Presentation on theme: "Mesa County Community Health Needs Assessment- A Case Study"— Presentation transcript:
1 Mesa County Community Health Needs Assessment- A Case Study Setting Benchmarks for the Community Health Improvement Plan
2 Context Health Leadership Consortium (since 2007) Colorado Public Health Act & PPHR (2008)Dartmouth Atlas (2009)Mesa County Health Department Advanced Practice Center -Blueprint for the Use of Volunteers in Hospitals and Rural Medical Centers (2009) (health.mesacounty.us/MesaAPC)Reorganization (2010); New Director (Jan. 2011)Health Informatics Program (Summer 2011)
4 Continuous Quality Improvement (CQI) Model Mesa CountyContinuous Quality Improvement (CQI) Model
5 Creating a Community Health Improvement Model MAPP???
6 Considering everything else? Merging MAPP Phases with “local strategies” and research.Colorado Health Assessment and Planning System (CHAPS)Precede- ProceedModel PhasesCommunity Assessments
7 Aligning the approaches LHD System AssessmentNPHPSPData Collection and Community Resource InventoryCommunity Assessments:Schools Local Services Plan (3yr)Bridges out of Poverty (2009)Hospitals (3yr)United Way (2005, as needed)Community Health Needs Assessment (CHNA)Community Themes Assessment“Forces of Change”Drivers, Resources, Integrated DataPrecedePhase 1-3CHAPS IIICHAPS IVCHAPS II
8 Considering MAPPMobilizing Action for Partnerships and Planning (MAPP)
13 CHNA Process Data Collection and Community Resource Inventory Over 250 indicatorsAligned with State/National BenchmarksIdentify relevant community coalitions,non-profits and governmental organizationsData Collection and Community Resource InventorySteering CommitteeSubject Matter Content Focus GroupsCommunity Focus GroupsCHNA Final ReportCommunity Health Needs Assessment (CHNA)Community Health Improvement Plan
14 34 Measures Where Mesa County Ranks Below Colorado Child abuse rates • Juvenile property crime rates • Live births where mothers gained an appropriate amount of weight • Incidence of invasive cancer • Incidence of cancer of the lung and bronchus • Incidence of invasive cancer of the cervix • Incidence of invasive cancer of the prostate • Salmonella incidence • Motor vehicle hospitalization • Percent of adults 18+ who are obese • Suicide hospitalizations • Percent of adults 18+ with arthritis • Heart attack hospitalizations • Number of homes tested for radon • Children who were physically active in the past 7 days • Adults who currently smoke cigarettes • Women who smoked during the last three months of pregnancy • 3rd grade children with caries • Women who experienced major stress before delivery • High school student that felt sad or hopeless • Students who considered suicide • Women who drank alcohol during the last three months of pregnancy • High school drinking • Adults with poor health • Poor physical health • Poor mental health • Adults who visited the dentist • Adults who have had a flu shot • Adult cholesterol screening • Papanicolaou smears • Adult FOBT screening • Influenza hospitalizations • major congenital anomalies • Adults who have asthma
15 What are your “Priority Areas” Mental HealthUnintended PregnancyPrenatal HealthTobacco UseObesityFamily Abuse and ViolenceScreeningOral HealthSexually Transmitted Disease’sUnintended Injuries
16 CHNA- Who Steers the Ship? City Of Grand JunctionColorado West Regional Mental HealthCommunity HospitalFamily Health WestHilltopMarillacMesa County 211Mesa County Department of Human ServicesMesa County Health DepartmentMesa County Local Emergency Planning Committee (LEPC)Mesa County School District #51Mesa Developmental Services, Inc.St. Mary's Hospital
18 Using Content Focus Groups Discussion during the focus groups covered:Mental HealthObesityMaternal and Child HealthFamily Abuse and ViolenceTobacco UseScreening and Early Detection
19 Using Content Focus Groups Selected membership representing :Subject Matter ExpertsHealth Care ProfessionalsLocal Coalition MembersResidents who have been directly or indirectly affectedDraft legislation Public Health revitalization actStandardize delivery of public health services across the state in each county. If you are new to MC and it seems like public health in MC is different than the county you came from that is true!
20 Using Content Focus Groups Identify determinants of behaviors and environmental factorsIdentify community resources and gapsSuggest additional dataRecommend possible areas for program/policy implementation and/or public health improvementsDraft legislation Public Health revitalization actStandardize delivery of public health services across the state in each county. If you are new to MC and it seems like public health in MC is different than the county you came from that is true!
21 Align with Colorado “Winnable Battles” Clean AirClean WaterInfectious Disease PreventionInjury PreventionMental Health and Substance AbuseObesityOral HealthSafe FoodTobaccoUnintended Pregnancy
22 6 Priorities to 3 Winnables Steering Committee PrioritiesMesa County Winnable BattlesMental HealthFamily Abuse and ViolenceMaternal and Child HealthObesityTobacco UseScreening and Early DetectionUnintended PregnancyObesitySuicide
23 “Stories” Unintended Pregnancy “First Trimester issues need to be addressed- alcohol, smoking, and access to primary care.”“Evaluation of current programs and their outcomes is needed.”“Mesa County rates for unintended pregnancy among teens need to address the lack of teen sexual health education and ethnic factors.”
