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Cynthia Stone, DrPH, RN; Alison Redenz, MURP, AICP;
Andrea Bochenek, MPH; Ellie Hansotte, MPH

METHODS TO CONDUCT A HEALTH IMPACT
ASSESSMENT LEARNING COLLABORATIVE  

Abstract
Background: Indiana University Richard M. Fairbanks School of Public Health (IU FSPH) and 
the Health and Hospital Corporation of Marion County, through the Marion County Public Health 
Department (MCPHD), created a Health Impact Assessment (HIA) Learning Collaborative. The 
purpose of the HIA Learning Collaborative was to strengthen the capacity of both the academic and 
community partners to carry out HIAs. Entities recognize the value of creating a collaborative team 
to assure personnel are trained and available to provide time and expertise for plan reviews, formal 
feedback, data reports, literature summaries, and input in potential health/social impacts related 
to projects, which can ensure these impacts are considered in development work. In addition, the 
MCPHD and IU FSHP intend to increase HIA capacity in Indiana and remain committed to including 
health impact data into non-health sector decision making. 

Methods: The group planned to meet monthly over the year with the following learning objectives. 
A survey was created in Survey Monkey in order to evaluate the overall HIA Learning Collaborative 
experience and to assess whether or not the learning objectives were met. The survey consisted of 
11 questions: nine were multiple choice and two were open-ended. 

Results: The majority of the objectives were met. 

Conclusion: There is interest in conducting HIAs in the future and several ideas were generated.



Methods to Conduct a HIA Learning Collaborative Stone; Redenz; Bochenek; Hansotte

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Introduction/Background
Indiana University Richard M. Fairbanks School 
of Public Health (IU FSPH) and the Health and 
Hospital Corporation of Marion County, through 
the Marion County Public Health Department 
(MCPHD), created a Health Impact Assessment 
(HIA) Learning Collaborative to be conducted 
over one year. The collaborative was formed 
with a small funding opportunity from the 
Indiana University Center for Translational 
Science, Community Health Engagement 
Program. MCPHD wanted to increase staff that 
were familiar with the steps of a HIA and were 
able to apply the HIA process with community- 
based projects. The U.S. Department of Health 
and Human Services recommends HIA as one 
important resource for implementing many of 
the Healthy People 2020 Objectives, particularly 
those that focus on the social determinants 
of health (Healthy People 2020 Advisor 
Committee, 2010). The purpose of the HIA 
Learning Collaborative was to strengthen the 
capacity of both the academic and community 
partners to carry out HIAs. Entities recognize 
the value of creating a collaborative team to 
assure personnel are trained and available to 
provide time and expertise for plan reviews, 
formal feedback, data reports, literature 
summaries, and input in potential health/social 
impacts related to projects, which can ensure 
these impacts are considered in development 
work. In addition, the MCPHD and IU FSPH 
intend to increase HIA capacity in Indiana and 
remain committed to including health impact 
data into non-health sector decision making.

Additional partner organizations were invited 
to participate in the HIA Learning Collaborative, 
including the Top 10 Coalition, the YMCA of 
Greater Indianapolis, and the Indiana State 
Department of Health. A total of eight individuals 
from the various organizations routinely 
participated during the year- long collaborative 
sessions. 

The learning collaborative members wanted to 
discuss the concept of Health in All Policies. This 
led to a video conference with a staff person 
at the National Association of City and County 
Health Organizations (NACCHO). NACCHO has 
been providing technical assistance to several 
local health departments about putting health 
into all policy discussions and evaluating the 
impact of this change. HIAs are one tool that can 
be employed to put health into the policies and 
programs of non-health sectors, which is the 
intent of Health in All Policies (American Public 
Health Association (APHA), 2012). 

