Ask The Expert Understanding the Issues: How to Use Community - - PowerPoint PPT Presentation
Ask The Expert Understanding the Issues: How to Use Community Assessment, Evidence, and Theory to Inform Your Cancer Control Approaches with Dr. Jennifer Leeman, Dr. Cam Escoffery, and Dr. Patricia Mullen The session will begin at 12:00 p.m.
The session will begin at 12:00 p.m. Eastern. Audio: Use computer speakers or phone (1-866-307-6033) If connecting by phone, please put your phone on mute!
Live tweet this event: @GWCancerInst #CompCancer #TAPAskExpert
Associate Professor of Behavioral Sciences and Health Education at the Rollins School of Public Health
Assistant Professor in the School
Professor at University of Texas School of Public Health Center for Health Promotion and Prevention Research
Understanding the Issues: How to Use Community Assessment, Evidence, and Theory to Inform Your Cancer Control Approaches
Jennifer Leeman, DrPH, MDiv University of North Carolina at Chapel Hill Cam Escoffery, PhD, MPH, CHES Rollins School of Public Health, Emory University Pat Mullen, PhD University of Texas School of Public Health
processes for selecting, adapting, and evaluating an evidence-based approach
community assessment
multiple levels of determinants
communications project
approaches, programs and policies
Jennifer Leeman, DrPH, MDiv Assistant Professor, School of Nursing & Principal Investigator, Cancer Prevention & Control Research Network Collaborating Center University of North Carolina at Chapel Hill
Houston
Funders
(Escoffery et al. 2012; Hannon et al. 2013)
they lack knowledge and skills
need for training on how to – Find EBS – Assess strength of evidence supporting an EBS – Assess EBS fit with their population or setting – Assess organizational capacity to implement EBS – Adapt EBS to population or setting – Implement with quality (Escoffery, Hannon, Maxwell, Vu, Leeman et al. 2015)
http://cancercontrol.cancer.gov/use_what_works/start.htm
Lesesne, C. A., Lewis, K. M., Moore, C., Fisher, D., Green, D., & Wandersman, A. (2007). Promoting Science-based Approaches to Teen Pregnancy Prevention using Getting To Outcomes.
with the Best Fit
Fit Your Community
based Strategies
Assessing your Community Implementing & Evaluating Establishing Goals & Objectives; Planning for Evaluation Finding Evidence Selecting Best Fitting EBAs Adapting
processes for selecting, adapting, and evaluating an evidence-based approach
assessment
behavioral/environmental objectives based on community assessment data
A Community Assessment is a systematic data collection to look at the difference between what is and what should be in a group and situation of interest, AND the identification of resources available to address this gap.
(Adapted from Gilmore & Cambell cited in Green & Kreuter, 2005)
in your community
may support or inhibit goal attainment
(e.g., determinants of health)
1. List three things that you would like to know about your community before developing a health communication plan. 2. Where can you find this information?
Risk Factor Surveillance System (BRFSS)
A Community Assessment can be conducted in a community by addressing the constructs of the PRECEDE phases in the PRECEDE-PROCEED Model.
Phase 4: Determinants of Behaviors Phase 3: Behavioral and Environmental Factors Phase 2: Health Problems Phase 1: Quality of Life
Sources: Green & Kreuter, 2006; Bartholomew et al., 2006
PRECEDE: Predisposing, Reinforcing, and Enabling Constructs in Educational/Environmental Diagnosis & Evaluation (leads up to the intervention) PROCEED: Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development
The range of social, environmental and personal factors that influence health behaviors
E.g., social support for change
E.g., parks, access to healthy foods
E.g., Socio-economic position, religious & cultural values, knowledge, attitudes & beliefs about health risks and behaviors, communication preferences and media access
Phase 1: Quality of Life Example Questions
Life expectancy What is the average lifespan?
Phase 2: Health Problems
Chronic disease rate Which diseases are most prevalent?
Phase 3: Behavioral Factors
Behaviors What behaviors put people at risk? What is their media use? How do they seek health info? Social factors Where do people spend most of their time?
Phase 3: Environmental Factors
(e.g., social, built, and media environment)
Environmental What facilitates/hinders healthy behaviors? Demographics Where do they live? Communication Where do people obtain health information? What are their communication preferences?
