Transforming the Cross Cultural Collaborative of Pierce County through assessment capacity building.

BACKGROUND: Underserved populations are underrepresented in public health initiatives such as tobacco control and in cancer clinical trials. Community involvement is crucial to interventions aimed at reducing health disparities, and local health departments increasingly are called upon to provide both leadership and funding. The Tacoma Pierce County Health Department (TPCHD), in conjunction with 13 key community-based organizations and healthcare systems, formed the Cross Cultural Collaborative of Pierce County (CCC) that successfully employs needs-assessment and evaluation techniques to identify community health initiatives. METHODS: Community leaders from six underserved populations of the CCC were trained in needs-assessments techniques. Assessments measured effectiveness of the collaborative process and community health initiatives by using key informant (n = 18) and group interviews (n = 3). RESULTS: The CCC, facilitated by its partnership with the TPCHD, built capacity and competence across community groups to successfully obtain two funded public health initiatives for six priority populations. Members expressed overall satisfaction with the training, organizational structure, and leadership. The CCC's diversity, cultural competency, and sharing of resources were viewed both as a strength and a decision-making challenge. CONCLUSION: Public health department leadership, collaboration, and evidence-based assessment and evaluation were key to demonstrating effectiveness of the interventions, ensuring the CCC's sustainability.

Farm elders define health as the ability to work.

Thirty percent of America's 2.2 million farms are operated by individuals older than 65 years. This study examined how older farmers define health and determined whether demographic characteristics, farm work, and physical and mental health status predict health definition. Data were collected via telephone and mailed surveys during the baseline wave of data collection in a longitudinal study of family farmers residing in two southern states (n=1,288). Nearly 42% defined health as the "ability to work" compared to a physical health-related definition. Predictors of defining health as the ability to work included being White, performing more farm tasks in the past week, taking prescription medications daily, and having minimal health-related limitations to farm work. Health behaviors are centered on the individual's perception of health. Understanding the defining attributes of health can support better approaches to health care and health promotion, particularly among rural subcultures such as farmers, whose identity is rooted in their work.