Source: GRADY MEMORIAL HOSPITAL CORPORATION submitted to
EMORY/GRADY URBAN HEALTH INITIATIVE PROGRAM
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
EXTENDED
Funding Source
Reporting Frequency
Annual
Accession No.
1004110
Grant No.
2014-33800-22390
Project No.
GEOW-2014-03237
Proposal No.
2014-03237
Multistate No.
(N/A)
Program Code
LN.C
Project Start Date
Sep 1, 2014
Project End Date
Aug 31, 2018
Grant Year
2014
Project Director
Moore, C. E.
Recipient Organization
GRADY MEMORIAL HOSPITAL CORPORATION
80 JESSE HILL JR DRIVE SE
ATLANTA,GA 303033031
Performing Department
Urban Health Initiative
Non Technical Summary
The Northwest Atlanta Healthy Hub will advance its plans to transform Northwest (NW) Atlanta into a Healthy Hub using a multi-partner, inter-agency, community-driven approach already underway in this target neighborhood. The NW Atlanta Healthy Hub will offer a set of interconnected initiatives and programs to address issues related to food security, food access, obesity, and other social determinants of health. Over the next three years, the Healthy Hub will accomplish the following: • Expand Super Giant Foods Community Garden to include additional beds, greater volunteer assistance, and embedded educational opportunities • Deliver a multi-method approach to food literacy education that targets children, youth, young adults, and older residents through a collaboration with Truly Living Well, Cooking Matters, and local supermarkets • Launch school-based gardens through a partnership with the Atlanta Public Schools Farm to School Initiative • Create and deliver customized resident leadership training (known as Health Champions) designed to sustain the NW Atlanta Healthy Hub The NW Atlanta Healthy Hub will fully address the CFPCGC program objectives by strengthening existing strategic alliances, building the capacity of residents to address their local food needs, and disseminating best practices with the community as part of their efforts to advance a unifed community response to local food access.
Animal Health Component
0%
Research Effort Categories
Basic
10%
Applied
60%
Developmental
30%
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
90360101170100%
Goals / Objectives
Goal 1 (Healthy People, Strong Communities): Improve knowledge and skills among residents of all ages of the connection between food quality, healthy environments, and healthy people.Goal 2 (Justice and Fairness): Promote access for all community members to fresh, healthy, affordable, and locally grown produce.Goal 3 (Strong Communities): Broadcast findings from the NW Atlanta Healthy Hub to expand the Community Food Project network, strengthen community voice, promote project sustainability, and contribute to the overall knowledge base about best practices
Project Methods
The primary methodological approach to this initiative utilizes Community-based participatory research. This applied collaborative approach that enables community residents to more actively participate in the full spectrum of research (conception - design - conduct - analysis - interpretation - conclusions - communication of results) with a goal of influencing change in community health, systems, and programs. Through partnerships with community members and researchers, combined knowledge and action for social change to improve community health and often reduce health disparities can occur.These partnerships build communication, trust and capacity, with the final goal of increasing community participation in the research process. Quantitative and qualitative analysis will be performed.

