program planning: community nutrition assessment 2005
TRANSCRIPT
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Program Planning: Community Nutrition Assessment
2005
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Program Planning Basics
• Systematic process
• Continual feedback and evaluation
• Cyclical: based on increasing understandings of the true nature of the situation and the effectiveness of interventions.
• Starts with an assessment of the current situation
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Assessment
Prioritize
Analyze problem and propose model to address
Develop Intervention goals, objectives, implementation plan
Outcome evaluation
Process Evaluation & Adjustment
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Why Do Assessment?
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Community Nutrition Assessment:
• Anchors program/intervention in the reality of the community
• Essential part of ongoing process:– Needs assessment– Designing and implementing services– Evaluation – Improving programs and services
• Includes community and stakeholders as fully active participants
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Community Nutrition Assessment:
• Based on assets more than deficits
• Helps to integrate nutrition programs into community-based health programs and plans
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Successful Community Assessment Includes:
• Understanding current conditions of families and individuals
• Evaluating local capacities for supporting health and nutrition needs
• Building community support for implementing changes
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Models and Protocols for Community Assessment
• Planned Approaches to Community Health (PATCH) – CDC
• Assessment Protocol for Excellence in Public Health (APEXPH) – NACHO (National Association of County Health Officials)
• Moving to the Future: Developing Community Based Nutrition Services – ASTPHND (Association of State and Territorial Public Health Nutrition Directors)
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Strategic Planning for Initiatives to Address Local Health Efforts
• Community Assessment
• Organize a community planning group
• Define community boundaries
• Gather information– Statistical profile– Qualitative data– Community Resources
Agency for Health Care Policy and Research
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Strategic Planning, cont.
• Analyze Information– Common issues– High risk individuals– Unmet needs– Prioritize
• Develop and implement community health plan
• Monitor and evaluate community health plan
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Steps to Assessment• Convene a planning group• Define community• Identify Community Assets• Identify Perceived Needs• Build Demographic Profile• Analyze Community Health Status• Analyze Community Nutrition Status• Identify Community Resources and Service
Utilization• Identify common issues and unmet needs• Prioritize
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Community Nutrition Planning Group: Responsibilities
• Collect data and information• Identify health needs and gaps in service• Set priorities• Develop a plan• Help to implement interventions• Assist in evaluation
– Of assessment, planning, and intervention process– Of impact of intervention
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Community Nutrition Planning Group: Potential Members
• Community leaders• Consumers• Health and Nutrition Service providers• Health organizations• Schools• Political office holders or their staff• Fitness professionals• Representatives from greater community health
planning groups
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Define the Parameters
• Public Health Nutrition: Assuring conditions in which people can be nutritionally healthy
• Community: “A community is any group sharing something in common”
Community Tool Box
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Community Description
• Geographic boundaries• General history• Key people and leaders• Demographics• Financial & economic information• Important issues• Morale and involvement levels• Key allies and rivals• Unspoken rules and norms• Attitudes and opinions• Strengths and shortcomings
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Identify Community Assets
• Physical structure, place, business
• Concerned citizens
• History of successful efforts
• Organizations
• Individual and group skills
• Communications systems
• Relationships
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Identify Perceived Needs
• WHY?– To understand public opinion– To become aware of needs the planning
group doesn’t know about– To gather support & expand group expertise– To make decisions about priorities– To plan programs in ways that will be
acceptable to stakeholders
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How do we assess perceived needs?
