Conversation starters

Volunteers prepare food for Carry On Bags
Volunteers prepare food for Carry On Bags.

The Business Leadership Network engages with Iowa communities to facilitate discussion and collaboration on public health projects.

Sometimes simple conversations can kick-start great ideas. Take the time Laurie LaVan, a media associate in the Fairfield Community School District in southeast Iowa, joined several other teachers in sharing concerns about students going hungry.

“The conversation turned to elementary students who come to school on Monday and say they haven’t eaten since they left school the Friday before,” LaVan says. “It became clear to us that hungry students could be found throughout the district.”

That exchange led to a community meeting, which resulted in the formation of Carry On Bags, a nonprofit organization that addresses food insecurity among preschool to grade 12 students in Jefferson County, Iowa. Each week, the program provides approximately 300 food bags filled with snacks and simple meals that allow children to “carry on” without school meals over weekends and during school breaks. The project’s partners include school personnel, a local church, grocery store, and dozens of volunteers.

The College of Public Health is working to spark more conversations that generate partnerships like these through its Business Leadership Network (BLN). The BLN reaches out to businesses and communities in Iowa to form collaborations around public health needs identified by local residents.

“The people who live and work in communities know best what their health concerns are,” says Tara McKee, BLN coordinator. “Our role is to facilitate conversations about those topics, encourage connections to address concerns, and provide education and resources whenever possible.”

Community Grants in Action

In 2015, the college’s Iowa Institute of Public Health Research and Policy established the Business Leadership Network Community Grant Project. The grants of up to $3,000 fund collaborative projects and programs that support community health. Carry On Bags was one of five inaugural recipients of the community grants, and is using the funds for food and containers to transport the bags to schools.

The organization is interested in evaluating its impact, so McKee connected Carry On Bags board member Dee Sandquist with CPH Assistant Professor Natoshia Askelson, who has research interests in food insecurity issues.

“I’m helping them put together a quick online survey for parents to fill out. The university will host the survey and provide them with a basic summary,” explains Askelson.

The remaining first-year grants included projects focused on keeping at-risk youth active and safe by providing weekend activities (Fort Dodge), engaging youth and adults in dialogue through a shared book reading (Webster City), educating elementary school children about oral health (Creston), and establishing a worksite wellness education, recognition, and reward program (Cerro Gordo County).

Worksite Wellness

Community partners lead a discussion in Centerville.
Community partners lead a discussion in Centerville.

The worksite wellness initiative, a partnership of the Cerro Gordo County Department of Public Health, Mason City Chamber of Commerce, and Mason City Blue Zones Project, has offered several “lunch and learn” sessions for local businesses. The topics have included packing healthy lunches, strength training, and ergonomics and safety. In August, Nathan Fethke, CPH associate professor of occupational and environmental health, spent a day conducting on-site ergonomic assessments at four major employers in the Mason City area.

“He visited with management and employees to reinforce all the things they were doing right, and to offer suggestions for areas of improvement,” says Kelli Huinker, health promotion manager for Cerro Gordo County Public Health. “Having access to experts from the University of Iowa has been great.”

The major component of the grant, says Huinker, has been the creation of a Worksite Wellness Awards Program that “recognizes local organizations that go above and beyond to support their employee’s well-being.” The first annual awards were announced in October.

“We want to recognize employers that are already investing in wellness initiatives, and encourage other businesses to get involved in worksite wellness programs,” says Huinker. “Our goal is to make these programs sustainable.”

On the Road

The BLN is also taking College of Public Health faculty and students on the road to engage in public health-related conversations. As of November 2016, the BLN has hosted 15 community forums around the state with business owners, economic development leaders, public health officials, health care providers, local elected officials, agency and organization representatives, and the general public. Topics have included agricultural health and safety, cyberbullying, health care reform, women’s health, and substance use.

University of Iowa President Bruce Harreld visited Mason City in November as part of a Community Forum, which focused on workplace health and safety, mental health, obesity, and more.
(Watch a video about the Mason City visit.)

