population.health.blog

Garrett County Insights

Chronic Diseases (Cancer, Heart Disease, Diabetes, etc…)

Insight #1

According to the most recent Garrett County Community Health Assessment (https://mygarrettcounty.com/cha2021/), Chronic Diseases (Cancer, Heart Disease, Diabetes, etc…) was the 6th most important priority identified by Garrett County stakeholders in the prioritization survey (see more in the 2019-2021 Community Health Assessment Research Portal – CHArp
https://garrettcountyhealthdepartment.github.io/CHArp/).

The latest guidelines demonstrate that, based on the best science, everyone can improve their health just by moving. (https://health.gov/paguidelines/default.aspx)

The CARC demonstrates they are interested in youth by tracking utilization and offering special programming. Visit their action group to learn more about their efforts to address chronic diseases at: https://mygarrettcounty.com/groups/garrett-college-community-aquatic-and-recreation-complex/

Not into the gym? Check out a new trail in our area and learn more about local non-profit Garrett Trails, by checking out their action group at: https://mygarrettcounty.com/groups/garrett-trails/

or simply walk to your neighbors to say hi to get your heart pumping (as long as it’s warm enough to be outside).

Insight #2

“Seven of the top 10 leading causes of death in the United States are from chronic diseases. Eating a diet rich in fruits and vegetables daily can help reduce the risk of many leading causes of illness and death, including heart disease, type 2 diabetes, some cancers, and obesity.” (CDC, https://www.cdc.gov/media/releases/2017/p1116-fruit-vegetable-consumption.html)

It’s difficult to find programs or county-wide initiatives for addressing chronic diseases that are open to everyone in Garrett County.

The Garrett County Health Planning Council (https://mygarrettcounty.com/groups/health-planning-council/) just held a breakout to see how we could work together more effectively to help people make choosing a healthy lifestyle the easier choice! Check out what they are planning at https://mygarrettcounty.com/groups/health-planning-council/ad-hoc-committee-on-diabetes/.

Do you have an idea that would help Garrett County residents prevent and/or manage diabetes? We’d love to hear your thoughts in any of these action groups!

Insight #3

The Age-Adjusted Death Rate (C. Heart Disease) in Garrett County, Maryland is 53.7% higher than the national average.

This is very important as heart disease is the leading cause of death in the United States (https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm).

“The prevalence of heart disease in Garrett County is high and residents of all ages need to know their risks and how to prevent a cardiovascular event. The goal is to get those already diagnosed with high blood pressure to take their medications and make lifestyle changes as prescribed by their doctors, and to identify those with undiagnosed hypertension.” Check out the inspiring Blood Pressure Monitoring Program Action Group at: https://mygarrettcounty.com/groups/blood-pressure-monitoring to see how the Garrett County Health Department’s Health Education and Outreach Unit is working to improve access to screening in Garrett County.

Taking Action!

We hope you’ve enjoyed learning about these Garrett County Insights. Stay tuned for more data insights as we work through the extensive Garrett County Community Health Assessment to share important findings with our community stakeholders. Visit mygarrettcounty.com and keep up to date with the insights as they are reported at the Health Planning Council by all of our sectors. Follow that group by joining https://mygarrettcounty.com/groups/health-planning-council/.

Updating From The UCPT (2018 Versions)

Disable, but do NOT uninstall the UCPT plugins. (Depending on the version you have, this may be either one UCPT plugin or three separate modules: UCPT Manager, UCPT Strategy Card, and UCPT Raw Data.)
Search the WordPress plugin repository inside your admin panel (yoursite.com/wp-admin) under the plugins tab for “Garrett County Planning Tool” (The new version merges both the UCPT and GCPT branches to facilitate open source development and compatability as the projects continue to grow rapidly.)
Activate your new “Garrett County Planning Tool” plugin.

Community Collaboration For Public Health Professionals

Working Across Sectors

Article written by Shelley Argabrite, Chief Health Strategist at the Garrett County Health Department

Creating a vision for our county and incrementally measuring our progress toward the goals we set together has created a true culture of collaboration in Garrett County.
-Shelley Argabrite

In the community forum of the adaptive planning tool found at MyGarrettCounty.com, individuals have the space to openly discuss issues, concerns and suggest solutions to address what matters to them most. Community feedback on such a large scale has informed prioritization of health related topics and helped us develop ways to track our progress as we measure the work we are doing on a local level to address the most pressing health related topics.