Progress 09/01/14 to 08/31/17

Outputs
Target Audience: The target audience during this reporting period is the residents of NW Atlanta which are located in a designated food desert. This includes children and adults who face a myriad of obstacles in achieving economic prosperity, good health, and life-long success. The rate of poverty in this community is more than double the state average (45.6% vs. 18.5% respectively) and the most recent unemployment rate is a staggering 33.5% compared to 14% for the city, and just 35% for all of Georgia. Changes/Problems:Following the request in 2016 by Emory University made to Grady Health Foundation to transfer salary dollars for time and staff effort devoted to grant related activities, a sub-contrracting and approvals process was immediately initiated. Due to renegotiation of indirects rate at the institutional level and approvals process at the USDA level to include organizational assurances that the salary dollars transfer from Grady Foundation to Emory University was appropriate and allowable, the contracting process continued into 2017. As of End of August 2017, the agreements between Grady and Emory are in final processing, with expected final signatures at end of September 2017. Because UHI has had additional external grants and general core funding that have functioned as the 1:1 in-kind match for the USDA funding, we have had no delays in work, nor have we been hampered in our abilitiy to achieve all objectives, as evidenced by successful milestones described elsewhere in this progress note. Our Community Teaching Garden is located on the premises of a Daycare Center, which closed a few months ago and the property has been sold. We have been permitted to continue to have our Community Garden at this site until the end of the year, but with the closure of the Daycare Center, it has significantly impacted the traffic to this area and we have had a decline in the number of community participants at our garden since it closed. We have, however, recently found a site within our target area to relocate the garden to which will be a more visible location and closer to schools, an assisted living complex, and apartment complexes. We believe that as we continue to develop our YA-E program and our senior citizen program, this new location will be a great asset. What opportunities for training and professional development has the project provided?Our Community Teaching Garden project has provided training for the Community in: Gardening, including how to grow their own produce in a limited space, how to create a community garden that can feed a community, how to grow food in a healthy (natural/organic) manner. Business Skills, related to an agriculture-based business--to help bring in more food access to the community. Leadership Skills--to create strong community leaders from within who understand the importance of access to healthy food and clean air, soil and water. In addition, we have provided opportunities for training and professional development for many students of medicine, public health, and other disciplines from multiple institutions in the metro Atlanta area. Many students have worked with this project over the past three years and have learned first hand about the social determinants of health from actually being in the community and interacting with the residents. Students from areas such as engineering and environmental science have worked with us and have gained knowledge and experience in developing irrigation systems, soil testing and water quality. How have the results been disseminated to communities of interest? We have had several articles published in the Emory-at-Grady Newsletter, the Emory Wheel, and the Emerald Corridor Newsletter. CNN has acknowledged our work in NW Atlanta in their broadcasts Presentations to multiple classes in the Rollins School of Public Health 4 Grand Rounds Conferences in medical facilities in Atlanta What do you plan to do during the next reporting period to accomplish the goals? Nothing Reported

Impacts
What was accomplished under these goals? Goal 1 (Healthy People, Strong Communities): During the past year, our "Urban Garden Boot Camp" program has evolved into a much more robust "Young Ag-Entrepreneur" Program (YA-E) in which we focused on a combination of gardening/agricultural education, community leadership, and business skill development. The YA-E Program consists of ten weeks, with two 2-hr sessions/week. While the YA-E Program is primarily focused on youth (middle-high school), it has also been attended by adults, including senior citizens. The goal of this program is three-fold: 1) to educate the community members on the importance of good nutrition and to teach gardening skills so that residents could grow their own produce, 2) teach business skills related to starting an agricultural based business to help increase food access within the community as well as address the lack of income opportunities in these low-resourced communities, and 3) teach leadership skills to develop strong community leaders from within the community. We utilized the knowledge and skills of our staff, as well as our local Master Gardeners and County Extension Agents to help teach these sessions. Goal 2 (Justice and Fairness): Our YA-E Program has been open to any members of the community who wish to attend. The program included experiential learning in which the participants put their knowledge into practice at our Community Teaching Garden by building and maintaining raised beds, planting vegetable seeds (and seedlings that they established) into the raised beds and the ground plots, maintaining the garden with natural/organic fertilization and pest control methods, and providing guidance and garden tours as new community members would visit the garden. The produce grown in our Community Teaching Garden was given to community members, including residents at a nearby homeless encampment who frequented the garden. Goal 3 (Strong Communities): During our YA-E Program, we taught the participants about the importance of networking and continued learning. We sponsored the youth (as well as some of the adults in the community) to attend local conferences and meetings on urban agriculture and encouraged them to fully participate in these conferences to be seen as leaders in the local urban agricultural movement. We have formed many collaborative partnerships with other individuals and organizations (private, faith-based, and governmental) involved in the community food network. Our partnership activities have included participation in (and marketing of) their events, serving on their advisory panels, and sharing resources. Our program has a strong emphasis on developing strong community leaders from within the communities, and we incorporate leadership skill training with our workshops. During our YA-E Program, participants created container gardens and other produce-based items, which were sold at local events to create funds to sustain the program.

