February 2019 Coffee & Discussion Minutes

Topic: Nature and Health Champions
Location: Sand Ridge, South Holland, IL
SUMMARY:

• The term “nature champion” means different things to different people.
  • For implementing ParkRx in health care settings we need people to reach out and educate providers in both the health benefits of nature, about the resources available to them to share with their patients, and how to use the ParkRxAmerica.org (or other available) web-based platforms.
    •  If we want to take an active role in educating and engaging health care providers in prescribing nature, we may need to think in terms of “nature-health care liasons”.  “Nature champion” may be too broad a term.
  • For reaching the general population, we need to develop more culturally sensitive and appropriate ways to approach communities.  Learn to listen and ask people what they want, not just “take the message” to them.

Notes From the Meeting
Action Items

• We need a logo! 
  • If anyone is, or know someone who is, good at graphic design, we could use the help. Terry will send out examples of what we are looking for   
• Speakers Bureau!
  • Need a list of people who would offer to be speakers, groups they would be comfortable with, and people who have resources they would like to share from previous talks.
  • We made a Google Sheet, if you are interested in being one of our speakers please fill out your info
• Core Presentation!
  • A basic presentation that people could edit and take to different groups, could go hand in hand with the Speakers Bureau
  • If interested in putting this together, contact Terry
• Mapping Nature-Activities onto State Curriculum
  • Three people volunteered to do this, they and any other interested folks can work off of this Google Document in the NCH2 Google Drive.
• We need to examine our methods and see what we could be doing differently!
  • Are our current methods inclusive enough?  Need to see if/how we could be doing things differently to broaden our reach and achieve outcomes
  • If interested, contact Terry
• Where should we send doctors we connect with that are already doing nature prescriptions, or are interested in doing them?
  • Send them to us!  We can invite them to the coffee, add them to the listserv, tell them to contact Terry directly or at [email protected]
  • Cathy: maybe do a blog post interviewing a doctor that participates in the program could be a helpful connection to bring more doctors in
    • Lydia: Dr. Zarr has articles already that we would be welcome to use
    • Terry: Institute for the Golden Gate serves as a clearing house for a lot of this info, so we can look to them for resources.  Once we have a website, we can share this more.

Questions for discussion:

• How are we defining what a champion is? What role do they play, what are we asking from them?
• How do we find and recruit our health and nature champions in the medical community?
• In addition to Parks Rx, what other relationships are we seeking to broaden our scope?
• What role can Forest Therapy guides play in serving as health and nature champions and would they be willing to promote both Park Rx America programs as well as Forest Bathing initiatives?
• Once we find a champion what resources do we provide to them to facilitate health and nature programs and projects?                                
• Between 10:30am-12:30pm tour of Sand Ridge Nature Center and guided Forest Therapy walk available to participants.

Announcements

• One Earth Film Festival going on, all films focused on nature and sustainability, info on screenings and locations can be found online at oneearthfilmfest.org
• Next Coffee: March 22nd at Openlands (Wabash & Washington), tentative topic is on creating culturally relevant pockets of nature in urban settings

Discussion

• Context & Recap of Dr. Zarr's visit
• Dr. Robert Zarr from Park Rx America gave a talk a few weeks ago at The Farm on Ogden
  • Pediatrician from DC that started an organization trying to connect physicians with public green space and walking paths that they could recommend to their patients through written prescriptions (on paper or electronically through the app) for recreation
  • Currently trying to expand the platform nationally and work with land management organizations and ALL prescribers (not just physicians! Anyone who counsels and writes prescriptions), also trying to connect webpage with more programmatic components (organized group activities/events)
    • Need a nature champion

 

Topic: What is a nature champion and why do we need them?

• Terry: A Nature Champion is someone who has committed to trying to get more people outside, working within the framework of a particular institution to make these programs happen
  • Have to be the "squeaky wheel" inside an organization to get things going
• Sheila says it is someone who can help to educate our target audience, as not everyone knows how to access/what to do in nature
• Cathy suggests that the group should focus on professionals who can actually prescribe recreation
• Kelly says that someone who could facilitate these groups could also be key, the in between of prescriber and client
• Debbie points out the importance of finding someone who is committed to learning from the people we are attempting to connect to nature, if we always focusing on taking things to the group and educating them, we miss the value of what nature means to this community and what they are interested in
  • Sheila: This makes me think of patient centered care
  • Terry: The Park Rx model does implement patient centered care, asking the patient where they like to recreate, what's near them, pull up the location's pictures on the website, very conversation focused
• Laura: I think it depends on the outcomes we are looking for; we need to identify the best array of people to deliver those outcomes
• Terry: clarifies that nature champions are different than those who are already prescribing,

How do we recruit people who are in the healthcare profession to become prescribers?

