Activities of nine local health departments in implementing a community health improvement tool

The Institute of Medicine defines the mission of public health as "society's interest in assuring the conditions in which people can be healthy" and outlines the core functions of assessment, policy and assurance as a framework for public health work at the federal, state and local levels (Institute of Medicine, 1988). In the area of assessment the Institute of Medicine calls for public health agencies at all levels to "regularly and systematically collect, assemble, analyze and make available information on the health of the community, including statistics on health status, community health needs and epidemiologic and other studies of health problems" (p.7). For local health departments, the Institute of Medicine describes the need for "assessment, monitoring and surveillance of local health problems and needs and of resources for dealing with them" (p. 7). Local public health agencies are also charged to provide "policy development and leadership that foster local involvement and a sense of ownership, that emphasize local needs, and that advocate equitable distribution of public resources and complementary private activities commensurate with community needs" (p. 7). The community health assessment process, the focus of this paper, requires community engagement and provides valuable information to create a picture of the health of a population, identify areas of concern and suggest appropriate areas for improvement. (Halverson & Mays, 2001). This paper describes the process of implementing a new community health improvement tool, Mobilizing for Action through Planning and Partnerships (MAPP), for nine local public health agencies. While many factors such as organization size, setting, budget and population size could conceivably influence the implementation process they are not within the scope of this paper. Presented here is a framework that compares the experiences of the nine sites using four common themes identified through the interview process. Concrete examples willshow how sites provide leadership for MAPP, organize partners, mobilize internal and community resources to enhance the public health infrastmcture and system, and use the MAPP website. To set the context, a review of select assessment tools will explain the origins and rationale for MAPP. A description and justification for the use of qualitative data to study MAPP's implementation process follows. A table and more in-depth description will be used to explain findings and lead to discussion. The paper concludes with a summary of limitations and implications for practitioners.Master of Public Healt