Community collaborations

Stanford programs help residents improve health options

Norma Taylor of East Palo Alto is working to make fresh produce from the local farmers' market available to more residents.

It's just a third of a mile from the East Palo Alto farmers' market to Runnymede Garden Apartments-the city's only housing facility for seniors and adults with disabilities-but to the building's residents, it might as well be a trek up Mount Everest.

Conditions can be challenging for those using wheelchairs or walkers, with a trip to the market requiring residents to travel down a busy street and to navigate around sidewalks blocked by parked cars, poorly lit streets and a crosswalk light too brief for them to cross the four-lane intersection.

These physical barriers to fresh-food sources are often overlooked by city planners, said Matthew Buman, PhD, a postdoctoral scholar, and Sandra Jane Winter, PhD, a research associate at the Stanford Prevention Research Center, who reviewed an audit of 40 senior living centers in Northern California.

Their work inspired the team to find a better way to alert city officials about these obstacles. One answer to the problem is the Stanford Healthy Neighborhood Tool, a software application that allows community advocates wielding smart phones and tablet computers to document impediments to walkability, safety and access to healthful food.

Residents as advocates

It is one of several healthy-aging studies being spearheaded by Abby King, PhD, professor of health research and policy and of medicine. She is bringing together experts in community health, psychology, design and engineering to explore how mobile devices and communication technologies can be used to get seniors off the couch and into their community to exercise, shop, garden and socialize.

The new Stanford app allows community health advocates to walk around a neighborhood, take a picture of a hazard using a mobile device's built-in camera, and make a voice recording explaining the hazard. Once a picture is taken, the app records the hazard's precise location using the built-in GPS. All the hazard photos and locations can be downloaded instantly to a map on a website so that they can be shared with researchers, city planners or policy makers.

"It's all about empowering seniors to improve their own neighborhoods and to educate city officials about what's important to them," said Buman. "Having concerned residents talking about these problems adds urgency to the changes that need to be made."

The first phase of the project focused on using the tool to encourage more healthful eating and exercise among seniors living in communal housing facilities in San Mateo County, including Runnymede Garden Apartments. San Mateo County Health System representatives, who have been important collaborators in this and other Stanford healthy-aging projects, helped select the site and community partners.

Challenges and solutions

Buman and his colleagues began by assembling volunteers at each facility to join a Neighborhood Eating and Activity Advocacy Team (called NEAAT for short). Initially the Stanford group acted as facilitators at the meetings and had participants document neighborhood hazards and assess access to fresh produce. This auditing process gave residents the chance to see their neighborhoods in a new light, enabling them to identify challenges and possible solutions.

In East Palo Alto, residents discovered three major challenges to eating healthier foods-accessibility, cost and education. After a few brainstorming sessions and a little research on how their local government works, the residents came up with a plan.

Norma Taylor, a retired licensed vocational nurse and one of the NEAAT team's most ardent fresh-food crusaders, focused on accessibility. "I worked through the city to find an unused shuttle bus to take residents to the Saturday farmers' market, and now I'm looking for a driver," she said. She also began spreading the word to Runnymede residents about coupons for free produce at the farmers' market, made available with the help of Collective Roots, a local nonprofit.

Dominique Cohen, the Midpen Housing service manager for Runnymede Gardens, and building resident Bobby Hamilton worked on lowering the cost of fresh vegetables by revitalizing the fallow garden behind the facility. They assigned raised beds to residents who wanted a plot, and then enlisted Collective Roots to educate them on organic gardening techniques.

Another educational component involved teaching residents how to cook with fresh produce. They called in Cooking Matters, a nonprofit that educates families in how to prepare nutritious and affordable meals. Cooking Matters now runs regular classes for Runnymede residents.

Joining forces

The project was also designed to work with East Palo Alto officials to fix the environmental hazards affecting senior and disabled residents. Through the neighborhood audits, the NEAAT team identified the need for a new crosswalk near the local market, longer crosswalk lights and speed bumps to discourage drivers from speeding. While implementing these changes in a cash-strapped city takes time, the collaboration resulted in a senior citizens' advisory panel that is working with the transportation and public works commissions to advocate for these types of improvements.

East Palo Alto's city planner, Brent Butler, is an enthusiastic supporter of the project. "The farmers' market and the NEAAT program at Stanford are examples of collaborations that are really essential, especially given the recession and challenges that a city such as ours is currently facing," he said.

To see a YouTube video about this program, go to tinyurl.com/3po49vb.