CHANGE Tool Impacts Communities
In 2007, CDC's Healthy Communities Program recognized a need for new ways of assessing and documenting policy, systems, and environmental changes in communities to advance the nation's efforts to prevent chronic diseases and reduce related risk factors. After conducting a literature search, reviewing numerous community assessment publications and tools, and soliciting feedback from both internal and external partners, CDC's Healthy Communities Program developed the Community Health Assessment aNd Group Evaluation (CHANGE) tool.
What is the CHANGE tool?
CHANGE is a data-collection tool and planning resource for community members interested in making their community a healthier one. This tool provides a community with a picture of the policy, systems, and environmental change strategies currently in place and helps identify areas for improvement. Examples of these strategies include:
- Adopting tobacco-free policies at schools and health care facilities
- Implementing healthy vending machine policies at worksites
- Developing accessible walking paths
- Retrofitting streets with bike lanes and sidewalks
- Creating farmer's markets and community gardens
- Promoting stair use in public buildings
The CHANGE tool promotes collaboration among a community team or coalition and local stakeholders to survey and identify community strengths and areas for improvement, in order to prioritize community needs. A community that used the tool described it as "a great community engagement tool for stakeholders and consortium partners." Another community noted, "Simply the act of doing the CHANGE assessment raises awareness among participants involved, and raises new ideas for positive action among coalition members."
How can the CHANGE tool be used?
CHANGE can be used to:
- Gain a picture of current policies and strategies
- Develop a community action plan that impacts social and built environments to create positive behavior changes and improve the health of people living in their communities
- Make the best use of available local resources and partnerships for addressing community needs
In addition, CHANGE helps communities to monitor and track progress across one or more years by using a 1-to-5 rating scale that allows users to measure incremental changes. CHANGE users have noted how helpful the tool is for:
- Showing specific examples of policy, systems, and environmental change strategies
- Guiding conversations about the importance of policy change
- Uncovering new areas for community action
- Providing a systematic way for communities to assess and document community needs and assets
- Promoting collaboration and establishing new partnerships among community stakeholders
New York City uses the CHANGE tool
New York City, a Strategic Alliance for Health community, was funded by CDC's Healthy Communities Program in 2009. They used the CHANGE tool to confirm what they had suspected; they needed to focus their efforts in improving access to healthy food, providing access to new opportunities for physical activity, and establishing a standardized nutrition and wellness policy at schools and afterschool programs. The Director of the New York City Strategic Alliance for Health, Javier Lopez said, "The assessment allowed us to focus our consortium members on specific areas that as a coalition we were able to work on together and improve." The CHANGE tool helped identify the root cause of why school wellness and nutrition had become a problem in New York City elementary schools. As a result, the New York City Strategic Alliance for Health developed the Excellence in School Wellness Award to help elementary schools review and monitor their progress in meeting 16 specific nutrition, physical activity, and wellness policies. The two geographical areas targeted were East and Central Harlem in Northern Manhattan and the South Bronx since obesity rates in these neighborhoods were almost 55% higher than the city overall. Within the first year, 40 schools received the award, and the CHANGE tool was utilized to monitor and reassess the policies to be more specific to New York City Department of Education guidelines, as well as to create a sustainable plan to transition from a voluntary project into a standardized tool for 800 elementary schools to meet the established wellness policies.
To date, more than one hundred communities are using the CHANGE tool, including Strategic Alliance for Health and Action Communities for Health, Innovation, and EnVironmental change (ACHIEVE) communities. These communities are funded through CDC's Healthy Communities Program to implement policies that sustain environmental and systems changes that reduce the burden of chronic disease and achieve health equity.
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