Mobilizing For Action Through Planning And Partnerships Research Articles

Results From a National Mixed-Methods Study Exploring Community Health Improvement Implementation: An Opportunity to Strengthen Public Health Systems Through Collective Action.

There are multiple calls for public health agency role and workforce transformation to increase capacity to orchestrate cross-sectoral partnerships that set and implement strategies addressing the structural and social determinants of health. Mobilizing for Action through Planning and Partnerships (MAPP) may be one tool for collective action to improve population health and equity. However, little is known about the Action Cycle in MAPP and implementation of resulting community health improvement plans. To explore the characteristics of MAPP users who completed the MAPP Action Cycle and factors that facilitated or inhibited implementation activities during this phase. We used a sequential participatory mixed-methods design involving 2 phases of data collection. The first data collection phase included a Web-based survey using Qualtrics. The second data collection phase included qualitative key-informant interviews and focus groups. A national public health and health care advisory group informed the evaluation throughout the entire process to ground the process in practice and experience. This study showed that some MAPP participants do not conduct implementation activities as defined by the MAPP Action Cycle and of those who do, implementation activity varies by participant experiences conducting MAPP and accreditation status. The MAPP users who completed 3 or more rounds of MAPP were more likely to align and integrate MAPP within their agencies as well as organize a collaborative implementation process with partners. More resources and skills in planning that facilitate long-range partnerships were noted as key to implementation. Opportunity remains to improve implementation in MAPP. National leaders should explore and build capacity and infrastructure within public health agencies and with their partners to create a system of readiness and an infrastructure that support implementation over time.

Development, implementation and evaluation of the \u2018BELIEVE\u2019 program for improving physical activity among women: a mixed method action research study

BackgroundThere is insufficient physical activity among women. Yet the implementation of effective, multilevel, and evidence-based interventions may address this. Since the lifestyle of individuals is formed in many different social, physical and cultural contexts, it will be necessary in designing such interventions to involve many stakeholders. Consequently, the present study took a mixed method action research approach in developing, implementing and evaluating a bespoke program to improve physical activity among women.MethodsThis study was conducted within the Khoramroudi neighborhood of Tehran between 2013 and 2015 utilizing the four main phases of action research. The Mobilizing for Action through Planning and Partnerships (MAPP) process was used to design the study. During the initial phase, participants were organized into three groups; a core support committee, a steering committee, and a study population. Qualitative and quantitative data were also collected during this first phase. During the second phase, interventions were developed and implemented. In the third phase, an evaluation was carried out using both quantitative (Designing a quasi-experimental study) and qualitative methods. During the fourth phase, an exploration of the structure and process of action research was completed with the aim of providing a conceptual model and descriptions of the context.ResultsThree strategic interventions were effective in improving physical activity among women: (1) utilization of sports assistants; (2) Local health promotion and the dissemination of an informational, motivational and culturally competent booklet entitled “Educational content for sport assistants" (3) Group-based cognitive behavioral therapy. Quantitative results [Significant difference between the total score of PA before the intervention, and 1 and 3 months after the intervention (P < 0.001)] and the results of qualitative evaluations were shown to improve physical activity among participants. The newly co-created “adjusted MAPP model” was offered within three action cycles. The structure of this was described to capture the impacts of interactions among a variety of stakeholders.ConclusionThe comprehensive identification of problems led to the development of collaborative strategies. Strategies of action research can positively affect physical activity among women. To improve physical activity outcomes more generally, the use of MAPP principles and strategies is suggested to meet the specific needs and strengths of all community members.

