities during the six month progress check-in call. Conclusion

Notes from workgroup discussions

The third of three Champlain Valley Healthy Lifestyles Collaborative roundtables convened key cancer and chronic disease stakeholders and continued information-sharing and amplifying regional efforts to tackle nutrition, physical activity and obesity-related health effects. By using a PSE approach, the workgroup is working to increase access to nutrition, physical activity and obesity interventions by aligning with the 3-4-50 state communication campaign and streamlining referrals to self-management programs.

16

Success Indicators


I have the knowledge to address nutrition, physical activity and obesity

4.30

4.25

I have the skills and resources to address nutrition, physical activity and obesity

4.00

4.25


3.70

4.00


3.90

3.50


4.80

4.50

I can make a difference in addressing nutrition, physical activity and obesity

4.50

4.00

Making a difference in nutrition, physical activity and obesity is within my control

4.10

4.00

Participation in this roundtable will empower/has empowered me to contribute to addressing nutrition, physical activity and obesity

4.10

3.50

I have the support I need from the community in addressing nutrition, physical activity and obesity

3.80

4.00

I have the support I need from local government entities in addressing nutrition, physical activity and obesity

3.50

4.00

I have the support I need from state government entities in addressing nutrition, physical activity and obesity

3.70

3.75

I have the support I need from national government entities in addressing nutrition, physical activity and obesity

2.90

3.25

I have the support I need from academic entities in addressing nutrition, physical activity and obesity

3.50

3.75

I have the support I need from health systems entities (e.g. hospitals, insurers) in addressing nutrition, physical activity and obesity

3.30

3.50

I am confident in my ability to make a difference in nutrition, physical activity and obesity

4.20

4.00

I am confident in the ability of the roundtable members to make a difference in nutrition, physical activity and obesity

4.20

3.50

Addressing nutrition, physical activity and obesity is an overwhelming task

3.80

4.00

Figure 16. Pre and post-roundtable survey results (1= strongly disagree; 5=strongly agree)

Acknowledgments: Special thanks to Champlain Valley AHEC’s Judy Wechsler and Jane Nesbitt for coordinating the event, presenters for sharing their expertise, and workgroup leaders, Ed DeMott, Vermont Department of Health; Pam Farnham, University of Vermont Medical Center; Ashwinee Kulkarni, Vermont Department of Health; and Jonathan Billings, Northwestern Medical Center.

17

FLORIDA COMMUNITY ROUNDTABLE

Goal: To promote increased integration of cancer and chronic disease efforts by convening key stakeholders and strengthening relationships at the state level.

Intended Outcomes of the Third Roundtable: 1. Deeper and common understanding of how chronic disease and cancer efforts can be integrated. 2. Commitments from Gulfcoast South AHEC, Comprehensive Cancer Control stakeholders, chronic disease groups and community stakeholders to implementing health care coordination strategies to reduce the impact of obesity on Floridians’ health. 3. Consensus on an initial plan of action to address nutrition and physical activity and integration and collaboration of efforts in Florida.

Description and Overview Twenty-one cancer, chronic disease and community stakeholders convened on Tuesday, May 2, 2017 in Tampa, Florida for the third of three annual Florida Community Roundtables (Figure 17). There were diverse professions and interests represented at the roundtable, including public health professionals, health educators, community health workers, non-governmental or non-profit organization professionals and Figure 17. Gulfcoast South region public or government employees. (Figure 20). Topic and Strategy

highlighted in dark blue (Image courtesy of Gulfcoast South AHEC)

