Category Archives: Data Collection

CHM Lab Exercises Updated!

One of the most valuable resources for Community Health Mappers remains the series of lab exercises created two years ago. Our workshops, while effective, are short and only scratch the surface of what you can do with mapping tools. They are basically a quick start guide to Community Health Mapping. The labs however, can be used as a resource to help you build your skills once you’ve taken the first steps towards mapping your community.

The technology changes rapidly. QGIS produces a new stable version every 4 months. Annually QGIS also produces a long-term release. Carto and Fulcrum also update their tools on a regular basis. This mean the lab exercises need to be updated to keep pace.

The good news is that this spring the labs were all updated and expanded. There is some foundational knowledge needed to really take the next step after a workshop. The current revised set of labs includes Lab 0: A Community Health Map Introduction and Reference. This lab has background on the Community Health Maps project and the workflow. It also contains a Glossary of GIS terms, and several appendices covering: A) available software, B) data sources and C) everything you need to know to better understand coordinate systems and projection.

The remaining labs are as follows:

Lab 1 covers field data collection and has been updated to work with Fulcrum. This has allowed us to unify the exercise into one document for both iOS and Android users.

Lab 2 shows you how to bring your field data into QGIS. This includes a tour of the QGIS interface, and how to map coordinate data stored in a spreadsheet.

Lab 3 is named Combining Field Data with other Organizational Data. It shows you how to work with coordinate systems in QGIS. It also covers how to join tabular data to the attribute table of a GIS layer. This is a step that often has to be done to merge socioeconomic data from the U.S. Census to census geography such as tracts or block groups. It concludes with a lesson on address geocoding. This is the process you use to produce points from addresses.

Lab 4 shows you how to do some basic spatial analysis. You learn how to clip data to your study area, measure proximity, query your data to select features and calculate areas/ density.

In Lab 5 you learn how to use some of the great data visualization techniques found in only in QGIS. The lab then walks you through how to compose a map. Along the way you learn some data styling tricks and how to use the Print Composer.

The series concludes with Lab 6 Data Visualization with Carto. Carto underwent a major update and rebranding since the first edition of these labs were created. You can use this exercise to see how to work with the new Carto Builder interface and tools to create an online map of your results. It covers uploading your data, styling and sharing your map with others.

The four labs that deal with QGIS have been updated to include some exciting new features that have been added to QGIS in the last year. Links to the lab data are included. So head to the Resources page and build your Community Health Mapping skills!

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!

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.

GIS as an Educational Tool at MUSC

Submitted by Jennifer Rewolinski

Dr. Deborah Williamson is an Associate Professor in the College of Nursing at the Medical University of South Carolina (MUSC), Charleston. Dr. Williamson, Community Health Maps (CHM) and MUSC have partnered in providing training that integrates GIS and CHM tools for a high school Teen Health Leadership Program. Dr. Williamson has worked with both community members and students.

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Dr. Deborah Williamson (MUSC)

Dr. Williamson believes that, “GIS has the potential to substantially increase community engagement and is truly a concept of the neighborhood taking control of their data.” She notes that while researchers might study a community, that a community’s input is essential to understanding the cultural and environmental context surrounding health issues: “GIS mapping puts the community members on more of a level playing field with their research partners.” GIS can empower and educate community members to identify their key issues, to become a part of an analysis, and to provide solutions. When communities are given the opportunity to map their own health, discovery, and awareness, positive changes can result.  When a community feels it has more of a say through engagement with GIS, or communication with a map, intervention is more likely to be effective.

For the past three semesters, Dr. Williamson has used GIS in her own classroom as a capstone project for population health students.  They, “find it fun and can take it with them into other settings, it fits into the world of new technology, and it takes people to the next step of looking at health issues.” Mapping offers a different way to help students visualize Social Determinants of Health and to make the connection between what population health is, and the factors that promote or deter it.

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MUSC students presenting their capstone work at the APTR Conference in Albuquerque (April 2016)

Finally, Dr. Williamson sees GIS as bi-directional: it supports visualizing gaps and assets while also providing the ability to disseminate and build on information via intervention programs to improve health outcomes and strengthen communities. GIS is also broadly applicable to almost any discipline and easily used by those with little expertise. “Presenting raw data to a community or students doesn’t mean a lot,” Dr. Williamson comments, “but when that same data is aggregated visually it instantly communicates a message to any audience.” GIS is clearly suitable as an effective educational tool in the classroom and in communities.

