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Measuring Outcomes in a Community Resilience Program: A New Metric for Evaluating Results at the Household Level.

ABSTRACT: Community resilience programs require metrics for evaluation but none exist for measuring outcomes at the household and neighborhood level. We develop and describe a new index, the LACCDR index of community resilience, to examine how resilience varied across communities at baseline, prior to implementation of the Los Angeles County Community Disaster Resilience Project (LACCDR). We surveyed 4700 adult residents in the sixteen LACCDR communities in English, Spanish and Korean. Each of the survey domains were selected a priori as outcome indicators aligned to the theoretical levers of community resilience. Survey questions were drawn and adapted from published studies and national surveys. Factor analysis demonstrated five separate factors composed from 18 items and explaining 46.7% of the variance. The factors were characterized as community engagement, emergency supplies, communication with neighbors, civic engagement, and collective efficacy. Baseline results for the 16 communities are provided. We conclude that the LACCDR community resilience index can be used to measure resilience program outcomes at the neighborhood and household levels.

SUBMITTER: Eisenman DP

PROVIDER: S-EPMC5077704 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

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Measuring Outcomes in a Community Resilience Program: A New Metric for Evaluating Results at the Household Level.

Eisenman David P DP Adams Rachel M RM Rivard Helene H

PLoS currents 20160928

Community resilience programs require metrics for evaluation but none exist for measuring outcomes at the household and neighborhood level.<h4>Objectives</h4>We develop and describe a new index, the LACCDR index of community resilience, to examine how resilience varied across communities at baseline, prior to implementation of the Los Angeles County Community Disaster Resilience Project (LACCDR).<h4>Methods</h4>We surveyed 4700 adult residents in the sixteen LACCDR communities in English, Spanis ...[more]

PMID: 27807510

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Project description:BackgroundEnvironmental health research involving community participation has increased substantially since the National Institute of Environmental Health Sciences (NIEHS) environmental justice and community-based participatory research (CBPR) partnerships began in the mid-1990s. The goals of these partnerships are to inform and empower better decisions about exposures, foster trust, and generate scientific knowledge to reduce environmental health disparities in low-income, minority communities. Peer-reviewed publication and clinical health outcomes alone are inadequate criteria to judge the success of projects in meeting these goals; therefore, new strategies for evaluating success are needed.ObjectivesWe reviewed the methods used to evaluate our project, "Linking Breast Cancer Advocacy and Environmental Justice," to help identify successful CBPR methods and to assist other teams in documenting effectiveness. Although our project precedes the development of the NIEHS Evaluation Metrics Manual, a schema to evaluate the success of projects funded through the Partnerships in Environmental Public Health (PEPH), our work reported here illustrates the record keeping and self-reflection anticipated in NIEHS's PEPH.DiscussionEvaluation strategies should assess how CBPR partnerships meet the goals of all partners. Our partnership, which included two strong community-based organizations, produced a team that helped all partners gain organizational capacity. Environmental sampling in homes and reporting the results of that effort had community education and constituency-building benefits. Scientific results contributed to a court decision that required cumulative impact assessment for an oil refinery and to new policies for chemicals used in consumer products. All partners leveraged additional funding to extend their work.ConclusionsAn appropriate evaluation strategy can demonstrate how CBPR projects can advance science, support community empowerment, increase environmental health literacy, and generate individual and policy action to protect health.

Project description:The concept of community resilience has gained considerable attention in the global health discussions since the Ebola outbreak of West Africa in 2014-2015. However, there are no measurement models to quantify community resilience. Without measurement models, it is unclear how to test strategies for building community resilience or to describe their likely intended and unintended results and their impact on health outcomes. We propose a measurement model for community resilience with relevant constructs and indicators to measure these constructs. We conducted a scoping review, systematically searching, screening and selecting relevant articles from two bibliographic databases (PUBMED and Google Scholar) for literature using search terms such as "resilience", "community resilience" and "health systems resilience". We screened 500 papers, then completed a full text review of 112 identified as relevant based on their title and abstract. A total of 27 papers and reports were retained for analysis. We then aggregated and synthesised the various definitions of community resilience and the frameworks for understanding these definitions. We identified key constructs from these frameworks and organised these constructs into domains and sub-domains. We proposed indicators to capture aspects of these domains and sub-domains and operationalised these indicators as a measurement model for quantifying community resilience in health systems. We propose a model with 20 indicators to assess community resilience. These indicators tap into various constructs from different theoretical frameworks of community resilience and are useful for assessing the level of knowledge, financial resources, and human, social and physical capital that are needed (or lacking) to respond to any types of shock, including health shock at the community level. This is an initial attempt to describe a multilevel measurement model for quantifying community resilience. This model will help to guide the development and testing of strategies for strengthening community resilience and will require further work to assess its relevance, reliability and validity in different LMIC settings.

Project description:IntroductionPeople living in the same area share similar determinants of infant mortality, such as access to healthcare. The community's prevailing norms and attitudes about health behaviours could also influence the health care decisions made by individuals. In diversified communities like Ethiopia, differences in child health outcomes might not be due to variation in individual and family characteristics alone, but also due to differences in the socioeconomic characteristics of the community where the child lives. While individual level characteristics have been examined to some extent, almost all studies into infant mortality conducted in Ethiopia have failed to consider the impact of community-level characteristics. Therefore, this study aims to identify individual and community level determinants of infant mortality in Ethiopia.MethodData from the Ethiopian Demographic and Health Survey in 2016 were used for this study. A total of 10641 live births were included in this analysis. A multi-level logistic regression analysis was used to examine both individual and community level determinants while accounting for the hierarchal structure of the data.ResultsIndividual-level characteristics such as infant sex have a statistically significant association with infant mortality. The odds of infant death before one year was 50% higher for males than females (AOR = 1.66; 95% CI: 1.25-2.20; p-value <0.001). At the community level, infants from pastoralist areas (Somali and Afar regions) were 1.4 more likely die compared with infants living in the Agrarian area such as Amhara, Tigray, and Oromia regions; AOR = 1.44; 95% CI; 1.02-2.06; p-value = 0.039).ConclusionIndividual, household and community level characteristics have a statistically significant association with infant mortality. In addition to the individual based interventions already in place, household and community-based interventions such as focusing on socially and economically disadvantaged regions in Ethiopia could help to reduce infant mortality.

Dataset Information

Measuring Outcomes in a Community Resilience Program: A New Metric for Evaluating Results at the Household Level.

Publications

Measuring Outcomes in a Community Resilience Program: A New Metric for Evaluating Results at the Household Level.

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