review. The Steering Committee included community stakeholders, Camden County Public Health leaders, and Coastal Health District staff. Final input was invited and the plan updated to reflect those changes. Public health staff further reviewed the plan with technical advisors in April. Final changes were made to the document, the CHIP was published on the Public Health website for community input, and plans made for final Board of Health adoption at the next quarterly meeting in Summer 2014. The illustration below describes the process as one with increasing focus, based on needs, resources, and community partnerships. Broad-based community input from survey/focus groups/community meetings Priorities/partner identification set by community partners that create vision and broad goals and identify outputs and outcomes Goals/partnerships refined by a steering committee with knowledge of resources and insights from data collection Using budget information and community priorities, Public Health uses community, collaborative, steering committee input to formalize strategic plan and set performance goals (© Jenny Solomon | Dreamstime Stock Photos, The cycle illustrated below indicates the CHIP process is both iterative and cyclical. The Third Phase: Implementation and Evaluation The goal of the ongoing Community Health Improvement planning process is to create a document to be used by the community, in partnership with Public Health, as a roadmap and foundation for cultural, environmental, and social change that leads to health improvement. Camden County Public Health Department is now establishing a Community Health Coalition to share the plan with the wider community, to fully engage participants, to review and revise activities and responsible parties as needed, and to monitor outputs and
Southeast Georgia Health System/Discharge planners and ER Gateway/Other Behavioral Health Providers Federally Qualified Health Center (proposed expansion of McKinney Center in Waycross) Community Case Management Programs, including Community Care, Area Agency on Aging, SOURCE School system Public Health Media College of Coastal Georgia and other nursing programs in the region Public health, SGHS, Gateway, nonprofits will encourage sign-up for insurance, assist in access to Navigators Community forums led by trained laypersons/navigators in churches to discuss primary care School nurses will make referrals to available providers Information provided through hospital, nonprofits/Public Health “Frequent fliers” to Emergency Room identified by hospitals with referrals to physicians (SGHS) Hospital will track/trend inappropriate ER visits Recruitment of primary care providers/mid-levels (SGHS, Chamber) Recruitment of dentists willing to accept Medicaid/insurance (Chamber) Recruitment/retention of mental health professionals Reach out to 500 uninsured individuals to encourage them to sign up for insurance Conduct 1 community per month Make 4 referrals per month to providers Provide 100 pamphlets Distribute 5 frequent fliers per month Create and distribute monthly report to ER and hospital officials Recruit 3 primary care providers per year Recruit 5 dentists per year who are willing to accept Medicaid/insurance Recruit 3 mental health professionals per year More patients will seek primary care first patients will use the ER inappropriately More doctors, dentists, and mental health providers will accept Medicaid and other insurance on the Exchange More clinics open after hours New providers attracted to the community, leading to greater access Less waste and redundancy in care provided as tests are not repeated, due to primary care coordination Improved access to primary care Improved continuity of care for better outcomes Increase patient awareness of cost of care and appropriate care
Improve access to care and services for special populations. Resources/ Inputs Resources essential to conduct this program/effort including community partners Activities How we will accomplish our planned activities and who will be engaged. Outputs The amount of service delivered or number of people served Short-Term Outcomes Benefits to Participants, Often at Individual Level Long-Term Impacts Changes that will occur in organizations, community, or systems due to effort Coastal Regional Coaches Jacksonville Vet Center St. Marys VA Outpatient Clinic Local physicians Gateway/Other Behavioral Health Providers FQHC (if funded) Churches Medicaid Health benefits managers Southeast Georgia Health System School nurses Volunteers Law enforcement agencies Area Agency on Aging, Medicaid waiver programs Public Health Law enforcement will collect and trend data of persons jailed with a diagnosis of mental illness PeachCare and transportation providers coordinate with media on talking points about transportation, access to providers Vet Center Jacksonville, VA Outpatient Clinic will coordinate care across spectrum for veterans/families Law enforcement will provide access to mental health consults in jail; consider telepsychiatry in (if available, affordable) School nurses will make referrals for appropriate services including mental health Increased training for school nurses on psychiatric issues (Gateway, CCAR) Distribute monthly report Conduct 4 briefings monthly Conduct weekly meetings to coordinate care across units Have 4 mental