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University of Wisconsin–Madison

Assessing and Improving Community Health in Wisconsin

Shawano-Menominee Counties Health Department

Implementation Approaches

Youth:

Goal: Reduce youth access to alcoholic beverages

  • Conduct random, unannounced compliance checks by having underage individuals, under the direct supervision of adults, attempt to purchase alcoholic beverages from alcohol license holders

Goal: Hold “mock accident” programs at all county high schools

  • At least every other year, hold “mock accident” programs at all county high schools that exhibit a representation of an accident caused by alcohol intoxication, and the mock arrest, processing, prosecution, conviction, and sentencing of students posing as the perpetrators of the crime

Screening, Treatment, and Follow-up:

Goal: Screen high school students and adults for alcohol use and abuse

  • Ensure that alcohol use and abuse questions are included on standard screening health histories, questionnaires, admission forms, and screening forms
  • Encourage health care providers to inquire about alcohol use as part of their routine health assessment regimen

Goal: Ensure access to treatment

Resource guide

  • Research and create a resource guide that identifies where an insured or uninsured person can go locally to receive psychological and pharmacological treatment for alcohol addiction
  • Make guides available to health care providers, school counselors, substance abuse counselors, Alcoholics Anonymous organizations, Department of Community Programs, WIC, food pantries, Social Services, and the Health Department

  • Encourage employers and insurers to cover psychological and pharmacological treatment for alcohol addiction for employees

Community Initiatives:

Goal: Create an alcohol use/abuse workgroup

  • Create a mission, vision, and expectations for the group and its members
  • Invite community members with a vested interest in alcohol use/abuse, such as law enforcement personnel, school counselors, Mothers Against Drunk Driving members, substance abuse counselors, Department of Community Programs staff, Alcoholics Anonymous representatives, primary care providers, concerned parents, family members of alcoholics, victims of alcohol-related crimes, student groups (i.e. Students Against Destructive Decisions)

Goal: Establish an Alcohol prevention specialist

  • Seek out funding for a full or part time position dedicated to coordinating a HSC Alcohol Workgroup, community education on alcohol use and abuse, and legislative advocacy
  • Seek out funding for a health educator, school liaison officer, or other professional to staff the position
  • Identify a position currently established in an agency that would be appropriate to absorb the duties of an alcohol prevention person; alternatively, identify an agency that would be willing to create an alcohol prevention position

Goal: Reduce the social acceptability of alcohol abuse

  • Encourage employers to sponsor alcohol-free Christmas parties, company picnics, and banquets
  • Prohibit beer or liquor sponsorship of youth or family events, such as fireworks displays, rodeos, youth sporting events, youthrelated fundraisers, and school-sanctioned events
  • Deny liquor licenses to youth sporting events or family events where children or adolescents are likely to attend
  • Contact local elected officials in cities, villages, or townships when alcohol licenses come up for initial issue or for renewal
  • Speak at hearings or at “sound off” portions of public meeting agendas
  • Engage the media via press releases, letters to the editor, radio talk shows, opinion editorials, and newsletters

Goal: Support policies at the county, city, village, and township levels

  • Encourage townships, villages, and cities to raise liquor licenses to the maximum allowable amount, and allocate the increase in proceeds for community education and law enforcement
  • Pass local or state legislation that restricts alcohol consumption to controlled areas (i.e. “beer gardens” or “beer tents”) at fairs, sporting events, outdoor events, and music festivals
  • Support the use of wristbands at fairs, sporting events, outdoor events, and music festivals where alcohol consumption cannot be restricted to controlled areas
  • Pass legislation that eliminates or limits the size, color, and content of beer or liquor advertising visible from the street, road, or highway
  • Support legislation banning liquor or beer advertising within 500 feet of schools and parks

Goal: Create a community education campaign to reduce inappropriate use of alcohol

  • Create alcohol awareness campaigns that address appropriate and inappropriate use of alcohol, resources for addiction assessment and treatment, legal issues with providing alcohol to minors, and activities communities can undertake to combat underage and inappropriate use
  • Set up displays at health fairs and high foot traffic areas
  • Engage in Media advocacy several times throughout the year by disseminating information on alcohol use and abuse through: letters to the editor, radio talk shows, press releases, school newsletters

Goal: Statewide advocacy

  • Encourage state law makers to lower the legal blood alcohol limit to the level recommended by national highway safety and law enforcement agencies.
  • Encourage state law makers to substantially increase the fines, jail time, and other penalties for first time and subsequent offenses of driving while intoxicated.
  • Encourage state lawmakers to increase the tax on beer and liquor sales so that Wisconsin falls within the upper 25% bracket for alcohol taxes nationally. Ensure that additional tax revenue is earmarked for expanded law enforcement activities, and alcohol education, awareness and treatment programs.

