Collaborative Process Summary

In September 2021, the group began the initial process of prepping for the 2022 Community Health Assessment. The 2022 CHA was structured around the collection of primary and secondary data. There were two main sources of primary data collected, a community survey and focus groups. The community survey included questions regarding health behaviors and community issues. Before sharing the survey, it was first required that the previous CHA survey be reviewed and revised. The survey was revised to remove questions that would not yield quality results and to help increase participation. This year, the community survey was offered to both residents of Burke County and to those who work in the county but do not call Burke home. Although, most survey respondents came from Burke residents. The community survey brought in 2,149 results; double the return from the 2019 CHA. The survey was offered in both English and Spanish and was made accessible through scanning a QR code, clicking or copying the direct SurveyMonkey link, and through paper copies.

Focus groups were also a part of the primary data collection phase. The BWI planned for nine, specific and diverse groups that consisted of the Hmong community, Hispanic community, Deaf and Hard of Hearing community, LGBTQ+ community, African American community, Young Professionals, local college students, persons without permanent housing, and older adults. There were seven groups that met the criteria of a focus group, resulting in 46 group participants. Diversity, equity, and inclusion were of top priority to the BWI when organizing plans for the focus groups. This was evident through representation of seven of the nine groups.

Secondary data is data that has already been collected and analyzed from an outside source. The data that was used was gathered from reliable state, national and local sources and was collected within the last five years.

Secondary data was then cross examined with the results from primary data. The BWI paid special attention to areas where Burke was improving or declining. This step took place in June 2022 and was essential before moving to the priority selection phase.

Key Findings

In June 2022, the BWI analyzed the primary data (community survey and focus groups) for commonly shared themes. It was evident in the responses provided through the survey and focus groups, that the COVID-19 pandemic affected everyone in varying degrees. Many challenges that people faced before the pandemic were only enhanced once COVID struck. These common themes were noted and cross

examined with secondary data points. If the secondary data revealed a negative increase or decline in a specific area, the group referred to the created list and made note of any secondary evidence to support the concern. The list was further narrowed down to reflect the resources currently available within the community before the voting process took place. The voting list for the 2022 CHA consisted of six priorities:

• Mental Health
• Obesity with Risk Factors
• Substance Use Disorder
• Homelessness/Lack of Affordable Housing
• Health Literacy/Cultural Competence
• Transportation

The Nominal Group Method

The Nominal group method is defined as a structured method for group brainstorming that encourages contributions from everyone and facilitates quick agreement on the relative importance of issues, problems, or solutions. This method allowed voices that can sometimes be overshadowed by others in a group setting; to vote without biases. In July 2022, a group discussion was held a week before the voting process to allow any questions, concerns, or comments to be addressed. The group met via Zoom on July 19^th, 2022, where the voting poll was given. All members were presented with consistent information on primary data collection results and the secondary data that was pertinent to Burke County. Members also created a list of local resources currently available within the county.

Health Priorities

Three rounds of voting occurred. The first round was given a weighted scale of (3), the second round a weight of (2), and the final round a weight of (1). The results were as follows:

1. Mental Health
2. Substance Use Disorder
3. Obesity with Risk Factors

Next Steps

With completion of the document wrapping up in October 2022 and through the assistance of Results Based Accountability ^TM and the Clear Impact Scorecard, the BWI will work on developing goals and strategies around the three identified priorities to create a Community Health Improvement Plan (CHIP). The CHIP is the Community Health Assessment in action. The BWI and community members will start this process at the beginning of 2023. During this process, it is critical that certain questions are asked, such as “What is the story behind the curve that we, see? Why is mental health and substance use disorder such an issue in our community? What is occurring that is increasing our obesity rates?” Asking these questions beforehand helps guide the direction of any strategies we hope to implement—it is the “why” before the “how.”

We strongly encourage those in the community to become involved in the solution! Ways to get involved include:

• • Contact Miranda Smith (miranda.smith@burkenc.org) or any other member from the Burke Wellness Initiative to get updated on the upcoming meetings.