Measuring our collaborative work is not an easy task. In Garrett County, we created a space that everyone could track their individual contributions toward prioritized health outcomes. On the Garrett County Planning Tool, this hyper local data collection is completed within Action Groups. Action Groups were created to activate sustainable mobilization of the discussions in the community forum and actualize strategies for community improvement marking an important step toward ensuring that measures reflect what is most important.

Within action groups, multisectoral partners work collectively on a strategy reporting incremental data that ensures responsiveness of the public health network in Garrett County.
-Shelley Argabrite

Ready to learn more and start building your community platform on our open source stack? Check out our free plugin template at: https://population.health.blog/garrett-county-planning-tool/

Article written by Shelley Argabrite, Chief Health Strategist at the Garrett County Health Department

Community Health Improvement for the Public Health Professional

Increasing Awareness & Engagement

Article written by Shelley Argabrite, Chief Health Strategist at the Garrett County Health Department

Do people in your community know what health planning is, why it’s attempted and how it can impact their daily lives? The results from our 2016 Community Health Needs Assessment¹ let us know too many people in our community weren’t aware of core safety net programs let alone a community health improvement plan. As public health professionals we need to make sure the public is well informed of the available services in the community and clearly communicate how people can become more involved in the process. Communities are hurting; many struggle to afford adequate essentials like food, shelter, and medical services. Yet others in the same community are thriving and have a very different quality of life. To accomplish meaningful health improvement planning we need to meet our communities where they are and give everyone an opportunity to participate.

To address the growing disparities candidly we need to understand and appreciate as many perspectives as possible.
-Shelley Argabrite

In Garrett County, this meant changing the way we approached elements of health planning. We began by defining health planning within the constructs of our health department and the community we serve. It’s important to consider state and local governance and accreditation status as both aspects may provide frameworks in how health planning activities are operationalized.

The state of Maryland is considered a largely shared state in governance with the local boards of health in every county in Maryland.² This allows the local health departments to be more nimble and uniquely positioned to tailor systems and approaches that are reflective of the local community. In Garrett County’s case, I was hired as a health planner to carry out the essential functions of leading the community health assessment and the community health improvement plan after initial Public Health Accreditation was sought through the Public Health Accreditation Board. ³ Since that time, the team has been expanded and preparations are being made to create a Population Health Unit housed within the local health department to lead the effort.

Equity in community engagement is largely supported by the high standards that accompany accreditation.
-Shelley Argabrite

Equitable approaches are woven through the standards and measures set forth by the Public Health Accreditation Board, and by committing to follow those standards, health departments have no other option, and must accept the challenge of improving equity. As a new health planner, I inherited an existing community health improvement plan and an action plan issued from PHAB within my first week of employment. The standards to improve equity from PHAB were instrumental in gaining the support needed to innovate and make equity a priority as we moved toward functioning as a high level health department.

If you don’t know, find out.

So, how many people in your community are aware that your health department is involved in conducting a community health assessment or crafting a community health improvement plan? That was one of the first questions we had to answer for ourselves and the answer caused us to question everything. We found that only ½ of 1% of our entire county population was aware we had a community health improvement plan. Out of the approximately 150 people that were aware of our health improvement processes, most of them were agency stakeholders. A turning point in our process was honestly assessing equity within our community, and inherently, addressing the unmistakable need to drastically change our approach.

In a National Community Engagement Analysis Survey conducted at PHIT (Public Health Improvement Training) in Alberqueque, a sample of 100 communities revealed that less than 5% of community members were aware of either a community health assessment or community health improvement plan.

This supports the notion that community engagement is difficult and our agency is not alone in this journey. Inspiration to innovate and drive change toward improving equity is being recognized on national levels with competitive funding opportunities.⁴ Take the time to honestly assess how you approach improving equity and seek ways to improve it. I invite you to consider once again your governance and how the policies in place empower or hinder your ability to be inclusionary in the processes of health planning. There are many great tools out there, so find one and use it. As we refine our approaches toward improving equity, take the time to redefine your own operating standards, and make the case for equity conversations in your community. We are called to a higher standard and our communities are depending on our abilities to ignite change by collaborating with everyone!

