1. PATHWAYS TO PROGRESS Using Community-Based Research to Improve Rural Community Health Kenneth L. Stewart, Ph.D. Angelo State University
Presented to:
2017 Rural Health at the Crossroads Conference
Managing Challenges and Disparities in Rural Health
June 21-23, Amarillo Civic Center, Amarillo, Texas

2. Strategies for Development at Community Development Initiatives
The social health indexing project
Monthly pathways to progress
Community-Based Research
PARTICIPATE IN COMMUNITY RESPONSES

3. The Social Health Indexing Project
The San Angelo Social Health Index: The flagship of the project assesses social problems challenging development in San Angelo. The index provides historical comparisons going back to the year 2000.
The West Texas Violence Index: Assesses violent crime, domestic violence, and accidental deaths over a rolling five-year time frame. Compares San Angelo, Abilene, Midland, and Odessa.
The Children of San Angelo Social Health Index: Compares the quality of life for children living in the city’s 20 Census Tracts.
The Seniors of San Angelo Social Health Index: Measures the quality of life among elders in the city’s Census Tracts.
The San Angelo Neighborhood Development Index: Compares the city’s Census Tracts on key socio-economic development factors.
The ASU Women’s Health Index: Assesses the state of women’s health in San Angelo, Abilene, Midland, and Odessa. Expanding coverage to all West Texas metro areas.
The San Angelo Opportunity Index: A new addition to the Social Health Indexing Project assesses neighborhood characteristics supporting (or hindering) the socio-economic opportunity and success of residents.
Note:
These projects involve tracking, annually collecting, calculating, evaluating, and reporting 118 specific statistical data point about San Angelo and other communities in West Texas.
The different comparison frameworks – historical and geographic
Focus on various vulnerable populations - children, elders, women.
Idea to expand Women’s Index to all WT cities.

4. Opportunity Index Example Results

5. Monthly Pathways to Progress
Pathways to Progress is a monthly column published by the regional newspaper, the San Angelo Standard Times.
Frequent use of Social Health Indexing Project data.
Topical headlines for the first five months of thus year:
Rights for disabled move; more needed.
The importance of equal distribution.
Progress made in poverty fight.
Too much violence in West Texas cities.
Celebrate the good and address the bad.
The CDI page at ASU has an edited collection for
Note:
These materials along with Index reports, are supplied free-of-charge to community-based organizations – like a large business card for CDI.
Also note the importance of translating for public consumption.

6. Letter to the Editor: Spreading wealth isn’t progress
Not Everyone Loves Us!
Letter to the Editor: Spreading wealth isn’t progress
This nation’s liberal mob is obviously not happy with just their treacherous habit of academically dumbing down America’s youth by teaching falsified history laced with atheistic Darwinian fantasies devoid of constitutional and Judeo-Christian principles.
… professors [are] desperately trying to convince all Americans that equal distribution of wealth is an important pathway to progress even though most patriots know it is “progress” directly to the irresponsible rot of the socialistic swamp…
Still, numerous community-based organizations are using our products for:
Presentations, public outreach, education, and information.
Grant applications.
Planning, setting priorities, programming.
Discourse in the “public square.”

7. Community-Based Research Projects
2016 Regional Coordination Transportation Plan, Concho valley Transit District and Concho Valley Council of Governments.
2016 Analysis of Impediments to Fair Housing Choice, City of San Angelo.
A Survey on High School Equivalency and Adult Education and Literacy Service Needs in the Concho Valley, Howard College of San Angelo and the Concho Valley Workforce Development Board.
Health and Behavioral Health Needs of the Poor and Extremely Poor in West Texas, a community-based community health needs assessment in 20 West Texas counties, San Angelo Health Foundation and Methodist Health Ministries of South Texas.