Health Related Quality of Life and Social Support: A Rural Mobilizing for Action Through Planning and Partnerships Feasibility Study

Background: Rural communities face geographical health inequities that can reduce quality of life. However, rural communities are thought to have close social networks and higher levels of support. The purpose of the current study was to determine the feasibility of utilizing a social support measure within the Mobilizing for Action through Planning and Partnerships (MAPP) quality of life assessment process. Methods: Study participants (n=242, mean age: 46.5) completed a demographic questionnaire, Sense of Social Support Scale, and selected questions from the World Health Organization Quality of Life survey. Results: Findings indicate that perceived social support predicts health related quality of life (p=&lt;.001). In terms of social support, keeping in touch with friends and solicitation of help from friends were negatively associated with quality of life (p=.001; p=.018) respectively. The relationship between income level and health related quality of life was statistically significant (p=.018). Implications and Conclusions: Findings indicate that the measurement of social support and health related quality of life can be beneficial within a general rural community sample. Incorporation of social support measures within community based quality of life assessments can assist public health professionals with the development of appropriate programs and services.

Implementation and Evaluation of a Program for Improving Physical Activity Among Women: Mixed Method Action Research

This study was conducted through three main phases of action research in Khoramroudi neighborhood in Tehran on the basis of Mobilizing for Action through Planning and Partnerships (MAPP) process. The exploratory phase was for designing the program. The monitoring and evaluation phase was done by quantitative and qualitative methods. Reflection phase was an exploration of the structure and process of the action research. On the basis of prevalence of inadequate physical activity and the most important barrier and facilitator of physical activity, three strategies were extracted (the use of peer mentors, increased awareness of available sports services and group-based cognitive behavioral therapy). The action research could improve physical activity among women on the basis of an adjusted MAPP process. Funding Statement: This study was funded and supported by Tehran University of Medical Sciences (grant no. 92-02-28-23311). Declaration of Interests: There is no conflict of interest. Ethics Approval Statement: This study was approved by the ethics committee of Tehran University of Medical Sciences (no. 92-02-28-23311).

Intentional Paradigm Change: A Case Study on Implementation of Mobilizing for Action through Planning and Partnerships (MAPP).

Intentional Paradigm Change: A Case Study on Implementation of Mobilizing for Action through Planning and Partnerships (MAPP).

Enhancing Themes and Strengths Assessment: Leveraging Academic-Led Qualitative Inquiry in Community Health Assessment to Uncover Roots of Community Health Inequities.

Rigorous qualitative research can enhance local health departments' efforts to gain a deeper insight into residents' perceived community health inequities necessary for productive community health assessments (CHAs) and community health improvement plans (CHIPs). The Chicago Department of Public Health and the Partnership for Healthy Chicago used the National Association of County & City Health Officials' Mobilizing for Action through Planning and Partnerships (MAPP) model to conduct its CHA/CHIP, Healthy Chicago 2.0 (HC 2.0). Public health graduate students conducted qualitative research for part of the Community Themes and Strengths Assessment (CTSA), one of the 4 MAPP assessments. Using a health equity lens, this qualitative component included focus groups and oral histories with residents in Chicago Community Areas with the highest social and economic hardship to better understand how residents perceive health inequities in their respective neighborhoods. Community-based organizations in 6 Chicago neighborhoods with the highest quartile of social and economic hardship. Forty-eight Chicago residents from 5 community areas participated in focus groups, and 6 residents of a Mexican ethnic enclave shared oral histories. Residents' perceptions of community needs and assets. Needs identified include inaccessible resources and opportunities, economic instability, and safety. Assets include the efficacy and agency of resilient residents, as well as faith and spirituality. Systemic and institutional discrimination was identified at the roots of community health inequities. Through qualitative inquiry, the more nuanced understanding of how residents perceive health inequities better positioned HC 2.0 to develop upstream strategies in line with advanced health equity practice. Engaging qualitative academic researchers in CTSA brings academic expertise to enrich the CHA while providing real-time learning experiences to prepare future public health practitioners to work on upstream structural determinants of health.

137: THE EVALUATION OF A DRUG USE PREVENTION PROGRAM AMONG ADOLESCENCES BASED ON MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS PROGRAM (MAPP) – ISFAHAN: 1392

The propagation of teen drug use cessation programs internationally are increased in recent decade. Use of evidence-based teen drug use prevention program might help more decrease the prevalence of drug...

