Promoting Health Equity - A Resource to Help Communities Address ...

More documents

Recommendations

Info

46 > Qualitative interviews or focus groups. Qualitative interviews, or guided discussions, can occur with individuals or with groups. Such interviews allow you to ask specifc questions about social determinants of health, including current or historic experiences. Developing an interview guide with an outline of questions and probes (follow-up or clarifying questions) to be asked of each individual or group will increase the quality and amount of information gathered from participants. One beneft of this method is that it allows you to obtain more in-depth information than you might from a brainstorming process while still providing a community perspective. You can also identify additional groups in your community and ensure that individuals from each of these groups are interviewed, allowing for a wider range of perspectives than you might get from brainstorming. 75,76 > Photovoice. Photovoice is a way of conducting a community assessment through still photographs or video. The photography may be conducted by members of the community or by outsiders. Typically, the images collected are used to generate dialogue among community members or community agencies about the conditions in the community. 77 > Community observation and audits. Community audits are tools that can be used to systematically track various social and physical structures as well as individual behaviors in a geographic location. Audits may, for example, be checklists that indicate whether there are sidewalks or streetlights in a particular location. Audits can also be used to identify the presence or absence of merchants who sell fruits and vegetables as opposed to snack foods and alcohol. Alternately, audits can be used to assess the number of vacant lots, playgrounds (with and without equipment), or graffti. Community audits may be used with geographic information systems software to create maps indicating the presence or absence of various structures in different areas. Printed poster-sized maps and pushpins can also be used to indicate the presence or absence of various structures. 78–81 > Concept mapping. Concept mapping is a process that uses complex qualitative data to engage participants in the defnition and measurement of key determinants. In addition, it provides participants with the opportunity to develop conceptual frameworks of how the determinants relate to each other and to health and behavior. Concept mapping includes six overall steps: preparation (select a group of participants and determine focus), group brainstorming to generate statements, structuring statements through a sorting process to create clusters, representation of the statements/ clusters using a map, interpretation of the maps and utilization of the maps. This process is considered particularly appropriate for obtaining information regarding group-level defnitions and perceptions as opposed to individual conceptualizations. 82–84 > Health impact assessment (HIA): HIA is a combination of procedures, methods, and tools by which the potential impact of a policy, program, or project on the health of a population can be assessed. It is similar to an environmental impact assessment, though the emphasis with HIA is the impact on humans rather than the environment. HIA can range from simple, fairly easy-to-conduct analyses to more in-depth, complex analyses. HIA is a broad concept often interpreted in different ways by different users, but there are common elements that can provide a framework for common action among multiple users. Some of these common elements include: social impact assessment, epidemiological assessment, retrospective evaluation of community interventions, health inequalities impact assessment, and hazard mapping. While retrospective analyses are possible, HIA is considered most effective when used prospectively, or before deciding upon and implementing a course of action. 85 > Appreciative inquiry. (AI) AI is a change strategy that identifes existing strengths in a community, group, or system and then actively builds on these strengths to improve a situation. AI often begins by asking such questions as “What is working well here?” and “Why is this working well?” Rather than focusing on problems, AI uses positive words, stories, and images to describe conditions that currently exist and then positively describes conditions the group would like to create. Steps in the process often include discovery, visioning, designing, and creating/sustaining. Capturing and enhancing positive aspects can access untapped potential, which can then be directed toward positive change. 86