Goal: Improve licensed beverage server education

  • Research which agency, body, or group sets the learning objectives for licensed beverage server classes
  • Encourage addition of content teaching students how to know when patrons are intoxicated and what actions to take

Goal: Provide alternatives for safe transportation

  • Maintain and promote designated driver programs and “Safe Ride” programs, where patrons under the influence are provided transportation to get home.

Goal: Increase physical activity, improve nutrition, and decrease obesity

  • Promote multi-component interventions aimed at diet, physical activity, and cognitive change.
  • Conduct community-wide campaigns that involve many community sectors in visible, broad-based, and multiple interventions to increase physical activity.
  • Pursue environmental and policy approaches to create expanded opportunities for physical activity and non-motorized transportation.
  • Conduct individually adapted health behavior change interventions to teach people specific skills that help them incorporate physical activity into their daily routine.
  • Encourage non-family social support interventions that focus on changing physical activity by building, strengthening, and maintaining social networks that provide social support. The resulting behavior changes can be made through social networks or through existing non-family networks, such as work colleagues.
  • Place “point of decision prompts” next to elevators and escalators to motivate people to use the stairs.
  • Institute interventions that modify curriculum and policies to increase the amount of time that students engage in moderate or vigorous physical activity while in physical education classes.

Goal: Increase the number of worksites that offer nutritious foods

  • Encourage employers to provide nutritious offerings in their vending machines, break rooms, and cafeterias

Goal: Start a campaign to have restaurants identify healthy entrees

  • Consult with nutritionists and dieticians to determine what reasonable parameters a “healthy” restaurant meal should fall into; set limits for calories, fat, saturated fat, fiber, and sodium.
  • Contact restaurants within the county and identify which ones would want to participate in a program that tags or identifies their healthy entrees
  • Apply for grant funding
  • Hire a nutritionist or registered dietician to analyze restaurant entrees for nutrient content
  • Allow restaurants to tag their menu entrees with little heart stickers to designate them as “heart healthy”

Goal: Increase access to locally grown fresh produce

  • Foster the creation of “farmers markets” in villages around Shawano County
  • Support the creation and continuation of community gardens and elderly or handicapped accessible gardens
  • Increase the redemption of Women, Infants, and Children’s (WIC) program vouchers or drafts at farmers markets and locally grown fresh produce stands

Goal: Maintain tobacco prevention programs

  • Maintain current tobacco prevention staffing
  • Continue to pursue state tobacco prevention and control funding

Goal: Decrease youth tobacco use

  • Create adolescent tobacco cessation programs that focus on immediate consequences of tobacco use and coping strategies to use while trying to quit.
  • Engage in long-term, high intensity media campaigns (television, radio, billboards, print media, movies) conducted over long periods of time with brief, recurring messages to inform and motivate individuals to quit or remain tobacco-free.
  • Increase the unit price of tobacco products by increasing the state sales tax on them via: media advocacy, legislator advocacy
  • Conduct random, unannounced compliance checks by having underage individuals, under the direct supervision of adults, attempt to purchase tobacco products from establishments holding licenses to sell tobacco products.

Goal: Increase tobacco cessation

  • Increase the unit price of tobacco products by increasing the state sales tax on them via media and legislative advocacy
  • Implement high-intensity behavioral and pharmacological interventions and at least one month follow-up for hospitalized patients
  • Provide and encourage nicotine replacement therapy to tobacco users trying to quit
  • Institute provider reminders that prompt or remind health care providers to determine patients’ tobacco use status and/or deliver brief advice to quit. Reminders include stickers on patient charts, vital signs stamps, medical record flow sheets, checklists, and computer screens
  • Promote telephone-based advice and counseling programs aimed at helping tobacco users quit (i.e. Wisconsin Tobacco Quit Line)
  • Reduce financial barriers that may stop patients from using effective behavioral or pharmacological therapies

Goal: Eliminate exposure to second-hand smoke

  • Support smoke-free indoor air laws through media and legislator advocacy

Goal: Make affordable and convenient primary care available

  • Encourage primary care providers (such as medical centers, clinics, health care systems, and pharmacies) to offer affordable primary care services at convenient hours to outlying areas of the county, and maintain such services already established in areas within the county.

Goal: Work to make affordable health care available to everyone

  • Encourage state and national lawmakers to establish affordable and readily accessible health care for all constituents. Encourage state lawmakers to provide adequate funding for state health programs (i.e. Medicare, Medicaid, etc.) to cover the cost of services provided.

