Community Health Program Planning

Community Health: Module II - FA Davis Chapters 4 & 5

• This module covers community health assessments, focusing on population health.
• Six approaches to community health assessment are discussed in the lecture notes.
• Assessment frameworks are also detailed.
• Secondary data analysis is highlighted.
• Methods to gather primary data using qualitative and quantitative techniques are detailed.
• The importance of using multiple tools and techniques in conducting assessments is emphasized.
• The usefulness of implementing community assessments is also explained.
• A hypothetical community assessment using an assessment framework is outlined.
• Analysis of primary and secondary data is presented to identify strengths and needs within a community.

Learning Outcomes

• Defining community health assessment within the context of population health is a core outcome.
• The description of six approaches to conducting an assessment is crucial.
• Understanding assessment frameworks is vital.
• Utilizing secondary data to identify a community's health characteristics is also highlighted.
• The ability to describe qualitative and quantitative methods for collecting primary data is also essential.
• Learning about multiple techniques and tools used for community assessments is explained.
• The usefulness of assessing communities is described.
• Conducting hypothetical assessments is one key aspect explored.
• Analyzing data to determine the strengths and needs of a community is also a key consideration.

Community Health Assessment

• A community health assessment is a strategic plan for understanding the health of a community.
• Data gathering, analysis, and use to inform community understanding and action are emphasized.
• Priorities are defined and resources are recognized.
• Actions to address community health needs are crucial.
• Assessments are crucial functions of public health systems.
• Development of policies, interventions, and programs are identified.

Conducting a Community Health Assessment

• Defining skills and competencies for effective community assessment.
• Essential skills include appropriate health indicator selection and effective data collection methods.
• Data evaluation and interpretation, with identifying and utilizing data gaps, are emphasized.

Health of a Community

• Three critical characteristics are described to assess the health of a community.
• These criteria include health status, community structure (demographics and available resources), and competence (community functioning effectiveness).

Effective Community Functioning

• Community competence measures, conflict containment/resolution, participant interaction, decision-making, and management of community relationships are highlighted.
• Community participation, local service usage, self-/other awareness, and effective communication are key elements for effective community functioning.

Purpose of Community Assessment

• Gathering information about community health is a primary goal.
• Identifying areas for action is required, resulting in improved community health.
• The first step in health planning using a community baseline assessment is emphasized.
• The process supports health program evaluation.

Types of Assessments

• Different types of community assessments are described.
• These include comprehensive, population-focused, setting-specific, problem-based, health impact, and rapid needs assessments.

Assessment Types

• A comprehensive assessment investigates community assets, unmet needs, and improvement opportunities, collecting data on community demographics, health status, and services.
• Health status and needs of the community are critical parts of this assessment.

Population-Focused Assessment

• A population-focused assessment defines a large group based on common characteristics like age, gender, ethnicity, residency, and presence of common health issues.
• Examples of populations include pregnant women in a community, individuals aged 65 with diabetes, and immigrants from a specific country of origin.

Setting-Specific Assessments

• An assessment focused on the specific setting’s assessment of its own strengths and weaknesses in terms of policies and programs.
• Who are the people within the settings, identifying unique data relating to the community.

Problem-Based or Health Issue Assessments

• Centered on identifying pertinent health issues, prioritizing at-risk populations, and a critical analysis of the environment, policies, and practices relevant to the specific issue.
• Identifying those at risk is highlighted.

Community Assessment/Nursing Process

• The steps involved in community assessment are presented, comparing the process to a similar nursing process.

Assessments (Further Detail)

• Health impact assessments focus on measures put in place to protect community health; policies, plans, and projects are key features of this assessment.
• Outcomes include the ability to actively engage participants.
• Decision-makers and the development of health-related decisions are highlighted.
• Tools to evaluate the effect of public health-related interventions are reviewed.
• The assessment includes a shift toward recognizing strengths and maximizing support for community development.