Additional Resources:

See the Equity Profile designed by the Colorado Department of Public Health & Environment found here https://www.colorado.gov/cdphe/ohe

References

Garrett County Health Department 2016 Community Health Assessment. Garrett County Health Department. Oakland, MD: Population Health Unit; 2016 https://mygarrettcounty.com/cha/.
http://www.astho.org/Research/Major-Publications/ASTHO-NORC-Governance-Classification-Report/
Public Health Accreditation Standards & Measures Version 1.0. Alexandria, VA: Public Health AccreditationBoard; 2011. http://www.phaboard.org/wp-content/uploads/PHAB-Standards-and-Measures-Version-1.01.pdf. Accessed July 6, 2017.
Public Health National Center for Innovations. Alexandria, VA: PHNCI; 2018. https://phnci.org/journal/phnci-innovation-grant-program

Author: Shelley Argabrite, M.A., Strategic Health Planner, Garrett County Health Department

Investing in Open Source Public Health

Successes & Replication

Following an incredibly successful pilot launch in Garrett County, Maryland, the Garrett County Health Department was able to apply for and receive funding from the Robert Wood Johnson Foundation thru the Public Health National Center for Innovation (PHNCI), a division of the Public Health Accreditation Board (PHAB).

This funding assisted in the open source release, expansion, and later replication of the Garrett County Planning Tool (Universal Community Planning Tool, UCPT, previously) in diverse communities across the United States, including: the District of Columbia (DC), Allegany County, Maryland, Medina County, Ohio, Flathead City-County, Montana, and Clackamas County, Oregon.

Following these five highly successful pilots in communities both rural and urban, from coast-to-coast, Garrett County received additional funding to compose an open source guide and toolkit (v1, UCPT) and PHNCI published a comprehensive, cumulative case study produced by NORC at the University of Chicago.

The Garrett County Planning Tool continues to be replicated in communities to this day, and currently has a waiting list of communities looking for technical assistance.

Community Engagement For Public Health Professionals

Article written by Shelley Argabrite, Chief Health Strategist at the Garrett County Health Department

What are you most passionate about for your community? Should we be surprised when programs have little to no impact on health outcomes when we fail to consider the community’s deep rooted concerns? Asking residents a few questions about their well-being on a long questionnaire every few years for our community needs assessment does not get to the heart of building community buy-in to improve health.

Our intention when we opened our processes digitally was to start a conversation. It was important to us that people knew there was a place where they could truly be heard. Their ideas, questions, concerns, passions and general perspectives though they may differ from others had a place in the larger collective called Garrett County.

We wanted to foster a sense of belonging for everyone regardless of their status, place of employment, or any other qualifier by inviting all people to our table to have a conversation around topics that impact their daily lives and together, get closer to the solutions we need to improve our health by improving our lives.
-Shelley Argabrite

Let’s consider a few questions as we proceed with an equity lens and explore community engagement:

Why are we engaging with the community in the first place?
What do we hope to accomplish by engaging with the community?

If you are in the field of public health improvement and are interested in making a difference, you know it is impossible to succeed without collaboration.

Writing a plan with little or no input from the community may check the box, but how much impact does it actually have?
-Shelley Argabrite

Why are we engaging with the community in the first place?

Our answer is that it gives our work meaning. Writing a plan that lacks collective vision from the community is one that will certainly sit on the shelf and will not inform the work we do to improve health by ultimately seeing better outcomes. We engage with our community because we exist to serve them.

The strength of a public health system rests on its capacity to effectively deliver the 10 Essential Public Health Services: Monitor health status to identify community health problems. Diagnose and investigate health problems and health hazards in the community. Inform, educate and empower people about the health issues. Mobilize community partnerships to identify and solve health problems. Develop policies and plansthat support individual and community health efforts. Enforce laws and regulations that protect health and ensure safety. Link people to needed personal health services and assure the provision of health care when otherwise unavailable. Assure a competent public health and personal health care workforce. Evaluateeffectiveness, accessibility and quality of personal and population-based health services. Research for new insights and innovative solutions to health problems.¹

I invite you to pause and answer this question for yourself. Where do you fit and why are you engaging with the community? Public health is changing² and in an effort to exceed the current standards set for us, I encourage you to lead your community on this equity quest through unprecedented engagement.

