For public health departments around the country, staying ahead of emerging health issues is a top priority. Skilled departments rely on regularly collected quantitative data to target and pinpoint health issues as they arise. Yet survey data rarely answer the question of why certain health issues take hold in specific populations, and can be a poor indicator of early developing health issues.
To address these information gaps, the District of Columbia’s Department of Behavioral Health collects qualitative data using a standard protocol called Community Conversations. This “bottom-up” approach has helped the Department identify nascent health issues in neighborhoods and communities around the District.
Identifying the Gap
At the District of Columbia’s Department of Behavioral Health, Community Director Eric Chapman can pinpoint the moment it became clear that qualitative data collection would become an integral part of the department’s needs assessment process.
“It was 2012,” Chapman explains. “And we kept hearing about utilization of synthetic marijuana from the heads of our prevention centers.” Washington, D.C. is made up of eight wards or neighborhoods, and the four D.C. Prevention Centers serve two wards each.
“We wanted to learn more about synthetic marijuana use in the District. So we brought folks from the wards into a room for a conversation, and found out that there were certain gas stations where people could buy it. Community members then brought us to these spots and we were able to speak directly with people who were actively using. It allowed us to learn firsthand about the problem.”
With the help of D.C.’s Epidemiological Outcomes Workgroup and the Research Triangle Institute, those first forays into qualitative data collection led to the development of the Community Conversations Workbook. The workbook serves as a training manual for Prevention Center practitioners on how to collect empirically sound data using a community meeting as the primary data source.
Today, each of the four D.C. Prevention Centers is required to hold at least four Community Conversations a year. “Community Conversations are part of the scope of work of each of the Prevention Centers,” explains Chapman. Conversations are guided by quantitative data collected by the epidemiological workgroup, which provides each of the Prevention Centers with ward-specific numerical data on issues related to substance misuse. The conversations are conducted with the goal of learning the story behind the numbers—specifically, how the community perceives these health issues.
Customizing Data Collection
Community Conversations can take many forms, which, Chapman explains, helps the Prevention Centers and the Department of Behavioral Health collect data thoughtfully and intentionally. “There are different protocols for different-sized groups,” Chapman explains. The workbook provides separate guidance for facilitating key partner interviews, general conversations with large community groups, and more targeted conversations with small community groups.
Chapman highlights the workbook’s strength in explaining how data collection goals differ for each type of conversation. In the large-group conversations, held quarterly, Prevention Center directors share data to elicit reactions and impressions from ward residents on documented health issues. By contrast, small-group conversations provide an opportunity for Prevention Center staff to learn more about emerging health needs that come to light anecdotally. In both types of Community Conversations, Chapman and the Prevention Center directors have found that people welcome the opportunity to discuss health issues in their community.
Building Strong Connections
For the Prevention Centers, an additional benefit of the Community Conversation protocol is that it provides a ready mechanism for responding to community member needs. “For example, we were contacted by a few parents at a high school who were concerned about substance abuse,” Chapman explains. “Digging deeper, we found that these concerns were widespread and shared among many of the parents. So the director of the Prevention Center that serves that ward held a small Community Conversation to help shed light on the issue.”
Like most community members who have participated in these conversations, the parents in this session relished the chance to talk through their experiences. They highlighted the difficulties of parenting young teens in a climate that seemed to push alcohol consumption. A few also revealed that their children were using a wide assortment of illicit substances in addition to alcohol. “We were able to analyze the information gathered during the conversation and recalibrate the Prevention Center efforts to address the issue,” Chapman says. “Also, during the conversation itself we were able to offer a little bit of education and support for the parents.”
Weighing Challenges and Benefits
Implementing Community Conversations as a standard qualitative data collection protocol has not been without challenges. For example, explains Chapman, “A Community Conversation may highlight an issue that we don’t have the capacity to address at that moment.” This can be both challenging and frustrating. Chapman makes clear to his staff that however tempting it may be to arrive at solutions, the Community Conversation protocol needs to be “used with fidelity, which means the facilitator should not be promising stuff” to community members.
Despite these challenges, Chapman believes in the benefits of the Community Conversation approach, citing, in particular, how it has informed the Department of Behavioral Health’s strategic planning and funding decisions. “Community Conversations allow us to deeply explore the quantitative data and figure out where we need to learn more about a health issue,” Chapman explains. “They also provide the context we need to allocate funding more efficiently to better address emerging needs.”
For Chapman and the directors of the D.C. Prevention Centers, Community Conversations have been key to building strong connections with their clients throughout the District. “Having Community Conversations has made us able to speak more confidently about differences between wards and to find common themes across them,” he explains.
To learn more about D.C.’s Community Conversations, contact Lourdes Vazquez, CAPT Southeast Resource Team Coordinator, at firstname.lastname@example.org.