Community Assessment

Setting the Stage for Effective Programs

Welcome and Introductions
 Learning Objectives
• Explain the benefits of conducting a
comprehensive community assessment
• Define the three phases of a community
assessment
• Identify your community assets and needs
• Determine factors that contribute to
community health needs
 Learning Objectives
• Locate secondary data for your assessment
• Identify and select appropriate data collection
methods for your community assessment
• Analyze and prioritize data to inform your
program goals and objectives
• Explore formats for presenting data to
community
• Integrate findings from assessment in grant
proposals
Defining community

INTRODUCTION TO COMMUNITY
ASSESSMENT
 What is Community?
A group of people
• Linked by social ties
• Sharing common perspectives or interests
• Who may or may not share a geographic
location
 Community Members
Community Members have characteristics in common
such as:
• Common culture or ethnic heritage
• Where they live
• Similar age
• Speak the same language
• Religion
Communities are not homogeneous and seldom
speak with one voice
 Healthy Community

A healthy community is a place where people provide

leadership in assessing their own resources and needs,
where public health and social infrastructure and policies
support health, and where essential public health
services, including quality health care, are available.
-Institute of Medicine, 2003
 Healthy Community

 Clean, safe high quality  Diverse, vital, and

environment innovative city economy
 Stable ecosystem  Connection to past
heritage
 Strong, supportive
 Appropriate level of access
community to public health
 High degree of public  High health status
participation
 Access to a variety of
experience and resources
 ACTIVITY 1:
PLANNING FOR YOUR COMMUNITY NEEDS
ASSESSMENT
BEGINNING TO DESCRIBE YOUR COMMUNITY
What does your community look like?
Who is a part of your community?
What makes your community and its people special?
 What is Community Assessment?
• A process by which
community members gain
an understanding of the
health, concerns, and
health care systems of the
community by identifying,
collecting, analyzing,
disseminating information
on community assets,
strengths, resources, and
needs.
 Program Planning Model

Community Goals and Program

Assessment Objectives Planning

Formative Evaluation
Dissemination Program Program
of Results Evaluation Implementation

Process Evaluation
 Why do a Community Assessment
(CA)?
• Identify and set priorities based on the need

• Make decisions about how to improve the

community or organization based on needs and
available resources

• Outline goals and objectives of a program

• Provide standards for an evaluation of a program

 Why do a Community Assessment
(CA)?
• Identify outside organizations or agencies that may
help meet the needs or provide resources
• To understand the determinants of a health issue
• Helps to decide how to best address a health issue
• Provide a systematic basis for which organizational
decisions are made
• Serve as a public relations tool
• Create an awareness of a community concern or
problem
 Benefits to Conducting CA
• Strengthening community involvement in
decision making
• Better use of resources
• Improved communication with the public and
other organizations
• Improving data quality
• Sustaining health initiatives
when resources decline
 Challenges to Conducting CA
• Working across professional boundaries- tackling
territorial attitudes preventing power or information
sharing
• Lack of shared language between community sectors
• Lack of commitment from key stakeholders or team
members
• Difficulties in accessing relevant local data
• Difficulties in accessing the target population
• Difficulties in translating findings into
effective action
 Critical to Understanding
Communities
• Personal opinions, attitudes, risk or behavior
assessment
• Ecological or contextual influences
• Resources, capacities, or assets available
Three-Phase Plan for Assessing Needs

