Identifying community priorities for neighborhood livability: Engaging neighborhood residents to facilitate community assessment (original) (raw)
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Neighborhood Mapping and Evaluation: A Methodology for Participatory Community Health Initiatives
Objectives: This paper describes the use of neighborhood mapping as a key element in an ecological study of a community-based urban infant mortality prevention program. We propose the use of neighborhood mapping in evaluation research to more fully examine the local context of community health programs. Mapping can be used to study community change and to describe community assets and structural, epidemiological, and social features of neighborhoods that may influence program implementation and outcomes. Methods: Data on physical features were collected by community residents during street-by-street neighborhood walkthroughs. Other data sources included program records, Census, birth certificate, and state and city data. Analytic methods included geo-coding, exploratory factor analysis to create spatial density indicators of neighborhood features at the Census block group level, and analysis of associations between neighborhood features and outcomes. Results: Point and chloropleth maps provide a powerful illustration of neighborhood features (e.g., vacant buildings), client distribution and participation, health outcomes, and change over time. Factor analysis indicated two salient clusters of non-residential land use: (1) legitimate daily usage (liquor stores and other businesses) and (2) non-legitimate daily use (houses of worship and vacant buildings). A composite scale was created to indicate overall risk related to physical neighborhood features. Conclusions: Neighborhood mapping is a powerful tool that brings participants and residents into the research process. Moreover, it can improve understanding of the role of neighborhood ecology in program implementation and outcomes.
The Healthy Community Neighborhood Initiative: Rationale and Design
Ethnicity & Disease, 2016
IntroductIon African Americans, Latinos, and adults from other racial/ethnic minority groups have higher rates and worse control of chronic conditions such as obesity, diabetes, cardiovascular disease and stroke than their White peers and face worse outcomes from these conditions. 1-5 Residence in low-income, underresourced communities is also associated with poorer chronic disease outcomes. 1,2,6-10 At the individual and the community levels, many shared mechanisms may contribute to health inequities, among them lower educational attainment and income, higher rates of deleterious health behaviors, poorer access to health care and health-promoting resources, lower quality of care, and chronic stressors. 11-14 There is limited understanding, however, of the best strategies for improving individual health outcomes and reducing health disparities in communities where physical and social conditions undermine efforts to prevent and manage chronic conditions. 15-19 An emerging literature suggests that interventions developed through community-academic partnerships have the potential to translate Objective: To describe the design and rationale of the Healthy Community Neighborhood Initiative (HCNI), a multicomponent study to understand and document health risk and resources in a low-income and minority community. Design: A community-partnered participatory research project. Setting: A low-income, biethnic African American and Latino neighborhood in South Los Angeles. Participants: Adult community residents aged >18 years. Main Outcome Measures: Household survey and clinical data collection; neighborhood characteristics; neighborhood observations; and community resources asset mapping. Results: We enrolled 206 participants (90% of those eligible), of whom 205 completed the household interview and examination, and 199 provided laboratory samples. Among enrollees, 82 (40%) were aged >50 years and participated in functional status measurement. We completed neighborhood observations on 93 street segments; an average of 2.2 (SD=1.6) study participants resided on each street segment observed. The community asset map identified 290 resources summarized in a Community Resource Guide given to all participants. Conclusions: The HCNI communityacademic partnership has built a framework to assess and document the individual, social, and community factors that may influence clinical and social outcomes in a community at high-risk for preventable chronic disease. Our project suggests that a community collaborative can use culturally and scientifically sound strategies to identify community-centered health and social needs. Additional work is needed to understand strategies for developing and implementing interventions to mitigate these disparities.
Factors Affecting the Progress of Community Health Assessment and Improvement Activities in Kansas
Journal of Public Health Management and Practice, 2015
Context: Community health assessment (CHA) and community health improvement planning (CHIP) are important functions for local health departments (LHDs) but may present challenges, particularly in rural settings. Objective: The purpose of this 2-year, mixed-methods study was to identify factors that impede or promote the timeliness and quality of CHA-CHIP completion in Kansas. Design: Focus group interviews, conducted at baseline (2012) and at 1 year (2013), included 15 and 21 groups, respectively. Scores from a 12-item attitudinal survey that explored participants' confidence to perform CHA-CHIP activities were collected in tandem with focus groups. Setting: Kansas counties that planned to conduct a CHA-CHIP process during 2012 and/or 2013 were eligible to participate. Participants: There were 128 study participants (57 in 2012, 71 in 2013), who were predominantly female (83%), aged 51 years or older (61.4%), and lived in rural areas (84.6%). Public health region representation in 2012 and 2013 was 73% and 93%, respectively. Main Outcome Measures: Changes in perceptions about CHA-CHIP inputs, process, outputs, outcomes, and self-efficacy to perform CHA-CHIP activities were explored. Results: Progress in CHA-CHIP implementation was reported in 2013. Most participants perceived the CHA-CHIP process as valuable and enhanced the LHD's visibility. Rural participants reported having completed the CHA phase, whereas urban LHDs had progressed into the planning and implementation stage. Potentiators of the CHA-CHIP process included (1) parallel assessment activities conducted by other community organizations, and (2) for rural counties, a functioning 501(c)3 community health coalition. Perceptions about the importance of
Using the Healthy Community Assessment Tool: Applicability and Adaptation in the Midwest of WA
Population based studies have associated poor living conditions with the persistent disparity in the health of Aboriginal and non-Aboriginal Australians. This project assesses the applicability of the Health Community Assessment Tool and its role in improving the environment of a small community in the Midwest of WA. The action research cycles started with the initial reflection on the suitability of the HCAT version 2 for the local community context and whether it was fit-for-purpose. The researcher provided ‘critical companionship’, while the participants of the study were invited to be co-researchers (the Assessors) who critically examined the HCAT and assess the community. The relevant domains to the serviced town (an outer regional community) were pest control and animal management; healthy housing; food supply; community vibrancy, pride and safety; reducing environmental tobacco smoke; and promoting physical activity. The Assessors found the HCAT descriptors mostly...
