title: Connecting Boston's public housing developments to community health centers: who's ready for change?
abstract: BACKGROUND
  Despite close proximity to community health centers, public housing residents are at increased risk of uncontrolled chronic disease, in part because of underutilization of routine health care.
  
  
  OBJECTIVE
  To assist in program planning, the Partners in Health and Housing Prevention Research Center (PHH-PRC) used the Community Readiness Model to compare readiness of public housing developments and community health centers to address community-identified health priorities. The model assumes that program success to affect change depends on matching the community's level of readiness to address the issue.
  
  
  METHODS
  Key respondent interviews were conducted across 15 communities: Eight housing developments and seven health centers. Interviews were scored across six dimensions on an anchored, 9-point scale and averaged to provide a composite readiness score. Higher scores indicate increasing levels of readiness. Interview transcripts were reviewed for consistent themes.
  
  
  RESULTS
  Health centers scored significantly higher (mean, 5.88) than housing developments (mean, 3.33), corresponding with the Preparation stage of readiness compared with the Vague Awareness stage, respectively. Both scored highest in Existing Programs and Resources and lowest in Knowledge of Efforts. Qualitative analysis revealed a lack of existing partnerships between housing developments and health centers as well as significant social barriers preventing housing residents from engaging in care.
  
  
  CONCLUSIONS
  We found a mismatch in readiness to address community health priorities. Although health centers have programs to address health issues, community awareness of programs is limited and barriers to engaging in care persist. The model provided a useful tool for engaging communities into shared program planning.
authors.affiliation: Women's Health Unit, Section of General Internal Medicine, and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, USA.
authors.forename: Tracey A
authors.initials: TA
authors.lastname: Battaglia
authors.forename: Samantha S
authors.initials: SS
authors.lastname: Murrell
authors.forename: Sarah Gees
authors.initials: SG
authors.lastname: Bhosrekar
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Caron
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Bowen
authors.forename: Eugenia
authors.initials: E
authors.lastname: Smith
authors.forename: Richard
authors.initials: R
authors.lastname: Kalish
authors.forename: Jo-Anna
authors.initials: JA
authors.lastname: Rorie
mesh_terms: D000328:Adult; D001900:Boston; D003151:Community Health Centers / Q000458:organization & administration* / Q000706:statistics & numerical data; D003299:Cooperative Behavior; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D007373:Interinstitutional Relations; D007857:Leadership; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000458:organization & administration*; D011638:Public Housing / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014505:Urban Population