204618 Community-driven policy goals: Health system improvement through culture change

Monday, November 9, 2009

Holly Avey, PhD, MPH , Georgia Health Policy Center, Georgia State University, Atlanta, GA
Heather Devlin, MA , Georgia Health Policy Center, Georgia State University, Atlanta, GA
Karen Minyard, PHD , Georgia Health Policy Center, Georgia State University, Atlanta, GA
Naima T. Wong, PhD, MPH , Georgia Health Policy Center, Georgia State University, Atlanta, GA
Natalie Towns, MSW , Georgia Health Policy Center, Georgia State University, Atlanta, GA
Tina Anderson Smith, MPH , Georgia Health Policy Center, Georgia State University, Atlanta, GA
This study engaged members of a rural community in the design of strategies for sustainable health system improvement. An ongoing community-based participatory research approach was used by a regional healthcare access coalition and a state health policy center to engage a consumer work group, which met regularly for over a year. The study began by presenting the consumer group with local data on health, background on the drivers of community health, and examples of successful improvement models. Consumers reflected on this data and offered their insight, then further information was provided regarding the social determinants of health, using the World Health Organization's framework. The group selected three determinants as their focus for further work: access to healthcare, stress, and healthy living. Local experimentation was recommended to identify promising interventions that might improve social determinants of health in their community. Mini-grant photovoice projects focused on increasing access to healthy food, decreasing stress among workers and empowering the homeless. Reflections on the projects revealed themes of empowerment and systems thinking insight. Culture change was identified as the ultimate goal of health system improvement to manage chronic disease and improve access to well care. This consumer group saw the social determinants of health as part of their local health system. Opportunities to engage in learning and short-term project development revealed the need for policies that support both cultural and environmental change to improve healthy consumer choices. Consumer recommendations have been integrated into ongoing community health improvement planning.

Learning Objectives:
1. Describe how to foster a systems thinking approach with a community group 2. Demonstrate how to engage a community group in a short-term project by building on a long-term relationship 3. Explain how to engage a community in addressing social determinants of health from a policy perspective.

Keywords: Culture, Community-Based Partnership

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I participated in the design, implementation, and evaluation of this project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.