Debi Nelson, Interim Director Office of Healthy Carolinians/Health Education February 5, 2009

Debi Nelson, Interim DirectorOffice of Healthy Carolinians/Health Education

February 5, 2009

What is a Community Health Assessment?

Engages multiple organizations, agencies and community members

Informs action plans, decisions, funding requests, and interventions

Creates a positive environment for discussion and change

A process by which community members gain an understanding of the health concerns, and health care systems of the community by identifying, collecting, analyzing, and

disseminating information on community assets, strengths, resources, and needs.

A process by which community members gain an understanding of the health concerns, and health care systems of the community by identifying, collecting, analyzing, and

disseminating information on community assets, strengths, resources, and needs.

Overview

The Community Assessment Guidebook:

Guides you through eight phases as you complete a collaborative and comprehensive assessment

Encourages systematically engaging county residents in assessing local problems and assets

Eight Phases of Community Health Assessment

Phase 1: Establish a Community Assessment Team

Phase 2: Collect Community Data (primary/secondary)

Phase 3: Collect and Analyze Your Community’s Health Statistics (state and local

resources)

Phase 4: Combining Your County’s Health Statistics with Your Community Data

Phase 5: Solicit Community Input to Select Health Priorities

Phase 6: Create a CHA Document

Phase 7: Disseminate the Community Assessment Document to the Community

Phase 8: Develop the Community Health Action Plans

Appendices

A. Accreditation StandardsB. Sampling GuidesC. Community Health Opinion SurveyD. Listening Session ToolkitE. Resource GuideF. Statistical Primers

CHA Timeline CHA Report is due once every 4 years.

Each county assigned to a 4- year cycle Due first Monday in December CHA completed before accreditation Community Health Action Plan forms due

the 1st Friday of June after CHA completed Recertification scheduled the year after

CHA

Annual SOTCH report issued every year during other 3 years

What is a SOTCH? State-of-the-County’s Health Report

Identifies emerging issues• Annual review of morbidity and mortality data

Highlights new initiatives• Economic or political changes

Shows progress with priorities identified in the Community Health Assessment

• Keeps community informed

Required by the Consolidated Agreement and Accreditation Standards

What’s New in CHA? Guidebook has been revised, reorganized,

and updated (2008) Available at the Office of Healthy Carolinians

website and on CD Major revisions include:

tips and tools to improve data collection, analysis, and interpretation

additional guides to help you better understand the community assessment process





resources)






Phase 1

Guides you through gathering a team of people who can represent the different viewpoints in your community

Changes Updated tools and section wording to increase sensitivity and encourage

team diversity

Phase 1: Establish a Community Assessment Team Influential organization reps + community

residents= Your Community Team!

Sample structure of CHA team:1. Advisory group2. Work group3. Project Facilitator

Make a budget and secure funds for your Community Assessment

Example of Phase 1 Tools





resources)






Phase 2 Step-by-step primary and secondary data

collection from your community Changes

Primary data requirements (see next slide) Major overhaul of the survey section to

include survey design and methodology Listening Session Toolkit and Community

Health Opinion Survey revised and moved to Appendix

Updated resources and contact info

PHASE 2: CHANGES

Primary Data Requirements

Main Method of Data Collection

1. Inventory the community health resources

You must choose at least one of the following:

2. Conduct a community health opinion survey Describe methods for selecting participants. Convenience sampling- must collect at least 500 surveys Random or systematic sampling- must show calculation or describe methods for

determining sample size

3. Conduct listening sessions or focus groups Show methods for selecting groups Must have 15 minimum sessions with participants covering key ethnic, age,

income, educational attainment and geographic regions of the county.

Supplementary Methods of Data Collection

1. Gather others’ local data 2. Interview key informants from your community 3. Map the assets of your community

(Note: Assets mapping can contribute information crucial to selecting priorities and later selecting interventions once priorities have been determined.)

PHASE 2: NEW TOOL





resources)






Phase 3 Leads you through secondary data collection

from several resources Changes:

More definitions, tip boxes and simple statistical examples and explanations

Reorganized to follow accreditation standards!

Removed County Health Data Book Worksheets

NC-CATCH -- a new, more user friendly resource for secondary data collection

PHASE 3: CHANGES

Keep track of accreditation standards as you follow along in the book!

PHASE 3: CHANGES

Tip boxes provide definitions and step-by-step instructions on creating useful statistics and comparisons!





resources)






Phase 4

Guides you on how to combine and interpret your community’s data from all sources.

