Hi, my name is. I am working with the Community Committee for Health

Public Housing Community Readiness Assessment: Interview Guide Date: Development: Interviewee Name: Introduction Hi, my name is. I am working with the Community Committee for Health Promotion at the Prevention Research Center at Boston University School of Public Health on a project related to heart health. We are talking with key people to ask opinions and beliefs about heart health that exist in your housing development. The purpose of this study is to learn how [Dev Name] is dealing with heart health and to develop heart health programs for [Dev Name] residents. During the interview, I will be asking you about heart health. Just to be clear I am referring to all health problems that can cause heart attacks and strokes. These include things like high blood pressure, high cholesterol levels, sugar diabetes, being overweight or smoking cigarettes. If someone has any of these health problems, their heart health is at risk. SHOW HEART HEALTH INDEX CARD Additionally, I will be asking you about what you think residents know about heart health, not just about what you know. 1

The entire interview, including your name and the name of your development, will be kept confidential in other words your answers will never be linked to your name. I will be recording our interview so I can double check my notes. The tape will be erased once the interview is typed out. Interview Questions 1. Tell me about [Dev Name]. PROMPT: How long have you lived in (Dev Name)? What do you think is the best thing about living at (Dev Name)? How do residents participate in your community (ex. Unity Day)? 2. Using a scale from 1-10, how much of a concern do you think heart health is to the residents of [Dev Name] with 1 being not a concern at all and 10 being a very great concern? Please explain. SHOW SCALE INDEX CARD 3. Do you know if there are activities or programs in your development that promote heart health? If YES: GO TO #3Y If NO: GO TO #3N 2

PROMPT: I am interested in any programs/activities that help residents here get medical care for their high blood pressure, high cholesterol, obesity or sugar diabetes. Activities can include anything that may improve heart health, such as screening vans, support groups, cooking and nutrition classes, walking groups, or anything that helps people get active, eat healthy, or help them take care of their sugar diabetes, high blood pressure, or high cholesterol. 3N. Is anyone in your development trying to get an activity or program started to address heart health? IF YES: How so? Do you know who will pay for these programs? SKIP TO # 16 (page 5) 3Y. Can you please describe these activities/programs? 4. How long have these activities/programs been going on in [Dev Name] 5. Who do these activities/programs serve? PROMPT: For example, individuals of a certain age group, ethnicity, etc. 6. Are the programs free? If so, do you know who pays for them? 3

PROMPT: For example, do you pay to participate, does the state pay for the programs, etc. 7. Is anyone measuring how successful the current programs are, or looking for ways to improve them? IF YES: What do you know about that? 8. How many residents do you think are aware of these programs? Would you say none, a few, some, or most residents of [Dev Name] are aware of these programs? Please explain. 9. What do the residents know about these activities or programs? PROMPT: For example, do they know the purpose of the activities, who can participate, or how to get involved? 10. What is good about these programs? 11. What is bad about these programs 12. Do any of these programs seem unavailable to residents in [Dev Name]? PROMPT: For example, individuals of a certain age group, ethnicity, income level, geographic region, or programs at a certain time, location, etc. 4

13. Is there a need to add more heart health activities or programs at [Dev Name]? If NO: Why not? 14. Do you know if there is any planning to add more activities/programs for heart health in [Dev Name]? Please explain. 15. If so, do you know if the program will be free? If it is free, do you know who will pay for it? 16. What do you think about the people in charge of the programs? Do they seem to have a lot of expertise and training? Did you understand the program? Were your needs met? 17. During our conversation, have any other programs come to mind? ALL ANSWER 18. Can you think of any active residents in your development? PROMPT: For example, people who give you lots of information, someone you would go to for information, or someone you think represents you 5

19. Out of the residents you ve just named, who would you consider to be leaders in heart health? 20. Using a scale from 1 to 10, how much of a concern is heart health to the active residents of [Dev Name] (with 1 being not at all and 10 being of great concern )? Please explain. SHOW SCALE INDEX CARD PROMPT: Ask them to answer #19 for each leader they name 21. How are these active residents involved in activities or programs to promote heart health? PROMPT: For example, are they involved in a committee, task force, etc.? How often do they meet? 22. Do you think the active residents would support additional activities or programs to promote heart health among residents? IF YES: How might they do that? IF NO: Why not? 23. What is the overall feeling among [Dev Name] residents regarding heart health? 24. Do the residents of [Dev Name] support having program/activities that promote heart health? 6

