Community Injects Related to Local Environmental Justice and Climate Change Impacts

OMB Control Number: 0970-0531

Expiration Date: 09/30/2025

Discussion Guide

Community Conversations and Stakeholder Interview

The climate justice exploratory meetings include semi-structured community conversations and individual stakeholder interviews. This is a collaborative approach between health and human services and highlights a new avenue in inter-agency collaboration between the Office of the Assistant Secretary for Health (OASH) and the Administration for Children and Families (ACF). 

Purpose and Use of Information: The main objective of these conversations is to collect information from community groups and individuals concerning their needs, plans, previous experiences, and existing resources with respect to protecting their community from the health effects of climate change. The following discussion guide will be used to elicit information to:

1. Identify the existing strengths in community climate resilience;

2. Determine existing gaps in community climate resilience plans and resources;

3. Articulate obstacles/barriers experienced in building resilience; and

4. Establish how Federal resources can help address gaps and mitigate obstacles.

Privacy: The information provided will be combined with that of other respondents and discussed internally among Federal staff within the U.S. Department of Health and Human Services. Descriptive information about programs may be included in summaries, but no individuals’ identifying information will be provided publicly to the extent permitted by law.

Voluntary Participation: Providing information for the purposes described is voluntary.

This discussion guide is not a script and, therefore, will not be read verbatim. The moderator will use these questions as a roadmap and probe as needed to maintain the natural flow of conversation.

• Instructions for the facilitator/interviewer are in [bold, italicized brackets].

• Key questions or statements are in bold.

• Question probes are italicized.

THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13)

Public reporting burden for this collection of information is estimated to average 1 hour (60 minutes) per respondent with 25 individual respondents. This time allowance includes time for reviewing objectives, gathering information, and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.

DISCUSSION GUIDE

1. Introductions (10 min)

[Facilitator/interviewer introduces self, reviews ground rules with participants, and asks for participants’ brief personal background]

• Thank you for meeting with me today. My name is __________ and my agency has been contracted by the U.S. Department of Health and Human Services (HHS) to conduct this community conversation. Before we begin, I want to share a couple of ground rules:

  • Your participation is voluntary, and you have the right to stop at any time. If I ask any questions you do not wish to answer, you do not have to respond.

  • There are no wrong answers here; we just want to know what you think.

  • If it’s okay with you, I’d like to audio-record our conversation. The recordings will only be used to confirm our notes and allow us to revisit this conversation. Additional project staff may hear the tapes at a later date. However, your name and personal information will be removed from any quotes and will not be used in any of our summaries.

  • This conversation is focused on climate, health and resilience in your community, so I’d like to ask you to think specifically about your community when providing your answers.

  • May I start recording now?

  • We will have about 90 minutes for our discussion.
    
    
    

• Do you have any questions before we begin?

• Just to give you a brief background about this conversation. The purpose of these conversations is to collect information from community groups and individuals concerning their needs, plans, previous experiences, and existing resources with respect to protecting communities from the health effects of climate change. This session is one of several similar conversations that will be used to inform the coordination of federal resources to support community climate resilience, with a focus on protecting those who are most at-risk from the health impacts of climate change.

• Can you give me some background about yourself, your work, and (if applicable) how your work relates to climate change and/or health?

• How do you define your community for the purposes of describing community health, or for resilience planning? (i.e., Neighborhood, city or town, county, regional, state, etc.)

  • How do you engage with your community?

• Great, thank you for sharing. Now we will begin to talk about local community environmental stressors and challenges.

2. Local Community Environmental Stressors & Challenges (15 min)

[Facilitator/interviewer asks questions to assess the local community’s environmental stressors and challenges]

• Has your community experienced challenges with food safety and security, air pollution, access to safe drinking water, or other environmental stressors that affect the community’s health and well-being?

• Follow-up: Which of these stressor(s) is your community most concerned about?

• Are there specific groups within your community that these stressors affect more? (i.e. children, elderly, low income etc.)

