Attachment 16. Ontario County Public Health Revision Date: Page 219 of 223

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Attachment 16 Ontario County Public Health Priority: Prevent Chronic Diseases Focus Area 1: Reduce Obesity in Children Adults Do the suggested intervention(s) address a disparity? Yes No *Objective 1.0.1 Targeting Geneva area (low income) Objective 1.3.2 Targeting FQHCs for Breastfeeding Friendly Certification (low income population). Goal Outcome Objectives Interventions/Strategies/Activities Process Measures Partner Role Partner Resources #1.1 Create communi ty environm ents that promote support healthy food beverage choices physical activity. Overarching Objective 1.0.1: reduce the percentage of children who are obese: By 5% from 13.1% (2010) to 12.4% among WIC children (ages 2-4. (Data Source: NYS Pediatric Pregnancy Nutrition Surveillance System [PedNSS]) By 5% from 17.6% (2010-12) to 16.7% among public school children Statewide reported to the Student Weight Status Category Reporting system. (Data Source: NYS Student Weight Status Category Reporting [SWSCR]) (Prevention Agenda [PA] Tracking Indicator) Implementation of evidence based programs including Get Up Fuel Up Food, Fun, Fitness. Implementation of evidence based programs such as Rethink Your Drink (group workshops). www.cdph.ca.gov/programs/cpn s/pages/rethinkyourdrinkcurri culum.aspx Provide food demos, classroom based lessons, afterschool workshops, presentations at school assemblies fairs, family parent events. Assist schools in high need communities in implementing policies, systems, practices that improve access to nutrition education, healthy foods, physical activity. Number of programs/ presentations offered. Number of participants. Pre/post test data from programs. Participant feedback. FF Thompson (FFT) to provide Get Up Fuel Up program. Finger Lakes Health (FLH) to provide Food, Fun, Fitness program. (CHAT) Public Health (PH) Ontario County Health Collaborative (OCHC) led by PH, to provide support through promotion networking. FL Eat Smart NY (Cornell Cooperative Extension (CCE)) to Provide programming, presentations, support to Geneva. -FFT: 0.25 FTE/ Grant Dollars= $6,800.00 -FLH: 0.03 FTE -PH: $14,739.86 (2 include FL Eat Smart NY/CCE OCHC. 1 Page 219 of 223

#1.3 Exp the role of health care health services providers insurers in obesity preventio n. Objective 1.3.2: By 2018, increase the percentage of infants born in NYS hospitals who are exclusively breastfed during the birth hospitalization by 10% from 43.7% (2010) to 48.1%. Data Source: Bureau of Biometrics Biostatistics, NYSDOH; NYC Office of Vital Records, NYC DOHMH) (Also, see: Focus Area Maternal Infant Health) Objective 1.4.2: increase the percentage of employers with supports for breastfeeding at the worksite by 10%. Baseline to be determined. (Data Source: NYSDOH Healthy Heart Program Worksite Survey) (Also, see: Focus Area Maternal Infant Health) Recruit hospitals to participate in quality improvement efforts to increase breastfeeding exclusivity at discharge. Encourage recruit pediatricians, obstetricians gynecologists, Federally Qualified Health Centers (FQHCs), other primary care provider practices clinical offices to become New York State Breastfeeding Friendly Practices. Specifically target FQHCs first, to reach low income population (disparity). Encourage recruit CACFP participating daycare centers/homes to become New York State Breastfeeding Friendly Certified. Identify location for Baby Café. Use the Business Case for Breastfeeding to encourage employers to implement breastfeeding-friendly policies. Number of breastfeeding classes offered. Data from breastfeeding classes. Number of primary care practices that are designated as NYS Breastfeeding Friendly. Number of women reached by policies practices to support breastfeeding. Develop a second Baby Café in the County. Number of employers that have implemented lactation support programs. Number demographics of women reached by policies practices to support breastfeeding. CSH, FFT, Finger Lakes Community Health (FLCH) to participate in quality improvement efforts to increase breastfeeding exclusivity at discharge. Encourage affiliated practices to become BF Friendly Certified. Finger Lakes Health to provide breastfeeding educational materials at affiliated family doctors. PH, S2AY Rural Health Network (RHN), WIC, Child & Family Resources (CFR), Finger Lakes Breastfeeding Partnership (FLBP) to provide training, education, assistance to practices daycare centers/homes to become BF Friendly Certified. FFT CSH to work internally to implement breast feeding worksite strategies. FLH to distribute Business Case for Breastfeeding CLC referral materials to practices who see new mothers. PH FLBP/S2AY RHN/Regional Worksite Wellness Committee to reach out to provide support to worksites in -CSH: 200 staff hours/ -FFT: 0.02 FTE per -FLH: 0.01 FTE -PH: $13,475.02 (2 -WIC: 0.40 FTE -FLBP/S2AY RHN: $3,300 (2 include FLCH CFR. -FFT: 0.01 FTE per -CSH: 100 staff hours -FLH: 0.01 FTE -PH: $6,209.08 (2 -FLBP/S2AY RHN/Regional 2 Page 220 of 223