IF YES: Could you please explain this, for example, how do they show this support? IF NO: Could you please explain? 25. What do you think are the main things that prevent your development from addressing heart health? 26. What do [Dev Name] residents know about heart health in general? PROMPT: For example, do they know the signs, symptoms, consequences of poor heart health, and the effect of poor heart health on family and friends, etc? 27. How much do residents know about the heart health of the other residents in [Dev Name]? 28. What type of information is available to residents of your development about heart health? PROMPT: For example, newspaper articles, brochures, posters? 29. Do you know if there s any data or numbers about the heart health of residents living in your community? For example, data from BPHC, BHA, CHCs IF YES: How do people get this information? 30. What is your development s attitude toward supporting heart health? PROMPT: For example, does the development provide space for events/programs that promote heart health? 7

31. What is the attitude of the community around your development toward supporting heart health? PROMPT: For example, would local businesses donate money/resources? Would people volunteer? Do you see flyers from the health centers? 32. Who would someone affected by poor heart health turn to first for help? Why? 33. Do you think residents from your development use community health centers for their heart health? Why or why not? 34. What role do you think local CHCs could or should play to get heart health information to residents? 35. Have you ever heard of a patient navigator? IF YES: Can you describe one? IF NO: A patient navigator is someone who knows the health care system and helps patients overcome their barriers to getting health care. The navigator works directly with people helping them get the care they need, making sure they understand the process, and helping them communicate with their doctors. The navigators also know about many different kinds of local resources. For example, a navigator can help a patient make an appointment at a time that s best for the patient, make sure the patient has a ride to the 8

doctor s office, help with any insurance issues, help the patient feel comfortable asking questions, make sure a translator is there if necessary, and follow-up with the patient after the appointment. 36. Do you think that a patient navigator would be useful in your community to help residents get heart health care at local community health centers? Why or why not? 37. We ve been talking a lot about heart health (diabetes, high cholesterol, smoking, high blood pressure, being overweight). Do you think these are the biggest health concerns at your development? If not, what do you think is the biggest health concern? (Top 3) DEMOGRAPHICS 1. Gender: 2. What is your race or ethnicity?: White Hispanic/Latino/Chicano American Indian/Alaska Native African American/Black Asian/Pacific Islander Other 9

3. What is your age range?: 19-24 25-34 35-44 45-54 55-64 65 and above 4. Do you live in [dev name]? IF YES: How long have you lived there? IF NO: What community do you live in? 5. Do you work in [dev name]? IF YES: How long have you worked there? IF NO: Where do you work? 6. Do you have a title at [dev name]? 8. Anything else you want us to know? Thank you! 10

Community Health Center Readiness Assessment: Interview Guide Date: CHC: Interviewee name: Introduction Hello, my name is from. I am working with Boston University Clinical and Translational Sciences Institute (CTSI) and the Prevention Research Center at the Boston University School of Public Health to learn more about how [CHC] is dealing with [health priority]. CTSI is a program funded by the National Institute of Health to promote translational research, in order to bring scientific discoveries from the lab into the community to improve clinical care for patients. A principle focus of CTSI is to engage the community in the research process. The purpose of this interview is to learn more about [health priority] at [CHC] so that we can provide useful feedback to help guide future intervention planning or improve current [health priority] programs. During this interview, when I ask you about [CHC] I am referring to the entire [CHC] community, which includes patients, providers, administrators, and staff. I will be taking notes as we talk, and I would also like to record our interview so that I can double check my notes. The tape will be erased once the interview is transcribed. Will that be okay with you? Interview Questions 1. Tell me about [CHC]. PROMPT: For example, patient demographics, unique programs, community outreach strategies, etc. 11