Publications


    Progress 09/01/15 to 08/31/16

    Outputs
    Target Audience:The target audience during this reporting period is the residents of NW Atlanta which are located in a designated food desert. This includes children and adults who face a myriad of obstacles in achieving economic prosperity, good health, and life-long success. The rate of poverty in this community is more than double the state average (45.6% vs. 18.5%, respectively) and the most recent unemployment rate is a staggering 33.5% compared to 14% for the city, and just 3.5% for all of Georgia. Changes/Problems:On 2/6/2016, one of our work sites was unexpectedly closed. We successfully relocated within the target community. We notified our program officer who confirmed there was no need for a change in scope as the initial goals, objectives and match were not changed. The new site is adjacent to a MARTA rail station, a youth/day-care center, neighborhood health ceter, and the Department of Family and Childrens' Services. We now have much better exposure to the community in this new site. It is also close enough to the former location that we believe that all of the community members who frequently visited us at the previous location will still be able to visit us at the new location. This transition has positively impacted our work in the target community. A number of challenges were initially encountered upon initiating the disbursement of the NIFA USDA award. The current fiscal agent, the Grady Health Foundation, went through a reduction-in-workforce and other changes that caused a delay in receipt of funding. Work commenced and continues, yet some expenditures have not yet been made. All other schedules and goals are on track. There have been no unexpected outcomes or protocols that have changed during this reporting period. Additionally, the Grady Health Foundation has been asked by Emory University to transfer salary dollars to Emory for key personnel participation. Emory's administrative team asked to renegotiate the indirect rate. Upon discussion with the Grants Awards Management Divisioin Chief, it was determined that as long as there was no reduction of salaries and time commitment of 25% or more of what was initially proposed then the change is permitted. What opportunities for training and professional development has the project provided?We have established a partnership with Volunteer Emory (undergraduate students), Rollins School of Public Health, Emory University School of Medicine, Emory Nell Hodgson Woodruff School of Nursing, Georgia Institute of Technology, and community members from ages 4-80+. Through these partnerships we have provided individual and group skills trainings in gardening, leadership, nutrition, and cooking. We have created monitoring and evaluation classes for students to assist with their understanding of research methodology to facilitate assessment of our programs and projects. Additionally, we have had individual and group instruction for students on scientific publications and dissemination techniques to effectively relay our work. We have initiated training of store lay ambassadors to provide educational in-store experiences for cusomers. Through this work, they will teach community members as well as their individulal families and co-workers how to read nutritional labels, cost-price comparison, nutritional goals, and healthy shopping on a budget. How have the results been disseminated to communities of interest? We have had several articles published in the Emory-at-Grady Newsletter, the Emory Wheel, and the Emerald Corridor Newsletter CNN has acknowledged our work in NW Atlanta in their broadcasts Presentations to multiple classes in the Rollins School of Public Health 4 Grand Rounds Conferences in medical facilities in Atlanta What do you plan to do during the next reporting period to accomplish the goals?We will continue our current work in conjunction with efforts to increase community involvement and leadership from the target community. We will continue to develop additional initiatives such as the TNT (Tuesday Noon Together) Program designed to provide skill sessions, community engagement and nutritional education for seniors. As a part of this program we will also integrate these activities with the youth programs to facilitate intergenerational knowledge and experiences. We will continue to attract and retain student leaders from across several universities in Atlanta. Moreover, we will continue to attract, train and retain community leaders from our target neighborhood. We will plan and facilitate 2 community forums to showcase the accomplishments and evaluation findings of the project. We plan to recruit a second cohort of 10 NW Atlanta residents to participate in an Urban Gardening Boot Camp. In each of the ways the Urban Health Initiative partners with the community, especially in the two teaching gardens and our partnership with Wayfield Foods, we are moving forward towards community leadership and sustainability. Success over the coming year will come by advancing each of the initiatives toward greater collective community impact.

