The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #61326

Dennis R Joyner, MPH¹, Marcus G. Plescia, MD, MPH², Kelly Blasky, MPH¹, and Teresa Scheid, PhD³. (1) Carolinas Community Health Institute, Carolinas HealthCare System, 101 WT Harris Blvd; Suite 5104, Charlotte, NC 28262, 704-548-5610, Dennis.Joyner@carolinashealthcare.org, (2) Department of Family Medicine, Carolinas HealthCare System, PO Box 32861, Charlotte, NC 28232, (3) Department of Sociology & Anthropology, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC 28223-0001

Regional healthcare systems are evolving across the US. These systems have significant opportunities to adopt community-oriented approaches to health planning. In 1998, a non-profit, vertically-integrated, regional healthcare system established Carolinas Community Health Institute (CCHI) to identify, understand and respond to health needs from a community perspective. The project was implemented in four communities: two rural counties, a rural/urban transitional county, and an inner-city community. The structure of the project, based on established community health planning theory, involved five steps: 1) support or help form a local community coalition, 2) hire and support a local coordinator, 3) prepare a formal community assessment, 4) provide funding for multiple, locally designed interventions, and 5) evaluate each intervention.

In four case studies, we present the steps, challenges, and common principles faced by CCHI at the local level. The case studies were prepared based on semi-structured key informant interviews in each county and with CCHI steering committee members, review of existing written documents, and unstructured discussions with the Project Director. Based on content analysis of the interviews and subsequent pattern matching among and between cases, we developed and validated a four-domain framework to assess the characteristics of local communities that define their capacity and readiness to engage in community health planning efforts: 1) key stakeholders/leaders, 2) existing levels of coordination, 3) infrastructure, 4) level of local receptivity. This framework can be used by large healthcare systems, and by other organizations to better support local health initiatives.

Learning Objectives:

At the conclusion of the session, the participant will be able to:
• Describe process evaluation methods used in the assessment of a regional effort to support local community health initiatives.
• Identify challenges associated with developing collaborative initiatives between traditional healthcare systems and community groups and organizations.
• Describe the varying dynamics associated with working with different geographic populations from rural to urban settings.
• Describe a four-domain framework to assess the capacity and readiness of local communities to engage in community health planning initiatives.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.