• Using the healthy communities planning process, develop strategies to mobilize the community for change.
• Facilitate an assessment of community health needs.
• Empower the community to prioritize and select issues in need of community solutions.
• Develop and implement community intervention strategies.

1995

• In October 1995, the US partners conducted an initial assessment and examined existing morbidity and mortality statistics in the region. They also conducted a meeting with key stakeholders and the local health council to assess their communities' health priorities, strengths, weaknesses and threats (SWOT) anaylsis in planning for change.

1996

• The Official Memorandum of Understanding signing ceremony was held in January 1996 in Cleveland, Ohio. Following the signing ceremony the Slovak delegation participated in a number of meetings to learn about the U. S. health care delivery system, volunteerism, fundraising, and health promotion and disease prevention programs. The delegation also received a computer and printer purchased through AIHA/USAID funds to enable them to begin collecting data on community risk factors, morbidity and mortality statistics.
• In February 1996, following the delegations' trip to Cleveland, Ohio the Turcianske Teplice healthy community leaders hosted a meeting of 13 representatives of the Healthy Cities Association of Slovakia. The meeting focused on lessons learned during their intense study tour in the United States and future planning strategies for the Turcianske Teplice Health Planning Council.
• The residents of Turcianske Teplice participated in events to improve their health and environment, from World Health Day April 7 to Earth Day on April 22, 1996. Activities included a health walk, planting trees, and picking up litter. During the month of April, officials set up a pilot blood pressure monitoring station at city hall.
• In conjunction with World Health Day, community members participated in the WHO Healthy Cities campaign. With support from USAID/AIHA, the community sponsored its first poster campaign to promote healthy lifestyles. The contest winner was recognized through a mass distribution of the poster, which focused on increasing awareness of "what creates a healthy community."
• Representatives of another AIHA Healthy Communities partnership (Aid to Children at Risk Foundation) presented a two-day seminar on June 3-4, 1996 in Turcianske Teplice, to train teachers and principals on drugs and stress-related problems affecting the youth of Slovakia. This workshop was a concrete illustration of the two healthy communities programs sharing expertise in common areas of concern.
• Turcianske Teplice hosted a seminar July 1- 11, 1996 for over 150 volunteers from the National Humanity and Health Club. This workshop focused on topics including how to reduce stress and negative thinking.
• The Slovak partners launched a major fund-raising drive in their community to purchase a new ambulance for the region. The Slovak partners also received support from their partners in the US.
• A behavioral epidemiologist from Case Western Reserve University held workshops, discussed methodologies and assisted the Turcianske Teplice team in the development of a Family Stress Survey.

1997

• The Slovak Republic's President, Michal Kovac, made his first presidential visit to the Town of Turcianske Teplice in March 1997. The Mayor of Turcianske Teplice discussed the AIHA partnership program with him during his visit.
• Mayor Chlapikova gave a presentation at a USAID-sponsored International Conference: "Realizing the Vision of Health Reform," on March 18-21, 1997 in Bratislava, Slovakia. Dr. Chlapikova presented the Turcianske Teplice's "Mobilizing Citizen Initiative" process.
• In Spring of 1997, town officials, representatives of the local schools, along with the medical, law enforcement, and transportation communities, developed an innovative program designed to reduce traffic accidents, limit accident-related injuries and mortality, and reduce health care costs arising from accidents in Turcianske Teplice. The three-year project, sponsored in part by the healthy communities partnership, focuses on educating children and adults in first aid and traffic safety, improving the conditions of local roads, and establishing better emergency care for traffic-related injuries.
• Through the assistance of AIHA/USAID, the partners officially opened a Community Health Advisory and Education Center on October 29, 1997. Over ninety people attended the grand-opening and ribbon-cutting ceremony hosted by the Mayor of Turcianske Teplice, including the entire town council, mayors from surrounding towns, a representative of the Slovak Ministry of Health, and the Zilinsky Kraj regional director.
• Germany's Boehringer Mannheim company donated a Reflotron IV valued at $7,000, to the Community Health Advisory and Education Center, for use in blood cholesterol screening.
• Community members from Turcianske Teplice participated and presented in the Healthy Communities - Healthy Cities Dissemination Conference in Banska Bystrica from November 19 to 21, 1997. Co-sponsored by AIHA and the Association of Healthy Cities of Slovakia, over 150 community health leaders including partners from three community health partnerships in Slovakia; AIHA partners from Latvia, Hungary, Romania; USAID representatives; and representatives from several Slovak cities participating in the World Health Organization's (WHO) Healthy Cities project. During the three-day conference, participants discussed the building blocks of an effective healthy communities program, addressed issues such as community needs assessment, community leadership, multi-sectoral cooperation, fundraising and city health planning.
• In November, a delegation from Latvia, Hungary and the US visited the Community Health and Advisory Center in Turcianske Teplice. During the visit, the Mayor provided an orientation to the healthy communities methodology that enabled the community to achieve its goals.

