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Scott Webb: Blue Zones Project is a community wellbeing improvement initiative, designed to change the way people experience the world around them. Because healthier environments naturally nudge people towards healthier choices, Blue Zones Project focuses on influencing the life radius. That's the area close to home in which people spend 90% of their lives.

And joining me today to tell us about the Blue Zones Initiative in Salinas and Monterey County is Tiffany DiTullio. She's the Executive Director of the Blue Zones Project. This is Ask The Experts, a podcast from Salinas Valley Memorial Healthcare System. I'm Scott Webb.

So Tiffany, thanks so much for joining me today. We got a lot to talk about. We're going to talk about the Blue Zones Project. So I want to hear all about this. I want you to tell us about it. What is it and what is its purpose?

Tiffany DiTullio: Blue Zones Project focuses on influencing the life radius, which is essentially the 10 miles around which a person lives, works and plays.. So think about where you work or where you live and then pause and say, "Where do I grocery shop? Where do I eat out? Where do I recreate?" So really working to develop the environment around a person's life radius to push them towards the healthy choice.

So for example, with policy, we work with the county and city leaders to focus on policy improvements or alignments that are related to tobacco cessation, increasing food access and built environment. So smoke-free parks or walkability and bikeability to address the diverse modes of transportation that create access and connections to healthy choices would be a few examples.

So the purpose is simple, really. It's working collaboratively to make small incremental changes, to make the healthy choice the easy choice by creating an environment that is a sustainable environment of wellbeing, where it's almost impossible not to make the healthy choice.

Scott Webb: This is so cool and so ambitious. And I'm interested, you know, to know how and when did you all have the idea for this project? How and when did it come to Monterey County?

Tiffany DiTullio: Well, Salinas Valley Memorial Healthcare System has really been a champion for bringing Blue Zones Project to Monterey County. Salinas Valley Memorial invited Blue Zones Project to Salinas in October of 2018 and did a site assessment to identify, specifically in Salinas, what are the strengths opportunities and challenges within that community as well as determining the desire for the community to make this type of change.

It's a big undertaking. That site assessment resulted in an incredible partnership between Salinas Valley Memorial Healthcare System, Taylor Farms, and Montage Health to bring Blue Zones Project to Salinas and ultimately throughout Monterey County.

Scott Webb: Yeah, I know that a SVMH and the entire system really is so community focused and really cares about the community, all the stuff that they do and go out, you know, to speak directly to the ag workers is really amazing work. And this sounds a little like maybe a superhero group or something, but what is the Power Nine?

Tiffany DiTullio: Ah, the Power Nine. Simply stated, the Power Nine really represents the nine elements that were found consistently throughout the five original blue zones. And when we talk about the Power Nine, we break it down into four smaller categories.

So one category is move naturally. So looking around your personal environment to identify ways to have natural movement, whether that is bringing a pair of tennis shoes to work and putting them under your desk to encourage you to take walking breaks, parking further away, walking your dog, creating walking meetings, gardening, anything that would encourage you to move a little bit more naturally.

The next category is what we refer to as the right outlook, so knowing your purpose, what gets you out of bed in the morning and really making time to downshift, slow down or, like I usually say, have a little me time.

And then eating wisely is a really important category. A lot of people tend to overeat. So under the eating wisely, we talk about the eat until you're 80% full rule. In Okinawa, they pause before each meal to say, "Hara hachi bu," which essentially is a reminder to themselves to not eat for the pleasure of eating, but eat until they're full. We also encourage a plant-slant, which is not a diet. It's not vegetarian, don't eat meat. It's simply stated, "Look for opportunities to incorporate more fresh fruits and vegetables and whole grains into your daily foods." And then my personal favorite is wine at five, which you know, we joke about wine at five. It's not necessarily about the wine. It's about the pausing to make the connection that's important.

And then the last category is belong. So really looking around to create a healthy social network, connect or reconnect with religion or that group that really grounds you and then always prioritizing family and essentially putting family first.

Scott Webb: Yeah. And that's something that is so important to all of us. And it seems especially so during the pandemic, making sure that we check in with family and putting them first. And when we had to Zoom, we zoomed, you know, just some way to maintain those connections with family and friends. And I know you started out in Salinas and so how did the community react to it?

