Engaging Community in Evaluation and Health Services: Lessons Learned from a County Health Enterprise Zone

Health literacy is essential for an activated, empowered client population for health care systems. Yet, close to half of all Americans lack the skills needed to navigate the complicated health care system. People with low health literacy have difficulty comparing health insurance plans, understanding their benefits, and calculating their share of medical costs. They are less likely to ask questions, seek out health information or understand medical jargon or words specific to the medical field. Prince George's County Health Department, MD, is addressing the critical health and health literacy needs of its residents by including a community-based health literacy campaign in their Health Enterprise Zone (HEZ) grant initiative. The Health Department was one of five entities awarded an HEZ grant to develop five patient-centered medical homes in the low-income medically underserved area of Capitol Heights, MD. Now in the second year of a four-year grant, the County has completed three primary care homes where there were zero primary care physicians. As part of its health literacy campaign, we created a steering committee of residents and with the residents planned and implemented a random, household survey. The survey had three purposes: 1) to get a zip-code, city level look at health care use, health status, and health perceptions; 2) to gather data that will help inform and create campaign messages and tactics about health literacy; and 3) to measure resident's health literacy and health care perceptions as a pre-test to evaluation of the campaign. The survey process included community health workers, over 20 student and resident volunteers who were trained as interviewers, months of planning and production of materials, and various approaches to knocking on doors and mailing information. This presentation will share lessons learned as well as recommendations for engaging community in evaluation and in health care development