Abstract
Community Dialogues: Engaging, Encouraging, & Empowering Community/Academic Conversations
E. Yvonne Lewis, BS, BBA1, Tonya French-Turner, MBA2 and Kenneth Cabine, MPH, MS3
(1)National Center for African American Health Consciousness, Flint, MI, (2)Healthy Flint Research Coordinsting Center, Flint, MI, (3)Healthy Flint Research Coordinating Center, Flint, MI
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Community-based participatory research (CBPR) allows community members to participate in research that benefits the community at large. Having community at the forefront ensures that research is community based, versus community placed. For CBPR to thrive, the community must have an impetus for participation and investment in the work. In Flint, Michigan, the challenge was determining how researchers and community might coordinate the research agenda and concerns to create an equitable research partnership. The establishment of mutual respect and understanding is critical between community and academia to move the research forward.
To address inequities that exist in CBPR, the Healthy Flint Research Coordinating Center (HFRCC) Community Core adapted the Community Dialogue model; which includes a minimum of four consecutive facilitated conversations engaging both community and academia. During each session, participants are guided through a series of four problem solving questions. These conversations begin with establishing a problem statement, which is then used to guide the remainder of the sessions. Ultimately, these participants identify the best possible solution(s) for addressing barriers and commit to working towards implementation. Participants are asked to attend all sessions to maintain continuity. The two Dialogue sessions held during the first year of HFRCC identified the best possible solutions as: mutual respect between researchers and community participants, effective communication of research processes, development of community-driven research agendas, and utilize social media as a platform to engage community residents.
Conclusion: We present a model that allows community members to participate in research that benefits the community at large.
Advocacy for health and health education Assessment of individual and community needs for health education Communication and informatics Diversity and culture Public health or related education Public health or related research
Abstract
Establishing population health data in flint: A response to a community based needs and assets assessment
Mieka Smart, DrPH, MHS1, Rolando Barajas, MPH1, Richard Sadler, PhD1, Cynthia Hines, DHA2 and Debra Furr-Holden, PhD3
(1)Michigan State University, Flint, MI, (2)Central Michigan University, Mount Pleasant,, MI, (3)Michigan State University College of Human Medicine, Flint, MI
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: The Flint Center for Health Equity Solutions’ Needs and Assets Assessment (NAA) identified the need for a comprehensive public health data resource in Flint. The NAA highlighted that current local public health datasets are lacking in terms of their methodological rigor and/or their comprehensive coverage of public health issues. As a response, the Flint Area Study’s (FASt) first wave is underway. The FASt is a longitudinal inter/multi-generational cohort study designed to assess environmental exposures and elucidate their long-term effects on Flint residents.
Methods: The FASt uses a random probability sample and has three assessment phases. Phase 1 involved compiling a list of 400 inhabited households from random block-faces and collecting qualitative data on Flint neighborhoods. Phase 2 involved using the NIfETy Method to assess social- and physical-environmental conditions at the Phase 1 households. Phase 3 will consist of residential surveys that measure for physical/behavioral health, multi-level social dynamics, and biological specimen collection every three years.
Results: Results from Phase 1 show that one-third of the assessed block-faces contained fewer than two inhabited households. Results from Phase 2 show geographical clustering of evidence of potentially protective environmental factors, levels of physical disorder and levels of social-environmental risk (including aggression, signs of violence and presence of alcohol and other drugs). Phase 3 is underway.
Conclusions: FASt Phases 1 and 2 identified locations for targeted environmental intervention. Once combined with individual health outcome and biological data from Phase 3, the comprehensive FASt dataset will provide valuable information about unmet health needs.
Epidemiology Public health or related research Systems thinking models (conceptual and theoretical models), applications related to public health
Abstract
Measuring Social Support for Physical Activity and Nutritional Behavior Change in Flint, Michigan: A Mixed Methods Approach in the Church Challenge
Rodlescia Sneed, PhD, MPH1, Vicki Johnson-Lawrence, MS, PhD1, Ariel Angel-Vincent, MPH1 and Bernadel Jefferson2
(1)Michigan State University, Flint, MI, (2)Faith Deliverance Center, Flint, MI
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: Numerous studies have found that supportive social networks are crucial for positive health behavior change. Interventions to promote behavior change continue to be important in minority communities with high chronic disease rates. The Church Challenge is a faith-based multilevel community-based intervention to promote healthy diet and physical activity behaviors in order to reduce blood pressure levels among African American churchgoers in Flint, MI. Within the context of this intervention, we use a mixed methods approach to understand the role of social support specifically within faith-based settings for behavioral change among Church Challenge participants.
Methods: Our quantitative measure captured frequency of social support across multiple domains including interactions with friends, romantic partners, children, other church members, and coworkers. We then designed a set of semi-structured interview questions to collect complementary qualitative data to characterize social support from the perspective of the study participants, 1-3 members of their social networks, and as viewed by health team members of the participating churches.
Results: With the 5 African-American churches currently enrolled in the study, our quantitative and qualitative measures have been well-received, but continue to be modified in response to the content recommendations of faith leaders within the churches. While the quantitative measures cover multiple domains of support, the depth of the relationships was more clearly captured with the qualitative assessment.
Discussion: Approaches that utilize qualitative information are paramount for understanding the ways that social networks can hinder or promote behavioral changes crucial for reducing chronic disease burden in this population.
Public health or related research Social and behavioral sciences
Abstract
Incorporating Community Expert Knowledge to Establish the Flint Geospatial Healthfulness Index and Contextualize Neighborhood-Level Factors in Health Behavior Change
Richard Sadler, PhD1, Christopher Hippensteel, MS; BS1, Victoria Nelson, MA; BA1, Ella Greene-Moton1 and Debra Furr-Holden, PhD2
(1)Michigan State University, Flint, MI, (2)Michigan State University College of Human Medicine, Flint, MI
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
The built environment can affect one’s ability to change behavior, thus neighborhood-level disparities contribute to health equity concerns. The NIMHD-sponsored Flint Center for Health Equity Solutions was established to address such concerns and inform policy change in Flint, Michigan, through the lens of community-engaged research.
To inform individual and community-level interventions, we compiled spatially varying data that may correlate to health behaviors. We then engaged community and academic partners in their opinions about Flint’s built environment via a multiple-criteria decision analysis. This informs GIS-based variable weights that comprise a healthfulness index, signaling a neighborhood’s relative health promoting or degrading qualities.
Broad categories and variables within them were ranked in order of importance using the analytic hierarchy process. Weights were then applied to corresponding map layers containing each variable, yielding ‘healthfulness scores’ for every home and neighborhood. These scores are then appended to research subjects to determine relationships between healthfulness and public health intervention outcomes. Areas with relatively better scores are expected to correlate more strongly to better or more sustained behavior change (while controlling for other individual-level factors) and vice versa.
Flint is a notable case for the development of this index not only because of its water crisis, but because of decades of disinvestment that drive disparities. Yet this work is important to many communities with large inequities in health outcomes and built environments. Taking stock of assets and needs within a community lends critical insight into best next steps toward enacting policy change to advance health equity.
Assessment of individual and community needs for health education Chronic disease management and prevention Public health or related public policy Public health or related research Social and behavioral sciences