Seattle Partners Projects

Through our collective work of the past five years, we have concluded that a promising but underutilized strategy for improving urban health is to address key social and community-level factors that affect health. In particular, SPHC has singled out community-building and developing social support as strategies well suited for public health-community partnerships interested in addressing social determinants of health.

Completed Projects:

• Domestic Violence Support Groups
• Promoting Assets Across Cultures (PAAC)
• Rainier Beach Community Education Project

Community Research Center

• Seattle - King County Healthy Homes - Asthma Intervention Project
• Reality Check Project: Monitoring the impact of welfare reform
• Small Scale Evaluation of Community-based Programs
• Senior Immunization Project - Central Area Senior Center
• Garfield Community Research Room

Projects Linked to Seattle Partners:

• Domestic Violence Grants: Researcher/Practitioner Partnerships
• King County Community Indicators Project
• Ethnicity and Health Study

Domestic Violence Support Groups

"We can help each other": Social support and life skills development for Russian, Somali, Vietnamese and Cambodian/Lao survivors of domestic violence

Public Health--Seattle and King County in collaboration with Refugee Women’s Alliance (ReWA), a community-based provider of domestic violence (DV) services, conducted a pilot project to intervene in DV among refugee and immigrant communities in Seattle. This project was an outgrowth of qualitative research with these communities and will test the effectiveness of providing culturally appropriate social support and enhancing basic life skills among Russian, Somali, Ethiopian and Cambodian/Lao survivors of DV. Our previous research found that many refugee/ immigrant victims experience a profound sense of isolation. Social support was seen as essential for coping with the isolation and violence in their lives. Basic life skills such as banking, using the transportation system and access to services were both absent and critical for achieving independence from their abusers.

This intervention served approximately 70 women who were victims of DV by providing culturally and linguistically appropriate educational and skill-building support groups. The support groups were ethnically and linguistically specific (e.g. Russian women speaking Russian in one group, Vietnamese women speaking Vietnamese in another). There were two phases to this intervention; each phase was seven months. The evaluation used qualitative and quantitative measures to document program effects and provide important information about promising community based and culturally appropriate approaches to addressing DV in refugee and immigrant communities.

In summary, Domestic violence is a leading public health issue with significant consequences for women’s health and well-being. Ethnicity and culture influence how women respond to abuse. DV interacts with other social determinants of health, such as poverty, housing, oppression, stress, unemployment, lack of social support, lack of education, and other family violence. Immigrant and refugee survivors need basic life skills, but culturally competent, language-specific social support usually is not available to them. Using Participatory Action Research, we developed first-language, educational support groups for Cambodian, Ethiopian, Russian, and Somali women. The evaluation used a quantitative/qualitative, pre-post design. Findings show that support group participation is strongly associated with: 1) reduced DV incidence, DV frequency, and perceived stress; and, 2) increased social support, knowledge about where to turn for help, and ability to perform daily living skills.

Promoting Assets Across Cultures (PAAC):

Partners: Asian Counseling and Referral Services, Horn of Africa Services, International District Housing Alliance, Safe Futures Youth Center, Seattle Housing Authority

The PAAC Program goals are to increase community leadership and developmental assets among multicultural youth, increase intergenerational communication and support and increase positive role models of interethnic relationships. The intervention includes developing multi-ethnic youth leadership teams of 12 to 15 youth in three low income housing project sites, organizing parents of the youth into multi-ethnic parent groups, and implementing three projects annually per target site that build community under the leadership of the project teams.

Seattle Partners and our agency partners conducted a formative evaluation and will disseminate findings to PAAC communities and stakeholders to inform the next stage of PAAC program/curriculum development as well as other community provider programs. The findings were used to support needed policy advocacy with the Seattle Housing Authority and other institutions working in these communities such as the Seattle Police Department.

Seattle Partners has provided training and technical assistance in developing a framework, logic model and curriculum for the intervention.

