How To Improve Health Care In A Community

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Transcription:

Dallas County Community Health Needs: So Many Possibilities

What happened last time A facilitated kickoff meeting Data collection Surveys: online and paper Community Conversations Group prioritization and planning

Benefits of that process Community Connections Stakeholder identification of the priorities Representation from community members Workgroups dedicated to each priority

Priorities that surfaced Obesity Access to Care Substance Abuse and Mental Health

Work toward those priorities Support for a Health Navigation Program and Community Resource Directory CTG Cross-over work: Community Gardens, NEMS-R and NEMS-V assessments with noted improvements by restaurants and other vendors Barriers to initiation of treatment services within 7 days addressed successfully, Work centered around the ACE study with the creation of an active coalition, Continued coalition support for decreased risk behavior in our youth

Something extra: Jen s CHNA HIP Unmet Need Project A new strategy that not only educates individuals about healthy food choices, but also supports system and environmental changes to ensure there is access to healthy, affordable, and culturally appropriate food. Our residents of Hispanic origin purchase culturally appropriate foods at local Tiendas. These stores typically carry meat and baked goods. Fresh fruits and vegetables at theses stores are more rare to find. We are working with 3 Tienda owners to add fresh produce to their stores We are also interested in the conversations surrounding convenience stores and the addition of more fresh produce to their shelves.

The Dream We hope to have data that indicates disparities and social needs in our communities We hope to have data that can be shared with other community partners We hope to have data that we can measure over time We hope to have partners that are interested in having their existing work measured We hope to have a plan that is executable We hope to have a plan that produces results We hope to evaluate our work in a meaningful way

Can we produce a snapshot that is meaningful and useful in our communities? Social assessment, Situational Analysis, Community Capacity Health Status Assessment Epidemiological Assessment Selecting Health Priorities Determining the Sources of Priority Health Problems Selecting Behavioral and Environmental Priorities Identifying Contributors Administrative and Policy Assessment

What might be different this time Mobile applications to gather data? Household surveys in selected neighborhoods? Digging deeper into the priorities? Maps that start conversations A tri-county needs assessment and plan that expands our reach Measured disparities and social needs New and established stakeholders

Social Determinants of Health Indicators http://www.cdc.gov/dhdsp/docs/data_set_directory.pdf http://www.naccho.org/topics/infrastructure/chaip/uploa d/final-resources-on-social-determinants-of-health- 112811.pdf

Models: MAPP Mobilizing for Action through Planning and Partnership Develop partnerships, identify participants, organize them into workgroups Groups design the planning process, assess resources, and determine a management plan Groups collectively create a shared community vision and values statement Four MAPP Assessments are completed Results of the four assessments and the vision and values statements are used to create a prioritized list of strategic issues

Model: CHANGE The Community Health Assessment ANd Group Evaluation Assists communities in identifying and prioritizing community health needs. The tool is Microsoft Excel-based and allows for data entry and analysis. The tool guide and excel templates are available at http://www.cdc.gov/nccdphp/dch/programs/healthyc ommunitiesprogram/tools/change/downloads.htm.

Model: CASPER The Community Assessment for Public Health Emergency Response Originally developed for rapid needs assessment after disasters Methodology has been used for collection of primary data for a CHNA in North Carolina Cluster sampling, household surveys

Tools: Community Commons Report Area Total Medicare Beneficiaries Beneficiaries with Depression Percent with Depression Dallas County, IA 5,328 766 14.38% Iowa 450,866 67,386 14.95% United States 34,126,305 5,271,176 15.45% Report Area Total Population, 2013 Dentists, 2013 Dentists, Rate per 100,000 Pop. Dallas County, IA 74,641 20 26.79 Iowa 3,090,416 1,851 59.89 United States 316,128,839 199,743 63.18

Tools: GIS Maps

Tools: THRIVE Toolkit for Health and Resilience in Vulnerable Environments A Community Approach to Addressing Disparities in Health Features community conditions that influence the Healthy People leading health indicators 4 clusters, 13 factors Takes place within a community process Builds on community strengths and utilizes community capacity

Tool: PARTNER Program to Analyze, Record, and Track Networks to Enhance Relationships (PARTNER) The free Microsoft Excel-based tool provides a social data analysis based on survey responses from partner organizations to assist with recognition of gaps and redundancy in relationships across the collaborative. Results can be presented to the collaborative and used in public reporting.

22 Talking with our stakeholders Key Informant Interviews - Interviews with a small number of individuals who are most knowledgeable about an issue. Focus Groups - A small group (8-12) is asked to openly discuss ideas, issues and experiences. Mini-surveys - A small number of people (25-50) is asked a limited number of questions. Neighborhood Mapping - Pictures show location and types of changes in an area to be evaluated. Flow Diagrams - A visual diagram shows proposed and completed changes in systems. Photographs - Photos capture changes in communities that have occurred over time. Oral Histories and Stories - Stories capture progress by focusing on one person s experience. http://depts.washington.edu/ccph/pdf_files/evaluation.pdf

We re asking questions! How do health disparities affect you/ your work? Your agency? How does your agency affect health disparities? How is your work/ your agency helping to build resilience in our community? Which social determinants of health is your work/agency most concerned with? Who is missing from our table? How do we find them? How would health needs information be useful to you/your agency/ our community?