Asset Assessments

• The positive aspects, capacities, and resources of a community are identified through an asset map.
• Community assets are mapped, including people in the community, places (geographic areas) within the community, and systems (organizations and institutions).

Engaging Community-Based Participatory Research (CBPR)

• CBPR is emphasized as an approach for community health assessments, wherein members take active roles and highlight expertise and interest.
• It is a collaborative approach that acknowledges expertise, and a shared interest to build community capacity.
• CBPR benefits, including contribution equity, research and action balance, cultural competence, and an engaged community change process, are explored and emphasized.

CBPR - Continued

• Key goals and essential principles of CBPR are also introduced, with a focus on community benefit, capacity building, partnership, involvement, evaluation, fairness, representation, and sensitive data dissemination.

Assessment Models and Frameworks

• The CHANGE and MAPP models for community health evaluation are reviewed, highlighting their benefits and practical steps.
• There are several assessment frameworks, and they are vital to choosing the appropriate approach during data collection.
• CHANGE and MAPP models are emphasized for their comprehensive approach to community health planning.

Community Health Assessment and Group Evaluation (CHANGE) Model

• The CDC's CHANGE model, based on the socioecological model, guides communities with developing action plans, identifying resources, and evaluating intervention effectiveness, and includes an evaluation plan.

CHANGE Model - Continued

• This model aids community members in completing an assessment.
• Action plans stem from community assessment and are prioritized in community health needs.
• Community activities are structured and coordinated around common goals.

Mobilizing for Action through Planning and Partnerships (MAPP) Model

• This model guides community health improvement through a multi-step process involving partnerships, assessment, issue identification, and goal setting.

Comprehensive Community Health Assessment

• MAPP and CHANGE are highlighted as assessment blueprints useful in community health assessment.

Importance of Data Collection

• Both primary and secondary data collection methods are vital, with primary data being obtained by the evaluation team in the current situation or by analyzing historical data.
• Secondary data could include previous census data.
• A windshield survey provides primary data about the community, including identifying vital issues, people living in the community, and resources that are available to the local area.

Primary Community Assessment

• Detailed characteristics of assessing communities are described, including various methods, like neighborhood associations, educational institutions, and places of worship.

Preliminary Observational Data

• A CHANGE model to gather data includes surveying different sectors, collecting information on resources (such as schools and health centers), and conducting questionnaires to get data on the issues.
• Numerical and categorical data collection is essential to understanding community issues.

Conducting a Survey

• Specific steps in survey methodology such as defining the sample, selecting data collection methods, and defining the items included in community surveys are detailed.
• Both primary and secondary data are explained with importance to community assessments.

Secondary Data Not Specific to Individuals

• Data related to the environment, like environmental pollutants, traffic volume, and community resources like farmers' markets and hospitals, are essential in community assessments.

Primary Community Health Data Collection

• The importance of identifying gaps in existing secondary information is paramount.
• Approaches to fill these gaps through multiple methods are explored.
• Resource inventory is equally important, supported by quantitative data sources like surveys and qualitative data gathering methods.

Qualitative Data

• A detailed explanation of diverse methods of collecting qualitative community-based data is provided, including conducting interviews (especially focus groups), involving key informants, and using photo voice techniques (where community members photograph their lives in the context of the community itself).

Additional Survey Tools

• Community mapping is utilized to visualize issues, identify populations at risk, and describe the scope of community health issues.
• Geographic Information Systems are explained with the collection of data that can be stored, retrieved, and used for analysis to show trends.

Analysis of the Data

• Data analysis helps establish a clear understanding of the community's health issues based on findings from collected data.
• Comparisons with other communities are essential for analysis and contextualization.
• Identifying trends helps in the interpretation of the collected information and the prioritization of public health concerns in assessing and addressing community health issues (also known as contextual analysis).

Post-Assessment Phase

• Including stakeholders in the review process of an assessment to prioritize actions is emphasized.
• Stakeholder validation is an important step in community planning.

Questions to Review

• A community health assessment is a critical ongoing process, involving analysis of community health data to develop needed interventions.
• A windshield survey refers to direct observation of issues and resources within a community.

