How do we define “our” Community

of Health Behavior and Health Education at the School of Public Health at the University of North Carolina Chapel Hill, under the guidance of a preceptor from the Orange County Health Department and faculty of their program, conducted an Action Oriented Community Diagnosis of Cedar Grove, Orange County, North Carolina.<br><br> The purpose of this document is to summarize that process. A brief description of the Cedar Grove community is presented to provide background information about the context of the process. This is followed by a description of the qualitative methodology used by the student team to conduct the diagnosis.<br><br> Results of the process, including a discussion of themes identified as important by community members and a description of the community meeting, the concluding event of the diagnosis, are presented. This is followed by a summary of future plans made by community members and service providers as well as recommendations for future action made by the student team. While many valid and important concerns were identified through the diagnosis, the Cedar Grove community has a history of successful problem-solving.<br><br> It is our hope that this process has renewed the interest of community members and service providers alike in working together to address issues related to the future vitality of Cedar Grove. We hope that this document will be of use to them in those efforts. An Action-Oriented Community Diagnosis of Cedar Grove iii Table of Contents Acknowledgements...............................................................................................................<br><br> .........................i Executive Summary.............................................................................................................. ........................ii Table of Contents.............................................................................................................. ...........................iii Abbreviation List..............................................................................................................<br><br> ............................v INTRODUCTION .................................................................................................................. ......................1 Geography...................................................................................................................... ...............................3 History .......................................................................................................................<br><br> ...................................3 Demographics................................................................................................................... ............................4 Economics...................................................................................................................... ...............................6 Education......................................................................................................................<br><br> ................................7 METHODS........................................................................................................................ ...........................7 Methods of Gathering Data...................................................................................................... .....................7 Documents Reviewed ............................................................................................................<br><br> .......................8 Development of Interview Guides................................................................................................ ................9 Recruitment Process............................................................................................................ ........................10 Interviews.....................................................................................................................<br><br> ...............................11 Data Analysis Process.......................................................................................................... .......................11 Planning of Community Meeting.................................................................................................. ..............13 Personal Perceptions and Assumptions...........................................................................................<br><br> ............17 THEMES ........................................................................................................................ ............................18 Theme 1: Does the community need to use the Northern Orange Center more to have services increased? Or, do services need to be increased for the community to use the Northern Orange Center more?<br><br> .........18 Theme 2: Cedar Grove would like county resources to address problems that have already been identified..................................................................................................................... ................................22 Theme 3: Cedar Grove has a need for more recreation for all ages...........................................................24 Theme 4: Water and septic system restrictions limit development in Cedar Grove, which affects many aspects of the community....................................................................................................... .....................25 Theme 5: The people of Cedar Grove have had to address the community's transportation needs by looking after each other.<br><br> ..................................................................................................... ........................27 Theme 6: Growth is causing increased traffic on Highway 86 and Efland-Cedar Grove Road. ...............29 Theme 7: Cedar Grove does not have a central place for finding information about services and activities in the community...............................................................................................................<br><br> .........................30 Theme 8: More daycare is needed in the community.............................................................................. ..32 Difference between Service Providers and Community Members and Implications .................................33 COMMUNITY MEETING ............................................................................................................. ...........35 The Event......................................................................................................................<br><br> ..............................35 Outcomes....................................................................................................................... .............................37 RECOMMENDATIONS................................................................................................................ ............39 Appendix A: Interview Guides, and IRB Fact Sheets.............................................................................<br><br> ...42 A1: Community Member Interview Fact Sheet..................................................................................... ....43 A2: Service Provider Interview Fact Sheet..................................................................................... ...........45 A3: Community Member Focus Group Fact Sheet...................................................................................<br><br> .48 A4: Community Member Interview Guide.......................................................................................... ......49 A5: Service Provider Interview Guide.......................................................................................... .............51 A6: Community Member Focus Group Guide ........................................................................................