Community Health Needs Assessment (CHNA) Overview Kaiser Permanente South Bay Area. kp.org/communitybenefit

Transcription

1 Community Health Needs Assessment (CHNA) Overview Kaiser Permanente South Bay Area kp.org/communitybenefit

2 ASR CHNA Team Lisa Colvig-Amir, Vice President of Evaluation Jennifer van Stelle, Ph.D., Project Manager Melanie Espino, Senior Research Analyst Today s Additional Facilitators McHale Newport-Berra, Casey Coneway, Christina Branom 2

3 Agenda CHNA Goals and Requirements KP CHNA Process Examining the Data Selecting Health Needs to Address Implementation Strategies 3

4 Agenda CHNA Goals and Requirements KP CHNA Process Examining the Data Selecting Health Needs to Address Implementation Strategies 4

5 What is Community Health Needs Assessment (CHNA)? A systematic examination of the health status indicators for a given population that is used to identify key problems and assets in a community. The ultimate goal is to develop strategies to address the community s health needs Source: Public Health Accreditation Board s (PHAB) Definition from the PHAB Glossary of Terms Version 1.0: Turnock, B. Public Health: What It Is and How It Works. Jones and Bartlett,

6 Goals of CHNA Gather robust data to understand health needs community-wide Results drive Community Benefit investments Community Benefit will continue to impact community health through collaborative relationships 6

7 CHNA: Federally Required Every three years Includes implementation plan Make widely available to the public Implementation Strategies adopted by hospital s Board of Directors and filed with IRS (990H) 7 7

8 Other CHNA Requirements Consult with: o Public health experts o Community leaders o Representatives of community members in high need populations: low-income, underserved, chronically ill, and minority groups Identify and prioritize community health needs Identify known facilities / resources available to meet needs Choose needs for implementation and document strategies 8

9 Agenda CHNA Goals and Requirements KP CHNA Process Examining the Data Selecting Health Needs to Address Implementation Strategies 9

10 CHNA Process in South Bay Area Analyzed data from KP CHNA Data Platform Compared data to benchmarks and other secondary data Collected community input Listed and prioritized 12 health needs Selected needs to address 10

11 Secondary Data Collection CHNA Data Platform Over 100 health indicators Basis for identifying health needs that missed benchmarks Sources such as: CDPH, CHKS, CDE Fitnessgram, CDC 11

12 12

13 CHNA Platform 13

14 Primary Data Collection Purpose: Assess community health, not KP member health Partnered with S.C. C. Community Benefit Coalition o Hospital Council of Northern & Southern California o El Camino Hospital o Lucile Packard Children's Hospital at Stanford o O Connor Hospital o Saint Louise Regional Hospital o Stanford Hospital & Clinics o Santa Clara County Public Health Dept. o United Way of Silicon Valley 14

15 Primary Data Collection Health providers/stakeholders o 9 focus groups with 79 participants o Represented various geographic areas and sectors o 9 key informant interviews Community members (residents) o 7 focus groups with 50 participants o Various ages, geographic areas 15

16 Agenda CHNA Goals and Requirements KP CHNA Process Examining the Data Selecting Health Needs to Address Implementation Strategies 16

17 Needs: Health Conditions

18 Drivers of Health Conditions Society/ Environment Behaviors Access & Delivery 18

19 Behavioral Health & Violence 19

20 What does the community say? I will quit when the stress goes away. I got started due to peer pressure when I was 14. As a child I would go to the stove and light [my Dad s] cigarettes, but when I turned 14 was when I really got started smoking. I had quit for 5 years, and stress caused me to go back stress at work. 20

21 Healthy Eating/Active Living 21

22 What does the community say? With the way jobs are now, you have to work til the job is done So that s where a lot of my bad habits came from being on the road. I was eating breakfast, lunch and dinner on the road. Working. And I was doing that six, seven days a week, so when did I have time to exercise when I didn t have time for family? Which caused stress, which caused me to gain weight it s just a vicious circle. 22

23 Access to Healthcare Drivers 23

24 Agenda CHNA Goals and Requirements KP CHNA Process Examining the Data Selecting Health Needs to Address Implementation Strategies 24

25 Selection of Health Needs Needs selected in advance to drive funding (per ACA requirements) Community Benefit Contributions Committee discussed health conditions and drivers CBC applied selection criteria to determine needs that will be addressed in the next grant cycle 25

26 Needs Selection Criteria 1: Severity: How bad are consequences? 2: Magnitude: How many affected? 3: Disparities: Are vulnerable populations worse off? 4: Existing promising approaches: Are there known strategies to address the need? 5: KP assets: Can KP make a meaningful contribution? 26

