In late March 2016, the Public Health Foundation (PHF), in collaboration with the Centers for Disease Control and Prevention (CDC) and Association for Community Health Improvement (ACHI)/Health Research & Educational Trust (HRET), hosted a webinar focused on The Guide to Community Preventive Services (The Community Guide) and how it can support community health improvement efforts. The Community Guide, a free resource for evidence-based recommendations and findings from the Community Preventive Services Task Force, can play a valuable role in the community health improvement efforts of hospitals and health departments and is being used in a new pilot initiative aimed at helping hospitals use evidence to take action and implement community health improvement activities in collaboration with health departments and other community stakeholders.

 

With nearly 300 people in attendance at the webinar, numerous questions and comments related to The Community Guide, ACHI’s Community Health Assessment Toolkit, and the population health driver diagram framework being used to support collaborative community health improvement were shared. Read on to learn more about these questions and their answers, and add your own questions and ideas in the Comments section below or send them by email to kamos@phf.org!

 

The Community Guide
Q : How is the "Community" in The Community Guide defined?
A: As shown in The Community Guide Glossary, community is defined as a group of individuals sharing one or more characteristics such as geographic location (e.g., a neighborhood), culture, age, or a particular risk factor. In The Guide to Community Preventive Services, for the purposes of evaluating whether interventions make communities healthier, CDC has chosen to apply the broadest possible use of “community.”

 

Q: How are "new" community health topics identified for Community Guide review? For example, topics like opioid and prescription use are becoming community priorities and yet have not been reviewed. What is the timeline for new priority identification and review?
A: The Community Preventive Services Task Force underwent an extensive prioritization process in 2015. It considered 40 health topics aligned with Healthy People 2020 topic areas. For each topic, the Task Force requested input from Task Force Liaison organizations and the general public, and considered eight criteria:

 

The Task Force identified 11 priority areas for new Community Guide reviews in the coming years. They are:

Q: Does The Community Guide offer any tools/resources on developing effective interventions to specifically and appropriately target diverse communities that require culturally-sensitive approaches?
A: Within the topic of Health Equity, The Community Guide offers resources in the area of Promoting Health Equity Through Education Programs and Policies and Promoting Health Equity: Housing Programs and Policies, specifically in the area of Tenant-Based Rental Assistance Programs. Other reviews that might be of interest include Interventions Engaging Community Health Workers to Prevent Cardiovascular Disease and Reducing Structural Barriers for Clients to Increase Appropriate Breast, Cervical, and Colorectal Cancer Screening.

 

Q: Can I enter an activity such as "farmers market" and find out if it is a recommended strategy? I’m interested in urban farmer markets as a health strategy.
A: The Community Guide’s newly-developed Beta site allows the user to search by key terms, such as “farmers market.” Click on this link to visit the new site: https://beta.thecommunityguide.org/. Currently, The Community Guide does not contain a systematic review on the effectiveness of farmers markets as a single strategy, nor as a component of a broader strategy to improve nutrition and reduce obesity. Obesity and nutrition reviews are currently in progress. The next review in this area to be brought to the Community Preventive Services Task Force is Interventions to Offer Healthier Foods and Beverages in Schools.

 

Q: I don't see Overdose or Suicide Prevention in the "Topics" - will those be added? What about "Stigma Reduction?”
A: The Community Preventive Services Task Force identified Prescription Drug Overdose as a prioritized topic in 2015. Suicide prevention is addressed under Mental Health and Violence related to Firearms. CDC’s partners in the military have expressed real interest in suicide prevention so the Community Guide Branch reached out to CDC’s National Center for Injury Prevention and Control to determine whether there were community-based strategies to prevent obesity. Reviews in this area will be likely if CDC can find interventions to assess that fit within The Community Guide’s scope. “Stigma reduction” as a standalone topic is not addressed.

 

Q: Is herbal supplement or breast feeding included?
A: Currently, none of the topics reviewed by the Community Preventive Services Task Force have included evidence on herbal supplements or breast feeding.

 

Q: What about topics like precision medicine and community use?
A: Currently, none of the topics reviewed by the Community Preventive Services Task Force have included evidence on precision medicine and its use in the community. You may wish to review resources provided by CDC’s Office of Public Health Genomics such as blogs on precision medicine (e.g., The Shift From Personalized Medicine to Precision Medicine and Precision Public Health: Words Matter!) and What Public Health Can Do Now in Human Genomics to Save Lives and Improve Health.

 

Q: Many community needs do not have established evidence-based programs developed yet. There is not enough science in relation to the needs, particularly new emerging or growing needs.
A: While broadening the evidence base for public health prevention is the Community Preventive Services Task Force’s ongoing mission, the work to date included in The Community Guide reflects prioritized topics based on input from representatives of local, state, and federal public health agencies, as well as non-governmental organizations concerned with promoting good health and well-being. CDC certainly agrees with the need for more evaluation and research studies to further build the evidence base.

 

Q: The preface to The Community Guide should include a "disclaimer" that many of the successful population-based interventions (e.g., tobacco control, seat belt use) did not have well documented evidence-based guidance or results before initiation. The Community Guide should stress proceeding when there are promising practices and the promise of population-based health benefits.
A: The Community Guide is appreciative of the suggestion to provide such a disclaimer and that it may help people better understand that “insufficient evidence” findings do not mean that an intervention doesn’t work, but that the evidence is insufficient to determine whether or not the intervention works. The Community Preventive Services Task Force has considered including “promising practice” as a category of Task Force Recommendations and Findings on a number of occasions. To date, the Task Force has decided not to include this category due to concerns about the lack of a rigorous evidence science base for defining a promising practice.

 

Q: Will The Community Guide 2.0 include resources in Spanish and other languages?
A: There are no plans at this time to provide materials in the Spanish language or others.

 

ACHI Community Health Assessment Toolkit
Q: What type of evaluation tools are being considered for the 2.0 toolkit being developed?
A: ACHI is in the process of determining which tools and resources will be considered for the next version of the toolkit. Stay tuned for additional details in the Fall of 2016!

 

Population Health Driver Diagram Framework
Q: Is there a contact we could reach out to regarding starting a population health driver diagram process between hospitals and public health? How to begin?
A: PHF can come to your community to help with customized Driver Diagram Development for Community Health Challenges. For details about cost and getting started, please contact Margie Beaudry at 202-218-4415 or mbeaudry@phf.org.

 

Additional Resources
The following resources provide additional information about The Community Guide and this pilot initiative aimed at helping hospitals, health departments, and other community stakeholders use evidence-based recommendations and findings found in The Community Guide to take action and implement community health improvement: