The "Story Behind the Curve" helps us understand why the data on people dying from poisonings is the way that it is in our community. When we understand the root causes of our community problems, we have a better chance of finding the right solutions, together.

What's Helping? These are the positive forces are work in our community and beyond that influence this issue in our community.

• Project Lazarus coalition in place
• Free naloxone available through program with Mountain Projects, Inc. and Smoky Mountain LME/MCO
• Policies in place at Harris Regional Hospital to prevent over-prescribing
• Relationship with law enforcement and other agencies to hold Operation Medicine Drop annually
• Proven ROI on substance abuse prevention programs

Project Lazarus Public Health Model

What's Hurting? These are the negative forces are work in our community and beyond that influence this issue in our community.

• Topic still viewed as taboo
• Residents don't know who to turn to if they or loved ones are battling addiction
• Don't believe they are at risk or don't understand risk of overdose
• "Not in my backyard" mentality

Partners in our Community Health Improvement Process:

• Jackson County Department of Public Health
• Area Agency on Aging
• Good Samaritan Clinic
• Harris Regional Hospital
• Jackson County Department on Aging
• Jackson County Parks and Recreation Department
• Jackson County Public Schools
• Jackson County Department of Social Services
• Mountain Projects, Inc.
• Vaya Health
• Western Carolina University
• WNC Healthy Impact

Partners With a Role in Helping Our Community Do Better on This Issue:

• Behavioral and mental health providers (Ex. Meridian Behavioral Health Services)
• Clean Slate Coalition
• Community members with a vested interest
• Department on Aging
• Eastern Band of Cherokee Indians
• Faith-based community
• Local government (town & county commissioners)
• Law enforcement
• Medical professionals
• MountainWise
• Parents
• Tobacco Prevention Control Branch
• Those in recovery
• Western Carolina University

The following actions have been identified by the School Health Advisory Council and community members as ideas for what can work for our community to make a difference on unintentional poisonings.

Actions and Approaches Identified by Our Partners

These are actions and approaches that our partners think can make a difference on unintentional poisonings.

• Education in schools, communities, and churches
• Community involvement and buy-in
• Trauma-informed community
• Integrated care
• Media campaigns
• Access for those in the Medicaid gap
• Jail ministry

What is Currently Working in Our Community

These are actions and approaches that are currently in place in our community to make a difference on people dying from poisonings.

• Safe Kids Jackson County
• WNC Teen Institute
• Operation Medicine Drop events
• Permanent dropbox at Jackson County Sheriff's Office in Sylva and Cashiers
• Permanent dropbox at Walgreens in Sylva
• Naloxone distribution through Mountain Projects, Inc.
• Media campaigns
• Senior Seminar

Evidence-Based Strategies

These are actions and approaches that have been shown to make a difference on unintentional poisonings.

What Community Members Most Affected by unintentional poisonings Say 

These are the actions and approaches recommended by members of our community who are most affected by unintentional poisonings

• Better, more affordable, more accessible treatment is needed
• Community needs to become trauma informed
• Social determinants of health need to be addressed and improved

Process for Selecting Priority Strategies

During our group process, the following criteria were used to select priority health issues for our community to focus on in the next three years:

• Criteria 1 – How important or relevant is this issue?
  • Size & severity of the problem
  • Urgency to solve the problem
  • Focus on equity
  • Linked to other important issues
• Criteria 2 – What will we get out of addressing this issue or how impactful is it?
  • Availability of solutions/proven strategies
  • Builds on or enhances current work
  • Significant consequences of not addressing issue now
• Criteria 3 – Can we adequately address this issue?
  • Availability of resources (staff, community partners, time, money, equipment) to address the issue
  • Political capacity/will
  • Community/social acceptability
  • Appropriate socio-culturally
  • Ethical
  • Can identify short-term, easy wins

Participants used a modified Hanlon method to rate the priorities using the criteria listed above. Then dot-voting and techniques were used to narrow to the top 2 priority health issues.