OutsideIn SLO: We Take Health and Climate Change Personally

State: CA Type: Model Practice Year: 2016

San Luis Obispo (SLO) County has a population of approximately 279,000 people and is located midway between Los Angeles and San Francisco on the Central Coast. Most of the county’s 3,326 square miles are unincorporated. The majority of residents live along the coast or along the main highway corridor. According to the 2015 County Health Rankings, a project of the Robert Wood Johnson Foundation, SLO is ranked 9th in health outcomes, out of 58 California counties. According to census data from 2013 American Community Survey, the population of the county is primarily white (71%), with Hispanics being the largest ethnic group (21%). Approximately 14% of people live below the poverty level but the low-income population appears to be under-represented in terms of census data and Cal-Fresh participation rates. While only 6.5% of total county residents participate in Cal-Fresh, 44.3% of all school-age kids qualify for the Free or Reduced Meal Program. The northern part of the county is very conservative politically; the central and coastal areas tend to be liberal and progressive. OutsideIn SLO: We take Health and Climate Change Personally (, is a climate change and health education campaign lead by a partnership between the SLO Public Health Department and the California Department of Public Health (CDPH). OutsideIn SLO was designed to highlight the co-benefits between climate change mitigation and health promotion, focusing on key strategies for reducing greenhouse gas emissions (GHGs) that also have a beneficial effect on health and quality of life. It is the first formal climate and health education campaign implemented by a local health department in California. According to Georges Benjamin, MD, Executive Director of the American Public Health Association, “Climate change is one of the most serious public health threats facing our nation. Yet few Americans are aware of the very real consequences of climate change on the health of our communities, our families and our children.” According to Edward Maibach, MPH, PhD, and his colleagues at the Center for Climate Change Communication at George Mason University, public health professionals have many opportunities to engage Americans in climate change issues, “thereby enhancing climate change understanding and decision-making capacity among members of the public, the business community, and government officials.” The campaign was designed to be emotionally compelling, to be immediate and action-oriented, to educate individuals that it was their responsibility to be part of the solution, and to be positive. The campaign had three broad goals:• Train staff, clients, and the community on the relationship between climate change and health• Motivate people to take action• Do it all on a shoestring budget Planning for the campaign began in January 2014 and the evaluation of the campaign was started in August 2015. The campaign was very successful and all objectives were met.• 20 presentations were made to over 700 people including training the majority of public health staff, and educating numerous community groups .• Outreach was performed at 10 different farmer’s markets.• The campaign garnered coverage in 8 different earned media pieces including newspaper articles, and radio interviews. In addition, at least one post per week was featured on the public health department’s social media accounts.• Three different public service announcements were aired, both in English and Spanish, in over 1,500 spots on local radio stations.• 1,100 WIC families received either individual or group education on climate change. Messaging was integrated into the WIC nutrition curriculum, connecting climate and health co-benefits of buying local, seasonal produce, as well as active transportation, and things clients could do at home.• Over 1,700 hundred hours of staff time collectively was spent on the project but because this was spread out between many staff members the burden was not unreasonable. Other than paying a student intern to help coordinate the many program facets, little additional funding was necessary to make the program operational. The reception to the program was very favorable, both from inside the public health department and in the community at large. The local Congresswoman who represents our district heard about what public health was doing and made a visit to see us to learn more, She was extremely impressed both by the breath of our activities and the fact that we were able to do it with little funding. As the final evaluation report is being completed, the goal is to distribute it to all the health officers in the state, hoping that our project will influence them to try a similar project in their jurisdictions. We also have been noticed by state and national WIC officials who hope to learn how they can also integrate climate change education into their WIC clinics.