Method for conducting HIA Learning Col-
laborative
The group planned to meet monthly over the 
year with the following learning objectives:

1. Describe the purpose, benefits, and 
challenges of a Health Impact Assessment.

2. Develop an in-depth knowledge of the 
process and analytic methods used in the 
assessment step.

3. Demonstrate the ability to think critically 
and analyze how the findings related to 
policy decisions.

4. Conduct an HIA on a local project/ 
process/ or policy.

A Canvas web-based course site was created 
from the learning management system at 
Indiana University to store materials and 
allow for sharing of information. Access to the 
course was generated by completing a guest 
account request. Several of the participants had 
previously used Canvas. 

The textbook Health Impact Assessment in the 
United States by Ross, et al. (2014) was used 
for the background sessions of the HIA process. 
During the first five months, different steps of 
the HIA process were studied. Each session 



Methods to Conduct a HIA Learning Collaborative Stone; Redenz; Bochenek; Hansotte

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lasted for 90 minutes and covered the readings 
and discussion of application using the cases 
in the book (Ross et al. ,2014). The session 
following the book discussion included a case 
presentation with each participant reviewing 
and analyzing a different HIA case from the 
PEW Charitable Trusts website (PEW Health 
Impact Project, 2020). The group also discussed 
potential HIA topics that could be conducted in 
Marion County.

The second half of the year was used to meet 
the objective to conduct a HIA on a local project 
or policy. To accomplish this objective, the 
learning collaborative worked with the graduate 
Health Impact Assessment course at IU FSPH. 
The HIA Learning Collaborative generated a 
problem statement for the City of Indianapolis-
Marion County, stating a need for more access 
to parks and green space. According to the Trust 
for Public Land, Park Score Index (2019), only 
35% of Indianapolis residents have access to a 
park within a 10-minute walk, compared to the 
national average of 54%. The 10-Minute Walk 
Campaign, a partnership between the National 
Recreation and Park Association (NRPA) and 
the Trust for Public Land, uses the 10-minute 
walk as a benchmark. The project calls on cities 
across the U.S. to “Make the 100% Promise to 
make sure that everyone in your city has safe, 
easy access to a quality park within a 10-minute 
walk of home by 2050” (NRPA, 2019, para 1). 
Two topics were chosen by the HIA collaborative 
that could address the statement of need for 
more parks and greenspace access within 
the City-County’s current funding limitations. 
This includes, 1) opening access or allowing 
shared use agreements to school grounds and 
2) green schoolyards in Indianapolis schools 
to increase greenspace access. Two HIA 
Learning Collaborative members presented 
an overview on the benefits to communities of 
having open access to school grounds and the 
health benefits of green schoolyards for healthy 

communities and suggested assessment tools 
that could be used to explore these topics. 
The students conducted windshield surveys to 
begin to learn about two neighborhoods that 
could be used for the HIA topics. The students 
conducted interviews of school personnel using 
the assessment tools that were recommended. 
An additional HIA that updated a previous 
HIA performed to support building a grocery 
store in a food desert was conducted by a 
third group of students, and two other HIA 
Learning Collaborative members assisted them 
with demographic data to use as part of the 
assessment of their area. 
The final HIA Learning Collaborative meeting 
included power point presentations by a student 
representative of each of the HIA projects. A 
good question and answer discussion occurred 
after each presentation. 

Method of Evaluation
Two members of the collaborative created a 
survey in Survey Monkey in order to gather 
data to evaluate the overall HIA Learning 
Collaborative experience and to assess whether 
or not the learning objectives were met. The 
survey consisted of 11 questions: nine were 
multiple choice and two were open-ended. 
The survey link was disseminated to all HIA 
Learning Collaborative members through 
email. Of the eight members who regularly 
participated, seven group members completed 
the survey.  Once responses from all members 
were collected, the results were exported into 
Microsoft Excel for analysis. Frequencies were 
calculated and graphs were generated using 
Microsoft Excel. A copy of the actual survey can 
be found in Appendix A.

Results of Survey
The nine multiple choice questions were 
answered by all seven respondents. The results 
are displayed in the section below.