<br><br> ...53 A7: Referral Script........................................................................................................... ..........................55 Appendix B: List of Interviewees.............................................................................................. ................56 A8: List of Interviewees......................................................................................................<br><br> .......................57 Appendix C: List of Secondary Data Sources ................................................................................... ........58 A9: Secondary Data Sources .................................................................................................... ..................59 An Action-Oriented Community Diagnosis of Cedar Grove iv Appendix D: Community Meetings Materials.......................................................................................<br><br> .....60 A10: Community Meeting Flyer................................................................................................... ..............61 A11: Community Meeting Invitation.............................................................................................. ............62 A12: Community Meeting Agenda..................................................................................................<br><br> ...........64 A13: Community Meeting Fact Sheet ............................................................................................. ...........65 A14: Themes selected by community members...................................................................................... ...66 Appendix E: IRB Approval Letter................................................................................................<br><br> ..............67 Appendix F: Tables............................................................................................................. ........................68 A16: Services at Northern Orange............................................................................................... ...............69 Appendix G: Miscellaneous&&&&&&&&&&&&&&&&&&&...&&&&&&&..&&&70 A17: Names of Community-driven Clubs in Cedar Grove&&&&&&...&&&&&&&&&&...&71 A18: Data Analysis Spreadsheet&&&&&&&&&&&&&&&&&&&&&&&&&&&..&72 A19: Complete List of Themes&&&&&&&&&&&&&&&&&&&&&&&&&&&&....73 An Action-Oriented Community Diagnosis of Cedar Grove v Abbreviations and Alternative Names used in this Document CAT Coordinated Agency Transport CBPHI Community Based Public Health Initiative JOCCA Joint Orange/Chatham Community Action Northern Orange Human Services Center Northern Orange Center OPT Orange County Public Transportation TIME Teens Influencing the Minds of Everyone An Action-Oriented Community Diagnosis of Cedar Grove 1 INTRODUCTION How We Define Cedar Grove Over the course of the past seven months, our definition of Cedar Grove has changed from vague physical descriptions to friendly personal stories.<br><br> When first told we would be working in a place called Cedar Grove, we were very unclear about what this meant. Since none of us are from North Carolina, we had limited knowledge of life outside of Chapel Hill. Outside sources informed us that Cedar Grove was relatively rural and had a changing population.<br><br> We also heard something about an old school used by the community and a burned out church. As we started to work in the community, our challenge was to define for ourselves where Cedar Grove began and ended physically. After our first driving tour, we made the following comments: cThe town intersection was a lot smaller than I thought.<br><br> Basically, it was a four way stop with two corners empty& d cIt also seemed to be VERY spread out with no common gathering area. d cCedar Grove did not appear to have clear boundaries, although there was a sign announcing the town limits as we entered from the south. d cThe surrounding area was rural, including farmland, cattle and chicken ranches, a number of stables, several home-based businesses (mostly automotive services), modular homes, and a few large stately two-story homes. d cWe passed the post office and then Cedar Grove United Methodist Church. (The church that burned down sometime after Christmas last winter.) d As evidenced by the comments above, we struggled to define even the center and boundaries of this township. However, over the past seven months, our definition of Cedar Grove has broadened beyond mere physical characteristics to include an appreciation of the richness of history and community life in the area.<br><br> We understand now that Cedar Grove is defined in part by established families that take pride in self-reliance and community service. It An Action-Oriented Community Diagnosis of Cedar Grove 2 is defined by the presence of a strong social network of community members anchored by churches that dot the landscape. It is defined by its remote location in northern Orange County, far from the bustle of the more affluent and influential center of Chapel Hill to the south.<br><br> Cedar Grove is also defined by the inevitable changes brought on by growth occurring throughout the Triangle Area. Our personal definition of Cedar Grove now must also include our personal experiences in the community. Although we are far from being insiders in Cedar Grove, talking with community members has allowed our definition of the community to go beyond just the physical characteristics and be transformed by personal stories.<br><br> For example, instead of picturing Cedar Grove as a rough geographic circle or zip code on a map, we now say: cOh that is where ( ) lives. She has really worked hard in the community. She is a great example of the characteristics that so many people in Cedar Grove admire. d cRemember the story ( ) told us about the Old Cedar Grove School&? d cWasn 9t it great to see everyone talking about the concerns in the community? d cWhen I was at the softball game Tuesday I said hi to (___________) and we had a great conversation. d Overall, Cedar Grove is a quiet rural area, where residents enjoy living.<br><br> The area is rich with the history and traditions of many generations. Although many new residents have come to Cedar Grove, it has not lost the close rural feeling often described by community members. In fact, one of our team members has thought of moving to Cedar Grove, explaining, cIt might just be what I 9ve been looking for. d Our assignment was to get to the heart of what it is like to live in Cedar Grove 3 to find out what the strengths of the community are, as well as the challenges.<br><br> We started with a review An Action-Oriented Community Diagnosis of Cedar Grove 3 of secondary data documents and a driving tour of the area. Through participation in several community events, we were introduced to individuals who are familiar with Cedar Grove and began a process of interviewing. Both community members and service providers were interviewed in order to gain both an insider and outsider perspective of the community.<br><br> Since our introduction to Cedar Grove back in November, we have interviewed over 30 people 4some long time community members, some newcomers, and some service providers who work with families in Cedar Grove 4and talked informally to many more. Geography Described by community members as cGod 9s country, d Cedar Grove is a pastoral township approximately 12 miles across, located in the northern half of Orange County, North Carolina. It is equally close to Person and Caswell Counties on the north side, Alamance County on the west side, and Durham County on the east.<br><br> The next closest town is Hillsborough, which lies 8 miles to the south. The community contains parts of three watersheds: Back Creek, Little Creek, and the Upper Eno River, the last of which is part of the reservoir that serves Hillsborough. Residents must use wells to get drinking water and septic systems to dispose of wastewater.