Climate change presents an important challenge for public health, but it also offers tremendous opportunities to create healthier, more vibrant and sustainable communities. While considerable work has been done in recent years to increase public knowledge about the implications of climate change, few formal efforts have used a health frame to reach the public. In 2015, the Lancet Commission stated: “The health community has a vital part to play in accelerating progress to tackle climate change. Health professionals have worked to protect against health threats, such as tobacco, HIV/AIDS, and polio, and have often confronted powerful entrenched interests in doing so. Likewise, they must be leaders in responding to the health threat of climate change. A public health perspective has the potential to unite all actors behind a common cause—the health and wellbeing of our families, communities, and countries.” Climate change will impact everyone who lives in every community on earth. According to Dr. Margaret Chan of the World Health Organization, “climate change is the defining issue for the 21st century. Climate and weather variables affect the air people breathe, the food they eat, the water they drink, and the chances that they will get infected with a life-threatening infectious disease.” However, while everyone will be impacted by climate change, some people will suffer more than others. The term “climate gap” is used to describe the impacts to the poor and people of color who will:• Suffer higher mortality and health impacts and who will experience more frequent and intense heat waves• Be exposed to higher air pollution levels – the current pattern of pollution exposure and health inequality could become even worse• See the “spending gap” widen and pay a greater cost for basic necessities• Experience reduced economic opportunities with shifting job opportunities and greater job losses It is difficult to estimate how many people were reached in our county by OutsideIn SLO. We know we reached over 700 people in formal presentations. Of the 700, approximately 130 were public health staff (72% of total full time staff members). We know we reached 1,100 WIC families, which represents about 5,000 people (estimating 4-5 people per family). The WIC families represent people in the climate gap, the most vulnerable in our community. We also know that at least the 800 followers of our Facebook page were exposed to our social media posts. But it is hard to estimate how many people saw us at farmer’s markets, heard the radio spots, listened to the talk shows, or read the articles in local papers. Our radio spots were placed on every major radio station in our county, so we had thorough coverage, but no one contacted us to ask for more information as a result of those spots being aired. Previous work in climate change in our county consisted of:• The planning department completed one of the first climate action plans (CAP) in the state in 2010. CAPs were mandated by state government to address greenhouse gas emissions (GHG). The Health Officer and Environmental Health Director participated in planning sessions to develop the plans but they were primarily the work of the planning department.• The Health Promotion Director had participated in workshops offered by the state on climate change communication. As a result, she began making presentations to graduate students at the local university as to why climate change is a public health issue.• HEAL SLO, the county obesity prevention coalition, had been in existence for eight years. The coalition did the normal things a coalition like this does, educating the community on healthy eating and active living, but had also been involved in innovative policy projects. In 2012, they worked with diverse partners to pass a Buy Local ordinance, directing county staff to purchase local produce whenever possible in the course of county business. Also in 2012, a Healthy Communities workgroup was formed. The purpose of this multi-disciplinary group is to review new development proposals through a health lens, sending written comments to the planning commission.• About the same time OutsideIn was started, the county also started participating in CalBRACE. BRACE (Building Resistance Against Climate Effects) is a CDC project that helps jurisdictions identify climate impacts in their region and prioritize interventions. CalBRACE is the CDPH partner in nationwide BRACE efforts. Researchers at CDPH developed indicators and vulnerability assessments for each participating county.• Finally, both the Health Officer and the Health Agency Director were supportive of climate change work and had participated in workshops and symposiums on the issue. We know that OutsideIn SLO was an innovative approach, at least in California. CDPH works with all local health jurisdictions on many different health issues and they are not aware of anything like this being done statewide. There is some work being done on climate change in many local health departments but what is being done occurs in emergency preparedness programs, and is usually funded by federal dollars, or the work is done in environmental health departments, often collaborating with planning departments. Our approach was a health promotion approach and we were attempting to connect with people’s values and emotions, but also to compel them to action. The idea was simple. Health educators are already in the community educating on nutrition and exercise. It would be