Author Archives: Geomenke

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FOSS4G user/advocate/trainer | Conservation GIS specialist for hire | Co-author 'Mastering QGIS' | 14ers | Good coffee | Paleo | Fitness | Vinyl

Remembering a Community Health Maps Milestone

By John Scott (CPSC)

In June 2016, a Community Health Maps (CHM) symposium was convened by the Center for Public Service Communications and Health-Equity.Org. It was hosted by the National Library of Medicine and held at Lister Hall on the grounds of the National Institutes of Health campus in Bethesda, Maryland.

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The relevance of the CHM initiative to NLM’s mission has to do with improving the ability of community-oriented organizations (and researchers and other public health professionals) to collect, organize and visualize data and other health information to better-understand health conditions and support decision-making for resource allocation.  While access to quality health information is frequently a focus of attention, the ability to visualize data and information — to better understand and portray their significance to the community — has received less attention. This is in part because the availability of affordable GIS platforms and data collection and visualization applications is relatively recent.  Historically, the cost to procure platforms and applications, to train users and to sustain operations has been prohibitive for communities and community-based organizations whose health budgets are already strained.

The purpose of the workshop, therefore was to share the CHM workflow with community-based and minority health organizations so that they would be in a better position to serve their populations by knowing how to collect and maintain their own data, rather than — or at least in addition to — having to rely solely on national/state agencies or majority-institution partners to provide data to them.

Participating were seventy-six community-oriented health professionals who were drawn from throughout the country. The workshop was made possible with funding by the Robert Wood Johnson Foundation. During the workshop several Community Health Mapping pilot projects were highlighted, including:

  • Obesity research at the University of Hawai’i School of Medicine’s Department of Native Hawaiian Health
  • Research on noise pollution at the Seattle Indian Health Board/Urban Indian Health Institute
  • Projects including a youth initiative measuring community water quality
  • Smoking cessation
  • Access to health care by migrant workers
  • Building a zika awareness curriculum at the Medical University of South Carolina
  • University of Washington School of Public Health graduate student capstone projects featuring the CHM workflow.
  • Mapping Curb Ramp Accessibility around a Silver Spring, MD Assisted Living Facility
  • Visualizing an Intervention for Tobacco Control
  • Teens Map Environmental Health of Their Community (Sea Islands, South Carolina)

Kurt Menke, of Bird’s Eye View GIS, and CHM partner, also offered training in the use of CHM tools in five parts:

  1. Introduction to Community Health Maps
  2. Learn to use Fulcrum to build a data collection form
  3. Exercise using data collection form to collect data around the conference center
  4. Mapping data collected during previous exercise online in Carto
  5. Brief introduction to mapping the data in QGIS

Learning Objectives for the training session were:

  • Describe the Community Health Maps workflow which includes low-cost and open resources for community mapping and data visualization.
  • Create a data collection tool on a mobile device that can be used to collect community data.
  • Learn how to map data collected online in and on the desktop.

Workshop participants were also introduced to the recently developed set of six online “labs”:

  1. Field Data Collection
  2. Bringing Field Data into QGIS
  3. Combining Field Data with other Organizational Data
  4. Basic Spatial Analysis
  5. Cartography with QGIS
  6. Data Visualization with Carto

These labs are now available on the Community Health Maps Resources page.

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Other highlights of the workshop include a keynote presentation by Dr. John P Wilson, Professor and Director of the Spatial Sciences Institute at USC Dana and David Dornsife College of Letters, Arts and Sciences, University of Southern California. His talk was titled, “Community Health Mapping: In a World Awash with Geographic Data and Tools.” His presentation can be downloaded here as a PDF (3.86Mb).

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spotlight-balbus1Also presenting was John Balbus, M.D., M.P.H., Senior Advisor for Public Health and Director of the National Institute for Environmental Health Science-WHO Collaborating Centre for Environmental Health Sciences at the National Institutes of Health. His presentation was “From the Pump Handle to Hazardous Waste: Mapping Environmental Health and Justice.” It can be downloaded here as a PDF (3.48Mb)

An Interview with John Scott

Interviewer: Kurt Menke, GISP

What is your background?

My professional experience has been in two areas: disaster risk reduction and reducing health disparities. In 1990 I formed the Center for Public Service Communications. Since

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John Scott – President – Center for Public Service Communications (CPSC)

then I have provided guidance and expertise to individuals, communities and public sector organizations. I help them apply telecommunications and information technologies to reduce health disparities, improve health services to underserved
and disenfranchised individuals and communities and to improve the collection and sharing of scientific, technical and community knowledge. The end goal is to reduce human vulnerability to natural hazards. I’ve been a consultant and advisor to the National Library of Medicine for more than 20 years.