adopting breastfeeding friendly policies. Worksite Wellness Committee: $3,300 (2 Priority: Prevent Chronic Disease Focus Area 2: Reduce Illness, Disability Death Related to Tobacco Use Secondh Smoke Exposure. Do the suggested intervention(s) address a disparity? Yes No *Objective 2.1.3 Low income population youth. Goal Outcome Objectives Interventions/ Process Measures Partner Role Partner Resources #2.1 Prevent initiation of tobacco use by youth young adults, especially among low socioecono mic status (SES) populations. Objective 2.1.3: By December 31, 2018, increase the number of municipalities that restrict tobacco marketing (including banning store displays, limiting the density of tobacco vendors their proximity to schools) from zero (2011) to 10. (Data Source: Community Activity Tracking, CAT) Strategies/Activities Encourage municipalities to implement policies that protect youth from tobacco marketing in the retail environment, also known as the point-of-sale (POS). Number of municipalities that restrict tobacco marketing in stores, including: o Tobacco display restrictions o Prohibiting the coupons multipack discounts Number of elected officials communicated with about the impact of retail tobacco marketing on youth. Number of public hearings attended. Number of organizations/key community leaders engaged in efforts. Information, advertisements, media utilized to educate promote efforts. Tobacco Action Coalition of the Finger Lakes (TACFL) to provide programming, outreach to elected officials, attendance at public hearings, education/media outreach. OCHC led by PH, to provide support through promotion networking. Efforts to be led by TACFL. Additional partners include OCHC. -PH: $661.02 (2 3 Page 221 of 223

Priority: Prevent Chronic Disease Focus Area 3: Increase Access to High Quality Chronic Disease Preventative Care Management in Both Clinical Community Settings. Do the suggested intervention(s) address a disparity? Yes No Goal Outcome Objectives Interventions/Strategies/ Process Measures Partner Role Partner Resources #3.2: Promote evidencebased care to manage chronic diseases. Objective 3.2.4: increase the percentage of health plan members, ages 18-85 s, with hypertension who have controlled their blood pressure (below 140/90) Activities Participation in regional blood pressure registry. Number of primary care practices that submit patient numbers to registry. PH, FLH, CSH, FFT, S2AY RHN to provide assistance in recruiting practices to participate in registry. FLH FFT to provide Data to Finger Lakes Health Systems Agency (FLHSA) through EHR transfer. FLHSA to provide programming, reports, technical assistance to practices partners. -PH: $1,303.62 (2 -FLH: 0.02 FTE -CSH: 200 staff hours -FFT: 0.02 FTE per -S2AY RHN: $2,475 (2 #3.3 Promote culturally relevant chronic disease selfmanageme nt education. Objective 3.3.1: increase by at least 5% the percentage of adults with arthritis, asthma, cardiovascular disease, or diabetes who have taken a course or class to learn how to manage their condition. (Data Source: BRFSS; annual Promote the evidence-based interventions to prevent or manage chronic diseases. Percent of adults with one or more chronic diseases who have attended a selfmanagement program. Number of providers that use their EHRs to trigger them to speak to their patients about their weight, diet exercise, refer them to EBIs. FFT Wayne CAP to offer conduct CDSMP classes. Promote enroll members in classes. PH to coordinate training for additional CDSMP trainers. OCHC to identify additional partners that can be trained in CDSMP, promote classes support as a county wide initiative. -FLHSA: in kind -Wayne CAP: $10,211 -FFT: 0.04 FTE/ Grant Dollars= $7,000.00 -PH: $3,668.04 (2 -S2AY RHN/Regional 4 Page 222 of 223

measure, beginning 2013) S2AY RHN / Regional Living Healthy Group to assist with coordination of evidence based programs provide back-up peer leaders for classes. Living Healthy Group: $1,886 (2 include OCHC. Priority: Promote Mental Health Prevent Substance Abuse Focus Area 2: Prevent Substance Abuse Other Mental Emotional Behavioral Disorders Do the suggested intervention(s) address a disparity? Yes No Goal Outcome Interventions/Strategies/ Process Measures Partner Role Partner Resources #2.1 Prevent underage drinking, nonmedical prescription pain relievers by youth, excessive alcohol consumption by adults. Objectives Objective 2.1.2: December 31, 2018, reduce the percentage of youth ages 12-17 s reporting the use of non-medical painkillers. (Baseline: 5.26% 2009-2010, NSDUH, Target: 4.73%) - Tracking Indicator Activities Implement strategies to prevent overdose including Engaging the community coalition building Educating prescribers Reducing supply diversion control through lock your meds campaigns, placing prescription drop boxes, facilitating drug take back days Harm reduction through Narcan trainings Community based prevention education Continued evaluation of project components/success Number of members engaged in coalition. Number of schools student participants. Number of trainings held for prescribers. Number of medication drop boxes placed ( drug take back days). Number of educational trainings, workshops, forums held (number of participants). Substance Abuse Prevention Coalition (Partnership for Ontario County) to provide programming, trainings, educational sessions, facilitate coalition, work with law enforcement to place drop boxes ( drug take back days). PH, CSH, FLH, FFT, Ontario County Mental Health (OCMH), OCHC, law enforcement to provide support through promotion, networking, sending staff to trainings (NARCAN, Mental Health First Aid, etc.). CSH houses a psyche unit providers numerous in/outpatient services for psyche substance abuse, case management. PH, FLH, FFT, CSH to provide NARCAN trainings /or education. -PH: $2,372.13 (2 -CSH: 6,240 staff hours -FLH: 0.01 FTE -FFT: 0.01 FTE include the Substance Abuse Prevention Coalition, OCHC, law enforcement, OCMH. 5 Page 223 of 223