1. Debi Nelson, Interim Director Office of Healthy Carolinians/Health Education February 5, 2009

2. What is a Community Health Assessment?  Engages multiple organizations, agencies and community members  Informs action plans, decisions, funding requests, and interventions  Creates a positive environment for discussion and change A process by which community members gain an understanding of the health concerns, and health care systems of the community by identifying, collecting, analyzing, and disseminating information on community assets, strengths, resources, and needs.

3. Overview The Community Assessment Guidebook:  Guides you through eight phases as you complete a collaborative and comprehensive assessment  Encourages systematically engaging county residents in assessing local problems and assets

4. Eight Phases of Community Health Assessment Phase 1: Establish a Community Assessment Team Phase 2: Collect Community Data (primary/secondary) Phase 3: Collect and Analyze Your Community’s Health Statistics (state and local resources) Phase 4: Combining Your County’s Health Statistics with Your Community Data Phase 5: Solicit Community Input to Select Health Priorities Phase 6: Create a CHA Document Phase 7: Disseminate the Community Assessment Document to the Community Phase 8: Develop the Community Health Action Plans

5. Appendices A. Accreditation Standards B. Sampling Guides C. Community Health Opinion Survey D. Listening Session Toolkit E. Resource Guide F. Statistical Primers

6. CHA Timeline  CHA Report is due once every 4 years.  Each county assigned to a 4- year cycle  Due first Monday in December  CHA completed before accreditation  Community Health Action Plan forms due the 1 st Friday of June after CHA completed  Recertification scheduled the year after CHA  Annual SOTCH report issued every year during other 3 years

8. What is a SOTCH?  State-of-the-County’s Health Report  Identifies emerging issues Annual review of morbidity and mortality data  Highlights new initiatives Economic or political changes  Shows progress with priorities identified in the Community Health Assessment Keeps community informed  Required by the Consolidated Agreement and Accreditation Standards

9. What’s New in CHA?  Guidebook has been revised, reorganized, and updated (2008)  Available at the Office of Healthy Carolinians website and on CDOffice of Healthy Carolinians  Major revisions include:  tips and tools to improve data collection, analysis, and interpretation  additional guides to help you better understand the community assessment process

11. Eight Phases of Community Health Assessment Phase 1: Establish a Community Assessment Team Phase 2: Collect Community Data (primary/secondary) Phase 3: Collect and Analyze Your Community’s Health Statistics (state and local resources) Phase 4: Combining Your County’s Health Statistics with Your Community Data Phase 5: Solicit Community Input to Select Health Priorities Phase 6: Create a CHA Document Phase 7: Disseminate the Community Assessment Document to the Community Phase 8: Develop the Community Health Action Plans

12. Phase 1  Guides you through gathering a team of people who can represent the different viewpoints in your community  Changes  Updated tools and section wording to increase sensitivity and encourage team diversity

13. Phase 1: Establish a Community Assessment Team  Influential organization reps + community residents= Your Community Team!  Sample structure of CHA team: 1. Advisory group 2. Work group 3. Project Facilitator  Make a budget and secure funds for your Community Assessment

14. Example of Phase 1 Tools

15. Eight Phases of Community Health Assessment Phase 1: Establish a Community Assessment Team Phase 2: Collect Community Data (primary/secondary) Phase 3: Collect and Analyze Your Community’s Health Statistics (state and local resources) Phase 4: Combining Your County’s Health Statistics with Your Community Data Phase 5: Solicit Community Input to Select Health Priorities Phase 6: Create a CHA Document Phase 7: Disseminate the Community Assessment Document to the Community Phase 8: Develop the Community Health Action Plans

16. Phase 2  Step-by-step primary and secondary data collection from your community  Changes  Primary data requirements (see next slide)  Major overhaul of the survey section to include survey design and methodology  Listening Session Toolkit and Community Health Opinion Survey revised and moved to Appendix  Updated resources and contact info

17. PHASE 2: CHANGES

18. PHASE 2: NEW TOOL

19. Eight Phases of Community Health Assessment Phase 1: Establish a Community Assessment Team Phase 2: Collect Community Data (primary/secondary) Phase 3: Collect and Analyze Your Community’s Health Statistics (state and local resources) Phase 4: Combining Your County’s Health Statistics with Your Community Data Phase 5: Solicit Community Input to Select Health Priorities Phase 6: Create a CHA Document Phase 7: Disseminate the Community Assessment Document to the Community Phase 8: Develop the Community Health Action Plans

20. Phase 3  Leads you through secondary data collection from several resources  Changes:  More definitions, tip boxes and simple statistical examples and explanations  Reorganized to follow accreditation standards!  Removed County Health Data Book Worksheets  NC-CATCH -- a new, more user friendly resource for secondary data collection NC-CATCH

21. PHASE 3: CHANGES Keep track of accreditation standards as you follow along in the book!

22. PHASE 3: CHANGES Tip boxes provide definitions and step-by-step instructions on creating useful statistics and comparisons!

