West Chatham County : an action-oriented community assessment : findings and next steps of action

This paper details the Action-Oriented Community Assessment (AOCA) of West Chatham County conducted from October 2005 through April 2006 by five graduate students in the Department of Health Behavior and Health Education at the University of North Carolina at Chapel Hill School of Public Health. The project was conducted in partnership with the Chatham County Community Health Assessment Team and another student team working in the eastern side of the county, and was guided by three field advisors from the Chatham County Public Health Department and Chatham Habitat for Humanity. The field advisors helped initiate contacts within the community and offered guidance and advice throughout the process. The AOCA is designed to assess a community’s strengths and needs as identified by those in the community and to encourage service providers and community members to take action to address identified needs. To gain an understanding of the community, the team began the process by attending community events and collecting secondary data. The team interviewed a total of thirty-three service providers and community members about their perspectives on important issues in West Chatham, and held a community forum on April 28, 2006, to present results on the following five topics: infrastructure planning, communication, recreation, division and diversity, and service barriers for Latinos. Detailed below are the themes presented at the forum and the action steps that emerged to address these issues. Population growth has lead to a need for better planning for resources and infrastructure, especially water and sewage. 1. Members of the group will create a grassroots education project on the issue of water. 2. Members of the group will encourage people to attend Board of Commissioners meetings through advertisements at churches. 3. Members of the group will encourage the County and municipalities to work together. The lack of common communication sources creates disparities in knowledge about programs, services, and social activities. 1. Members of the group will consult with business leaders about the cost-effectiveness of producing part of the Chatham News/Chatham Record in Spanish and then approach the editor/owner of the newspaper to discuss. 2. A member of the group will investigate adding news that is broadcast in English on WNCA to the Spanish radio broadcast at WNCA. 3. Members of the group will promote the recent upgrade of WNCA to 5000 watts on the Chatham Schools website (http://www.chatham.k12.nc.us/). 4. A member of the group will send letters to all the churches in Chatham County. The messages to be included in the letter were undecided. West Chatham County needs additional resources, such as land and funding, for recreational facilities, which could serve as a gathering place for community members as well as a place for physical activity. 1. Group members committed to creating a task force with diverse representation of all racial groups to use as a space for individuals to voice recreation needs. a. Include people from School Board, Board of Commissioners, Recreation Department, and recreation coaches. b. Investigate funding opportunities. c. Lobby for recreational needs of specific groups and county as a whole. The lack of interaction between racial/ethnic groups contributes to misunderstanding and divisions between these groups. 1. Group members will organize a diversity task force. 2. Create an in-depth “dismantling racism” program and encourage as a required training for government employees and people in the education system. Language barriers continue to restrict Latinos’ access to services. 1. Approach service providers and identify their needs for bilingual communication. 2. Involve county commissioners to increase bilingual signs in the county. 3. Invite the Adult Basic Skills Coordinator to be a part of the group that is interested in reducing language barriers. 4. Make ESL classes more accessible through additional training, advertising, transportation, and childcare. a. Contact Chatham churches about starting classes and offering a basic curriculum. This document details the West Chatham AOCA process and results and is intended to serve as a resource for the Chatham County Public Health Department, the Community Health Assessment Team, and other service providers and community members in Chatham County. It is divided into five sections: Introduction, Findings, Community Forum, Methodology, and Limitations, Recommendations, and Conclusion. It is the team’s hope that service providers and community members will use information in the document to inform current and future program planning, and continue to build upon the many positive efforts occurring in West Chatham.Master of Public Healt

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Incarceration is associated with sexually transmitted infections (STIs) including human immunodeficiency virus (HIV). Incarceration may contribute to STI/HIV by disrupting primary intimate relationships that protect against high-risk relationships. Research on sexual network disruption during incarceration and implications for post-release sexual risk behavior is limited. We interviewed a sample of HIV-positive men incarcerated in North Carolina to assess how commonly inmates leave partners behind in the community; characteristics of the relationships; and the prevalence of relationship dissolution during incarceration. Among prison inmates, 52% reported having a primary intimate partner at the time of incarceration. In the period prior to incarceration, 85% of men in relationships lived with and 52% shared finances with their partners. In adjusted analyses, men who did not have a primary cohabiting partner at the time of incarceration, versus those did, appeared to have higher levels of multiple partnerships (adjusted prevalence ratio (PR), 1.5; 95% confidence interval (CI) 0.9–2.6; p = 0.11) and sex trade, defined as giving or receiving sex for money, goods, or services (adjusted PR, 2.1; 95% CI 0.9–4.8; p = 0.08) in the 6 months prior to incarceration. Involvement in financially interdependent partnerships appeared to be associated with further reductions in risk behaviors. Of men in primary partnerships at the time of prison entry, 55% reported their relationship had ended during the incarceration. The findings suggest that involvement in primary partnerships may contribute to reductions in sexual risk-taking among men involved in the criminal justice system but that many partnerships end during incarceration. These findings point to the need for longitudinal research into the effects of incarceration-related sexual network disruption on post-release HIV transmission risk