Exploration Data Gathering Utilization

Phase 1 Phase 2 Phase 3

Preassessment Assessment Postassessment
Preparing for a community assessment

IDENTIFYING ASSETS AND

EXPLORING NEEDS
 Assets
• Asset- a capacity that contributes to success

• Shift of focus from individual and community

deficits or needs oriented maps
• Crime
• Unemployment
• Poor housing
• Assets and capacities that can be tapped or
mobilized to address community concern
 Assets
• Individual Assets • Organizational Assets
– Skills, talents, and – Association of
businesses
experience
– Citizens’
– Individual associations
businesses – Cultural
– Home-based organizations
enterprises – Communication
– Personal income organizations
– Gifts of labeled – Religious
people organizations
 Roles for Individuals in Community
Health
• Talents
• Leader
• Connector
(gatekeepers)
• Giver
• Others
 Private, Public and Physical Assets
• Private/Non profits • Public Institutions and
– Higher education Services
institutions – Public Schools
– Hospitals – Government agencies
– Social services – Police/Fire/Safety
agencies
– Libraries
– Parks
• Physical Resources
– Land, buildings,
houses
– Energy and waste
resources
Existing Information Resources in Your
Community

• Chamber of Commerce
• Phone Book
• Internet
• Local Newspaper
• Previous Inventories (e.g., United Way,
Guidestar)
 Why do we need to assess
community assets?

• Get community involved!

• Discover resources for health planning
• Discover community settings and channels for
health promotion
• Find individual or organizational leaders for
partnerships
• Create assets inventory for action planning
Individual Asset Inventory Tool Individual Skills/Assets Inventory
Inventory Tool 1A

Name_________________________ Phone________________________ Date__________________________

Health Construction & Repair Food

Caring for the Elderly Painting Catering
Caring for the Mentally Ill Plumbing Preparing for Many People
Caring for the Sick Electrical Serving to Many People
Caring for Disabled People Carpentry Operating Commercial Equipment
EMT or Emergency First Aid Brick and Masonry Baking
Nursing Experience Wall Papering Meat Cutting and Preparation
Nutrition Furniture Repairs Bartending
Exercise Locksmith or Lock Repairs
Building Garages Transportation
Office Dry-wall and Taping Driving a Car
Typing (WPM______) Cabinetmaking Driving a Van
Taking Phone Messages Welding and Soddering Driving a Bus
Writing Business Letters Concrete Work Driving a Tractor-Trailer
Receiving Phone Orders Heating and Cooling Systems Driving a Commercial Truck
Operation Switchboard Flooring and Carpeting Operating Farm Equipment
Bookkeeping Roofing Driving Emergency Vehicles
Computer Information Entry Other_________________________
Computer Word Processing Supervision
Other_______________________ Maintenance Writing Reports
Floor Cleaning/Refinishing Filling Out Forms
Child Care Carpet Cleaning Working with a Budget
Infant Care (0-1 yr) Household Cleaning Recording of Activities
Child Care (1-6 yrs) Lawn Mowing and Yard Work Writing Proposals or Grants
Adolescent Care (7-13) Gardening Planning Projects
Taking Kids on Field Trips Tree and Shrubbery Care Supervising Projects
Pre-school Care Other_________________________

Source: Vitalizing Communities, Community Guide , 1999, J. Allen, S. Cordes, and J. Hart, p. 28
 Association Asset Inventory Tool
Associational Assets Inventory
Inventory Tool 2

Community_________________
Date______________________
Page ____ of ____

Program/Services
Name of Association Contact Person/Info Misson Audience/Population Offered

Examples:
Business Association: Chamber of Commerce, neighborhood business associations, trade groups,…
Charitable Groups/Drives: Red Cross, Cancer Society, United Way, Diabetes Association,…
Youth Groups: 4-H Clubs, Future Farmers, Girl Scouts, Boy Scouts, YMCA, YWCA,…
Civic Events: art fair, health fair, 4th of July, town festival,…

Source: Adaptation of: Vitaling Communities, Community Guide, 1999. J. Allen, S. Cordes, and J. Hart, p.31
ACTIVITY 2:
COMMUNITY ASSET INVENTORY

What are your community’s individual assets?

