Population and Community Health Interventions

What do population and community health interventions need to ensure?

Meeting individual, group, and population occupational health needs

What does the occupational therapy practice framework outline occupational therapy's role in?

Health promotion

Triple Aim of Population and Community Health Interventions

1. Improve the health of populations

2. Enhance the care experience (e.g. client-centered)

3. Reduce health care costs

Quadruple Aim of Population and Community Health Interventions

1. Improve the health of the population

2. Improve the patient experience

3. Reduce health care costs

4. Improve care team wellbeing

Quintuple Aim of Population and Community Health Interventions

1. Population health

2. Patient experience

3. Reducing health care costs

4. Care team well-being

5. Equity and inclusion (e.g. needs, data, stakeholders)

What term can be defined as the levels of cooperation, coordination, and collaboration characterizing the relationships between professions in delivering patient-centered care?

Interprofessional teamwork

Interprofessional Teamwork

Levels of cooperation, coordination, and collaboration characterizing the relationships between professions in delivering patient-centered care

What is a big part of health promotion and education?

Program development

Program Development

Planning and developing implementation and evaluation strategies

What does program development involve?

Continuous cycle of needs assessment, planning intervention, implementation, and evaluation with feedback at each step to revise or improve previous steps

5 Steps of Program Development

1. Needs assessment and analysis

2. Strategic planning

3. Resource mobilization

4. Implementation and monitoring

5. Operational peer review and evaluation

Best Practices of Program Planning

Communication with targeted group

Identifying strengths, weaknesses, opportunities, and threats

Establishing priorities, objectives, and resources

Designing, implementing, and evaluating program activities

What is the most important step before initiating a program?

Preplanning

Preplanning of Program Development

Who should be involved (e.g. key stakeholders)?

When should planning occur?

What resources are needed (e.g. internal, external)?

What process will be followed (e.g. brainstorming)?

Stakeholders

Persons who may or may not benefit directly being involved in the potential program but who may have a stake in the program's outcome and often the ability to influence that outcome

What stakeholders should those developing a program start with?

The people they wish to serve within the community

What is key in program development?

Collaboration (shared decisions)

Cooperation (working together)

Coalition (team)

What data can program developers use to gather information in the preplanning phase?

Previous data from other sources

Qualitative data (e.g. focus groups, interviews, testimonials)

Internal and External Resources of Program Development

Attitudes

Policies

Available expertise

Time

Space

Money

Priorities that fit with an organizations mission

What term can be defined as a collaborative approach to research that equitably involves all partners in the research process and recognizes the unique strengths that each brings?

Community based participatory research

Community Based Participatory Research

A collaborative approach to research that equitably involves all partners in the research process and recognizes the unique strengths that each brings

What is the difference between program development and community based participatory research?

Mutual ownership and shared decision making

Building partnerships between researchers and communities

Range of settings (e.g. rural vs urban)

Variety of research methods

What does community based participatory research start with?

A research topic of importance to the community

What is the aim of community based participatory research?

Combine knowledge with action to achieve social change, improve health outcomes, and eliminate health disparities

Purpose of Community Based Participatory Research

Open communication with community members

More likely to meet community needs

Community's attitudes can change benefitting the community

Breaks down cultural, racial, and class barriers

Community Based Participatory Research Process

Community assessment and diagnosis

Defining the issue and forming a research question

Implement

Evaluation and interpreting results

Disseminating and translating research findings

How does community based participatory research involve communities?

Community entry

Health problem identification

Study design (e.g. pre/post-test)

Participants recruitment and retention

Data collection

Data analysis and reporting

Report dissemination (e.g. conference)

Who is involved in community based participatory research?

People most affected by the research issue

Who is trained in community based participatory research?

Both academics and lay community members

Who does community based participatory research assist?

Target community

What data is collected in community based participatory research?

Qualitative research

Quantitative research

3 Models of Community Based Participatory Research

1. Single-theme collaboration

2. Targeted, area-based collaboration

3. Broad-based coalition

Who does single-theme collaboration most commonly occur between in community based participatory research?

A university-based center and a community organization

Who does targeted, area-based collaboration most commonly occur between in community based participatory research?

Academic researchers and a small group of community organizations

Who does the broad-based coalition most commonly involve in community based participatory research?

Grassroots organizations

3 Types of Community Based Participatory Research Interventions in Occupational Therapy

1. Community-based

2. Community-level

3. Community-centered

Which type of intervention provides health services in community settings where people live, work, go to school, or play (e.g. community mental health); community-based, community-level, or community centered?

Community-based

Which type of intervention is population focused, changing norms in behavior to facilitate health outcomes (e.g. smoking cessation at restaurants, drinking and driving, sexually transmitted infections prevention); community-based, community-level, or community centered?