<br><br> The majority of the land is used for agriculture and dairy farming; however, some of the large landowners of Cedar Grove have recently sold land to developers, in response to the growth in the population. History Cedar Grove originally began as a settlement for Scottish and Irish Presbyterians, German Methodists, and Quakers. This diverse mix opened their own churches in the middle of the 1700 9s and began dairy and tobacco farming.<br><br> There was a rise in gristmills as well as sawmills to process wood from trees cleared to create farm fields (Bull et al., 1993). Africans An Action-Oriented Community Diagnosis of Cedar Grove 4 were brought to Cedar Grove towards the end of the 1700 9s to work as slaves on the farms run by Caucasian settlers. When slaves were freed and allowed to own land, they remained in the area, resulting in the Caucasian and African American landowners that currently reside there (Bull et al., 1993).<br><br> The family farms and the strong church community contributed significantly to the history of Cedar Grove. As a result, harvest festivals and church outings are central to the social fabric of the township and are a large part of the daily life and activities of its residents. Recently, the farming industry has gone through a series of changes and many farmers have transitioned out of tobacco in order to make ends meet.<br><br> Demographics Cedar Grove has a population of 4930 (U.S. Census Bureau, 2002). The age, gender, ethnicity, and income of this population help define characteristics of the community that distinguish it from the rest of Orange County.<br><br> Age 4Although all ages are represented in Cedar Grove, a large proportion of the community is aging and moving out of the workforce. Not only does this change the services needed in the area, but the leaders who previously took part in organizing the community are no longer able to be as active. Therefore, there is an expressed need for the younger population to learn from their elders and take on new roles in the community.<br><br> Unfortunately, much of the younger generation that grew up in Cedar Grove is moving away and newcomers are replacing them. The increasing age of many long-time community residents may impact the future of Cedar Grove. An Action-Oriented Community Diagnosis of Cedar Grove 5 Gender 4While interacting with community members, we observed that both men and women fulfill roles that help meet the needs of the community.<br><br> Both are active in community planning, church, and the development of community activities. When asked to identify other community leaders for future interviews, both men and women provided names across gender and race. Nevertheless, those individuals repeatedly identified as community leaders and as being "involved" are women.<br><br> These women play a central role Cedar Grove's community life. Ethnicity 4 According to the U.S. census, the population of African Americans in Cedar Grove has decreased over the past ten years while the Caucasian population has increased (U.S.<br><br> Census Bureau, 2002). However, Cedar Grove still has the highest proportion of African Americans in the county and we found no evidence from our interviews that the African American community is leaving Cedar Grove (U.S. Census Bureau, 2002).<br><br> Nevertheless, there has been considerable growth in the area, bringing in primarily Caucasian professionals who live in Cedar Grove and work in Research Triangle Park (RTP) and Durham. Due to conflicting reports, it is unclear how many Latinos live in Cedar Grove, although the most recent census indicates the number to be under 200 (2002). While many Latinos use services at the Northern Orange Human Services Center, not many actually live within the limits of the township, with the exception of some living and working on farms.<br><br> People describe the interactions between African Americans and Caucasians as friendly, although most of the time there is not a lot of interaction between the two groups. The main housing communities, churches, and convenience stores are divided along racial lines. However, these two groups have come together in the past to solve common problems, benefiting the community of Cedar Grove as a whole.<br><br> An Action-Oriented Community Diagnosis of Cedar Grove 6 Income 3 The role income plays in the community is difficult to determine, since not all income levels were represented by interviews. According to the 1990 U.S. Census, the median annual income of Cedar Grove was $30,000 per household in 1989, with approximately 10% of individuals living below the poverty line at the time.<br><br> Median income for the state of North Carolina at the time was $26,500 per household with 13% of individuals living below the poverty line (U.S. Census, 1990). Data on income from the 2000 Census was unavailable at the time this document was written.<br><br> Economics Many described Highway 85 as the cdividing line between the haves and the have-nots d (Orange County Healthy Carolinians Task Force, 1996). The transition from farming tobacco to other types of crops, combined with the closing of textile mills and other sources of employment, has hit the northern part of the county hard. Meanwhile, office and service industry work are increasing in areas surrounding Cedar Grove.<br><br> Consequently, whereas farming used to be a main source of income, the selling of land for development and working outside the community in non-manufacturing jobs has increased dramatically over the past 15 years. Today, less than 1% of the jobs in Orange County revolve primarily around agriculture, and there is evidence that the farmers in Cedar Grove work other jobs in addition to farming in order to make ends meet. In a recent article in the North Carolina Farm Bureau, one farmer from Alamance County summed up the issue by stating: The majority of small farmers have public jobs to help make ends meet.<br><br> On the other end of the spectrum are large farmers who invest millions of dollars in land and equipment, only to make an annual income in the $30,000 range. But the medium-size farmer is really stuck because he doesn 9t have the time for an off-farm job and he can 9t make enough money in farming to survive (Street, 2002). An Action-Oriented Community Diagnosis of Cedar Grove 7 This type of situation is true for many farmers in Northern Orange County and in Cedar Grove specifically.<br><br> Education According to community members, educational opportunities need to reflect the shift from farming into the commercial and business sectors. Therefore there is a need for more skills development opportunities, such as computer classes. Currently there are no schools in Cedar Grove.<br><br> Residents of Cedar Grove attend schools in surrounding towns such as Hillsborough, Chapel Hill, Durham, and Efland-Cheeks. Since there are no schools in Cedar Grove continuing education classes are limited and difficult to access. METHODS Methods of Gathering Data The primary method of gathering information was through qualitative interviewing.<br><br> A total of 32 individual community members and service providers participated in interviews or a focus group (See Appendix B). Prior to conducting any interviews or the focus group the team received IRB approval # 01-1527 (See Appendix E). This means that a panel of experts from the UNC-Chapel Hill School of Public Health has reviewed this project and feels that individuals participating were safe from harm.<br><br> Copies of the Fact Sheet used to obtain consent can be found in Appendix A. Other methods included reviewing secondary data documents (See Appendix C), touring the community and attending community events. An Action-Oriented Community Diagnosis of Cedar Grove 8 Documents Reviewed The student team reviewed a total of eight secondary data documents (See Appendix C).