What are your community’s association assets?
What is a Needs Assessment (NA)?
• A systematic set of procedures
undertaken for the purpose of setting
priorities and making decisions about
program or organizational improvement
and allocation of resources. The
priorities are based on identified needs.
 Community Needs
• Need: a discrepancy or gap between
“what is” and “what is desired or
should be”
 Types of Needs
• Normative: need relative to some standard (e.g., Healthy
People 2010 objectives)

• Perceived: felt needs of people

• Expressed: needs based on behavior (e.g., seeking of that

need; met or unmet demand)

• Relative: needs relative to other communities/geography

(e.g., county, state)
 Levels of Needs
• Primary stakeholders (Level 1): service receivers-clients,
patients, consumers

• Secondary (Level 2): service providers and policy makers-

health care professionals, administrators

• Tertiary (Level 3): resources or solutions: buildings,

facilities, supplies, technology
 Other Considerations
Community needs assessment exist with
external forces:
– Funding sources
– Physical environment
– Political factors
– Organizational mandates
 Factors that Influence Need
• To understand a community, you must
understand the factors that cause health
disparities and health problems.

• There are health models that guide the

process of diagnosing a community’s health
and identifying needs.
 PRECEDE Model for Community
Assessment
• Planning is based on multiple disciplines: epidemiology; the
social, behavioral, and educational sciences; and health
administration

• Two fundamental propositions:

• (1) health and health risks are caused by multiple factors

(determinants)

• (2) because health and health risks are determined by

multiple factors, efforts to effect behavioral,
environmental, and social change must be
multidimensional or multisectoral, and participatory.
 PRECEDE Assessment Steps
• Step 1: Social diagnosis
• Step 2: Epidemiological diagnosis
• Step 3: Behavioral and environmental
diagnosis
• Step 4: Educational and Organizational
Diagnosis
• Step 5: Administrative and Policy Diagnosis
 Step 1: Social Diagnosis
Quality of
life Subjectively defined problems
and priorities of individuals or
communities

• Absenteeism • Crime • Hostility • Self-esteem

• Achievement • Illegitimacy • Unemployment
• Crowding
• Aesthetics • Performance • Votes
• Discrimination
• Alienation • Riots • Welfare
• Happiness
• Comfort
 Example of Step 1: Social Diagnosis

• Childhood obesity is rising in your

community
Step 2: Epidemiological Diagnosis
Identify specific health goals or
problems that may contribute to
Health social goals from Phase 1

• Disability • Morbidity
• Discomfort • Mortality
• Fertility • Physiological Risk
• Fitness Factors
 Example of
Step 2: Epidemiological Diagnosis
• How do you know it is a problem?
– Number of children identified as overweight
– Number of children identified as obese
– Number of other chronic conditions (diabetes,
heart disease)
Step 3: Behavioral and Environmental
Diagnosis
Behavior
Identify specific health-related
behavioral and environmental
Environment
factors

• Compliance • Preventive • Access

• Consumption actions • Affordability
patterns • Self-care • Equity
• Coping • Healthcare
Utilization
 Example of Step 3: Behavioral and
Environmental Diagnosis
• Behavioral conditions related to obesity
– Eating habits
– Physical activity
• Environmental conditions related to obesity
– Availability of healthy eating in neighborhood
– Convenience of fast foods
– Places to participate in physical activity
– Safety of outdoor areas
 Step 4: Educational and Organizational
Diagnosis

Predisposing
factors Examines conditions linked to
health status to determine what
Reinforcing factors causes them
Predisposing Reinforcing Enabling
Enabling factors factors: factors: factors:
• Knowledge • Attitudes of • Availability
health of resources
• Attitudes
personnel,
• Accessibility
• Beliefs peers, family
members • Referrals
• Values
• Rules/Laws
 Example of Step 4: Educational and
Organizational Diagnosis
• Predisposing Factors: conditions that provide the
rationale or motivation for a behavior
– E.g. taste of fatty, high sugar, high calorie foods;
wanting to be health and look attractive
• Reinforcing Factors: factors subsequent to a
behavior that provide a reward or incentive
– E.g. toys in fast food kids meals; colleague support of
healthy eating habits
• Enabling Factors: antecedents to behavior that
facilitate a motivation to be realized
– E.g. Convenience of a drive through; menu labeling
 Step 5: Administrative and Policy
Diagnosis

