Improving Health Outcomes in a Rural Community

Drivers for Improving Health in the Roanoke Valley

While conducting its 2012 community health needs assessment, the staff at Halifax Regional Medical Center in Roanoke Rapids, in collaboration with the county health department and the early leaders of the RV-CHI, identified 6 primary concerns: hypertension, diabetes, heart disease, stroke, cancer, and renal disease. They found obesity was a contributing factor to each. The assessment revealed that childhood obesity had risen in Halifax County from 19.1% in 2007 to 21.7% in 2009. The team was determined to turn this trend around. “In trying to establish an action plan [to lower obesity rates], we decided that…the best way to get a parent to do something is to have their child go about it first,” said Karen Daniels, Vice President of Nursing Services at Halifax Regional. The group anticipated that targeting childhood obesity would have a ripple effect, first within families and then throughout the county.

Ways Improvements are Being Achieved

For the past 6 years, the RV-CHI has worked tirelessly to improve health for all Roanoke Valley residents and has created a unique model of collective impact to reduce isolation and increase positive social change. The mission of the RV-CHI is to improve the health of Roanoke Valley residents by providing healthy, accessible, affordable foods and easy access to exercise and physical activities. In 2014, with the support of the KBR, the RV-CHI kicked off the “Get Fit, Stay Fit Roanoke Valley” (GFSFRV) campaign. The comprehensive, 5-year effort to engage residents across Halifax and Northampton counties through education, healthy eating, and physical activity was part of a long-term initiative, Healthy Places NC. Healthy Places NC, a program of KBR, launched in Halifax County in 2012 to improve health outcomes in rural, financially disadvantaged counties in North Carolina. The overarching goal of the GFSFRV is to empower all residents in the Roanoke Valley to adopt healthier lifestyles, access preventative services, and take positive actions to improve health in their communities. To achieve this goal, the RV-CHI maintains a Coordinating Council (CC) that guides and directs all efforts. The CC works in partnership with 5 RV-CHI workgroups: Public Awareness; Data/Health Assessment; Finance; Community Partnerships; and Program Development/Implementation. Monthly meetings and daily communication help to maintain a high level of engagement and commitment among the committees. To ensure wide community participation, open quarterly meetings are held for all community partners to exchange information, share challenges and successes, and provide updates on events and opportunities relevant to the Roanoke Valley.

Education and Faith Community Partners

Since 2014, the RV-CHI has annually sponsored or participated in an average of 40 events and reached approximately 8,500 community members. Events vary from the RV-CHI-sponsored Play Days to larger annual events, including the RV-CHI's signature program FamilyFest and the International Walk/Bike to School Days. The RV-CHI also supports smaller events, such as workplace and church health fairs, and larger events, such as the Roanoke Valley Chamber's Business Expo, the annual Ducky Derby, and the Enfield Peanut Festival. The RV-CHI's work has also encouraged agencies that normally would not work together to collaborate on serving the community in new ways. Groups such as the Good Will Community Foundation, Park Rangers, and Community Gardeners have enabled the RV-CHI to further engage the community and promote the message of health, wellness, and active living far and wide.

Community Organizing—It Works

Educational and faith-based partners in the region are vital to the success of the RV-CHI's efforts. The Halifax, Northampton, Roanoke Rapids, and Weldon School Systems, as well as the Halifax Public Health System, the School Health Network, and the Coordinated Approach to Child Health program (which is designed to promote physical activity and healthy food choices), have provided dedicated leadership that has increased participation in Roanoke Valley events. One such event is International Bike/Walk to School Day, which reaches an average of 5,000 students each year. The RV-CHI also enhanced the existing Expanded Food and Nutrition Education Program in Halifax and Northampton Counties, reaching 907 and 918 youth in 2015 and 2016 respectively. Halifax Community College has also been a key partner within the RV-CHI. The college's leadership and commitment are apparent in its hosting of the annual FamilyFest in 2015 and 2017, and its ongoing provision of free and accessible opportunities including health screenings, community health events, and the Fitness Interactive Trail located on its campus. Moreover, enhanced communication and coordination between educational institutions and the community have increased the number of summer feeding programs, the distribution of 30 library kits to local libraries and elementary schools, the implementation of healthy snack bars for school and other workplace employees, and more recently, the formation of the RV-CHI Youth Council.

The Partners in Faith (PIF) group has also been a vital component of the RV-CHI. More than 30 churches and other faith-based organizations meet monthly and average 25 participants per meeting. PIF works diligently to build momentum around healthy eating and active living in the Roanoke Valley by sponsoring and supporting monthly play days and offering local events, such as health fairs, healthy cooking classes, and exercise classes. Additionally, the group embraces the ideas of offering healthy food options at events and promoting healthy preparation of members' favorite foods. Members of PIF shared ways that they have incorporated healthy eating opportunities within their churches. Outreach to this group has focused on strengthening its organizational capacity, and teaching leadership skills including strategic planning, collaboration, and grant writing. As a result, several PIF members have successfully implemented healthy eating and active living programming with funding support from the RV-CHI mini-grant initiative.

In addition to the work of the partners mentioned above, several grassroots efforts are underway to increase access to healthy food and places to engage in physical activity. These efforts are designed to create a sustainable structural and social environment conducive to healthy living in the Roanoke Valley. Through the implementation of classic community organizing strategies, RV-CHI members and partners, including A Better Chance, A Better Community (ABC2), have successfully launched new partnerships that have resulted in 6 corner stores that now offer fresh produce; a farmer's market that not only brings local produce and grass-fed meats to the community, but also accepts SNAP/EBT and special “tokens,” keeping their produce affordable to those who could not otherwise afford it; and a Local Foods Roundtable effort, which examines ways to increase access to fresh and affordable food for the region. One of the most impactful efforts that RV-CHI partners assisted with was the creation, approval, and implementation of a master recreation plan for Halifax County. As a result of the plan, the community has since introduced a county-wide recreation advisory committee, a new BMX bike and skate park, walking trails, and a myriad of other planned recreational facilities in the years to come.

The needs of Roanoke Valley residents are being addressed by many organizations that deserve recognition for their diligent work. In addition to the partners described above, the RV-CHI has also successfully engaged local medical providers to offer patient education toolkits that include health-related brochures, listings of community resources, and upcoming health and wellness events. Additionally, RV-CHI provides these physician offices with healthy recipes and a fruit or vegetable of the month that can be provided to patients. The RV-CHI also has positive relationships with local fitness centers, which have afforded community members free passes to start exercise programs. These fitness centers also direct monetary awards back to the community for sports equipment, incentives, and program supplies.

As with any community-driven effort, effective interaction is key to achieving sustainable, external health outcomes. Consistent meetings, phone calls, and emails, along with timely sharing of information, contributed to the increase in awareness and authentic collaboration within the Roanoke Valley community. RV-CHI members consistently promote the RV-CHI's work at meetings and events, and are never shy about recruiting new partners to join them at the table. Reciprocity is also key to the RV-CHI's success. Partners eagerly support others' large-scale efforts like the required community health needs assessments, and consistently demonstrate professionalism and care toward one another and the community.