Table 3.1: Applying Assessment Methods to Different Types of Social Determinants Method Context Example measures Review of existing data Surveys, qualitative interviews, focus groups, appreciative inquiry, concept mapping Brainstorming Social Economic Environment Social Economic Environment Social Economic Environment > Crime rates. > Housing patterns. > Law enforcement policies. > Poverty rates. > Local tax dollars spent on health, education, transportation, etc. > Policies on government spending. > Land-use policies (e.g., commercial, residential, parks). > Industry standards (e.g., pollutants). > Maintenance policies and procedures (e.g., trash, playground equipment). > Perception of racism and discrimination. > Perception of a sense of community. > Feeling safe from interpersonal crime. > Perception of job availability. > Perception of local businesses’ fnancial contributions to the community. > Attitude toward policies on public spending. > Knowledge of environmental hazards in the community (e.g., pollution, illegal dumping). > Perception of access to places and resources to maintain health. > Attitude toward policies related to the environment (e.g., pollutants). > Community list of priority concerns. > Perception of strengths and weaknesses of previous efforts to address concerns. > Identifcation of innovative ways to address concerns. 47
Page 1 and 2: Promoting Health Equity A Resource
Page 3 and 4: Promoting Health Equity A Resource
Page 5 and 6: Table of Contents Introduction p.4
Page 7 and 8: Participants October 28-29, 2003 So
Page 9 and 10: Infant mortality Table 1.1: Example
Page 11 and 12: Access to resources Income Housing
Page 13 and 14: Learning from doing Chapter 2 of th
Page 16 and 17: 14 1CASE STUDY Who we are: A black
Page 18 and 19: 16 CASE Poder es Salud 2STUDY (Powe
Page 20 and 21: 18 CASE 3STUDY Project BRAVE: Build
Page 22 and 23: 20 C ASE 4S TUD Y Healthy Eating an
Page 24 and 25: 22 5CASE STUDY Taking Action: The B
Page 26 and 27: 24 6CASE STUDY The Community Action
Page 28 and 29: 7CASE STUDY 26 New Deal for Communi
Page 30 and 31: 28 8CASE STUDY From Neurons to King
Page 32 and 33: 30 9CASE STUDY The Delta Health Cen
Page 34 and 35: 32 Developing a Social Determinants
Page 36 and 37: SECTION 1 34 Creating Your Partners
Page 38 and 39: 36 PERSPECTIVES — Community Yvonn
Page 40 and 41: 38 MOVING FORWARD Sample Partnershi
Page 42 and 43: 40 Building partnership capacity Re
Page 44 and 45: SECTION 2 42 Focusing Your Partners
Page 46 and 47: 44 2. Talk to other community partn
Page 50 and 51: 48 Photovoice Community audits Heal
Page 52 and 53: 50 7. With information gathered and
Page 54 and 55: 52 ExAMPLE FROM THE FIELD Creating
Page 56 and 57: SECTION 3 54 Assessing community ca
Page 58 and 59: 56 ExAMPLE FROM THE FIELD Mapping C
Page 60 and 61: SECTION 4 58 Once your partnership
Page 62 and 63: 60 ExAMPLE FROM THE FIELD Selecting
Page 64 and 65: 62 MOVING FORWARD Community Develop
Page 66 and 67: 64 Social action What is social act
Page 68 and 69: 66 When working to incorporate chan
Page 70 and 71: 68 Be sure to frame your message in
Page 72 and 73: 70 Policy and environmental change
Page 74 and 75: 72 MOVING FORWARD Ways to Support P
Page 76: 74 ExAMPLE FROM THE FIELD Selecting
Page 79 and 80: Before writing your action plan, yo
Page 81 and 82: Continually monitor your group’s
Page 84 and 85: SECTION 6 82 It is important to inc
Page 86 and 87: 84 MOVING FORWARD Evaluating Your P
Page 88 and 89: 86 It is important to note that mos
Page 90 and 91: SECTION 7 88 Eliminating inequities
Page 92 and 93: 90 Closing Thoughts Since the Socia
Page 94 and 95: 92 Suggested Readings and Resources
Page 96 and 97: 94 Miringhoff M, Miringhoff, ML. Th
Page 98 and 99:
96 James SA. Confronting the moral
Page 100 and 101:
98 Partnerships Alter C, Hage J. Or
Page 102 and 103:
100 Wolff T, Kaye G. From the Groun
Page 104 and 105:
102 Kingsley GT. Building and Opera
Page 106 and 107:
104 Stokols D. Translating social e
Page 108 and 109:
106 References 1. Institute of Medi
Page 110 and 111:
108 34. Hertzman C, Power C, Matthe
Page 112 and 113:
110 71. Granner ML, Sharpe PA. Eval
show all

Promoting Health Equity - A Resource to Help Communities Address ...

Create successful ePaper yourself

Delete template?

Save as template?