The Affordable Care Act and Community Benefit: A Mandate Catholic Health Care Can (Partly) Embrace

The 2010 Patient Protection and Affordable Care Act (ACA) requires not-for-profit hospitals, including Catholic hospitals, to engage in meaningful community assessment and collaboration efforts in order to maintain their tax-exempt status. Now that the ACA has been upheld by the U.S. Supreme Court, this paper argues that the requirements related to a more robust community engagement process should be embraced by Catholic not-for-profit hospitals and health systems. Apart from the legal requirements under ACA, an equally persuasive moral mandate to engage in community-level assessment and action exists in the ethical tradition of Catholic health care, particularly in the notions of the common good, preferential option for the poor, and subsidiarity. This paper examines the compelling nature of these moral norms in light of the dual goals of improving overall community health and reducing health disparities among vulnerable populations. It concludes with the examination of one model of community collaboration: Mobilizing for Action through Planning and Partnerships (MAPP).

The San Francisco Community Vital Signs

A coalition of local public health system stakeholders in San Francisco developed a community assessment and strategic planning tool, the San Francisco Community Vital Signs (SFCVS). The SFCVS builds on the Mobilizing for Action through Planning and Partnerships (MAPP) model by incorporating Internet-based technology into local public health system evaluation and strengthening. This article describes the overlap between the SFCVS and MAPP processes, the manner in which information technology facilitated the SFCVS process, and a template for infusing a Web-based platform into the MAPP model. Internet-based applications helped to implement many (16 of 41; 39%) of the components of the SFCVS process. Of these 16 process measures, the majority (10; 63%) required the use of Web-based technology. The SFCVS demonstrates that a MAPP-like process can leverage the Internet to augment the functionality of public health activities.

Identifying priority healthcare trainings in frozen conflict situations: The case of Nagorno Karabagh.

IntroductionHealth care in post-war situations, where the system's human and fixed capital are depleted, is challenging. The addition of a frozen conflict situation, where international recognition of boundaries and authorities are lacking, introduces further complexities.Case descriptionNagorno Karabagh (NK) is an ethnically Armenian territory locked within post-Soviet Azerbaijan and one such frozen conflict situation. This article highlights the use of evidence-based practice and community engagement to determine priority areas for health care training in NK. Drawing on the precepts of APEXPH (Assessment Protocol for Excellence in Public Health) and MAPP (Mobilizing for Action through Planning and Partnerships), this first-of-its-kind assessment in NK relied on in-depth interviews and focus group discussions supplemented with expert assessments and field observations. Training options were evaluated against a series of ethical and pragmatic principles.Discussion and EvaluationA unique factor among the ethical and pragmatic considerations when prioritizing among alternatives was NK's ambiguous political status and consequent sponsor constraints. Training priorities differed across the region and by type of provider, but consensus prioritization emerged for first aid, clinical Integrated Management of Childhood Illnesses, and Adult Disease Management. These priorities were then incorporated into the training programs funded by the sponsor.ConclusionsProgramming responsive to both the evidence-base and stakeholder priorities is always desirable and provides a foundation for long-term planning and response. In frozen conflict, low resource settings, such an approach is critical to balancing the community's immediate humanitarian needs with sponsor concerns and constraints.

Building and Measuring Infrastructure and Capacity for Community Health Assessment and Health Improvement Planning in Florida

COMPASS (Comprehensive Assessment, Strategic Success) is the Florida Department of Health's community health assessment and health improvement planning initiative. Since 2002, COMPASS built state and county health department infrastructure to support a comprehensive, systematic, and integrated approach to community health assessment and planning. To assess the capacity of Florida's 67 county health departments (CHDs) to conduct community health assessment and planning and to identify training and technical assistance needs, COMPASS surveyed the CHDs using a Web-based instrument annually from 2004 through 2008. Response rate to the survey was 100 percent annually. In 2007, 96 percent of CHDs reported conducting assessment and planning within the past 3 years; 74 percent used the MAPP (Mobilizing for Action through Planning and Partnerships) framework. Progress was greater for the organizational and assessment phases of the MAPP-based work; only 10 CHDs had identified strategic priorities in 2007, and even fewer had implemented strategies for improving health. In 2007, the most frequently requested types of training were measuring success, developing goals and action plans, and using qualitative data; technical assistance was most frequently requested for program evaluation and writing community health status reports. Florida's CHDs have increased their capacity to conduct community health assessment and planning. Questions remain about sustaining these gains with limited resources.

