The CDC CHANGE Guide’s approach to building a healthy community: 8 Action Steps

We conducted evidence based research based on the Center of Disease Control CHANGE guide methods that have been used by individuals in other communities to improve and create a healthier community.

The change guide consists of 8 actions steps in which we had to culturally and linguistically adapt to our specific research in the Dominican Republic.

• Assemble a community team:
  • Our team consists of neighborhood associations in Las Malvinas II
  • Elementary schools in Las Malvinas II
  • University representatives from Clemson and UNIBE students
  • Clemson Creative Inquiry Team
• Develop a team strategy:
  • Conduct evidence based research to build a healthier community in Las Malvinas II
  • Conduct a plan to improve the community health situation based on the community assets
  • Translate our knowledge of US public health policies and adapted it to the problems specific to Las Malvinas
• Review 5 CHANGE sectors:
  • Within each sector we came up with 5 priorities in which we thought needed improvement in Las Malvinas. Based on the priorities that we chose, we came up with questions for individuals in each sector
  • Adaption of CDC Priorities to Las Malvinas II Priorities: 

Still to come:

• Gather Data: 
  • We  are going to gather data using qualitative and quantitative techniques when studying abroad in the Dominican Republic
  • Closed ended questions through GIS survey app on our iphones where we will go from door to door in the community
  • Open ended questions in our focus groups and interviews

• Review Gathered Data
• Enter Data
• Review Consolidated Data
• Build Community Action Plan 
  • When we are entering and reviewing our consolidated data, we will see which areas need improvement and which areas are the community strengths based on what we collected
  • Community Health Assessment
  • Community Health Improvement Plan

We focused on five local community health priorities: sanitation, education, chronic disease management, vaccine preventable diseases, and unwanted pregnancies.

Research questions were organized in five CHANGE sectors: community at large, school, healthcare, community organizations/institution, and work sectors.

The ArcGIS survey system was used to collect household-based data for quantitative analysis.

• survey consists of closed ended questions to collect objective and quantitative data
• data was collected from DR residence ranging from 18-65 years old (resided in DR for at least 1 year)
• informed verbal consent addresses confidentiality, contact information and agreement to participate before taking the ArcGIS survey
• data includes questions based on the study’s five public health priorities that deal with individual and community assets, selected community risk factors, and history of disease within the household
• upon return from the DR at the end of March the data generated, in combination of qualitative data collected and through triangulation, will be analyzed and used to develop a CHA and a CHIP

From the data collected reports will be drawn up based on proportion of certain responses to the GIS survey. The proposed poster will present a preliminary analysis of descriptive survey data by using frequency measures to map individual and community assets, selected community risk factors, and history of disease within Las Malvinas Households. This preliminary analysis intend to explore the relationship between risk and protective (assets) factors with the reported frequency of disease by utilizing geographic information through GIS. The CHIP will be proposed to UNIBE coalition of community organizations to guide further efforts to improve Las Malvinas resident’s health and well-being.

My CI group wanted to incorporate  Service Learning Activities to do with the kids at the Elementary and Middle Schools while in the Dominican Republic.

Here are some of our ideas!

Building a mini garden:

• learning objective:  learn about importance of recycling old resources and environment
• target audience: elementary and middle school kids
• time needed: one hour
• location: community garden, elementary school
• resources needed: old tires, knife to cut tire, dirt, seasonal plants/vegetables

Making Silly Putty

• learning objective: learn basic chemistry behind plastics and importance of recycling
• target audience: elementary and middle school students
• location: elementary school
• time needed: one hour
• Directions:
  • Mix glue with food coloring
  • Pour liquid starch into colored glue mixture.
  • Stir and let sit for five minutes.
  • Pull putty out of mixing bowl & set it on a paper towel. Knead putty in hands for 5-10 minutes.
  • Play with it!

Hygiene Simon Says

• Simon says with body parts (Simon says brush your teeth, Simon says brush your hair, etc
• Bilingual version: Simon says first in Spanish, then teaches the kids how to say it in English
• Incorporate reward
• Learning objective: learn about dental and body hygiene (i.e. showering, brushing teeth, washing hands, etc) and learn English
• no extra materials needed
• elementary (or middle school) target audience

Dental Hygiene

• Learning Objective: Dental hygiene
• Handout instructions about proper dental hygiene, with instructions about proper teeth brushing
• Cut the bottoms off of large plastic soda bottles and turn them upside down – they look like teeth! Spray them with whip cream (toothpaste) and apply chocolate chips or any other candy (bacteria/cavities) and  give the kids toothbrushes to brush the teeth clean.
• target audience: elementary school students (11 and under)
• ideal location: elementary school/after school program at community center
• time needed: one hour
• materials needed: whipped cream, candy (chocolate chips, gummy bears), large plastic soda bottles, toothbrushes

Sources:

• http://www.pbs.org/parents/crafts-for-kids/homemade-silly-putty/
• http://www.mixer2mower.com/18-easy-to-make-diy-raised-garden-beds.html/3
• http://www.instructables.com/id/Used-Tired-Raised-Garden-amp-Tree-Ring/
• kristin-senseofwonder.blogspot.com

Welcome to my blog on “Building Healthier Communities in the Dominican Republic“! This is an undergraduate research and study abroad Creative Inquiry through Clemson University.

Low-income and low-resourced communities face many health-related challenges that inhibit their development. In order to build healthier communities, collaborative public health services and programs within the community are needed. 

In our creative inquiry, we are researching the community of Las Malvinas II in Santo Domingo, a low resourced community in the Dominican Republic.  Based on previous research from UNIBE university students in the DR and available public health data, we culturally and linguistically adapted CDC’s CHANGE guide to conduct a Community Health Assessment (CHA) and to develop a Community Health Improvement Plan (CHIP) in Las Malvinas.

Qualitative and Quantitative Data Analysis:

• Qualitative Data Collection: Interviews, Focus Group
• Quantitative Data Collection: GIS Survey

CHANGE sectors we focus on: Community At Large Sector, Community Institution/Organization (CIO) Sector, Health care sector, School sector, Work sector

Community Health Priorities we focus on: education, unwanted pregnancies, vaccine preventable diseases, chronic diseases, sanitation

This experience has further improved my cultural competence, critical thinking skills, and has allowed me to develop evidence-based learning skills to conduct research beyond my creative inquiry class.