health consults per week Make 4 patient referrals for appropriate services 6 trainings per year Persons with mental illness will be able to access care Persons with chronic disease will better understand how to care for themselves Churches will in a health informational role to expand outreach Hospitals will make appropriate referrals Proposed FQHC will allow for integration of care with Gateway and other mental health providers Transportation will be available to those who need it Veterans will find resources for care within community Aging population will be able to access disease management support Mental health is no longer taboo for discussion All citizens know how to access needed resources Persons with disabilities fully access health care in the community Volunteers support good health by expanding outreach
Reduce the percentage of Camden County residents who are obese. Resources/Inputs Resources essential to conduct this program/effort including community partners Activities How we will accomplish our planned activities and who will be engaged. Outputs The amount of service delivered or number of people served Short-Term Outcomes Benefits to Participants, Often at Individual Level Long-Term Impacts Changes that will in organizations, community, or systems due to effort Public Health WIC Parent-teacher organizations Camden County Public Service Authority - Department of Leisure Services Home Owners’ Associations, Apartment Complexes Hospital Community volunteers with interest in wellness/nutrition 4-H Girl Scouts Grant funding to pay for BP cuffs, scales, training for FD and laypersons Medical providers Housing Authority Schools governments Create awareness of link between obesity and chronic disease through education at health fairs, FQHC, case management entities, 4-H, YMCA, other nonprofits WIC consults with new mothers Camden fitness center will track/trend participation School will track/trend FitnessGram® results Health fairs with BP, cholesterol checks, weight, blood sugar screens (SGHS, other providers, fitness centers) Community food and fitness events Classes offered by Leisure Services on nutrition, exercise Help clarify what obesity is (people do not realize that they are obese) through Have monthly health fairs and distribute 100 pamphlets Conduct 4 consultations with new mothers weekly Distribute monthly report FitnessGram results distributed to school officials and parents At least 2 community wellness events are held annually providing these services Develop partnerships among famer’s markets and gyms Offer 4 classes per month Disseminate 4 press releases per month Individuals will distinguish between healthy and unhealthy foods Persons who lose weight more likely to exercise, further improving health Individuals will recognize and address weight problems Children will influence parents Churches will take leadership role in improving health status of members Changes in eating habits Healthier community More active community Community has culture of good health/fitness Less chronic disease More children are active
Increase access to healthy foods and information about nutrition. Resources/ Inputs Resources essential to conduct this program/effort including community partners Activities How we will accomplish our planned activities and who will be engaged. Outputs The amount of service delivered or number of people served Short-Term Outcomes Benefits to Participants, at Individual Level Long-Term Impacts Changes that will occur in organizations, community, or systems due to effort Public Health WIC Parent-teacher organizations Hospital Community volunteers with interest in wellness/nutrition 4-H Businesses/Chamber Girl Scouts/Boy Scouts Medical providers Housing Authority Schools Community gardens CMAP Coastal Georgia Community Action Authority Nutrition classes offered at least annually (Public Health and community partners) WIC consults with new mothers Health fairs will offer nutrition information (SGHS, other providers, Gateway) Community food and fitness event to promote wellness Have Farmer’s Market (seasonal) that accepts EBT cards Community gardens will offer seasonal produce in gardens or contribute to Farmers Market (need partner) Continue to enforce policies that remove sugary, high-fat snacks from schools, including classroom snacks Provide 4 consultations per week to new mothers Conduct 4 a year At least 1 community-wide wellness event is held annually (need partner, Public Service Authority) Recruit 1 farmer’s market per Increase marketing of community gardens Review policies monthly Offer twice a week Individuals will distinguish between healthy and unhealthy Healthy foods, including fresh fruits and vegetables, are available and accessible Persons who lose weight more likely to exercise, further improving health Individuals will recognize and address weight problems Children will influence parents Churches will take leadership role in improving health status of members Changes in eating habits Businesses encourage healthy habits Healthier community More active community Community has culture of good health/fitness Less chronic disease More children are active More productive workforce
