3/20/18 Empowering Denvers Youth to Conduct Health Assessment Work - - PDF document

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Empowering Denver’s Youth to Conduct Health Assessment Work

Culture of Data April 6th, 218

Brenna M. Spencer-Castañón, B.A. Abigail Steiner, M.S., M.P.H.

Welcome to Denver

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• Population: 693,060
• Percent change 2010 – 2016: +15.5%
• Below Federal Poverty Level – 18.30%
• Demographics
• Hispanic or Latino:

30.5%

• Black: 10%
• White Alone: 54%

Meet Denver’s Youth

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In 2015

104,982

lived in Denver, which is 15% of the Denver population. youth ages 13-25

(Colorado Department of Local Affairs, 2015)

45% identify as Hispanic 5% identify as Asian 39% identify as White-non Hispanic 1% identify as American Indian 10% identify as Black-non Hispanic

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Key Terms

§ Community Based Participatory Research (CBPR) – A collaborative research approach that directly involves the community affected by the issues being studied in all aspects of the research § Youth Leadership Team (YLT) – Team of Denver youth hired by Denver Dept. Public Health & Environment/Denver Public Health to be the experts on youth health and conduct health assessment work

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What is Denver’s Youth Health Assessment?

§ A collaboration between Denver Public Health and Denver Department of Public Health and Environment to better understand the health issues facing Denver’s Youth § Included the participation of youth-serving community partners and the creation of a Youth Leadership team to lead the assessment

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What Makes This Assessment Different?

2017 Youth Health Assessment § Engaged the community and then went to the data § Denver’s Public Health agencies were focused on looking at things differently in this assessment to make the data effective and usable out of a commitment to health equity

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3/20/18 3 WE DID THIS WHY

Health Assessment in Denver DPH and DDPHE produce a health assessment every 3 - 5 years to: » Shed light on health status of Denver residents » Inform strategies designed to improve well-being of all residents » Prioritize health equity and clarify social & economic barriers to health

WE DID THIS WHY

Improving upon Denver’s Past Health Assessments Previously published health assessments missed the opportunity to: » Take a sufficiently deep dive to explore health issues facing a specific group. » Engage community members to actively participate in and lead the process. » Ask the target population to define assets and protective factors for success. Community-Engaged Approach

CBPR OVERVIEW

***Image Adapted from Let’s Talk Cochrane

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Community-Based Participatory Research (CBPR)

Community-Engaged Approach

YHA OVERVIEW

Phases of Work

» Phase 1 – Planning & Youth Leadership Recruitment » Phase 2 – Community Engagement » Phase 3 – Synthesis » Phase 4 – Quantitative Supplement » Phase 5 – Product Development » Phase 6 – Launch » Phase 7 – Dissemination & Empowerment

DPH and DDPHE recruited a group of youth from across Denver to form a Youth Leadership Team (YLT) for this work.

» 100+ applied. 9 selected. » Trained in assessment research » Trained in social and economic barriers to health » Met January 2017 – January 2018 » Guided this work as paid consultants and SMEs

YHA Core T eam provided support to the YLT .

Community-Based Participatory Research (CBPR)

Community-Engaged Approach

YHA OVERVIEW

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To understand issues affecting youth health in Denver and youth-defined

• pportunities to support youth success, the YLT designed a survey and

YHA core team conducted community-partner interviews.

WHA T WE DID

Data Collection

WHA T WE DID

§ Supported and trained youth in Assessment related decisions including: – How we would and could obtain data – What were the questions that needed to be asked

• Based on what they had learn about health assessments, social

determinants of health, and their lived experiences – What did we want to know

• Most difficult part of the process!!

14 Data collected youth peer surveys

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listening sessions with youth

21 interviews

partner organization

the survey asked two open-ended questions: What is the most important issue impacting your health and the health of the young people you know? Why? What does success look like for you in your community?

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WHA T WE DID

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Allowed for a deep dive into the questions and ability to gain a deeper insight into the topics youth discussed Allowed for the youth leaders to reach youth that are traditionally harder to reach via survey methods

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WHA T WE DID

Data collected

youth peer surveys

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listening sessions with youth

21 interviews

partner organization

17 » YLT reviewed all youth survey responses and YHA core team reviewed key findings from community partner interviews » Key themes emerged through collaborative review and group discussion » Youth leaders led a conversation with YHA Core Team members to synthesize key strengths and challenges in youth health. » Traditional surveillance data sources (12) were analyzed to complement qualitative findings

WHA T WE DID

Data Analysis and Synthesis

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WHA T WE DID

Report Development and Community Feedback

» YHA Core Team drafted summary report » YLT and public health staff provided feedback on drafts to clarify and strengthen messaging » Young people from across the city were invited to in-person events to provide feedback on whether key messages matched their experiences

• r the experiences of youth in their communities

» Community partners came together to review and discuss the findings and feedback Conducting a health assessment through authentic and structured community engagement is somewhat novel as a public health practice. » 1 feedback session with community partners » 2 feedback sessions with youth » Ensured data was interpreted correctly » Provided specific examples » Community partners brainstormed next steps Youth not involved in writing this report said the findings resonated with them and that there were no major health topics missing.

What the Community Thought About This Report

What We Found

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3/20/18 8 KEY FINDINGS

» Treated and respected as unique, multi-faceted individuals » Guided toward a positive and healthy future » Resilient and able to bounce back » Connected to their communities Youth in Denver want to be:

Young people want to be engaged in decisions that impact their lives.