• Listening sessions
• Public forums
• Key informant interviews
• Needs assessment survey or survey of concerns
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Demographic Profile
• Economic status: income, employment, % below poverty
• Education levels
• Age and gender
• Race & ethnicity
• Social factors: homelessness, immigration status, family composition, TANF utilization
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Community Health Status
• Causes of Mortality
• Hospital discharge data
• Disease prevalence data
• Food bourne illness reports
• Years of potential life lost
• Infant mortality
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Community Nutritional Status
• Pregnancy related: – weight gain in pregnancy– Pre-pregnancy weight– Anemia
• Disease prevalence: HIV/AIDS, cardiovascular disease, diabetes
• Activity levels (BRFSS)• Food intake: fat, fruits & vegetables (BRFSS)• Dental health• Food/dieting related behaviors (YRBS)• Food Security (BRFSS)
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Community Resources & Service Utilization
• What resources are available?• To what extent are people using them?• Sources of Information:
– Citizens– Service providers
• Tools– Existing data– Interviews– Surveys
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Examples of Community Nutrition Resources
• Food assistance programs (WIC, Basic Food, etc.)
• Grocery stores with high quality produce
• Food Service with health promoting food options
• Educational programs
• Media
• Profession and non-profit organizations
• Nutrition counseling
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Criteria for defining/prioritizing community problems
• Frequency• Duration• Scope or range• Severity• Perceptions• Root causes (“but why?”) & ability to impact root
causes (effectiveness of interventions)• Barriers to resolutions• Political and financial support
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Group Work: Roles
• Assign roles within a breakout group:– Mayor who has lead the charge for a comprehensive
strategic plan for economic development that includes recreation and attracting active retirees.
– County Health Officer: a family practice MD who is a strong advocate for breastfeeding
– Bicycle Alliance member– Anti hunger and farmers market advocate– School administrator– Nutritionist from the local health department
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Group Work: Develop Problem List
• Brainstorm nutrition & physical activity related issues & problems that arise from these data
• Choose 5 issues that are of interest to all stakeholders
• Prioritize these issues using criteria in these slides
• Establish the one issue or problem that all stakeholders will be comfortable working on for the next two weeks
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Community Inventory Moses Lake
Factors that affect nutrition and
physical activity choices
June - August 2002
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Moses Lake
• Agricultural community• Recreation destination • Population: 14,953 in 2000 census • Unemployment rate: 8.5% (2001)• 2,246 cases of food assistance ( MRDA, Oct 2001 )
• 33% population increase from 1990-2000• Workforce: primarily agriculture; Increasing food
processing and industrial manufacturing base• 48% school children eligible for free or reduced
lunch
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Ethnic Distribution
White 77%
African American 2%
Other 21%
Hispanic 25%
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Interviews with Nutrition and Physical Activity Professionals
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Top Health Concerns
• Obesity
• Poor nutrition
• Diabetes
• Smoking
• Unplanned pregnancy
• Poor medical “compliance” among minorities
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Perceived Barriers to Accessing Healthy Food and Physical Activity
• Healthy food• Lack of education• Lack of recognition/concern for food choices• Cultural attitudes• TIME- easier to access fast/junk food
• PA• Lack of awareness/perceived need• Difficult to get people interested/time factors• Poverty/poor nutrition • Language issues• Decreased emphasis on PE in school
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Readiness for Change andLevel of Interest
• Level of interest: medium-high interest
• Awareness: strongly represented in need to educate through schools, starting early
• Infrastructure- Moses Lake/Grant County have strong community health programs
• Perceived readiness to change- medium to high• Community level exposure- festivals and summer
recreation- based activities may reach large numbers
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Solutions/Priorities for Change
• Increase nutrition and PE curriculum requirements• Increase staffing to implement programming,especially
In schools and existing food programs• Increase access for all members of community through
“riverwalks”, lengthier bike paths, schools indoor walking programs (inclement weather)
• Promote active lifestyles for families; “Free exercise”• Coordinate community resources to “make healthy
lifestyle changes happen” (= coalition-building!)• Promote positive media campaigns
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Interviews with Community Leaders
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Is obesity a problem?
