Coquille Indian Tribe
Healthy Communities Project
M7572
Healthy Places, Healthy People:
A Framework for Oregon*
 Together heart disease, stroke, diabetes and
chronic respiratory disease account for three of
five deaths in Oregon.
 61% of adults have one of the following: arthritis,
asthma, diabetes, heart disease, high blood
pressure, high cholesterol and stroke.
 89% have one of the risk factors for these
conditions: current smoker, overweight or
obese, physical inactivity or consumption of too
few fruits and vegetables.
*Healthy Places Healthy People: A Framework for Oregon; OR DHS, Public Health Division, Health
Promotion Chronic Disease Prevention. December 2008
Healthy Places, Healthy People: A
Framework for Oregon
 Oregon Health Promotion Chronic Disease Prevention
Program
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Vision 2020: All People in Oregon live, work, play and learn
in communities that support health and optimal quality of life.
Mission: To advance policies, environments and systems
that promote health, and prevent and manage chronic
disease.
 Work together to reduce exposure to tobacco products
and secondhand smoke, make it easier to access healthy
foods and be physically active, and assure people can
easily manage their chronic diseases.
Coquille Indian Tribe Healthy
Communities Project
 The Healthy Communities Project:
Gathering partners and stakeholders to access the
environmental and policy factors that affect the health of the
community and the chronic disease environment.
 Identify community health strengths and needs of the
Coquille Indian Tribe.
 Develop a multi-year plan focused on improvements to help
community members be as healthy as possible.
 Purpose
 Reduce the incidence of chronic disease most closely linked
to tobacco use, physical inactivity , and poor nutrition.
 Improvements to policy and environmental factors, policies,
social norm and best practices to improve healthy behaviors.
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Coquille Indian Tribe Healthy
Communities Project
 Examples
Tobacco Free Worksite Policy
 Examples of Health Policy that are now expectation:
 New York City Tenements Sanitation
 Indian Health Service
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Water and Sanitation
Tobacco Use
 Surgeon General’s Report 1964
Seat Belts and Car Seats
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Coquille Indian Tribe Healthy
Communities Project
 OR Health Authority Health Promotion Chronic Disease
Prevention (H.P.C.D.P.) Tobacco Prevention Education
Program (T.P.E.P.) “Healthy Communities” Funding
 Conduct Community Health Assessment based on CDC
CHANGE (Community Health Assessment and Group
Evaluation) Tool
 Modified to meet the needs of the Coquille Indian Tribal
Community
T.P.E.P. Stakeholders
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Health and Human Services Administrator
Assistant Health and Human Services
Administrator
Tribal Council Representative
Elders Program Coordinator
Community Health Representative
Coquille Indian Tribe Police Representative
Coquille Indian Tribe Housing Authority
Human Resources Director
Prevention Coordinator
Health Advisory Board Representative
Coquille Indian Tribe Healthy
Communities Project
 Environmental Changes:
 Policy Changes: laws,
physical, social, economic
factors that influence
practices
 Examples
regulations, rules, protocols
that guide behavior
 Examples
 Policies that require
healthy food choices be
offered at meetings
 Policies Smoke Free
Tribal Events
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Walking path around the
Kilkich Community
Nasomah Healthy
Traditions Incentive
Framework
C.H.A.N.G.E.
Sample Questions
 Community-At-Large Sector
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Physical Activity
To what extent does the
Tribe encourage walking by
developing, maintaining,
and/or promoting walking
routes to, from and around
tribal properties?
To what extent does the tribe
offer, promote, or provide
access to traditional cultural
physical activities like
dancing?
Leadership
Does the Tribe have a health
promotion budget?
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Nutrition
To what extent does the
Tribe use locally grown and
traditional foods at Tribal
restaurants and events?
Tobacco
To what extent does the
Tribe prohibit commercial
tobacco use for outdoor
public places?
Chronic Disease
Management
To what extent does the
Tribe educate Tribal
members about obesity
prevention?
C.H.A.N.G.E.
Sample Questions
 Health Care Sector
 Physical Activity
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To what extent do health care
providers assess patients’
physical activity during routine
office visits?