The Local Public Health System Assessment of MAPP/The National Public Health Performance Standards Local Tool

The Local Public Health System Assessment (LPHSA) in Mobilizing for Action through Planning and Partnerships (MAPP), and the Local Tool of the National Public Health Performance Standards Program (LT/NPHPSP)--which are one in the same-attempt to assess the capacity to provide the essential public health services. Both tools have been utilized in various public health practice settings; however, users have been challenged with the complexity of the tools and time and human resource investment necessary to complete them. The recent Journal of Public Health Management and Practice issue focus on MAPP provided several examples of LPHSA implementation, both as a component of MAPP and as a stand-alone activity in the context of performance standards. The uniqueness in our approach involved a collaborative between a community-based organization, a public health academic program, and a governmental public health agency which conducted the LPHSA in a manner that did not require actual modification of the tool itself, was practical and feasible, and was of benefit and value to all partners.

The MAPP Training Program Evaluation

This article reports on an evaluation of regional training programs designed to increase the knowledge and use of Mobilizing for Action through Planning and Partnerships (MAPP). The objectives for the MAPP training program included teaching participants about MAPP resources on the Web, providing participants with instruction about what MAPP is, and why it is important for community health improvement. Participants were also instructed on how to implement MAPP through a series of concrete steps such as mobilizing community partnerships, creating an action plan, conducting a series of assessments, and identifying strategic issues. An on-site survey with pretraining and posttraining questions and a follow-up survey were developed and administered to participants to assess their readiness levels to access MAPP resources and actively use and promote MAPP in their communities. The findings indicate that participants' knowledge of MAPP and confidence to use it improved as a result of training. Six months after training, participants' readiness levels increased from pretraining levels in the areas of incorporating MAPP into their roles, presenting MAPP to community partners, and using MAPP for community health improvement projects. Making changes in their organizations and communities to implement MAPP did not change significantly from pretraining levels. Just under half of training participants were implementing MAPP 6 months posttraining.

Lessons From the MAPP Demonstration Sites

This article describes one component of a three-part evaluation of a community health improvement model called MAPP (Mobilizing for Action through Planning and Partnerships). This component examined the use of MAPP by nine local public health agencies that acted as demonstration sites. Using qualitative data from telephone interviews, focus group data, and document reviews, the evaluators identified four themes associated with how MAPP was implemented and the factors that influenced implementation. A level of activity was assigned to each site for each of the four themes. Combining data from multiple demonstration sites, evaluators characterized common activities for each theme. Findings reveal that those sites with health director buy-in and full-time coordination for MAPP were associated with high levels of partnership development. The MAPP Web site, in its current state, does not appear to provide an advantage over using a printed copy of MAPP. Evaluation data from training programs and Web site users (the other two components of the evaluation) support key findings from the demonstration sites and reveal crosscutting themes for all components of the MAPP evaluation. Investigating other situational and contextual factors that influence the nature and success of MAPP implementation would be useful.

