Intentional design of health promoting neighborhoods: A strategic tool of participatory community assessment

Background Determinants of health models summarize the myriad of dynamic and interdependent factors influencing the health of community populations but do not explicitly address leadership or strategic factors necessary to make these models effective. Qualitative analysis of our needs assessment was designed to give insight to these elements from a public perspective. Methods Qualitative data collected from 19 key leaders and 13 focus groups including 115 individuals representing vulnerable populations provided depth and validation to quantitative data. Participants described factors of an ideal community, issues facing them and that the Mayor consider for improvement. Constant comparison yielded themes that were sorted by frequency and coded using the Evans and Stoddart Field Model domains. The emergent improvement model integrated the notion of intentionality within each domain. Results The concept of intentionality of community design emerged through transcript analyses from a majority of key leaders (n=16) and all focus groups. Intentionality of leadership, values and strategic planning were seen as critically important to community design elements of transportation, community involvement, fostering socialization, recreation and the physical environment, education, and revitalization. Themes drawn from the analyses generated a model for community design including intentional values-based leadership and development of places, programs, and policies that cultivate and maintain a healthy local environment. Conclusions Intentionality of community design is a high-level concept that provides a framework for comprehensive participatory community needs assessment and health improvement processes including mapping data elements, summarizing data, and bringing diverse stakeholders to the planning table to proactively address critical issues.