Health Education
Reviewing identified barriers and
Policy regulation initiating organizational, regulatory
organization
and policy changes to overcome
those barriers

Assessment of: Assessment of:

Resources needed Policies and regulations

Available resources Political forces
Barriers to implementation
Example of Step 5: Administrative and
Policy Diagnosis
• Health Education: a coordinated school health
approach for children that increases physical
activity, decreases fat and caloric intake, and
increases fruit and vegetable consumption

• Policy regulation/organization: Healthy school

lunch programs and implementation of
nutritional standards and regulations
 Questions?

What are some examples of these steps for your topics?

Phase 1: Preassesment
Exploring and Organizing for Action
 Phase 1: Preassessment
• Set up CA committee Exploration

• Investigate what is already known about the

needs of the target group

• Determine the focus and scope of the

assessment

• Determine specific data to collect and how data

will be used
 Stakeholders and Target
Population
• Stakeholders – key contact and other key informants in
the community, public health organizations and other
related services, target population
• Key agencies, participants, health professionals

• Partners – Coalition members, advisory board members

• Target Population – people directly affected by the

needs assessment process (often termed priority
population)
 Questions?

Who would you include in the needs assessment?

 Needs of Target Population
• What is already known about the needs of the
target group?
• Gather info, but don’t reinvent wheel
• Use census bureau to gather demographics
about a population, community, or city

• What other CA reports exist?

• Who else has conducted CAs?

 Preassessment

• Interview key contact, stakeholders, and

informants
• Conduct community analysis and review
of literature
• Identify major areas of need for data
collection instrument
• Gain commitment for all stages of the
assessment
 Set up CA Committee
• Include voices of the community:
• Community members

• Stakeholders
• Key Organizations
• Health professionals

• Staff

• Leaders from community organizations

 Key Informant Interviews
• Held with people who are knowledgeable of the
community, health topic or organization

• Interviews are interactive and allow open dialogue

• They are conversations with a reason between 2 people

• Helps to frame what topics to ask about during data

collection
 Interviewing Key Informants
• Key informant
– A person in the community or target population
– A person working with the community
– A person who has access to information about the
target population
• What are some interview questions that you
would want to ask your key informants?
• For community members
• For service providers
• For elected officials
Steps in Key Informant Interviews
• Develop the instrument
– What do you want to measure?
– Key topics for the semi-structured interview

• Develop a sample of individuals with personal knowledge about the

population of interest, the target audience or the community
– Purposive sampling instead of convenience
– Need representation from range of sectors/perspective to avoid bias
– Snowball sampling to get names of other potential interviewees

• Decide on methods
– Face to face or phone
– Number of interviewers
– Taping vs. note-taking
 Steps in Key Informant Interviews
• Conduct the interview
– Introduce yourself and provide the purpose for the interview
– Ensure confidentiality of the information provided
– Take notes or tape the interview
– Listen and probe for further information (very important!!)
– Thank for interviewee

• Debrief and write out more notes to yourself

 Successful Interviewing
• Keep the goal of the interview in mind

• Practice, practice, practice

• Have small talk to build rapport

• Be professional (look sharp and be on time)

• Don’t stop at Yes or No answers. Probe…

• Treat individual with respect (you are listening to their opinions)

 Types of Questions
• What is his/her position or role?

• Issues/needs Identification
– What are the needs or issues in your community? Or Do you think X is
a need or problem?
– Who does the issue affect?
– Why does the need exist?
– What causes the problem

• How do people feel about [the need]?

• What would you like to see happen with [the need or concern]?

• What are the barriers to addressing the need?

 Types of Questions
• What are potential ways to address the need?

• What resources (assets) are available to address the need?

• What would encourage more support around the issue/need in your

community?