Rainier Beach Community Education

Partners: Rainier Beach Advisory Council, Seattle Parks and Recreation at Rainier Beach Community Center, members of Rainier Beach neighborhood
The Rainier Beach Community Education project has primarily established a computer learning center and the group was successful in obtaining a larger technology grant from the City of Seattle with assistance provided by the Community Research Center. Seattle Partners staff provided coordination and technical assistance to the Rainier Beach Advisory Council Community Education Group. Specifically, we helped to connect the group with other resources such as access to 21st Century Learning grant support and the New School, which opened in 2002 as an experimental school with funding from the Stuart Sloan Foundation. The New School will be open year-round and will eventually serve students in kindergarten through 8th grade using a community school model.

Seattle - King County Healthy Homes - Asthma Intervention Project

The indoor home environment presents a range of health risks, including asthma triggers and exposures to toxics such as lead, pesticides and volatile organics. Minority and low income populations are at increased risk for many of these exposures and children are most sensitive to their effects. Asthma is an important health consequence of these exposures and its incidence and mortality appear to be steadily increasing, especially among low-income children.
To address these concerns, we have developed the Seattle-King County Healthy Homes Project. Paraprofessional community home environmental specialists (CHES) provide a comprehensive package of interventions to reduce the total exposure burden of indoor environmental health risks. CHES conduct an initial home environmental assessment in low-income households with asthmatic children age 4-12. This initial assessment is followed by five to nine visits over the next 12 months in which CHES work with tenants, offering a comprehensive package of education and social support, encouragement of behavior changes, provision of materials to reduce exposures (bedding covers, vacuums, door mats, cleaning kits), and help in advocating for improved housing conditions. Detailed protocols for addressing each exposure are available at our web site http://www.metrokc.gov/health/asthma/healthyhomes.htm.

We are assessing the effectiveness of our program by measuring changes in knowledge, behaviors, indoor environmental quality, asthma-related health status and health services utilization. An earlier intervention group is being compared with a later intervention group using a randomized, controlled study design.
Community participation has been an important component of this project. The project has been developed by a partnership of community agencies, a tenant’s union, an environmental justice organization, the local health department, the CDC-sponsored Seattle Partners for Healthy Communities and the University of Washington. Primary funding has been provided by the National Institute of Environmental Health Sciences with additional support from the Nesholm Foundation, the Seattle Foundation and the Seattle-King County Department of Public Health. The project started in October 1997 and will conclude in September 2005. For more information, call 206-296-6817.

Reality Check Project: Monitoring the impact of welfare reform

The Reality Check project was initiated by a coalition of community based agencies (WA Welfare Reform Coalition (WWRC)) in an attempt to document the impact of welfare reform legislation on local communities.

WWRC approached Seattle Partners for assistance with scientific and technical aspects of conducting a survey and data analysis:

• Seattle Partners provided funding to hire bilingual interviews who were welfare recipients themselves to gather surveys and do further outreach to communities who might be under-represented in the survey.
• Interviewers received training on conducting interviews and data entry skills.
• Surveys were collected and analyzed and a reports were released in 1999 and 2000. Reports were used for legislative advocacy and received considerable media coverage.

Small Scale Evaluation of Community-based Programs

Seattle Partners assisted community-based agencies with evaluation of programs that promote individual and community capacity to improve their economic and social well-being. These evaluations were a pilot that led to the establishment of the Community Research Center. Our approach to evaluation will follow our community collaboration principles and include the following approaches:

• Evaluations are designed to yield comparable information about the elements of community-based programs that are successful
• Evaluations incorporate community-defined measures of success
• Evaluations are designed to promote community accountability, improve program operation and support requests for continued funding

We evaluated three programs:

• Asian Counseling and Referral Services (ACRS) Day Activities program,
• ACRS Vocational Services program
• Wilderness Inner-City Leadership Development program (WILD).

Senior Immunization Project - Central Area Senior Center

The aims of this project were to:

increase influenza and pneumococcal immunization rates among seniors in Central Seattle using a randomized, controlled trial design

• increase seniors’ knowledge about these immunizations
• change attitudes of seniors which inhibit receipt of immunizations
• increase recognition among seniors of the Senior Center as resource for health promotion and disease prevention

This project was selected based on a community prioritization of senior immunizations as an area for improvement. Additional support for this project was provided with matching funds from the United Way to Senior Services of King County.

The project was developed with active involvement of a project advisory group composed of senior center members and staff, as well as technical advisors from the University of Washington, the Health Department, Health Care Financing Administration (HCFA) and the Visiting Nurses Association. Community collaboration principles have guided the development of the Senior Immunization Project.