Tiffany DiTullio: Well, so far, the community's reacted very positively. We're excited about the early adopters and the early successes. I think with any new project or any new program, you really have to listen a little bit more than you speak. So in order for us to support the great work already being done in the community, we have to understand it first, get an idea of who's doing what and how they're doing it. And then looking for alignment and collaborative opportunities that allow us to really have the opportunity to elevate the good work that they're doing.

At the start of each community project is a period that's referred to as discovery. And then the discovery process, we hold focus groups, a lot of one-to-one meetings, policy meetings with local municipalities, working with schools and work sites, all with the goal of really understanding what infrastructure already exists, what potential partnerships are there, and then how can we come together to really kind of push that boulder in the same direction. You know, oftentimes organizations have a similar goal or objective, and maybe that objective is creating a healthier community. So how do we align our resources and our strategies to make sure that we're actually able to move that needle?

Scott Webb: Yeah, that's so great. Just making sure that everybody's pushing or pulling, whatever the metaphor is, doing it in the right direction, the same direction, and it does sound like there's a lot of benefits to the community. But maybe have you brag just a little bit, what have you accomplished so far in the community and what are some of your future goals?

Tiffany DiTullio: Well, the project officially launched into the implementation stage at the end of June of 2019. So in the first eight months, and I cap it at eight months, because as we all know, we ended up with a life-changing circumstance in March of last year. But in that first eight months, we were able to make some incredible inroads.

We had 10 large employers achieve Blue Zones work site approval, which means they are committing to creating a healthier environment for their employees. Whether that be through integrating work site wellness or creating walking paths or in the hospital's case, really creating healthy options to eat in the cafeteria. Again, pushing people to make the healthy choice the easy choice.

We were able to engage over 5,500 people in some element of our project, whether it was a walking moai and moai is a term that we use for bringing people together for a common interest. We launched plant-slant potluck moais. We provided purpose workshops in the community. The schools are really our champions and they're embracing the project. So we've been excited to reinvigorate and kind of kickstart some of those school gardens with schools that may have had a latent garden on campus that they weren't really using and showing them how to align those gardens with the current curriculum that they're using with math and sciences for a real hands-on opportunity when the students returned to school.

And one of our greatest wins that I was proud of early on is really coming together to support the Monterey County Health Department in their goal of having all Monterey County parks smoke-free. This was a huge endeavor. A lot of people had been working on it for a very long time. So to be able to come in and support them with that was remarkable.

We also did some really fun work with the Salinas Regional Sports Authority. They were redoing their soccer fields and essentially quadrupling the size of open space accessibility for soccer fields. And they had placed a walking path around the perimeter of the soccer fields. And I actually used to coach at those soccer fields, so I loved the idea of giving people who are observing a sport the opportunity to find natural movement by instead of sitting and watching, perhaps they just walk around the soccer fields. So we worked with them to install fitness equipment along the walking path and shaded benches for those people who may not be able to walk the whole path, but want to enjoy being outside in a safe comfortable place.

And we're currently working with a lot of local organizations to support community gardens. And to see that work come to fruition, whether it be in housing communities or community parks, for me is a really special thing because it's something that addresses a need in our community. And it really supports all the different pillars and beliefs of Blue Zones Project, whether that be move naturally by gardening or access to fresh fruits and vegetables or even connect, connecting with your community.

Scott Webb: Wow. It sounds like you've got so much buy-in from all the perspective partners, whether it's employers, schools, local government, everybody seems to have bought in, which is really amazing. And when we talk about that and we talk about the community and doing the outreach, where there could be a bit of a language barrier, how are you handling that?

Tiffany DiTullio: That's a great question. When we talk about Blue Zones Project, it was evident early on that we really needed to make sure that in Monterey County and specifically in Salinas, that our community members saw themselves in this project and that they were reflected in this project. So we spent a lot of time pausing and looking at our materials and making sure that our outreach and our materials were culturally appropriate and appealing to everybody, that anything that we put out was available in English and Spanish. We addressed reading levels and really have a strong commitment to making sure that the voice is relevant to our community. Because as I said, this is a project where community engagement is the most critical part. So making sure that people feel a part of the project was important.