    Impacts
    What was accomplished under these goals? A Community Advisory Board was initiated and established which has met quarterly throughout this granting period. Additionally, we were able to establish subgroups to address issues of nutrition and food security, nutritional health in veterans, seniors, and youth. Through work with this Board and its subgroups, we were able to create a Northwest Atlanta Food SecurityHealth and Wellness Conference with approximately 80 participants from a wide variety of target community organizations. We received the first grant awarded by a new foundation, the Emerald Corridor Foundation, to address food security in low-resourced areas. This grant promotes justice and fairness by increasing access to knowledge and food products within an additional area of our target community. We successfully relocated our Super Giant Foods Community Teaching Garden to a site that increased access through co-location with a chidcare center, a community clinic, WIC office and adjacent to a public transportation faciity. This new location is well within our target community, which allows community members from the former site to continue to participate in activities while also providing enhanced exposure to community members and students.

    Publications


      Progress 09/01/14 to 08/31/15

      Outputs
      Target Audience:The target audience during this reporting period is the residents of NW Atlanta which are located in a designated food desert.This includes children and adults who face a myriad of obstacles in achieving economic prosperity, good health, and life-long success.The rate of poverty in this community is more than double the state average (45.6% vs. 18.5%, respectively), and the most recent unemployment rate is a staggering 33.5%, compared to 14.0% for the city, and just 3.5% for all of Georgia. The demographic characteristics of our target audience is shown in Table 1. Demographic Characteristics NW Atlanta Atlanta Georgia Percent African American residents 96.9% 61.2% 33.5% Median household income $24,087 $45,171 $39,666 Poverty level 45.6% 24.4% 18.5% Percent of residents who walk to work 10.1% 3.5% 2.6% Unemployment rate 33.5% 14.0% 3.5% An health assessment conducted with a sample of 94 residents of NW Atlanta revealed: High prevalence of diabetes (20.2%), which was almost double the national average (11.3%) The most common barriers to grocery shopping were transportation (35.1%) and money (25.5%). A staggering 28.7% went grocery shopping just once a month or less often More than two thirds (67.7%) ate fast food 1 to 2 times a week, while another 19.4% did so 3 to 4 times a week The most frequent barrier to healthy cooking was no or poor cooking skills (17.0%) More than half (55.3%) had worried at least once in the 4 weeks prior to the assessment that their household would not have enough food Efforts To address these issues, we have created an advisory council with representatives from community and community organizations. Meetings have been performed each quarter. Subgroups meet regularly between the advisory council meetings. Our program has nitiated an Inventory Assessment of Corner Stores in West Atlanta. With this information, we are engaging store owners in the process and introducing them to the opportunity to increase healthy options within their stores. Approximately 40% have voiced an interest in participating in additional healthy options. Boot camps have been provided to children and adults at our current teaching garden through a partnership with the HEALing Community Center, a federally qualified healthcare center in the region. Through these activities, the garden has also been expanded. 147 unique participants have been recorded as having participated in the garden activities. An additional community teaching garden has been identified which will be co-located with an additional grocery store in the NW Atlanta area. We have further developed a transportation initiative utilizing resources from the community which include a van which is provided by a community church, sponsored by a second church to cover the cost of the driver and gas. A focus group of community individuals determined that there should be a cost of $1 for each rider. Currently, this initiative provides 3 trips per month to grocery stores that provide healthy food options. Additional funding has been recently secured from WellCare to further develop the program which will allow the program to increase the number of trips per month. Changes/Problems:A number of challenges were initially encountered upon initiating the disbursement of the NIFA USDA award. The current fiscal agent, Grady Foundation, has undergone a reduction in work force and other changes that caused a delay in receipt of funding. Work commenced and continues, yet some expenditures have not yet been made. All other schedules and goals are on track. There have been no unexpected outcomes or protocols that have changed during this reporting period. What opportunities for training and professional development has the project provided?Through this initiative, we have provided opportunities for training graduate students and community members in data collection, monitoring and evaluation as well as community outreach, retention and education. A master gardener inconjunction with our boot cam training has provided additional skills inthe design and maintenance of an urban garden with the intention of community members utilizing these skills in their indivual residences. Additioinally, skills are taught that will enable individuals the opportunity to pursue urban agriculture careers. How have the results been disseminated to communities of interest?As we are in the initial stages of our program, we have had articles published in local magazines and newspapers. Additionally, dissemination of our workj has occured through the National Weather Channel. Presentations of our work has occcured throughout the Atlanta School Systems, local health facilities and grocery stores. What do you plan to do during the next reporting period to accomplish the goals?In the next reporting period, we will continue to pursue opportunities to publish our work in peer reviewed journals. We also intend to continue to broadcast the success of this initiative through the current venues that have provided excellent means of creating disourse with our communities.