Correct Answers

• Detailed explanations on community assessment as an ongoing process and the concept of a windshield survey.

Types of Assessments

• Various community health assessment types (comprehensive, population-focused, setting-specific, issue-based, health impact, needs-based).

Identifying Primary Health Issues

• The importance of leveraging tools to identify primary health issues such as assessment tools, health rankings, national standards, and previous community programs to identify the priorities of the community.

Logic Model: Driving Design - Moving in Logical Order

• A logic model is introduced.
• It visualizes the steps in program design using five steps.

Logic Model - Basic Logic Model

• Steps to create a basic logic model (including inputs, activities, outputs, outcomes, and impact) are visualized.

St. Louis Project: Protecting Vulnerable Populations in the Event of Disaster

• Inputs, activities, outputs, outcomes, and evaluation steps are detailed in this project.

Healthy People (HP) 2030 and Beyond

• A description of the intention to guide and set plans for a community.
• Planning, implementing, and evaluating public health interventions for communities.

MAPIT

• A community-focused approach to achieving national health objectives.
• Leveraging national resources and tools to promote national health goals.
• Detailed steps for mobilizing community resources to reach health promotion goals are included.

Program Planning Models

• The basic models used for health program planning are described (PRECEDE/PROCEED, MAPP, CHANGE, and Logic models).

Program Planning: Precede-Proceed Model

• Precede and proceed models are detailed.
• Steps in community planning for a specific issue.
• Predisposing, reinforcing, and enabling factors for effective interventions are identified.

Precede-Proceed Model - Continued

• The stages and context of this multifaceted model.
• The focus is on consulting the community for a clear understanding of their resources and needs.

Precede 4 Phases (Community Assessment)

• Phase 1 and 2, including identifying desired outcomes and determinants of these issues.
• Phase 3, describing predisposing, enabling, and reinforcing factors affecting the prioritization process.
• Phase 4, identifying factors for implementation.

Proceed 4 Phases

• Detailed steps in the program design, implementation, and evaluation stages of the multi-phase assessment process.

MAPP Tool

• This tool offers an inclusive approach to planning and engaging communities.

CHANGE Model

• The importance of utilizing assets and areas for development to improve communities.
• Engaging community members, and working towards program implementation.

Classic Example

• A specific example of achieving an overall health improvement outcome through behavior changes to address the problem of increased smoking prevalence, improving quality of living for community members.

What do these do? (Identifying Primary Health Issues)

• Identifying the primary health concerns of a community.
• Utilizing tools like community health assessments, MAPP, health rankings, and national standards to pinpoint specific issues.

Logic Model: Driving Design - Moving in Logical Order and Basic Logic Model Visualization

• Illustrating program planning by using a visual (logic model) showing the linkages between different aspects of a community project, showing how resources lead to activities producing outputs and then outcomes.
• Showing the inputs, activities, outputs, outcomes, and impacts.

Evaluating health programs in a community

• This part of the slides discusses the different types of evaluation, how these are used for developing effective programs within communities, and how these evaluations are used for continuing and improving community health programs.

Formative Evaluation

• Describes ongoing evaluation strategies, and ongoing feedback opportunities.
• This provides helpful data and information for making changes.

Process Evaluation

• Explains how evaluations can be conducted to establish the effective implementation of programs.

Summative Evaluation

• Explains the purpose and methods used for program outcome evaluation, offering an assessment of the impact.

Formative vs. Summative Evaluations

• Differentiates formative from summative evaluation styles of community health assessments.

Question: Program Goals

• Briefly outlines the true/false question about whether community planning goals are able to be measured and what factors play a role in these evaluations..

Question: When Does Formative Evaluation Occur?

• Question covering the timing of formative evaluation. This part covers the different times when evaluation can happen within program design and implementation.

Answer: Formative Evaluation Question Response

• The response to the multiple choice question on when formative evaluation occurs.

Community Tool Box Examples

• Website sources providing specific examples.