<br><br> In this section a brief summary will be provided as to why the secondary data documents were reviewed. The first two documents reviewed were from a community diagnosis done by a previous student team: c1992 Secondary Data d and c1992-1993 Action Oriented Community Diagnosis of Cedar Grove. d These two documents summarized the experience of the previous student team that worked in Cedar Grove. Not only did this help us develop an idea of what it was like for students to work in Cedar Grove, it also allowed us to have an overview of the Action-Oriented Community Diagnosis process.<br><br> The secondary data document was not as helpful as the final community diagnosis document because it contained a lot of county and state data, which does not accurately represent Cedar Grove. Next, cThe 1996 Healthy Carolinians 4Orange County Community Health Assessment (Preliminary Report to the Orange County Health Department and Healthy Carolinians Task Force) d and cThe 2000 Orange County Health Department and Healthy Carolinians of Orange County Community Assessment d were reviewed. Although it was interesting to read these documents, again, the secondary data did very little to help develop a picture of the historical or current state of Cedar Grove.<br><br> Consequently, these documents were mainly reviewed as an introduction to the project and to provide some basic background of Orange County. The 1990 Census and 2000 Census are online and can be searched by county subdivision. This allowed us to obtain background information such as family size, income, population, and average price of homes in Cedar Grove.<br><br> This secondary data source was used to provide us some sense of what to expect when we went into the community. An Action-Oriented Community Diagnosis of Cedar Grove 9 The two most helpful secondary data sources were not found until later in the process. These were cThe Community Based Public Health Initiative (CBPHI) d document, and the cTask Force Report for Northern Orange Human Services Center .<br><br> d These documents provided information specific to life in Cedar Grove. The CBPHI project, similar to the community diagnosis process, helped identify community needs and resources. Although created some years ago, concerns identified in this document are still relevant to the community today.<br><br> This document also provided us with a list of key community leaders who were previously very active in the community. cThe Task Force Report for Northern Orange Human Service Center d summarized Orange County 9s current assessment of and future plans for the building and the surrounding land. In addition to more formal secondary data documents, the team also read the weekly News of Orange newspaper.<br><br> This newspaper allowed the team to stay current with community events and identify key leaders in the community. Development of Interview Guides Prior to conducting interviews, the team developed interview guides for service providers, community members, and focus groups (See Appendix A). The guides were developed after reviewing the first four secondary data documents, examples of guides used by student teams in the past, and from our initial tour and visits in the community.<br><br> A pre-test was performed with both a service provider and a community member. Feedback on the type of questions, layout, and general flow of the interview was obtained and revisions were made based on the suggestions given. In addition, throughout the process the interview guides were further revised according to the background of the interviewee and the team 9s changing information needs.<br><br> An Action-Oriented Community Diagnosis of Cedar Grove 10 Recruitment Process The student team was introduced to the community through a guided tour provided by an African American service provider. During this tour, the student team had the opportunity to visit with members of Lee 9s Chapel during their Annual Thanksgiving Senior Fellowship. In addition, the student team attended the Annual Harvest Festival hosted by the Cedar Grove United Methodist Church at the Ruritan Club.<br><br> Through these initial encounters, we were introduced to many leaders of the community, who provided us with contact information for key community members and service providers to interview. From the initial interviews, a referral system was used to obtain the names of additional community members and service providers to interview. To do this, the interviewee was given a sheet (See Appendix A) with scripted text explaining the community diagnosis process and was asked to call recommended individuals to obtain their permission to be contacted.<br><br> During this beginning phase, the team attempted to contact all of the people on the referral lists. As the number of referral lists grew, the team contacted only those individuals who were mentioned multiple times. Through this process, we gained access to mostly long-time residents of Cedar Grove, many of whom are part of families that have been in the area for generations.<br><br> Although there are many newcomers, they are often not considered to be part of the cCedar Grove community d by either African Americans or Caucasians with strong ties to the area. In addition, the majority of interviewees were women. Women community members were more often available for interviews and service providers were more likely to be women.<br><br> Furthermore, since there are limited services offered in Cedar Grove, a large percentage of the service providers interviewed were also community members. Although interviewing An Action-Oriented Community Diagnosis of Cedar Grove 11 people that played this dual role in the community gave us a unique and interesting perspective, the lack of interviews with decision makers at the county level may have prevented us from gaining a clear view of how Cedar Grove is seen in the larger context of county and state political processes. Interviews For individual interviews, one team member would conduct the interview, while the second team member took notes.<br><br> If permitted, the interview was audiotaped. Afterwards, the two team members discussed the contents of the interview. This conversation allowed us to reword or add questions for future interviews, give feedback on interviewing skills, and clarify or highlight main points of the interview.<br><br> After each interview the note taker listened to the audiotape and transcribed the interview. The note taker was able to produce clear notes that contained the full contents and context of the interview. Data Analysis Process In order to interpret the information gathered during interviews and focus groups, the student team developed a data analysis process.<br><br> Once the interview was transcribed, a non- interviewer/note taker and the interviewer were assigned the primary data analysis of the interview. In this process, the responses of each interview were divided into discrete segments, which were each assigned one or more codes. The data analysis was organized on an excel spreadsheet (See Appendix G).<br><br> The initial codes that were obtained from the interview guide questions and secondary data (deductive coding) were: community life , growth, employment , recreation , the community meeting , and community resources, church, transportation, source of information . During the interview and data analysis process, additional topics that became apparent were added to the An Action-Oriented Community Diagnosis of Cedar Grove 12 spreadsheet (inductive coding). These codes were agency, problem solving , community issues , social life , and group divisions .<br><br> Each code was clearly defined. After the primary data analysis was completed, the interviewer reviewed the contents for accuracy and provided feedback on the appropriateness of the coding. The two team members then met to compare and combine their individual analyses.