Goal #4: Decrease the prevalence of diabetes and hypertension among Camden residents. Planned Work Intended Results Decrease the prevalence of diabetes Camden residents. Resources/ Inputs Resources essential to conduct this program/effort including community partners Activities How we will accomplish our planned activities and who will be engaged. Outputs The amount of service delivered or number of people served Short-Term Outcomes Benefits to Participants, at Individual Level Long-Term Impacts Changes that will in organizations, community, or systems due to effort Public Health WIC Hospital Medical providers CMAP Churches Fire departments Grant for blood pressure cuffs, training of laypersons Case managers Community Care, SOURCE, waiver programs FQHC – if implemented Coastal Georgia Community Action Authority Nutrition classes available (Public Health, partners) WIC consults with new mothers Diabetes support group available (SGHS) Diabetes screening available at no or low cost at Health Department Blood sugar screenings and blood pressure checks available (SGHS, other providers, Gateway) Food distribution sites offer diabetes screenings (CGCAA) Blood pressure cuffs/scales available at fire departments 24/7 Offer classes annually Conduct 4 consultations with new mothers per month Offer support groups per month Diabetes screenings available at least 2 times/year in community (SGHS, Public Health) Conduct annually at community health fairs One distribution site per month Have 2 BP cuffs/scales at fire departments Pre-diabetics increase awareness Diabetics better manage disease through better nutrition and exercise Churches will take leadership role in improving health status of members Hypertensives more of need to monitor blood pressure Persons with hypertension better manage disease through better nutrition and exercise Churches will take leadership role in improving health status of members Reduce long-term disability Reduce number of strokes Healthier community More active community Less chronic disease More productive workforce Lower health care costs
Camden Public Health reported 150 blood tests showing high lead blood levels in 2012. Camden Primary Performance Indicator: By 2018, Urban Institute data for benchmarking, increase the availability of housing units for extremely low-income renters above the 2012 level of 23 available and affordable rental units per 100 households. Camden Primary Performance Indicator: Using Public Health data for benchmarking, by 2018, reduce to zero the number of blood tests showing high lead blood levels. Goal #1: Parents know about effective care and nurturing of children. Planned Work Intended Results Parents know effective care and nurturing of children. Resources/ Inputs Resources essential to conduct this program/effort including community partners Activities How we will accomplish our planned activities and who will be engaged. Outputs The amount of service delivered or number of people served Short-Term Outcomes Benefits to Participants, Often at Individual Level Long-Term Impacts Changes that will occur in organizations, community, or systems due to effort Public Health School system/school nurses Day care providers Faith-based providers Churches Missions for Camden, Faith in Action Camden County Family Violence Task Force In-school or after-school programs for teen moms still in school (CareNet, other partners needed) DFCS makes recommendation to visit Public Health when aware of teen pregnancy or pregnancies in at-risk families (DFCS, Public Health) Continue Care Net’s “Earn You Learn” program Enroll 15 teen moms per school DFCS creates and distributes quarterly report to Public Health Recruit 10 participants per month Conduct 4 visits per month children in single parent families (County Health Rankings) Mandatory reporters better trained Parenting classes available for all teens and at-risk families throughout the year Family violence reduced Less child abuse More agencies collaborating for effective outcomes Fewer cases of child abuse Healthier children Higher graduation rate More students with on-time graduation rates Lower rate of child abuse
Ob/Gyn referrals to social service providers/Public Health for pre-natal education DFCS funding for in-home visits SGHS Mandated reporters Parent-teacher organizations Babies Can’t Wait Camden Community Alliance and Resources Workforce Investment Act Provider (Paxen) Camden County Attendance Panel Local Interagency Planning Team Department of Juvenile Justice Governor’s Office for Children and Families In-home visits for new mothers in at-risk families (dependent on grant funding) Free parenting classes by groups, churches (need to identify partners) Clear referral processes for families to parenting classes, financial management, nutrition classes offered by Public Health/community partners (Community Health Coalition, SGHS, Gateway) Public Health follows positive pregnancy tests to offer services, counseling Increased use of training for mandatory reporters (available online through Governor’s Office for Children and Families) All new mothers receive information on community resources for parenting classes while in the hospital (SGHS) At least one no-cost or parenting class available at all times in Camden County (faith-based groups, nonprofits, DFCS, community partners) At-risk families receive at least one home visit after birth of baby (dependent on grant funds) After every positive test provide a consultation Offer 2 trainings per month Distribute materials to mothers Each school parent-teacher organization will offer at least
