Past Accomplishments

2015 — 2018: Healthy Tarrant County Collaboration’s strategic plan centered community partner engagement:

Healthy Retail Policies and Strategies:  Powered by our Plan4Health grant we tested the ability of new retail models to increase sales of fresh fruits and vegetables in the East and Southeast Fort Worth food deserts.

  • Healthy Corner Stores. We worked with two convenience stores to expand their product lines to include fresh produce, healthier dairy, and shelf stable foods.   As we searched for the ideal candidates for the project we realized that there were some other bright spots in the region — small stores selling an array of grocery staples.  Of the approaches we tested, we believed that the healthy corner store was the most viable model for replication.   Tarrant County has many convenience stores operating in underserved neighborhoods, and in many cases these stores have operated successfully for decades.  Many of the store owners are proud to have developed a successful business in an area where few businesses have succeeded.  While most are not interested in expanding their products to include fresh produce and healthy dairy, meats, and grains, a few are.
  • Mobile Produce Sales. In 2016 Fort Worth adopted an ordinance amendment which allows mobile sales of fresh produce.  Prior to this it was legal to sell ice cream and frozen treats from trucks, but selling apples, bananas and lettuce was illegal!  We began our efforts reaching out to existing vendors selling ice cream and frozen treats from push carts and trucks.  Unfortunately, none of them were willing to expand their business model to selling fresh produce.  We also sought sponsors willing to underwrite the operating costs for produce carts and trucks, but were not able to find anyone willing to do this on a continuing basis.  We are continuing to look for sustainable models for selling fresh produce from mobile carts and trucks.
  • Urban Agriculture.  We are met and began working with four grassroots groups wanting to start urban farms.  The sizes of the future farms range from roughly ½ acre to several acres.  The City of Fort Worth passed an urban agriculture ordinance in 2016 which makes it legal for urban farms to exist on land zoned for other uses, such as residential or commercial, with a special permit.  We believe that as these farms develop, others will also emerge with an interest in growing and selling fresh produce in the neighborhoods.

Policy-Systems-Environmental (PSE) Strategies:   Through this period we provided an array of educational information and workshops to our members and other coalition partners on how to incorporate policy, systems, and environmental strategies into their work.  In 2018 students and faculty from the University of Texas at Arlington’s College of Nursing and Health Innovations worked with us to draft a white paper on PSE strategies and to produce a well attended PSE mini-conference.   White Paper on PSE – Final 11.12.18

Primary Data:  We studied the processes used by hospitals and community based organizations to assess local health needs, and identified some strategies that could be employed to strengthen the voice of the community through qualitative data.


2013 – 2015: Healthy Tarrant County Collaboration focused its efforts on the following:

Core Skills for Population Health Work: We studied the core competency documents for several health professions, including Health Education Specialist, Public Health Social Work, Public Health Nurse, Public Health Professionals, Social Work Practice, Masters of Public Health, and Doctor of Public Health, seeking to find the common themes reflected in each profession.

After finding the common themes, we continued working to identify the behaviors and skills that were characterized by each of the competencies, but soon realized that if the information was to be understood by non-health professionals (from elected officials to business leaders, to grassroots groups), it was important to further distill and simplify the language. The final result, in 2014, was a single-page document that describes 8 skills in simple language that is at the 7th grade reading level. The final core skills descriptions were tested in a presentation to a group of health coalition representatives in May 2014 and a focus group with Community Health Worker students in June 2014. Opportunities for training on these skills is being offered to HTCC and other health-focused coalitions regularly through 2015.

This initiative inspired the Community Health Outreach department at Cook Children’s Health Care System to conduct a similar examination of the core skills needed for each of its employee positions, and to develop a matrix of training opportunities to support skills development.

Coalitions Awareness: Beginning in 2012 the work group conducted a community-wide scan to identify health-focused coalitions active in Tarrant County, and found approximately 38 different groups. The group used the coalition classification process developed by Dr. Francis Dunn Butterfoss to classify the groups identified, and sought to gather some consistent information sets on each. Linda Fulmer has continued to update the data as new information becomes available.

In 2014 the work group held a Coalitions Breakfast, inviting leadership from each of the identified coalitions to a presentation that provided information on the numbers and types of coalitions active in Tarrant County, and an opportunity to get to know one another. The presentation also included an introduction to the Population Health Core Skills that the Population Health Work Group developed. The Coalitions Breakfast has become an annual event, and is augmented with an electronic newsletter sent to coalitions regularly.

Diabetes Prevention: HTCC’s Diabetes Prevention Work Group expanded to include a number of additional community partners offering various diabetes prevention and management programs. The group used the Spectrum of Prevention framework to identify a wide array of existing initiatives aimed at the six levels of the Spectrum of Prevention, and identified that HTCC’s most important role lies in convening the coalition / network around diabetes prevention.