• Have we covered everything that is important?

• Conclude by asking “Is there anything important you think I missed?”

• Are there any other people you think

• we should talk to?
 Types of Questions - Organization
• How would you describe the current status of the
organization?

• What are you doing well? (start with assets)

• What are areas in your organization that needs improvement?

(weaknesses)

• What issues or challenges does the organizations face?

• What are key unmet needs or issues of your participants?

 Key Informant Interview Analysis
• Identify key themes

• Compare and contrast data from various

interviewees
– Are there similarities or differences in people’s
responses
– Are perspectives on an issue similar across
different groups (e.g., participants and providers)

• Seek additional interviews (perspectives), if

needed
ACTIVITY 3:
KEY INFORMANTS
Who are your key informants?
What questions would you ask?
Phase 2: Assessment
Gathering what you need
 Phase 2: Assessment Data
Gathering
• Prepare logistics for data collection
• Prepare, test, and pilot survey (or other methods)
• Modify as necessary

• Administer survey (or other methods)

• Analyze data and prepare results
• Prepare results with tables, figures and graphics

• Discuss & share results with CA committee

 Types of Date Sources
• Primary Data Sources- information collected
directly by you or your organization
– Example: community health concern survey

• Secondary Data Sources- information

collected by someone else
– Example: emergency room discharge records
 Primary Data Sources

Quantitative: Qualitative:
• Surveys/questionnaires • Professionals or
for key community community members
members or audience who are knowledgeable
of interest about health issue or
audience
• Methods: • Methods:
• Surveys • Interviews
• Direct observation • Focus Groups
of community or
people • Public meetings or forum
• Windshield survey
 Secondary Data Sources
• Reports about the community from schools, medical
systems, health departments, or city governments

• Reports about health topics from Centers for Disease

Control and Prevention that describe rates and who
has diseases

• Literature review

• Websites

• Your agency (services, participation)

 Reasons for Conducting a
Literature Review
• Provide an understanding of the topic and its
context

• Build on existing knowledge and ideas

• Highlight sentinel work or exemplary studies

• Identifies gaps in the literature

 Literature Reviews
• Before you begin, ask yourself:
– What is the specific problem or question I want to define?
– What type of literature should I review?
– What issues should I be looking at more
closely?
• Journals versus magazines:
– Peer review
• Web sites:
– .gov, .org, and .edu versus .com
– Editorial board
– Update
– Online databases
Levels of Data for Community Analysis

National

State

Local
 National Level
• U.S. Bureau of the Census (people)
• Vital Registration System (births, marriages)
• National Case Reporting System
– Federal & State Reporting System
• National Health Surveys
– Behavior Risk Factor Surveillance System (BRFSS)
– National Health Information Survey
• National Health Organizations
– CDC
– American Cancer Society, etc.
 State Level

• Bureau of Vital Statistics

• State Health Department
• State Department of Education
• State Department of Justice
• Office for Motor Vehicles
• Offices of Voluntary and Private Health
Agencies
• Fact Books
 Local Level

• Chamber of Commerce • Public/Private Mental

• City, county, regional and Public Health
planning offices Centers
• Newspaper Offices • Community Residents
• Public Libraries • Participants in
• Insurance Companies Programs or Services
• School Systems • Neighborhood leaders
• Hospitals
 Questions?

Where do you go for local data?

