Using Community-Engaged Research to Explore Social Determinants of Health in a Low-Resource Community in the Dominican Republic: A Community Health Assessment.

Previously published community health assessments (CHA) have explored social determinants of health in low-resource, Haitian-majority Dominican communities. The present CHA was conducted in Las Malvinas II, a Dominican-majority low-resource community, and represented a first step for developing a building a healthier community process. A binational community-academic partnership adapted the Centers for Disease Control and Prevention's CHANGE (Community Health Assessment and Group Evaluation) guide to conduct a CHA through community-engaged, mixed-methods research. Data were collected on five community selected public health priorities (i.e., education, sanitation, unwanted pregnancies, chronic disease management, and vaccine-preventable diseases) and community assets through focus groups, interviews with key informants, and a household survey using GIS (geographical information systems) technology. Of all five priorities, unwanted pregnancies and sanitation received the lowest average CHANGE tool ratings for both policies and Systems and Environment. However, data gathered on the five public health priorities reflect the perceived needs and assets of Las Malvinas II, and are equally important in improving the community's health and well-being status. Community members identified as important goals the construction of a primary health clinic, as well as a bigger school, that includes pre-school and high school levels. A coalition emerged from the CHA to address the identified issues. The coalition used CHA findings to develop a community health improvement plan. The establishment of a primary health care center and a bigger school were identified as primary goals.