Mandatory parenting classes for persons reported for child abuse/neglect (not just referrals); Resources for parenting provided to at-risk families while in the hospital; Peer Mentorship Program; Establish and publicize a help line; Families with history of child abuse/neglect have mandatory in-home visits after birth of new baby; Offer GED testing subsidies for civic engagement; and Employers subsidize tech school and Georgia Virtual Technical Connection courses that lead to certificates, diplomas, or degrees. Goal #2: All children live in safe homes. Planned Work Intended Results All children live in safe homes. Resources/Inputs Resources essential to conduct this program/effort including community partners Activities How we will accomplish our planned activities and who will be engaged Outputs The amount of service delivered or number of people served Outcomes Benefits to Participants, Often at Individual Level Long-Term Impacts Changes that will occur in organizations, community, or systems due to effort Public Health DFCS Camden Community Alliance and Resources Community organizations that work with family violence, including Task Force Against Family Violence DFCS requires parenting classes for families with reported child abuse/neglect Community resource list given to parents when abuse/neglect suspected but not substantiated (DFCS) Parenting classes available on a regular basis (PH/community partners/schools) Resource list of community organizations readily available for law enforcement, hospital, DFCS, social service organizations annually (CCAR and partners) Fewer children in single parent homes (County Health Rankings) Fewer children in foster care (Administration on Children and Families) Fewer substantiated cases of child abuse/neglect Higher graduation More intact families Higher family incomes Healthier families Lower crime rate
Georgia Commission on Family Violence Georgia Bureau of law enforcement CareNet Mandatory reporters SGHS Churches Social service organizations like Salvation Army Schools Safe Harbor Children’s Center CASA Georgia Office for Children and Families Mandatory Reporter Training Babies Can’t Wait Georgia Department of Early Care and Learning Head Start GBI/local law enforcement handles criminal cases, but also makes referrals to community resources (Community Health Coalition makes connections) Include link to resource material for social supports on Family Connection web pages (CCAR) Churches/social service organizations provide family counseling (churches, partners) Churches/social service organizations publicize counseling options, train on mandated reporting protocols (churches, Faithworks, child advocacy groups, domestic violence groups) Online training for mandatory reporters (Georgia Office for Children and Families) CareNet continues to offer “learn to earn” classes for mothers Increase access to first trimester prenatal care (prompt referrals, ready Make 10 referrals per month Add link to website and update quarterly Offer counseling once a week Conduct monthly trainings Establish trainings for new hires and current employees monthly classes Make 15 referrals per month (Administration on Children and Families) Improved reporting of abuse/neglect More people are made aware of how to report child abuse/neglect More collaboration between medical providers and social service agencies
access to pregnancy tests) (Public Health) Community wide Back to Sleep campaign (Public Health, SGHS, community partners) Conduct campaign annually Policy changes needed: Provide a continuum of care social service providers; and Provide affordable and housing for families. Goal #3: Reduce the rate of teen pregnancy. Planned Work Intended Results Reduce the rate of teen pregnancy. Resources/ Inputs Resources essential to conduct this program/effort including community partners Activities How we will accomplish our planned activities and who will be engaged. Outputs The amount of service delivered or number of people served Short-Term Outcomes Benefits to Participants, Often at Individual Level Long-Term Impacts (Changes that will in organizations, community, or systems due to effort) Schools School nurses Churches Public Health Offer age-appropriate sex education in schools (already in curriculum) Teen parenting classes offered by agencies (CareNet, other partners?) All middle and high school continue age-appropriate sex education, teen pregnancy (schools) Offer classes monthly to teen parenting classes Teen birthrate decreased (County Health Rankings data) Teen birth rate among minors decreased (OASIS) Students stay in school longer (graduation rate) More high school graduates get better jobs, change children born to single mothers cost to system if parents are mature and working
