Department of Health and Human Services
Centers for Disease Control and Prevention
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Heart-Healthy and Stroke-Free: A Social Environment Handbook
This document is also available in
Portable
Document Format (PDF - 1.2M).
Chapter One: Getting StartedSocial environments are critically important for sustaining heart-healthy and stroke-free communities. In this chapter, we discuss how to get started planning and implementing a social environment assessment for your own community. At specific points, we will refer you to the chapters on Social Environment (Preventive and Medical Services, Heart-Healthy Living, and Quality of Life) and to the chapters on Practical Methods (Direct Observations and Windshield Surveys, Photography and Videography, Key Informant Interviews, Library Resources and Newspapers, and Searching the Internet). We encourage you to refer to these sections of the handbook for more specific ideas, concepts, and methods to apply to your own project. Project Questions and GoalsThe kind of information you need, and its intended purpose, will drive your assessment plan. It is important to clearly define project questions in advance, keeping them focused and problem-oriented so the information gathered will be best suited for your overall goals. A carefully designed study will allow efforts to be well-focused and will result in more informative, useful results. The Social Environment chapters (Preventive and Medical Services, Heart-Healthy Living, and Quality of Life) will help you identify specific questions for each of these aspects of the social environment that contributes to heart-healthy and stroke-free communities. Thoughtful consideration of focused, specific project questions is critical to the overall success of your assessment. Resource constraints may also influence your choice of questions and your overall goals. Focused, problem-oriented questions lead to well-designed assessments that can be conducted with fewer resources. For example, an assessment that attempts to answer a broad question such as, “Why do two geographic areas differ in heart disease and stroke outcomes?” is likely to require significant resources, time, and effort. In contrast, questions such as, “What local policies are inhibiting or promoting disease prevention?” or “How can prevention programs be tailored to specific populations in my area?” address specific topic areas that can be studied and analyzed with fewer resources and that potentially have more significance for the community.
Scope of Project and ResourcesThe scope of your project will be determined by your resources (i.e., personnel, space, equipment, funding, and time) and your geographic target. The assessment will evaluate both needs and assets in your community to answer each question. For example, the assessment should examine whether preventive and medical services in the community are adequate (assets) or lacking (needs). Chapter 2 provides a detailed discussion of what such services entail and how to include them in your assessment. Historical and contemporary processes influence the development of any
social environment. These processes operate at a number of geographic
scales, for example, city, county, and state levels. An in-depth discussion
of geographic scales and their influence on a population’s overall health
can be found in Chapter 3. Selecting an appropriate geographic scope of
analysis will help to identify the processes that have been most influential
in a particular area. In general, the larger the geographic scope of the
study, the more resources, time, and effort will be necessary to examine the
influence of the social environment on heart disease and stroke. As you define the scope of your project, carefully consider the resources available to you, such as funding, staff, and time. Some resources are required regardless of funding levels (i.e., time, space, equipment, and personnel). It is important to examine these aspects of your project in conjunction with your assessment questions and goals, because all of these factors will guide the development of your assessment. As you develop your project plan and consider staffing priorities, you may want to collaborate with community members. Staff comprising community leaders, university students, and other local volunteers, can provide diverse perspectives as you assess the strengths and challenges of your community in terms of heart and stroke health. An assessment founded on multiple perspectives will be more accurate and better able to effect positive social change. Assessment MethodsWith your focused project questions and resource constraints in mind, you can now choose the methods that you will apply to your project. The focus of your questions will guide the methods that you choose. Every community faces challenges and has important strengths. Various approaches can be used to measure these aspects in the social environment. For example, traditional “needs assessments” tend to focus on a community’s deficiencies to identify areas where improvements are needed; they rarely take into account the resources, strengths, and assets that can be used to create and promote health in communities. Needs assessments generate a great deal of useful information, including analyses of community health priorities and problems. Ultimately, they lead to suggested interventions based on a specific community’s needs. In contrast, “asset mapping” focuses on a community’s strengths in an effort to match these strengths to community-defined needs. This approach to assessing a social environment recognizes that a community may already have the capacity to address its own challenges. Both approaches potentially can offer valuable information and perspectives that may be used in combination for your social environment assessment. The Practical Methods chapters (5–9) outline specific methods that you can use for your assessment. Depending on the focus of your questions, some methods may be more useful to you than others. Chapters 5–7 describe various methods of data collection: direct observation, surveys, photography/videography, and interviews with people in the community. Each chapter provides a definition, description, examples of implementation, and important points to consider for each method. Chapters 8–9 address various forms of media that you can consult for your assessment: library resources, local newspapers, and the Internet. Chapter 11 provides further resources, including Web sites. These media resources can add to your assessment by giving you snapshots of current events important to the community.
The findings from your social environment assessment can potentially effect positive social change in your community. The issues that you uncover and analyze may have important implications for policy. For example, your assessment may recommend that the community establish safe and clean venues for a recreational environment. Communicating these needs, as well-defined products of your social environment assessment, to city or civic boards can influence policy. Cultivating a relationship with local media outlets, such as newspaper and radio, is another way to publicize your findings and recommendations and to engage the community in a discussion on effective implementation. WorksheetsThroughout this handbook, we provide sample worksheets to help you plan, record, and summarize results, and transform your results into action to help improve your community. Blank copies of all of the worksheets are included in Chapter 10. These may be reproduced freely and distributed to your colleagues and community partners. Further Reading
Date last reviewed:
07/09/2007 |
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Once
you have completed your assessment and its analysis, consider how your
findings might be useful for influencing public policy to best meet the
health needs of the community. Organizations such as the AHA, CDC, and
National Institutes of Health recognize the importance of various public
policies on heart disease and stroke risks for communities. 