• 5/10 reported that it was a visible problem– Not perceived as unique to ML– Due to sedentary lifestyle and fast foods– Concern because see in children in schools
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Perceived Levels of Physical Activity
• 9/10 believe that lack of physical activity is a problem in Moses Lake– Don’t see people exercising (but I do)– Fairly active community– Poor community & people don’t know that
there are free opportunities for recreation here– There is a general lack of facilities in rural
towns in general– Same as nation as a whole
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Perceived Problems due to Poor Diet
• 9/10 thing that poor diet is a problem in Moses Lake– Heavy use of fast foods (5)– Rushed lifestyle (3)– Poverty– People don’t know how to cook
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Awareness of Nutrition and Physical Activity Programs in Community
• 7/10 were aware of some– Private health clubs and weight loss programs– Hospital classes– School classes– City Parks and Recreation, skate park, pool,
skating rink– Programs for Seniors
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Community Inventory Goals
• Assess factors which affect nutrition & physical activity choices in Moses Lake
• Assist AC members to determine what project(s) are appropriate for the community
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Healthy Communities, Healthy Living Planning Document Based on State Plan for Nutrition and Physical Activity
• Enhanced opportunities for recreation & physical education
• Increased access to healthy foods
• Assurance that transportation, urban planning, & public safety systems support active lifestyles
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Key Community Documents• City of Moses Lake: Planning Commission
Recommended Comprehensive Plan • Parks, Recreation, & Open Space Plan • Community Streets & Utility Standards • Municipal Code for Major Subdivisions • “Just Data” Grant County Health District
Community Assessment Data • Draft VISION 2020 Strategic Plan • A Description of Grant County: Population --
The Changing Face of Grant County -- August 2001
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Community Resources• Police Department: http://www.moses-lake.com/police/ • Parks and Recreation: http://www.mlrec.com/ • School district: http://www.moseslakeschools.org/ • Chamber of Commerce: http://www.moseslakechamber.org/ • Moses Lake Information: http://www.moses-lake.com/ • Grant County Economic Development Council: http://www.grantedc.com/ • Samaritan Healthcare: http://www.samaritanhealthcare.com/ • Moses Lake Community Health: http://www.mlchc.org/ • Moses Lake Clinic: http://www.wvclinic.com/locations/MLC.asp • Port of Moses Lake: http://www.portofmoseslake.com/ • Columbia Basin Herald: http://www.columbiabasinherald.com/ • Aging and Adult Care of Central Washington: http://www.aaccw.org • Grant County: http://www.grantcounty-wa.com• Grant County Health District: http://www.granthealth.org/
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CI Committee Members
• Anne Henning• Becky Meyer • Bev Shuford • Brenda Teals • Caren Jacobson • Dave Helms • Debe Nuss • Diana McKinsey• Emily Dufault • Fernando Alvarez• Jane Kim
• Judi Ellis• Laure Grammer• Lori Barlow • Lori Moholt • Mary Falconer • Mary Talcott • Ryan Hopkins• Spencer Grigg • Teri Carpentier• Tracy Fisher • Tim Varney
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Community Action
Info / Training
Development
RecruitmentPre-work
Sample audit
• Walkability• Map of physical environment • Non-section specific research
Methods
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Community Action
Info / Training
Development
RecruitmentPre-work
Sample audit • Sample audit presented at 1st AC meeting• Call for volunteers to assist in finishing the section-specific audit• Follow-up recruitment post 1st AC meeting via phone / email
Methods
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Community Action
Info / Training
Development
RecruitmentPre-work
Sample audit
• Forms and instructions for assessment• Segmentation of ML • Technology for summarizing results• Information and training
Methods
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Community Action
Info / Training
Development
RecruitmentPre-work
Sample audit
• Roll call• Segmentation of ML• Process overview• ‘Size’ of task
Methods
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Community Action
Info / Training
Development
RecruitmentPre-work
Sample audit