Scott Webb: And I'm sure one of the biggest struggles through this pandemic is just trying to persevere, right? And stay focused and keep your eye on the prize if you will. And I know that you've been able to make strides. So how have you been able to do that and how have you pivoted as an organization during the pandemic?

Tiffany DiTullio: The great thing about Blue Zones Project is we're not the first one. So Salinas is actually the 47th Blue Zone Project community, which means we have access to other successful communities, all of which are at different stages of project implementation. And so for us, that means we have the benefit of seeing what works in other locations, especially comparable communities. And then we can learn from those best practices.

We've been able to come together as diverse communities throughout the United States, with the support of the central team to really assess how can we continue to be relevant during a time when everyone in one way or another is being impacted. We had to be able to provide value with thoughtfulness and understanding that other things may have a higher priority for some of those organizations that we had previously engaged.

So we had to pivot and really ask ourselves, "How can we support the community? What can we do differently to help our community feel supported by Blue Zones Project?" And for us, that really meant looking to our sponsors to see how we could potentially support some of the efforts that they were making in the community. Salinas Valley Memorial, for example, and their approach to educating farm workers with respect to COVID and increasing food access and access to prescriptions for seniors, looking to align with the organizations who needed volunteers and connect them with our Blue Zones Project volunteers.

We were able to support a project that Salinas Valley Memorial did with CHISPA impacting over 400 residents by doing outbound calls with volunteers to check in on all of their residents and ask a few meaningful questions to assess did they have enough food to eat? Did they have access to food? Did they have access or any issues getting their prescription medication filled? And then also identifying if potentially they were isolated and did they have that right tribe? Did they have that group of people they could reach out to? And if not, how could we connect them with a resource to really ward off isolation during a pretty scary time?

So it was interesting for us to look that way. And then as an organization, Blue Zones Project really had to switch to be relevant. Everybody moved to a digital environment. So pre-COVID, we were holding in-person workshops and in-person cooking demos and in-person walking groups and in-person potluck groups, and now we had to move everything virtually.

So we moved our purpose workshops, which are technically a very hands-on interactive program and just did a phenomenal job moving that to a remote platform. Our potluck moais look a little bit different. You know, we're not all in the same room, sharing the same food, but we're sharing the recipes, we're sharing the pictures and we're still connecting to come together to share that time.

We worked with Blue Zones Project on distributing something called Healthier At Home, which were tips for remote workers, tips for students on how to make the most of your remote environment. We launched a fantastic well-being page in collaboration and with support from Salinas Valley Memorial and Montage Health, giving resources in English and Spanish related to mindful meditation, cooking classes, diabetes education, you name it.

And then with schools, I think that was something that surprised us the most. When the schools went remote, no one anticipated it would be this long. So we were able to provide digital content for them to integrate and align with their current curriculum, so that students still felt engaged when everybody was really pivoting to try to say, "How can we continue important education?"

So we were able to provide them with resources about reducing sugar-sweetened beverage consumption, diabetes awareness, diabetes education, just some really great facts that students could not only learn from, but also share with their families. So I would say we haven't slowed down a bit. In fact, in some ways, I feel like the project has accelerated in areas that maybe we hadn't thought of before.

Most recently, we did a really great project with our Blue Zones Project-approved restaurants and, you know, they've been hit hard. The hospitality and restaurant industry has been hit significantly hard with closures and restrictions and outdoor dining and take out only. So we just launched a significant social media campaign to drive awareness and connection, promoting takeout, highlighting restaurants and menus in order to really help support those local businesses. And the feedback that we've gotten has just been incredible.

Scott Webb: Incredible is a great word to use there. My head is spinning. It's just you guys are doing so much meaningful work and, as you say, you haven't slowed down. If anything, you've accelerated and, now, you're expanding, right? So tell us about the expansion.

Tiffany DiTullio: Oh, the expansion's an exciting time. So back in 2018, when Salinas originally launched as a community, it was always the intent of our sponsors, Salinas Valley, Memorial Taylor Farms and Montage, from the start, to take this throughout the county, which I think is an incredible commitment, especially when you reflect on our current circumstances to still move forward with that original intent of really committing and supporting the community as a whole. It's inspiring,

In February of 2020, literally a week before the pandemic hit, we held a site assessment similar to what we had done in Salinas. But this time, it was a four-day assessment with time spent on both the peninsula and in the county with a focus on South County, really to hold the site assessment and evaluate the readiness for expansion. And then, we hit pause because we all had to turn our attention to something else.

