SAH Year 2: CHANGE

ReassessmentShannon Griffin-Blake, Ph.D.

Team Lead, Program Services and EvaluationCDC’s Healthy Communities Program

National Center for Chronic Disease Prevention and Health Promotion

Strategic Alliance for Health Action InstituteApril 29, 2010

Community Health Assessment aNd Group Evaluation (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 GuideBackground & introductionStep-by-step process

Achieving Multi-level Impact

Socio-Ecological Model Institute of Medicine

, 2003

LargestImpact

SmallestImpact

Factors that Affect HealthExamples

Eat healthy, be physically active

Rx for high blood pressure, high cholesterol, diabetes

Brief intervention for cessation treatment

Socioeconomic Factors

Changing the Contextto make individuals’ default decisions healthy

Long-lasting Protective Interventions

ClinicalInterventions

Counseling & Education

Poverty, education, housing, inequality

0g trans fat, salt, smoke-free laws, tobacco tax

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

Using CHANGE on Annual Basis

Action

Plan

Implement

Evaluate

CHANGE Completion over SAH

Project Period

Yr. 1 Yr. 3 Yr. 5

Baseline2009

Reassessment 32012

Reassessment 42013

Yr. 4Yr. 2

Reassessment 12010

Reassessment 22011

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

CHANGE Action Guide

CHANGE Action Guide

CHANGE Action Guide proposes 8 step process

Step 1: Assemble Community TeamConsortium with broad participation from community leaders:

Step 2: Develop Team Strategy

Deciding on how best to complete CHANGE sectors or sites:

1. Whole team2. Splinter into smaller groups

(2 or more members)

Step 3: Review 5 CHANGE Sectors5 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.

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

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

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

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

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

Questions?