Gulfcoast South AHEC created a roundtable planning committee consisting of Ansley Mora from Gulfcoast South AHEC, Susan Scherer from RN Cancer Guides, Venessa Rivera Colon from Moffitt Cancer Center, Kristin Chesnutt from American Cancer Society, Megan Carmichael from Pinellas Country Florida Department of Health, Lynda Gowing from Pasco County Florida Department of Health and Katy Wilbur from Manatee Country Florida Department of Health. Planning committee members from year 1 chose nutrition, physical activity and obesity as the roundtable topic that remained constant across the three years of the initiative. The planning committee chose community-clinical linkages as the strategy for year 1, coordination between health professionals for year 2, and policy, systems and environmental approaches for year 3. Roundtable Meeting Summary After words of welcome from the AHEC and GW Cancer Center organizers and brief introductions, GW Cancer Center presented an introduction to PSE change to orient workgroup members less familiar with the roundtable strategy. The rest of the morning consisted of informative presentations from subject matter experts and brief updates on the progress of year 2 workgroups. Ashley Caraccio from Primary Care & Partnerships to Improve Community Health (PICH) and Florida Department of Health, presented on a healthy eating initiative called “Fun Bites.” The campaign was adapted from a University of Southern Florida Community-Based Prevention Marketing program originally implemented in Lexington, Kentucky. The program has since expanded to 12 locations in St. Petersburg and uses eye-catching signage and promotional material at concession stands to highlight healthier choices. Next, Rocio “Rosy” Bailey, Food System Consultant at In Season Pro, LLC, presented on increasing healthy options through PSE interventions. She focused on food deserts in Pinellas County and how mobile produce vending and vegetable prescriptions have

18

9 8

8 7

7 6

5

4

4

4 3

3

2

2

1

1

1

0


potential to increase healthy eating behaviors in the region. Following these presentations, Gulfcoast South AHEC Assistant Director Ansley Mora reported on the progress of the year 2 workgroups. The year 2 Resources and Health Records Workgroup goal was to coordinate data using electronic health records. Workgroup members realized the complexities of advancing activities to improve data infrastructure after reaching out to electronic health records and information technology experts at the University of South Florida. However, members of Southwest Florida Cancer Control Collaborative (SWCCC), who are also part of the workgroup, successfully coordinated referrals and resources to local survivorship and nutrition programs. The objective of the second workgroup, Federally Qualified Health Center (FQHC) Referrals, was to increase referrals from FQHCs to patient navigators, community health workers, case managers and resources to promote healthy behaviors. A workgroup member’s organization reported hiring a community patient navigator to assist community members through the health system and refer them to resources. Next, Ansley Mora led a discussion on the current landscape of nutrition programs using PSE strategies. The GW Cancer Center assisted in facilitating a discussion to determine workgroup topics. Individual roundtable participants shared issues most important to their work pertaining to nutrition, physical activity *Non-profit organization/non-governmental organization **Some respondents selected more than one option

GW Cancer Center facilitator provides an overview of PSE change

19 Florida Community Roundtable

and obesity; their priorities and goals; desired outcomes; and expertise and resources they can provide. The GW Cancer Center facilitators then consolidated issues, priorities, goals and outcomes shared by the group into topics. These topics included data collection; resource sharing; capacity building; and behavior change education coordination. The group arrived at the consensus to create a singular workgroup to promote collaboration and cohesion between the various stakeholders present for the afternoon workshop.

Ashley Caraccio of Florida Department of Health presents on “Fun Bites,” a communication campaign designed to encourage healthy snack choices at concession stands

The topic of the workgroup, Increasing Access to Healthy Foods, was determined through continued discussion among the 18 present participants. After lunch, GW Cancer Center facilitated afternoon workgroup discussions and the workgroup leader tracked key information and planned activities using the Workgroup Activity Plan Worksheet (Appendix B). The workgroup planned activities over the next year that will contribute to priorities and goals of all involved parties. Workgroups discussed common goals, shared resources and potential communication, education and training activities that could increase access to nutritional food and decrease the burden of obesity in Southwest Florida. Activities included developing an asset map for several Southwest Florida counties, performing a scan of existing produce-delivery systems and policies and identifying at least one county where it is feasible to introduce a fresh produce truck. Workgroups committed to creating SMART objectives and communicating and meeting as necessary, whether in-person or by conference call. It should be noted that the workgroup has shifted its focus since the May roundtable meeting to developing a Training for Community Health Workers, specifically addressing healthy eating and physical activity and promoting colorectal cancer screening. Partnered with the Southwest Florida Community Health Worker Regional Network, the workgroup is working to fine-tune the topic area for this in-person training that is expected to take place on November 7, 2017. Jamie Baker-Douglin of the Senior Connection Center, Inc. is working closely with Ansley Mora to co-lead this initiative. Evaluation A paper survey was administered after the meeting to assess process outcomes, which showed positive results (Figure 21). Comments included: 

“Very good networking. Topic at hand is very large/multi-faceted. Big goals!”