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Table 1: Number and percentage of respondents who felt that the HIA Learning Collaborative 
objectives were met

HIA Learning Collaborative Objective N Percent

Describe the purpose, benefits, and challenges of a Health Impact 
Assessment

7 100.00%  

Develop an in-depth knowledge of the process and analytic methods used in 
the assessment step

6 85.71%

Demonstrate the ability to think critically and analyze how the findings 
related to policy decisions

6 85.71%

Conduct an HIA on a local project/ process/ or policy 3 42.86%

One hundred percent (7/7) of HIA Learning 
Collaborative members who completed the 
survey reported that they believed Objective 
1, “describe the purpose, benefits, and 
challenges of a Health Impact Assessment,” 
was met during the allotted time. Nearly 86% 
(6/7) of HIA Learning Collaborative members 
who completed the survey reported that the 
believed Objectives 2 and 3, “develop an in-
depth knowledge of the process and analytic 
methods used in the assessment step” and 
”demonstrate the ability to think critically 
and analyze how the findings related to policy 
decisions,” respectively, were met. Nearly 43% 
(3/7) of HIA Learning Collaborative members 
who completed the survey reported that they 
believed Objective 4, “conduct an HIA on a local 
project/ process/ or policy,” was met.

Overall, participants responded that using 
in person sessions with a zoom option was 
accommodating (Pre COVID-19 restrictions). 
The majority reported that using the Canvas 
site for resources and minutes was useful. 
The majority reported the book was helpful 
to access the baseline content. An adequate 
number of meetings were held with 10 total 
meetings over the calendar year. The majority 

of participants reported they have adequate 
personnel to conduct an HIA and feel confident 
to lead an HIA in the future.
 
Future/ Next Steps
Several ideas were generated from the survey 
for potential HIAs in Marion County. This 
includes the following:

• Determining the health impact of the 
future proposed transit lines

• Identifying the health impacts of zoning 
land use changes

• Examining the health impacts of the 
proposed I-70-I-65 freeway improvement 
project

There is also interest in continuing the HIA 
Learning Collaborative by expanding the 
membership and using the collaborative to 
provide technical assistance when participant 
organizations are ready to begin a HIA. There is 
need to seek out additional funding to further 
expand HIA efforts. The group is also interested 
in better collaboration between the county 
health department and the City of Indianapolis 
to expand on the Health in All Policies work that 
has begun. 



Methods to Conduct a HIA Learning Collaborative Stone; Redenz; Bochenek; Hansotte

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References
American Public Health Association. (2012). Health in All Policies. American Public Health  Association. 

Health impact assessment: a tool to benefit health in all policies. American Public        Health 
Association. http://www.apha.org/NR/rdonlyres/171AF5CD-070B-4F7C-A0CD- 0CA3A3FB93DC/0/
HIABenefitHlth.pdf. 

Healthy People 2020 Advisory Committee. (2010). Healthy People 2020: An Opportunity to Address 
Societal Determinants of Health in the U.S. Healthy People Advisory Committee. https://www.healthypeople.

gov/sites/default/files/SocietalDeterminantsHealth.pdf
Ross, C.L., Orenstein, M., & Botchwey, N. (2014). Health Impact Assessment in the United States. New  

York: Springer Publications. 
Pew Charitable Trusts). (2020). Health Impact Projects Health Notes. https://www.pewtrusts.org/en/

projects/health-impact-project
National Recreation and Park Association. (2019). Trust for public land: 10 minute walk campaign: Are 
you 100% in?  10 Minute Walk.Org  https://10minutewalk.org/#Join-us

http://www.apha.org/NR/rdonlyres/171AF5CD-070B-4F7C-A0CD- 0CA3A3FB93DC/0/HIABenefitHlth.pdf.
http://www.apha.org/NR/rdonlyres/171AF5CD-070B-4F7C-A0CD- 0CA3A3FB93DC/0/HIABenefitHlth.pdf.
https://www.healthypeople.gov/sites/default/files/SocietalDeterminantsHealth.pdf 
https://www.healthypeople.gov/sites/default/files/SocietalDeterminantsHealth.pdf 
https://www.pewtrusts.org/en/projects/health-impact-project
https://www.pewtrusts.org/en/projects/health-impact-project
https://10minutewalk.org/#Join-us 


