Use of a community coalition to interpret contextual data: lessons from the Taking Neighborhood Heal

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Use of a community coalition to interpret
contextual data lessons from the Taking
Neighborhood Health to Heart study 

• Diane K. King, PhD
• Jennie L. Hill, MSc
• Deborah S. Main, PhDSupported with a grant from
  
• National Heart, Lung and Blood Institute (NHLBI)

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Purpose of this presentation

• To describe how our research team partnered with
  a multi-neighborhood coalition to interpret
  neighborhood-level data collected through walking
  audits.

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A Natural ExperimentThe Stapleton Airport
Redevelopment Project
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Taking Neighborhood Health To Heart Study Aims

• To understand
• neighborhood structural and social variables on
  cardiovascular health and health behavior of
  people living in a newly built active living
  community AND
• whether the active living community influences
  the health and health behavior of people living
  in the 4 adjacent neighborhoods.

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(No Transcript)
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Surrounding Neighborhoods- AMENITIES
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Surrounding Neighborhoods- INCIVILITIES
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Neighborhood Demographics
Sources 2007 Piton Foundation 2000 US Census
Stapleton ethnicity data from TNHTH study
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Taking Neighborhood Health to Heart Coalition

• Coalition formed in 2007 from an existing
  5-neighborhood council
• Meets monthly, rotating locales
• Research team facilitator
• Bi-lingual materials translator
• Children welcome, dinner provided
• Shared agenda (research/community)
• 35 attendees, demographically diverse

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TNHTHEvolved Study Aims

• To study the impact of the built environment on
  disparities in CVD risk and physical activity
  among adults living in 5 diverse, Denver Metro
  area neighborhoods and to
• make sense of data with the community and
  identify potential programs to improve health.

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Coalition Activity 1

• Objective
• Assure Local Relevance of Walking Audit
• Task
• Adapt audit tool to include
• locally relevant variables

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COALITION ACTIVITY 1Local Relevance of Walking
Audit
No changes to Connectivity, Walking
Infrastructure, Safety, Transportation
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Collecting Neighborhood Data

• Census tract maps created for each neighborhood.
• 10 of blocks randomly selected, stratified by
  residential density.
• 8 Auditors were trained.
• Auditors paired for safety and to inter-rater
  reliability.
• 415 Blocks walked (x2).
• Household survey data were simultaneously
  collected by trained community members.

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Results

• Surrounding neighborhoods varied significantly
• Walkability
• Connectivity, mixed land-use, sidewalks, crossing
  aids
• Presence of physical incivilities
• Declining houses/land, litter/graffiti, broken
  windows
• Adjacent neighborhoods had fewer environmental
  features that promote healthy eating or walking
• Sidewalks, destinations
• Places to purchase groceries, healthful food
• Felt less safe vs. Stapleton neighborhood

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Coalition Activity 2Making Sense of the Data

• Objective
• Identify the relative value of neighborhood
  features destinations-- from the residents
  perspective.
• Task
• Rate each business as having
• high (3),
• medium (2) or
• low (1)
• value to the neighborhood

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Mix of Food Retail and Fitness
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Community Perspectives on Data Sharing. . .

• If you look at the pictures, these nice ones are
  Stapleton, and these others look like my
  neighborhood. I am working hard to improve my
  neighborhoodbut if you share only the bad things
  about it no one will want to move there and all
  my hard work will be for nothing.

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Community Perspectives on Data Sharing (contd)

• I dont care if you stigmatize my neighborhood
  if it will get the city to fix the problems
• stigmatize away!

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Community Perspectives on Data Sharing (contd)

• Can we define the difference between
  stigmatizing and describing neighborhoods? I
  think its important to describe the reality of
  these neighborhoods.

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LESSONS

• Context and mix of neighborhood variables is
  important.
• Residents are best qualified to assign value.
• Neighborhoods high in physical incivilities may
  also be rich in social resources.
• Use caution when sharing neighborhood data, to
  avoid stigmatizing low income neighborhoods.
• Build trust by clearly specifying the purpose and
  intended results for sharing data.
• Link positive outcomes to communitys efforts.

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Thank You!Taking Neighborhood Health To Heart
Neighborhood Coalition