 Nutrition
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To what extent do the health
care facilities provide free or
low cost weight management
or nutrition programs?
 Tobacco
 To what extent do health care
providers provide regular
counseling about the harm of
commercial tobacco use and
exposure during routine office
visits?
 Chronic Disease Management
 To what extent do the health
care facilities have a systematic
approach to diabetes care?
 Leadership
 To what extent do the health
care facilities provide access to
medical services outside of
regular working hours ?
C.H.A.N.G.E.
 20-40 Questions in each sector
Major Community Events, Health Care, Education, Tribal
Government, Work Site
 Score
 Policy
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1 - Not identified as a problem
3 – Policy formulation and adoption
5 – Policy evaluation and enforcement
Environment
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1 – Elements not in place
3 – Some elements in place
5 – All elements in place
C.H.A.N.G.E. Findings
 Chronic Disease Management
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Received high scores except Major Community Events
had scores less than 3
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Education (Afterschool/Summer Programs/ Head Start
and Tutoring)
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Reason: No onsite preventative medical
screenings and chronic disease management
education and prevention
Lower score due to inconsistent engaging of
parents in chronic disease prevention for Tribal
youth
Tribal Community low scores for use of traditional
wellness to address chronic disease
CHANGE Findings
 Nutrition
 Low policy scores but high environmental.
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Many evaluated a 2 for policy and a 3 for
environmental support. Indicating support from some
but not consistent enough for policy.
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Examples: nutrition labeling of foods at Tribal events,
healthy options at all Tribal events, healthy vending
machines, access to refrigeration for staff, weight loss
programs, promotion and education regarding
traditional foods, programming to support community
gardens, etc.
C.H.A.N.G.E. Findings
 Physical Activity
 Most differences between sectors
For Example: Education and Tribal
Community had only one score below 3 but
worksite had many 1 and 2 scores.
The environmental score for traditional cultural
physical activities was 4 however, the policy score
was 1.
Midwinter gathering and Restoration Celebration
had both scored low for policy but high in
environmental.
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C.H.A.N.G.E. Findings Physical Activity
CHANGE Findings Physical Activity
CHANGE Findings
 Commercial Tobacco Use
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Overall the Tribe’s policies and environmental
support for commercial tobacco cessation received
high scores.
Access to commercial tobacco cessation products
and services was indentified as particularity strong.
Three questions scored low:
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Education sector scored a 2 for referring
participants for tobacco cessation.
Tribal Community received a 1 for
environmental elements in place to prohibit
commercial tobacco promotions, and prizes.
CHANGE Findings –
Commercial Tobacco
Healthy Communities Discussion Draft:
Community Health Action Plan
 Goal:
 To support Tribal members and Tribal employees making
healthy choices, improving their health and well-being.
 Strategies:
 Develop policies and programs that make it easier for Tribal
members and employees to:
 Choose to eat healthy foods
 Engage in physical activity
 Self-manage chronic disease
 Reduce, quit, or never start using commercial tobacco
products
Coquille Indian Tribe
Sample Strategies
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Policy Actions: Healthy Foods
 Develop a “Healthy Food” policy for all Tribehosted events and meetings with food that
requires:
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Healthy food choice alternatives at all events and
meetings with food.
Traditional food options, with labeling that describes
the food and its nutritional value, be available at all
Tribe-hosted events and meetings with food.
Smaller or half portions and “tasting options” with
serving size labeling to be offered at all Tribe-hosted
events and meetings with food.
Coquille Indian Tribe
Sample Strategies
 Program Activities Physical Activity
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Develop informational materials about walking
trails on Kilkich community land.
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Create maps or brochures of walking trails, include
mileage information, elevation gain, and level of
difficulty.
 Funding Opportunity
Next Steps
 Currently in the Process of Completing the
Healthy Communities Action Plan.
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Goal to complete 6-30-12.
 Gain support and approval through the
appropriate Coquille Tribal Channels.
 RFP “Oregon Healthy Communities
Implementation Program”.
Healthy Tribal Communities
 Contact:
 Kelle Little, RD, CDE
Health and Human Services Administrator
Coquille Indian Tribe Community Health Center
kellelittle@coquilletribe.org
541-888-9494 , ext: 20217