      Impacts
      What was accomplished under these goals? IMPACT: The Urban Health Initiative (UHI) at Emory University, in partnership with the Grady Health Foundation, launched a Community Food Project in Northwest (NW) Atlanta that builds on a multi-partner, community-driven approach already underway in this target neighborhood to address issues related to food security, food access, obesity, and other social determinants of health. UHI has cultivated relationships with community leaders and residents, Section 8 apartment complex owners, managers, residents and community health providers, local food retailers and other businesses, school principals, and multiple faith and non-profit organizations to begin to address the food and health needs of this community. Funding from the US Department of Agriculture (USDA) is helping us leverage existing partnerships and community engaged work to address the multi-faceted food needs of the residents of the NW side of Atlanta, while uplifting community engagement and increasing self-reliance. It is also anticipated that lessons learned, such as the effort it takes to maintain ongoing relationships and participation among volunteers, can be discussed and results will be made available to the general food security interest groups across the United States. Objectives by Goal: Goal I (Healthy People, Strong Communities): Improve knowledge and skills among residents of all ages of the connection between food quality, healthy environments, and healthy people. Major activities completed/experiments conducted: During the first year of this grant, the Healthy Hub leadership team created an advisory council that includes representatives from community and community organizations. One goal has been to understand and increase the knowledge base about the target community, food insecurity and other social determinants of ill-health community members face. Meetings have been performed each quarter. Subgroups regularly met between advisory council meetings. Members have been introduced to garden work, Grow Where You Are boot camps, Cooking Matters, and other evidence-based programming, providing a change in knowledge. For some, they have become active in the actual work, providing a change in actions. The team initiated an Inventory Assessment of Corner Stores in West Atlanta. With this information, we are engaging store owners in the process and introducing them to the opportunity to increase healthy options within their stores. Approximately 40% have voiced an interest in participating in additional healthy options. Boot camps have been provided to children and adults at our current teaching garden through a partnership with the HEALing Community Center (HCC), a federally qualified healthcare center in the region. Through these activities, the garden has also been expanded. An additional community teaching garden has been identified, which will be co-located with an additional grocery store in the NW Atlanta area. Healthy Hub Advisory Board Meetings and Healthy Hub Subcommittee Meetings have been held throughout the time period. The Garden Team partner with HCC for boot camps, and participants learn about opportunities to improve their physical and dental health through medical services, as well as active events such as Walk with a Doc, to increase physical activity. Students and faculty from The Georgia Institute of Technology are developing a low technology Irrigation Project/System to assure maximum rooftop water use. Our second teaching garden to be co-located with a grocery store is under development, supported by a grant from the Emerald Corridor Foundation. We have further developed a transportation initiative utilizing resources from the community that include a van that is provided by a community church, sponsored by a second church to cover the cost of the driver and gas. A focus group of community individuals determined that there should be a cost of $1 for each rider. They said, "Charge is a small amount, so we participate, not become dependent." Currently, this initiative provides 3 trips per month to grocery stores that provide healthy food options. Additional funding has been recently secured from WellCare Medical Plan to further develop the program, and that will allow these low-resourced riders access to the 2 teaching gardens and associated grocery stores, as well as health and dental care.

      Publications

      • Type: Other Status: Published Year Published: 2015 Citation: Weather Channel http://link.brightcove.com/services/player/bcpid1496007759001?bckey=AQ~~,AAAAAAQxtuk~,N9g8AOtC12eDhj9Li1v3hu9fCeX8Osz7&bctid=2775905170001
      • Type: Other Status: Published Year Published: 2014 Citation: Turning a food desert in to a healthy garden AJC.com http://atlantaforward.blog.ajc.com/2014/11/28/turning-a-food-desert-in-to-a-healthy-garden/