The work group also created a cross-walk between the goals and action steps outlined in the North Texas Diabetes Strategic Plan, and using the resources identified in the Spectrum of Prevention exercise, identified existing community partners whose work is aligned with the North Texas Diabetes Strategic Plan.

During 2014 HTCC facilitated the North Texas Community Health Collaborative’s outreach to community leaders in the 76112/76119 zip codes, engaging local elected officials to invite and facilitate two sessions to gather the community’s perspective on what the community can do to reduce chronic disease disparities in their neighborhoods. The community’s ideas are grouped into five priorities: Communications, Food Access, Physical Activity, Community Engagement, and Activism.

The ALIVE! project, funded by a grant from the Cancer Prevention & Research Institute of Texas, was completed in February 2014. The project sought to implement a research-tested intervention that was originally tested in workplace implementation in local African American congregations. The project outcomes found that participants who fully implemented the program were successful in changing their health habits.

Lactation Support Initiatives:

Provider Education: HTCC continued to encourage physician champions to reach out to their peers to increase support for Breastfeeding Friendly Physician Offices. Dr. Erin Hamilton-Spence has been the primary champion, and she has made many presentations and grand rounds. In 2013 HTCC partnered with the Texas Breastfeeding Coalition to provide a 3-hour CME program for North Texas physicians on breastfeeding. In 2014, HTCC arranged for Dr. Hamilton-Spence to provide a Grand Rounds at UNTHSC’s Office of Professional and Continuing Education for CME that was taped and is now available for providers to view free of charge.

Workplace Lactation Support Programs: During 2012 and 2013, Tarrant County Public Health and JPS Health Network served as pilot sites for developing a more robust Mother-Friendly Worksite toolkit. Lessons from the new toolkit were shared with HTCC members and all were encouraged to support a robust implementation of worksite programs. While not every institution chose to seek a robust worksite program, all currently meet the minimum standards required by law.

Some that went above the minimum standards were JPS Health Network, which implemented their worksite program across the full system. Cook Children’s Health Care System, which also became Mother-Friendly certified as a system, becoming the first pediatric health system in the US to become certified as a system.


2010 – 2013: Healthy Tarrant County Collaboration expanded its work during this period to implement several new initiatives, including:

1. Community Partnerships: Healthy Tarrant County Collaboration worked with community partners to implement several programs:

  • Faith Community: Visit! Healthy Tarrant County Collaboration partnered with the American Diabetes Association (ADA) in 2010 to bring their Project POWER and Por tu Familia programs to Tarrant County Congregations. With the closing of the ADA’s office in Tarrant County, the organization lost some of its reach in Tarrant County. The partnership also extended to helping to support the annual Pastor’s Breakfast that the ADA uses to promote all of its Live Empowered programs to the community.
  • Neighborhood Associations: In 2011 as part of the North Texas Health Equity Project, HTCC presented a workshop, Supersize Your Neighborhood’s Health to neighborhood leaders as a grassroots counterpart to the year-long Tarrant County Obesity Prevention Policy Council project aimed at engaging local decision makers in understanding the role policy plays on health outcomes. The project fulfilled the goal of engaging neighborhood leaders, and some of those continued to work on these issues through the Tarrant County Voices for Health initiative.
  • Tarrant County Voices for Health: During 2012 and 2013, Healthy Tarrant County Collaboration participated actively in the Mobilizing for Action through Planning and Partnership (MAPP) Steering Committee. In 2013 Healthy Tarrant County Collaboration took the lead on conducting the Forces of Change Assessment for this initiative. The Forces of Change Assessment is one of four assessments conducted during the MAPP process, and the results of the four assessments are used to develop a Community Health Improvement Plan.

2. Organizational Policies and Professional Practice: Lactation Support. From 2010 through 2013 Healthy Tarrant County Collaboration worked with its own member organizations and systems to advocate for implementation of effective lactation support programs. During this period Tarrant County Public Health and JPS Health Network received grants to implement pilot programs that informed the Texas Department of State Health Services’ development of an expanded Mother Friendly Worksite Employer Toolkit. Cook Children’s Health Care System became the first children’s hospital system to receive designation as a system. In addition, the University of Texas at Arlington opened five designated Mothers Rooms across its campus.

3. Research: In September 2011, Healthy Tarrant County Collaboration received an award from the Cancer Prevention Research Institute of Texas to bring a research-tested program to Tarrant County. A Lifestyle Intervention Via Email (ALIVE!) provides personalized coaching delivered through email to help participants improve physical activity and nutrition habits. Initially tested in workplace implementation, HTCC’s project reached out to African American adults through churches and community college campuses. The project concluded in February 2014, and the final evaluation is in process.