Tag Archives: Fulcrum

Exploring Accessibility and Sustainability at the University of Maryland School of Public Health

By: Jessica Throwe, Sofia Marmolejos, and Colette Hochstein

The National Library of Medicine (NLM) periodically hosts classes to introduce aspiring
public health professionals to the benefits of using low-cost GIS mapping tools in
community health research. Recently, NLM interns Jessica Throwe and Sofia
Marmolejos, along with NLM Research Assistant Julian Argoti, presented Community
Health Maps (CHM) to University of Maryland School of Public Health undergraduate
and graduate students.

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The first presentation was held during a seventy-five minute “Principles of Community
Health” class of twenty-five undergraduates. A second was provided to a close-knit
class of ten graduate students studying community health and health literacy.
After an introduction to Community Health Maps and to the history and ideology of
GIS/mapping in health research, students used Fulcrum, a mobile data-collection
utility, to create customized forms for collecting data on their mobile phones. They
were then given thirty minutes to explore the classroom building and collect data on the
health topic of their choice. The data collected included the geographic location,
functionality, and visual appearance of the points of interest.

The larger undergraduate class chose a wide variety of subjects, ranging from nearby
bus stops and curb ramps to building water fountains and bathroom stall colors. The
smaller graduate class focused on the school building’s resources, including hand
sanitizer dispensers, bike racks, compost bins, wheel chair accessibility, and food
offerings. After the data collection and review process, problems with the building’s
resources became more apparent, which sparked ideas regarding potential
improvements.

One group noticed that although the school has a new sustainability initiative, of the
twenty locations in the building with trash and recycling bins, only three included a
compost bin. Another group found that the hand sanitizer dispensers functioned
everywhere except right outside the gym, a site where this product is in high demand. A
third group discovered the school has a limited number of locations to purchase snacks,
and that each of these contains just one vending machine which does not offer healthy
food options.

This introduction and exposure to Community Health Maps allowed University of
Maryland undergraduate students to explore the concept of mapping and to make
connections with community health research. UMD graduate students actively applied
the CHM processes to discovering geospatial inconsistencies in their built environment
and to brainstorming areas for potential improvements within the building.
NLM looks forward to learning how students of varied educational levels will apply
Community Health Maps to future educational and professional experiences.

CHM Frequently Asked Questions (FAQ’s)

There are some questions I am asked regularly when teaching CHM workshops. This blog post addresses those common questions, many of which deal with data security.

Can more than one person collect data at the same time with Fulcrum?

Yes it is possible add users to your Fulcrum Organization for team based data collection. You set this up from your Fulcrum Settings page. When adding users you can give them a Role as a Standard User, Manager or Owner. You can also grant member access to your individual data collection apps. At that point those users have the access you granted them via their Role in your organization.

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Is there an organizational account for Fulcrum?

Not really. An organization can have a single account, but that account needs to be associated with a single email address. So the user name and password would then need to be shared with anyone in the organization. This isn’t the way Fulcrum is set up to work and they prefer users not do this. A better way is to create an account and add users to your organization.

The exception to this is Fulcrum Community This is a version of Fulcrum for use in humanitarian relief and disaster situations. You need to apply for a Community license. If granted you can invite any number of data collectors via their email address and they don’t have to have accounts. The Community license is free and lasts one year. We used this in Miami last fall and the project is features on the Community flood page  (Post-Irma Environment Reporting)!

When does Fulcrum record the point?

The point is taken when you click “Save”. You may have backed up to take a photo. However, when you are ready to save the record, you should have your device as close to the object you want to map as possible.

Why do I end up with two datasets from Fulcrum?

Photos you take with your mobile device are geotagged. When you download your data from your Fulcrum account you may end up with two datasets. One is based on your data collection app. The other is based on the coordinates embedded in the photos you took. For example, if you backed up to take a photo of a bench and then saved your point standing over the bench, you will be able to see both where the photo was taken and where the bench is located.

How accurate are the points collected with my mobile device?

There are a number of things that can affect data accuracy such as the quality of the GPS receiver, current satellite configuration, limited sky view, proximity to large buildings, tree cover etc. There is a two part blog post about this you can read here.

One thing to keep in mind is that when you are using Fulcrum to collect field data, the point is taken when you click “Save”. You may have backed up to take a photo. However, when you are ready to save the record you should have your device as close to the object you are mapping as possible. It is also possible to edit and correct point locations after the fact via Fulcrum, Carto or QGIS.

Is my data secure on QGIS?

QGIS is simply a piece of desktop software, not a platform for data storage. With QGIS you can map and analyze your spatial data. Data security has more to do with the security of your computer network and your system for backing data up. QGIS has no more bearing on data security than any other piece of desktop software such as ArcGIS or Microsoft Excel.

Does Fulcrum have HIPAA compliant security?

No. Fulcrum does employ 256-bit SSL connections to keep data safe as it travels to and from your cloud account. As they say, this is the same level of security provided by online banking and e-commerce sites. However, The HIPAA Security Rule requires implementation of three types of safeguards: 1) administrative, 2) physical and 3) technical. So Fulcrum is not HIPAA compliant. However, if they hear from enough users that this is a crucial feature they will likely work on it!

