1. SAH Year 2: CHANGE Reassessment Shannon Griffin-Blake, Ph.D. Team Lead, Program Services and Evaluation CDC’s Healthy Communities Program National Center for Chronic Disease Prevention and Health Promotion Strategic Alliance for Health Action Institute April 29, 2010

2. CHAN GE CHANGE C ommunity H ealth A ssessment a N d G roup E valuation ( CHANGE ) Background How can CHANGE be a useful SAH tool? How can local level data assist you in your efforts? Why are we using the CHANGE tool? How best to complete CHANGE Reassessment? How can CHANGE data help revise SAH CAP? CHANGE Action Guide Background & introduction Step-by-step process

3. Achieving Multi-level Impact Socio-Ecological Model Institute of Medicine, 2003

4. Largest Impact Smallest Impact Factors that Affect Health Examples Eat healthy, be physically active Rx for high blood pressure, high cholesterol, diabetes Brief intervention for cessation treatment Socioeconomic Factors Changing the Context to make individuals’ default decisions healthy Long-lasting Protective Interventions Clinical Interventions Counseling & Education Poverty, education, housing, inequality 0g trans fat, salt, smoke-free laws, tobacco tax

5. CHANGE: Local-Level Data Provide direct input to decision-makers about community needs Establish baseline or starting point Use annually for multiple observations to monitor and track progress across SAH project period Inform prioritization for Community Action Plan (CAP) development

6. Using CHANGE on Annual Basis Action Plan Implement Evaluate

7. CHANGE Completion over SAH Project Period Yr. 1 Yr. 3 Yr. 5 Baseline 2009 Reassessment 3 2012 Reassessment 4 2013 Yr. 4 Yr. 2 Reassessment 1 2010 Reassessment 2 2011

8. CHANGE CHANGE: Overview Frame and understand the current status of community health Provides a snapshot of policy, systems and environmental change strategies (‘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

9. CHANGE Action Guide

10. CHANGE Action Guide proposes 8 step process

11. Step 1: Assemble Community Team Consortium with broad participation from community leaders:

12. 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)

13. Step 3: Review 5 CHANGE Sectors 5 Sectors: 1.Community: Includes community-wide efforts that impact the social and built environments; such as food access, walkability or bikeability, smoking bans, and personal safety. 2.Community-Based Institution (CBI): Includes entities within the community that provide a broad range of human services and access to facilities, such as childcare settings, faith-based organizations, senior centers, YMCAs, health and wellness organizations, boys and girls clubs, and colleges/universities. 3.Health Care: Includes places people go to receive preventive care or treatment, or emergency health care services; such as hospitals, private doctors’ offices, or community clinics. 4.School: Includes all primary and secondary learning institutions (e.g., elementary, middle and high schools, whether private, public, or parochial). 5.Work Site: Includes places of employment; such as private offices, restaurants, retail establishments, or government offices.

14. Step 3: Review 5 CHANGE Sectors Sectors: Minimum of 5 sites per sector Question: Have I lost any sites? Modules: Consider scope of questions Question: What is needed to gain insight into these questions? Data Collection Methods: Stay with same methods used in Year 1, but can supplement 2 or more methods per site

15. 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

16. Step 5: Review Gathered Data Review all data for each site Maintain consortium decision-making process Determine each item response Be consistent on using CHANGE scale Document, Document, Document - Using comment boxes

17. Step 6: Data Entry CHANGE Sector Excel files Quantitative Response: Item Response Selection (Scale) Qualitative Response: Comment Boxes for Item Documentation New CHANGE Summary Statement

18. SAH Timeline CHANGE Reassessment: May - July 2010 Revise CAP: August – September 2010 Submit Results in Annual Report: December 2010 MIS upload capacity for CHANGE Summary Statements: June 2010

19. Questions?