KEY FINDINGS

Young people want to be engaged in decisions that impact their lives. » Mental health (specifically depression) » Pressure and expectations to perform well » Challenges related to living a healthy life » Contact with the criminal justice system » Exposure to violence » Rapid population change in communities » Substances such as alcohol and marijuana

What Stands in The Way of Youth Health?

KEY FINDINGS

Young people want to be engaged in decisions that impact their lives.

» Being treated as unique and complex individuals » Having their perspective and voice valued » Having the ability to realize their current and future potential » Interacting with systems that support and cultivate resilience What Does Success Look Like for Denver Youth?

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What We Can Do!

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§ Validate the complex demands

• n young people’s time and the
• verwhelming pressures they

face § Advocate for comprehensive, youth-friendly behavioral health services (including mental health and substance use services)

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§ Support policies and programs that create access to healthy food and physical activities § Create safe community spaces like Mental Health Center of Denver’s drop-in center and dedicated youth library spaces where young people can feel safe gathering and spending time with their peers

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§ Expand access to youth friendly health clinics § Recognize that youth experiences in Denver are often unique based on each community’s experience and assets; each community deserves focused attention

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§ Acknowledge that community trauma impacts youth and their families, and explore ways to mitigate those impacts and promote community resilience § Align with community action groups to ensure that youth concerns and youth voices are included in those efforts

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Conclusion

Don’t be afraid to have the community direct (especially youth!) in health assessment work

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To learn more about collaborative efforts to take action on

• pportunities identified in the YHA, please contact:

» Maritza Valenzuela – Youth Health Program Manager, Denver Public Health » maritza.valenzuela@dhha.org To learn more about community based participatory research and health assessment, please contact: » Abbie Steiner – Shared Epidemiologist, Denver Public Health & Denver Department of Public Health and Environment » abigail.steiner@dhha.org

WHA T HAPPENS NEXT

How you can learn more:

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ACKNOWLEDGEMENTS

Olivia Almon Denver High School Student Ali Bradley Denver High School Student Jazzmine Cotton Denver College Student Esmeralda Gutierrez-Rivera Denver High School Student Jirah Lawrence Denver High School Student Amatullah Malki Denver High School Student Akeri Quincer Denver High School Student Zach Simon Denver High School Student Zach Vultao Denver High School Student

Youth Leadership Team

Charlene Barrientos Ortiz Colorado School of Public Health Greg Budney Denver Public Health William Burman Denver Public Health Lindsey Coulter Denver Department of Public Health and Environment Nikki Heider Denver Public Health Lydia Hooper Fountain Visual Communications Meghan Hughes Denver Department of Public Health and Environment Emily Johnson Colorado Health Institute Bob McDonald Denver Department of Public Health and Environment Dean McEwen Denver Public Health Christie Mettenbrink Denver Public Health Sonja O’Leary Denver Health School-Based Health Centers Emily Pabst Denver Public Safety Peak Creative Team Ken Scott Denver Public Health Emery Shekiro Denver Public Health Lisa Straight Denver Department of Public Health and Environment Kimberly Taylor Denver Public Health

ACKNOWLEDGEMENTS

Support Staff and Partners

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Boys & Girls Clubs of Metro Denver Civic Canopy Colorado Youth Matter Denver Health School-Based Health Centers Denver Health STEPP Program Denver Housing Authority Denver Human Services Denver Public Library Denver Public Safety/Denver Juvenile Services Center Denver Public Schools Denver Victim Offender Reconciliation Program (VORP) Gang Rescue and Support Project (GRASP) Groundwork Denver Padres y Jóvenes Unidos Planned Parenthood Rainbow Alley Servicios de la Raza Street Fraternity The Mayor’s Office of Children’s Affairs Mental Health Centers of Denver Urban Peak

ACKNOWLEDGEMENTS

Youth-Serving Organizations

2010 Census Tract Boundaries: United States Census, 2010 2006-2015 DOLA Population Estimates: Colorado Department of Local Affairs, 2015 2016 ESRI Population Estimates: ESRI Community Analyst, 2016 Annual Deaths and Causes of Death: Registries & Vital Statistics Branch, Colorado Department of Public Health and Environment, 2011-2015 Chlamydia case rate: Colorado Patient Reporting & Investigation Surveillance Manager, 2016 Counts, rates, and causes of youth trauma EMS transports: Denver Health Paramedic Division, 2011-2015 Depression Prevalence, Colorado Health Observation Regional Data Service, 2015 Emergency department visits and hospitalizations: Colorado Hospital Association, 2013-2015 Firearm deaths: Colorado Violent Death Reporting System, 2011-2015 Low income census tracts & food deserts: Food Access Research Atlas - Economic Research Service (ERS), U.S. Department of Agriculture (USDA). Obesity prevalence: Denver Public Schools Height and Weight Screening Data, 2015/2016 School Year Uninsured prevalence, usual source of care, and emergency room use: Colorado Health Access Survey, 2015 Self-reported substance use, physical activity, and social emotional health behaviors: Healthy Kids Colorado Survey, 2015 Youth arrests and victims of violent crime: Denver Public Safety, 2015- 2016 Positive Youth Development Factsheet, Colorado Department

• f Public Health and Environment

2017 Point In Time Summary: Denver County, Metro Denver Homeless Initiative, 2017 Gentrification Study: Mitigating Involuntary Displacement, Denver Office of Economic Development, 2016 Mayor Hancock’s State of the City Address, 2017

SOURCES

This Photo by Unknown Author is licensed under CC BY-SA 36

E-mail: Brenna.spencer-castanon@denvergov.org

Questions? Thank you!