20



“Appreciate the brainstorming and community resources we exchanged to further our cause.”  “I look forward to our future efforts and where we will be by year end time.”  “It was hard to reach a common goal due to all the various current initiatives and other collaborations in this area.” Roundtable participants were also asked to complete an online survey before and after the roundtable to assess changes in participants’ perceived capability to address nutrition, physical activity and obesity; expectations of the roundtable; belief that they will be able to make a difference in the field; perceived support and reinforcement of their activities; and confidence in the capability of the roundtable to make a difference, which showed some positive outcomes with several indicators unchanged (Figure 22). Comments included: 

“I enjoyed the roundtable, but I am not sure how effective we will be at tackling a problem since it was so hard to reach a common goal to work on.”



“Strongly agree we need to expand networking and write for state/ region grants so all counties are represented with funding. Maybe we can invite big business/ local [government] representatives to planning next time to engage awareness and possible funding support. I know they are busy but they have interns they can send to bring back information on Community Health risks. We all work and wear multiple hats so live 'Go to meetings' are a suggestion to share funding resources, share local business partnerships that have been successful and use it as a forum to convey the strengths and challenges to fund Nutrition, Physical Activity and Obesity in each of our served communities. The buy in to health and nutrition needs to expand to private business for funding grants are great and sometimes short lived, we need to initiate other support systems to continue our efforts. I like the idea of using interns to assist and pilot a community host Facebook website we could fund it with private industry ad space. Post “GoLive” events to advertise our [community] events and local grocery and farmers market that want to partner with Access/[Electronic Benefits Transfer] EBT for payment. The more we are in the public view the more [government] will take notice of our mission.”

Ansley Mora of Southeast Gulfcoast AHEC leads an active “standing break” to get roundtable participants out of their chairs before presentations resume

Participants vote on the most important and feasible topics to improve nutrition, physical activity and obesity in Florida

21 Florida Community Roundtable

Roundtable participants also completed a survey to assess changes in social networks before the roundtable meeting in 2015, 2016 and 2017. These results will be shared in the cumulative three-year roundtable report to be released in early 2018, following the wrap up of year 3 projects. Challenges and Lessons Learned

Jamie Baker-Douglin of Senior Connection Center serves as workgroup action planning scribe while GW Cancer Center facilitators take notes on flipcharts

Anecdotal feedback and the process evaluation feedback show that the roundtable meetings have generally helped to increase coordination and communication of state and regional nutrition and physical activity programs and activities in Southwest Florida. The Florida Community Roundtable can continue to hold discussions with dedicated SWCCC stakeholders about ways to actively involve chronic disease professionals that could add value and provide information and resources untapped by cancer initiatives. Conclusion The third and final Florida Community Roundtable convened key cancer and chronic disease stakeholders to discuss ways to tackle nutrition, physical activity and obesityrelated health effects. The singular workgroup is working to coordinate with the Southwest Florida Community Health Worker Regional Network to develop a training focusing on nutrition services and physical activity through PSE approaches. With this partnership in conjunction with supplemental funding from GW Cancer Center, this training is set to be a promising product of workgroup members dedication and a testament to the roundtable’s success in coordinating efforts between cancer and chronic disease professionals.

Process Indicators


The roundtable was run efficiently

4.60


4.60


4.80


4.80


4.50


22

Success Indicators


I have the knowledge to address nutrition, physical activity and obesity

4.29

4.67

I have the skills and resources to address nutrition, physical activity and obesity

4.00

4.44


4.29

3.78


4.50

4.11


4.86

4.67

I can make a difference in addressing nutrition, physical activity and obesity

4.21

4.44

Making a difference in nutrition, physical activity and obesity is within my control

3.86

3.88

Participation in this roundtable will empower/has empowered me to contribute to addressing nutrition, physical activity and obesity

4.00

3.78

I have the support I need from the community in addressing nutrition, physical activity and obesity

3.57

3.67

I have the support I need from local government entities in addressing nutrition, physical activity and obesity

3.29

3.67

I have the support I need from state government entities in addressing nutrition, physical activity and obesity

3.36

3.56

I have the support I need from national government entities in addressing nutrition, physical activity and obesity

3.29

3.22

I have the support I need from academic entities in addressing nutrition, physical activity and obesity

3.36

3.67

I have the support I need from health systems entities (e.g. hospitals, insurers) in addressing nutrition, physical activity and obesity