Sources: Emory Prevention Research Center & Bartholomew et al., 2006
Phase 4: Determinants of Behaviors
Health problems What are their health problems? What are barriers to improving health care? Values/Attitudes What is important to them? (areas in their lives in which you can put messages in context) What are their opinions? What are their attitudes toward the condition/behavior? Individual factors What are the personal knowledge/attitudes regarding the health issue/behavior? What are important lifestyle factors (cultural foods, interactions)? Social and cultural factors What are commonly held beliefs and attitudes about health, health care, health institutions, or particular health behaviors such as exercise? Demographics of target population Where do people live? What are the ethnicities, education levels, ages, etc.?
Sources: Emory Prevention Research Center & Bartholomew et al., 2006
A community asset or resource is: anything that improves the quality of community life. Assets include: – Capacities and abilities of community members – A physical structure or place or infrastructure
For example, a school, hospital, church, library, recreation center, or social club; Communication channels
– A business that provides jobs & supports the local economy – Civic or Cultural associations (a Neighborhood Watch or a
Parent Teacher Association)
– Local private, public, & nonprofit organizations
Data that you collect
Data that has already been collected and published in a report, website, publicly available dataset or journal article
Departments)
What other sources would YOU include?
List of Secondary Sources: Handout #1
Example: What is the CRC Incidence in Salt Lake County? Scroll down to Salt Lake
– What is the specific problem/question that I want to address? – What type of literature should I review? – What issues should I be looking at more closely? – What are the key words?
Journals versus magazines: – Peer review – Use review articles How to search: – Key words with quotes – Publication Year – Combining terms (internet & youth & physical activity) Web sites: – .gov, .org, & .edu vs .com – PubMed.gov
– Unstructured or semi-structured interviews – Focus Groups (small group discussions) – Public meetings or forum – Direct observation of community or people
– Structured interviews – Surveys
Important considerations: – Participants
Representative of the group you want to learn about?
– Methods used to collect data (e.g., Mail, Online, Phone, In Person)
Influence types of people who will respond
– Resources Needed (e.g., Cost, time, incentives, and human resources)
Vary depending on methods used
Literature Review Secondary Data Collection Primary Data Collection
Communication Plan: Audience Important Determinants at multiple levels Current Interventions/infra structure
attitude, or behavior
“SMART” Objectives Specific: Who and What? Measurable: How much/many? Achievable: Attainable w/ given time frame & available resources. Realistic: Address the scope of the problem and programmatic steps that can be implemented w/in the time frame. Time specific: By When?
Example Goal: – “Reduce cervical cancer mortality in the community”. Example Objectives: – Knowledge: “By the end of the first education session, at least 80% of the participants will be able to list three risk factors for cervical cancer”. – Attitude: “By the end of the program, at least 80% of the participants will answer “strongly agree” or “agree” to whether they think cervical cancer screening is important to their health”. – Behavior: “5 months after the program ends, at least 50%
Health Goal:
Reduce CRC morbidity & mortality
Behavior:
>60% will
screening
Environment:
Free or low cost fecal tests are available
Knowledge:
>80% can list 3 CRC screening
types
Attitude:
>90% rate CRC screening as very important
Self-efficacy:
>80% express confidence in their ability to obtain CRC screening
What is the level(s) of the intervention? –Individual (e.g., risk communication, social cognitive theory) –Interpersonal ( –Organization Community (e.g., Diffusions of Innovations,
What are you impacting? –Awareness –Knowledge or skills –Behavior –Social influence –Systems change –Environmental change
What theory includes those constructs or domains?
–Social Cognitive Theory (SCT )
behavior)
behavior or issue
strategies to meet the needs of your community (ie., best messages, materials, delivery/channels)
make them more relevant to the community (e.g., change content, modify message?, images?, etc.)
Assessing your Community Implementing & Evaluating Establishing Goals & Objectives; Planning for Evaluation Finding Evidence Selecting Best Fitting EBAs Adapting
Remember to cite the source for your approach! 49
they include?
relatively unbiased?
51
studies or >=1 systematic review(s) with strong positive results; no substantial contradictory evidence.
research evidence is limited…
DP001944)
Research-tested interventions – interventions for which efficacy/effectiveness has been tested in one or more research studies... Practice-tested interventions – practitioner-developed interventions that show promise based on their underlying theory, use of evidence-based strategies, and potential for public health impact (RE-AIM) based on evaluation findings… Emerging interventions - practitioner-developed interventions that show promise, but lack evaluation data.
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