CHM thanks Dr. Williamson for her continued collaboration and time spent advancing the CHM program through use of the CHM tools at MUSC. CHM values our partnership with MUSC and hope that the future is as mutually beneficial as the past few years.

Field data collection for the CHM workflow bridges the divide between learning in a classroom and experiencing conditions in a community. For the capstone project, students use CHM labs and parts of the CHM workflow, including phone data collection with iForm or Fulcrum, integration of the data into QGIS, and presenting the data with Carto or Google Maps. Dr. Williamson’s students often upload their data from iForm to Google Maps because of its familiarity and easy access.

One student project involved identifying migrant camps as a community in need, and assessing the community through surveys and key informant interviews.  When the data showed that migrant workers often lack knowledge of health information and access to healthcare services, students mapped locations of migrant camps near Charleston, SC in relation to urgent care facilities and shared the data with the migrant outreach workers from a local community health center. Later, an intervention was developed to provide hands on CPR and first aid instruction to 60 workers. This project displays successful application of CHM tools in an educational and community context resulting in an intervention that may offer real change.

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Map of MUSC Population Health student’s capstone project showing the locations of migrant camps and urgent care facilities in Charleston, SC.

Visualizing an Intervention for Tobacco Control

Submitted by Jennifer Rewolinski

Dr. Heckman, an assistant professor of psychiatry and behavioral sciences at the Medical University of South Carolina (MUSC) in Charleston, used Community Health Maps (CHM) tools in his research on tobacco control. Smoking is the leading preventable cause of death worldwide and costs the US $130 billion in direct medical costs annually. Smoking is still a major public health issue that influences mortality, morbidity, healthcare costs, the environment, and quality of life.

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Dr. Bryan Heckman

The outcome of Dr. Heckman’s precision medicine project will be a mobile app that aids smokers who recently quit by alerting them of proximity to stores which sell cigarettes or alternative nicotine products. Studies show that greater tobacco retailer density is associated with greater incidence of relapse; Dr. Heckman believes that mapping provides a new approach to visualizing environmental factors. A CHM training event at MUSC spurred his decision to integrate mapping into his own work using the CHM labs as a guide. These labs provide step-by-step instructions for implementing the CHM workflow. He used the data collection app Fulcrum on an iPhone to collect information on retailers: GPS coordinates, type, type of tobacco products sold, e-cigarette advertising, and photos. His team also used a high-powered Trimble GPS device to test accuracy of phone GPS, and the accuracy of phone GPS was adequate and more cost effective than more expensive GPS devices.

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Figure 1. Dr. Heckman’s in progress map shows higher numbers of tobacco retailers are associated with  Census Tracts that have both higher poverty and a higher percentage of minority populations.

Dr. Heckman integrated his Fulcrum data into QGIS software. He added national datasets from the American Community Survey and Behavior Risk Factor Surveillance System for Census tract data, and Synar for retailer data to check the validity of the Fulcrum data; field data collection with Fulcrum revealed a more accurate list of current retailers than the national secondary datasets provided. Dr. Heckman believes QGIS is a powerful tool with many features; he was not only able to use QGIS to monitor and visualize his research questions but also to guide his project decisions and hypotheses. His results will guide policy recommendations, improve access to care, and deliver novel interventions.

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Figure 2. Dr. Heckman’s in progress map shows higher numbers of tobacco retailers are associated with Census Tracts with higher percentages of minority populations.

For those attempting to undertake a health GIS project on their own, Dr. Heckman emphasized that all the tools needed are provided on the CHM blog; only time and patience are required. He also recommends asking for help and reaching out to other CHM users who have experience. Dr. Heckman’s project has the potential to affect behavior change and reduce health disparities via a mobile intervention app which identifies nearby tobacco retailers and prompts and provides an intervention and awareness of a health issue. Dr. Heckman’s experience is an example of how the CHM blog and tools might be used.

Dr. Heckman would like to thank Kurt Menke and the CHM team, Dr. Williamson from MUSC, and his mentors for inspiration and growth. He would also like to acknowledge the Hollings Cancer Center and American Cancer Society Institutional Research Grant that helps support his work, and Alex Hirsch for his help coordinating the project.

The CHM team would like to extend their own gratitude to Dr. Heckman as they sincerely appreciate his time and his support of the CHM blog.

