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Public Health - Seattle & King County

SPHC completed projects

Through our collective work over nine years, we have concluded that a promising but underutilized strategy for improving urban health is to address key social and community-level factors that affect health. In particular, SPHC has singled out community-building and developing social support as strategies well suited for public health-community partnerships interested in addressing social determinants of health.

Community Research Center

The Community Research Center provided technical assistance to non-profit community based and grassroots organizations in Central, Southeast and Southwest Seattle in the areas of grant-writing, community-based research and program evaluation.

Sustainable Evaluation Project

The purpose of the Sustainable Evaluation (SE) project was to build internal capacity around program evaluation for community-based organizations and grassroots groups. Two waves of the project were carried out: (1) the first round of SE projects were implemented during Jan-Dec, 2002, $24,000 of funding was provided to three organizations ($8,000 each) to pay for agency evaluation related expenses including compensation for a graduate student assistant who provided regular technical assistance and support for the evaluation activities; and (2) the second round began May 2003 and ended in Dec, 2003, $12,000 of funding was provided to three organizations to pay for staff time and evaluation related expenses to enhance their existing activities. The second wave, which focused on organizations that were more "evaluation ready" contributed to enhancing sustained changes for these agencies and organizations.

General Technical Assistance

Apart from the larger projects, the majority of CRC staff time was spent working intensively with staff from community-based organizations and providing a range of technical assistance, including grant writing, needs assessment and evaluation. Ongoing relationships were developed with 24 organizations, including 11 that were provided with CRC funding and 13 that received in-kind, staff support only. This technical assistance resulted in a number of concrete benefits to organizations and CRC help was viewed favorably by recipients.

Conclusions

The CRC provided a number of concrete benefits to community-based organizations and grassroots agencies in the communities served by Seattle Partners.  However, helping to build sustainable evaluation capacity in small community-based organizations and grassroots groups remained a challenge due to many external and internal constraints faced by agencies and their staff members, especially technical capacity and resources.

Domestic Violence Support Groups

"We can help each other": Social support and life skills development for Russian, Somali, Vietnamese and Cambodian/Lao survivors of domestic violence

Public Health - Seattle and King County in collaboration with Refugee Women’s Alliance (ReWA), a community-based provider of domestic violence (DV) services, conducted a pilot project to intervene in DV among refugee and immigrant communities in Seattle. This project was an outgrowth of qualitative research with these communities and will test the effectiveness of providing culturally appropriate social support and enhancing basic life skills among Russian, Somali, Ethiopian and Cambodian/Lao survivors of DV. Our previous research found that many refugee/ immigrant victims experience a profound sense of isolation. Social support was seen as essential for coping with the isolation and violence in their lives. Basic life skills such as banking, using the transportation system and access to services were both absent and critical for achieving independence from their abusers.This intervention served approximately 70 women who were victims of DV by providing culturally and linguistically appropriate educational and skill-building support groups. The support groups were ethnically and linguistically specific (e.g. Russian women speaking Russian in one group, Vietnamese women speaking Vietnamese in another). There were two phases to this intervention; each phase was seven months. The evaluation used qualitative and quantitative measures to document program effects and provide important information about promising community based and culturally appropriate approaches to addressing DV in refugee and immigrant communities.In summary, Domestic violence is a leading public health issue with significant consequences for women’s health and well-being. Ethnicity and culture influence how women respond to abuse. DV interacts with other social determinants of health, such as poverty, housing, oppression, stress, unemployment, lack of social support, lack of education, and other family violence. Immigrant and refugee survivors need basic life skills, but culturally competent, language-specific social support usually is not available to them. Using Participatory Action Research, we developed first-language, educational support groups for Cambodian, Ethiopian, Russian, and Somali women. The evaluation used a quantitative/qualitative, pre-post design. Findings show that support group participation is strongly associated with: 1) reduced DV incidence, DV frequency, and perceived stress; and, 2) increased social support, knowledge about where to turn for help, and ability to perform daily living skills.

Promoting Assets Across Cultures (PAAC)

Partners: Asian Counseling and Referral Services, Horn of Africa Services, International District Housing Alliance, Safe Futures Youth Center, Seattle Housing Authority.

The PAAC Program goals are to increase community leadership and developmental assets among multicultural youth, increase intergenerational communication and support and increase positive role models of interethnic relationships. The intervention includes developing multi-ethnic youth leadership teams of 12 to 15 youth in three low income housing project sites, organizing parents of the youth into multi-ethnic parent groups, and implementing three projects annually per target site that build community under the leadership of the project teams.

Seattle Partners and our agency partners conducted a formative evaluation and will disseminate findings to PAAC communities and stakeholders to inform the next stage of PAAC program/curriculum development as well as other community provider programs. The findings were used to support needed policy advocacy with the Seattle Housing Authority and other institutions working in these communities such as the Seattle Police Department.

Seattle Partners provided training and technical assistance in developing a framework, logic model and curriculum for the intervention.

