Getting Kids and Families in Shape in Cambria County, Pennsylvania

For years in Cambria County, Pennsylvania, nonprofit organizations such as the Windber Research Institute have strived consistently to improve local and regional health conditions. So when the county ranked in the bottom tier in the 2010 County Health Rankings, officials were disheartened — but grateful to have a third-party data source to validate their own observations to the community.

“It was concerning in that we have, over the years, been able to galvanize the community and work with health care systems and politicians to address certain issues, so there was that level of continued frustration to see that we ranked low,” said Matt Masiello, a pediatrician and director of the Center for Health Promotion and Disease Prevention at WRI. “But potentially five years ago, we could have been lower. It gave us an opportunity … to use this information to bring the community together.”

First, WRI formed the Cambria County Health Coalition specifically to address the county’s results in the rankings (64th out of 67 counties in health outcomes; 51st in health factors). The institute also hosted a health forum to present the rankings to a number of local and regional attendees, including health care providers and school representatives.

“When the information came through on Cambria County, we contacted the county commissioners and asked them to convene a meeting specifically regarding the County Health Rankings,” Masiello said. “So they sent the word out … to come to a gathering where we at the institute developed a PowerPoint presentation revolving around the county health ranking information in general, and specifically about Cambria County.”

Encouraging attendance wasn’t difficult, he added.

“The mandate to gather is not often made by the county commissioners in such a large regional manner,” he said. “ I think it was enough. The invite was extended to a few key community players who accepted, and many others followed.”

The format of the rankings also appealed to the area’s policymakers, Masiello added.

“The County Health Rankings outlined exactly what the goals and objectives were and how, very specifically, the counties were ranked — in two major categories, and county by county,” he said. “So that presentation alone captured the attention of the politicians, certainly, because it came from a national study essentially which commented specifically about our county.”
Following the forum, attendees were asked via survey which of the county’s health concerns should take priority. The results indicated that the largest concern was for the area’s obesity rate (31 percent, compared to a target value of 25 percent, according to the Rankings), so the coalition chose to focus its action plan on that area — specifically, in helping to promote and increase enrollment in existing obesity prevention programs.

”The action plan was to develop a working group on childhood and adult obesity,” Masiello said. “The various agencies that had programs in that area came together to strategize on how to appropriately disseminate the information on those programs.”

One such program is KidShape, which according to the coalition’s abstract  paper is a wellness awareness program “for obese or at-risk children, adolescents and their families.”
To extend the program’s reach, the working group focused on publicity, tweaking things such as the language in advertisements. Using the word “obesity,” for example, may repel some families or teens who are, in fact, obese, so the group replaced the phrase “obesity prevention” with “family fitness, wellness and nutrition” in radio and television ads and flyers. Members also wrote personal letters to every school nurse and physical education teacher in the county, and reached out personally to at-risk families, Masiello said.

“We asked 15 families to participate in the group, where a child and a family member come to these sessions, held three to four times per year,” he said. “In the year prior to the formation of the coalition we’d been only getting one or two families participating, which we found to be amazing because 30 to 40 percent of the kids in this area are obese. We were getting hardly any of them.”
But after the coalition got involved, he said, attendance spiked.

“We were able to reach the number required for each session. It went up to 15, directly because of the County Health Rankings, based on comments from participants,” he said.
Encouraged by such results, Masiello said he’s optimistic that other health behaviors in the county can be changed — but that sustained improvement will continue to rely on the County Health Rankings.

“We’re definitely moving in that direction, but it really goes to the need to have the County Health Rankings around for a number of years,” he said. “The reason that I’m optimistic is that it’s no longer one individual or one research institute trying to make a difference in the community. Now we can go to a national health tool to comment on where we have been and where we potentially can go to.”