By Pamela DeCarlo
Henry Ford knew what he was talking about when he said, “Coming together is a beginning. Keeping together is progress. Working together is success.”
All across the Bay Area, people with common goals and interests are working to address health disparities, and progress is being made. But true success comes in finding ways to connect diverse individuals and their efforts; to share insights, expertise, and resources; and to work together to achieve results. And that is exactly what the San Francisco Health Improvement Partnerships (SF HIP) has set out to do.
With support from the Community Engagement & Health Policy (CE&HP) program of the Clinical and Translational Science Institute (CTSI) at the University of California, San Francisco (UCSF), SF HIP is bringing people together and helping to deepen relationships over time to build trust, a key element of any collaboration.
Here are some examples of how SF HIP’s relationship-building effort is leading to productive and inspiring work.
Health in Schools
In early 2010, CTSI’s Roberto Vargas attended a meeting of the Shape Up San Francisco initiative at the San Francisco Department of Public Health (SFDPH). He soon recognized that some of the interventions being discussed were in line with the work that USCF researchers, and pediatrician Kris Madsen in particular, were working on. Vargas sent the Shape Up team a relevant article published by Dr. Madsen, and at the team’s request, arranged for Dr. Madsen to attend the group’s next meeting to discuss her work.
That initial meeting led to collaboration on several grants and studies. In the summer of 2010, Christina Goette, Shape Up Director at DPH served as a co-investigator with Dr. Madsen on a study assessing physical education in 26 San Francisco Unified School District (SFUSD) schools. Findings were subsequently used to determine the quality and quantity of Physical Education in elementary, middle, and high schools; and to develop policy recommendations for SFUSD.
Dr. Madsen and her team later received pilot funding from the CTSI CE&HP program to conduct a baseline study of the Safe Routes to Schools program prior to a change in the school assignment process. Madsen’s team used a Student Travel Tally to gather baseline data for 72 out of 73 elementary schools. The San Francisco Metropolitan Transit Authority used the study findings to apply for infrastructure grants for schools across the city.
Nutritious Eating
In late 2010, CTSI and SFDPH jointly planned and convened the first San Francisco Health Improvement Partnerships (SF HIP) meeting on obesity-related chronic disease prevention. The convening brought together a diverse group of nearly 50 individuals from city government, SFDPH, service agencies, SFUSD, and universities, all of whom were working to address health disparities in San Francisco. The result was the formation of three working groups, each addressing a major local issue: Food Access, Youth & Physical Activity, and Breastfeeding.
In the Food Access working group, for example, Takai Taylor of Hunters Point Family met Hilary Seligman, a researcher and clinician at UCSF. The two formed a collaboration to explore providing Women, Infants & Children (WIC) vouchers for the purchase of fruits and vegetables grown by young people in Bayview. Although the program has not yet been funded for implementation, this partnership is one example of the many budding relationships resulting from SF HIP efforts to bring people together.
Health & Physical Activity
Another conversation begun at the convening—this one bringing together representatives from government and academia—occurred between San Francisco Supervisor Eric Mar, CTSI’s Roberto Vargas, UCSF faculty members Laura Schmidt and Robert Lustig, and Christina Goette of SF DPH. The group came together to discuss the feasibility of a soda tax or some type of regulation to limit access to sweetened beverages in San Francisco, and UCSF faculty presented research on the impact of similar efforts nationwide. While this strategy was sidelined for a few months, the conversation has recently been renewed, initiated by Supervisor Mar’s staff members. The meeting last October laid the groundwork and introduced key partners for subsequent work together.
With these relationships now in place, both the Food Access and Youth & Physical Activity Partnership working groups became partners with the SFDPH on a HEAL (Healthy Eating Active Living) Zone grant proposal to Kaiser Permanente. In July, 2011, SFDPH was awarded the HEAL Zone grant, which includes $1 million over three years to combat obesity in the Bayview neighborhood by making it easier for residents to engage in healthy behaviors.
SF HIP is supporting planning activities for the HEAL Zone by funding a community input process and pilot grant effort; and bringing experts from UCSF, SFDPH, and other organizations together to review research findings and pre-existing health metrics that can serve as outcome measures.
Building on other SF HIP relationships, representatives from CTSI worked with Southeast Food Access Food Guardians and the San Francisco Department of the Environment to plan the HEAL Zone community input process. As subcontractors, The Food Guardians conducted a community input survey, as well interviews and focus groups in Bayview/Hunters Point. That data, along with input from UCSF researchers, is being used to inform a HEAL Zone Community Action Plan. UCSF researchers will provide technical assistance to Bayview HEAL Zone pilot funding applicants and grantees as they develop their pilot projects and evaluation plans.
Community Transformation
The relationships between UCSF and the SFDPH also resulted in USCF being invited to the planning group of a Centers for Disease Control (CDC) Community Transformation grant proposal. The focus of the grant was on expanding efforts in tobacco-free living, active living and healthy eating, quality clinical and other preventive services, and healthy and safe physical environments. UCSF’s role was to develop an evaluation plan, which included bringing in faculty members from the Institute for Health Policy Studies and the Center for Vulnerable Populations.
In September of 2011, San Francisco was one of only 29 counties nationwide to be awarded a Community Transformation grant. Although the funding awarded won’t support UCSF evaluation time, CE&HP faculty and staff members will continue to partner as SFDPH implements activities through this grant.
These examples demonstrate some of the ways that relationships formed and fostered through the SF HIP program are promoting progress and change in San Francisco. By bringing together leaders and representatives from service and non-profit organizations, research and academic institutions, private firms, and government, we are not only coming together, but actually working together, to reduce health disparities and promote health equity in San Franciscans.