• Sections• Data collection• Continued follow-up / cheerleading by email• Trouble-shooting• Evaluation
Methods
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1. Recreation & physical education
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1. Recreation & physical educationSchools• School district has a written policy
requiring P.E. K-12
• P.E. per week– Elementary: 60 minutes– Middle: 250 minutes– High school: 450 minutes
• School district has started to implement the Health & Fitness EALRs
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1. Recreation & physical educationFacilities• Community Schools serves to interface with the
public regarding public use of buildings, community improvement classes, & school-related volunteer activities
• All school with indoor rec facilities are available based on priority areas:– 1st: School activities– 2nd: Parks ‘n Rec– 3rd: Other programs
• All schools with outdoor rec facilities available to the public after priority areas have been accommodated
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1. Recreation & physical educationProgramming• Organized athletics • Aquatic Center• Cal Ripken• Yoga• City of Moses Lake Walking
Program• Walk Across Washington• Spring Festival• Kayaking• Kickboxing• Karate• Thai Chi• Special Olympics• Physical activity & strengthening• Dancing• Skate Park
Parks & Recreation Facilities Parks & Recreation Facilities Parks & Recreation Facilities The Learning Center Moses Lake – City Hall Moses Lake Parks & Recreation Facilities Parks & Recreation Facilities Parks & Recreation Facilities Marital Arts Academy Marital Arts Academy Parks & Recreation Facilities Hospital Senior Center Parks & Recreation Facilities
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2. Access to healthy foods
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2. Access to healthy foodsBreastfeeding
• Samaritan Hospital is not considered a ‘Baby Friendly Hospital’ by BFHI standards supported by WHO / UNICEF
• ML does not have an official ‘Breastfeeding Friendly’ program for workplaces & business, but . . .– Moses Lake Clinic– Community Health– Hospital– ASMI
• Mothers breastfeeding in ML– Early postpartum 90% – At 2 months 50% – At 6 months 20% – At 1 year - -
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2. Access to healthy foodsFarmers market & CSA
• Columbia Basin Farmers Market– Saturday AM – mid-June through late October – Wednesday PM – mid-July through mid-September
• ML & Grant County farmers represented• 1 farmer sells apples & resells oranges to
MLSD• 5-A-Day message promoted• Food bank receives inkind donations from local
processing plants & houses the Gleaning program
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2. Access to healthy foodsFood Security
• Poverty status in Grant County, 1999– 13% of families– 17% of individuals
• Food assistance– Food Bank– Free & reduced breakfast & lunch
– WIC– Congregate & home-delivered meals
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2. Access to healthy foodsFood Security: Seniors
June July
Meals Seniors Meals Seniors
Congregate
1142 251 1088 237
Home-delivered
1194 58 1215 55
60+ population for county was 11,220
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2. Access to healthy foodsFood Security: Schools
Free Reduced Enrollment
% receiving
ES 1398 369 3072 57.5%
MS 618 186 1525 52.7%
HS 511 167 1798 37.7%
TOTAL 2527 722 6395 50.8%
1998-2001 Grant county 50.7%; WA State 31.2%
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0
0.25
0.5
0.75
1
1.25
1.5
Choc High fatsnacks
Soft drinks Low-fat milk F & V H2O
ES MS HS
2. Access to healthy foods2. Access to healthy foodsSchools: LunchlineSchools: Lunchline
*
ES no food vending, but Fruitopia; no a la carte
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2. Access to healthy foodsSchools: Lunchline
Rating
ES 4.4
MS 3.3
HS 3.5
How congruent are breakfast & lunch programs with Dietary Guidelines for Americans?
Scale: ‘1not well at all’ to ‘5 Scale: ‘1not well at all’ to ‘5 extremely well’extremely well’
50% of ES had 5’s!50% of ES had 5’s! Possible association with Possible association with
low SESlow SES 5 star salad bar5 star salad bar Nutrition educationNutrition education
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Fruits / veggies?
Quality Health promotion
Bike facilities
Frank’s Market
Grocery Outlet
2.5 (18)
Safeway 2.0 (25)
Super 1 1.6 (26)
2. Access to healthy foodsGrocery stores & markets
Quality scale: “1 = poor”; “2=good”; “3=excellent”
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Number ‘Healthy’ label?
