1. Community Assessment: Using CHANGE (Community Health Assessment aNd Group Evaluation) to Understand Community Needs and Assets for Creating Healthier Communities ACHIEVE Action Institute April 25, 2012 Shannon Griffin-Blake (CDC) Rachael Banks (2012 Mentor – NACDD) National Center for Chronic Disease Prevention and Health Promotion Division of Community Health

2. Community Assessment: Using CHANGE (Community Health Assessment aNd Group Evaluation) to Understand Community Needs and Assets for Creating Healthier Communities Shannon Griffin-Blake, PhD Acting Director, CDC’s Healthy Communities Program (HCP) Program Services and Evaluation Team Lead, HCP Division of Community Health

3. Community Health Assessment aNd Group Evaluation (CHANGE) Background: Can assessment be a useful part of ACHIEVE process? How does local-level data assist you in your work? What is the value of assessing population-based strategies? How can CHANGE help inform your ACHIEVE efforts? CHANGE Action Guide: Step-by-step process Rachael Banks: 2012 Mentor - Oregon

4. CHART development & joint ownership Capture community snapshot (local-level data) Prioritize targeted action Population-based strategies Document success COMMITMENT ASSESSMENT PLANNING IMPLEMENTATION EVALUATE ACHIEVE PROCESS

5. ACHIEVE Program Why are we here? ACHIEVE’ing Multi-level Impact: Creating healthy environments Developing community support Influencing social norms Facilitating healthy behaviors Implementing high impact strategies

6. Why Population-Based Strategies? Build on lessons learned Want to see community- level change More sustainable Make the healthy choice, the easy choice!

7. Emerging Vision CHANGE Setting Priorities (Community Action Plan) >>>>>> Local Trends Existing Initiatives Community Assessment >>>>>>

8. ACHIEVE Process: Assessment What is a community assessment ? An examination of a community’s current assets, needs, resources, strengths, and challenges. Document community resources, infrastructures, relationships, and operations Identify potential areas for targeted action Build CHART consensus Strengthen team cohesion

9. Why are community assessments important? Consider existing community strengths that can be mobilized Identify gaps or areas for improvement Assist in making decisions about where to focus resources and interventions in order to maximally benefit the community Guide where CHART starts: Develop a common understanding and determine what factors are needed in order to track or monitor change Provide community ‘voice’ or insight into community context ACHIEVE Process: Assessment

10. “A community assessment process is not just a matter of surveying what people need, but it is a community organizing strategy. By rigorously and creatively assessing community needs, the process gives real ‘voice’ to individuals in the community…voices that can significantly influence program design.” Source: Chang, H. Drawing Strength from Diversity: Effective Services for Children, Youth, and Families. Los Angeles: California Tomorrow; 1994. Why complete a community assessment?

11. How to complete a community assessment? Use as CHART activity Operationalize CHART principles Create information sharing across team members Solidify decision-making Create community engagement and ownership ACHIEVE Process: Assessment

12. CHANGE Tool Purposes: 1)Capture current snapshot of the community 2)Group activity/consensus building CHA C ommunity H ealth A ssessment NGE CHANGE a N d G roup E valuation ( CHANGE )

13. CHANGE: Overview Frame and understand the current status of community health Provides a snapshot of policy, systems, and environmental strategie s (‘assets’ and ‘needs’) Move the community towards sustainable change Allows communities to track progress across a 5-point scale so incremental changes can be noted Prioritize community needs and consider appropriate allocation of resources Used annually to assess current strategies, chart progress and offer new priorities

14. CHANGE: Gathering Local-Level Data Establish baseline or starting point for ACHIEVE efforts Provide direct input to decision-makers about community needs Inform prioritization for Community Action Plan (CAP) development Can use annually for multiple observations to monitor and track progress Prepare for future opportunities

15. CHANGE: Benefits What have we learned… ‘helped coalition members get involved early’ ‘helped explained policy’ ‘changed how people think about policy’ ‘surprised by results’ ‘did not realize how important data can be for us’ ‘uncovered other assessments in my community we could tap into’

16. Rachael Banks Multnomah County Health Department ACHIEVE Mentor Coach CHANGE: Local Experience

17. Why CHANGE is Awesome! Framework to build on existing data Way to engage community and CHART Policy-focus, organizational changes Baseline and track progress Starts community conversation of success

18. Multnomah County CHANGE Story: –CHART formed due to health disparities data –Gathered existing reports, focus groups and coalitions –Compiled data and prioritized next steps to assess policy

19. Quotes from CHART “I kept engaged because I appreciated that upfront work was completed. The coaches honored the work already done without assuming we knew everything” -CHART member

20. Way to Honor Community Wisdom Community Engagement –CHART can prioritize sites –CHART can conduct assessments Observations in settings Windshield tours Focus groups –CHART can summarize findings