Media advocacy

  • Letters to the editor
  • Radio talk shows
  • Press releases
  • Opinion editorials

Legislator advocacy

  • Letters, e-mails, face-to-face meetings, attending listening sessions
  • Testify at hearings in person or in writing
  • Pass resolutions at the township, village, city, and/or county level and notify the appropriate state or national leaders

Alcohol Use

Goal: Ensure access to treatment

Resource guide

  • Research and create a resource guide that identifies where an insured or uninsured person can go locally to receive psychological and pharmacological treatment for alcohol addiction
  • Make guides available to health care providers, school counselors, substance abuse counselors, Alcoholics Anonymous organizations, Department of Community Programs, WIC, food pantries, Social Services, and the Health Department

Goal: Teach suicide warning signs

Train people who have contact with populations at risk for suicide:

  • How to identify the warning signs of suicide and what to do if a person exhibits signs of suicide ideation
  • How to initiate “means reduction” (removing items from the home environment of a person at risk that can be used to commit suicide and which that person has verbalized they intend to use to commit suicide, such as firearms, medications, ropes, etc.)

Goal: Educate the community on suicide

  • Engage in Media advocacy throughout the year by disseminating information on suicide warning signs and responses to warning signs: letters to the editor, opinion editorials, radio talk shows, press releases, newsletters, website

Goal: Educate middle/high school students on suicide

  • Have friends or family members of people who have died by suicide, or those who have attempted suicide, speak in middle school or freshman health classes when those classes cover mental health or suicide.

Goal: Maintain the coalition infrastructure

  • Maintain the ROADS 401(c)3 status
  • Hold regular meetings
  • Recruit new members, especially mental health professionals
  • Keep the officer and board member positions filled
  • Maintain and update the bylaws
  • Apply for grant funding as needed
  • Create annual plans for activities and budget for those activities
  • Maintain the ROADS website
  • Maintain and support the Survivors of Suicide (SOS) Support Group for family members and friends of people who have completed suicide, and for people who have attempted suicide

Goal: Educate community members on mental health and resources available

  • Encourage employers to participate in Employee Assistance Programs (EAP)
  • Make EAP information on mental health widely available to employees via paycheck stuffers and posters on bulletin boards 
  • Employers should encourage managers to offer EAP to workers who appear to be in crisis
  • Distribute information on mental health (such as depression, anxiety, stress, effective communication, relationships, etc.) through media outlets
  • Encourage employers to include mental health screening as part of their employee wellness program

Goal: Advocate for adequate mental health resources locally and statewide

Communicate and work with Social Services, Department of Community programs, mental health services agencies, primary care providers, medical centers, regional mental health agencies, committees and elected/appointed officials overseeing aforementioned agencies, and state legislators to improve:

  • The length of time consumers must wait to receive services
  • Mental health professional shortages
  • Coordination with, and involvement of, families when consumers are discharged
  • Communication barriers between mental health professionals and families due to HIPPA and confidentiality obstacles

Goal: Promote correct child safety seat use

  • Create child safety seat incentive and education programs to reward parents for getting and correctly using, or getting children to correctly use, child safety seats.

Goal: Make seatbelt use a primary state law

  • Encourage state law makers to make seatbelt use subject to primary law enforcement.

Goal: Increase fines for child safety seat and seatbelt violations

  • Encourage state law makers to raise fines related to child safety seats and seatbelt non-use to effective levels.

Goal: Promote seatbelt use through incentive programs

  • Conduct seatbelt use incentive programs, where drivers are rewarded for using their seatbelts.

Goal: Discourage cell phone use and texting while driving

  • Encourage local law makers to enact legislation that discourages cell phone use and texting while driving

Goal: Fluoridate all community water supplies

  • Initiate a campaign to educate the community on the benefits of community water fluoridation
  • Educate city, village, and township leaders

Goal: Offer yearly school-based pit and fissure sealants to elementary students

  • Survey school administration staff members to identify which schools are interested in participating
  • Identify dentists who would be willing to volunteer
  • Create a budget proposal of how much a school-based sealant program would cost, given the number of students participating, supplies, salary and mileage for a coordinator, and equipment needs
  • Apply for grant funding to cover costs
  • Have coordinator organize and implement the sealant clinics in the schools

Goal: Make fluoride varnishes and supplements available

  • Apply for funding, and make fluoride varnishes available for Head Start classes, Women, Infant, and Children (WIC) agencies, and daycares
  • Apply for funding, and make chewable and liquid fluoride supplements available for all county children 6 months through 16 years of age

Goal: Educate parents and children on oral health

  • Encourage the creation and maintenance of oral health education programs that target both children and adults