Meaningful engagement of community members is often a desired goal of multi-sector collaborations working to improve community health, though in reality, this can be very difficult to achieve. A recent All In: Data for Community Health webinar featured presenters from two communities—Seattle, WA and Garrett County, MD—who developed innovative processes to engage residents in providing valuable data to inform community health improvement planning.
Dr. Nadine Chan, Assistant Chief at Public Health – Seattle & King County, a BUILD 1.0 awardee, shared the story of how qualitative data was collected from residents of the Chinatown-International District to provide compelling evidence that the physical and social environment in the neighborhood had significant implications for community health, ultimately motivating the Seattle City Council to take action. Shelly Argabrite, Strategic Health Planner at the Garrett County Health Department, a PHNCI awardee, explained how a digital data platform has transformed the way they engage hard-to-reach rural residents in community health planning, making the process more equitable and using multi-sector data to drive decision-making.
As they shared the barriers and opportunities they encountered along the way, the following key messages surfaced.
1. Capture community voices that tell the story behind health data
Chan stated that traditional sources of health data do not always tell the full story of what’s happening at the local level. In some situations, it makes more sense for community partners to collect additional information, providing a more complete picture of community health needs. She explained:
“It made sense for community-based organizations to lead this particular project, especially because they bring the hyper-local context, the rich history, and the coalition building and community voices that don’t come through well in high-level data we have access to in government and health systems.”
Community-based organizations were able to collect more nuanced data through focus groups and surveys with youth, elders, business owners, and other community members. And in turn, data aggregated by the health department may be validated by residents. This information revealed common themes around social/physical isolation and perceptions about safety and cleanliness in the neighborhood that helped guide the focus of the community action plan that was ultimately developed.
2. Make planning processes more inclusive by going digital
When Argabrite started her role at the Garrett County Health Department, located in rural Appalachia, less than 0.005% of the population was involved in community health improvement planning. The health department decided to build a digital platform that would collect information from residents to make the process more equitable. She reflected:
“We started discussions and asked people to share, within those broad terms of health, their passions, concerns, and solutions. This was groundbreaking for our community and gave people the ability to participate that have never been able to do so before.”
The new platform resulted in a 3000% increase in community participation in health improvement planning, involving thousands of new residents in the process. Argabrite also engaged local libraries, social service agencies, and other community organizations that have front-line interactions to promote the tool to people that may not have digital access.
3. Move conversations upstream by focusing on policy and systems changes
Chan encouraged others to think strategically about advocacy opportunities. She described a key meeting where partners discussed which policy levers were available to activate systematic changes that would make the Chinatown-International District healthier, safer, and more livable for residents, which culminated in a Community Action Plan.
This action plan and the associated data that was collected from community members was presented to the City Council and ultimately motivated them to commit half a million dollars in resources directly to the neighborhood. This allowed the collaboration to make systems-level changes that had a lasting impact, such as planning community events to reduce social isolation and working with business owners to respond to issues related to proper waste disposal.
Although the impact of advocacy is sometimes considered “too hard to measure,” Chan recommended the Harvard User’s Guide to Advocacy Evaluation Planning, which walks through the process of evaluating advocacy efforts.
4. Engage partners by sharing actionable data from residents
When Garrett County Health Department developed their digital platform, it enabled multiple sectors to collect data from community members together for the first time. Rather than waiting until formal program evaluations were released to make changes, partner organizations were able to review community-generated data on a more regular basis, allowing them to be proactive in making improvements that generated better outcomes. Argabrite recalled:
“Because of community input, we’ve been able to shift priorities and look at social determinants of health like food insecurity, broadband internet access, and homelessness—things that weren’t traditionally looked at in our planning process before. That’s a direct result from community engagement in the planning tool.”
The code for the software is available for free on Github for other communities that would like to use and adapt it for their community health planning efforts.
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