<br><br> After eight interviews were analyzed, it was clear that the interviewer and the additional primary data analysis person were coding interviews similarly. Consequently, it was determined that two team members were not needed to complete the data analysis process. Therefore, the remaining data analysis was assigned to one non-interviewer/note taker.<br><br> Although this method worked better for the team, it may have added bias to our results because the perspective of two individuals was not longer used. The individual spreadsheets were then combined into one large excel workbook, in which the data were sorted according to codes. For example, all the information related to recreation was placed in one excel sheet, while all the information related to transportation was placed in another.<br><br> Information that was related to more than one topic, and consequently double or triple coded, was duplicated and sorted accordingly. While combining the spreadsheets the data was reviewed to ensure that all of the interviews had been coded consistently. Once the data analysis was sorted into the appropriate codes, the team assigned topics to each team member for aggregate data analysis by the following groups: 1) community/social life , community resources , and agency 2) recreation , employment , and political climate 3) problem solving , issues , church , and group divisions 4) transportation , sources of information , growth , and the community meeting .<br><br> An Action-Oriented Community Diagnosis of Cedar Grove 13 Each member of the team reviewed their code sheets, and developed a corresponding summary sheet. The summary sheet was subdivided into main points, themes, and relevant quotes for each of the perspectives: 1) community members, 2) community members/service providers, and 3) service providers. At the end of the summary sheet, information relating to future directions as well as a paragraph synthesizing the information in the summary sheet were included.<br><br> The final result was a summary sheet for each code that provided the team with detailed and appropriate information to discuss relevant themes that appeared during the interviews and focus group. The team met together to review each summary sheet and transformed the information related to each code into relevant themes. This process was important because a theme is different than a code in that it makes a statement about a particular issue.<br><br> For example, for the code crecreation d, the initial theme developed was: cthere are not enough opportunities for recreation in Cedar Grove. d The themes that were mentioned several times were chosen and cut out of the summary sheet and placed in a pile. Initially 42 themes were selected, but after sorting them into like piles, 19 relevant and representative themes were identified (Appendix G). These 19 themes were then brought to service providers and community members to review and sort, a process that is explained in more detail in the community meeting planning process.<br><br> Planning of Community Meeting In order to present the community with the most important themes gained through the AOCD process, a community meeting was organized. The idea behind this meeting was that the presentation of the themes along with the different perspectives of community members and service providers would encourage community members to take action. To plan for the An Action-Oriented Community Diagnosis of Cedar Grove 14 community meeting we asked for input from both community members and service providers in a variety of ways.<br><br> First, at the end of every interview we asked people for advice about where and when to hold the community meeting, how to get people to come, and how and where to advertise. We also held two planning meetings in Cedar Grove, to which we invited a combination of service providers and community members. Finally, because we were concerned about low attendance at the planning meetings, we asked a community member to invite a few community leaders to her home for a brief planning meeting.<br><br> After compiling all the suggestions that people had given us about the community meeting during interviews, the team chose a date, time, and location. Among the interviewees, there seemed to be a consensus that the Northern Orange Center would be a neutral and convenient place to hold the meeting. They also felt that having the meeting at 7 pm on a weeknight other than Wednesday would increase the likelihood that community members would be able to attend.<br><br> We tried to form a planning committee for several reasons. First and foremost, we wanted to make sure that the meeting would be useful to Cedar Grove residents and felt we would not be able to achieve that goal without involving community members in the planning process. We needed input on which themes would be presented and discussed at the community meeting.<br><br> Also, feeling that community members would be more receptive to hearing about issues in Cedar Grove from their fellow neighbors, we hoped that some of the planning committee members would be interested in helping present our findings to the community. Furthermore, from our interviews it was clear that word of mouth would be the best way to advertise the meeting. We hoped that planning committee members would be able to help us An Action-Oriented Community Diagnosis of Cedar Grove 15 activate that informal communication network.<br><br> Last, we hoped that the planning committee would work with our preceptor to follow-up with community members and service providers after the meeting to support people in taking action on the issues addressed at the meeting. Despite our efforts, we were not entirely successful in forming a planning committee. Finding a time that worked for people was extremely difficult.<br><br> Although evenings were the best time to hold the planning meetings for community members, they were not convenient for service providers. Also, leaders in the community often had evening obligations such as classes, church activities, civic group meetings, etc. Because we could not identify a time and day that worked for the majority of the group, we decided to cancel the first meeting because a low turnout was anticipated.<br><br> We tried to reschedule it for a cbetter d time, but without much luck. Two community members and our preceptor were present at the first meeting. That evening we talked about what a community meeting meant to them, how to advertise, and how to involve the county at the meeting.<br><br> Based on that discussion we decided to call it a ccommunity meeting. d We presented a few flyer designs, and based on their feedback the final version of the flyer and invitation was created. (See Appendix D). It was also decided that we would ask one representative at each of the churches if they would be willing to be the person listed on the flyer to contact for more information about the community meeting.<br><br> We hoped that this would increase community ownership and lend credibility to the meeting. We provided those individuals with customized flyers that listed their name and phone number and a short description of the meeting to read during church announcements. Our preceptor and another service provider attended the second planning meeting.<br><br> We had hoped to select the themes to be discussed at the community meeting that evening, but did not feel comfortable doing so without community members present. Instead, we discussed how An Action-Oriented Community Diagnosis of Cedar Grove 16 the county should be involved in the community meeting and logistics, such as distribution of the flyers and invitations to service providers. We also had both service providers do a pile sorting activity where they grouped the themes into appropriate categories.