Loren Bell
Linnea Sallack, MPH, RD
Altarum Institute

Increased collaboration between national and
community partners

Increased community capacity to implement policy
systems, and environmental (PSE) improvements

Increased messages on the importance of policy,
systems, and environmental improvements

Increased access to environments with healthy food
or beverage options in local communities

Increased opportunities for chronic disease
prevention and care through community and clinical
linkages in local communities

Capacity: Whether and how local projects achieved
increased collaboration across partners and increased
community capacity to implement PSE change.

Project outcomes: Whether and how local projects
achieved objectives to increase access to environments
with healthy food or beverage options and increase
opportunities for chronic disease prevention and care.

Success factors: Describe what contributes---or
presents challenges---to achieving objectives and
sustaining project efforts.

Most Cohort 1 project coordinators reported “little” or
“some” prior experience with community
engagement--working collaboratively with and
through groups to address issues affecting well-being.
“I’m our agency’s community outreach coordinator. I attend
community partner meetings and health fairs.”
“I established a breastfeeding coalition and have collaborated
with food pantries.”

Cohort 1: Change in Experience with Community
Engagement

About half the project coordinators reported challenges
building coalitions early in the project due to:
 Lack of existing, viable coalitions
 Availability and time challenges for coalition
members
 Time required to build relationships
 Delay in project launch

Once the coalitions were in place, most projects
reported few barriers to implementing their
objectives….and indicated most of the coalitions
would continue beyond the project.
“The biggest success is the relationship building, bringing
people from the community together to talk about what our
needs are and how we can move forward as a group.”
“I am surprised at the overwhelming support and
involvement of our local government, stakeholders and
community. Our coalition members are highly engaged and
committed.”

All projects indicated that they will continue to
engage with some or all of the community partners
after the project ended.
“Everyone is excited about the changes in our community
and we will continue the strategies.”
“It’s a bigger picture for the way we’re serving clients…not
just the WIC clients but the families, the community…we
are more of a team.”
Cohort 1 & 2: Early-Implementation Experience with
Community Engagement
Early Implementation Survey
100%
Percentage of Project Coordinators

90%
80%
41%
40%
70%
None
60%
13%
50%
Little
Some
40%
Substantial
47%
30%
33%
20%
10%
12%
13%
Cohort 1
(n=17)
Cohort 2
(n=15)
0%

Most Cohort 1 project coordinators reported limited
prior experience with policy, systems and
environment (PSE) change efforts.
“My focus is on programs…providing services and resources
vs. PSE work.”
“Working with some community groups enabled us to work
on policy-level changes such as community/worksite
breastfeeding policies.”

Cohort 1: Change in Experience with PSE Efforts

Lessons learned
“The PSE change thing was huge… .going from
individualized care to community engagement and policy
change has been a big learning experience .”
“The experience helped us in expanding our traditional
roles because we have skills and experience to offer to the
community.”
“We were working on projects that impacted policy, system
and environmental changes, but we didn’t call it that or
recognize it as being that! We were just improving our
community .”
Cohort 1 & 2: Early-Implementation Experience with
PSE Efforts
Early Implementation Survey
100%
Percentage of Project Coordinators

90%
18%
33%
80%
70%
None
35%
60%
13%
50%
13%
40%
30%
20%
47%
40%
10%
0%
Cohort 1
(n=17)
Cohort 2
(n=15)
Little
Some
Substantial

Success in Achieving Objectives

Across all Cohort 1 projects
 Nearly 40% of the targets for intervention
settings were achieved or exceeded.
 About half (48%) of the targets for population
reached were met or exceeded.
 For targets not achieved, there was significant
progress towards meeting the goals.

Most success reported for objectives around:
 Increasing healthy food options in stores
 Promoting WIC and enhanced WIC referral systems
 Developing tools and resources to increase awareness




of healthy eating options and preventive care services
Increasing businesses that publicly promote/welcome
breastfeeding
Increasing healthy restaurant menu options
Greater access to and utilization of farmers’ markets
Increasing donations of fresh produce by farmers to
food banks/pantries

Greatest challenges reported for objectives around:
 Working with schools to increase offerings of drinking
water and healthier food options
 Increasing the number of WIC-authorized retailers
 Implementing “green prescriptions” for healthy foods
and lifestyles
 Increasing the number of businesses that that develop
policies to support breastfeeding

What will Cohort 2 experience?

All projects reported they would continue to work with
the community partners.

Most projects reported that coalitions would continue
to meet.

75% of projects reported they would seek funds from
other sources to continue their activities.

Most projects reported activities would continue even if
there was no additional funding.
“We are just getting started and the community is fully
engaged and excited. We want to continue to grow.”

Ensure community buy-in and facilitate effective
community coalitions and partnerships.

Foster ongoing communication and exchange of ideas
among stakeholders.

Leverage expertise of coalition members, partners
and WIC staff.

Be realistic and focused on the quality and
feasibility—not quantity—of project objectives.

Plan thoughtfully and recognize that time and
resources are limited.

Learn/understand the cultural issues and needs of the
community.

Recognize--and borrow--successful efforts of other
groups.

WIC can play an important role in creating partnerships to
implement PSE changes for improving the food environment
and promoting linkages for chronic disease prevention and
treatment services.

Building strong community coalitions leads to successful
implementation of interventions and sustainability of these
efforts.

Some objectives and strategies require longer term
commitments—the short CPHMC period limited success.

CPHMC projects are an asset for WIC agencies that are
interested in community-based work…there are many valuable
lessons.

CPHMC project experience demonstrates WIC’s capacity
to improve the community that exists outside of the clinic
walls….to help families adopt healthy behaviors, have
positive pregnancy outcomes and healthy children.