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Section 18. PACE EH: Protocol for Assessing Community Excellence in Environmental Health

What is PACE EH?

__ PACE EH is a process for assessing and analyzing the environmental health of communities and for creating plans to address threats and create improvements.

__ It is constructed around 13 tasks:

  • Task 1: Determine Community Capacity to Undertake the Assessment
  • Task 2: Define and Characterize the Community
  • Task 3: Assemble Community Environmental Health Assessment Team
  • Task 4: Define the Goals of the Assessment
  • Task 5: Generate the Environmental Health Issue List
  • Task 6: Analyze Issues with a Systems Framework
  • Task 7: Develop Appropriate Community Environmental Health Indicators
  • Task 8: Select Standards
  • Task 9: Create Environmental Health Issue Profiles
  • Task 10: Rank the Environmental Health Issues
  • Task 11: Set Priorities for Action
  • Task 12: Develop an Action Plan
  • Task 13: Evaluate Progress and Plan for the Future

Why use PACE EH?

__ PACE EH is a participatory process.

__ The process brings together numerous people and organizations from various sectors, many of whom may not normally have contact.

__ PACE EH takes a community perspective on health.

__ PACE EH is flexible.

__ The process helps empower communities to identify and use their own resources.

__ PACE EH looks at the environment in an inclusive way

__ PACE EH raises the profile of the environment as the foundation and context of community health.

__ Through the CEHA team and associated work groups, PACE EH builds leadership and connections for other initiatives and issues, health-related or not.

__ The process is structured to keep all participants focused on the community and its concerns, rather than their own.

__ PACE EH examines environmental issues in a systems framework.

__ Because of its structure, the PACE EH process is likely to have a real impact on community health.

Who should be involved in using PACE EH?

__ People affected by environmental health issues, including:

  • Vulnerable populations
  • People with environmentally-influenced health conditions
  • Workers in dangerous or unhealthy jobs

__ People indirectly affected by environmental health issues, including:

  • Landlords who might be responsible for removing environmental hazards
  • Business owners who may have to change their use of products or methods

__ Individuals and organizations that provide services to affected populations, such as:

  • Health professionals and institutions
  • Human service organizations
  • Educators and schools
  • Public services – police, fire, EMS

__ Government

  • Federal/state/local environmental agencies and officials
  • Public health agencies – state/federal/county DPH, local boards of health

__ Advocacy and community groups

  • Environmental organizations
  • Community activists
  • Faith communities

__ Others with a vested interest, such as:

  • Business and industry
  • Labor
  • People with relevant expertise – scientists, researchers, professionals, etc.

When should you use PACE EH?

__ When the community is experiencing rapid growth.

__ When a new commercial or residential development is being proposed.

__ When a new industry is moving in.

__ When changes are proposed that will affect the natural environment.

__ When there’s an upsurge in what might be environmentally-caused illness, or when community health seems to be deteriorating.

How do you use PACE EH?

__ Choose a convener, whether a public health agency or official or some other trusted entity.

__ Deal with longstanding mistrust, turf issues, and factionalism.

__ Task 1: Determine community capacity to undertake the assessment.

  • Specify the resources, skills, and capacities needed for the assessment.
  • Specify the available resources, skills, and capacities.
  • Review possibilities for collaboration.
  • Determine ability to carry out the assessment.

__ Task 2: Define and characterize the community.

  • Define the community.
  • Describe the community’s characteristics, composition, organization and leadership.
  • Refine the definition of the community as needed.

__ Task 3: Assemble a Community-based Environmental Health Assessment Team.

  • Clarify expectations of team members.
  • Identify and invite individuals to help design and carry out the assessment.
  • Determine a governing structure, decision-making structure, and ground rules.

__ Task 4: Define the goals, objectives, and scope of the assessment.

  • Establish goals and objectives for the assessment
  • Describe the vision that will guide the process.
  • Describe the scope of issues to be addressed by the assessment.
  • Define key terms.

__ Task 5: Generate a list of environmental health issues.

Evaluate and select data-gathering method(s).

  • Collect data on community concerns.
  • Collect data on community knowledge, attitudes, behaviors, and perceptions.
  • Create a manageable list of issues.

__ Task 6: Analyze the Issues with a Systems Framework.

  • Understand the framework.
  • Identify the connections among health status, affected populations, exposure factors, environmental agents/conditions, contributing factors and behaviors, and public health protection factors for selected environmental health issues.

__ Task 7: Develop Locally Appropriate Indicators.

  • Develop a list of potential indicators.
  • Identify key indicators based on selected criteria.

__ Task 8: Select Standards Against Which Local Status Can be Compared.

  • Identify externally driven standards.
  • Agree upon locally appropriate standards.

__ Task 9: Create Issue Profiles.

  • Adopt a standardized format for organizing information.
  • Gather information.
  • Collect data for locally developed indicators.
  • Develop a summary statement.

__ Task 10: Rank issues.

  • Determine the purpose of ranking.
  • Decide on ranking criteria.
  • Select a method for ranking.
  • Rank the issues.

__ Task 11: Set priorities for action.

  • Determine local priority-setting criteria.
  • Select a method for prioritizing.
  • Determine priorities.

__ Task 12: Develop an action plan.

  • Develop goals and objectives.
  • Identify contributing factors.
  • Identify possible interventions and prevention activities.
  • Identify community assets.
  • Identify potential barriers.
  • Select an intervention(s)/activity(ies).
  • Determine resource needs.
  • Identify potential partners.
  • Provide training.
  • Develop timeframe.
  • Determine measures of success.

__ Task 13: Evaluate progress and plan for the future.

  • Agree on the questions to be answered by the evaluation.
  • Evaluate the success of the assessment process.
  • Begin preparations for ongoing community-based environmental health assessment activities.