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Appendix A

Health Impact Learning Assessment Learning Collaborative
1. Please select which of the following objectives you felt were reached during the learning 

collaborative (choose all that apply):
 r  Describe the purpose, benefits, and challenges of a Health Impact Assessment
 r   Develop an in-depth knowledge of the process and 

analytic methods used in the assessment step
 r   Demonstrate the ability to think critically and analyze 

how the findings related to policy decisions
 r   Conduct an HIA on a local project/ process/ or policy

2. Did you feel that the setup of the learning collaborative (meeting in person or via zoom) was 
accommodating?

 r Very accommodating    
 r Accommodating
 r Neutral
 r Not very accommodating
 r Not accommodating at all

3. How helpful was it to use Canvas for sharing articles and PowerPoint presentations?
 r Very helpful
 r Helpful
 r Neutral
 r Not very helpful
 r Not at all helpful
 r N/A, I did not have access to Canvas

4. How useful was the book (Health Impact Assessment in the United States) in learning about 
HIAs and meeting the learning collaborative objectives (listed in question 1)?

 r Very useful
 r Useful
 r Neutral
 r Not very useful
 r Not useful at all

5. How do you feel about the number of meetings for the HIA LC?
 r Too many meetings
 r Adequate number of meetings
 r Not enough meetings



Methods to Conduct a HIA Learning Collaborative Stone; Redenz; Bochenek; Hansotte

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6. Do you believe that your organization has the capacity to complete a HIA?
 r Yes
 r  No
 r  Undecided

7. After participating in the HIA Learning Collaborative, how confident would you feel leading a 
HIA?

 r  Very confident
 r Confident
 r Neutral
 r Not very confident
 r Not confident at all

8. After participating in the HIA Learning Collaborative, how confident would you feel being a 
part of a HIA?

 r Very confident
 r Confident
 r Neutral
 r Not very confident
 r Not confident at all

9. Do you think Health Notes would be a useful tool in the future?
https://www.pewtrusts.org/en/research-and-analysis/fact- sheets/2017/11/pilot-pro-
gram-to-help-states-and-localities-consider-health-in- policymaking

 r Very confident
 r Confident
 r Neutral
 r Not very confident
 r Not confident at all

10. What do you think is needed to conduct a HIA in the future?

11. Please list ideas for potential HIAs in the space below.

https://www.pewtrusts.org/en/research-and-analysis/fact- sheets/2017/11/pilot-program-to-help-states-and-localities-consider-health-in- policymaking 
https://www.pewtrusts.org/en/research-and-analysis/fact- sheets/2017/11/pilot-program-to-help-states-and-localities-consider-health-in- policymaking 


Methods to Conduct a HIA Learning Collaborative Stone; Redenz; Bochenek; Hansotte

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CORRESPONDING AUTHOR
Cynthia Stone, DrPH, MSN, RN
Department of Health Policy and Management
Indiana University-Purdue University Indianapolis 
1050 Wishard Blvd. RG 5128
Indianapolis, IN 46202
cylstone@iu.edu

CHIA Staff:

Editor-in-Chief 
Cynthia Stone, DrPH, RN, Professor, Richard M. Fairbanks School of Public Health, Indiana 
University-Purdue University Indianapolis

Journal Manager 
Angela Evertsen, BA, Richard M. Fairbanks School of Public Health, Indiana University-Purdue 
University Indianapolis

Chronicles of Health Impact Assessment Vol. 5 Issue 1 (2020) DOI: 10.18060/23874
© 2020 Author(s): Stone, C.; Redenz, A.; Bochenek, A.; Hansotte, E. 
       This work is licensed under a Creative Commons Attribution 4.0 International License

mailto:cylstone@iu.edu

