GENESIS HOSPITAL
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PART V, SECTION B, LINE 5: A PARTNERSHIP WAS DEVELOPED TO DO A COMBINED HEALTH DEPARTMENTS AND GENESIS CHNA. THE GENESIS SERVICE AREA (GSA) COUNTY HEALTH DEPARTMENTS AND OHIO UNIVERSITY COLLABORATED TO DESIGN A MECHANISM TO COMPLETE THE 2021 CHNA. THIS PARTNERSHIP BECAME THE SOUTHEASTERN OHIO HEALTH IMPROVEMENT COLLABORATIVE (SOHIC) AND IS MADE UP OF COSHOCTON CITY AND COUNTY HEALTH DEPARTMENTS, GENESIS, MORGAN COUNTY HEALTH DEPARTMENT, NOBLE COUNTY HEALTH DEPARTMENT, PERRY COUNTY HEALTH DEPARTMENT, ZANESVILLE-MUSKINGUM COUNTY HEALTH DEPARTMENT, OHIO ALLIANCE FOR POPULATION HEALTH, OHIO UNIVERSITY'S (OU) COLLEGE OF HEALTH SCIENCES AND PROFESSIONS, AND THE OU'S VOINOVICH SCHOOL OF LEADERSHIP AND PUBLIC SERVICE. SOHIC CONTRACTED WITH THE NORTHWEST HOSPITAL COUNCIL OF OHIO TO DESIGN THE ASSESSMENT TOOLS, ADD RELEVANT SECONDARY AND MORTALITY DATA, AND DEVELOP THE REPORTS. THE INFORMATION CONTAINED IN THE 2021 CHNA REPORT ARE BASED UPON DATA OBTAINED FROM RESPONSES TO WRITTEN COMMUNITY HEALTH SURVEYS (CHS) THAT WERE COLLECTED FROM APRIL THROUGH MAY 2021. THE CHS FOCUSED ON ADULTS AGES 19 AND OLDER. IN ORDER TO MAINTAIN COMPLETE OBJECTIVITY THROUGHOUT THE SURVEY PROCESS, THE COLLABORATIVE ENGAGED THE SERVICES OF THE HOSPITAL COUNCIL OF NORTHWEST OHIO AND OHIO UNIVERSITY TO ADMINISTER THE SURVEYS AND COMPILE THE RESULTS. SURVEYS WERE ALSO CONDUCTED WITH KEY LEADERS FROM THE GSA COUNTIES. THESE SURVEYS WERE INCLUDED IN THE ANALYSIS OF THIS REPORT AND INFORMED PRIORITIZATION OF ALL THE RESULTS TO IDENTIFY THE TOP HEALTH NEEDS OF OUR COMMUNITIES. GENESIS COMMUNITY BENEFIT STEERING COMMITTEE PRIORITIZED THE INFORMATION AND DETERMINED SIX TOP HEALTH NEEDS: MENTAL HEALTH ISSUES, HEART DISEASE, CANCER, STROKE, DIABETES, AND SOCIAL DETERMINANTS OF HEALTH.PROCESS AND METHODS FOR ENGAGING COMMUNITY: MULTIPLE SECTORS, INCLUDING THE GENERAL PUBLIC, WERE ASKED THROUGH EMAIL LIST SERVS, SOCIAL MEDIA, AND PUBLIC NOTICES TO PARTICIPATE IN THE PROCESS, INCLUDING DEFINING THE SCOPE OF THE PROJECT, CHOOSING QUESTIONS FOR THE CHS, REVIEWING INITIAL DATA, PLANNING A COMMUNITY RELEASE, AND IDENTIFYING AND PRIORITIZING NEEDS. SOHIC WORKED TOGETHER TO CREATE ONE COMPREHENSIVE CHNA, WITH MORE THAN 88 COMMUNITY MEMBERS ATTENDING THE COUNTIES' RELEASE OF THE REPORT AND PROVIDING FEEDBACK ON THE KEY ISSUES FOR THE GSA.PRIMARY DATA COLLECTION METHODS:THE FINDINGS IN THE COMMUNITY HEALTH NEEDS ASSESSMENT ARE BASED ON