Through the years, I’ve realized that my skills seem best suited to working with change agents. These are individuals and organizations whose missions focus on enhancing capacities and improving access to technologies that enable positive change at the community level. I guess the tag line says it best, the mission of CPSC is: “Empowering competent enthusiastic people to do good things.” That’s my story and I’m stickin’ to it.

You’re the original architect of CHM, what was your inspiration?

 Well, Kurt, I would say that we, together, have been architects of CHM, with a long-term commitment and guidance from the National Library of Medicine. As you will remember, it was back in 2003 that we met. I had organized a meeting of the National Congress of American Indians President’s Task Force on Health Information and Technology in Honolulu, Hawai’i, hosted by the Native Hawaiian health organization Papa Ola Lokahi.

At that meeting, you gave a presentation on work you were doing with the National Indian Council on Aging. At that moment, it was obvious to me that mapping would be a great tool for underserved community-oriented environmental health advocacy groups and public health agencies. It could help them engage with community residents and empower them to collect, maintain and visualize their own data, rather than relying solely on national or state agencies, or majority-institution partners to provide data to them. It took us a while to settle on our current course but the ride was interesting and the result was, I think, worth waiting for.

Why do you think CHM has been so successful?

While access to quality health information is frequently a focus of attention in efforts to reduce health disparities in underserved communities, the ability to visualize spatial data and information has received less attention. This is in part because the historic scarcity of affordable and intuitive data collection and mapping applications. Additionally, the cost to train users, and sustain operations, has been prohibitive for communities and community-oriented organizations whose health budgets are already strained. I think we’ve found a model, with the Community Health Maps workflow, that addresses these historical challenges.

Without equal access to GIS tools, communities might have access to completed maps, but they cannot actively participate in, much less create and be responsible for their own initiatives. I think CHM has been successful because the approach we have envisioned enables that access, and CHM users thus far have appreciated the freedom they have, to explore ideas and to create hypotheses that they have not had access to until now.

What sets CHM apart from other public health mapping initiatives?

I think what sets CHM apart from other public health mapping initiatives is that our approach involves using relatively low cost tablets and smartphones – technology that has become ubiquitous and with which users are comfortable — combined with a selection of low/no-cost applications for data collection and visualization. With these tools, data can then be analyzed and presented without purchasing expensive software licenses. These tools allow expert and novice users, with little budget resource, to implement mapping workflows. Introducing such workflows to community-oriented public health professionals empowers users to collect, analyze, display and share their own spatial data. Importantly, many of these tools can also be used to share data collected using other programs, such as ESRI’s ArcGIS and national/state- derived databases such as CDC’s Behavioral Risk Factor Surveillance System and Public Use Data files from National Center for Health Statistics.

Where would you like to see the project go from here?

What we have developed is essentially available at no or very little monetary cost. I don’t want to underestimate or undervalue the labor and intellectual time that is required to learn how to use the tools. But we believe that organizations and individuals who work to improve the quality of life in underserved communities will see the benefit of using the CHM resource as a worthwhile commitment of time.

The National Library of Medicine has been a great partner and continues to plan an integral part in planning the course for CHM. Through NLM’s outreach efforts we have several successful pilot projects that readers of this blog will be familiar with. Through these continued efforts of sharing the tools through NLMs network of libraries I hope the use of CHM will grow. My hope is also that more academic health schools will introduce the CHM into their teaching and research programs as have the University of Washington and the Medical University of South Carolina, two of our partners. I’d also call to the attention of your readers the labs that you have developed and are available on this blog. My hope is that they will encourage prospective CHM users to try the workflow at their own pace.

Catch Community Health Maps at the Association for Prevention and Teaching Research Conference (APTR) in Savannah next week!

Last year Community Health Maps was invited to present at the Association for Prevention and Teaching Research (APTR) Conference in Albuquerque, NM. We brought two students from the University of Washington Department of  Community Oriented Public Health, and two students from the Medical University of South Carolina, to present their capstone project posters.

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Student posters from 2016

Myself, John Scott, Dr. Williamson and Dana Burshell also combined to create a CHM panel. The panel discussion session was packed and to our collective surprise we heard “oohs” and “ahhs” as we showed some of the mapping tools live. We were approached by some of the organizers about teaching a workshop the following year.

