title: Community Health Policy Assessment of a Rural Northeast Missouri County using the Centers for Disease Control and Prevention's CHANGE Tool.
abstract: BACKGROUND
  In order to build a framework to address policy gaps and needs, community's risk factors were identified and the extent to which current policies were in place to address the risk factors were compared.
  
  
  METHODS
  Face-to-face interviews, using the US Centers for Disease Control and Prevention's CHANGE tool were conducted in a rural Northeast Missouri county possessing exceptionally high chronic disease rates to assess the factor(s) had the greatest influence on the rates in each sector of the community.
  
  
  RESULTS
  The Health Care Agency sector possessed the most factors categorized as environmental and policy assets, and the Community-at-Large and Business/Worksite sectors seemed to possess the least environmental and policy factors categorized as assets.
  
  
  CONCLUSIONS
  Because organizational policies can strongly influence community health practices and behaviors, collaborative leadership from the Health Care Agency sector, comprehensive worksite health promotion programs in the Business/Worksite and Community Institutions/Organizations sectors, and tobacco-free school policies are recommended. Multiple community sectors must work together to change not only behaviors but also environments in this county.
authors.affiliation: Department of Health Science, Truman State University, Kirksville, Missouri 63501, USA.
authors.forename: Mitch
authors.initials: M
authors.lastname: Stewart
authors.affiliation: Department of Health Science, Truman State University, Kirksville, Missouri 63501, USA.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Visker
authors.affiliation: Department of Health Science, Truman State University, Kirksville, Missouri 63501, USA.
authors.forename: Carolyn C
authors.initials: CC
authors.lastname: Cox
keywords: CHANGE tool; Health policy; Health promotion