Physicians, including pediatricians/OB-GYNs Parents Sex education curriculum in Camden Schools Law enforcement – CHAMPS program Teen mothers CareNet Peer Counseling Program DFCS United Way After-school programs provide counseling (YMCA) Peer mentor programs (CareNet) Parental training on signs that a child is sexually active (Schools) on at-risk youth (DFCS) School nurses offer classes Teen mothers invited to talk to student groups about challenges of teen pregnancy Public Health/community partners work with teens who have had a pregnancy to reduce chances of a second pregnancy Public Health tracks age of teen births for trending Outreach to older teens about free/low cost birth control DFCS makes referrals to Public Health/community partners for education and counseling Increase parent involvement with schools, particularly during middle school and high Offer 3 after-school programs Offer 2 peer mentor programs Offer monthly parental training Develop a strategic plan on recruiting at-risk monthly classes Offer monthly discussions after school Develop a program and enroll 10-15 committed teens per year Create and distribute quarterly report Conduct 4 health per year Refer 10-15 clients per month Recruit 20-40 parents Fewer low birth weight babies (OASIS) Fewer children in poverty (Kids Count) Reduce rate of abuse/neglect Healthier babies
school (schools, United Way) Policy changes needed: substantive and collaborative andragogical parent involvement opportunities; and Offer new Navy recruits sex education. Goal #4: Increase affordable and safe housing alternatives for low-income families and persons with special needs. Planned Work Intended Results Increase safe and affordable housing alternatives for low-income families and persons with special needs. Resources/ Inputs Resources essential to conduct this program/effort including community partners Activities How we will accomplish our planned activities and who will be engaged. Outputs The amount of service delivered or number of people served Short-Term Outcomes Benefits to Participants, Often at Individual Level Long-Term Impacts Changes that will occur in organizations, community, or systems due to effort Developers Financial institutions/lenders Habitat for Humanity Chamber of Commerce Department of Community Affairs Department of Housing and Urban Development More affordable housing starts (developers, Department of Community Affairs, Housing and Urban Development) Habitat, through its Brush with Kindness program, make physical improvements to substandard housing (Habitat) Local governments identify abandoned homes and take Develop a partnership among housing developers and banks Recruit 20-35 volunteers Identify 3 homes per month Fewer people live in substandard homes Neighborhoods are more stable when housing is decent Families have access to safe and affordable housing More permanent residents who become a part of the community Crime is reduced and more people venture out of their homes to use local parks, thus healthier community Fewer abandoned, neglected homes More pride in community
College of Coastal Georgia Camden Community Alliance and Resources Public Health Foundation – Camden: Childhood Literacy of Camden Girl Scouts/Boy Scouts School system New FQHC (if funded) Ferst Foundation will provide one book on good health as part of its childhood literacy campaign Public Health/hospitals will provide low literacy materials for health education 4-H will include some aspects of health education in educational activities Libraries will maintain materials on health education Girl Scout/Boy Scout programs will include health education activities Continue providing health education included in all schools according to state guidelines Low literacy materials are available at public locations, including library, Public Health, hospital, and FQHC (Public Health and community partners, SGHS) Add 3 components of health education in educational activities Low literacy materials are available at public locations, including library, Public Health, hospital, and FQHC (Public Health and community partners, SGHS) At least 20 residents will complete GED through Wellcare program by 2017 (Wellcare) Add 2 health education activities in programs Create and distribute report to officials annually Recruit 3 translators Improved collaboration among agencies
Hospital/organization that can host drunk driving simulation Victims of DUI accidents Camden Community Alliance and Resources Georgia Department of Natural Resources Law enforcement will monitor and trend DUI arrests Virtualization demonstrations of drinking and drinking for those arrested (need partner/funding) Social norms campaign that makes binge drinking unacceptable/deemed unhealthy (CCAR and partners) Establish victim impact panels to talk to offenders (DUI schools, others) Create and distribute report quarterly to law officials Conduct twice a month at DUI schools Conduct campaign annually Conduct victim impact panels annually Policy changes needed: Link education, engineering, encouragement, and enforcement strategies; Increase taxes on alcohol; Regulate marketing of alcoholic beverages; and Conducting information and educational campaigns in support of effective policy measures. Problem Statement: Safety issues and risk-taking affect the health of Camden County residents. County Health Rankings indicates that the rate of violent crime in Camden is 492/100,000, higher than the Georgia rate of 437/100,000. In 2012, there were 2 murders, 7 rapes, 23 robberies, 175 assaults, 343 burglaries, 1054 cases of larceny, and 44 vehicle thefts (Georgia Bureau of Investigation). There were 343 men and 192 women who were aggressors in domestic violence cases (Georgia Bureau of Investigation). According to the Department of Juvenile Justice, 287 children had interactions with the system.