What do we hope to accomplish by engaging with the community?

In Garrett County, we want to build trust by cultivating relationships through conversations. A community forum in the digital sense could be considered a dated concept, but what emerges through this technology is essential, it is communication. We utilized the forum concept and applied it so we could “engage” in two way communication. In the literature the concept is referred to as dialogic communication³ and that type of communication is ancient compared to our archaic, dated technological forum. We know that to attain this ancient and at times mystical art called communication, we need several elements. For the purpose of this excerpt, we simply began. We created a place and invited people to join us. In that place there are real people from all sorts of backgrounds communicating in a transparent way. Together, community members and agency stakeholders alike ask questions and find answers collaboratively. We have a shared vision, it’s to make Garrett County the best place to live, work and play! In order to achieve that every member in our community needs to be a part of the conversations that create the plan to incrementally make that happen.

There is a growing body of evidence that supports the notion that a sense of belonging is recognized as an important determinant of psychological and physical well-being. ⁴

Being invited is the very first step.
-Shelley Argabrite

Sources

https://www.cdc.gov/stltpublichealth/publichealthservices/essentialhealthservices.html
https://phnci.org/fphs
Augustine Pang, Wonsun Shin, Zijian Lew & Joseph B. Walther(2016) Building relationships through dialogic communication: organizations, stakeholders, and computer-mediated communication, Journal of Marketing Communications, 24:1, 68-82, DOI: 1080/13527266.2016.1269019
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4546026/

Article written by Shelley Argabrite, Chief Health Strategist at the Garrett County Health Department

Connecting Your Community Health Assessments & Community Health Improvement Plans

Connect Your Community Plans

You’ve just finished your incredible Community Health Assessment (CHA), and you’re ready to take your first steps into the daunting realm of Community Health Improvement Planning (CHIP) – there’s just one problem, you have no clue where to start.

We’ve been there, and shelves of books, frameworks, and plans only seem to complicate processes that should, rather simply, focus on people over checking the necessary boxes.

Well, lucky for you! We’ve traversed the depths of the Internet, combed over the countless conferences, and scavenged databases and diagrams to produce a simple, easy to implement tool that you can build around your community’s vision in less than an hour to produce a Community Health Improvement Plan that matters and is utilized across sectors to build a Culture of Health.

The Garrett County Planning Tool simplifies these linkages by organizing community-sourced, hyperlocal data around your community’s priorities – not a standard boilerplate – and reflects the programs and systems that support your network of care.

Once you install the free, open source Garrett County Planning Tool plugin (compitable with most WordPress-based websites), you’re only a few minutes away from beginning to demonstrate value through dynamic insights that emerge within minutes of completing your installation (and connecting it with popular services, such as Google Analytics, Facebook Insights, etc…).

To get started, or learn more about the Garrett County Planning Tool, visit https://population.health.blog/garrett-county-planning-tool/.

Pre-Launch Strategies

With a score of at least 7 or more from the Action Plan for Readiness exercise, approach this venture with confidence that you’ve got what it takes to make the implementation of the GCPT successful in your community!

However, if your community scores lower than a 7, implementing the GCPT may be exactly what your community needs. Sometimes offering something different is all it takes to bring community champions forward, or begin conversations about culture that haven’t previously been discussed. More effort will be necessary for successful implementation, but overcoming barriers are what helps us grow. So think outside the box, seek a fresh perspective, and dig in!

Before we get into the actual technical install let’s think about where people are going to access your platform. Whether you’re doing this on your own or working with a technical team, you’ll need to have a good idea of what you want your domain name to be before you start the process.

What’s in a name?

Choosing your domain name carefully with inclusion at the forefront is a critical piece to the success of your efforts. It’s unlikely that the community or agency stakeholders will feel ownership of the platform if it’s buried in an organization’s existing website. A name that is reflective of the purpose and is easy to remember is a great place to begin.

Collaboration: A Fresh Perspective

You’ve already identified the person who will champion this effort in the “Readiness Exercise”. The highest performing GCPT implementers have an attitude of service and are eager to invite both the community and agency stakeholders to share what matters to them by conveying the benefits of the platform and meeting people where they are! Traditional approaches to engagement and the notion of “setting the table” aren’t recommended. However, pulling up a chair to their table and fostering meaningful relationships that will be reflected on the Planning Tool is the essence of the type of true community engagement that can be beautifully demonstrated on your installation just as it is in Garrett County, MD, home of the GCPT family.