27 Selected Health Priorities Healthy Eating/Active Living (HEAL) Behavioral Health Substance Abuse & Mental Health Violence Access to Health Care Services 27

28 Behavioral Health Data SCC Binge drinking - adults Binge drinking - youth Poor mental health - adults 25% 16% 12% 9% 17% 14% Latino and Black youth exhibit depression in higher proportions, and Black youth consider suicide more often than their peers in the county / California 28

29 Healthy Eating/Active Living Data SCC Adult obesity Child obesity Stroke death rate Diabetes 55% 31% 24% overall 39% Latino 16% 27.4 overall 41.3 Black % overall 14% Black 8% Drivers Santa Clara worse off then California: Less grocery store access Less WIC food store access Less fruit/vegetable consumption (youth) More fast food access 29

30 Violence Data Gang involvement for Blacks, Hispanics higher in Santa Clara than California 28% of middle/high school students report being physically bullied Number of SCC Homicides * Source: OAG.CA.GOV ( ) (2013) 30

31 Access Data SCC Linguistically isolated 22% 20% Unemployed 8% 10% (US: 7%) Youth visiting dentist 7% 10% Adults without dental ins. 28% 28% Community expressed concern over lack of providers, especially those who speak languages other than English, which increases time to get appointments and increases wait times. 31

32 Agenda CHNA Goals and Requirements KP CHNA Process Examining the Data Selecting Health Needs to Address Implementation Strategies 32

33 Implementation Strategies What does the literature say about root causes? Are there evidence-based practices? What types of practices can we address with CB? 33

34 Behavioral Health Strategies School based interventions for youth that involve skills training to improve social relationships Addiction education or programs for youth to prevent alcohol, tobacco, marijuana initiation and use Skill building curricula for parents that provides information about child development and support to parents that focuses on positive parent-child interactions 34

35 Behavioral Health Strategies Youth and family interventions focused on building skills and communication to reduce substance use and aggression Programs, home visiting or support groups for parents that provides parent education, increases family functioning and teaches effective coping strategies Group cognitive behavioral group programs for: Adolescents or adults: Coping with stress, anxiety, or depression Young offenders (reduce recidivism & violent crime) Children or adolescents who have experienced trauma 35

36 Behavioral Health Strategies (Cont d) Early childhood screening developmental delays/behavior issues Adverse Childhood Experiences (ACES) training for service providers In-Kind Contributions, Collaborations, Initiatives Educational Theatre Program School Linked Services Collaborative Physician speakers Health Education materials Trauma-Informed Northern California Initiative 36

37 HEAL Strategies (Cont d) Accessibility of Farmer s Markets & use of EBT Nutrition Education & Skill Building Creating/enhancing places for physical activity and programs that increase physical activity Design and land use policies, including creation of more green/ park space Point-of-decision prompts for Healthy Eating, Active Living 37

38 HEAL Strategies (Cont d) Breastfeeding education for worksites and hospitals/clinics Adopt healthy policies & practices in schools, worksites, public places which: o o Restrict unhealthy foods and increase availability of healthier food Reduce sugary beverages consumption In-Kind Contributions, Collaborations, Initiatives Thriving Schools, Weight of the Nation, Everybody Walk ReThink Your Drink Campaign BANPAC, Let s Move Salad Bars to Schools 38 Physician speakers in schools through partnerships

39 Violence Prevention Strategies Mentoring programs - high risk youth Parent and youth aggression reducing programs Life skills education to develop healthy relationships/responses Youth intimate partner violence prevention programs Routine screening for intimate partner violence by clinicians 39

40 Violence Prevention Strategies (Cont d) Parenting education to promote positive parent-child/youth interaction Mother child bonding programs for domestic violence-affected mothers Programs to create caring school climates/reduce bullying & violence In-Kind Contributions, Collaborations, Initiatives Educational Theatre Program Clinician speakers Health Education materials 40 Collaborating on violence prevention campaigns

41 Access to Healthcare Strategies Support community health centers, clinics or Federally Qualified Health Centers for efforts such as: o Community health workers o Patient navigators Medical Homes with an emphasis on preventative care and screening 41

42 Access to Healthcare Strategies (Cont d) Addressing barriers to care that disproportionately impact underserved populations Interventions to improve health literacy Increase access to Oral Health Services In-Kind Contributions, Collaborations, Initiatives Charity Care (Medical Financial Assistance, Subsidized Care): $38 million KP Child Health Program Sharing of protocols, research: $20.5 million 42

43 Next Steps Grant guidelines released end of February Grantmaking Process meeting March 7 (Sobrato Center) 43