Prevent initiation of drug abuse that causes poor judgment and links to violence and injury Resources/ Inputs Resources essential to conduct this program/effort including community partners Activities How we will accomplish our planned activities and who will be engaged. Outputs The amount of service delivered or number of people served Outcomes Benefits to Participants, at Individual Level Long-Term Impacts Changes that will occur in organizations, community, or systems due to effort Public Health Churches Schools School nurses Parent-teacher organization Teen Maze 4-H leaders, pastors Parents Law enforcement CHAMPS program (law enforcement) Safe Kids Camden Community Alliance and Resources Continue with curriculum on risk behaviors for middle school students (schools) Continue with CHAMPS, the Camden program from law enforcement on risky behaviors (schools, law enforcement0 Create the social norm that drug is not socially acceptable; conduct social norms campaign (CCAR) School counselors/nurses notify parents of suspected drug abuse (schools) Department of Education tracks and trends marijuana, alcohol, and other drug use among students (HS Student Health Survey) Conduct simulations of drug use and driving (schools, law enforcement, Teen Maze) Create and distribute quarterly report Distributer quarterly report on progress Conduct social norms campaign annually Notify parents weekly Create and distribute quarterly report Conduct 4 simulations per year Students who do not use drugs are less likely to use as adults Students who do not use or more likely to finish school Reduction in teen pregnancy rate Reduction in motor vehicle accidents Healthier students without long-term problems Students who do not use drugs are less likely to engage in risky behaviors Increase in graduation rates Greater likelihood of attending post-secondary schools More productive workforce Healthier community
Goal #4: Reduce the incidence of sexually transmitted diseases. Planned Work Intended Results Reduce the incidence of sexually transmitted diseases. Resources/ Inputs Resources essential to conduct this program/effort including community partners Activities How we will accomplish our planned activities and who will be engaged. Outputs The amount of service delivered or number of people served Outcomes Benefits to Participants, Often at Individual Level Long-Term Impacts Changes that will occur in organizations, community, or systems due to effort Public Health W.I.S.E. Schools Hospital/Medical Providers Parents Parent-Teacher Organizations Case managers at advocacy organizations DFCS Gateway/Other Behavioral Health Providers Remove embarrassment from asking for condoms at Public Health Provide ready access at Public Health to condoms for those who cannot afford them Provide STD information to community-based case managers for sharing with clients Educate WIC clients about STDs DFCS provides education to its clients Gateway provides education to clients Provide sex education to middle and high school students (as mandated by state) Distribute 3 condoms to every client in a secluded office Distribute 3 condoms to every client Provide 5 trainings a year to case managers Educate each WIC client after lab work has been completed Provide monthly education; distribute materials Provide monthly education to clients Offer 3 sex education classes Less disease, less Ease of obtaining condoms improves Increased knowledge of STDs and risks Students make better choices Adults have access to condoms Reduced health care costs
Prevent initiation of smoking/tobacco among youth. Resources/Inputs Resources essential to conduct this program/effort including community partners Activities How we will accomplish our planned activities and who will be engaged. Outputs The amount of service delivered or number of people served Short and Long-term Outcomes Benefits to Participants, Often at Individual Level Long-Term Impacts Changes that will occur in organizations, community, or systems due to effort Parents School Students Public health Law enforcement Convenience stores, places that sell cigarettes Physicians/medical providers Relay for Life Physical education teachers Funding for billboards, campaigns Law enforcement upholds existing laws tobacco purchase Compliance checks at stores selling cigarettes (law enforcement) Social norms campaign to make tobacco use uncool (CCAR) Demonstration of lung from smoker (work with local providers, schools) Testimonials from former smokers with lung disease (schools) Increase “no smoking” areas where young people gather (local governments) Continue CHAMPS training (law enforcement) Schools continue with state mandated education on behaviors Develop partnerships with stores Conduct monthly compliance checks Conduct campaign annually Conduct 5 demonstrations per year Recruit 5-7 former smokers to give testimonials Designate 8-10 no smoking annually Conduct CHAMPS training Create and distribute trends report to school officials monthly Healthier and more active students Fewer younger students start smoking Students will influence parents to quit smoking Younger students delay experimentation rate of lung disease As young people smoke, social norms will have more influence Fewer “years of potential life lost”
Policy changes needed: More smoking prohibited areas; Increase cigarette tax in Georgia to make cigarettes more expensive; Better enforcement of tobacco purchasing laws; More law enforcement compliance activities; smoking age to 21; and Restrict E-nicotine delivery systems, align with tobacco and smoke free designated areas. Goal #2: Decrease the total number of people who smoke/use tobacco or nicotine. Planned Work Intended Outcomes Decrease the number of people who smoke/use tobacco. Resources/Inputs Resources essential to conduct this program/effort including community partners Activities How we will accomplish our planned activities and who will be engaged. Outputs The amount of service delivered or number of people served Short and Long-term Outcomes Benefits to Participants, Often at Individual Level Long-Term Impacts Changes that will occur in organizations, community, or systems due to effort Children of parents who tobacco Schools Relay for Life American Cancer Society American Lung Association Public health Physicians/medical providers Churches Businesses Schools continue mandatory education on health risks, including tobacco (part of curriculum) Social campaign to make tobacco use uncool (community partner, American Lung Association, Cancer Society) Demonstration of lung with cancer/smoker (sponsored by hospital, providers, etc.) Testimonials from former smokers with lung disease (schools) Create and distribute annual reports on mandatory education Conduct campaign annually Conduct 5 demonstrations per year Recruit 5 individuals who will provide testimonials Healthier and more active adults people start smoking Students will influence their parents to quit smoking Lower rate of lung disease Fewer “years of potential life lost” Social norms will influence adults