easy to combine messages, focusing on the co-benefits. For example, while advising people to use active transportation and ride their bikes to work, the educator could say that riding bikes is great for your heart, can help you maintain a healthy weight AND is good for the environment and helps reduce GHGs. In an interview during the evaluation phase, the Health Officer stated: “The co-benefit message was really important, particularly for a public health department to say that we are coming at this from a health improvement perspective for the individual. That really resonated for me and a lot of other people. Embedding the program in the health promotion division was one of the smartest things we did. While our health educators are speaking to community groups they can educate about nutrition and physical activity - but also ask people if they know that eating healthy and riding their bikes goes beyond personal wellbeing and can impact the community at large?” Probably the most innovative part of the project was integrating the climate change message into WIC classes. WIC is a federally-funded health and nutrition program for women, infants, and children. WIC helps families by providing nutrition education, issuing checks for healthy supplemental foods, and making referrals to healthcare and other community services. Participants must meet income guidelines (185% of the federal poverty level) and be pregnant women, new mothers, infants, or children under age five. Because climate change was a new topic for the WIC Program to address, the first step was to train WIC staff. The WIC Program manager said, “I think a lot of the staff was like me with their initial impressions. They never saw the link between the health issues and climate change. It was new information for them. We had solid support from the staff after the training that this was an important topic to address with our WIC clients.” The OutsideIn SLO team worked with WIC staff to develop the WIC class curriculum and Spanish language translation. The class that was developed was about 20 minutes long and covered:• The difference between weather and climate• Climate impacts to expect in SLO, along with related health impacts (increased temperature, wildfires, drought, sea level rise, extreme weather events , decreased air quality)• What people can do to make a difference – active transportation, buying local/seasonal produce, decreasing home energy use, and drinking tap versus bottled water. SLO is experiencing an extreme drought and this was an opportunity to discuss the benefits of drinking tap water. A handout was developed that showed if a person drank 20 gallons of tap water per month the annual cost was $2.78. If they drank 20 gallons of bottled water per month, purchasing single bottles each time, the annual cost was $1,988.00. Many clients came from countries were tap water was not safe, but were receptive to this idea once educated, because of the financial savings.
As previously mentioned, the project was designed to highlight the co-benefits between climate change mitigation and health promotion, focusing on key strategies for reducing greenhouse gas emissions that also have a beneficial effect on health and quality of life. The development of the project occurred along the following timeline:• January 2014 - CDPH proposed the partnership to SLO Public Health Department. The Division Manager in charge of the project got permission to participate from the Health Officer and Health Agency Director. The Division Manager began reaching out to community partners to ask them if they would be interested in participating and advising the project as it unfolded. An impressive groups of community members agreed to participate including: a retired member of the Board of Supervisors, several members of the Planning and Building Department; representatives from the Air Pollution Control District (APCD); representatives from the metropolitan transportation planning organization (SLOCOG); representatives from the Sierra Club; a representative from the largest private local funder, the SLO County Community Foundation; a private healthcare consultant; the Executive Director of the Bike Coalition; the Environmental Health Director; WIC staff; several planners from local private businesses; several representatives from local non-profits serving low-income residents; and numerous representatives from the local university (faculty from the City and Regional Planning Department, the Executive Director of the Center Sustainability in the Agriculture Department, and staff from their obesity research center). All of these collaborators were regular partners with Public Health on many other initiatives. One of the advantages of a small community is that everyone knows each other and is supportive of each other’s work endeavors.• March 2014 – Public Health convened the group and CDPH led a workshop to introduce the pilot project and engage the partners. The workshop included an overview of the public health impacts of climate change, a review of the data demonstrating public attitudes and perceptions on climate change, a review of recent climate change ads and messages, a discussion of how to frame climate change from a health perspective, and brainstorming to develop a campaign logo, tagline, and materials. CDPH hired a marketing firm to help develop the materials and their initial ideas were discussed with the group. • June 2014 – A second planning meeting was held. A draft of the campaign materials was presented to the committee and they made recommendations. An implementation plan was discussed and community partners were asked how they could help support the campaign.