Celebrating health literacy in Salem, Missouri

The outcomes of our community project’s partnerships have been as diverse as the terrain of the 4 Missouri communities where we took on this collaborative work. From the rugged Ozarks around Salem to the rolling farmland of Northeast Missouri, the challenges and opportunities that community members identified have led us to very different approaches.

At the same time, our work in Salem illustrates the health literacy-based principles at the foundation of a truly community-engaged process: ask good questions, really listen to the answers, and build on existing strengths.

In Salem, as with our other communities, we needed to understand the first-hand experiences of the people who live there, and that’s how we began in late 2016.

Start by listening

Through a series of meetings and interviews with community leaders, we asked a lot of questions to gain their wisdom and insight on the topic they are most expert in: their own community’s experiences with things like healthcare and health insurance. This rich qualitative data helped us paint a picture of Salem, in terms of its strengths, needs, and ideas to make a tangible impact in the face of challenges like access to health care and a high rate of uninsured families and individuals.

A community meeting in Salem, MO. Photo: Jesús Quiñones/HLM

Our plain language approach helped these foundational conversations to be real and authentic, free of the jargon that too often bogs down discussions around health care or health policy. This also helps to build trust, and trust is a great beginning.

A map to move forward

The next step involved a more formal data gathering process with our partners from the Mission Center. Called asset mapping, the goal of this approach was to more fully involve Salem community members in the effort to address the community’s health concerns.

An asset mapping approach helps identify the strengths and assets in a community by creating a visual map of existing resources, such as community organizations, volunteer groups, and initiatives. In Salem, we engaged about 30 community members, who represented at least a dozen organizations in these sessions. In a town of about 5,000 people, this level of participation is phenomenal, and our partnership with the Salem Interagency Networking group was invaluable to making these meetings possible.

While access to care is a complex and nuanced issue, particularly in rural areas, this asset mapping group identified a very immediate barrier to care: a lack of reliable transportation. Our response: immediate availability of transportation funds to community members, disseminated strategically through our trusted community partners, using our boost funding mechanism.

Conversations continue around a more long-term, regional health transportation solution.

“Our work highlighted the prevalence of service needs, specifically how a lack of basic transportation disrupts access to medical care, access to food, maintaining gainful employment, and a general sense of social connection,” said Brett Harley, Community Resourcing and Outreach Coordinator at Your Community Health Center in nearby Rolla, MO.

"It informed people what services are available and provided a way for people with vehicles and those who "rideshare" a way to fill their gas tanks. Hopefully, initiatives like this will inspire decision makers to take action towards a permanent solution," Harley added.

Building sustainability and meaningful outcomes

Like all the communities we partnered with, Salem is unique. But that doesn’t mean we can’t take any lessons away to apply elsewhere. Here are a few takeaways from our community health literacy program in Salem:

1. Ask questions of the community – when you’re ready to launch a community wellness program, always lead with the stories. Talk to people. Understand their concerns. Ask questions about approaches they think might work.

2. Let their answers be your guide – external consultants can bring deep experience in certain aspects of health-related activities, but only first-hand experiences from community members can lead to solutions that are tailored to the community.

3. Keep connecting – the strongest partnerships are those that create or build on infrastructure to keep activities moving over time. We were fortunate that Salem had a strong collaborative group in place through the existing Salem Interagency Networking meeting, and our community project layered activities onto this existing structure.