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2.0 Core Strategy Recommendation
This section describes a core strategy recommendation
for community health improvement. As background,
subsections 2.1 to 2.3 describe considerations for
Section Outline
making choices, a set of driver diagrams, and a concept
for a ‘first-up initiative’ approach. Subsection 2.4 2.1 Considerations for Making Choices
presents the core strategy recommendation.
2.2 Driver Diagrams
2.3 A ‘First Up Initiative’ Approach
2.1 Considerations for Making Choices
First-Up Initiative: Collaborative Action through
2.4
Community action planning typically requires choice- Community Collaboration Hubs
making to select which community initiatives to pursue
from among multiple options. The CHIP Workgroup and
the Action Planning Groups considered multiple factors
in the process of selecting a focus for action. These considerations included the following
Four focus areas. The action plan would have to address each of four focus areas in some fashion. Firearm
violence, heart disease, infant mortality, and substance are all important community issues. Each could be
addressed through a comprehensive community approach with its own theory of change, intervention strategy, and
set of objectives.
Six localities. The action plan would have to reach across six localities, including four cities (Hampton, Newport
News, Poquoson, and Williamsburg), and two counties (James City and York). Each of these localities has a
distinctive community culture and infrastructure. While some localities have a substantial history of collaboration,
collaboration across all six would require significant efforts to build mutual understanding, relationships, and
connections.
Community assets. The Action Planning Groups identified dozens of community organizations and programs that
are working to address various aspects of firearm violence, heart disease, infant mortality, and substance use. All
of these entities represent assets that could be mobilized to address community needs. It was also recognized that
these organizations may not be fully aware of each other’s scope of work and capabilities, and there is value in
fostering mutual awareness of community partners working across the region.
Community data. The Action Planning Groups reviewed community data sets that indicate areas of need across
the four topic areas. It was also acknowledged that readily available data sets are not adequate to support small-
area analysis of risk at the zip code or census tract level. It may be possible to produce more granular community
data through partnerships between public health and various community organizations, but this will require some
capacity building over time.
Commitment to health equity. All of the planning partners share the commitment to advance health equity
through community health improvement. The work of health equity requires deep understanding of people and
populations at the neighborhood level, which in turn requires both data and dialog to develop deeper insights for
designing community interventions.
Scope of intervention. In considering community needs and possibilities, it became apparent that the scope of
intervention could include elements of early detection of risk, community-based prevention strategies, and
strategies to facilitate access to treatment. These strategies would need to be differentiated across the four focus
areas.
Evidence on ‘what works.’ As part of the planning process the four action planning groups reviewed the published
evidence on ‘what works’ (promising practices, evidence-informed practices, evidence-based practices). The
evidence review was conducted by staff with a focus on community-based interventions more so than primarily
clinical or legal interventions. The results suggest that collaborating to identify at-risk populations and connect
people to existing resources can be a logical starting point for community action. As these collaborative
connections are built, there is potential to discover gaps in community supports that could be addressed through
creation or expansion of community supports.
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