Average # healthy options
Bike facilities
Fast food14 5 5.1 1
Sit-down13 2 11.3 0
Both5 0 7.4 0
2. Access to healthy foodsEating establishments
Healthful food and beverage options include low-fat, low-calorie, nutrient-dense foods
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2. Access to healthy foodsConvenience stores
Healthful food and beverage options include low-fat, low-calorie, nutrient-dense foods
11 stores assessed11 stores assessed 9.7 healthful food options9.7 healthful food options 1 store with bicycle facilities1 store with bicycle facilities
9 stores9 stores 2 stores2 stores 1 store1 store
‘‘1-25’ car parking1-25’ car parking‘‘101+’ car parking101+’ car parking‘‘26-50’ car parking26-50’ car parking
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2. Access to healthy foodsProgramming
• Diabetes class• WIC / MSS• Breastfeeding class• Food Assistance
• Congregate meals• Home delivered meals• Weight loss• Extension Family Nutrition
Education Program (EFNEP)
• Farmers Market
Hospital Community Health Moses Lake Clinic Food Bank / Community
Services of Moses Lake
Home and Community Services Offices
Senior Center Senior Center TOPS WSU Cooperative Extension
Civic Center
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3. Infrastructure & built environment
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05
10152025303540
% o
f are
a
Incorp Unincorp
3. Infrastructure & built environment3. Infrastructure & built environmentZoning, permitting, & land useZoning, permitting, & land use
Incorporated land = 6843 acres; Unincorporated land = 13,361 acres Land use / zoning maps available in the Comp Plan
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Manuf / Trailers
13%
Single66%
Multiple21%
3. Infrastructure & built environment3. Infrastructure & built environmentLand use: housing distributionLand use: housing distribution
Coding encouraging activity-Coding encouraging activity-friendly and mixed-use friendly and mixed-use communities are encourages communities are encourages in the City of Moses Lake: in the City of Moses Lake: Comprehensive PlanComprehensive Plan
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• Miles of street:
• Miles of street with sidewalk on at least 1 side:
• Proportion of streets with sidewalk on at least 1 side:
• Miles of bikepath, separated from roadway
• Miles of shared path (bikeped) available:
267 miles
97 miles
36.3%
1.9 miles
8-foot: 1.7 miles
10-foot: 23.5 miles
3. Infrastructure & built environment3. Infrastructure & built environmentPublic works supporting PAPublic works supporting PA
Sidewalks of all widths, except for those in the central business district, are available for bikeped transportation
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3. Infrastructure & built environmentWalkability• 27 walks taken• 16 sections• Individual scales ‘1 awful’ to ‘6 excellent’• Overall scale
Sidewalks
Crossings
Drivers Safety rules
Pleasant
Overall
Average Score
3.7 4.0 4.1 4.1 3.9 19.7
26-30 Celebrate!26-30 Celebrate!21-25 Celebrate a little . . .21-25 Celebrate a little . . .16-20 Okay, but needs work.16-20 Okay, but needs work.11-15 Needs a lot of work11-15 Needs a lot of work 5-10 Call out the NG . . . 5-10 Call out the NG . . .
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• Sidewalks• Street crossings• Traffic & driver
behavior• Safety• Appeal• Overall score• Scale
0
5
10
15
20
25
30
Basinhomes
Larsonbase
New firestation
Gilletepark
26-30 Celebrate!26-30 Celebrate!21-25 Celebrate a little . . .21-25 Celebrate a little . . .16-20 Okay, but needs work.16-20 Okay, but needs work.11-15 Needs a lot of work11-15 Needs a lot of work 5-10 Call out the NG . . . 5-10 Call out the NG . . .
3. Infrastructure & built environmentWalkability
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• Sidewalks• Street crossings• Traffic & driver
behavior• Safety• Appeal• Overall score• Scale
0
5
10
15
20
25
30
Pelicanpoint
Knollsvista
Montlakepark
Gardenheights
26-30 Celebrate!26-30 Celebrate!21-25 Celebrate a little . . .21-25 Celebrate a little . . .16-20 Okay, but needs work.16-20 Okay, but needs work.11-15 Needs a lot of work11-15 Needs a lot of work 5-10 Call out the NG . . . 5-10 Call out the NG . . .