• July 2014 – In response to questions asked by community partners at the June meeting, CDPH led a webinar educating them on what they could say to their clients and staffs about climate change and health. The Planning and Building Department presented information from the CAP and discussed their energy efficiency rebate program. Also during this month, a formal MOU was signed between the Public Health Department and CDPH.• August 2014 – Public Health hired a student intern to coordinate the campaign. In addition to the student, the internal team consisted of the Division Manager and two CDC Public Health Associates (CDC hires new graduates and places them with local public health departments around the nation for two year work assignments to help develop the capacity of the public health workforce). OutsideIn SLO was formally launched at the HEAL SLO quarterly meeting on August 13. At the launch, everyone who was present (about 50 people) took a large piece of paper and filled in the blank, “I take health and climate change personally because…” Once completed, each person’s picture was taken with their statement and they were featured on our Facebook page over the course of the next month. This generated a lot of traffic to our site. Implementation of the project over the next nine months followed a varied course. All managers in public health were notified and were asked if they wanted training of their staff on climate change and health. The Division Manager developed a Power Point training that covered everything from a basic primer of what GHGs are and how they influence the planet, to what people think about climate change, to health and climate impacts. The original version of the Power Point was one hour long, but several shorter versions were also developed, based on the time available for the training. WIC staff was trained first, in preparation of their climate change classes, but all nurses were trained, as well as environmental health specialists, lab technicians, people working in emergency preparedness, and health educators. After internal training was complete, staff reached out to community groups and offered the training. In the initial planning meetings, many stated that reaching out to the faith community was extremely important due to health equity issues and the climate gap. Staff contacted the Interfaith Council on Faith and Justice and was invited to present to their directors, who took the message to their congregations. As a result, several congregations in the north county gathered together and heard an hour talk on climate change and health that was attended by over 60 people. Another group that was initially identified as important to reach was the agricultural community. SLO is an agricultural county. The 2014 Crop Report, produced by the County Agriculture Department, found the top three commodities (strawberries, wine grapes, and cattle) to be valued at over $500 million. The planning committee realized that the agricultural community is often conservative and may be unaccepting of climate change messages. With the help of CDPH in securing the speaker, OutsideIn SLO and the Center for Sustainability at Cal Poly hosted a Resilient Food Systems Conference where California Department of Food and Agriculture Secretary Karen Ross delivered the keynote presentation, making the connection between health, climate change and resilient food systems. Secretary Ross is well-known and highly respected in SLO and her message was positively received by those in attendance. Collaboration with one of the libraries occurred but was really quite accidental. This library was located in the northern part of the county. Their city staff had developed a CAP because it was mandated by the state, but their council directed staff to remove all references to GHGs causing climate impacts. The library decided to sponsor a climate change art contest and highlighted books on climate change during the month of November. Our staff noticed that this was occurring, contacted the library director and offered to help. We gave a training on climate change and health that was attended by about 20 people, staffed a children’s event, and developed bookmarks on climate change that were eventually distributed to all branch libraries in the county. There were numerous trainings in schools. The APCD, an initial partner, had a class on air quality and asthma that they had been offering to local elementary schools for many years. Our staff worked with their staff and tweaked their curriculum to define the connection between climate change and health. All students who participated in the class were given bookmarks. One of the health educators incorporated climate change and the concept of co-benefits into classes she was doing at middle and high schools on nutrition and exercise. Several staff members used the Power Point and made presentations at the local university. Many other community groups were reached out to. One of the members of the Tobacco Control Coalition was a huge climate change organizer and he asked staff to present to the coalition. He was able to tie tobacco farming practices to GHG emissions. The Health Commission, an advisory body to the Board of Supervisors, had an hour training which was extremely well-received. A group of first