MAPP in Action in San Antonio, Texas

San Antonio was selected as an official Mobilizing for Action through Planning and Partnerships (MAPP) demonstration site by National Association of County and City Officials in 2000. The San Antonio Metropolitan Health District, under the leadership of Dr Fernando A. Guerra, agreed to facilitate the process. The MAPP process provided the San Antonio Metropolitan Health District, the local public health authority, a defined process for community health improvement, as well as a mechanism to help bridge the gap between public health and the community. The San Antonio Metropolitan Health District organized a Core Planning Team to lead the MAPP process in April 2001. By October 2002, the Core Planning Team was expanded to a full community working group named the Alliance for Community Health in San Antonio and Bexar County (Alliance). The Alliance identified six strategic issues, which eventually became the basis of the San Antonio Community Health Improvement Plan. The strategic issues are Public Policy, Data Tracking, Healthy Lifestyles, Promoting a Sense of Community, Access to Care, and Safe Environment. San Antonio's MAPP experience has been successful in bringing together the public health system partners, and establishing public health priorities collectively. The MAPP process has resulted in the development of many new initiatives, and, most important, has opened the door to many partnership opportunities in the future. The work of the Alliance, through the MAPP process, has helped to leverage resources for public health improvement in San Antonio, and has the potential to effect positive change in public health in the future.

MAPP in the Classroom

As Mobilizing for Action through Planning and Partnerships (MAPP) becomes increasingly important for community public health practice, it is critical to examine what learning MAPP entails as well as its barriers and benefits. Competency-based education and training interventions that prepare public health workers to effectively contribute to the implementation of MAPP in their communities face significant obstacles. Current public health education and training programs are poorly positioned to enhance MAPP-related competencies among significant numbers of public health students and workers. Establishing the community as the classroom for learning MAPP and forging links with professional education and lifelong professional development strategies are necessary for MAPP to be successful in promoting healthy communities.

Developing the MAPP Community Health Improvement Tool

From 1997 to 2001, the National Association of County and City Health Officials, in collaboration with the Centers for Disease Control and Prevention's Public Health Practice Program Office, developed a new community strategic planning tool, titled Mobilizing for Action through Planning and Partnerships (MAPP). This article provides a chronological description of the development of MAPP, devoting significant attention to pivotal decisions, development milestones, and distinguishing features of this new public health planning tool. All phases of the development ensured a practice-driven process, ongoing substantive input from the field, careful attention to research and literature, and intentional linkage with related efforts. This deliberate process laid the foundation for a tool that is not only well grounded in research and concepts but also relevant for practical use in communities. The process also demonstrates how practice-based research can be conducted in a way that effectively balances the need for applied relevance with intellectual integrity.

Integrating MAPP, APEXPH, PACE-EH, and Other Planning Initiatives in Northern Kentucky

Northern Kentucky is the first NACCHO demonstration site in the nation to utilize the Mobilizing for Action through Planning and Partnerships (MAPP) tool as one element in the development of a comprehensive community health plan. The Northern Kentucky Independent District Health Department utilized several strategies to integrate MAPP and a variety of assessment tools into a continuous and seamless planning process that resulted in the Master Health Plan for Northern Kentucky 2005. These strategies were developed from using many of the assessment and planning tools developed by the National Association of County and City Health Officials including MAPP, the Protocol for Assessing Community Excellence in Environmental Health, and the Assessment Protocol for Excellence in Public Health. Strategies included maintaining a consistent committee structure, integrating other processes into the MAPP process, combining community objectives and strategies into a Master Health Plan, and developing a unified evaluation plan.

Utilizing a National Performance Standards Local Public Health Assessment Instrument in a Community Assessment Process

The Clarendon County Turning Point Initiative was launched with the goals of conducting a community-wide health assessment and developing a community health improvement plan. For the community assessment, the National Association of County and City Health Officials' (NACCHO's) Mobilizing for Action through Planning and Partnerships (MAPP) model was used. One of the assessments conducted through the MAPP model was the National Public Health Performance Standards Local Public Health Systems Assessment. The process for conducting the assessment using the local performance instrument is described. Clarendon County Turning Point Initiative conducted a one-and-a-half-day retreat to complete the local performance instrument. The committee planning the process identified and recruited stakeholders, collected data/information from stakeholders, and hired a consultant to facilitate the one-and-a-half-day retreat. The data analyzed with the local performance instrument identified opportunities and gaps in public health services in Clarendon County.