EvidenceBased Public Health: Improving Practice at the Community Level Community Assessment

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Evidence-Based Public HealthImproving Practice
at the Community Level Community Assessment
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Learning Objectives

• Understand importance of conducting a community
  assessment.
• Understand the types of data that are appropriate
  for assessing the needs and assets of the
  population/community of interest.

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Why?

• provide insight into the community context
• ensures that interventions will be designed,
  planned, and carried out in a way that maximizes
  benefit to the community
• make decisions about where to focus resources and
  interventions
• ensure that all members of the partnership have
  an understanding of the issues
• influence others in the community and command
  support and resources for your efforts
• understand where your partnership is starting,
  and what kinds of things you want to track along
  the way in order to determine how your efforts
  are contributing to change.

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What?

• Tells us
• The main health concerns in the community
• The main reasons for these health concerns
• The strengths/assets in the community
• Where we might want to intervene to create change

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Ecological Framework what types of things
influence health behavior

• Individual knowledge, beliefs, attitudes,
  skills
• Social family, friends (social support and
  social networks)
• Governmental Organizational policies
• Environmental access to infrastructures
  resources

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Assess existing data

• Morbidity/mortality
• Behavior
• Social indicator particularly important as we
  move toward environmental and policy changes

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Community Health Center

• Focused on health of
• Adults
• Provide the following information to help them
  determine where to focus their efforts
• Health clinic records
• Behavioral Risk Factor Survey
• The Community Health Center said this data was
  not helpful. What might be some of their
  concerns?
• Do these tell us about individual, social, or
  govt/organizational, environmental factors
  influencing health?

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Decide what you need to knowMatch to assessment
methods

• See handout

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Collect new data

• Survey behavioral, organizational, physical
  environment, partnership
• Record review hospital records, housing
  records, community agencies, recreational
  facilities policies and their enforcement
• Qualitative interviews
• Photovoice
• Community audits

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Community Audits

• A tool to assist in documenting observations (see
  audits)
• Social physical structures supporting physical
  activity
• Sidewalks, trails, lighting, scenery, safety
• People walking, talking, fighting, gang and drug
  related activity
• Can be done by researchers and community members

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Audits- Physical Activity

• Lower income African American communities
  primarily in urban center- had more sidewalks,
  but not well maintained, fewer street lights,
  more trash, less park equipment
• Put in finfindgs re concept mapping and
  qualitative interviews in phys act add info
  from concept mapping primary issues from forum-

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Photography and video clips

• Take photographs or video clips of things in the
  community that influence physical activity
• Can be done by researchers and community members

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Qualitative Data
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Class Exercise

• Please take a few moments to observe what is
  around youand write down what you observe

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Tell me what you observed
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Observations

• level of detail
• people versus surrounding behaviors versus
  environment
• race/class/ethnicity
• assumptions - family, friends, husband/wife
• observations vs. interpretations
• senses - sight, sound, smell, touch
• awareness of our own biases and tendencies
• Did you tell people you were observing them?
• Did you participate?

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Other issues to consider

• Duration of observation Short term vs. long
  term
• Focus of observation narrow, single component
  of program vs. entire program

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Concept mapping

• Methods
• brainstorming
• RANK the issues in terms of importance
•  Can be conducted by researchers and community
  members

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Qualitative Interviews

• General Interview Guide

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General Interview guide

• List of questions or issues to be explored - a
  framework
• Can get similar information from several
  individuals
• General topics and probes
• General outline to discuss on predetermined
  subject
• Maintain conversational quality
• Individual or group

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Types of questions you can ask

• Behavioral/ experience
• Opinion/value
• Feeling
• Knowledge
• Sensory
• Demographic/background
• (all past, present, future)

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Recording the data

• Permission and consent
• Notes - during and after the interview include
  your feelings tired/excited how did the
  interview seem to you?
• Note surroundings
• Tape recording - make sure it is on, make sure it
  worked two tape recorders

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Analysis

• From transcriptions and notes
• Computer programs
• Focused coding - with predetermined categories in
  mind
• Open coding - categories and themes from the data
  itself
• Multiple coders
• Label so you can go back to context
• Triangulation

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Class exercise

• Analysis of data
• NOTE The class will have an opportunity to
  review concept mapping statements regarding
  facilitators and barriers to physical activity

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Useful websites

• The Research Methods Knowledge Base
• http//trochim.human.cornell.edu/kb/
• Knight Foundation
• http//www.knightfdn.org
• The Community Toolbox
• http//ctb.lsi.ukans.edu/
• Program Evaluation Tool Kit
• http//www.uottawa.ca/academic/med/epid/toolkit.ht
  m
• The Community Health Status Indicators (CHSI)
  Project
• http//www.communityhealth.hrsa.gov

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Findings Physical Activity

• Most important factors influencing physical
  activity among African American women
• Safe and inviting environments
• Knowing our neighbors
• Access to parks/places to walk
• Facility policies ability to take a class
  rather than full membership

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Are these factors

• Individual?
• Social?
• Governmental Organizational Policies?
• Environmental?

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Community Assessment

• Decide what to assess
• Decide the best method to collect the data to
  answer your questions
• Develop a work plan that identifies tasks to
  accomplish, partner roles and responsibilities,
  and a time frame for completion
• Collect the information and organize it as it is
  collected so that it can be shared with all
  partners, community stakeholders, and community
  members.

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Community Assessment

• Present information gathered and summarized from
  the community assessment back to partners
• Coalition/partnership
• Community forum
• Meetings with community groups
• Move to Action Planning what do we do to create
  the desired changes?