August 1, 2018

From Samantha Kinney, MPH, Community Health and Wellness Coordinator, Yamhill County Public Health

Community Health Improvement Process

In 2017, Yamhill County Public Health completed its Community Health Assessment, an assessment completed every 5 years and used to prioritize efforts to create a healthier community. Through a thorough vetting process and input from community members, the community selected four priorities areas: Behavioral Health, Tobacco & Vaping Prevention, Preconception Health, and Trauma Prevention Reduction & Community Resiliency. The Collective Impact model was determined to be the model that would effectively create lasting change in these areas. The key conditions for the collective impact approach include having: a common agenda, shared measurement, mutually reinforcing activities, continuous communication, and backbone support organizations. Trauma prevention, reduction and community resilience was identified as a top priority to pivot all facets of life including education, behavioral health, physical health, judicial, and quality of life indicators. The trauma-reduction approach to serving children, youth, and families involves a paradigm shift to support changes in everyday practices and policies on how to promote resilience. The overall goal of a trauma-reduction approach is to develop programs, services, and environments that do not re-traumatize while also promoting coping skills and resilience in individuals and the community.

Selecting Trauma Reduction Matrixes and Creating Performance Measures

When selecting trauma prevention and reduction strategies, Yamhill County used the Protective Factor Framework to strengthen families within five concepts: parental resilience, social connectivity, knowledge of parenting and child development, concrete support in times of need, and social and emotional competence of children. The community then formulated activities under each factor with the notion of adopting new programs and practices and or expanding additional services needed within certain geographic areas of the county.

Five strategic initiatives were developed to address the trauma and increase community resilience.

Strategic Initiative 1: Increase the number of trauma-informed organizations within the community
Strategic Initiative 2: Enhance protective factors that contribute to safe, stable, and nurturing families and overall community wellness
Strategic Initiative 3: Increase protective factors that support and develop parental resilience and knowledge of child development and available parenting resources
Strategic Initiative 4: Increase social and emotional competence among children
Strategic Initiative 5: Build on existing prevention collaborations to further align efforts across the county and leverage funds to support the work

The Critical Importance of Frequent Measurement

A performance management system is vital to learn whether Yamhill County is achieving the kind of trauma prevention and reduction strategies anticipated within the community. Over time, Yamhill County will be developing a system in which every subcommittee will be reporting annually on the selected performance measures. To that extent Yamhill County will be monitoring the population indicators to see if the strategies are effectively improving the health and wellbeing of the community. These measures include program outcomes, reach, knowledge gain, practices adopted to mitigate trauma in the future, and overall sifts in the population’s experiences.

The Role of Evidence-Based Interventions in Achieving Our Goals

The ability to provide impartial assessment of the impact of policy changes, evidence-based programs, and practices has demonstrated value. Yamhill County has invested in the implementation of evidence-based interventions in order to address trauma and increase community resilience. The outcome measures in evidence-based programs such as PAX Good Behavior Game, Positive Family Support and Nurse Family Partnership have shown to improve general population indicators with effective implementation. These measures were selected as population indicators for the community to monitor.

Next Steps

As part of the effort to provide continuous communication, Yamhill County Public Health will convene regular meetings with community partners who are taking action on the developed work plans. In these meetings Yamhill County will report progress on the work plans and selected priority area measurement indicators. Additionally, this will allow the partners to keep each other updated on the work that has been completed, as well as serve as a forum to help troubleshoot and solve problems that arise.

Helpful Resources and Program Information

For more information, please contact Samantha Kinney, MPH at kinneys@co.yamhill.or.us.