24 Data Source: Epidemiology, Planning, and Evaluation Branch, CDPHE
26 “Stories” Obesity“Severe Needs Schools (those with a large number of students that are at 185% of FPL) and the “Working Poor” are part of the target population.”“There needs to be a community-wide effort to address this issue- the issue of “healthy minded” parenting.”“Incentives are weak in light of the perceived costs/time/effort required to maintain healthy behaviors.”
29 “Stories” Suicide“Substance use/abuse is a contributing factor in the majority of the cases. The likelihood of intervention decreases as poverty increases.”“Early reporting of annual figures show 2011 rates (of child and partner abuse) increasing over 2010.”“ Most services are currently response-based and public awareness for early intervention is beginning to grow.”“Stress, anxiety, depression, and substance abuse need to be addressed with collaborative efforts. Training and resources in the county seem to be lacking alignment.”
30 Data Source: 2010 Coroner’s Report, Mesa County
31 Social Determinants: Obesity Behaviors / EnvironmentActivityNutritionDeterminantsParenting skillsVideo games/TV in place of physical activityParents have no timeAvailability of resourcesSelf esteemAwareness of resourcesPerceived consequencesPerception of cost of healthy foodsFragmented prevention/intervention efforts
32 Social Determinants: Suicide Behaviors / EnvironmentSubstance AbuseDepressionSense of ControlDeterminantsAwareness of resourcesParentingSelf esteemAvailability of resourcesCoping skillsEconomyStigma associated with seeking helpFragmented prevention/intervention efforts
33 Social Determinants: Unintended Pregnancy Behaviors / EnvironmentSmoking during pregnancyUnprotected sex in teensSubstance use during pregnancyDeterminantsParentingPeer pressureSelf esteemAwareness of resourcesPerceived susceptibilityPerceived consequencesCoherent communicationFragmented prevention/intervention efforts
34 Common Determinants Parenting Availability of resources Self esteem Awareness of resourcesPerceived consequencesFragmented prevention/intervention effortsCoherent communicationPerceived norms
35 Work toward efforts to… Address parents’ role in children's health and well beingCommunicate, over and over, the existence of key community resourcesIdentify and align community resources: when many programs work independently to address an issue, those agencies compete for clients and resourcesImplement continuous, far-reaching campaigns to address social norms, perceived consequences, and perceived benefits
36 Efforts must be… Sustainable Consistent Collaborative Frequent AppealingAppropriateAccessibleHighly Visible
37 Target Population Considerations Families at or below 200% of Federal Poverty Level (Obesity, Unintended Pregnancies, Unhealthy Pregnancies, Domestic Violence)Hispanic Teens (Unintended Pregnancies)Young and Middle Age Males (Suicide)Other?
38 Infrastructure Implications Community Health Improvement plan will include recommendations for:Continued Assessment and Evaluation: County Data and Information Advisory Consortium (CODIAC).Defining improvements in “Partnerships” that result in alignment and prioritizationWorking with the community to develop sustainability plans for programs that are demonstrating success.Evidence-based practices to address issues
39 5 year Improvement Cycle Population Health Advisory Committee will oversee all 3 Winnable Battle initiativesSuicide Prevention Summit“LiveWell” obesity campaign to address “Health Eating and Active Living” (HEAL)Teen Sexual Health and Pregnancy Prevention Coalition
40 CQI: Lessons LearnedKnow your data- where it comes from and what is importantIndicators- do you gather local data?Steering Committee for Needs Assessment and Data ReviewPopulation Health Advisory Committee to guide “Improvement” processes over the long run“Prioritization”- quantitative vs. “thumbs up”Health Informatics Infrastructure?
41 Thank You Comments/Questions/Suggestions: MesaAPC@mesacounty.us
42 ReferencesPrint Sources: Havlik, D.M. (2010). Mesa County Coroners Office. Suicide in Mesa County Electronic Sources: Colorado Department of Human Services. (2011). Retrieved September 2011, from Colorado Department of Public Health and Environment 2007 Child Health Survey. (2007). Retrieved May 2011, from Colorado Health Data: Regional Health Profiles. (2010). Retrieved May 2011, from Colorado Health Information Dataset. Retrieved May 2011, from Community Health Needs Assessment: Bridges Out of Poverty. (2009). Retrieved October 2011, from Injury Hospitalization Statistics. (2009). Retrieved August 2, 2011, from Mesa County Maternal Child Health Dataset (2009). Retrieved May 2011, from Mesa County Youth Risk Behavior Survey. (2007). Retrieved May 2011, from Omni Institute. Retrieved May 2011, from Pregnancy Risk Assessment Monitoring System. (2009). Retrieved June 9, 2011, from US Census Bureau American FactFinder. (2009). Retrieved June 3, 2011, from