3. Infrastructure & built environmentWalkability
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3. Infrastructure & built environmentBikeability• 23 rides taken• 14 sections• Individual scales ‘1 awful’ to ‘6 excellent’• Overall scale
Safety Surface Inter-
Sections
Drivers Ease Overall
Average Score
3.3 4.1 3.9 4.0 4.0 19.3
26-30 Celebrate!26-30 Celebrate!21-25 Pretty good . . 21-25 Pretty good . . 16-20 Okay, but not ideal.16-20 Okay, but not ideal.11-15 Poor – call the mayor!11-15 Poor – call the mayor! 5-10 Oh dear . . .5-10 Oh dear . . .
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• Safety• Surface• Intersections• Drivers• Ease• Overall score• Scale
0
5
10
15
20
25
30
Basinhomes
Larsonbase
Cascadevalley
GuffinEccles
26-30 Celebrate!26-30 Celebrate!21-25 Pretty good . . 21-25 Pretty good . . 16-20 Okay, but not ideal.16-20 Okay, but not ideal.11-15 Poor – call the mayor!11-15 Poor – call the mayor! 5-10 Oh dear . . .5-10 Oh dear . . .
3. Infrastructure & built environmentBikeability
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• Safety• Surface• Intersections• Drivers• Ease• Overall score• Scale
0
5
10
15
20
25
30
Pelicanpoint
Montlakepark
Gardenheights
Westlake
26-30 Celebrate!26-30 Celebrate!21-25 Pretty good . . 21-25 Pretty good . . 16-20 Okay, but not ideal.16-20 Okay, but not ideal.11-15 Poor – call the mayor!11-15 Poor – call the mayor! 5-10 Oh dear . . .5-10 Oh dear . . .
3. Infrastructure & built environmentBikeability
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3. Infrastructure & built environmentSchools & walk / bikeability
Schools # students % 1 mile
% walk /
bike
Bike
facilities
Basin homes
Longview 524 36% 15%
Larson base
North
Larson hts
CC
322
377
60%
85%
40%
65%
Guffin eccles
Discover
Midway
Frontier
252
86
661
23%
3%
10%
4%
8%
10%
Moses Lake end of the year enrollment: 6395 No schools in New fire station, Gillete park, or Cascade valley sections
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3. Infrastructure & built environmentSchools & walk / bikeability
Schools # students % 1 mile
% walk /
bike
Bike
facilities
Knolls vista Knolls vista
369 62% 45%
Garden hts Garden hts
HS
461
1672
48%
5%
20%
2%
Moses Lake end of the year enrollment: 6395 No schools in Pelican pt, Montlake park, or Westlake sections
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3. Infrastructure & built environmentParks & walk / bikeability
Parks Bike facilities
Parking
Basin homes
- - -
Larson base - - -
Fire station - - -
Gillete park Gillete
Cascade valley
Cascade ’76-100’
Guffin eccles
McCosh
Carl T. Ahlers
‘101+’
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3. Infrastructure & built environmentParks & walk / bikeability
Parks Bike facilities
Parking
Pelican pt - - -
Knolls vista Knolls vista ‘1-25’
Montlake park
Montlake ’26-50’
Garden hts - - -
Westlake ML Community
‘101+’
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3. Infrastructure & built environmentPedestrian / bike safety 2001
Pedestrian Bicycle
Collisions 6 5
Injury 1 None
2 Possible
2 Evident
1Disabling
1 None
2 Possible
2 Evident
Vehicle type 5 pickup or panel
4 pickup or panel
1 Lrg truck
Violation 5 Driver only
1 Ped only
3 Driver only
2 Ped onlyBlock watch program within city limits – 66 areas are involved. Community oriented policing in county.
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