What is open source?

It is both a software license and a way to create software. There are two main types of software licenses: proprietary and open source. Proprietary licenses tend to restrict your usage of the software in some way:

  • number of computers you can install the software on
  • the number of features available
  • the time period you can use the software (e.g., a year)

On the other hand open sources licenses tend to grant users rights and freedoms around using the software. For example with QGIS, the license grants you the freedom to install the software on any number of computers and access to all the features forever. The software also has no monetary cost, it’s free.

Open source is also a software development strategy. The developers work in an open and collaborative way. Many developers feel this is a more efficient way to create software. In an open source project all the source code is available. This last point may not be a hugely important consideration for many. However, access to the source code means that if you have the capability, you can study how the software works and improve it. Because of this feature open source software is not a “black box.” Additionally, even if you cannot program a new feature yourself, you can hire someone who can. Since you are not paying any licensing fees this is often a very viable option.


If you have any other questions about Community Health Maps email them to Kurt Menke and he will try to answer them and add them to this post!

Fulcrum Community

Last year Fulcrum rolled out a new service named Community. They describe it as a, “no cost, short term crowdsourced data collection solution for qualified humanitarian projects.” 

It works like Fulcrum, but you need to apply for a license. The application form is short and is right on the Community home page. In the application you need to describe your purpose and how long you will be collecting data. You also need to provide a project description. If approved you can invite any number of data collectors via email to share  your App (data collection form).  It is generally aimed at humanitarian agencies, non-profits, or government agencies. They restrict commercial use of this service.

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We used this last fall during King Tide data collection in Miami and it was a big success. In fact there are four main categories highlighted on the Fulcrum Community page: Hurricane, Tornado, Flood and Fire. If you click on Flood, the King Tide project is the first in the list. Clicking on it brings up a map with the data collected.

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One caveat is that the data collected falls into the public domain and can be downloaded freely by anyone. This is possible because the data are anonymized, meaning any private information is scrubbed. The data remain available for viewing and download after the event ends.

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It won’t be appropriate unless there is some sort of disaster relief or environmental issue that demands it, but it is another tool to keep in your Community Health Maps toolkit!

A Busy Summer with a QGIS Conference in Denmark and FOSS4G in Boston

This summer Kurt Menke first attended the 3rd Annual QGIS User Conference, Hackfest and Developer meeting in Denmark. From there he traveled to Boston to attend the Free and Open Source for Geospatial (FOSS4G) International Conference. 

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Trip Map Created in QGIS using Live Layer Effects

The QGIS conference was small and intimate and a lot of new information was shared by the developers about the future of QGIS.

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QGIS Conference

There was so much presented that this will be a separate future blog post. While there Kurt conducted a full day workshop on Data Visualization and Cartography in QGIS.

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Kurt Menke teaching about Data Visualization & Cartography in QGIS

He shared many of the new sophisticated and powerful data styling tools now found in QGIS including: 2.5D, 3D, Live Layer Effects, Inverted Polygon Shapeburst Fills, Blending Modes, and some plugins such as Time Manager. Perhaps this could be a workshop shared with CHM partners at a future date? Some examples are shown below:

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Use of Blending Modes to highlight road density

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Lower Manhattan displayed in 3D via the QGIS2ThreeJS plugin

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Cyclones Annually from 1950 – 2015 in QGIS with the Time Manager plugin

In Boston Kurt presented the Community Health Maps project. The talk was well attended and there was a lot of interest. Fulcrum was a sponsor of the conference, and Kurt was able to meet with several of the Fulcrum representatives. While there he learned about Fulcrum Community. This is a new initiative designed to help humanitarian agencies, non-profits, NGOs, or Government entities. To begin you need to request a Fulcrum Community account. One important caveat is that data collected via a Fulcrum Community account is anonymized, free, and open to all by default. It is essentially an initiative that will help in larger crowd sourcing efforts. More details will be forthcoming as Kurt explores this and how it may apply to Community Health Mappers.

This month (September), Community Health Maps will be travelling to the University of Connecticut (Community Medicine and Health Care) and to Miami to teach workshops. The workshop at the University of Connecticut will be to a large diverse audience. The Miami workshops will be focused on showing community members how to map damage and issues related to King Tides.

Stay tuned for blog posts on: 1) the future of QGIS, 2) Fulcrum Community, 3) experiences in Connecticut and 4) Miami.

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!

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.

CHM Workshop at the National Tribal Forum in Spokane, WA

This week the Community Health Maps team is heading to Spokane, Washington to teach a workshop at the National Tribal Forum for Excellence in Community Health Practice! We are honored to participate and engage a new community of mappers.2016-08-29_161231

It is a four hour workshop and by the end attendees will have:

  • Built their own data collection form in Fulcrum
  • Gone outside and collected some points
  • Made an online map of what they collected in Carto
  • Learned how to work with QGIS!

We’ll report back on how it goes when we return. Stay tuned!