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  1. Improving Health Outcomes Through a Multi-tiered Nutrition Program CSRHA – Annual Membership Meeting June 19, 2009 Chris Kelsch – Executive Director The Power of Working in Small Communities

  2. Winters Healthcare • Small FQHC – Western Yolo County • 28 Staff – 5 providers • 4 Exam Rooms – 3 Chairs Dental • 7,700 visits 2008 • Population ~7,000 • 48% Hispanic, 50% White, 2% Other • Orchards (Nuts and fruit)

  3. Medical and Dental Offices

  4. Community Food Project

  5. Why Community Nutrition? • Better support for diabetics • Started group diabetic visits 2006 • 2 Spanish groups • 1 English group • Results: better “management” of but… How do we change nutrition habits/behavior?

  6. Three Components of the Project • Nutrition and Exercise Groups • Show how to cook and eat differently • Weekly Farmers Market • Keep local grown food local • Increase access to fresh produce • Community Garden • Access to produce • Potential income for families through sales • Increase access to fresh produce

  7. Nutrition and Exercise Groups Nutrition Groups • Dietary education • Cooking with seasonal produce • EATING!! Exercise Groups • Stretching • Aerobics (walking) • Yoga

  8. Nutrition Groups WHO? • Diabetic Patients AND family members • Now - Patients of Winters Healthcare WHEN? • Three times week (M,T,W) • Meet in evening (6-7:30) • Three month cycle WHERE? • Local Parish Hall • Charge $2-3 per class • 10-17 persons per class • Food often donated

  9. Exercise Groups Exercise Groups • Meet Twice Weekly • Charge $2-3 per class • Yoga/dance studio offered space • Led by promotoras

  10. WHF Data 1st Exercise Class 1st Nutrition Class

  11. Weekly Farmers Market • Local growers both organic and conventional • Culturally integrated market • Market offerings include: • Prepared foods • Local vendors • Arts and crafts • Music

  12. Weekly Farmers Market

  13. Winters Farmers Market Place to relax Activities Music

  14. Community Garden WHO? • Garden for low-income community members to WHAT? • Grow produce for their families • Potential to sell produce at the market and via CSA WHERE? • Worked with City to identify best of four sites WHEN? • Goal- first planting spring 2010

  15. Community Garden Activities • Small Contract with “Community Garden Specialist” • Develop criteria for community garden membership • Allocate plots • Develop rules and regulations of garden • Break ground at garden site

  16. Partners and Roles Partners – “Food Project Committee” • Winters Healthcare • Market Manager – first two years • City of Winters • Responsible for sustaining market • Chamber of Commerce • Vendors and Eager to bring $$$ into business • Davis Farmers Market • Expertise in design and relationships

  17. How we organized it TIDES grant - $150,000 two years • Nutrition Exercise Program Add day to nutrition/exercise program • Farmers Market • Information from the Community • Survey of Residents - 432 surveys received! • Conducted 11 focus groups • Spanish-speaking community • Work with Local Expertise • Davis Farmers Market • Preliminary identification of local growers

  18. How we organized it Community Garden • Four potential community garden sites • Soil samples for city from Ag extension • Presented findings to City Council • Outside expertise to help establish • Local donated resources

  19. Current Issues I

  20. Issues-Potential Solutions • Issue: Market structure and access for low-income Spanish-speakers difficult • Potential Solutions: • Voucher Program (via donations/grants) • Community Supported Agriculture (CSA)

  21. Issues-Potential Solutions • Issue: Transferring the Responsibility of Market to City of Winters • Potential Solutions: • Vendor fees and sales revenue • Documenting time and developing process to ease transition

  22. Our Keys to Success • Identify people passionate about _______? • Nutrition, farming, gardens, health education • Contact City/Town -What they are doing? • Give people money from grants • Expect others to take control from beginning • Talk to council members and planning commission members • Take one piece at a time based on enthusiasm and timeline

  23. QUESTIONS? Ana Kormos – Outreach Health Ed /Market Manager 530-795-5200 wintersfarmersmarket@gmail.com Chris Kelschckelsch@wintershealth.org530-795-5200 www.wintershealth.org