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CHM Panel Discussion from 2016

That brings us to this years conference in Savannah Georgia. We will again have a panel session which will both provide an overview of the project, and highlight recent successes. The panel will be on Thursday April 6th at 3pm.

On Friday morning we will teach a 4 hour CHM workshop. This is a hands-on training session where you will learn how to incorporate the Community Health Mapping (CHM) workflow into your research and training programs. You will:

  • Learn how to use Fulcrum to create a data collection form
  • Go outside with your smartphone/tablet to collect some data around the conference center
  • Map the collected data in Carto
  • Work with the data in QGIS
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A preview of QGIS with some Savannah data that will be used in the workshop

We hope to see you there!

 

Q & A with Kurt Menke, CHM Moderator

By Jenny Rewolinski

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Kurt Menke, GISP

The following is a question and answer interview with the moderator of the with Community Health Maps (CHM) blog, Kurt Menke, GISP (Certified geographic information systems (GIS) professional). Kurt has worked with CHM since its inception in 2014 and is a valuable resource for users of CHM.

What is your background?

Kurt: I started out as an archaeologist. I spent 8 years in the desert southwest working on Anasazi pueblo archaeology. I went on to receive a Masters in Geography from the University of New Mexico in 2000. While in graduate school I began working at the UNM’s Earth Data Analysis Center (EDAC). That’s where I really learned about GIS. I worked there for 11 years as a GIS Analyst/Programmer.

When did you being using open source GIS?

It was at EDAC, about 15 years ago, when I was first exposed to open source mapping software. We began using Mapserver for web mapping applications, because it was faster and more stable than the Esri alternative. I realized there was a whole ecosystem of open source tools out there.

How did you first come to work with NLM?

Kurt: John Scott, President of the Center for Public Service Communications and I have collaborated on health related projects with NLM for over 10 years. We first met while I was working at EDAC on a project with the National Indian Council on Aging (NICOA). I had developed an app named the Interactive Health Atlas. That project eventually ended and I left the university to create my business Bird’s Eye View. John thought we should take the best parts of the NICOA project to the National Library of Medicine (NLM). It evolved into what we called the Health Equity Atlas. This was custom software we developed, which was really time consuming. It worked great, but wasn’t widely adopted. We learned a valuable lesson, for something like this to be successful, it needs to be something organizations are asking for. No matter how useful it may be, if people don’t have time for it, it will just sit on the shelf.

How did CHM begin?

Kurt: In 2012, John asked me to look at existing smart phone apps. His idea was, rather than developing a completely new application, we could use existing low cost software. Plus we would work with organizations who had mapping as a defined need. I ended up completing a thorough survey of smartphone data collection tools and some of them were perfect. I identified what I thought were the two or three best. We realized we could stitch together a series of low cost intuitive tools that collectively address everyone’s mapping needs.

We settled on Fulcrum, QGIS, and Carto as our core CHM workflow tools. We started with pilot projects at the University of Hawaii and the Urban Indian Health Institute in Seattle. Showing people how to use these tools via a train-the-trainer approach ended up working really well.

You are a QGIS expert. When did you first begin using QGIS?

Kurt: QGIS was started in 2002 and I began playing with it in 2005. I just discovered it fromDiscoverQGISCover a listserv. At first it was very limited, being little more than a data viewer. But I was really curious to see how it might evolve, so I started following it. It really started becoming a useful alternative in 2010. I gradually migrated to it with my business. I also started teaching GIS classes with it. I used to keep a list of things you could do with ArcGIS that you couldn’t in QGIS. Now it’s come so far that I have a list of things you can do in QGIS that you can’t in ArcGIS!

How has CHM evolved?

Kurt:  Once we realized we had something that would be useful to people, we began looking for partner organizations. These are organizations who work with data and can benefit from mapping, but lack the resources to get started. We conduct workshops and webinars to get people started down the mapping path.

Along the way I thought a blog would be a really helpful tool to keep people up to date with new technology. These tools are constantly improving and I thought this would be a way to share these enhancements with everyone. Later we realized we needed additional resources for people to continue to build their skills after the initial workshops. I developed a series of six labs covering the mapping tools in more detail. These labs were inspired from a separate project I worked on called the GeoAcademy. This is a complete college curriculum for teaching GIS using open source tools. It even won an award!geoacademy_logo_col_5

Our primary goal for CHM has always been to provide tools that are helpful to users. After years of trying to build something from scratch, we are now finally gaining some traction with CHM. It feels like a snowball, rolling downhill and gaining speed. I believe it is both because the tools are powerful and intuitive, plus we are getting better at identifying potential users.