 Types of Health Data
• Vital Statistics- government database recording births
and deaths
• Mortality- the number of deaths in a population
• Morbidity- the number of cases of a specific disease in a
population
• Incidence- the number of new cases of a specific
disease occurring during a certain period in a
population at risk
• Risk Factor- variable associated with an increased risk
for disease
• Hospital Discharge – number of hospital stays and the
reason for hospitalization
 Some Useful Web Sites
• U.S. Census Bureau: [Link]
• National Center for Health Statistics:
[Link]
• State Cancer Profiles: [Link]
(can be accessed through the Cancer Control PLANET Web
site, [Link]
• American Cancer Society’s Facts and Figures:
[Link]
• Online Analytical Statistical Information System (Oasis)
[Link]
 Sources of Health Data
• National Center for Health Statistics (CDC)
• Healthy People 2010 (CDC)
• American FactFinder (Browse Census data)
• Georgia Department of Community Health, Division of Public
Health
• Georgia Community Indicators
• Behavioral Risk Factor Surveillance System (BRFSS)
• National Health Interview Survey (CDC)
• OASIS
• Kids Count
• Kaiser State Health Facts
• Trust for America’s Health, Georgia State Data
• State Cancer Profiles
 Sources of Health Data
Georgia Department of Community Health, Division of
Public Health
• OASIS Health Statistics and Maps
• Behavioral Health (BRFSS)
• Chronic Disease
• Notifiable / Infectious Disease
• Perinatal / Infant Health
• Vital Statistics & Health Planning Reports
• Women’s Health
 Sources of Health Data:
OASIS
• Online Analytical Statistical Information System
• Georgia Department of Community Health, Division of Public Health
• Interactive, online tools to access health data for state of Georgia

– Vital Statistics (births, deaths, infant deaths, fetal deaths, induced

terminations)
– Georgia Comprehensive Cancer Registry
– Hospital Discharge
– Emergency Room Visit
– Risk Behavior Surveys (Youth Risk Behavior Survey (YRBS)
– Behavioral Risk Factor Surveillance Survey (BRFSS))
– STD
– Population data

[Link]
 Sources of Health Data:
BRFSS
• Tracks health conditions and risk behaviors in the
United States
• On-going since 1984
• Largest telephone health survey system in the
world
• SMART: Selected Metropolitan/Micropolitan Area
Risk Trends
– Analyzes data according to county or city area, must
have 500+ respondents

[Link]
 Sources of Health Data:
State Cancer Profiles
• National Cancer Institute Database
• Creates a cancer profile for the state according
to cancer site (e.g. liver, brain)
• Information includes: death rates, prevalence,
incidence, mortality, trends
[Link]
Screen Shot
 Sources of Health Data:
For Youth
• Kids Count
– Data Center provides state and community level data for
health conditions and health risks for children
[Link]
• Youth Risk Behavior Survey (YRBS)
– Monitors priority health-risk behaviors and the prevalence
of obesity and asthma among youth and young adults
– Includes national school-based survey conducted by CDC
and local surveys conducted by state, territorial, and local
education and health agencies
[Link]
Screen Shot
 Sources of Community Data:
• Georgia Area Labor Profile
– Georgia Department of Labor
[Link]
• County Snapshots
– Economic and Educational Indicators
[Link]/CountySnapshotsNet/
• The Georgia County Guide
– Calculates means/correlations
[Link]
• State and County DFCS Data
– TANF, Foster care, CPS, etc.
[Link]
• Your City or County website
 Use of Standards
Healthy People 2010
• [Link]
• Objectives for the nation
• Targets that were met in the last decade

Healthy People 2020

• View the proposed objectives
• [Link]

• Select an objective that corresponds with your health

topic
• Does your data support the objective?
Use of Relative Comparison/Trend Data

• Use tables & graphs to:

– Show how your region compares
to:
• Other regions
• State rates
• US rates
– Show how problem is getting worse
• Example: Obesity data for region
& state of Georgia
ACTIVITY 4:
CREATING A COMMUNITY PROFILE
Use the resources provided to create a community profile:
Community Background
Health and Social Systems
Health Status of Community
Learn about the Community

DATA COLLECTION METHODS

FOR PRIMARY DATA
 Goals of Primary Data Collection
• Learn about assets and perceived needs
• Elicit voice of community
 Data Collection Methods

