Best Practices for Community Health Needs Assessment and ...

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Best Practices for Community Health Needs Assessment and Implementation Strategy Development: A Review of Scientific Methods, Current Practices, and Future Potential

Report of Proceedings from a Public Forum and Interviews of Experts Public Forum convened by The Centers for Disease Control and Prevention Atlanta, Georgia | July 11?13, 2011

Kevin Barnett, DrPH, MCP | February 2012

Best Practices for Community Health Needs Assessment and Implementation Strategy Development: A Review of Scientific Methods, Current Practices, and Future Potential Report of Proceedings from a Public Forum and Interviews of Experts Kevin Barnett, DrPH, MCP February 2012

Submitted to The Centers for Disease Control and Prevention 1600 Clifton Road Atlanta, GA 30333

Submitted by The Public Health Institute 555 12th Street, 10th Floor Oakland, CA 94607

Developed with Funding was provided by the Centers for Disease Control and Prevention under cooperative agreement U38HM000520-03h with the National Network of Public Health Institutes. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.

ACKNOWLEDGEMENTS............................................................................................................................. i

EXECUTIVE SUMMARY........................................................................................................................... iiii

I. INTRODUCTION ............................................................................................................................... 1

A. Project Purpose ........................................................................................................................... 1 B. Impetus/ Rationale ...................................................................................................................... 2 C. History/Background ..................................................................................................................... 4 D. Project Design.............................................................................................................................. 7

1. Expert Panel Meeting............................................................................................................... 7 2. Key Informant Interviews ......................................................................................................... 8 3. University of Kansas Compendium ........................................................................................... 9 4. Report of Proceedings............................................................................................................ 10 E. Putting it All Together: A Logic Model ........................................................................................ 10 F. Definitions ................................................................................................................................. 12 II. COMMUNITY HEALTH NEEDS ASSESSMENT ................................................................................... 12

A. Shared Ownership of Community Health ................................................................................... 13 B. Defining Community ? Jurisdictional Issues ................................................................................ 18 C. Data Collection and Analysis ...................................................................................................... 27 D. Community Engagement............................................................................................................ 37 E. Priority Setting........................................................................................................................... 46 III. IMPLEMENTATION STRATEGY DEVELOPMENT AND EXECUTION................................................. 61

A. Alignment Opportunities............................................................................................................ 61 B. Monitoring and Evaluation......................................................................................................... 70 C. Institutional Oversight ............................................................................................................... 77 D. Shared Accountability and Regional Governance........................................................................ 87 E. Strategic Investment and Funding Patterns ................................................................................ 96 F. Public Reporting: Federal, State, and Local Issues..................................................................... 105 IV. CONCLUSION / NEXT STEPS.......................................................................................................... 120

APPENDIX A BIOGRAPHIES...................................................................................................................... i

APPENDIX B. FINAL AGENDA................................................................................................................... xi

ACKNOWLEDGEMENTS

We gratefully acknowledge our colleagues at the Centers for Disease Control and Prevention (CDC) for the sponsorship and guidance in the project, as well as the hosting of the expert panel meeting. In particular, we would like to recognize Paul Stange at CDC for his leadership in the engagement of colleagues, collaboration in the conceptualization of the project, assistance in the identification of leaders in the field, and facilitating the involvement of CDC leadership. We would also like to acknowledge CDC staffers Simeon Niles and Paula Staley for their participation in the expert panel meeting planning process, and Tanya Blocker, Kimberly Thaxton, Emily Johnston, and Ken Ward for their onsite support during the meeting.

We would also like to acknowledge our colleagues at the National Network of Public Health Institute for their effective management and coordination of all logistics associated with the planning and convening process. NNPHI support was provided under the leadership of Chris Kinabrew, with ongoing support from staff member Anooj Pattniak.

An important theme in the project is the opportunity for collaboration between hospitals and local public health agencies in conducting community health needs assessments and the development of community health improvement strategies. With this in mind, an opening plenary presentation was given by John Bluford, MBA, FACHE, Chief Executive Officer of Truman Medical Centers in Kansas City, MO. Mr. Bluford was also the Chair of the Board of Trustees of the American Hospital Association (AHA). Leaders from health systems and hospitals such as Aurora Health Care, Baylor Health Care System, Catholic Healthcare West, Duke University Medical Center, Kaiser Permanente, Trinity Health, and UMASS Memorial Health Care also participated on expert panels. Important input in the planning of the meeting was also provided by Janelle Gillings from the Association of State and Territorial Health Officers (ASTHO) and Julia Joh Elliger and Barbara Laymon from the National Association of County and Community Health Officers (NACCHO). NACCHO also sponsored a national webinar that provided an opportunity for over 300 public health leaders to address topics covered in the expert panel meeting.

In addition, we are grateful for the opportunity to collaborate with colleagues Stephen Fawcett, Christina Holt, and Jerry Schultz of the Work Group for Community Health and Development at the University of Kansas. Dr. Fawcett and his colleagues developed a companion report in the project entitled Recommended Practices for Enhancing Community Health Improvement, and made important contributions to the meeting. We would also like to acknowledge the contributions of Public Health Institute team members Smruti Shah and Reggie Jackson, contributed to the development of content for each element of the community health improvement process addressed as part of this report, and for their support of the meeting.

We would also like to acknowledge the contributions of Keith Hearle, Principal of Verit? Consulting, who provided invaluable input in the editing of this report. Last, but certainly not least, we would like to acknowledge the contributions of key leaders in the field for their

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participation in the key informant interview process, as well as those who served as expert panelists and participants in the meeting.

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