Product Directory

Our “Product Directory” includes a collection of all the publications and other products related to the Flint Center for Health Equity Solutions.  Most products in the database go through our Dissemination Request process.  However, some of the content in this database may not need a complete review.  If you are a community partner and have presented material to the community, e.g. PowerPoint to your work group, then please contact John Girdwood ( so that we can add your material to our Product Database.  Thanks!

Richard C. Sadler
Addressing health disparities requires both community engagement and an understanding of the social determinants of health. Although elements of the built environment can influence behavior change in public health interventions, such determinants have not been explicitly teased out via participatory mapping. An opportunity exists to integrate community voice in the development of such metrics. To fill this gap and inform the deployment of public health interventions in the Flint (USA) Center for Health Equity Solutions (FCHES), we created a means of assessing spatially-varying community needs and assets in a geographic information system (GIS), what we refer to as a healthfulness index.

We engaged community and academic partners in their expert opinions on features of Flint's built environment that may promote or inhibit healthy behaviors via a multiple-criteria decision analysis framework. Experts selected from and ranked 29 variables in 6 categories (including amenities, environment, greenspace, housing, infrastructure, and social issues) using the analytic hierarchy process. The resulting matrices of expert opinions were aggregated and appended as weights for each variable's corresponding map layer. When combined through map algebra, composite scores yield spatially-varying healthfulness indices which signal any neighborhood's relative health promoting qualities (along a 0–100 scale).

Results varied substantially across Flint, with the middle belt scoring highest and older neighborhoods in the northeast and north center of the city scoring lowest. Scores were
aggregated to 38 Flint neighborhoods; for each of two project-specific indices, these ranged from lows of 38.7 (Hilborn Park) and 41.8 (Columbia Heights) to highs of 52.9 (College Cultural) and 58.0 (University Ave Corridor). We hypothesize that—even when controlling for individual-level factors—we will measure better and more sustained behavior change among participants living in neighborhoods with high healthfulness scores. Future work will examine this hypothesis and determine the importance of such indices in other similar communities.
Mieka Smart
Conference Poster
Background: The Flint Center for Health Equity Solutions’ Needs and Assets assessment (NAA) identified the need for a comprehensive public health data resource in Flint. The NAA highlighted that current local public health datasets are lacking in terms of their methodological rigor and/or their comprehensive coverage of public health issues. As a response, the Flint Area Study’s (FASt) first wave is underway. The FASt is a longitudinal inter/multi-generational cohort study designed to assess environmental exposures and elucidate their long-term effects on Flint residents. Methods: The FASt uses a random probability sample and has three assessment phases. Phase 1 involved compiling a list of 400 inhabited households from random block-faces and collecting qualitative data on Flint neighborhoods. Phase 2 involved using the NIfETy Method to assess social- and physical-environmental conditions at the Phase 1 households. Phase 3 will consist of residential surveys that measure for physical/behavioral health, multi-level social dynamics, and biological specimen
collection every three years. Results: Results from Phase 1 show that one-third of the assessed block-faces contained fewer than two inhabited households. Results from Phase 2 show geographical clustering of evidence of potentially protective environmental factors, levels of physical disorder and levels of social-environmental risk (including aggression, signs of violence and presence of alcohol and other drugs). Phase 3 is underway. Conclusions: FASt Phases 1 and 2 identified locations for targeted environmental intervention. Once combined with individual health outcome and biological data from Phase 3, the comprehensive FASt dataset will provide valuable information about unmet health needs.
Rolando Barajas
Conference Poster
The Flint Center for Health Equity Solutions (FCHES) works with the Flint community to identify and resolve health inequity. A needs and assets assessment based on CDC metrics identified that Flint’s two strongest population health data sources capture only ~50% the data needed.

In response, the Flint Area Study (FASt)
- A longitudinal multi- and inter-generational study of risk and resilience.
- Designed to serve as a comprehensive data resource that will inform local policy and interventions.
- Will measure the epigenetic and behavioral impact of physical- and social-environmental exposures.