Community Health Assessment by Local Health Departments: Future Questions
Frontiers in Public Health Services and Systems Research, 2014
This "Letter to the Editor" is a response to the article "Community Health Assessment by Local Health Departments: Presence of Epidemiologist, Governance, and Federal and State Funds are Critical" published in volume 2, issue 6 of this journal. It considers how LHDs develop CHAs in complex jurisdictions, the roles of other professionals in the development of CHAs, and the conduct, quality, and use of CHAs.
Gaceta Sanitaria, 2018
A large volume of public health literature has shown how the social and physical features of a neighbourhood affect residents' health, and how they contribute to health inequalities. In this article, we argue that citizens, researchers, policy makers and health professionals should engage in creating a common, policy-relevant neighbourhood and health agenda to effectively improve population health and reduce health inequalities. We discuss four critical processes for advancing this neighbourhood and health agenda: 1) citizen participation and community empowerment; 2) policy making; 3) producing relevant research; and 4) how to best communicate between stakeholders. Various methodologies and experiences currently exist to secure and promote citizen participation. Sufficient funding of research projects and specific policies, as well as continued communication strategies among stakeholders, are necessary elements of this neighbourhood and health agenda. Establishing collaborative and sustained relationships between citizens, policy makers, health professionals and researchers at local and higher political levels is a challenging but necessary step. Developing participatory action research and local participatory policy efforts are important steps towards developing a policy-relevant neighbourhood and health agenda.
Building Healthy Community Environments: A Public Health Approach
Public Health Reports
Environmental quality has a profound effect on health and the burden of disease. In the United States, the environmentrelated burden of disease is increasingly dominated by chronic diseases. At the local level, public health practitioners realize that many policy decisions affecting environmental quality and health transcend the authorities of traditional health department programs. Healthy decisions about the built environment, including housing, transportation, and energy, require broad collaborative efforts. Environmental health professionals have an opportunity to address the shift in public health burden toward chronic diseases and play an important role in the design of healthy communities by bringing data and tools to decision makers. This article provides a guide for community leaders to consider the public health effects of decisions about the built environment. We present a conceptual framework that represents a shift from compartmentalized solutions toward an inclusive systems approach that encourages partnership across disciplines and sectors. We discuss practical tools to assist with environmental decision making, such as Health Impact Assessments, environmental public health tracking, and cumulative risk assessment. We also identify priorities in research, practice, and education to advance the role of public health in decision making to improve health, such as the Health Impact Assessment, as a core competency for environmental health practitioners. We encourage cross-disciplinary communication, research, and education that bring the fields of planning, transportation, and energy in closer collaboration with public health to jointly advance the systems approach to today's environmental challenges.
American Journal of Preventive Medicine, 2003
This case-community health assessment-is one of a series of teaching cases in the Case-Based Series in Population-Oriented Prevention (C-POP). It has been developed for use in medical school and residency prevention curricula. The complete set of cases is presented in this supplement to the American Journal of Preventive Medicine. Community health assessment is key to understanding the health problems and priorities of a population. This case outlines a process by which the participants can complete a health assessment of a community using indicator-based methods. Students construct a set of health indicators from a variety of domains, evaluate problems, and report on the health priorities for a community. The students relate identified health issues to underlying behavioral risk factors.
The Power of Community Voices for Enhancing Community Health Needs Assessments
Health promotion practice, 2016
As required by the Affordable Care Act, Community Health Needs Assessments (CHNAs) are formalized processes nonprofit hospitals must perform at least every 3 years. CHNAs are designed to help hospitals better tailor health services to the needs of local residents. However, CHNAs most often use quantitative, population-level data, and rarely incorporate the actual voices of local community members. This is particularly a problem for meeting the needs of residents who are also racial or ethnic minorities. This article discusses one model for integrating residents' voices into the CHNA process. In this model, we videotaped interviews with community members and then coded and analyzed interview data to identify underlying themes. We created a short video aimed at starting conversations about community members' concerns. In addition to demonstrating how other nonprofit hospitals may use qualitative data in the CHNA process, this article illustrates how adding qualitative data may...