responders meets on a quarterly basis and they asked for training, and one of our beach communities had a full day workshop on local health issues and asked for a presentation as well. In November 2015, the Division Manager appeared on a local talk radio show that was heard by someone who works in environmental health. She offered to coordinate all of the farmer’s market outreach using volunteers from the environmental health department. Ten different farmer’s markets were visited from January through March 2015. These outreach events provided opportunities to have personal one-on-one discussions with members the public, providing insights on how people in the community viewed climate change and their receptivity to supporting the health co-benefit areas identified by the campaign. To draw people to the OutsideIn booth, simple questions on climate change were developed and the questions were put on a wheel. The person at the event would come up to the booth, spin the wheel and answer the question. If correct, they got a “prize”; if incorrect, they would spin again and answer another question. The prizes consisted of organic seed packets and energy efficient light bulbs. Many people stayed to talk and kept spinning the wheel and said they didn’t want another prize – they just wanted to talk about this important issue. One of the most engaged groups who heard the presentation was a group of about 50 young adults who were in the California Conservation Corps (CCC). The CCC is a work development program specifically for men and women between the ages of 18 to 25, offering work in environmental conservation, fire protection, land maintenance, and emergency response to natural disasters. People who are accepted in the CCC are paid minimum wage and must agree to participate in weekly educational sessions. Many of them come from low-income families and view their time in the CCC as an initial step in finding their career path. The Corps members were completely engaged in the climate change presentation. Many of them stated this was the best talk they had ever had. They were particularly interested in the climate gap concept, having lived their lives in communities that were located on urban heat islands and were dotted with factories spewing toxins in the air. They all wanted to know what they could do to make a difference, and they stayed and talked to the instructor for 45 minutes after the presentation ended. When the campaign was introduced, press releases went out to local media. This generated numerous calls which resulted in the earned media pieces and the invitations to appear on talk radio shows. The student intern was tasked with providing the content for social media and worked with staff to develop relevant weekly postings. The public service announcements on radio were developed with public health staff and CDPH. Three different versions were created, one on local food, one on active transportation, and one on home energy use. All of the pieces had a similar format to help brand them as being from the same source. Below is the ad which focused on local food:• Did you know there are food choices you can make that both improve your health AND limit climate change?• You can grow your own garden, shop at farmer’s markets, and eat produce grown by local farmers.• Find more ways to protect your health and the planet at HEAL • OutsideIn SLO….We take health and climate change personally.• OutsideIn SLO is a partnership between community organizations, the San Luis Obispo County Public Health Department and the California Department of Public Health. As previously mentioned, one the goals of this campaign was to do it all on a shoestring budget. We often joked that we were working on a single shoestring as our official budget was so small. Costs were figured as follows:• The materials that were developed (3 different flyers on local food, active transportation, and home energy use, as well as a general brochure on OutsideIn SLO) were paid for by CDPH through a small grant that they had. Cost for material development as well as estimations of their staff time were about $10,000.• The student intern worked up to 10 hours per week and was paid $15/hour without benefits. Her total costs for the year were about $7,000. Our public health department received $10,000 for participating in CalBRACE so we used those funds to pay for the student intern.• Public health staff (Division Manager, WIC staff and staff members in Environmental Health) spent about 800 hours total working on the project. They did not code their time cards differently to work on OutsideIn SLO but just considered it part of their regular day. If we used the figure of $40 per hour, including salary and benefits, this would have cost $32,000 if we had not used currently employed staff.• Printing for additional materials beyond what CDPH paid for (including more brochures and the bookmarks) was about $2,500.• We paid $4,000 to the radio stations to run the public service announcements. We did this on the advice of our marketing consultant. If we had submitted the ads and asked for them to run for free the stations would have done it – but they never would have run the ads so often during the months they were airing.• There were additional minimal expenses for mileage and some basic office supplies. The bottom line is that public health ended up contributing about $5,000 in direct costs, above and beyond what we received from CalBRACE, to sustain the program through August 2015.