Phase 1 Goal: Generate the sampling frame for 400 Flint households (350 citywide + 50 oversample in North Flint), for a total of approximately 1,000 residents.
Rick Sadler, PhD
Conference Presentation
Oral conference presentation describing the development and use of the GIS-based healthfulness index.
Amy Drahota, PhD
Conference Presentation
Introduction: Focused dissemination of research outcomes is a key strategy for improving public health. While federally-funded research centers are required to have a dissemination core, efforts are typically directed toward academics (e.g., manuscripts, academic presentations). However, opportunity exists to leverage the dissemination core requirement in center grants by involving specific dissemination and implementation (D&I) research aims. Project Description: The NIMHD-funded Flint Center for Health Equity Solutions (FCHES) is a transdisciplinary collaborative center, utilizing a CBPR approach, focused on reducing health disparities. DISC specific aims include: (1) Converting FCHES research projects into hybrid effectiveness-implementation trials; (2) Collaborating with the FCHES Consortium Core to keep community partners informed of FCHES activities; (3) Evaluating dissemination, implementation and sustainment of previous health promotion efforts to inform the development of DISC D&I toolkits; (4) Developing a dissemination toolkit for community use then research its reach and impact across community agencies; (5) Utilizing D&I theory and research evidence to develop policy-change strategies and evaluate the reach and impact of these strategies; and (6) Training regional stakeholders in the use of D&I toolkits, policy-change strategies and effective dissemination of research findings. The DISC will generate knowledge that is relevant and meaningful to community needs. The primary audience for DISC efforts includes FCHES academic and community partners, community stakeholders, service providers, policy-makers, consumers, and the general public locally, regionally, and nationally. Evaluation Plan: We will provide the rationale for embedding D&I research questions into effectiveness trials as well as the specific processes that were utilized by the DISC team to accomplish this specific aim within two distinctly different FCHES research projects. Conclusion: To our knowledge, this is the first center-funded dissemination core that focuses on conducting D&I research within a NIMHD-funded center, collaborating with cores to embed D&I methods, and involving a CBPR approach to apply findings for community use. Moreover, the DISC may be able to act as a model for future center dissemination cores. Embedding dissemination and implementation science research into center project activities from the outset may facilitate uptake if findings and reduce research-to-practice gaps.
Sarah A. Stoddard, Ph.D.
Conference Poster
In 2011, nearly 20% of Flint residents participating in a community-wide survey on health reported that they or a family member were a drug user or addicted to drugs in the past 2 years.​ Prevention and treatment work, but little is known about how to effectively implement evidence-based programs in communities such as Flint.

Strengthening Flint Families (SFF) is substance use prevention initiative in Flint that combines three coordinated evidence-based interventions​:​

Peer recovery coaching (PRC): Certified Peer Recovery Coaches (PRCs) are peers to their clients, have been successful in the recovery process for more than two years, and have completed specialized training and supervision. PRCs assist individuals with challenges related to their recovery and enroll clients’ families into the Strengthening Families Program. ​

Strengthening Families Program: Strengthening Families Program: For Parents and Youth 7 - 17 (SFP 7 - 17) is an evidence-based program for families with children between the ages of 7 – 17. It consists of 10 interactive sessions that focus on strengthening protective factors and reducing risk factors for families.​

​Multi-media campaign: The campaign will deliver messages about the effectiveness and availability of family programs and substance use treatment and prevention in the community. Driven by the powerful message of growth and recovery from the affected populations, the campaign will be executed on social media platforms as well as print media and radio.
Dr. Vicki Johnson-Lawrence
Chronic disease carries high morbidity and mortality in the United States, with large racial and ethnic disparities observed in chronic disease. Physical activity and healthy food are vital for chronic disease prevention yet challenging to access in economically distressed areas. Public health prevention efforts have become particularly prominent within faith-based organizations over the last three decades. This manuscript describes the protocol of the Church Challenge, a multilevel cluster-randomized controlled nutrition and physical activity trial across 24 churches to reduce blood pressure by 6 mmHg among 576 residents in Flint, MI. The Church Challenge was developed using community-based participatory approaches and is rooted in a church-based program developed by and for primarily African-American Flint church congregations. This three-level intervention addresses health at the community (level 3), church (level 2), and individual (level 1) to reduce blood pressure, reduce chronic disease risk, and promote health equity and wellbeing in Flint. Churches are randomized in a 1:1 ratio to a 16-week physical activity and nutrition program or a 4-session health and wellness workshop. Flint is not a unique community but has a history of traumatic community wide events; even now, the public health infrastructure continues to be a challenge and distract residents from focusing on their health. This trial is highly significant and innovative because it uses a combination of evidence-based practices simultaneously supporting health behavior change for individuals and their faith organizations, and evaluates multilevel efforts to sustain long-term health promotion activities in vulnerable communities like Flint.