Community Health Policy Assessment of a Rural Northeast Missouri County using the Centers for Disease Control and Prevention's CHANGEtool

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. Face-to-face interviews, using the US Centers for Disease Con trol and Prevention’s CHANGEtool were conducted in a rural Northeast Missouri county possessing exceptionally high chronic disease rates to as sess the factor(s) had the greatest influence on the rates in each sector of the community. The Health Care Agency sector possessed the most factors cate-gorized 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. 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 In stitu-tions/Organizations sectors, and tobacco-free school policies are recom-mended. Multiple community sectors must work together to change not only behaviors but also environments in this county.