Community-level

4 Types of Community-Level Interventions

1. Sociocultural

2. Economic

3. Political

4. Environmental

What are community-level interventions based on?

Loose partnerships and grant funds

Which type of intervention is initiated by the community (e.g. food/meal services post hurricane Harvey organized by the community with assistance from researchers and corporations); community-based, community-level, or community centered?

Community-centered

What do community members act as in community-centered interventions?

Experts (seeking additional support if needed)

What do researchers act as in community-centered interventions?

Resources or facilitators

3 Models of Community Based Participatory Research in Occupational Therapy

1. MAPIT (mobilize, assess, plan, implement, track)

2. Person-Environment-Occupation-Performance Model

3. Quality of Life Model (doing, being, belonging, becoming)

What type of analysis can a clinician conduct using the Person-Environment-Occupation-Performance Model in community based participatory research?

Situational analysis (e.g. population description, environmental scan, health status, intrinsic factors, occupational participation)

Purpose of Occupational Therapy in Community Based Participatory Research

Capacity building (e.g. synergy - working together)

Developing a shared vision

Sustainability

What term can be defined as the process of identifying strengths, assets, needs, and challenges specific to a targeted community or population?

Needs assessment

Needs Assessment

Process of identifying strengths, assets, needs, and challenges specific to a targeted community or population

Tools of a Needs Assessment

Data analysis

Interviews and observations

Focus groups

Personas (e.g. archetype)

Case

2 Phases of a Needs Assessment

1. Planning and organizing

2. Methodology

What occurs during the planning and organizing phase of a needs assessment?

Information gathering (e.g. identify needs of target population)

Learn about community being assessed (e.g culture, resources)

Determine area of needs assessment

Perform a literature review

Identify goals and objectives (e.g. strategy, roles, schedule)

Who is information gathering in the planning and organizing phase of a needs assessment facilitated by?

Care provider

Practitioner

Community leaders

Community as a whole

What occurs during the methodology phase of a needs assessment?

Preparation (e.g. outcome measures)

Community profile (e.g. population, condition, context)

Evaluation (e.g. effectiveness, efficacy, achievement, results)

Outcome Measures of a Needs Assessment

Focus groups

Surveys

Town halls

Data collection

Data analysis

Final report presentation

Data Collection of a Needs Assessment

Secondary data (e.g. stakeholders, funding, time)

Written questionnaires

Interviews

Public forums (e.g. townhalls)

Focus groups

What term can be defined as the ideal state or ultimate level of achievement to which the organization aspires; vision or mission?

Vision

Vision

The ideal state or ultimate level of achievement to which the organization aspires

What term can be defined as an organization’s core purpose or the basis for its existence, focus, and actions; vision or mission?

Mission

Mission

An organization's core purpose or the basis for its existence, focus, and actions

INSPIRE Model

Identify core values

Name the population

Set the vision

Plan how to achieve the mission

Identify activities that align with the mission

Review, revise, and refine

Enlist others

Community Program Implementation Plan

Target population (e.g. who will the program serve?)

Recruitment (e.g. how will the program recruit those in need?)

What should the practitioner do prior to writing goals?

The practitioner should link the programming, implementation, and evaluation plan

Difference Between Goals, Objectives, and Activity

Goal: What is the aim

Objective: Attached to goals to ensure the desired result

Activity: Tasks performed that are aligned with goal/objective

SMART Objectives

Specific

Measurable

Attainable

Realistic

Time

What type of interventions offers health services in a community setting in which people live, work, go to school, or play?

Community health

Community Health

Offers health services in a community setting in which people live, work, go to school, and play (e.g. St. Vincent's)

3 Types of Community Partnerships

1. Community action (e.g. specific community issue or problem)

2. Community organization (e.g. agencies share same purpose)

3. Community development (e.g. increased participation of all)

How is trust established in the community?

Costs and benefits analysis

4 R's of Trust

Cultural norms

4 R's of Trust Establishment in the Community

1. Reliability

2. Roles

3. Respect

4. Rituals

2 Parts of a Sustainability Plan

1. Identify challenges to sustainability

2. Consult a committee or task force

Community Health Programs

Better Living for Texans

Healthy Texas women

STREETS (Safe Travel Environment Evaluation in Texas Schools)

Better Living for Texans

A statewide nutrition education program for adults and kids who want to learn how to eat well and save money

Healthy Texas Women

A program dedicated to offering women’s health and family planning at no cost to eligible women in Texas (e.g. help women plan their families)

STREETS (Safe Travel Environment Evaluation in Texas Schools)

Study will be conducted over a five-year period, and will ultimately help schools identify the most successful and efficient methods to promote active commuting like walking and cycling