Would you recount one experience with CHM that felt especially influential for CHM’s progress so far?

Kurt: Yes the first thing that comes to mind is the work with the Medical University of

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St. Johns HS students learning CHM

South Carolina (MUSC). In early 2015 I taught a CHM workshop to 8 people. The training went well. No one in attendance had ever worked with any type of mapping software before. Yet I was able to show them how to make a data collection form, collect points, and map the data in Carto. The next day I went to a high school on John’s Island and taught several students over their lunch break how to collect data. They picked up on it immediately and spent the semester mapping food and water locations on the island.

Months later, the MUSC participants were so excited by the possibilities that they asked me to come back. This second training had 25 people. Later that year we came back for a third workshop, and 80 people from across MUSC attended! That I could show such a large group, how to work with these tools in a half day was a real proof of concept!

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The third workshop at MUSC with 80 particpants

Several projects were inspired these MUSC workshops. Of particular note is Dr. Bryan Heckman’s smoking cessation research project. I must point out that Dr. Deb Williamson and Dana Burshell worked to organize and plan the MUSC trainings and deserve most of the credit for the turnout.

Our successful trainings with MUSC have served as a model for teaching bigger groups such as those at the CHM Symposium at the National Library of Medicine in June, 2016 and recent trainings in Seattle.

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The most recent workshop in Seattle

The most gratifying aspect of these workshops was seeing people shed their technological insecurities. It’s common for people to show up and admit they’re scared of the technology. To then see in a few short hours, they are getting it all to work, and actually getting excited about the possibilities, is a beautiful thing.

 What are your plans for the future of CHM?

Kurt: The work that people are doing right now with CHM barely scratches the surface in terms of the potential. I would like to get more community members involved. I envision a scenario where there is an organization can really engage with citizens to map the community. The data could be managed by a central data manager in the organization. It would be such a great way to involve the community in a project directly related to their healthcare.

I’d also like to see someone get past the initial data gathering and map making phase. QGIS has a lot of spatial analysis capabilities. I’d like to see someone push beyond the CHM labs and do some interesting analyses in QGIS or use some of the cool data visualization techniques in Carto.

What advice you would give to new CHM users?

Kurt: Don’t be afraid to dive in and use the tools. Be adventurous and creative with your projects. Don’t be afraid to mess up. That’s how you learn. There is no limit to the kinds of things you can accomplish with mapping and spatial analysis tools. If you can imagine it, it can be done.

CHM Conducts Three Workshops in Maryland

Last week Kurt Menke traveled to Maryland. Two workshops were held at the Prince Georges County Department of Social Services for people working on homeless issues. All attendees were novices to mapping technology. However, in the first hour they all built a data collection form in Fulcrum and went outside to collect some data around the building.

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Prince Georges County Community Health Mappers

The attendees represented a variety of organizations including many working with YouthREACH Maryland. REACH is an acronym standing for Reach out, Engage, Assist, & Count to end Homelessness. It is an effort to obtain accurate, detailed information on the number, characteristics, and needs of unaccompanied homeless youth in Maryland. Other organizations represented at these workshops included:

  • Maryland’s Commitment to Veterans
  • Maryland Department of Planning
  • Prince Georges Community College
  • St Ann’s Center for Children, Youth, and Familes
  • Maryland Multicultural Youth Center
  • So Others Can Keep Striving (S.O.C.K.S)
  • Sasha Bruce Youthwork
  • Lifestyles of Maryland.

In the final two hours of the workshops attendees learned how to map the data they collected in both Carto and QGIS. We also had time for a brief discussion about how CHM could be used in their projects. There were a lot of ideas shared about how the technology could help community engagement.

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The afternoon workshop attendees feeling accomplished after completing their Carto maps!

After the two PG County workshops, CHM traveled across the Chesapeake Bay bridge to Salisbury University on the eastern shore.

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The following morning we held a workshop geared towards social work students at Salisbury University. Attendees went through the CHM workflow and were introduced to Fulcrum, Carto and QGIS. Below is a map of data collected around the student center in Carto.

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Salisbury University Data Collection in Carto

The workshop concluded with a short introduction to working with data in QGIS.

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Salisbury University Data Collection in QGIS

The next scheduled workshop for the Community Health Maps team will be at the Teaching Prevention 2017 Conference in Savannah, Georgia. That conference takes place from April 5-7th. If you are interested in learning this technology this workshop will be a great opportunity!

New Year Will Bring Updated Labs Including Lab Zero!