3.21

3.78

I am confident in my ability to make a difference in nutrition, physical activity and obesity

3.93

4.00

I am confident in the ability of the roundtable members to make a difference in nutrition, physical activity and obesity

3.93

3.89

Addressing nutrition, physical activity and obesity is an overwhelming task

3.86

3.44

Figure 22. Pre and post-roundtable survey results (1= strongly disagree; 5=strongly agree)

Acknowledgments: Special thanks to Gulfcoast South AHEC’s Ansley Mora for coordinating the event and presenters for sharing their expertise: Ashley Caraccio, Florida Department of Health & PICH; and Rocio Bailey, In Season Pro, LLC.

23

FINAL CONCLUSION There are risk factors common to several chronic diseases, including cancer, such as smoking, physical inactivity, poor nutrition and barriers to health care access. CDC has identified the need for coordination across cancer-specific programs such as the national comprehensive cancer control programs and other chronic disease-specific programs to reduce duplication of efforts and improve health outcomes. The GW Cancer Center designed the Community Roundtables to integrate cancer and chronic disease efforts in four states to study and monitor the development of relationships between roundtable participants and improve program design and delivery. The GW Cancer Center organized the inaugural Community Roundtables in 2015 in partnership with AHECs in Kentucky, Vermont, Florida and South Dakota with the goal of increasing cancer and chronic disease integration over three years by convening key stakeholders and strengthening relationships between them. Roundtable participants include representatives from comprehensive cancer control programs and coalitions, chronic disease programs, universities and clinics. Participants create respective regional or state action plans addressing a chronic disease risk factor and choose a different strategy each year to ensure that the risk factor is addressed in a comprehensive manner over the span of the three-year initiative. Roundtable participants completed an online pre– and post– roundtable survey for each of the three roundtables to measure readiness to address the roundtable topic, support from community, local, state and national government entities to address the roundtable topic, and confidence in the capability of the roundtable members to make a difference. The data from these surveys show that the roundtable was successful in increasing readiness and confidence even when resources were lacking. The 2017 roundtable had lower attendance than the two prior years, limiting data collection and analysis for the final roundtable and comparison across the three years. However, confidence and readiness to address roundtable topics continued to increase. The roundtable pilot ends in spring 2018 with the conclusion of implementation of objectives and activities planned during the roundtables. The GW Cancer Center will produce a report that includes overarching conclusions about best practices for future implementation, replication and potential expansion, in addition to a more in-depth and broader analysis of social network data and indicators.

For more information on the Community Roundtables or Comprehensive Cancer Control Technical Assistance offered by GW Cancer Center, visit www.CancerControlTAP.org or contact us at [email protected]

SUGGESTED CITATION The George Washington University Cancer Center. Community Roundtables Year 3 Preliminary Report: Bridging Cancer and Chronic Disease. Washington, DC, October 2017. DISCLAIMER This work was supported by Cooperative Agreement #1U38DP004972-04 from the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.

24

Appendix A Community Roundtable Facilitator Guide

Goal: Integrate cancer and chronic disease efforts to decrease [health problem] in [area, region or state] by implementing [strategy].

Facilitators:  Help organize workgroup ideas that will go into their activity plan worksheets – help the workgroup identify and summarize common ideas, as well as prioritize actions.  Ensure the workgroup finalizes an action plan that includes specific tasks, timelines and responsibilities focused on increasing workforce improvement to address [health problem] in [area, region or state].  Ensure workgroup comes to a consensus on future workgroup meeting organizer(s), frequency and method of meetings.

Workgroup Goal: complete the workgroup worksheets to develop action plan There will be flip charts to take notes during brainstorming. The second page of the worksheet can be used to record final decisions. Note: any off-topic questions or comments raised during discussions can be noted in the “Parking Lot” on page 3 to be addressed in the next meeting. Introduction (15 mins) 1. 2. 3.

Review purpose (goal, desired outcomes) Review process (use of worksheet, flip chart and assign note taker) Have members introduce themselves

Workgroup Activity Plan Worksheet 1. 2.