Methods. Seniors were randomized to intervention or control groups. The intervention group received educational brochures mailed with reply cards to report immunization status, telephone calls from senior volunteers to unimmunized participants, and computerized immunization tracking.

Results. Among participants without prior pneumococcal vaccination, the pneumococcal immunization rate among the intervention group was significantly higher than that of the control group. Among those without influenza immunization in the prior year, significantly more were immunized against influenza in the intervention group than in the control group

Conclusions. The intervention increased both influenza and pneumococcal vaccination rates to high levels, suggesting that further progress in increasing adult immunization coverage among all seniors is possible.

Garfield Community Research Room

The Community Research Room at Garfield Community Center opened in November, 1995, with the assistance of a $10,000 grant from the Center. This project was funded in response to extensive input from key central area community groups who supported this effort. The funds were used to purchase computer hardware. The goal of the Research Room is to facilitate access to information and technical expertise for community members who wish to research a subject, write a grant or develop a project.

Projects Linked to Seattle Partners:

Domestic Violence Grants: Researcher/Practitioner Partnerships

This research project is a collaboration with DV service providers to understand access to and satisfaction with DV services among women from eight ethnic communities and lesbians. Utilizing a Participatory Action Research (PAR) model, service providers and researchers are working together to design and carry out this qualitative research project. Close involvement of community partners will help to ensure that research findings will be useful for informing a coordinated, culturally relevant system of response for women experiencing DV in Seattle.

Seattle Partners staff are the PI and Project Manager, two Community Board members are actively involved in the partnership, and a Technical Advisor is the co-investigator. A copy of the report describing the project is available at: http://www.metrokc.gov/health/dv/index.htm.

King County Community Indicators Project: Communities Count

The indicator initiative has developed a core set of social and health indicators for King County that reflect the wealth of knowledge and experience of both citizens and technical experts. Over 1,500 King County residents participated through a random digit dial telephone survey, a series of focus groups, five public forums held across the county, and two civic forums held in central locations. Their opinions on for what they value in their families and communities, what creates and sustains healthy people, and what social, health and economic problems they are concerned about were recorded and are expressed in this report as "valued conditions."

Technical advisors responded to each stage of citizens input and to refine the list of indicators based on which seemed most meaningful to citizens and most important to the overall health and well being of people and communities. Through the process 29 indicators were selected, grouped into four major domains: Basic Needs and Social Determinants of Well being, Positive Development through Life Stages, Safety and Health, and Community Strength.

Two Seattle Partners staff, one Community Board member and two Technical Advisors were involved in this project.

Communities Count reports provide a picture of the quality of community life across King County. Each of the 29 core indicators highlights a social, economic or health issue that is of value or concern to people in King County. The first report was published in June 2000, and a summary was published simultaneously as an insert in The Seattle Times. The second full report was released in December 2002, and a summary insert was published in The Seattle Times, as well as distributed broadly at public presentations. Each Communities Count report presents new primary data collected specifically for King County and its four sub-regions through a telephone survey (the Community Health Survey) and through qualitative data collected through interviews or focus groups. In addition, data from multiple existing sources are collected and analyzed for the four sub-regions, and for the county as a whole. The first two reports are used by a broad range of individuals, groups, and organizations throughout the county, including several levels of local government, local foundations and multiple service-providing agencies. Communities Count 2005 will be released in October 2005.

Ethnicity and Health Study

In 1998, the Seattle-King County Department of Public Health reported the results of the Ethnicity and Health Survey among King County adult residents (age 18 and older) of African American, Latino/Hispanic, Chinese, Filipino, Japanese, Korean, and Vietnamese heritage. The survey was conducted in English and survey questions were translated. Members of each of the communities represented in this report and persons knowledgeable about the health concerns of these communities provided valued assistance in developing this study and report. A total of 2,427 respondents completed the survey.

One of the major findings was that all groups reported experiencing discrimination based on race/ethnicity when seeking health services, especially African Americans. The Cross Cultural Health Care Program (CCHCP) is conducting a follow up study to assess discrimination in health care affecting African American residents of King County.

A report on Discrimination in Health Care was released in late 2000.

Two Seattle Partners and several Community Board members are actively involved in this project.