It has been 2 years since the Community Health Maps (CHM) lab exercises were first produced. Software changes quickly, and over the last two years the tools involved in the CHM workflow have undergone many changes. For example, this fall the pricing scheme for iForm changed. Though it is still a good product, this price increase puts it out of the category of low cost software. The companion site formhub.org no longer exists, making ODK Collect more difficult to work with. Fortunately Fulcrum is a fantastic alternative to those two data collection apps. QGIS has released 5 new versions and is now at version 2.18! CartoDb has been rebranded as Carto and has a new interface.

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The QGIS 2.18 Splash Banner

All these changes means it is time for all the lab exercises to be updated. Lab 1 will now be a single lab for both iOS and Android users with Fulcrum. Labs 2-5 will be updated to QGIS 2.18. Lab 6 will be updated to Carto’s new interface. The set of companion videos will also be redone and updated.

Many have worked through these labs and some provided feedback. This information is being used to improve the labs as they are updated. One new item will be Lab Zero. While the CHM workflow is intuitive, it has been suggested that more background information could be useful. Lab Zero will be a companion reference document to the CHM labs. It will contain: A) information on the background of the CHM project, B) software installation instructions , C) a glossary of terms, D) more thorough descriptions of some technical topics like coordinate reference systems, E) a description of how to interact with the QGIS community to get additional help, and F) a list of data resources. This work is in progress and will be ready this spring. Stay tuned!

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An image from the last task in Lab 4 showing the density of diabetics in Baltimore City along with dialysis clinics

 

CHM Has a Busy Fall with Workshops and Storms!

We had a busy fall giving three workshops in September and October. First Community Health Maps traveled to Spokane Washington to conduct a half day technical workshop at the National Tribal Forum for Excellence in Community Health Practice.

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This event was organized by the Northwest Portland Area Indian Health Board and supported by the Robert Wood Johnson Foundation. We weren’t certain who or how many would attend, and I expect attendees weren’t entirely sure what Community Health Mapping was all about either. However, it turned out to be a very engaged group representing tribes from many regions of the country. Within a few hours everyone was able to:

  • Create a field data collection form in Fulcrum
  • Collect some data around the conference center on their smartphones/tablets
  • Make a map of their data in Carto
  • Learn how to bring the data into QGIS

This was a typical CHM workshop with most never having done any mapping work before. As such it was a very empowering experience for the participants to learn how to use this technology to map their community in just a few short hours.

From there we traveled to Honolulu, Hawai’i to give a workshop organized by Papa Ola Lokahi. There were two hurricanes (Lester and Madeline) heading towards the islands. Fortunately they both veered off and didn’t cause any damage or disruptions! The attendees came with a plethora of ideas on how mapping could fit into their work including:

A) tracking scholarship recipients of the Native Hawaiian Health Scholarships program,

B) supporting the Native Hawaiian Cancer Network,

C) mapping Dr. Ben Young’s research on historical tracking of Native Hawaiian Health professionals,

D) mapping Native Hawaiian Homelands to provide resource data to providers and community members, and

E) use the CHM “train the trainer” model to increase ongoing trainings for service providers including community health outreach workers and patient community navigators in Hawai’i.

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Papa Ola Lokahi staff learning  how to map their community with tablets and smartphones

After a brief break we headed to Seattle, Washington, again there were two separate storms including, the remnants of Typhoon Songda, bearing down on the region threatening to disrupt power and services! Again fortunately the storms didn’t make a direct hit on the area and the workshop proceeded on schedule.

We went to train students in the capstone course of the Community Oriented Public Health Practice Program at the University of Washington. This is our second year supporting this program. The first year was a huge success with two students attending the APTR Conference and presenting their work.

Like last year we had  a full house with students eager to learn about community mapping. Both first year and second year students were in attendance. Several second year students will submit proposals for consideration, to receive a stipend and support for using Community Health Maps in their capstone projects. Jamie Smeland is the first of the group to be awarded the stipend for her capstone project entitled, “Honoring the Collective Wisdom: Documenting a Cross-Racial and Intergenerational Movement to Shift Power to Youth and Parent Leaders to Improve Educational and Health Outcomes for Students of Color in South Seattle & South King County.” We look forward to working with these students in the coming months.

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UW Community Oriented Public Health Practice Program capstone students learning the Community Health Maps workflow

In the near future we will be offering an updated set of Community Health Mapping labs and a platform for CHM webinars. Stay tuned! In the meantime if you are interested in Community Health Maps and/or receiving CHM training contact John Scott (jcscott at cpsc.com) for more details.