So in October of 2020, the sponsors realized that a healthier community was even more important now than ever and we launched the process. So we started with hiring additional team members to help cover the county level work and the peninsula city's work. And we're currently in the discovery phase of the expansion, which means we are hosting a lot of meetings. We've been meeting with most municipalities throughout Monterey County. We're holding focus groups related to policy work, tobacco-built environment, food access. We're holding focus groups with work sites and school sites, faith-based organizations, nonprofit organizations, and really learning a ton about the programs that exists throughout our community and how to align potential programs, again, to really elevate that work in a consistent way throughout the county. It's a really exciting time. And I'm just impressed every day at the number of work sites and school sites and city leaders who are so passionate about creating a healthier community. And I love learning from them.

Scott Webb: Yeah, I'm with you. I'm loving learning from you and you love learning from them. And with all this expansion and all this great work, I'm sure you could probably use some more bodies, some more people. So people want to get involved, how do they do that? How do they get started?

Tiffany DiTullio: I thought you'd never asked. They can visit our website, which is BlueZonesProjectMontereyCounty.com. That's our website that represents all of Monterey County. All communities on the Salinas peninsula cities and the county-wide application are all going to be on that same website.

People can sign up for our newsletter and just really start to see a little bit about who we are and what we do and where those impacts are made. People can take the pledge to commit to making their own small, incremental changes to support the project. They can sign up to volunteer. They can register their school or their work site as a potential opportunity for us to engage and really start that process.

I would highly recommend following us on social media. Our Instagram is bzpmontereyco. You'll get really hungry, especially during our restaurant campaign. Or you could visit the Facebook page, which is Blue Zones Project Monterey County. And we have a really active presence on social media right now because we're really trying to educate the community to see who we are, what we do, so that they can see themselves in the project.

Scott Webb: Yeah, I think that's key when we talked about buy-in earlier. You know, people really seeing themselves on how they can kind of fit into all of this. And I think I could talk to you all afternoon, but I know you've got other things to do, so let's just wrap things up here. Anything else you want to tell people, share with the community? What are the takeaways? What's the essential things we need to know about the Blue Zones Project?

Tiffany DiTullio: Well, I say it every day with our team and with the folks that we meet with. Blue Zones Project is a we project, meaning it's going to take all of us to create the healthy community we want to see. We have a strong local team that's passionate about Monterey County, passionate about food, access, passionate about creating this incredible environment where we all live, work and play. So our job is to work really hard to create the change that we want to see, but we need everyone in the community to participate, so that we make sure that the community we have is representative of the community that everybody wants. So I would say join us.

One other thing I wanted to share with you, Scott, is one of our main areas of focus, both in the Salinas project and as we expand throughout the County is food access. And one of the things I'm most excited about is any opportunity we have for capacity building. And we started a pilot project at Salinas Valley Medical Clinic at PrimeCare with the support of a very passionate physician, Dr. Joanna Oppenheim and we've been able to integrate food and security questions into the patient screening process. And if a need is identified through that screening process that takes place at the intake of every patient, the health system is able to provide resources and referrals to help bridge that need.

And I just think that there's so many great organizations in Monterey County working to meet the food access need, that raising awareness and utilization of those programs is really critical. So when I think about expansion and being able to take a project like that throughout Monterey County, that's important work.

Scott Webb: This has been so great, Tiffany, having you on. I want to check back in with you, you know, sometime down the road three months, six months and come back and let's, you know, see where we're at with the things you identified today as future goals and expansion and all this great work. I want to hear more about it. So thank you so much for your time today and you stay well.

Tiffany DiTullio: Thank you.

For more information about the Blue Zones Project, please visit BlueZonesProject.com/montereycounty. And we hope you found this podcast to be helpful and informative. This is Ask The Experts from Salinas Valley Memorial Healthcare System. I'm Scott Webb. Stay well, and we'll talk again next time.