Building Coalitions to Foster Healthy Louisiana Communities

Denise Holston, Eubanks, Gina E., Cater, Melissa W.

Denise Holston, Melissa Cater and Gina E. Eubanks

Contributing to the health and well-being of everybody in Louisiana has always been the goal of the LSU AgCenter nutrition education program. Helping people eat healthier, lose weight and exercise more goes a long way toward disease prevention and intervention. This will help hold down health care costs, improve workforce productivity and enhance the quality of life for everyone.

Instead of the more traditional model of teaching classes and working with families one-on-one, the new approach is to work with the entire community and determine changes to be made to make it easier for people live a healthier lifestyle. The new model began in 2013 with the establishment of the Healthy Communities program in West Carroll Parish. This effort, which included the Southern University Agricultural Research and Extension Center and the Pennington Biomedical Research Center as partners, involved extensive outreach and coalition building among all segments of the community. The success in West Carroll Parish then served as a model for expanding the Healthy Communities program into more parishes and obtaining ever-increasing amounts of grant money from local, state and federal sources, including in 2018 a $5 million, five-year grant from the Centers for Disease Control and Prevention Division of Nutrition, Physical Activity and Obesity.

A key aspect of the program is community mobilization, which occurs by engaging community coalitions and stakeholders to plan, develop, implement and evaluate strategies and approaches that address barriers and facilitators to healthy behaviors. Community mobilization is important because it creates opportunities, resources and partnerships, which enhance community buy-in.

To launch the initiative, the AgCenter agent first organizes and facilitates a community forum. These forums serve to build awareness and gather community support. In addition to assisting in stakeholder engagement, the community forums are a first step in conducting needs assessments in the parish. Forum attendees share information and perspectives on the assets and health challenges in the community and discuss the most beneficial and readily implementable changes. The forums are designed to be a structured group consensus meeting where facilitators ask participants about the perceived overall health status of adults and children in their parish; reasons for good or poor health; the strengths, weaknesses, opportunities and threats related to improving health; and their vision for a healthy community. At the end of the forum, attendees have the option of joining the local Healthy Communities coalition. The AgCenter agent selects coalition members to be representative of the demographics and sectors of the target community.

After the coalition is assembled, the AgCenter agent presents forum results at the first coalition meeting in each parish, which generally guides the direction of the coalition’s planning. Community coalition membership generally includes representatives from schools, local government, managed care organizations, faith-based organizations, businesses, nonprofit organizations, health care organizations, youth and community residents. Members contribute to the coalitions by helping to decide strategy, leveraging resources such as donations from business owners, volunteer labor, in-kind donations, and by raising awareness of community health needs through each coalition partner’s social and professional networks. See Table 1 for a list of the partnerships statewide as a result of the Healthy Communities program in three parishes — Madison, St. Helena and Tensas.

Over time, the AgCenter agent will work with the community coalition to consider the relevant information to select, plan and implement policy, systems and environmental approaches to make the healthy choice the easy choice. Examples of projects being implemented include:

  • Painted play spaces. AgCenter agents and community members identify public places that can be permanently stenciled to create opportunities for physical activity for children. Stenciled play spaces include games such as hopscotch, mirror me, and even basketball courts.
  • Community and school gardens. These have been developed in communities around the state. In Terrebonne Parish, the coalition is working to develop a community garden that will serve to provide fruit and vegetables to needy students and families. As part of their commitment, local businesses, groups and individuals sponsor gardens.
  • Smarter school lunch rooms. This is an intervention in the school cafeteria intended to reduce plate waste and promote healthy foods through printed reminders.
  • Walkability to everyday destinations. These interventions seek to make it easier to walk places in towns and communities. This may include painting or repainting of crosswalks.
  • Farmers markets. Several communities are establishing farmers markets where they have not had them before. For those communities that have an existing market, the focus is on promoting the market, which may include farmers market tours, cooking demonstrations and taste tests.
  • Faithful Families. This is a faith-based intervention developed in North Carolina that “builds on the connection between health and faith at multiple levels through individuals, interpersonal relationships, organizational policies and practices and environment, and the broader community.“
  • Healthy retail. Interventions include food demonstrations, signage, healthy food stocking and taste testing at grocery stores and other business establishments that sell food.

The collection of evaluation data is still in the early stages, but results indicate that members believe that the planning carried out by their groups has led to better targeting of services and programs. Members also expressed a sense of group cohesion, which is an important element of group success. When people feel connected to a group, they are better able to discuss issues and achieve consensus.

Denise Holston is an assistant professor in the School of Nutrition and Food Sciences; Melissa Cater is director for the LSU AgCenter Northeast Region as well as associate professor and an extension evaluation specialist; Gina E. Eubanks is an associate vice president and program leader of nutrition and food sciences.

(This article appears on the fall 2019 issue of Louisiana Agriculture.)

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Joy Sims, an AgCenter agent in Madison and Tensas parishes, leads a Healthy Communities coalition meeting in the Madison Parish Extension Office. Photo provided by Denise Holston

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Joy Sims, an AgCenter agent in Madison and Tensas parishes, center to the left of the banner, poses with members of the Healthy Communities coalition in Madison Parish. Photo provided by Denise Holston

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As members discuss issues, they make notes on wall posters around the room. This poster has notes about food and physical activity (PA). They use sticky notes to organize priorities. Photo provided by Denise Holston

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Joy Sims, an AgCenter agent in Madison and Tensas parishes, center, speaks with youth participants at a Madison Parish Health Fair. Photo provided by Denise Holston

1/9/2020 6:53:40 PM
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