Community Health Assessment aNd Group Evaluation

Community Assessment: Using CHANGE (Community
Health Assessment aNd Group Evaluation) to
Understand Community Needs and Assets for Creating
Healthier Communities
Shannon Griffin-Blake (CDC)
Rachael Banks (2012 Mentor – NACDD)
ACHIEVE Action Institute
April 25, 2012
National Center for Chronic Disease Prevention and Health Promotion
Division of Community Health
Community Assessment: Using CHANGE
(Community Health Assessment aNd Group Evaluation)
to Understand Community Needs and Assets for
Creating Healthier Communities
Shannon Griffin-Blake, PhD
Acting Director, CDC’s Healthy Communities Program (HCP)
Program Services and Evaluation Team Lead, HCP
Division of Community Health
Community Health Assessment aNd
Group Evaluation (CHANGE)
Can assessment be a useful part of ACHIEVE process?
How does local-level data assist you in your work?
What is the value of assessing population-based strategies?
How can CHANGE help inform your ACHIEVE efforts?
CHANGE Action Guide:
Step-by-step process
Rachael Banks:
2012 Mentor - Oregon
• CHART development & joint ownership
• Capture community snapshot
(local-level data)
• Prioritize targeted action
• Population-based strategies
• Document success
Why are we here?
ACHIEVE’ing Multi-level Impact:
Creating healthy environments
Developing community support
Influencing social norms
Facilitating healthy behaviors
Implementing high impact strategies
Why Population-Based Strategies?
• Build on lessons learned
• Want to see communitylevel change
• More sustainable
• Make the healthy choice,
the easy choice!
Emerging Vision
Setting Priorities
Action Plan)
ACHIEVE Process:
What is a community assessment?
An examination of a community’s current assets, needs,
resources, strengths, and challenges.
• Document community resources,
infrastructures, relationships, and operations
• Identify potential areas for targeted action
• Build CHART consensus
• Strengthen team cohesion
ACHIEVE Process:
Why are community assessments important?
• Consider existing community strengths that can be
• Identify gaps or areas for improvement
• Assist in making decisions about where to focus
resources and interventions in order to maximally benefit
the community
• Guide where CHART starts: Develop a common
understanding and determine what factors are needed
in order to track or monitor change
• Provide community ‘voice’ or insight into community
Why complete a
community assessment?
“A community assessment process is not just a
matter of surveying what people need, but it is a
community organizing strategy. By rigorously
and creatively assessing community needs, the
process gives real ‘voice’ to individuals in the
community…voices that can significantly
influence program design.”
Source: Chang, H. Drawing Strength from Diversity: Effective Services for Children, Youth, and Families. Los
Angeles: California Tomorrow; 1994.
ACHIEVE Process:
How to complete a community assessment?
• Use as CHART activity
• Operationalize CHART principles
• Create information sharing across team
• Solidify decision-making
• Create community engagement and
Community Health Assessment
aNd Group Evaluation (CHANGE)
CHANGE Tool Purposes:
1) Capture current snapshot of the
Group activity/consensus building
CHANGE: Overview
• Frame and understand the
current status of community
• Provides a snapshot of policy,
systems, and environmental
strategies (‘assets’ and
• 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
Gathering Local-Level Data
• Establish baseline or starting point for
ACHIEVE efforts
• Provide direct input to decision-makers
about community needs
• Inform prioritization for Community Action
Plan (CAP) development
• Can use annually for multiple observations
to monitor and track progress
• Prepare for future opportunities
CHANGE: Benefits
What have we learned…
• ‘helped coalition
members get involved •
• ‘helped explained
• ‘changed how people
think about policy’
‘surprised by results’
‘did not realize how
important data can be
for us’
‘uncovered other
assessments in my
community we could
tap into’
Rachael Banks
Multnomah County Health Department
ACHIEVE Mentor Coach
CHANGE: Local Experience
• Framework to build on existing
• Way to engage community and
• Policy-focus, organizational
• Baseline and track progress
• Starts community conversation
of success
Multnomah County
– CHART formed due to health disparities data
– Gathered existing reports, focus groups and
– Compiled data and prioritized next steps to
assess policy
Quotes from CHART
“I kept engaged because I appreciated that
upfront work was completed. The coaches
honored the work already done without
assuming we knew everything” -CHART member
Way to Honor
Community Wisdom
• Community Engagement
– CHART can prioritize sites
– CHART can conduct
• Observations in settings
• Windshield tours
• Focus groups
– CHART can summarize findings
Data Along-Side
Value of Policy
• Way to approach conversations
with stakeholders
• Asks questions that raises
awareness of importance of
• Provides range of options
• Tracks progress of policies over
Shows Where You Are,
Where You Can Be
You Can Do It!