Our goal was to educate the community about the health impacts of climate change and spur them to action. Probably one of the biggest things we learned was that most people were very receptive to our message. As mentioned, there are very conservative areas in our county and many of our elected leaders are conservative. We were often cautious when presenting our information, particularly if we were not sure of the makeup of the group. However, rarely did we encounter negative reactions from people. Some of this obviously is due to self-selection – if someone is a climate denier they are not likely to attend a presentation on climate change and health. But the staff who worked on this project was pleasantly surprised. One of the biggest challenges we encountered was moving from education to action. After we finished making educational presentations people would ask what they could do. We would give them the standard reply to buy local, ride their bike more, or reduce energy consumption but it often seemed to be an inadequate response. Yet, if we then suggested becoming politically engaged and contacting their elected representatives, writing letters and testifying at public hearings that seemed to be too big of an “ask”. People want to feel they are doing something to make a difference but simple actions seem too easy and important actions seem too hard. Our message continually reinforced that all of us have a role and even the simplest things taken collectively have an impact. Due to limited budget, we did not due a formal evaluation of the project but CDPH is currently finalizing a case study to share with other health departments in the state. Evaluation activities that were conducted include:• The majority of the data that was collected was qualitative. Prior to beginning and after activities were completed, CDPH staff interviewed selected SLO staff and partners about their views and hopes for the campaign, and their opinions on the campaign’s success.In addition, WIC staff members were also interviewed by the CDC Associates prior to implementing their classes and after. All who were interviewed demonstrated increased understanding and support for climate change issues as a result of the project. One of the most significant improvements was seen in one of the WIC dietitians who was very vocal and did not see any connection between climate change and health before the start of the project but who was making life significant changes after (including taking shorter showers and buying local produce).• WIC clients were also given a pre and post test, indicating their likeliness to take action to address climate change (scale of 1-5) :     While the results were not statistically significant, they indicate increased possibility for action as a result of the class. The major weakness of this effort was failure to follow up and determine if any action was actually taken. Staff has plans to offer climate change classes to WIC clients again next spring and hopes to do a more rigorous evaluation component, with matched pre and post surveys and follow up with clients at 3-6 months. One of the most interesting results of this survey was that the Spanish speakers appeared more likely to make changes both pre and post. In discussion during the classes, many of these clients volunteered keen insight on how climate change was already influencing their lives. (Many of the Spanish speakers come from farmworker families. With the presence of the exceptional drought in California, many farmworking jobs have been lost and families are struggling.)• There were plans to collect simple quantitative data on the number of presentations, number of people in attendance, number of people interacted with at farmer’s markets etc. but the data that was collected is very rough. If, for example, public health staff was doing a presentation they would come back after the event and write down number in attendance. But when partnering with APCD on the inclusion of climate and health messaging into their curriculum, we never received any data back – either on number of schools or number of children in attendance. If a farmer’s market was small and not many people visited the booth, it was easy to track how people were engaged, but if the market was busy no one remembered to write anything down. We do know the number of media pieces that appeared but other than reporting circulation numbers of the newspapers or potential reach of a radio station, we have no idea who bothered to pay attention to our articles. We do know our “likes” on Facebook increased from about 600 followers to over 800 followers after completion of the campaign, and our website traffic increased about 60% in the early stages of the campaign, but it is impossible to determine cause and effect from this data.• One of the evaluation questions we wanted to answer when designing the campaign was the effectiveness of OutsideIn SLO messages and materials in explaining the links between health and climate change. Subjectively we believe that the campaign materials along with staff interaction were very effective – but we can’t prove it. The only modification we made mid-campaign was to develop several versions of the training curriculum. We quickly realized that while an hour presentation was thorough and ideal, not every group had that amount of time. We used the hour curriculum for a template and developed three different versions – 15 minutes, 30 minutes, and the hour. We did not notice any difference in receptivity in shorter curriculums, but the longer version tended to generate the most interaction.