Changes: Reorganized to follow accreditation

standards Updated resources Includes definitions for important

health indicators





resources)






Phase 5 Gives practical methods and suggestions on how

to approach the community with assessment results

Changes: More tips on how and where to present

findings and how to publicize your community meeting

Selection of health priorities moved from Phase 6 to Phase 5 to emphasize community input

Problem Importance and Problem Prioritization Worksheets moved to Phase 5





resources)






Phase 6

Guides you through creating the community assessment report.

Changes: Formerly Phase 7 Now includes a sample outline with

suggested data sources





resources)






Phase 7

Advice on how to involve the community through strategic dissemination of the Community Health Assessment document

Changes: This is a brand new section!!! Includes a sample press release

PHASE 7: NEW TOOL





resources)






Phase 8

Guides you through creating the Community Health Action Plan

Changes: Revised guidelines for creating action

plans Revised Action Plan forms available

online at the Office of Healthy Carolinians website

Appendices


Accreditation Standards Essential Services

#1: Monitor health status to identify community health problems

#3: Inform, educate, and empower people about health issues

#4: Mobilize community partnerships to identify and solve health problems

#7: Link people to needed personal health services and assure the provision of health care when otherwise unavailable

#10: Research for new insights and innovative solutions to health problems

Accreditation Standards Benchmarks

#1: A Local Health Department (LHD) shall conduct and disseminate results of regular community health assessments.

#10: The LHD shall provide, support, and evaluate health promotion activities designed to influence the behavior of individuals and groups.

#11: The LHD shall convene key constituents and community partners to identify, analyze and prioritize community health problems/issues.

#12: The LHD shall develop strategies in collaboration with community partners to solve existing community health problems.

Accreditation Standards

Benchmarks cont. #13: The LHD shall identify and build upon

community assets and direct them toward resolving health problems.

#21: The LHD shall lead efforts in the community to link individuals with preventive, health promotion, and other health services.

#28: The LHD shall use research to develop and evaluate public health programs.

Accreditation Standards Additional Standards

Community health assessments should include: • Socioeconomic factors• Educational factors• Environmental factors

Analysis should include:• Trends• Comparison of local rates to state rates and HC 2010 objectives• Health priorities selection process

Reporting the assessment results to community should include at least 2 methods of communication directed each toward LHD stakeholders/community partners and general population (4 methods)

Accreditation ChecklistAccreditation Consolidated Agreement

Activity 1.1 – LHD shall conduct a comprehensive CHA every 48 months that includes

The Community Health Assessment (CHA) process shall

1.1.a Evidence of community collaboration in planning/ conducting assessment Be a collaborative effort with the local Healthy Carolinians partnership

1.1.b Reflect the demographic profile of population1.1.c Describe socioeconomic, educational & environment factors that affect health1.1.d Assemble/analyze secondary data to describe community health status

1.1.e Collect/analyze primary data to describe community health status Include collection of primary data at the county level

1.1.f Compile/analyze trend data to describe changes in community health status and factors affecting health

1.1.g Use scientific methods for collecting/analyzing data

1.1.h Identify population groups at risk1.1.i Identify existing and needed health resources1.1.j Compare selected local data with data from other jurisdictions

1.1.k Identify leading community health problems List of community health priorities based on CHA findings

Include a narrative of the assessment findings

Include community action plans to address the priorities issues.

Activity 1.2 LHD shall update CHA with an annual interim State of the County’s Health Report annually. The report shall demonstrate that the LHD is tracking priority issues identified in CHA, identify emerging issues, Identify new initiatives.

Activity 1.3 LHD shall disseminate results of most recent CHA and SOTCH report to LHD stakeholders/community partners and general populations. Two methods of dissemination each from stakeholders/community partners and two from general population required for CHA and SOTCH.

Appendices

A. Accreditation StandardsB. Sampling Guides-- A New Resource!C. Community Health Opinion SurveyD. Listening Session ToolkitE. Resource GuideF. Statistical Primers

SAMPLING GUIDES

Two easy-to-read sampling guides including introductory and two-stage cluster sampling instructions

Appendices


Community Health Opinion Survey

Includes pre-tested questions from previous CHA’s! Standardizes survey data collection! Saves time on survey question design!

Appendices


Listening Session Toolkit

Appendices


Resource Guide

Gives additional sources of all types of community data including environmental, educational, criminal, social, etc.

Changes: Website links updated August 2008 New resources added Reorganized by source, topic ,and

geographic level of detail (i.e.: state, county, regional)

Appendices


Statistical Primers

Provides instruction on: Age adjusted death rates Problems with rates calculated from small

numbers

Revised to include formulas, guidelines, definitions, and key points to remember

Questions?

Office of Healthy Carolinians Phone: (919) 707-5150 Email: [email protected] Website: www.healthycarolinians.org

Documents

Debi Nelson, Interim Director Office of Healthy Carolinians/Health Education February 5, 2009