Community Health Status and Community Themes & Strengths Assessments

1. Community Health Status and Community Themes & Strengths Assessments November 19, 2010

2. What we heard from you To learn… • More about the MAPP process • Helpful information on partnering for our network • How to strengthen our regional community health planning committee • How to complete a CHSA and CTSA • How to obtain information on community assets • How community health workers can impact this process • How to incorporate and connect community themes & strengths into the CHSA • How to adapt assessments to meet specific public health issues such as those important to EMS “To get a complete understanding of how to implement the MAPP process in the best possible manner.”

4. Traditional Data & Intervention • DATA: Sixty-four percent of adults are overweight or obese. • INTERVENTION: New worksite education programs to help employees improve diet and physical activity behaviors

5. MAPP Assessment Data & More Focused Intervention • CTSA: There are sidewalks and bike paths throughout the community, but residents do not feel safe using them. • LPHSA: The public health system is strong in monitoring health and health education but weak in mobilizing the community and developing improvement plans. • FOCA: New federal legislation may increase opportunities for economic development. Focused Intervention: Community coalition secures stimulus dollars and work with residents to improve the safety and accessibility of public parks and recreation facilities.

6. The Four Assessments • Forces of Change • Local Public Health System (NPHPSP) • Community Themes and Strengths • Community Health Status

7. Community Health Status Assessment Analyzes data about • Health status • Quality of life • Risk factors

8. Community Health Status Assessment • Convene a group of diverse community partners • Review results from other MAPP assessments • Select indicators of interest • Identify existing data sources • List missing data • Collect data • Organize and analyze data • Establish an updatable monitoring system • Evaluate and improve system

9. Community Health Status Assessment 11 Categories of Data • Demographic Characteristics • Socioeconomic Characteristics • Health Resource Availability • Quality of Life • Behavioral Risk Factors • Environmental Health Indicators • Social and Mental Health • Maternal and Child Health • Death, Illness and Injury • Infectious Disease • Sentinel Events

10. Sources of Data • State or local databases • Previously conducted health assessments or reports • Partners who have access to data through their organizations • Track down hard to find data • Consider whether new sources of data need to be developed • County Health Rankings

11. Clearinghouse Tools • Data worksheets • Sample surveys, also in Spanish • Assessment data presentation • Examples of CHSA reports

12. Community Themes and Strengths Assessment Identifies • Themes that interest and engage the community • Insights about quality of life • Community assets

13. Community Themes and Strengths Assessment Steps • Establish a subcommittee • Implement activities to identify community themes & strengths • Compile the results • Sustain community involvement

14. Community Themes and Strengths Assessment Three levels of information gathering should occur during the CTSA: • Open discussion to elicit community concerns, opinions, and comments in an unstructured way (e.g. community dialogues) • Insights regarding community quality of life – questions about quality of life in the community can identify specific concerns • A map of community assets. Asset Mapping is the process by which the capacities of individuals, civic associations, and local institutions are inventoried

16. Important Tip: Have community members participate on planning committees Community Themes and Strengths Assessment Collect community input via: • Focus groups • Surveys • Brainwriting exercise • Windshield surveys • Photovoice • Town hall meetings • Informal discussions with community

17. Community Themes and Strengths Assessment • Focus on Assets • Opportunities vs. problems • Partners vs. “clients” • Use Reflective Listening • Stop Talking • Listen Carefully • Repeat Back • Ask Questions to Probe for How’s and Why’s • Listen Again

18. Warren County, NJ

19. Warren County, NJ

20. Clearinghouse Tools • How-To Guide • Focus Group Guidelines • Photovoice Manual • Examples of CT&SA Reports • Asset Mapping Articles

21. Community Health Status andCommunity Themes and Strengths Assessments NACCHO Webinar November 19, 2010 Stephanie Welch Community Development and Planning Director Knox County Health Department stephanie.welch@knoxcounty.org (865) 215-5297

22. Overview • Which assessment should you do first? • Assessment tools and processes • Building in evaluation • Lessons learned

23. 69 34 82 14 74 13 81 63 83 56 46 76 37 07 90 85 10 44 67 25 87 29 42 32 11 80 30 19 95 65 01 86 22 71 45 03 43 47 21 18 15 94 93 73 75 78 17 49 41 08 53 88 05 68 89 39 04 57 38 60 72 20 51 02 16 12 59 54 62 31 61 77 64 24 35 91 50 79 55 36 28 33 06 26 58 70 52 • East Tennessee Region • 15 Rural Counties • Total population approx. 600,000 • Knox County • One of six “metro” TN counties • Population 430,000