The BLN will announce the second round of community grant recipients in December 2016. Additional support from the UI Provost’s Office of Outreach and Engagement, Iowa Farm Bureau Federation, and the Roy J. Carver Charitable Trust is funding the second grant cycle. Several more community forums are being planned for the spring.

“The BLN is a great way to learn about what’s happening in communities around the state, and to explore new areas where the college might partner on initiatives,” says McKee.

This story originally appeared in the Fall 2016 issue of InSight.

BLN, UI President Harreld visit Mason City

The UI College of Public Health’s Business Leadership Network held a community forum in Mason City on Nov. 4. Faculty and staff from the College of Public Health and UI President Bruce Harreld met with community leaders in health care, business, government, and education to discuss health topics.

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Mason City Globe Gazettte


Ryckman to be next Public Health Ambassador

Portrait of Kelli Ryckman, professor in the Department of Epidemiology at the University of Iowa College of Public Health.
Kelli Ryckman

Kelli Ryckman, associate professor of epidemiology and pediatrics, will be the 2016 – 2017 State Hygienic Laboratory Environmental and Public Health Ambassador.

Ryckman, who specializes in understanding genetic and metabolic predicators of preterm birth, will serve in the honorary position to help raise awareness of the public health laboratory system and its role in assuring the health of Iowans.

An open house to welcome Ryckman is scheduled for 3 – 4:30 p.m. on Thursday, Aug. 4 at the State Hygienic Laboratory on the UI Research Park Campus in Coralville.

“Dr. Ryckman’s research into how we can improve birth outcomes dovetails perfectly with the Hygienic Laboratory’s focus on maternal and newborn screening,” said State Hygienic Laboratory Director Christopher Atchison. “We look forward to expanding our work with Dr. Ryckman to further improve birth outcomes in Iowa.”

Ryckman has authored many studies, including research of metabolic profiles and gestation. She collaborated with the State Hygienic Laboratory and the Iowa Newborn Screening Program on the study.

Also scheduled for 2 – 4:30 p.m. on Aug. 4 is a visit to the laboratory by the UI Mobile Museum, which brings university artifacts, research and interactive displays to communities across the state.  The Hygienic Laboratory’s Ambient Air Quality program is featured in one of this year’s displays. Since April 2016, the Mobile Museum has traveled 4,366 miles and attracted 10,413 visitors.


Cancer prevention in a Latino community

storefronts in downtown West Liberty
Downtown West Liberty. Photo by David Wilson/Flickr

In many ways, West Liberty is a typical small Iowa town. The main street of this east-central Iowa community boasts a movie theater, hair salons, several restaurants, and other small businesses. What sets the town of 3,700 residents apart are its demographics—West Liberty is the first Iowa town to have a majority Latino population.

West Liberty is just one reflection of Iowa’s increasing diversity. From 2000  to 2014, the state’s Latino population grew 110 percent and now makes up 5.6 percent of Iowa’s total population.

The town’s diversity often attracts groups wanting to offer health care or other social services. However, says Jason Daniel-Ulloa, clinical assistant professor with the Department of Community and Behavioral Health, successful programs depend on trust that’s built with the community over time.

“You have to be present,” says Daniel-Ulloa. “You can’t roll in from out oftown, put up a couple of fliers, and have people to show up to your meeting.”

Concern about Cancer

In 2012, a team of College of Public Health investigators, including Daniel-Ulloa, began studying cancer issues and priorities in the state’s Latino population with funding from the Iowa Cancer Consortium. Cancer is the leading cause of death among Latinos, according to the American Cancer Society.

The researchers narrowed their focus to West Liberty, where they partnered with residents on community-based participatory research in cancer prevention. St. Joseph’s church, the local Catholic parish, has been an important partner in facilitating the effort.

“The church is a gathering place for the Latino community,” says Rev. Greg Steckel, pastor at St. Joseph, who helped identify a group of six church members to take part in a Photovoice project.

The participants took photos of what they perceived to be barriers to cancer prevention, then held group discussions. To disseminate the results of the project back to the community, a bilingual forum was held in in 2014, drawing about 50 residents. The forum revealed a community concern about cervical cancer, which had caused several residents’ recent deaths.