• Utilize expertise of
• Engage local community
• Use national resources
• Have fun, do more
• Build your legacy… and
document it
CHANGE Action Guide
Topics covered:
1. Data Collection (pages 1318)
2. Organizing and Using
CHANGE Data (pages 3238)
3. Developing and Revising
Your CAP (pages 39-40)
4. Evaluation and
Reassessment (pages 4344)
5. CD-ROM: Resource List,
Blank Worksheets,
CHANGE Sector Excel Files
CHANGE Action Guide
CHANGE Action Guide
proposes 8 step process
Step 1:
Assemble Community Team
CHARTs with broad participation from community leaders:
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)
Step 3:
Review 5 CHANGE Sectors
5 Sectors -Community-At-Large:
Includes community-wide efforts that impact
the social and built environments, such as
food access, walkability or bikeability,
smoking bans, and personal safety.
Places for assessment:
Grocery store, restaurant, media, city/county
government, community garden,
neighborhood, park, downtown center, retail
establishment/outlet, health department,
police/sheriff department
5 Sectors --
Community Institution/Organization (CIO):
Includes entities within the community that
provide a broad range of human services and
access to facilities
Sites for assessment:
Child care facility, faith-based institution (e.g.,
church, synagogue, mosque), YMCA, senior
center, health and wellness organization, and
college or university
5 Sectors --
Health Care:
Includes places people go to receive
preventive care or treatment, or emergency
health care services
Sites for assessment:
Hospital, health department, private
practitioner’s office, health maintenance
organization (HMO), home health agency, or
community clinic
5 Sectors -School: Includes all primary and secondary
learning institutions
Sites for assessment:
Elementary, middle and high school (whether
private, public, charter, or parochial)
5 Sectors -Work Site: Includes places of employment
Sites for assessment:
Private office, school, textile factory,
restaurant, retail establishment/outlet, bank,
health department, post office, or
manufacturing company
CHANGE Completion
• CHANGE Completion:
Community-At-Large Sector and
minimum of 1 additional sector
• Minimum of 3 sites per
additional sector
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
Data Collection:
Example Methods
Community-At-Large Sector:
• Face-to-Face Survey*
• Observation: Windshield Survey &
• Photovoice
• Walkability Audit
• Media Review
Community Institution/Organization
• Focus group
• Historical document review
• Walkability Audit
Health Care Sector
• Focus Group
• Observation: Checklist
School Sector:
• Walkability Audit
• Photovoice
• Observation: PTA Meetings
• Historical document review
Work Site Sector:
• Focus Group
• Historical document review
Community Strengths/Resources
Community Commons (Beta 2.0):
Released March 13, 2012
New Starter Maps & Tutorials
• With a few clicks, you can create compelling interactive maps to
tell your community story
• Useful tool for both those new to GIS and those experienced
with mapping
Available at:
CHANGE Action Guide
CHANGE Action Guide
proposes 8 step process
March 13, 2012
Step 5:
Review Gathered Data
• Consistent use of CHANGE scale
• Determine item responses
– Policy
– Environment
• Document, document, document:
Collect and maintain photos, checklists,
and surveys in comprehensive data file
Step 6:
Data Entry
• CHANGE Sector Excel Files
• Quantitative data:
‒ Item response selection
‒ 1-5 using scale
• Qualitative data:
‒ Comment boxes
‒ Documentation: Policy & environment
CHANGE Action Guide
CHANGE Action Guide
proposes 8 step process
ACHIEVE Action Institute
Workshop: April 25, 2012
Community Health Needs
Assessment and Improvement
Plans – Forces at Work
• Tax-Exempt Hospitals: Requirements for IRS
– Conduct community health needs assessment & implementation
– Involve public health experts and engage community members
• Voluntary Public Health Accreditation through the Public Health
Accreditation Board (PHAB)
– For state, tribal, local and territorial health departments
– Launched Fall 2011
– Requires a State/Community health assessment and State/
Community health improvement plan
The primary purpose of this training is to address
policy options to improve public health. There is no
intent to reflect a view on specific legislation.
Recipients (and their sub-tier contractors) are
prohibited from using appropriated Federal funds
for lobbying.

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