CHL 610 Week 6 Setting Priorities for Intervention Example

From Fourteen Problems to Three Priorities: How Residents and Partners Ranked Community Health Needs on a Yakima Valley East Side

[Student Name]

University of Phoenix

CHL/610: Community Health Assessment

Week 6 Assignment

[Instructor Name]

[Date]

The neighborhoods, candidate issues, scores, votes and chosen priorities are composites written for a model paper modeled on Yakima, Washington; research findings come from the sources cited.

At the steering committee's final assessment meeting, fourteen sheets of paper covered the wall, one for each issue the assessment had found. The hospital's implementation strategy, the health district's plan and the coalition's grants could realistically address three. A resident asked the obvious question: who decides, and how? This paper describes the priority-setting process that answered her.

The Candidate Issues

The fourteen candidates emerged from every stage of the assessment, from existing data to the youth photographs and the asset map: access to primary care, diabetes, obesity and healthy food, physical activity and safe places, mental health services in Spanish, oral health, housing cost and quality, food insecurity, farmworker occupational health, transportation, asthma, teen births and prenatal care, older adult isolation, traffic safety and immigration-related stress.

Why Method Matters

How priorities are chosen affects whether they are trusted. A review of 95 hospital community health needs assessments found wide variation in approach and quality, with stronger reports where hospitals partnered with local health departments, and called for clearer guidance aligning assessment and planning with a public health framework (Pennel et al., 2015). Transparent criteria were the committee's answer.

The Criteria

The committee chose six criteria: size, the number of residents affected; seriousness, including death, disability and cost; disparities, how far the east side trails the city or state; community concern, from the survey and focus groups; effectiveness, whether proven interventions exist; and capacity, whether partners could act within three years.

The Scoring Method

The committee adapted the Hanlon method, a common approach in which each problem is rated for how many people it touches, how grave it is and how well known remedies work, then checked against practical limits. Each issue was scored from zero to ten on each criterion by twelve committee members working independently, and the scores were averaged. Disparities and community concern were given equal weight to size and seriousness.

What the Data Contributed

Data anchored the scores. The County Health Rankings model, which ranks counties within each state from four groups of health factors, with behavior and clinical care alongside income, education, employment and the physical setting, reminded the committee that factors beyond clinical care drive health outcomes (Remington et al., 2015). Issues rooted in food, places and access scored high on size and disparities.

Scores in the Open

The committee posted the full scoring table at the community center and online. Access to primary care scored highest on size and community concern; diabetes and healthy food on seriousness and disparities; farmworker health on seriousness but lower on capacity; traffic safety on effectiveness but lower on community concern. Seeing the scores, residents could challenge them, and two did, leading the committee to raise transportation's disparity score after reviewing bus data.

The Community Forum

Residents had their own say. At a forum attended by 140 people at the community center, with interpretation and child care, each participant received five stickers to place on the issues they cared about most. Issues were explained in plain language on bilingual posters with photographs from the photovoice project.

Combining Scores and Votes

The committee combined its scores with the forum results, converting votes to a ten-point scale and averaging them with the committee's community concern scores. The top six after combining were access to primary care, diabetes and healthy food, safe places to be active, mental health in Spanish, housing and farmworker health.

Choosing Three

The final choice weighed feasibility and connections. Frieden's pyramid argues that altering surroundings so the healthy option becomes the easy one tends to outperform clinical care and education, since it touches more people and asks less of each (Frieden, 2010). The committee favored priorities where partners could change conditions, such as clinic hours, food availability and park safety.

The Three Priorities

First, access to primary care: extended clinic hours, a mobile clinic and community health workers. Second, diabetes and nutritious food: a healthy corner store program, a diabetes prevention program in Spanish and a farmers market accepting food benefits. Third, safe places to be active: lighting the river path, repairing the playground and partnering with the soccer league on field improvements. Each priority pairs a health problem with a change to the places where residents live.

How Residents' Votes Changed the Ranking

The forum shifted the ranking in two places. Safe places to be active moved from ninth on the committee's scores to third after residents gave it more stickers than any issue except primary care, driven by parents and youth. Traffic safety fell, because residents saw it as part of the same problem of unsafe streets and parks. Without the forum, the committee would likely have chosen oral health, which scored well on data but drew few votes.

Why Not the Others

Mental health in Spanish scored high but lacked an available provider workforce in the short term; the coalition will pursue a training grant. Housing scored high on seriousness but requires city policy beyond the partners' capacity; the coalition will advocate. Farmworker health will be addressed through the primary care priority, with outreach at work sites.

Connections Among Priorities

The three priorities reinforce one another. Community health workers in the primary care priority can refer patients to the diabetes prevention program. Lighting the river path supports the activity goals of diabetes prevention. The corner store program serves the same blocks as the mobile clinic. Choosing connected priorities lets limited resources work together.

Equity Check

The committee checked each priority against the question of who benefits. All three focus on the east side's highest-need blocks, including the mobile home park and farmworker housing, and include Spanish-language delivery.

Keeping Momentum

The committee knew assessments often stall after priorities are named. To keep momentum, it set a date for the first workgroup meetings before the forum ended, asked forum participants to sign up for workgroups on the spot and secured the hospital's commitment to fund a part-time coordinator. Sixty-two residents signed up that night.

Next Steps

The priorities will go to the hospital board, the health district's board of health and the coalition's members for adoption. Workgroups for each priority, with residents as co-chairs, will develop an improvement plan with objectives, strategies and measures within four months.

Limits

Scoring involves judgment, and forum participants may not represent all residents; night-shift workers and some farmworkers could not attend, so promotoras collected votes from 45 additional residents at work sites and the flea market. The committee will revisit priorities after one year.

Conclusion

Fourteen issues became three priorities through explicit criteria, a structured scoring method and a community vote. Evidence on uneven assessment quality supported transparency, the County Health Rankings model kept social factors in view and the health impact pyramid favored priorities that change conditions. Access to primary care, diabetes with better food access and safer spaces for exercise now move into planning.

References

Frieden, T. R. (2010). A framework for public health action: The health impact pyramid. American Journal of Public Health, 100(4), 590-595. https://doi.org/10.2105/AJPH.2009.185652

Pennel, C. L., McLeroy, K. R., Burdine, J. N., & Matarrita-Cascante, D. (2015). Nonprofit hospitals' approach to community health needs assessment. American Journal of Public Health, 105(3), e103-e113. https://doi.org/10.2105/AJPH.2014.302286

Remington, P. L., Catlin, B. B., & Gennuso, K. P. (2015). The County Health Rankings: Rationale and methods. Population Health Metrics, 13, Article 11. https://doi.org/10.1186/s12963-015-0044-2