Rainier Beach Community Education Project

Partners: Rainier Beach Advisory Council, Seattle Parks and Recreation at Rainier Beach Community Center, members of Rainier Beach neighborhood

The Rainier Beach Community Education project established a computer learning center and the group was successful in obtaining a larger technology grant from the City of Seattle with assistance provided by the Community Research Center. Seattle Partners staff provided coordination and technical assistance to the Rainier Beach Advisory Council Community Education Group. Specifically, we helped to connect the group with other resources such as access to 21st Century Learning grant support and the New School, which opened in 2002 as an experimental school with funding from the Stuart Sloan Foundation.

Seattle - King County Healthy Homes - Asthma Intervention Project

The indoor home environment presents a range of health risks, including asthma triggers and exposures to toxics such as lead, pesticides and volatile organics. Minority and low income populations are at increased risk for many of these exposures and children are most sensitive to their effects. Asthma is an important health consequence of these exposures and its incidence and mortality appear to be steadily increasing, especially among low-income children.

To address these concerns, we have developed the Seattle-King County Healthy Homes Project. Paraprofessional community home environmental specialists (CHES) provide a comprehensive package of interventions to reduce the total exposure burden of indoor environmental health risks. CHES conduct an initial home environmental assessment in low-income households with asthmatic children age 4-12. This initial assessment is followed by five to nine visits over the next 12 months in which CHES work with tenants, offering a comprehensive package of education and social support, encouragement of behavior changes, provision of materials to reduce exposures (bedding covers, vacuums, door mats, cleaning kits), and help in advocating for improved housing conditions. Detailed protocols for addressing each exposure are available on our Healthy Homes website.

We are assessing the effectiveness of our program by measuring changes in knowledge, behaviors, indoor environmental quality, asthma-related health status and health services utilization. An earlier intervention group is being compared with a later intervention group using a randomized, controlled study design.

Community participation has been an important component of this project. The project has been developed by a partnership of community agencies, a tenant’s union, an environmental justice organization, the local health department, the CDC-sponsored Seattle Partners for Healthy Communities and the University of Washington. Primary funding has been provided by the National Institute of Environmental Health Sciences with additional support from the Nesholm Foundation, the Seattle Foundation and the Seattle-King County Department of Public Health. The project started in October 1997 and will conclude in September 2005. For more information, call 206-296-6817.

Reality Check Project: Monitoring the impact of welfare reform

The Reality Check project was initiated by a coalition of community based agencies (WA Welfare Reform Coalition (WWRC)) in an attempt to document the impact of welfare reform legislation on local communities.

WWRC approached Seattle Partners for assistance with scientific and technical aspects of conducting a survey and data analysis:

  • Seattle Partners provided funding to hire bilingual interviews who were welfare recipients themselves to gather surveys and do further outreach to communities who might be under-represented in the survey.
  • Interviewers received training on conducting interviews and data entry skills.
  • Surveys were collected and analyzed and a reports were released in 1999 and 2000. Reports were used for legislative advocacy and received considerable media coverage.
Small Scale Evaluation of Community-based programs

Seattle Partners assisted community-based agencies with evaluation of programs that promote individual and community capacity to improve their economic and social well-being. These evaluations were a pilot that led to the establishment of the Community Research Center. Our approach to evaluation will follow our community collaboration principles and include the following approaches:

  • Evaluations are designed to yield comparable information about the elements of community-based programs that are successful
  • Evaluations incorporate community-defined measures of success
  • Evaluations are designed to promote community accountability, improve program operation and support requests for continued funding

We evaluated three programs:

  • Asian Counseling and Referral Services (ACRS) Day Activities program,
  • ACRS Vocational Services program
  • Wilderness Inner-City Leadership Development program (WILD).
Senior Immunization Project - Central Area Senior Center

The aims of this project were to:

increase influenza and pneumococcal immunization rates among seniors in Central Seattle using a randomized, controlled trial design

  • increase seniors’ knowledge about these immunizations
  • change attitudes of seniors which inhibit receipt of immunizations
  • increase recognition among seniors of the Senior Center as resource for health promotion and disease prevention

This project was selected based on a community prioritization of senior immunizations as an area for improvement. Additional support for this project was provided with matching funds from the United Way to Senior Services of King County.

The project was developed with active involvement of a project advisory group composed of senior center members and staff, as well as technical advisors from the University of Washington, the Health Department, Health Care Financing Administration (HCFA) and the Visiting Nurses Association. Community collaboration principles have guided the development of the Senior Immunization Project.

Methods. Seniors were randomized to intervention or control groups. The intervention group received educational brochures mailed with reply cards to report immunization status, telephone calls from senior volunteers to unimmunized participants, and computerized immunization tracking.

Results. Among participants without prior pneumococcal vaccination, the pneumococcal immunization rate among the intervention group was significantly higher than that of the control group. Among those without influenza immunization in the prior year, significantly more were immunized against influenza in the intervention group than in the control group

Conclusions. The intervention increased both influenza and pneumococcal vaccination rates to high levels, suggesting that further progress in increasing adult immunization coverage among all seniors is possible.

Garfield Community Research Room

The Community Research Room at Garfield Community Center opened in November, 1995, with the assistance of a $10,000 grant from the Center. This project was funded in response to extensive input from key central area community groups who supported this effort. The funds were used to purchase computer hardware. The goal of the Research Room is to facilitate access to information and technical expertise for community members who wish to research a subject, write a grant or develop a project.