• Sheila: Social workers and other trusted community leaders are really important.  In my opinion, the cortisol levels decreasing is fantastic, but the number one goal is quality of life
• Barb points out that healthcare professionals are more likely to be moved by science and evidence based studies
  • We need to have a couple of those really good evidence-based studies on hand, these are more persuasive to them than any anecdote or passionate champion
  • Steven adds that, from the practitioner's side, we must make this program easy for them to work with, ideally within the systems healthcare groups are already using so that they can digitally produce the prescription and send it to the patient
  • Jan agrees, saying that doctors are most concerned with a measurable outcome.  If doctors can incorporate Parks Rx into My Chart and track outcomes there, it would be more enticing
  • Kelly adds that software companies, like Epic, are another “cog in the machine” we need to be aware of
• Terry announces that Catherine Game of Brushwood Center submitted a letter of intent to BCBS focused on offering physician trainings at Brushwood or forest preserves
  • Perks: they get CME credit and forest therapy training, also become experts in the Park Rx program
• Fatima suggests that some kind of introductory program for the physicians to bring the special nature experience to them on a personal level would be impactful
• Debbie states that the nature champion needs to be more diverse to best carry the message to the widest audience
  • The understanding of how nature benefits health is great, but if we don't rethink the strategy the message may have a shelf-life.
• Cathy points out that going through healthcare professionals is not something that has been done before, at least not in Chicagoland
  • Debbie: It's not an “either or”, but a “both and”.  If I am sensitized to this position, I may ask my own physician about it and then they can direct me
• Amos: I am eager to know how we can create researcher and physician collaborations.  I would like to see strong research on specific interventions, we only have research on non-specific interventions.
• Terry suggests creating a document, flier, or infographic that lists the physiological documented health outcomes in addition to mental health outcomes, need to find more research on the physiological
  • Could be a useful document to equip our nature champion with
• Debbie suggested that ethnographic data and testimonials be included with the quantitative data.  If we wait on having enough data to convince them, we lose time. 
• To summarize, who do we need to recruit?
  • A variety of people both in terms of what they look like and who they will talk to so we can have culturally relevant conversations, but also we need to find people to go up the chain of medical groups and hospitals.  Perhaps we need to identify a few community healthcare organizations.  Need health professional liaisons, and community liaisons.
  • Kathleen: Also educators, going into schools to create advocates and champions out of teachers and students
• ACTION ITEM: need volunteers to take on the challenge of mapping potential outdoor activities onto the state curriculum  
  • Terry suggests talking to Sue Gaspar at extension service, start figuring out how to do this
• Sally: Would it be helpful for the group to have a leave-behind?  Something to drop off at various locations, doctors’ offices, etc.?
  • Terry: In terms of speaking to physicians, if they have something like that that they can just thumbtack to their wall as a reminder of something to mention to patients
  • Children and Nature Network just did something like this

 
Topic: How do we find and recruit people:

• Kathleen suggests that a full staff training could be an entry point. People who are giving care, who are stressed, learn the benefits for themselves and take it on as self-care, they are more likely to pass it on.
• Fatima: That sounds a lot like what we do with our corporate workdays, when a whole company comes out and we share our information and educate them
  • Terry asks if they would be willing to share practices so we can expand the model to medical groups, Fatima agrees
• Debbie: We need to move beyond what to do and get to how to do it.  When folks come to me with something overwhelming, I shut down.  How we engage those people right with us is more important, it's more important to share than convince.
• Terry: The Oakland study is good evidence of what you are saying, better health outcomes for those who were just prescribed to go outside than those given a specific day, some more flexibility is good. 
• ACTION ITEM: Is there a group willing to look at materials and talk about approaches to see what we could be doing differently and how?

Topic: In addition to Park Rx, what other relationships are we seeking to broaden our scope, what roles can Forest Therapy Guides Play?

• Amos: Dr. Zarr is training with ANFT to become a certified forest therapy guide, and we are seeing more and more physicians taking that training.  The word is getting around, it's a very interesting development.  Also in discussion with the Forest Service to work with their employees and bring more forest therapy techniques into naturalist training.  Group is also trying to develop more culturally competent teams, had our first training entirely in Spanish in the Pyrenees. Extends invitation to group to suggest new avenues to build out into
• Debbie: One of the things that I'm convinced of is if we don't remember history, the context of America, if we totally negate the fact that the land has been both a positive and negative experience depending on who you're talking to, we will not reach people.  How do I remember that, without guilt, in recognition of who I'm talking to?  Looking at getting the word out and how we recruit, that has to be integral.  If we put justice at the forefront, we can get where we want to go a little faster.  If we are going to progress, it cannot be an afterthought.  Later on, in terms of policies, we have to begin to look at the audience of who can get policies in place with data, not just funds but mindsets.  Get people who can have impact w/ policy making so it is progressive, sustainable, and holistic in nature-- this is part of the recruiting as well.
• Cathy: One way of connecting forest therapy guides to the county is to invite guides to come do walks with the county
• Christie says there is a list of all the certified forest therapy guides in the area they can share.

Topic: Once we find a champion, what resources do we provide them to facilitate nature projects and program

• Group consensus that a core slide presentation, printed materials to share at locations, a brochure of programs and other ways to get outside, including staffed sites that don't necessarily have a program going on could all be useful
• Group agreed that a brochure seems to be a big need
• David Victorson has volunteered to put together a website for us, resources would be easily accessible there