Have workgroup members write their names and organizations on the first page after they introduce themselves Ask someone to volunteer and record decision points on page two. This person will also be in charge of reporting out at the end of the day Discuss what success looks like and record on the right side of the second page (20 mins) Discuss and record SMART workgroup goal at the top of the page based on what was determined success looks like (10 mins) Discuss and record specific action steps, responsible person(s), due date in the matrix in the arrow (20 mins) Discuss and record critical success factors (e.g. what needs to be in place for the actions to happen and be successful), which could be PSE change, behavioral or partnership factors, in the circles below the arrow (10 mins) Discuss and record who should be involved, including those not present at the roundtable on the left side of the page (10 mins) Decide and record when the next workgroup meeting is, how often the workgroup will meet, who the organizer is, and how on the third page (5 mins)

3. 4. 5. 6. 7. 8.

Facilitator Tips during the Workshop  Maintain your role as facilitator. You may need to reiterate your role as the facilitator in the discussions, especially if your team is looking to you to make decisions for the team. The team members need to make decisions themselves, as they will be the ones implementing the action plan back home. 

Get past a controversy or stalemate. If the team seems to be stuck on an issue, or someone will not give up on an idea that is not supported by the majority of the team: o Record the issue or idea on flipchart paper as a “parking lot” idea or idea to come back to. During priority setting, the issue will either surface as a priority, or not. o Ask for a quick hand vote by the team – this will give you (and the team) a sense of where the group stands on the issue. Often these kinds of issues are perpetuated by one or two people, and not the whole team. Go with majority intent of the team.

25 

Give everyone a chance to provide input and be a part of the discussion. If someone or a few people in the team are dominating the discussion: o Go around the table and ask everyone to state their idea/suggestion o Specifically ask for a person’s opinion/idea. Say “Let’s hear from those we haven’t heard from yet”, ask another person on the team “What do you think about this?” o Ask the person(s) dominating the discussion to allow a chance for others to provide input. Say “Great ideas, now let’s hear what the other people on the team think.”



Manage the team’s time and avoid spending too much time on a task. If the team is particularly vocal on a given topic or task: o It is fine to spend some extra time on a task, provided the team is productive and dealing with issues related to the topic or task. Once you notice that new information is not being discussed, or the team is rehashing the same points, encourage the team to move forward. o If the team’s discussion is productive, but the time being spent on the issue is causing the team to get too behind in the overall task, record the main discussion points, and identify the issue as one that needs to be discussed in further depth at a future meeting. Move forward with the remaining tasks.

Appendix B

COMMUNITY ROUNDTABLE [Date]  [Topic]  [Strategy]

Workgroup Activity Plan Worksheet Workgroup topic: Workgroup member names and organizations (indicate workgroup lead with *): Name Organization

26

27

SMART Workgroup Goal:

BARRIERS 

SHARED VISION: What does success look like?

_______________________ _______________________

CRITICAL SUCCESS FACTORS 

   

DEFINE ACTION STEPS and MONITOR Task

1. CURRENT STATUS: Where do we stand today?

2.

____________________ ____________________ ____________________ ____________________

3.

4.

Responsible Person(s)

Due Date (mm/dd/yy)

28

“Parking Lot” questions and comments to be added to the agenda during the next workgroup meeting:

Next meeting (date and time):

How often the group is meeting:

Who is organizing the meetings:

How the group is meeting (in-person, conference call, etc.):

29

Appendix C

COLLABORATOR 1 Expertise/Resources:

Part II: COLLABORATION M1ULTIPLIER ANALYSIS WHAT RESULTS/OUTCOMES CAN BE ACHIEVED TOGETHER?

COLLABORATOR 4 Expertise/Resources:

Results/Outcomes:

Results/Outcomes:

Key Strategies:

Key Strategies:

COLLABORATOR 2

WHAT PARTNER STRENGTHS CAN THE COLLABORATIVE UTILIZE?

COLLABORATOR 5

Expertise/Resources:


Results/Outcomes:

Results/Outcomes:

Key Strategies:

Key Strategies:

COLLABORATOR 3

WHAT STRATEGIES/ACTIVITIES CAN 2+ PARTNERS WORK TOGETHER ON? WHO TAKES THE LEAD (L) AND WHO PLAYS A SUPPORTIVE (S) ROLE?

COLLABORATOR 6



Results/Outcomes:

Results/Outcomes:

Key Strategies:

Key Strategies:

www.preventioninstitute.org

Copyright © 2017 The George Washington University Cancer Center