SELF-ADMINISTERED CHS USING A STRUCTURED QUESTIONNAIRE. THE QUESTIONS WERE MODELED AFTER THE SURVEY INSTRUMENTS USED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) FOR THEIR NATIONAL AND STATE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS). THE HCNO ASSISTED WITH CHS DEVELOPMENT, GUIDED THE HEALTH ASSESSMENT PROCESS, AND INTEGRATED SOURCES OF PRIMARY AND SECONDARY DATA INTO THE FINAL REPORT. OU SOUGHT INSTITUTIONAL REVIEW BOARD (IRB) APPROVAL FOR THE CHS, ADMINISTERED THE CHS, AND COLLECTED THE DATA.THIS CHS COMPLETION PROCESS WAS CROSS-SECTIONAL IN NATURE AND INCLUDED A WRITTEN CHS OF ADULTS WITHIN COSHOCTON, MORGAN, MUSKINGUM, NOBLE, AND PERRY COUNTIES. FROM THE BEGINNING, COMMUNITY LEADERS AND MEMBERS WERE ACTIVELY ENGAGED IN THE CHS PLANNING PROCESS AND HELPED DEFINE THE CONTENT, SCOPE, AND SEQUENCE OF THE CHS. ACTIVE ENGAGEMENT OF COMMUNITY MEMBERS THROUGHOUT THE CHNA PLANNING PROCESS IS REGARDED AS AN IMPORTANT STEP IN COMPLETING A VALID CHNA.ONE ADULT CHS INSTRUMENT WAS DESIGNED FOR THE CHNA. AS A FIRST STEP IN THE DESIGN PROCESS, HEALTH EDUCATION RESEARCHERS FROM THE UNIVERSITY OF TOLEDO AND STAFF MEMBERS FROM HCNO MET TO DISCUSS POTENTIAL SOURCES OF VALID AND RELIABLE CHS ITEMS THAT WOULD BE APPROPRIATE TO ASSESS THE HEALTH STATUS AND HEALTH NEEDS OF ADULTS. THE INVESTIGATORS DECIDED TO DERIVE THE MAJORITY OF THE ADULT SURVEY ITEMS FROM THE BRFSS. THIS DECISION WAS BASED ON BEING ABLE TO COMPARE LOCAL DATA WITH STATE AND NATIONAL DATA. THE PROJECT COORDINATOR FROM HCNO CONDUCTED A MEETING WITH SOHIC. DURING THIS MEETING, HCNO AND SOHIC REVIEWED AND DISCUSSED BANKS OF POTENTIAL SURVEY QUESTIONS FROM THE BRFSS. BASED ON INPUT FROM SOHIC, THE PROJECT COORDINATOR COMPOSED A DRAFT ADULT CHS CONTAINING 110 ITEMS. IRB APPROVAL WAS GRANTED TO OU BY OU'S SOCIAL AND BEHAVIORAL IRB.THE SAMPLING FRAME FOR THE ADULT CHS CONSISTED OF ADULTS AGES 19 AND OLDER LIVING IN COSHOCTON, MORGAN, MUSKINGUM, NOBLE, AND PERRY COUNTIES. SEE BELOW FOR THE ESTIMATED NUMBER OF PEOPLE AGES 19 AND OLDER LIVING IN EACH COUNTY. THE HCNO STAFF ANALYSTS CONDUCTED A POWER ANALYSIS TO DETERMINE WHAT SAMPLE SIZE WAS NEEDED TO ENSURE A 95% CONFIDENCE LEVEL WITH A CORRESPONDING MARGIN OF ERROR OF 6% (I.E., THERE CAN BE 95% ASSURANCE THAT THE "TRUE" POPULATION RESPONSES ARE WITHIN A 6% MARGIN OF ERROR OF THE CHS FINDINGS)THE RANDOM SAMPLE OF MAILING ADDRESSES OF ADULTS FROM COSHOCTON, MORGAN, MUSKINGUM, NOBLE, AND PERRY COUNTIES WAS OBTAINED FROM MELISSA DATA CORPORATION IN