• The community of Turcianske Teplice hosted a visit by participants of the USAID/NIS Healthy Communities Study Tour, from May 10-13, 1998. Partners oriented the team to the partnership's activities, answered questions about the healthy community partnership process, and gave a tour of the project's tangible outcomes, which included a visit to the Community Health Advisory and Education Center and a viewing of the ambulance purchased through partnership efforts.

Family Stress Survey Administered

• During the beginning stages of the partnership, the US and Slovak partners identified the need for a collection of community-based health data as a health priority and a programmatic objective for the partnership. A behavioral epidemiologist from Case Western Reserve University held workshops and discussed the methodology with the Turcianske Teplice team in order to assist them in the development of a Family Stress Survey. The purpose of the study was to provide baseline data in which to assess and monitor the health of school-aged children and their parents in the district.

  A survey questionnaire was administered to over 1,600 school-aged children and 500 parents to assess the impact that the political and social transformation has had on their community. In 1996, 1,687 of the 1,850 children enrolled in grades 5-12 (91%) completed an extensive questionnaire, covering many topics including: disease and symptomatology, health and social risk behaviors, school and work achievement, peer and family relationships, psychological resources, and evaluation of personal and family stress. Where available, results of the survey were compared to other Slovak and European studies of adolescents as well as with behaviors of US teens. Overall, the number of Slovak adolescents engaged in risky behaviors was comparable to a level similar to adolescents in other cultures. In comparison to Western youth, Slovak adolescents were more likely to smoke and drink, but were less likely to use drugs, engage in sexual activity or to have had suicidal thoughts. Emotionally, the most vulnerable group of adolescents were young boys aged 10-13 however, girls had lower self-esteem than boys, similar to that of other cultures.

  Partners shared the results of the Family Stress survey at the AIHA Healthy Communities Dissemination Conference in Banska Bystrica in November 1997. Following the presentations, WHO's Healthy Cities Association of Slovakia considered conducting a similar survey in five additional cities in Slovakia.  In addition, the Mayor of Turcianske Teplice and an epidemiologist from Case Western Reserve University were invited to share survey results at WHO's International Healthy Cities Conference, "Marking a Decade of Healthy Cities Action," held in Athens, Greece, in June 1998.

New Ambulance Purchased

• The community recognized the need to provide reliable emergency transportation and chose to initiate a voluntary community fundraising drive to purchase an ambulance. The goal was achieved within a year of beginning the Healthy Communities Partnership. Town officials appealed to local civic groups, businesses and schools in the community, as well as to officials across the country, to raise money for the ambulance. US partners in Cleveland, Ohio also enlisted the help of the Cleveland-Bratislava Sister Cities organization, which raised funds by raffling prizes within Cleveland's Slovak community. With $40,000 from these sources, a Citroen ambulance was purchased and equipped. Through the process of raising funds, the community learned the importance of approaching new donors, establishing a system to recognize contributors, and changed the tax laws to encourage charitable contributions.

Community Health Advisory and Education Center Established

• In October 1997, the Turcianske Teplice partners opened the first Community Health Advisory and Education Center in Slovakia to be operated and financed entirely by a municipality - to make health promotion and disease prevention services accessible to the population at no cost. The Center provides hypertension and cholesterol screening; diabetes screening and counseling; education for women in self-breast examination; prenatal education; as well as drug, alcohol and smoking cessation counseling. The Center is opened five days a week for four hours a day, and is staffed by a part-time physician and a full- time nurse. Financial resources for the staff's salaries and purchasing supplies is provided by the City Hall of Turcianske Teplice, with partial funding from the Ministry of Health.