Mapping Curb Ramp Accessibility around a Silver Spring, MD Assisted Living Facility

Submitted by Jenny Rewolinski, University of Maryland, B.S. Community Health 2016

I just completed a spring internship with the National Library of Medicine (NLM). My goal was to demonstrate what a typical user of the Community Health Maps (CHM) blog might experience, while using the low cost resources it reviews to develop a mapping project with a public health focus. I read through the case studies on the CHM blog and used its labs to develop my project plan and to guide my related decisions.

Because of my experience with elderly relatives and my background in public health, I centered my project on how the senior population of a nearby Assisted Living Facility might safely navigate local sidewalks. According to the 2014 American Community Survey, 23% of people over 65 have some sort ambulatory disability. With this in mind, I decided to map local curb ramps –sloped transitions between sidewalks and streets which function as accessibility enhancements to help those with mobility issues to cross streets safely.

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Figure 1. Curb Ramp Data Collection using the iForm app

I used CHM Lab 1: Field Data Collection to learn how to design my own data collection form using iForm. My Curb Ramp form captured curb ramp location, conditions, and other observations such as seniors using the curb ramps, steep or damaged curb ramps, and a lack of sidewalks in the area. As discussed in a prior blog post, How Accurate is the GPS on my Smart Phone?, phone geolocation is usually accurate up to 8 meters. This was not precise enough for my curb ramp data, so I corrected for this on my form.  Over the course of 8 hours spanning 2 days, and with 2 other interns I collected 103 existing curb ramps and locations where curb ramps might aid accessibility.

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Figure 2. iForm Curb Ramp Data Collection Form

Next, I brought my iForm curb ramp data from my phone into the QGIS software by using instructions from CHM Lab 2: Bringing Field Data into QGIS.  I also used CHM Labs 3: Combining Field Data with Other Organizational Data and CHM Lab 4: Basic Spatial Analysis  to add data layers and to perform spatial analysis to finalize my map.

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Figure 3. Curb Ramp Accessibility of Senior Population of Silver Spring Assisted Living Center Map

This is my project map! I completed construction of my map using CHM Lab 5: Cartography with QGIS. In addition to my curb ramp data points, I added data layers for sidewalks, roads, places of interest (such as grocery stores, restaurants, bus stops,  theaters), and my Assisted Living Facility. My goal was to raise awareness of how accessibility can impact seniors’ sense of autonomy and empowerment, and their ability to exercise and to lead a healthier lifestyle. This map also provides recommendations for where more curb ramps should be placed based on observations during data collection. I plan to discuss this map and curb ramp recommendations with the city of Silver Spring and to create “safest route” guides for popular local destinations.

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Figure 4. A Safest Route Guide example showing safe and dangerous routes based on location of curb ramps and sidewalks

GIS has a huge potential to help us analyze health issues. When I began my project at NLM, I thought I would simply be mapping the location of curb ramps near a local Assisted Living Facility; however I discovered the significant need for more curb ramps as well as sidewalks around my project area.

I believe the conclusions I was able to reach by using the low cost CHM resources CHM are accurate and workable. I came to NLM with little to no GIS knowledge yet I learned from the CHM GIS labs, collected curb ramp data points and created a map that may bring awareness to a public health issue. In doing so I believe my experience is typical of many CHM users.

If I can do it, you can too!

Fulcrum Updates The App Designer

We introduced Fulcrum in a recent post and are very impressed with this tool. Recently Fulcrum updated their App Designer. Fields are now divided into categories from the most common and basic fields, to the most advanced.  The groups of fields have also been color coded from green to red to make this arrangement more intuitive. The five categories are: Basic, Choice, Design, Media and Advanced. At the top are Basic fields which include Text, Numbers, Date etc. This reorganization makes finding fields and developing a form even faster.

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Re-organization of the Fulcrum App Designer

One category of interest is Design. These are fields that can be used to organize your data collection form. Sections allow you to divide your form into parts. For example, you could separate your main survey questions from your data collector metadata questions. The example App below has two sections: Main section and Data Collection Information.

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A Fulcrum App Using Sections

Organizing your questions like this can help data collectors complete the form, especially for form with a lot of questions. The screenshot below shows how the above form is rendered on a smartphone.

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Data Collection App Implementing Sections on a Smartphone

In future posts we will give some helpful hints to working with Fulcrum including sharing forms, managing data and downloading data. Stay tuned!