The methodology applied for this CHNA and the subsequent implementation strategy for addressing identified issues includes four components:
This component is based on the principle that improving the community's health is a shared responsibility, if not a moral obligation of hospitals, public health agencies and the community at large. Putting this principle in practice, Parkland in collaboration with the DCHHS, employed public health practices to identify populations experiencing a higher burden of disease or health disparities, as well as the underlying social determinants of health driving these inequalities.
Parkland and DCHHS will use the results of this CHNA to develop programs and strategic initiatives aimed at improving health and reducing disparities.
Community Based Participatory Research (CBPR) was adopted to ensure the community had meaningful participation during the CHNA development. The Agency for Healthcare Research and Quality (AHRQ) defines CBPR as:
"A collaborative research approach that is designed to ensure and establish structures for participation by communities affected by the issue being studies, representatives of organizations, and researchers in all aspects of the research process to improve helath and well-being through taking action, including social change."
Applying CBPR, Parkland used focus groups to gather an array of perspectives from community stakeholders. The Focus groups were conducted in two phases.
- Phase I: Parkland in collaboration with Baylor Scott & White Health, Texas Health
Resources and Methodist Health System engaged IBM Watson to conduct a
series of focus groups to assess the perception of the health needs in Dallas
County. Focus group participants were invited based on their involvement
with public health or their work with medically-underserved, chronic
disease, low-income or minority populations. Participation was also sought
from community leaders, other healthcare organizations and providers,
including physicians.
- Phase II: Focused on gathering more in-depth input from the safety-net patient
population and frontline providers who care for them. This phase included
10 focus groups conducted by Parkland staff.
A summary of the focus groups session results is provided in the Community Input section of this report.
Data Collection: For this CHNA, quantitative and
qualitative data was collected and maintained in a
single repository to ensure consistency and accuracy.
Quantitative data was gathered from the primary
sources listed below. The qualitative data was gathered
through informational interviews and focus groups.
Primary Data Sources:
- Behavioral Risk Factors Surveillance System (BRFSS)
- Dallas County Health and Human Services
- Dallas-Fort Worth Hospital Council Foundation (DFWHC)
- DFWHC Healthy North Texas
- HOMES Uniform Data System (UDS) Annual Report, 2016-2018
- HRSA UDS Maps
- IBM Watson/Truven Health Analytics
- Metro Dallas Homeless Alliance
- Parkland Center for Clinical Innovation (PCCI)
- Parkland Health & Hospital System
- Texas Demographic Center
- Texas Department of State Health Services
- The Federal Reserve Bank of St. Louis
- U.S. Centers for Disease Control and Prevention (CDC)
- United States Census Bureau