21. Data Along-Side Stories

22. Value of Policy Perspective Way to approach conversations with stakeholders Asks questions that raises awareness of importance of environment Provides range of options Tracks progress of policies over time

23. Shows Where You Are, Where You Can Be

24. You Can Do It! Utilize expertise of CHART Engage local community Use national resources Have fun, do more Build your legacy… and document it

25. CHANGE Action Guide Topics covered: 1.Data Collection (pages 13- 18) 2.Organizing and Using CHANGE Data (pages 32- 38) 3.Developing and Revising Your CAP (pages 39-40) 4.Evaluation and Reassessment (pages 43- 44) 5.CD-ROM: Resource List, Blank Worksheets, CHANGE Sector Excel Files Website: http://www.cdc.gov/HealthyCommunitiesProgramhttp://www.cdc.gov/HealthyCommunitiesProgram

26. CHANGE Action Guide CHANGE Action Guide proposes 8 step process

27. Step 1: Assemble Community Team CHARTs with broad participation from community leaders:

28. Step 2: Develop Team Strategy Deciding on how best to complete CHANGE sectors or sites: 1.Whole team 2.Splinter into smaller groups (2 or more members)

29. Step 3: Review 5 CHANGE Sectors

30. CHANGE CHANGE Tool 5 Sectors -- Community-At-Large: Includes community-wide efforts that impact the social and built environments, such as food access, walkability or bikeability, smoking bans, and personal safety. Places for assessment: Grocery store, restaurant, media, city/county government, community garden, neighborhood, park, downtown center, retail establishment/outlet, health department, police/sheriff department

31. CHANGE CHANGE Tool 5 Sectors -- Community Institution/Organization (CIO): Includes entities within the community that provide a broad range of human services and access to facilities Sites for assessment: Child care facility, faith-based institution (e.g., church, synagogue, mosque), YMCA, senior center, health and wellness organization, and college or university

32. CHANGE CHANGE Tool 5 Sectors -- Health Care: Includes places people go to receive preventive care or treatment, or emergency health care services Sites for assessment: Hospital, health department, private practitioner’s office, health maintenance organization (HMO), home health agency, or community clinic

33. CHANGE CHANGE Tool 5 Sectors -- School: Includes all primary and secondary learning institutions Sites for assessment: Elementary, middle and high school (whether private, public, charter, or parochial)

34. CHANGE CHANGE Tool 5 Sectors -- Work Site: Includes places of employment Sites for assessment: Private office, school, textile factory, restaurant, retail establishment/outlet, bank, health department, post office, or manufacturing company

35. ACHIEVE: CHANGE Completion CHANGE Completion: Community-At-Large Sector and minimum of 1 additional sector Minimum of 3 sites per additional sector

36. Step 4: Gather Data Determine what information you need to collect to better understand your community…and complete CHANGE. Example Methods: Survey data Community dialogue Photovoice Community audit and observation

37. Data Collection: Example Methods Health Care Sector Focus Group Observation: Checklist School Sector: Walkability Audit Photovoice Observation: PTA Meetings Historical document review Work Site Sector: Focus Group Historical document review Community-At-Large Sector: Face-to-Face Survey* Observation: Windshield Survey & Checklist Photovoice Walkability Audit Media Review Community Institution/Organization Sector: Focus group Historical document review Walkability Audit

38. Photovoice Community Strengths/Resources

40. Community Commons (Beta 2.0): Released March 13, 2012 New Starter Maps & Tutorials With a few clicks, you can create compelling interactive maps to tell your community story Useful tool for both those new to GIS and those experienced with mapping

41. Available at: http://communityhealth.hhs.gov

42. CHANGE Action Guide CHANGE Action Guide proposes 8 step process CHANGE Webinar: March 13, 2012

43. Step 5: Review Gathered Data Consistent use of CHANGE scale Determine item responses –Policy –Environment Document, document, document: Collect and maintain photos, checklists, and surveys in comprehensive data file

44. Step 6: Data Entry CHANGE Sector Excel Files Quantitative data: ‒ Item response selection ‒ 1-5 using scale Qualitative data: ‒ Comment boxes ‒ Documentation: Policy & environment responses

46. CHANGE Action Guide CHANGE Action Guide proposes 8 step process ACHIEVE Action Institute Workshop: April 25, 2012

47. Community Health Needs Assessment and Improvement Plans – Forces at Work Tax-Exempt Hospitals: Requirements for IRS –Conduct community health needs assessment & implementation strategy –Involve public health experts and engage community members Voluntary Public Health Accreditation through the Public Health Accreditation Board (PHAB) –For state, tribal, local and territorial health departments –Launched Fall 2011 –Requires a State/Community health assessment and State/ Community health improvement plan

48. Disclaimer The primary purpose of this training is to address policy options to improve public health. There is no intent to reflect a view on specific legislation. Recipients (and their sub-tier contractors) are prohibited from using appropriated Federal funds for lobbying.