<br><br> They also provided feedback about the themes we had selected. After the second planning meeting, and with the community meeting quickly approaching, we still needed to choose which of the nineteen themes would be presented to the community and discussed at the community meeting. A team member spoke with one of the community members that came to the first planning committee about our dilemma.<br><br> She graciously offered to pull together a few neighbors who are long time Cedar Grove residents and community leaders. Two team members met with this group of five community members at one of their homes. At that meeting, through a pile sorting activity, the eight final themes were chosen.<br><br> Because we wanted a broad representation of community members to attend the community meeting, the team felt it was important to provide transportation and childcare. OPT agreed to bring any community members needing transportation to and from the meeting, which was advertised on the flyers. We also made arrangements for two volunteers to provide childcare.<br><br> Neither of these services was utilized. Advertising consisted of flyers distributed at local churches and posted at the Northern Orange Center and local stores, church announcements, word of mouth, reminder phone calls made by team members, and invitations mailed to approximately 100 people. Invitations were sent to all the community members and service providers with whom we had contact as well as past members of Voices of Cedar Grove and selected county officials.<br><br> An Action-Oriented Community Diagnosis of Cedar Grove 17 Personal Perceptions and Assumptions Our personal perceptions and assumptions influenced the entire process described above. In the beginning, as a group of Caucasian graduate students from distant parts of the country studying at UNC Chapel Hill, we were concerned about how the community would perceive us. Before we entered the community we had a long discussion about how we should introduce ourselves.<br><br> We decided on: cWe are here to see what 9s working well in the community and what could be better, d assuming that we would have control over what was said. Despite that discussion, we were introduced as students from UNC, doing a project in Cedar Grove, learning how to work with communities. Another aspect of the process impacted by our perceptions was the method of recruitment.<br><br> For example, we were introduced to the community through Lee 9s Chapel. However, we did not take full advantage of the networks that the church offered because we felt that it was necessary to go outside the church for a more diverse sample of the community. The process of gaining entry into the community might have been smoother if we had followed-up on the contacts that we initially made.<br><br> Our own personal perceptions and assumptions had an impact on the interview process as well. Although detailed guides were developed to aid us in conducting interviews, the type of follow up questions and the direction of the interview often depended on the interest of the interviewer. Because of this, information important to the community might have been overlooked.<br><br> As an outsider, understanding what information is relevant is often a difficult task. Also, after completing the interviews, we realized that it might have been helpful to develop an interview guide for interviewees that were both community members and service providers, since often a combination of the two guides was used. An Action-Oriented Community Diagnosis of Cedar Grove 18 In addition to the interviews, the data analysis process also might have been biased.<br><br> During the planning for the community meeting, it was interesting to observe how community members grouped the major themes we had chosen from the data. They were able to make connections between the themes that never would have been proposed by outsiders. Based on this experience, we think it would have been very helpful to include community members earlier in the data analysis process.<br><br> Having input from community members throughout the process would have reduced the influence of our perceptions as outsiders on the analysis and results. THEMES The following is a summary of the eight themes prioritized by community members. Each theme is discussed from the perspectives of community members, service providers, and community member/service providers.<br><br> The congruence and/or disconnect between these perspectives are also discussed. Theme 1: Does the community need to use the Northern Orange Center more to have services increased? Or, do services need to be increased for the community to use the Northern Orange Center more?<br><br> Actually, I 9ve never seen it used to its fullest extent. I don 9t know why. 4Service Provider What is now the Northern Orange Center was built in 1951 as an African American elementary school in response to the overcrowding of the Hillsborough High School for Negroes.<br><br> It was the first elementary school for African American children in Orange County, but was closed down when integration occurred in North Carolina. The county acquired the building in 1977 to provide services to Cedar Grove and the surrounding areas of Northern Orange (Ruffin- Villines, 1998). An Action-Oriented Community Diagnosis of Cedar Grove 19 Over the years, agencies such as Joint Orange Chatham Community Action (JOCCA), Cedar Grove Day Care, and Orange County Parks and Recreation, also began offering services in the old school.<br><br> The building became an example of how a rural community can use an existing structure for the provision of services. The table below (Table 1) provides a description of the programs now operating at the center. Appendix F contains a copy that can be used for further reference or photocopying.<br><br> Table 1 Cedar Grove Day Care The Cedar Grove Day Care Center was opened in September of 1981. Its purpose is to provide high quality educational and daycare programs to families of Northern Orange. Agencies provide subsidies in order to make daycare affordable to parents.<br><br> These agencies are Child Care Services Association, The Orange County Department of Social Services, and the Chapel Hill Outreach Early Head Start program. The Center serves infants and children from 0-5 and has a total of 31 spaces. Durham Technical Community College Durham Tech provides computer classes in one room at the Northern Orange Center.<br><br> The computers were donated by Orange County. Classes are usually held once a week for 10 weeks at a time. The Family Resource Center The Family Resource Center provides skill training, early childhood education, and assistance to families from the surrounding area.<br><br> Head Start Head Start has programs for children aged 3 to 5 years of age. However, Head Start will be moving out of the building and the programs for the younger children will be shifted to the daycare facilities. JOCCA Joint Orange Chatham Community Action (JOCCA) provides activities for seniors from 9am until 1pm daily.<br><br> Crafts are offered two days a week, exercise classes two days a week, and shopping trips on Fridays. Lunch is provided daily. Transportation to the center is available from Orange Public Transportation (OPT).<br><br> (More information about programs and schedules is available at the JOCCA webpage: http://www.co.orange.nc.us/aging/cedar.htm) Orange County Parks and Recreation Recreation and Parks is responsible for the maintenance of the building and the upkeep of the surrounding fields. They also run sports activities throughout the year such as baseball, softball, and basketball. While this is a long list of services, the question is: why aren 9t more Cedar Grove residents using them?