24. MAPP Assessments: Where to start? • Monroe County • Community Health Status Assessment • Health Council wanted data for grant writing • Jefferson County • Local Public Health System Assessment • Health Council concerned about health care service gaps, considering opening a free medical clinic for uninsured • Cocke County • Community Themes and Strengths Assessment • Health Council wanted to build community engagement with an interactive dialogue about health assets and needs • Knox County • Simultaneous: Community Themes and Strengths and Community Health Status • Community Partners expresses “assessment fatigue” and requested that health department bring something to the table to initiate MAPP

26. Community Health Status Assessment:Monroe County • Step 1: Strategic Planning Director provided CHSA Orientation for Health Council and Graduate Students • Step 2: Health Council identified examples of data desired and data sources (agency, contact name) for each of the CHSA categories • Step 3: Students gathered and compiled data • Step 4: Students presented data report to Health Council • Step 5: Strategic Planning Director facilitated evaluation meeting • Missing data? • Usefulness of report? • Did the process work (For community members? For students? For faculty? For HD staff?)

27. Community Health Status Assessment:Knox County • Step 1: Form staff assessment team • Step 2: Assign data categories to staff • Step 3: Gather and compile data • Engage partners – existing data sources? • Weekly meetings to evaluate progress • Step 4: Develop report format and write report

28. Data Categories Section 1: Community Description Section 2: Access to Health Care and Coverage Section 3: Quality of Life Section 4: Behavioral Risk Factors Section 5: Environmental Health Indicators Section 6: Social and Mental Health Section 7: Maternal and Child Health Section 8: Death, Illness and Injury Section 9: Communicable Disease

29. 176 sources of data and information • Utility Board • Area Planning Commission • Chamber of Commerce • Law Enforcement Agencies • Transportation Planning Organization • Parks and Recreation • Office on Aging • Etc

32. Community Health Status Assessment:Benefits • #1: Data for grant writing • #2: Data for program planning • #3: Set bar for measuring outcomes • #4: Help balance perception with reality • Both are important

34. Community Themes and Strengths Assessment:Cocke County • Step 1: Strategic Planning Director provided CTSA Orientation for Health Council • Step 2: Health Council identified methods for collecting data; decided on: • Paper survey (quality of life priorities) • Focus groups and interviews (needs and concerns) • Group dialogue (underlying issues and assets) • “Windshield” surveys (physical environment)

35. Community Themes and Strengths Assessment:Cocke County • Step 3: Meeting between Health Council and UT students • Step 4: Training on assessment methods • Step 5: Conduct assessment • Three months • Step 6: Report writing • Step 7: Report presentation at public meeting • Media coverage

39. Community Themes and Strengths AssessmentKnox County • Step 1: Core staff determined methodology and designed instruments • Researched other models • Surveys, Focus Groups, Key Informant Interviews, Group Dialogue • Goal: Engage a large, representative cross-section of community • Step 2: Full-staff inservice; engage staff in: • Pilot test assessment methods • Assist in marketing and conducting assessments • Step 3: Revise assessment instruments • Step 4: Train staff and student partners to conduct assessments • Recording devices, meeting facilitation, interview techniques, etc. • Step 5: Provided presentations and facilitated group dialogue at 27 community meetings • Step 6: Conduct assessment • Three months

40. Assessment Methods • Focus groups: • A group of approx. 10 people asked about their perceptions, opinions, beliefs and attitudes towards health in Knox County • Open invitation, used incentives • Key Informant Interviews • Key informants have an above average level of knowledge/experience about the topic • Careful selection through committee process • Group Dialogue • Open conversation, guided by a few questions and a facilitator • Used existing meetings of groups and coalitions

46. Community Dialogues andAssessment Marketing • Knox County Board of Health • Knox County Commission • Farragut Board of Mayor and Aldermen • Knox County Board of Education • Knoxville Local Emergency Planning Committee (LEPC) • United Way of Greater Knoxville • Smoke Free Knoxville Coalition • East Tennessee Worksite Wellness Roundtable • Council of Involved Neighborhoods (COIN) • Senior Safety Task Force • Engaging Boys & Men Task Force • Community Coalition on Family Violence • Greater Knoxville Nutrition Council • Community Action Committee Board • And more….

47. How was the information collected? • 3098 completed surveys • 9 focus groups/52 participants • 27 key informant interviews

48. Community Themes and Strengths AssessmentKnox County • Step 7: Transcribe focus group and interview recordings • Step 8: Data analysis • Step 9: Report writing • Step 10: Report editing • Step 11: More report writing…..