RANCHO SANTA MARGARITA, CALIFORNIA. CHS WERE MAILED IN EARLY APRIL 2021 AND RETURNED THROUGH MID-MAY 2021.PRIOR TO MAILING THE CHS, OU MAILED AN ADVANCE LETTER TO 2,000 ADULTS IN EACH COUNTY (COSHOCTON, MORGAN, MUSKINGUM, NOBLE, AND PERRY). THIS ADVANCE LETTER WAS PRINTED ON SOHIC STATIONERY AND SIGNED ON BEHALF OF THE GROUP BY THE CO-CHAIRS LINDA SUPPLEE OF GENESIS AND ANGELA DEROLPH OF THE PERRY COUNTY HEALTH DEPARTMENT. THE LETTER INTRODUCED THE CHNA PROJECT AND INFORMED READERS THAT THEY MAY BE RANDOMLY SELECTED TO RECEIVE THE CHS. THE LETTER ALSO EXPLAINED THAT THE RESPONDENTS' CONFIDENTIALITY WOULD BE PROTECTED, AND IT ENCOURAGED THE READERS TO COMPLETE AND RETURN THE CHS PROMPTLY IF THEY WERE SELECTED. LETTERS RETURNED AS UNDELIVERABLE WERE NOT REPLACED WITH ANOTHER POTENTIAL RESPONDENT TO RECEIVE THE CHS. LASTLY, IT IS IMPORTANT TO NOTE THAT THE ADVANCE WAVE LETTER STATED THAT IF THE RECIPIENT WAS SELECTED TO RECEIVE THE CHS, THEY WOULD RECEIVE A $2 BILL AS A THANK YOU FOR THEIR TIME TO COMPLETE THE CHS. AFTER SENDING THE LETTER, OU ENCOUNTERED PROBLEMS WITH THIS RECRUITMENT STRATEGY DUE TO INSTITUTIONAL RULES ABOUT EXCHANGING MONEY. A GIFT CARD DRAWING REPLACED THE $2 BILL INCENTIVE THAT WAS ORIGINALLY NOTED. THE LETTER INCLUDED ADDITIONAL INFORMATION REGARDING THE DRAWING WITH INFORMATION ON HOW TO ENTER BY FILLING OUT A POSTAGE-PAID CARD THAT WAS INCLUDED IN THE MAILING. INDIVIDUALS RECEIVING THE CHS AND POST CARD WERE ASKED TO PROVIDE EITHER THEIR PHONE NUMBER OR EMAIL ADDRESS AND INSTRUCTED TO MAIL THE POSTAGE PAID, POST CARD SEPARATELY FROM THEIR CHS. THIRTEEN WEEKS FOLLOWING THE ADVANCE LETTER, AN ADDITIONAL MAILING WAS ADMINISTERED. THE MAILING INCLUDED A PERSONALIZED, HAND SIGNED COVER LETTER (ON SOHIC STATIONERY) DESCRIBING THE PURPOSE OF THE CHS AND THE CHANCES OF WINNING A GIFT CARD, THE QUESTIONNAIRE, A SELF-ADDRESSED STAMPED RETURN ENVELOPE, AND A POSTCARD TO ENTER THE DRAWING FOR A $100 OR $25 GIFT CARD. THE MAILING MATERIALS WERE INCLUDED IN A LARGE COLORED ENVELOPE. A TOTAL OF 3,000 CHS PER COUNTY WERE SENT OUT BY OU. HSAS RETURNED AS UNDELIVERABLE WERE NOT REPLACED WITH ANOTHER POTENTIAL RESPONDENT.INDIVIDUAL CHS RESPONSES WERE ANONYMOUS. ONLY GROUP DATA WAS AVAILABLE. ALL DATA WAS ANALYZED BY HEALTH EDUCATION RESEARCHERS AT THE UNIVERSITY OF TOLEDO USING STATISTICAL PRODUCT AND SERVICE SOLUTIONS 26.0 (SPSS). CROSSTABS WERE USED TO CALCULATE DESCRIPTIVE STATISTICS FOR THE DATA PRESENTED IN THIS REPORT. TO BE REPRESENTATIVE OF EACH