<br><br> Each type of person we asked (community members, service providers, An Action-Oriented Community Diagnosis of Cedar Grove 20 and those who are both service providers and community members) had slightly different perspectives on this issue. When asked about services in Cedar Grove, community members infrequently mentioned the Northern Orange Center. Instead, they spoke mostly of community-driven civic clubs such as Teens Influencing the Minds of Everyone (TIME), 4-H, the Hillsborough Sertoma Club, and the Ruritan Club.<br><br> (Names of other community-driven clubs that were mentioned to the student team are located in Appendix G). When asked specifically about the Northern Orange Center, it was clear that the center does not have consistent name recognition in the community. The official name of the center is the cNorthern Orange Human Services Center. d However, people in the community call it cthe old school on Highway 86 d or cNorthern Orange Center d or cthe Resource Center. d Furthermore, some do not know what services are offered.<br><br> Others complain that the services are inconsistent and troublesome to use. There is also a belief that agencies do not offer services at the center or are understaffed and under resourced because the center is too far from the more populous and more politically influential southern part of the county. Community members feel that in order for the community to take an interest in the building, they have to see that the county is willing to provide needed resources.<br><br> This raises an important question: does the community have to show more interest before the county brings in resources or does the county need to bring in resources in order to generate community interest? According to service providers, the county has made efforts to make better use of the building. In November of 1999, the Northern Orange Human Services Task Force was created.<br><br> They conducted a community survey in January of 2001, which was administered by the staff of the Family Resource Center in order to assess community needs. These findings were shared An Action-Oriented Community Diagnosis of Cedar Grove 21 with Durham Technical Community College, the Skills Development Center, and Public Works and resulted in providing computer classes at the center and future plans for El Centro Latino to provide services to the Hispanic community. Yet, service providers also acknowledge that the county has not yet followed through on promises to restore the building or put in a new park.<br><br> Updates have been made to the building including new fluorescent lighting, a new roof, and an alarm system, but these changes are seen as minor. As one service provider put it, cSome people think that if they patch a hole in a wall they are satisfied instead of knocking the whole wall down and rebuilding it. d Service providers also cited a lack of community interest as another obstacle to bringing in more services to the Northern Orange Center. They are not sure if Cedar Grove residents will actually use these services.<br><br> There is a sense among service providers that people in the community do not push for the resources, do not take ownership of the building, and wait for the county to come in and change things. Service providers who are also community members have a somewhat different perspective on the use of the Northern Orange Center. In their opinion, one of the main reasons that people do not use the center is that they do not know about the services offered.<br><br> In addition, they mention a shift in focus of some programs. For example, the Family Resource Center was originally started as part of the Community Based Public Health Initiative to assist families from Cedar Grove, Efland, and Perry Hill. Since hiring a bilingual provider, it has become better able to serve the growing Latino community in the area.<br><br> Those who make use of the Family Resource Center are now almost exclusively Latino families who live outside the township. This change seems to have discouraged some local non-Latinos from using the Family Resource Center's services. An Action-Oriented Community Diagnosis of Cedar Grove 22 While all of these perspectives are important in determining the reasons why services are not utilized, the main obstacle to increasing the services offered at the Northern Orange Center is the condition of the wastewater treatment system.<br><br> It is estimated that the system has the capacity for 2400 gallons per day, but is actually experiencing 3500 gallons per day (Northern Human Services Center Task Force Report, 2001). While it is functioning properly, the continued overuse of the system will impact how well it functions in the future. The county is in the process of acquiring suitable land necessary to expand the system because it is necessary that the soil cperk d in order for the septic system to work properly (Water and septic issues are more fully described in Theme #4).<br><br> Therefore, a lack of publicity about programs, a shift in focus of some of the programs, and septic problems all affect the level of use of the Northern Orange Center by the community. Theme 2: Cedar Grove would like county resources to address problems that have already been identified. About 10-12 years ago, all of the agencies got together to talk to the county about the building, but nothing happened.<br><br> I just don 9t see how the building is serving the community. 3 Service Provider As stated in the previous section, the county has made promises to the community in terms of the resource center and other community needs. Service providers speak of the county measuring the windows they never replace, assessing ceilings that remain untouched after 30 years, and asking people time and time again about what they need at the center.<br><br> Many people feel that their needs have been clearly expressed to the county and are tired of expressing them again and again, feeling that no action will follow. One of the ways in which the community expressed their needs was through the Community Based Public Health Initiative (CBPHI). The CBPHI deserves special mention An Action-Oriented Community Diagnosis of Cedar Grove 23 because through its efforts, community members not only came together to discuss the strengths and needs of Cedar Grove, but they translated those discussions into community action.<br><br> The CBPHI ran from 1992 until 1997 at the Mt. Zion AME church, an active African American church in Cedar Grove. Funded through a Kellogg Foundation grant, it involved the UNC School of Public Health and the Orange County Health Department in training community members to organize and take action.<br><br> Many Cedar Grove residents came together in effective community action and produced several tangible results, such as: 1) the signs at either end of Highway 86 that say cWelcome to Cedar Grove Township d, 2) an annual Oktoberfest, and 3) the creation of the Family Resource Center. In addition to these results of the CBPHI, during the same time frame there was a lot of additional organizing through the Community Voices Program. Voices was a training program through Cooperative Extension and North Carolina A&T State University to develop community leaders.<br><br> Because of these programs, many community members feel that service providers should already be informed of what the needs of the community are. However, many service providers are either not informed of these issues or are unsure about whether the community will use new services offered. One main concern of the county is that resources will be put into the building and no one will use the new services.<br><br> One service provider stated their concern by asking, cIf we build it, will they come? d Therefore, task forces and extensive research are essential for the county to feel assured that people still have an interest in using the building. For example, based on the need to provide more resources to Northern Orange, a task force worked on developing a bond referendum to set aside funds for parks, schools, senior center, and affordable housing in Orange An Action-Oriented Community Diagnosis of Cedar Grove 24 County. This bond was passed in November 2001, which included money to make improvements to the Northern Orange Center and the surrounding land.