Community Champions

There are many resources that help us think about the ways we define and engage with our community. A collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute published a learning guide titled, Partnering with Residents-Getting Started*.

*http://www.countyhealthrankings.org/take-action-to-improve-health/learning-guides/partnering-with-residents

We suggest identifying a minimum of three active community champions as early in the process as possible to ensure everything from concept design to continued implementation of the GCPT is tightly woven with an active community presence that will improve organic sustainability of the work.

Foundations of the Action Groups within your GCPT

What matters most to people will be the basis of the action groups that create mobilization within your community. It’s here that you’ll gather both qualitative and quantitative data around the topics that are of greatest interest in your community. It’s helpful to work with your community champions to build a content framework for a few action groups before launch to use as a model as your process begins.

Pick a date and stick to it

Going “LIVE” and actually launching the site is more difficult than you might imagine. The installation of the GCPT has been the primary focus, but the Planning Tool needs to come to life! As we guided five diverse communities through an initial replication pilot, reassurance in their processes and coaching to maintain the original intent of the Planning Tool made it easier to commit. It takes serious vulnerability to put your work out for the world to see. There always seems to be something to tweak or another plug-in that may improve the user experience, but at some point, you need to trust your work and push the button. That’s why choosing a date ahead of time and strictly following your project timeline is recommended to launch within a reasonable time frame.

About the Garrett County Planning Tool

What is the Garrett County Planning Tool (GCPT)?

The Garrett County Planning Tool (GCPT) is the world’s first FREE and open source population health engagement framework built upon the world’s most popular content management system – WordPress – to enable every community to have the opportunity to increase transparency and activate engaged stakeholders.

Who can implement the GCPT?

Anyone! This work is being replicated in public health agencies, hospitals, non-profits, volunteer groups, higher education, library systems, and county governments. There is tremendous utility in a variety of sectors and we can’t wait to see who else joins the GCPT family!

Replication Sites:

Allegany County, Maryland – alleganyspeaks.com

District of Columbia – ourhealthydc.org

Medina County, Ohio – livingwellmedinacounty.com

Flathead City-County, Montana – flatheadforward.com

Clackamas County, Oregon – blueprintclackamas.com

South County, Rhode Island – ourbodiesminds.org

Cecil County, Maryland – mycecilcounty.info

Have you joined the GCPT family? Tell us so that we can feature you too!

Innovative Emerging Practice in Public Health

Imported article from May 2018.

The newest emerging practice in Public Health for digital community engagement is an innovative collaborative platform found at mygarrettcounty.com. For our rural Appalachian community, this platform is a radical shift away from the traditional bureaucratic process of creating a community health improvement plan led by the local health department. In just ten months we’ve increased awareness exponentially. Stakeholders are not only aware of our local Community Health Improvement Planning process, but nearly 5% of our entire population has actively engaged in formulating components of the next iteration of this plan. Creating a vision for our county and incrementally measuring our progress toward the goals we set together has created a true culture of collaboration in Garrett County.

Transparent dialogue between local health officials, agency stakeholders, and the general public continues to be a key component in improving equity and building capacity. Strategically investing in digital technologies allows people to collaborate more efficiently and work better as a team, which is helping us to achieve our desired outcomes. In the community forum of the adaptive planning tool found at mygarrettcounty.com, individuals have the space to openly discuss issues, concerns and suggest solutions to address what matters to them most. Community feedback on such a large scale has informed measure development and prioritization, marking an important step toward ensuring that measures reflect what is most important. Action groups were created to employ methods that will stimulate sustainable mobilization of the discussions in the forum and actualize strategies for community improvement. Within action groups, multisectoral partners work collectively on a strategy reporting incremental data that ensures responsiveness of the public health network in Garrett County.

With well over 55,000 page views and 1,485 active planning partners in less than ten months, the planning tool has completely changed the way our community conducts strategic health planning.

What’s most exciting is that we get to share this innovation with other communities! Our goal is to foster a culture of innovation in public health and successfully replicate and measure meaningful community engagement across our nation to improve health.

Imported article from May 2018.