Inventory Community needs & Resources John Prochaska, DrPH, MPH joprocha@utmb.edu

Learning Objectives To outline the value of participatory approaches to assessing community needs and resources To catalogue resources for secondary data relevant to assessing community needs and resources To discuss the utility of mapping in assessing community needs and resources

“Traditional” Approaches Researchers pre-define “problem” Little community involvement / paternalistic Researchers offer solutions, implement, evaluate and leave Programs are typically not feasible “real-world” solutions Communities Define problem within context Develop intervention Evaluation / measurement may not be adequate

Participatory Approaches – How To Goal – Community organization, capacity, capability to manage their own problems Functional unit – Community-researcher partnership Key – mutual say in the defining of the problem, development of the solution, distribution of resources Researcher should serve as organizer, technical advisor, and advocate Priority setting is a joint activity

How to (cont.) Typically start by getting familiar with the setting Develop contacts with key stakeholders, community informants, and the like Try to identify a “community champion” The person or persons who will serve as the initial (and potentially long-term) bridge between researcher and community Begin to examine context of the community How are problems defined and managed What role do various organizations play

How to (cont.) Consider various aspects of the community Health care arena Government Faith-based Educational Civic organizations Law enforcement Also, try to interact with individuals from various locations and with various affiliations Keep communicating w/ key stakeholders and community champion(s) Meet them on their turf

Open Communication Facilitates Trust COMMUNICATE COMMUNICATE Open Communication Facilitates Trust

How to (cont.) Conduct various assessment activities Ask questions about community issues that are important, what resources and strengths are in the community, who should be included that is “not here”, how has this community addressed past issues Get multiple perspectives Always remain cognizant of who is included and who is excluded / who is heard and who is not heard

Coalitions / Advisory Groups As the process develops, groups (or interactions between groups) will begin to form Might form from initial work by researcher Might already be in place, but needs strengthening / streamlining / modification Facilitates collective thought Serve as advisors, informers, the actual “doers,” etc. Also consider forming, or encouraging the formation of, groups of citizens not affiliated with various organizations – “regular folks” Gives additional voice to those who may be otherwise not heard

Process is Dynamic Nature of the process requires flexibility Communities are different Various time frames (hard to create timelines) Various personalities Communities (Bryan vs. College Station vs. New York City) Organizations (Cooperative Extension Agencies in various counties) Individuals (county judges, mayors, etc.)

Camping rules as applies to CBPR Always leave the site in better shape than when you arrive Before jumping into a river/lake, always investigate thoroughly (ask locals about stumps, overhangs, safe areas to “swim”) Not a good idea to leave fires burning when you leave with no one left to manage them or put them out

Is CBPR always the best approach? Not necessarily Very popular approach Many are conducting research under the title of CBPR, but are not Simply forming coalition to inform what is going on May be instances when not the best approach

(Cont.) Obvious emergent issue requiring fast response Flu epidemic, water quality issues, disaster response, STI outbreak, etc. However, community can still be involved Researcher identifies problem area Community helps to define determinates, ideas for feasible solutions, and helps w/ implementation Need to consider sustainability

Final Considerations When entering, interacting with, or simply visiting, please remember: This is someone’s home who is proud to live here and considers it a nice place It depends on where you are standing as to how dumb you are There is rarely a single best solution

Facilitated Process Personnel Materials Facilitator Scribe Note taker Flip charts and pens Maps (possibly) Handouts (brief 1 pagers, not extensive documentation)

Process Review assessment findings Highlight the top potential issues based on the data Use a participatory approach at ranking issues Consider available resources and funding, human resources, political will and potential barriers, economic impacts, cultural context, etc. Collective decision making ensuring as many voices are heard

Resources for Data and Assessments

Considerations with Data Source Boundaries State, Region, Zip Code, County, Census Tract Age Compared to other data sources Major events (Hurricane Ike) Benchmarks, Baselines, Relative Comparisons

Considerations With Analysis Geographic variance Areas of concentration Areas of great diversity Ratio / Denominator Comparison Group or Benchmark State & National level HP2020

Understand the Stakeholders

Full-On Community Assessment Demographics Health Indicators and Broader Determinants of Health Environmental Burdens Health Care Infrastructure, Access and Utilization Education Transportation Economy and Business Housing Government Social Services Faith-based Organizations Philanthropy and Power Brokers Social Capital Historical Considerations and Evidence of Past Collaboration Key Informants

Health Data Resources RWJF County Health Rankings http://www.countyhealthrankings.org Community Health Status Indicators http://wwwn.cdc.gov/CommunityHealth/homepage.aspx?j=1 DSHS County Reports http://www.dshs.state.tx.us/chs/cfs/Texas-Health-Facts-Profiles.doc Health Indicators Warehouse http://healthindicators.gov Census and American Community Survey (American FactFinder) http://www.census.gov 1115 Regional Assessments http://www.utmb.edu/1115/

Community Data Resources Census and American Community Survey Also grants access to economic and housing data Community Context Prizm http://www.claritas.com/MyBestSegments/Default.jsp?ID=20&menuOption=ziplookup&pageName=ZIP%2BCode%2BLookup Local media outlets Site visits & Key informants Other data sources USDA – http://www.ers.usda.gov/data-products/food-access-research-atlas.aspx EPA - http://www.epa.gov/myenvironment/ Dartmouth Atlas - www.dartmouthatlas.org

Full-On Community Assessment Demographics Health Indicators and Broader Determinants of Health Environmental Burdens Health Care Infrastructure, Access and Utilization Education Transportation Economy and Business Housing Government Social Services Faith-based Organizations Philanthropy and Power Brokers Social Capital Historical Considerations and Evidence of Past Collaboration Key Informants

Community mapping

Community Mapping Overview Purpose Information & Evidence Collection Informed Priority Setting Advocacy Community Empowerment

Approaches Varying scales of sophistication and technology Sketches Pre-developed paper maps, markers & stickers Online freeware Full-blown GIS development

Examples

Lessons Learned Must be a community-engaged process Local knowledge essential for data collection, interpretation, and movement towards action They will be the ones using it for their community’s benefit! Have structure, but realize this is a free-flowing process Reimburse participants for their time Intensive process Requires time/energy

Moving Forward Advocacy Technology Training & Dissemination of Methods Using data collected to create change in Port Arthur Technology Wii-Table Training & Dissemination of Methods