Transcript Data driven community health priorities: The community health improvement process in Kitsap County, Washington Beth Lipton, DVM MPH CPH Siri Kushner, MPH CPH APHA, San.

Data driven community health priorities:
The community health improvement
process in Kitsap County, Washington
Beth Lipton, DVM MPH CPH
Siri Kushner, MPH CPH
APHA, San Francisco, CA
October 29, 2012
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Presenter Disclosures
Beth Lipton
Siri Kushner
(1)
The following personal financial relationships with
commercial interests relevant to this presentation
existed during the past 12 months:
“No relationships to disclose”
At the end of this presentation you
will be able to:
1. Describe the data components of a
community health improvement process
2. Identify key epidemiological methods for
community health assessment
3. Discuss ways to ensure data drive decisionmaking related to community health priority
setting
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Kitsap County, Washington
2012 Population: 254,500
http://en.wikipedia.org/wiki/Kitsap_County,_Washington; WA State Office of Financial Management
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PHAB Standards for CHA/CHIP
• Standard 1.1 Participate in or conduct a collaborative
process resulting in a comprehensive Community Health
Assessment
– Describes the population served by public health
– Accessible to agencies, organizations and the general public
• Standard 5.2 Conduct a comprehensive planning process
resulting in a Community Health Improvement Plan
– Implementation in partnership with others
– Monitor progress on implementation in collaboration with
stakeholders and partners
http://www.phaboard.org/wp-content/uploads/PHAB-Standards-and-Measures-Version-1.0.pdf
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Community Health
Improvement Process
PHAB*
Standards
and
Measures
MAPP^
Assessments
Community Health
Assessment (CHA)
Community
Health Status
Forces of
Change
Community
Themes &
Strengths
Community Health
Improvement Plan
(CHIP)
Local Public
Health System
*PHAB: Public Health Accreditation Board
http://www.phaboard.org/wp-content/uploads/PHAB-Standards-and-Measures-Version-1.0.pdf
^MAPP: Mobilizing for Action through Planning and Partnerships
http://www.naccho.org/topics/infrastructure/mapp/
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Kitsap Community Health Priorities
(KCHP)
• Comprehensive community health improvement
process initiated and led by public health, nonprofit
hospital and United Way
–
–
–
–
–
socioeconomic, environmental and medical context
forum for collaboration/discussion on health and well-being
data repository
community-wide health priorities
plan for addressing and monitoring
progress on health priorities
http://www.naccho.org/topics/infrastructure/mapp/upload/MAPPfactsheet-systempartners.pdf
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Data Collection (1)
Community-wide Survey
Method:
Electronic:
email, websites,
newspaper,
promotional
‘business’ card
Paper:
distributed by
community
partners
Targeted Surveys
Paper and audience response:
completed at meetings of
invited community
representatives
Content:
Demographics, health status,
influence of community attributes on health
Produced
data for:
Themes & Strengths
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Data Collection (2)
Focus Groups
Method:
Content:
Meta-Analysis
Held within meetings
Pulled data from
of invited community
standard public health
representatives
data sources
Health status,
influence of
community
attributes and
trends on health
Produced Themes & Strengths,
data for:
Forces of Change
Reviewed results of
community agency
leader survey and
WA Public Health
Standards
Demographics, SES,
environment, health
Performance on
care, pregnancy/births, and prioritization of
quality of life,
essential public
behaviors, morbidity,
health services
mortality
Health Status
Local Public Health
System
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Qualitative Analysis
SAMPLE
POPULATION
MEASURE
THEMES
QUOTES
ANALYSIS TOOLS
EXCEL
SPSS
TAGXEDO
What prevents best possible health
CATEGORY
Representative survey responses
* poor personal choices related to health habits - lack of exercise, smoking, alcohol and drug abuse.
* Attitude of indifference...bad eating, smoking and drinking habits. Lots of overweight people.
PERSONAL
BEHAVIORS
* Stuck in their ways. Bad habits.
* For many, it is apathy. Don't take the time to exercise.
* lack of good family role models who "live" a healthy, active life
* lack of exercise (being lazy); parents not caring about children's health
* Sedentary lifestyles. Staring at screens all day. Some people just aren't willing to get off their butts.
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Quantitative Analysis
AGE
SAMPLE
POPULATION
SUBCOUNTY
AREA
MEASURE
GENDER
EDUCATION
INCOME
PROPORTION
POINT IN TIME
MEAN
TREND
RATE
COMPARISON
ANALYSIS TOOLS
CONFIDENCE
INTERVALS
CHI-SQUARE
*CHAT Community Health Assessment Tool. Washington State Department of
Health, Center for Health Statistics
**Joinpoint Regression Program. http://surveillance.cancer.gov/joinpoint/
EXCEL
SPSS
CHAT*
JOINPOINT**
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E.1.4. SMOKING DURING PREGNANCY
Sources: Birth Certificate Database, WA State Department of Health Center for Health Statistics; First Steps
Database, WA State Department of Social and Health Services. Trend years: 1992-94 to 2007-09.
1992-94
18.3%
2007-09
10.1%
KITSAP COUNTY
20.2%
12.7%
KITSAP COMPARED TO WA
worse
worse
WA STATE
TREND
KITSAP PREGNANT WOMEN BY SUBGROUP: 2007-2009
• 17.6% of pregnant women age <25
Bainbridge
2.6%
• 10.5% of pregnant women age 25-34
Bremerton
Central Kitsap
North Kitsap
South Kitsap
14.0%
7.7%
• 6.7% of pregnant women age 35+
• 32.0% of pregnant women with less
than high school education
10.3%
14.4%
• 24.9% of pregnant women on
Medicaid
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Turning Data into Health Priorities
• Audience
– who should review the data?
• Visual and verbal presentation
– how should the data be presented?
• Guidance on interpretation
– what do the data tell us?
• Priority setting
– where should efforts be focused?
• Action on priorities
– how do the data continue to drive decisions?
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Measuring Progress
Health Priority
Strategies
Process
Objectives
Baseline
measurement
Outcome
Objectives
Ongoing
measurement
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Data and Evaluation
Drive the Process
Plan process
and engage
partners
Conduct
assessments
and
establish
priorities
Better
Health
Identify
and
implement
strategies
Update
assessments
and reevaluate
priorities
Measure
and
report
progress
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Questions?
[email protected]
[email protected]
kitsapchp.com
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