Community Health Policy Assessment of a Rural Northeast Missouri County using the Centers for Disease Control and Prevention’s CHANGE tool

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.