2. Using a scale from 1 to 10, how much of a concern is [health priority] at [CHC name] (with 1 being not at all and 10 being a very great concern )? (1) 3. Are there programs or services at [CHC] that address [health priority]? (2) IF YES:GO TO #3Y. IF NO: GO TO #3N. RESPONDENT ANSWERED NO 3N. Is anyone at [CHC] trying to get a program started to address [health priority]? If YES: How will it be funded? Skip to #17 Leadership RESPONDENT ANSWERED YES 3Y: Can you please describe these programs/ services? 4. How long have these programs been going on at [CHC]? (3) 5. Who do these programs serve? PROMPT: For example, individuals of a certain age group, ethnicity, etc) (4) 6. How are these programs funded? (32) 7. Is there any evaluation of current programs/services? (6) 8. On a scale of 1 to 10, how sophisticated in the evaluation (with 1 being not at all and 10 being very sophisticated )? (7) 9. Are the evaluation results being used to make changes in programs, activities, or policies or to start new ones? (8) 10. Approximately how many people at [CHC], including patients, providers, administrators, and staff, are aware of the programs/services for [health priority] at [CHC]? Would you say 12

none, a few, some, or most community members are aware of these programs? Please explain. (9) 11. What does the [CHC] community know about these programs or activities? For example, do they know the purpose of the efforts, who they are targeted to, and how to access them? (10) 12. What are the strengths of these programs? (11) 13. What are the weaknesses of these programs? (12) 14. Would there be any segments of the community for which these services may appear inaccessible or unavailable? (Prompt: For example, individuals of a certain age group, ethnicity, income level, geographic region, etc.) (13) 15. Is there a need to expand these programs/services? If not, why not? (14) 16. Is there any additional planning for efforts/services going on at [CHC] surrounding [health priority]? If yes, please explain. (5) 17. Are you aware of any proposals or action plans that have been submitted for funding that address [health priority] at [CHC]? If yes, please explain. (33) 18. Who are the leaders at [CHC]? 19. Who are the leaders specific to [health priority] at [CHC]? 20. Using a scale from 1 to 10, how much of a concern is [health priority] to the leadership at [CHC] (with 1 being not at all and 10 being of great concern )? Please explain. (19) 21. How is the leadership involved in efforts regarding [health priority]? (For example, are the involved in a committee? How often do they meet?) (20) 13

22. Would the leadership support additional efforts? (21) If YES: How might they do that? IF NO: Why not? 23. What is the overall feeling at [CHC] regarding [health priority], especially as it affects patients at the health center? (22) 24. How does [CHC] support addressing [health priority] outside the health center? (23) 25. What are the primary obstacles to efforts addressing [health priority] at [CHC]? (24) 26. How knowledgeable is [CHC] about [health priority] in general? (For example, dynamics, signs, symptoms, local statistics, effects on friends & family, etc.) (25) 27. How knowledgeable is [CHC] about [health priority] as it pertains to the local community? (26) 28. What type of information is available at [CHC} regarding [health priority]? (27) 29. Is there data available about how [health priority] occurs in the local community? (28) If YES: How do people obtain this information? 30. What is [CHC] s attitude toward supporting efforts to address [health priority]? For example, do providers volunteer time, does [health priority] receive funding, does the health center provide space for events? (29) 31. Do [health priority] programs/services have a broad volunteer base? Please explain. (30) 32. On a scale from 1 to 10 what is the level of expertise and training among those working on [health priority] (with 1 being very low and 10 being very high )? Please explain. (31) 14

33. Who would an individual affected by [health priority] contact first for help at [CHC]? Why? (34) Additional Questions 1. How much of a priority is cardiovascular disease to [CHC]? 1a. If CHC s health priority is a risk factor for CVD: How much of a priority are other risk factors for cardiovascular disease to [CHC]? This includes risks such as: obesity, hypertension, diabetes, smoking, and high cholesterol. 2. What are the primary barriers to expanding cardiovascular disease programs? 3. Describe the relationship between [CHC] and Boston public housing developments. PROMPT: Provide list of closets few CHCs. 4. Does [CHC] have any current, proposed, or past initiative with any Boston public housing developments? 5. What is the capacity of [CHC] to care for more patients from public housing? 6. Have you heard of patient navigators? IF YES: Does [CHC] have any? What diseases do they navigate? Are there any navigators working in [health priority]? Are there any navigators working in cardiovascular disease? 7. How does [CHC] feel about patient navigators in general? 8. How would [CHC] feel about working with community-based navigators who are not part of your clinical practice? 15