• Are there any other environmental issues that your community is concerned about?

• How do these stressors affect your community’s health?

• In your community, has there been a change over time in the frequency or severity of extreme weather or natural disaster?

  • (For example: heat waves, droughts, floods, storms, or wildfires)

  • Follow-up: What efforts has your community made to prepare for these events?

  • How has your community’s physical and mental health been affected by these events?

• What health effects of these environmental stressors concern you the most?

3. Health Disparities (10 min)

[Facilitator/interviewer asks questions related to health disparities within the community]

• What are the health disparities that are most concerning in your community?

• What populations in your community are most at risk of health harms from the environmental and climate-change-related stressors we discussed?

• Has your community developed a plan to address the inequitable health impacts of climate change? (such as protections for those most vulnerable to extreme heat exposure, flooding, etc.)

4. Resource Needs (25 min)

[Facilitator/interviewer asks questions about resource needs within the community]

• During extreme weather or a natural disaster, what kind of support and resources do your community members need?

  • In this event, where do your community members seek support from within your community?

  • In this event, where do your community members seek support from outside of your community?

  • Are there designated places of shelter where the community can gather in the event of extreme weather or a natural disaster?

  • Are there trusted organizations or institutions that your community turns to in times of crisis or disruption?

  • What should be the role of medical clinics and hospitals to protect at-risk people (including those with medical vulnerabilities) in the event of extreme weather or a natural disaster?

• Are there individuals within your community who may need specialized assistance during an extreme weather event?

  • Follow-up: Does your community have a plan and designated resources to ensure that these individuals receive the assistance that they would need during such an event?

• What are strengths in your community’s disaster and climate change planning?

  • What are gaps?

• What resources does your community need to appropriately address these stressors?

• What are your priorities for your community as it relates to climate change/disaster planning and resilience?

• What do you see as strengths in the planning work? What gaps have you identified when working in climate and health?

• If so, how can governmental authorities best support your work?

• Tell us any stories of how federal government agencies have been helpful or have not been helpful in meeting your community’s needs when addressing the health impacts of climate change.

  • Unconventional ideas: housing assistance, other government programs?

• What actions by the other levels of government (Tribal, territorial, state, local) would be most helpful in addressing community needs for climate action to protect health?

5. Partnership Questions (10 min)

[Facilitator/interviewer asks questions related to partnerships]

• What partnerships have been the most valuable to you and/or your organization when doing climate change planning, resilience work, and preparedness? Why?

  • What organizations do you rely on for information about hazards and the impacts to your community?

• What additional partnerships would be helpful in developing and implementing climate change planning and addressing related health disparities?

• How do you think healthcare institutions and public health agencies should be involved in disaster and climate change related planning as well as addressing related health disparities in your community?

  • If this is already happening in your community, what is working well?

  • What could be better?

• As you may know the Federal government has regional offices. Have you had any interactions with them?

• If so, what is working well?

• What could be better?

• Which regional offices have you been in communications with? Which federal agencies?

6. Questions for Safety Net Health Centers (10 min)

[Facilitator/interviewer asks questions related to safety net health centers. Only needed if these representatives are in the room; otherwise, disregard]

• Are you experiencing changes in frequency and severity of extreme weather or natural disasters (e.g. extreme heat, wildfires, storms) that are impacting your care delivery?

• What role do your organizations play in addressing community needs in times of crisis or disruption? Does this role go beyond delivery of medical care?

  1. Follow up: what SHOULD your organization’s role be in meeting community needs in times of crisis?

  2. What additional resources or support do you need to serve in this role?

• What additional Federal resources or coordination of resources would be helpful in your planning to address climate change related impacts on your care delivery and your patients?

• What role should your organizations play in community, state, and regional climate change planning?

7. Closing (10 min)

[Thank the participants for joining the conversation and ask for any final comments or ideas]

• Before we conclude this session, are there any additional thoughts you would like to bring up that we did not cover?

• Thank you so much for your time and for sharing your expertise with us. We are grateful you were able to join us today.

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