mapping pathways: lessons learned from applied ... · • epi info training: ... – implemented...
TRANSCRIPT
Mapping Pathways: Lessons Learned from Applied
Epidemiology and GIS Training for Tribal Communities
This presentation was made possible through Cooperative Agreement # MPCMP101056‐01‐00 from the Office of
Minority Health, Department of Health and Human Services. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Department
of Health and Human Services.
Nicole Vanosdel, MSPatty Eagle Bull, MBA
Shinobu Watanabe‐Galloway, PhD
ESRI Health Users Conference – August 21, 2012
Kate Watkins, MPHCorey B. Smith, PhDGerri LeBeau, BS
Mapping Pathways into a Healthier Future
• 5‐year project funded by Office of Minority Health (OMH)
• Provides leadership, technical assistance, support, and advocacy to the 18 Northern Plains Tribal nations and communities in order to reduce the health disparities that currently exist for Tribal people of the four‐state region of Iowa, Nebraska, North Dakota and South Dakota.
“Mapping Pathways” Purpose
To increase the public health capacity of Northern Plains tribal communities by
strengthening the infrastructure of the tribal health workforce through training and
education
Long‐term Objectives
1.) Increase understanding of the contribution of gaps in usable data to health inequities
2.) Promote data activities aimed at improving the health status of tribal communities
3.) Improve the health status of Northern Plains American Indian communities
Data gaps contribute to health inequities
•Inadequate representation of American Indians in national surveys and other data sources–Sample size –Representativeness–Racial misclassification
•Limited availability of local data –Assess health status of tribal communities–Develop targeted intervention programs–Track progress of interventions
Role of Tribal Health Organizations• Indian Health Service is the primary provider of healthcare needs of American Indians in the region
• Tribal health departments are an integral part of the public health system
• Underutilization of available data by Tribal Health for planning, resource allocation, and policy development–Lack of qualified, trained staff –Limited resources (time, $)–Need for skills in epidemiology, statistics, GIS and other data‐related activities
According to a National Indian Health Board Survey…
• Only 44% of tribal health departments or organizations conducted a community health assessment in the past 3 years
• Of those who conducted assessments, 58% were primarily led by tribal departments or organizations. The remaining 42% was led by an outside party.
Tribal Health Organizations & the Public Health System
• Tribal Health Organizations are an integral part of the public health system– The public health occupations most frequently employed are administrators and primary health care providers (e.g., physicians, nurses)
– Only 6 percent of Tribal Health Organizations report having an epidemiologist or statistician on staff
Developing the Project•Formed partnerships
–UNMC College of Public Health–Tribal health departments–Tribal colleges–State Departments of Health
•Advised by a Tribal Steering Committee
•Developed curricula & Conducting workshops–Two workshops (Epi Info & ESRI ArcMap 10.0 Software)–Follow‐up webinars
•Ongoing needs assessment and evaluation–Workshop participants –State health departments–Tribal health organizations
Main Project Activities
• 2 Workshops per year– CDC Epi Info: Epidemiology Software to develop an understanding and use of data and statistics
– ESRI ArcMap: Builds on knowledge from 1st
workshop to show data geographically
• Follow‐up webinars to continue education and trouble‐shoot problems encountered.
Timeline: Year 1
• Developed curriculum
• Conducted two workshops for GPTCHB Program Staff
• Conducted a public health needs assessment
• Identified and acquired publicly available data
• GPTCHB began GIS activity
Timeline: Years 2‐4• Recruit individuals from tribal health programs to participate in training activities
• Continue trainings: in‐person workshops, webinars, and conference call consultations
• Work with tribal health programs to identify and acquire health data
• Provide technical assistance for GIS and epidemiology activities
Timeline: Year 5
• Continue working with tribes
• Wrap‐up project activities
• Seek opportunities to continue similar or related projects
What We Have Learned• Participants are interested in practical applications • Planning and implementation of workshops and webinars is
challenging due to range of skills and experiences (i.e., group heterogeneity)
• Need for additional instruction: –Basic computer skills–Concepts in epidemiology
• Native American sample data for teaching purposes is scarce• Many logistical and technical challenges
–Scheduling conflicts for participants—everyone is busy! –Constant updates for both Epi Info and ESRI ArcGIS software–Organizational bandwidth
• More opportunities for partnerships (e.g. Tribal colleges)…
Positive Changes from Year 1 to Year 2
• Epi Info Training:– Presented ‘What is data?’ and expanded examples of field applications
– File Management 101
– Distinguished between research and practice protocols
– Implemented Epi Info version 7
Positive Changes from Year 1 to Year 2
• ESRI ArcMap Training:– Increased length from 2.5 days to 4.5 days
– Changed curriculum from trainer guided to more of a self‐guided/self‐paced learning environment
– Utilized a computer classroom (every PC had the same operating system, pre‐loaded with the ESRI software)
Ongoing Challenges• Time Constraints:
– Finding the time required to continue to learn these software systems after the workshop is difficult for participants, who all have limited time to begin with
• Information Technology Problems:– Limited access to internet– Little or no technical support– Old/outdated hardware
• Scheduling difficulties for workshops
Positive Outcomes• An increased appreciation and understanding of how data can be used to tell a story to participant’s communities, and a desire to share this knowledge with their communities.
• Every participant at our recent training had several ideas of data that they wanted to use/collect to present their data geographically.
• A reinvigorated sense of purpose to work towards bettering their communities.
Looking forward• Scheduling:
– Moving workshops to non‐summer months to avoid scheduling conflicts
• Possibly divide the Epi Info workshop into 2 groups, based on skill level.
• Utilize the GIS Tutorial for Health (Kurland) book as an instructional tool in the GIS workshop
• Expanding partnerships
Contact
Kate Watkins
402‐559‐9393
Nicole Vanosdel
402‐559‐3755