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MAPP in Rural Communities: Questions and Answers


Questions

If you have additional questions, contact MAPP staff members at mapp@naccho.org and they will either answer your questions or connect you with a MAPP Mentor.


How have rural communities prepared to do MAPP?
Two main factors prepared the panelists from the March 2007 webcast entitled, Challenges in Implementing MAPP in Rural Areas for beginning the MAPP process. These factors included (1) Drawing from previous assessment experience and (2) Local health department leadership support. Panelists found that leveraging these two factors significantly contributed to their success. These factors are not unique to rural users.  In fact, these factors are the keys to success for many MAPP communities.

 

How were you able to build community ownership and support?
Panelists indicated that success, in large part, is defined by community ownership and collective thinking. One of the greatest benefits of MAPP is that, as opposed to grant-driven initiatives, it is a grassroots effort. A sense of ownership is key to building a solid, community-wide commitment to the MAPP process. Some suggested creating a sense of community ownership can be accomplished by ensuring that participants decide when and how often to meet, setting the agendas, and determining how to approach each phase of the process. Panelists also suggested decisions made by consensus may be more likely to be supported by the community. When a community feels heard and valued, they are often more supportive of the process.

Nashville participants approached MAPP as a community initiative rather than exclusively a health department project. In Nashville, members of the Leadership Council were appointed by the Mayor and were committed to providing leadership for MAPP activities. The Leadership Council provided guidance throughout the planning, implementation and evaluation stages. The LHD provided the MAPP Coordinator support, IT support for the web site and epidemiology assistance with assessments.

Panelists felt that the work completed during the Organizing for Success and Partnership Development phases was vital to the success of the Action Cycle. It is important to reinforce that this is a community-wide plan, and that no single agency is solely responsible for its success, but instead, everyone is collectively responsible. Panelists cautioned that it is important to set this tone early and continue to send this message to the community throughout the process.

 

What are the greatest challenges to implementing MAPP in a rural community?
Panelists agreed that a lack of resources, travel restriction based on geography, pre-existing issue-specific groups and small pools of community partners were among the greatest challenges to implementing MAPP in rural communities.

What strategies overcame the challenges of doing MAPP in a rural community?
Panelists were able to overcome challenges by emphasizing partnerships, creating a strong support network, using participants'' time well and making a concerted effort not to “reinvent the wheel.”

Emphasizing partnerships is paramount. Panelists stated that it is important to remind team leaders that spotlighting community health needs while anticipating and managing changes will result in better coordination of services. One MAPP coordinator in New Jersey said that, “Since funding will play a vital role in improving the quality of health services, meetings with team leaders were set to assure them that needs for funding and support would be coordinated. By giving tools to help them assess their needs it will be easier to make the best use of existing resources.”

Another coordinator stated that their team found ways to be successful and move forward without funding. In general, funding closely followed because the team’s application was strengthened as a consequence of their progress. This coordinator stated funding will always be a challenge; one thing to avoid however, is remaining inactive while waiting for a funder to step up to the plate. This could cause MAPP teams to lose momentum.

Panelists found that participants in Nashville addressed their lack of resources by capitalizing on community partnerships. Healthy Nashville partnered with America on the Move to log participant steps and to get basic reporting data. Healthy Nashville also partnered with Tennessee Public Health Association’s Legislative Network to actively advocate for smoke-free work site legislation and for an increase in tobacco sales taxes during the current legislative session.

Panelists discovered that partners often have competencies that the local health department may not have at their disposal. For example, one participant worked with the state university which provided the participant with data analysis assistance. Leveraging unique skills from partners demonstrates the value of each partner to the process.

In East-Central Nebraska, to address a lack of momentum and keep people motivated, the MAPP team worked at setting very clear goals. Making goals Specific, Measurable, Achievable, Realistic and Timely helped focus and energize the group.

In New Jersey, the MAPP teams were provided with a tool kit to help them create feasible and measurable action plans.  MAPP team members were also given a list of protocols and expectations.  As a means for maintaining commitment and accountability, team members were also asked to participate in the writing of the Community Health Improvement Plan.

 

Panelists stressed the importance of creating a strong support network by encouraging open communication among community partners. Also, having one dedicated staff person who stays with the process from start to finish is a significant advantage.

Panelists agreed that using participants’ time well is extremely important.  One strategy of ensuring effective time use is to promise all participants that meetings will only be held when there is an agenda and tangible tasks to discuss. By guaranteeing that meetings are purposeful and beneficial for all participating agencies participants’ time will be well used.

Although MAPP is a new way of doing business, it can and should be done within the context of pre-existing community efforts. Panelists encouraged participants to avoid “reinventing the wheel.” Whenever possible bring existing initiatives, data, past experiences and successes into the MAPP process.

Panelists found that if participants enjoyed coming to meetings it was much easier to keep them engaged throughout the process. Providing food and refreshments is a great strategy for making meetings fun for participants.

 
What have been the greatest benefits/outcomes of your MAPP process to date?

  • Other organizations felt the work was of such value that they put money behind it
  • Set new standards on how rural health should be done
  • Members of the local public health system have written MAPP into their five year strategic plans
  • Partners have used the MAPP document for grant applications
  • Many agencies have stated that they feel the community now “owns” these issues, not just their agency
  • Increased level of collaboration and cooperation
  • Strengthened the local public health system network
  • Revealed the need for a long-term, strategic approach for improving community health
  • Facilitated sustainable communication and understanding between local organizations
  • Increased membership of various local organizations
  • The local health department became a more visible and respected partner for community-wide events and initiatives
  • Initiated data sharing among partners
  • Strengthened partnership with local University MPH program
  • Prompted a reassessment of priorities and initiated an effort to be more proactive

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