COUNTY, THE ADULT CHS DATA COLLECTED WAS WEIGHTED BY AGE, GENDER, RACE, AND INCOME USING CENSUS DATA.DATA FROM SAMPLE SURVEYS HAVE THE POTENTIAL FOR BIAS IF THERE ARE DIFFERENT RATES OF RESPONSE FOR DIFFERENT SEGMENTS OF THE POPULATION. IN OTHER WORDS, SOME SUBGROUPS OF THE POPULATION MAY BE MORE REPRESENTED IN THE COMPLETED SURVEYS THAN THEY ARE IN THE POPULATION FROM WHICH THOSE SURVEYS ARE SAMPLED. IF A SAMPLE HAS 25% OF ITS RESPONDENTS BEING MALE AND 75% BEING FEMALE, THEN THE SAMPLE IS BIASED TOWARDS THE VIEWS OF FEMALES (IF FEMALES RESPOND DIFFERENTLY THAN MALES). THIS SAME PHENOMENON HOLDS TRUE FOR ANY POSSIBLE CHARACTERISTIC THAT MAY ALTER HOW AN INDIVIDUAL RESPONDS TO THE SURVEY ITEMS. IN SOME CASES, THE PROCEDURES OF THE SURVEY METHODS MAY PURPOSEFULLY OVER-SAMPLE A SEGMENT OF THE POPULATION IN ORDER TO GAIN AN APPROPRIATE NUMBER OF RESPONSES FROM THAT SUBGROUP FOR APPROPRIATE DATA ANALYSIS WHEN INVESTIGATING THEM SEPARATELY (THIS IS OFTEN DONE FOR MINORITY GROUPS). WHETHER THE OVER-SAMPLING IS DONE INADVERTENTLY OR PURPOSEFULLY, THE DATA NEEDS TO BE WEIGHTED SO THAT THE PROPORTIONED CHARACTERISTICS OF THE SAMPLE ACCURATELY REFLECT THE PROPORTIONED CHARACTERISTICS OF THE POPULATION. IN THE 2021 COSHOCTON, MORGAN, MUSKINGUM, NOBLE, AND PERRY SURVEYS, A WEIGHTING WAS APPLIED PRIOR TO THE ANALYSIS THAT WEIGHTED THE SURVEY RESPONDENTS TO REFLECT THE ACTUAL DISTRIBUTION OF EACH COUNTY BASED ON AGE, SEX, RACE, AND INCOME.
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SCHEDULE H, PART V, LINE 5 CON'T:
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MULTIPLE SETS OF WEIGHTINGS WERE CREATED AND USED IN THE STATISTICAL SOFTWARE PACKAGE (SPSS 26.0) WHEN CALCULATING FREQUENCIES. FOR ANALYSES DONE FOR THE ENTIRE SAMPLE AND ANALYSES DONE BASED ON SUBGROUPS OTHER THAN AGE, RACE, SEX, OR INCOME THE WEIGHTINGS THAT WERE CALCULATED BASED ON THE PRODUCT OF THE FOUR WEIGHTING VARIABLES (AGE, RACE, SEX, INCOME) FOR EACH INDIVIDUAL. WHEN ANALYSES WERE DONE COMPARING GROUPS WITHIN ONE OF THE FOUR WEIGHTING VARIABLES (E.G., SMOKING STATUS BY RACE/ETHNICITY), THAT SPECIFIC VARIABLE WAS NOT USED IN THE WEIGHTING SCORE THAT WAS APPLIED IN THE SOFTWARE PACKAGE. IN THE EXAMPLE SMOKING STATUS BY RACE, THE WEIGHTING SCORE THAT WAS APPLIED DURING ANALYSIS INCLUDED ONLY AGE, SEX, AND INCOME. THUS, A TOTAL OF EIGHT WEIGHTING SCORES FOR EACH INDIVIDUAL WERE CREATED AND APPLIED DEPENDING ON THE ANALYSIS CONDUCTED.
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