23. Eight Phases of Community Health Assessment Phase 1: Establish a Community Assessment Team Phase 2: Collect Community Data (primary/secondary) Phase 3: Collect and Analyze Your Community’s Health Statistics (state and local resources) Phase 4: Combining Your County’s Health Statistics with Your Community Data Phase 5: Solicit Community Input to Select Health Priorities Phase 6: Create a CHA Document Phase 7: Disseminate the Community Assessment Document to the Community Phase 8: Develop the Community Health Action Plans

24. Phase 4  Guides you on how to combine and interpret your community’s data from all sources.  Changes:  Reorganized to follow accreditation standards  Updated resources  Includes definitions for important health indicators

25. Eight Phases of Community Health Assessment Phase 1: Establish a Community Assessment Team Phase 2: Collect Community Data (primary/secondary) Phase 3: Collect and Analyze Your Community’s Health Statistics (state and local resources) Phase 4: Combining Your County’s Health Statistics with Your Community Data Phase 5: Solicit Community Input to Select Health Priorities Phase 6: Create a CHA Document Phase 7: Disseminate the Community Assessment Document to the Community Phase 8: Develop the Community Health Action Plans

26. Phase 5  Gives practical methods and suggestions on how to approach the community with assessment results  Changes:  More tips on how and where to present findings and how to publicize your community meeting  Selection of health priorities moved from Phase 6 to Phase 5 to emphasize community input  Problem Importance and Problem Prioritization Worksheets moved to Phase 5

27. Eight Phases of Community Health Assessment Phase 1: Establish a Community Assessment Team Phase 2: Collect Community Data (primary/secondary) Phase 3: Collect and Analyze Your Community’s Health Statistics (state and local resources) Phase 4: Combining Your County’s Health Statistics with Your Community Data Phase 5: Solicit Community Input to Select Health Priorities Phase 6: Create a CHA Document Phase 7: Disseminate the Community Assessment Document to the Community Phase 8: Develop the Community Health Action Plans

28. Phase 6  Guides you through creating the community assessment report.  Changes:  Formerly Phase 7  Now includes a sample outline with suggested data sources

29. Eight Phases of Community Health Assessment Phase 1: Establish a Community Assessment Team Phase 2: Collect Community Data (primary/secondary) Phase 3: Collect and Analyze Your Community’s Health Statistics (state and local resources) Phase 4: Combining Your County’s Health Statistics with Your Community Data Phase 5: Solicit Community Input to Select Health Priorities Phase 6: Create a CHA Document Phase 7: Disseminate the Community Assessment Document to the Community Phase 8: Develop the Community Health Action Plans

30. Phase 7  Advice on how to involve the community through strategic dissemination of the Community Health Assessment document  Changes:  This is a brand new section!!!  Includes a sample press release

31. PHASE 7: NEW TOOL

32. Eight Phases of Community Health Assessment Phase 1: Establish a Community Assessment Team Phase 2: Collect Community Data (primary/secondary) Phase 3: Collect and Analyze Your Community’s Health Statistics (state and local resources) Phase 4: Combining Your County’s Health Statistics with Your Community Data Phase 5: Solicit Community Input to Select Health Priorities Phase 6: Create a CHA Document Phase 7: Disseminate the Community Assessment Document to the Community Phase 8: Develop the Community Health Action Plans

33. Phase 8  Guides you through creating the Community Health Action Plan  Changes:  Revised guidelines for creating action plans  Revised Action Plan forms available online at the Office of Healthy Carolinians website Office of Healthy Carolinians

34. Appendices A. Accreditation Standards B. Sampling Guides C. Community Health Opinion Survey D. Listening Session Toolkit E. Resource Guide F. Statistical Primers

35. Accreditation Standards  Essential Services  #1: Monitor health status to identify community health problems  #3: Inform, educate, and empower people about health issues  #4: Mobilize community partnerships to identify and solve health problems  #7: Link people to needed personal health services and assure the provision of health care when otherwise unavailable  #10: Research for new insights and innovative solutions to health problems

36. Accreditation Standards  Benchmarks  #1: A Local Health Department (LHD) shall conduct and disseminate results of regular community health assessments.  #10: The LHD shall provide, support, and evaluate health promotion activities designed to influence the behavior of individuals and groups.  #11: The LHD shall convene key constituents and community partners to identify, analyze and prioritize community health problems/issues.  #12: The LHD shall develop strategies in collaboration with community partners to solve existing community health problems.