We learned many things as a result of this project, but in terms of sustainability we were able to demonstrate that integrating climate change messages into public health work is possible without spending a lot of money. We developed a logo, tagline and print materials but any health educator working anywhere in the country can add a climate change message to their nutrition and exercise curriculums, as long as their management approves. Other lessons learned include:• While people were receptive to our message, understanding climate change as a health issue was new for the public as well as many public health professionals. Prior to contact with OutsideIn SLO, many people were concerned about climate change but viewed the issue purely through an environmental lens. The CDC Public Health Associates made a presentation to their graduating class in Atlanta in May on what we had done in this project. One of the Associates stated, “After we gave the presentation, our CDC advisor came up to us and said, ‘I never would have thought of climate change as a public health issue or a priority, but you convinced me. ’ That was reaffirming that our message was new and interesting to the public health community. I think because I had studied this issue I thought everyone in public health had some sort of exposure to climate change, but that didn’t seem to be true.”• The materials that were developed and the initial trainings that occurred helped the staff and advisory group learn about the issue and support the project as it unfolded. This made them feel prepared to share information with others and have a deeper understanding of the issue before going out and talking with the public and other partners.• It is generally accepted that any project needs leadership support to be successful and it was especially true in the case of OutsideIn SLO. Having both the Health Officer and Agency Director in support of our goals and giving us permission to work on this during our daily routine made the project possible. The CDC Associates’ Supervisor also was supportive, which allowed our project to happen with little direct funding.• The advisory group struggled with the logo and project name and there never was consensus on the title “OutsideIn SLO”. We still have people saying that they don’t get it – what does it mean? I think what we learned was that naming things is tough. In public health we are not very creative with the titles of our programs. We call things, “The Tobacco Control Program”, or “The AIDS Program”, or “Maternal, Child, and Adolescent Health”. The advantage of these bland names is that people understand what the program is generally about without having to explain it too deeply. The disadvantage is that it is – bland! Our group understood that OutsideIn SLO would not translate well, so our decision to include the tag line (We Take Health and Climate Change Personally) was to help people understand what it was all about. But the name never had the full support of the advisory committee and remains a puzzle to many.• There was great value in having the public health department as the lead on the project due to the co-benefit frame. Public health is viewed as a trusted messenger and already has established relationships in the community. Their leadership normalized the climate change issue and their partnership with CDPH provided gravity. Everyone, regardless of political persuasion, values health and communities generally value the public health perspective. When asked for her advice to other public health departments considering whether to implement a climate change communication program, the Health Officer stated: “Our state is very diverse and in some other states public health professionals may not even be able to utter the words climate change if they want to keep their jobs. The benefit of the approach we took really allowed us to be more vocal and run with it. It allowed for more direct communication about climate change through the health promotion perspective. Our experience in SLO should give other counties the optimistic sense that it is okay to talk about climate change as a public health issue.”• Finally, while one of our goals was to demonstrate that this work was possible without a lot of funding, additional resources could have made the project more successful. Staff was always juggling duties and more outreach could have been done with more dedicated staff members. For example, one of our desires was to engage the business community. We printed some large window decals that could have been placed in windows of local business indicating their support of OutsideIn SLO. However, that would have required someone to go door-to-door explaining the program and asking businesses to participate. That never occurred but is something we would like to work on in the coming year. We also hoped to get many of our partners to engage on a deeper level by training their staffs on the issue – but that also never happened. We believe if we had money for mini-grants to help motivate partners to participate, partner engagement would have been more successful. Even offering a small amount of money legitimizes the work and usually increases participation. We intend to continue this work in the coming year. As mentioned, we already have had discussions among staff on continuing the WIC classes. We have a new Public Health Associate with a background in evaluation and an interest in climate change and health. She will take the lead and help us develop a more rigorous evaluation component, ensuring that are results are statistically significant, and we will follow up after the classes to try and assess if clients made any changes in their lives. The only thing about the classes themselves we intend to change is the paperwork. We gave WIC clients six different pieces of paper with information this past year, and the amount of paperwork was a distraction (as well as being counter intuitive to the conservation message!) We also would like to finish outreach to businesses and hope to attract some university students who could help us get the decals placed into local windows. In addition, one of our health educators wants to reach out to middle and high schools and present lessons on climate and health. We believe that middle and high school students are ready for the climate change message and have the potential to influence great change.
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