8. Methodist Healthcare Ministries of South Texas
Health & Behavioral Health Needs of the Poor & Extremely Poor in West Texas
The generous support of
Methodist Healthcare Ministries of South Texas
and the San Angelo Health Foundation
made this project possible.
Principal Investigators
Kenneth L. Stewart
Community Development Initiatives
Susan McLane Project Coordinator
Cera Cantu Americorps vista Project assistant

9. Regions of the Study Area

10. Overview: County Health Profiles
Secondary Data:
Community Economic Background
Demographic Profile Featuring Vulnerable Populations
Community Health Status Profile
Survey of the Poor & Extremely Poor in West Texas
Gap Analysis & Identification of Health & Behavior Health Needs
County Level Prioritization of Health & Behavioral Health Needs

11. Survey of the Poor & Extremely Poor Instrument & Data Collection
Content Coverage
Demographic characteristics
Medical, dental, & mental health services access
Morbidity experiences
Obesity & related factors
Mental health & substance use
Immunization & preventative health screening
3 page, 32 item questionnaire yielding 178 variables
31 parallels to the 2013 Texas BRFSS
Community Engaged
Informal, face-to-face interviews in English or Spanish
145 Community Contacts
72 Collaborating Organizations
9 Group Training Sessions for Facilitators
64 Trained Community-Based Survey Facilitators
Community-Based Needs Prioritization

12. Survey of the Poor & Extremely Poor Proportional Sampling
County of Residence
Sample n
Sample Percent
ACS Percent
Coke 5
0.80%
0.86%
Concho 8
1.30%
1.18%
Crockett 16
2.70%
1.58%
Edwards
0.96%
Irion 3
0.50%
0.35%
Kimble 9
1.50%
2.21%
Kinney 19
3.20%
2.18%
Mason
3.44%
McCulloch 22
3.70%
1.39%
Menard 10
1.70%
1.28%
Mills
1.56%
Runnels 37
6.20%
5.64%
San Saba 13
2.20%
2.10%
Schleicher
1.89%
Sterling
Sutton 2
0.30%
0.74%
Tom Green
275
46.10%
43.45%
Upton 12
2.00%
1.40%
Val Verde
124
20.80%
26.48%
Poverty Status*
Extremely poor
280
46.9%
37.3%
Poor
278
46.6%
62.7%
*The total sample size is 597. Frequencies and percentages for the poor and extremely poor do not sum to 597 & 100% because of missing data.

13. Gap Analysis of Elevated Risk
Mention additional finding on access problems to dental health and behavioral health.

14. Ten Prioritized Needs for Tom Green County
Prevention to Reduce COPD
Reduction of PPH from Congestive Heart Failure
Health Needs of Children & Seniors
Prevention to Reduce Cancer
Reduction of PPH from Influenza & Pneumonia
Improved Case Management for Vulnerable Groups
Promotion of Healthy Living to Vulnerable Groups
Reduce Obesity in Vulnerable Groups
Reduction of PPH from Diabetes
Prevention to Reduce Heart & Vascular Diseases

15. Community Responses
The Concho Valley VISTA Placement Program: CNCS, ASU, San Angelo Health Foundation Collaboration.
A Texas Mission of Mercy Concho Valley Mobile Dental Clinic: Texas Dental Association Smiles Foundation Collaboration with Methodist Health Ministries Wesley Nurses for an annual mobile dental clinic event beginning in 2017.
Laura W. Bush Institute for Women’s Health Institute Hispanic Initiative: Project to develop a community collaboration expanding public education and outreach events for the regional Hispanic community.
The Concho Valley Children’s Advocacy Center Collective Impact Initiative: Project to build a collaborative network of community-based organizations providing child and family well-being services.
The Concho Valley Rural Housing Initiative: Concho Valley Community Action Agency project to develop public-private partnerships for affordable, safe housing for low-income persons living in rural areas.
The San Angelo Diabetes Coalition: Collaboration by ASU, the San Angelo Health Foundation, the city’s two regional hospitals, and the local FQHC to increase coordination of diabetes education and prevention services to the community.

16. Community Health Needs Assessment Website

17. Contact Information
Kenneth l. Stewart, Ph.D. Director, Community development initiatives Angelo state university San Angelo, Texas (325) | Internet |