Engaging rural communities to incorporate social determinants in developing strategies to improve access to health care in the Missouri Bootheel counties

Authors: Ashish Shrestha, Katherine Stamatakis, Janice Ballard, Ardella Burgess, Elizabeth Baker

The aim of this study was to engage community members and practice partners across multiple sectors in a participatory strategy development process to a) identify social and organizational determinants of accessing health care, b) collectively prioritize identified issues, and c) develop strategies for change. A collaborative team of academics, practice partners, and community health workers collected data from community members and agency representatives through facilitated community forums and an online survey across four counties in the Bootheel region of Missouri, USA. Responses were then consolidated into a set of statements and later organized into concept maps presented to community participants for prioritization and strategy development. Participants identified several individual-, social-, community-, and organization-level barriers to accessing health care, including cost, lack of transportation, and lack of information about services. This study demonstrates a promising model for community-engaged health strategy development, and suggests community health worker partnerships can help facilitate this participatory planning process.