37. Accreditation Standards  Benchmarks cont.  #13: The LHD shall identify and build upon community assets and direct them toward resolving health problems.  #21: The LHD shall lead efforts in the community to link individuals with preventive, health promotion, and other health services.  #28: The LHD shall use research to develop and evaluate public health programs.

38. Accreditation Standards  Additional Standards  Community health assessments should include: Socioeconomic factors Educational factors Environmental factors  Analysis should include: Trends Comparison of local rates to state rates and HC 2010 objectives Health priorities selection process  Reporting the assessment results to community should include at least 2 methods of communication directed each toward LHD stakeholders/community partners and general population (4 methods)

39. Accreditation Checklist AccreditationConsolidated Agreement Activity 1.1 – LHD shall conduct a comprehensive CHA every 48 months that includes The Community Health Assessment (CHA) process shall 1.1.a Evidence of community collaboration in planning/ conducting assessment  Be a collaborative effort with the local Healthy Carolinians partnership 1.1.b Reflect the demographic profile of population 1.1.c Describe socioeconomic, educational & environment factors that affect health 1.1.d Assemble/analyze secondary data to describe community health status 1.1.e Collect/analyze primary data to describe community health status  Include collection of primary data at the county level 1.1.f Compile/analyze trend data to describe changes in community health status and factors affecting health 1.1.g Use scientific methods for collecting/analyzing data 1.1.h Identify population groups at risk 1.1.i Identify existing and needed health resources 1.1.j Compare selected local data with data from other jurisdictions 1.1.k Identify leading community health problems  List of community health priorities based on CHA findings  Include a narrative of the assessment findings  Include community action plans to address the priorities issues. Activity 1.2 LHD shall update CHA with an annual interim State of the County’s Health Report annually. The report shall demonstrate that the LHD is tracking priority issues identified in CHA, identify emerging issues, Identify new initiatives. Activity 1.3 LHD shall disseminate results of most recent CHA and SOTCH report to LHD stakeholders/community partners and general populations. Two methods of dissemination each from stakeholders/community partners and two from general population required for CHA and SOTCH.

40. Appendices A. Accreditation Standards B. Sampling Guides-- A New Resource! C. Community Health Opinion Survey D. Listening Session Toolkit E. Resource Guide F. Statistical Primers

41. SAMPLING GUIDES Two easy-to-read sampling guides including introductory and two-stage cluster sampling instructions

42. Appendices A. Accreditation Standards B. Sampling Guides C. Community Health Opinion Survey D. Listening Session Toolkit E. Resource Guide F. Statistical Primers

43. Community Health Opinion Survey Includes pre-tested questions from previous CHA’s! Standardizes survey data collection! Saves time on survey question design!

44. Appendices A. Accreditation Standards B. Sampling Guides C. Community Health Opinion Survey D. Listening Session Toolkit E. Resource Guide F. Statistical Primers

45. Listening Session Toolkit

46. Appendices A. Accreditation Standards B. Sampling Guides C. Community Health Opinion Survey D. Listening Session Toolkit E. Resource Guide F. Statistical Primers

47. Resource Guide  Gives additional sources of all types of community data including environmental, educational, criminal, social, etc.  Changes:  Website links updated August 2008  New resources added  Reorganized by source, topic,and geographic level of detail (i.e.: state, county, regional)

48. Appendices A. Accreditation Standards B. Sampling Guides C. Community Health Opinion Survey D. Listening Session Toolkit E. Resource Guide F. Statistical Primers

49. Statistical Primers  Provides instruction on:  Age adjusted death rates  Problems with rates calculated from small numbers  Revised to include formulas, guidelines, definitions, and key points to remember

50. Questions? Office of Healthy Carolinians  Phone: (919) 707-5150  Email: hcinfo@ncmail.nethcinfo@ncmail.net  Website: www.healthycarolinians.orgwww.healthycarolinians.org