<br><br> The Northern Orange Human Services task force was instrumental in helping to recommend that the bond referendum address both facility development and parkland acquisition, including a new park at the Northern Orange Center. Despite the passing of the bond, most community members are not currently informed of the county 9s plans and were interested in hearing more about the future of the Northern Orange Center and the 1.2 million dollars that has been set aside for a new park at the Northern Orange Center. (Aspects of the bond and how it will affect Cedar Grove are further discussed in Section 4.) Theme 3: Cedar Grove has a need for more recreation for all ages.<br><br> There 9s nothing out here. You know what I 9m saying. The only thing I see happening out here is people moving out here.<br><br> In Chapel Hill, you probably have all sorts of things to do. I like the area because it 9s quiet 4but there 9s nothing to do. There 9s not a lot of commotion.<br><br> 4Community Member When team members asked the question of community members, cWhat do people in Cedar Grove do for recreation? d the most common response was laughter, followed by a general statement that there are no recreational activities in Cedar Grove. Some community members cite the location of Cedar Grove and the attitude towards recreation as issues that contribute to the lack of recreation. cWe don 9t have much out here, d one community member said.<br><br> cWe 9re not big activity people. d However, the actions of the community seem to suggest that there are cactivity people d in Cedar Grove. There are some church-run and community-driven recreation efforts in the community. There are exercise classes at Mt.<br><br> Zion AME church and at the Northern Orange Center. There is a recreation club for youth and adults. There is the Golden Age Club for seniors.<br><br> An Action-Oriented Community Diagnosis of Cedar Grove 25 There are baseball and softball games organized at the Ruritan club, the Northern Orange Center, and at surrounding churches. Still, community members would like to have more activities for residents of all ages. Most community members are in favor of a new park in Cedar Grove where residents would have an opportunity to walk and exercise without feeling unsafe on the side of the highway.<br><br> Service Providers agree with community members on this point. They feel that not enough opportunities for recreation exist in Cedar Grove, citing the rural location and lack of available space as contributing factors. For instance, since many of the houses are located along the highway, there is a lack of safe places for children to play.<br><br> Most mention the Northern Orange Center as a resource, but state that there is currently not enough space for activities. Most community members agree that children have to go outside Cedar Grove for most recreational activities. Some community members feel that this contributes to youth leaving the community altogether.<br><br> Service Providers who are community members agree on this point as well. cYou find that there 9s not much for the youth in the community and they leave, d one community member/service provider stated. cThey don 9t bother to come back. d In addition, they are concerned that the lack of recreation for youth has contributed to an increase in drug use in the community.<br><br> Theme 4: Water and septic system restrictions limit development in Cedar Grove, which affects many aspects of the community. The structure of it is really, really good, it 9s just that it needs a larger septic tank system 4Service Provider Water in general is a particularly interesting topic in Cedar Grove. For example, there is a reservoir located within the township, but it is a water source for the town of Hillsborough, not the township of Cedar Grove.<br><br> This sparked a great deal of controversy in the community because An Action-Oriented Community Diagnosis of Cedar Grove 26 the county bought a substantial amount of community member-owned land to build the reservoir, yet community members do not benefit from the new water source. cJust a few miles across, west of here, there is the water reservoir, d a community member said. cBut Cedar Grove can 9t get the water.<br><br> I wish we could get the water and the sewer. d In addition, the acquisition of the land was also controversial. According to community members, the land where the reservoir was built was condemned and bought at prices below market value. The landowners of Cedar Grove sued the county to get a fair price for the land and won several of the lawsuits.<br><br> cThere is still tension about that, d stated one community member. cHillsborough had water problems, so they built a reservoir out here. d According to another, it is also affecting some of the community members who live near the reservoir. I know some of the people who are out that way and are not going to be able to use their basements anymore.<br><br> Now they have to build a garage. It 9s awful to think that you bought your house on a spot because you liked it and now it 9s changed because of the reservoir. Well water and septic systems are major issues in Cedar Grove.<br><br> All of the water supply for businesses and houses comes from wells fed by the Eno Riverbed. The wastewater is then treated by local septic systems instead of going through a wastewater treatment plant. While researching this topic, a service provider working for the county informed us that Cedar Grove is in a location that makes sewage disposal very difficult.<br><br> Existing treatment centers are uphill from the community, which means that for Cedar Grove to be part of the sewer system, wastewater would need to be pumped uphill at great expense. Septic systems are a logical alternative in Cedar Grove, but finding a location can be difficult because the soil is not uniformly suitable and cdoesn 9t perk d according to both service providers and community members. An Action-Oriented Community Diagnosis of Cedar Grove 27 The limitations presented by Cedar Grove 9s dependency on well water and septic systems are far-reaching.<br><br> According to community members, these restrictions prevent new services and businesses from becoming established in the township. Consequently, people must often go outside the community to work, do business, or obtain services. Without adequate public transportation, finding employment or performing necessary day-to-day activities can become a major burden for certain groups.<br><br> Theme 5: The people of Cedar Grove have had to address the community's transportation needs by looking after each other. A lot of people here are getting older, but they look after one another. People take care of their own, but I think they would get out more if there was more transportation.<br><br> 4 Community Member The majority of Cedar Grove residents rely on their cars to get where they need to go. Cedar Grove is large and spread out, so public transportation is limited. As one community member put it, cYou have to have a car to function. d Yet not everyone in Cedar Grove has a car.<br><br> Two groups with special transportation needs are seniors and mothers with young children. For these two groups, Cedar Grove 9s rural setting can make obtaining services, running errands, getting to recreation, and socializing difficult. Orange County Public Transportation (OPT) is the main public transportation service in Cedar Grove.<br><br> It serves most of the seniors that use the JOCCA services at the Northern Orange Center and is also responsible for transporting some of the Head Start

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