“The Photovoice project demonstrated that people get enough information about cancer to be afraid of it, but don’t really know what to do about it,” says Daniel-Ulloa.

Based on that feedback, the team developed a human papillomavirus (HPV) education intervention. HPV is the most common sexually transmitted infection in the United States and can cause cervical and other cancers. The HPV vaccine, given in a series of three doses over six months, protects against HPV-related cancers. The CDC recommends vaccination for all boys and girls ages 11 or 12, as well as catch-up vaccines for males through age 21 and for females through age 26 if they didn’t get vaccinated as adolescents. (See a related story about an HPV vaccine study on page 21.)

The intervention included the video Tamale Lesson, which uses storytelling to educate viewers about cervical cancer prevention and screening. Group discussions helped define what people did and didn’t know about cancer, HPV, and the vaccine.

“What was a revelation to me is that there’s a stigma attached to cancer in the Latino community that is culturally sensitive,” notes Steckel. “Cancer has a sense of guilt attached to it—that you must have done something to get this. That gray area is true for everyone, but it’s accentuated in the Latino community.”

A Sustainable Solution

University of Iowa third year medical student Brian Guetschow gives a flu shot to Jose Santos of West Liberty
University of Iowa third year medical student Brian Guetschow gives a flu shot to Jose Santos of West Liberty. (The Gazette, Cedar Rapids, Iowa)

The research team is now working to provide free HPV vaccinations to West Liberty residents. The effort is part of a pilot study intervention funded by the Cancer Prevention and Control Research Network and administered through the UI Prevention Research Center.

Another partner in the effort is the University of Iowa Mobile Clinic, a student-run organization that provides free basic health services to underserved populations. The clinic visits West Liberty every month.

The goal is to make the intervention sustainable by training a community health worker within the church who can conduct information sessions about HPV vaccination and direct people to resources.

“We’re trying to get people to get the first shot in the Mobile Clinic, then refer them to a nearby pharmacy or someplace they can get in and out with little paperwork and wait time,” explains Daniel-Ulloa. “The biggest barrier for the community is time. When you’re working hourly and the clinic closes before you get off work, it costs you money [to take time off].”

The researchers will track how many people receive the vaccine as a result of the intervention.

Building Trust, Embracing Ambiguity

As Daniel-Ulloa noted earlier, gaining a community’s trust doesn’t happen overnight.

“You have to take the time to get to know people and build relationships,” says Steckel, who has lived in West Liberty for more than three years and has worked with Daniel-Ulloa for much of that time. “You can’t come in and say you have all the answers. If you try to dominate the situation, you’ll run into resistance.”

“We found people who the community trusts,” Daniel-Ulloa says of the process. “We sat down with them and asked, What do you want us to do? And then you do it. You make an impact by creating relationships, being present in the community, and caring.”

Once relationships are established, cultural differences can still present some unexpected challenges. Meetings, for instance, may veer wildly from an outside organizer’s agenda.

“Latin America is built on a communal experience,” explains Daniel-Ulloa. “That’s why you talk for 45 minutes before you get down to business.”

Steckel echoes that events flow at their own pace, which runs counter to the time-conscious Anglo culture. “Leadership is also very fluid,” adds Steckel, who is Anglo. “You can easily be offended and offensive. I’ve learned to be aware of my own prejudices. I have different expectations, but I have to embrace the ambiguity.”

“You can’t plan everything,” Daniel- Ulloa agrees. “You can try, but you have to understand that it will disintegrate. And that’s difficult for providers. We train providers to be very uncomfortable with ambiguity.

“And that is the opposite of what you need to work in the community,” Daniel-Ulloa continues. “It’s more than being okay with ambiguity, you have to like it. Because it’s exciting. You have to be ready to change the course of the program.

“Set your eyes on the big goal you’re trying to get to,” Daniel-Ulloa advises, “and be creative about how you know that you’re getting there.”

This story originally appeared in the Spring 2016 issue of InSight