Individual: Group:
• Surveys • Focus Groups
• Interviews • Community forums
• Resource inventories • Nominal Group
• Observational methods Technique
• Windshield survey
• Tele/Electronic conferencing
 Individual Data Collection
• Surveys and questionnaires (mailed, telephone,
or face-to-face): a form containing a set of
questions sent/given to people to gain statistical
information

• Interviews: in-depth (formal or semi-informal)

questioning of people
 Planning for Interview

• Determine the Purpose

• Construct Interview Protocol (instructions and
questions)
• Select the sample
– Key informants
– Major stakeholders
– Convenience, purposive or random sample of population
• Train interviewers
• Conduct the Interview
• Debrief
 Key Points for Face-to Face Contact

• Build rapport
• Build competence
– you know the audience well
– you have worked here for X years
• Use nonjudgmental responses
– Okay or all right
– Do not “Good” or “Excellent”
• Use engaging body language
– Nod
– Lean closer
 Individual Data Collection

• Resource Inventory: The assessment of how

resources currently are allocated to health,
public safety, education, and human services

• Windshield Survey: Description of the

community using multiple data collection
methods
 Resource Inventory
• Used to inventory community assets
• Identification of critical priorities
• Survey determining what resources exist
• Target scarce resources at high-priority needs
• Reduce duplication of effort by providers and
funders in filling out forms with this
information.
 Windshield Survey
• Description of the community, geography and
boundaries of the areas you are interested in

• Multiple Data Collection

– Observation of key community sites
– Photography of community
– Written notes
 Windshield Survey
• Housing and zoning • Race/ethnicity
• Open space • Politics
• Boundaries • Media
• Commons/hangouts • Schools
• Transportation • Businesses
• Services/Stores • Religious institutions
 Windshield Survey
• Description of the community,
geography and boundaries of the
areas you are interested in
• Glance at the community from the
investigator’s perspective
– Ethnicities/culture
– Ages
– Hang outs
– Services/stores
 Group Data Collection
• Nominal group process: a group process technique to
generate ideas from a team in a short period of time.

• Focus group: a qualitative research tool in which a small

group of participants are brought together and asked to
join in discussion of their opinions about topics, issues,
or questions.

• Community Forum: a gathering of about 50 community

members to discuss community issues or concerns or to
gather votes
 Nominal Group Technique
Small group with limited interaction to generate and
prioritize needs

– Start with small group (10-30)

– Brainstorm ideas independently
– Go around room and capture ideas
– Clarify all ideas
– Have individual rank order ideas in terms of importance

– Outcome is list of ideas and order of priority

 Focus Group

• 6-12 people who share a common trait or interest

• Group responses to general issue
• Short protocol of questions facilitated by a trained
moderator
• General questions related to the topic with probes
• Need to conduct 2-3 to insure data validation
• Consider how best to stratify participants by
community characteristics
• Outcome is related to the topic of interest
 Community Forum
• Purpose: to bring together members of the
public who are interested in your mission and
assessment’s focus.

• Community forums provide a platform for an

open dialogue to establish better coordination
among the community members involved.
ACTIVITY 5:
PRIMARY DATA COLLECTION: METHODS AND PURPOSE

How will you collect data for your Community Needs Assessment?
Why did you choose these methods?
Deciding which methods to use

SELECTING THE COLLECTION

METHOD
 Designing the Instrument
• Fit with other data collection methods

• Kinds of questions that need to be asked based on

preliminary data gathering

• Types of decisions that will be made from data

• Kinds of questions to elicit usable data

• Data analysis strategy is synergistic with other data

collected
 Designing the Questionnaire

• How does the survey fit with the other CA data collection
tools?
• What kind of questions need to be asked?
• What types of decisions will be made from the data?
• What types of question will elicit usable data?
• How will the data be analyzed and synthesized with other
CA data?
 Types of Questions
• Demographics How old are you? What is your race/ethnicity?
• Sensory What are the most visually appealing aspects of your
community?
• Knowledge Second hand smoke can be harmful to those around me.
True or False?
• Attitudes Please rate your satisfaction with the dental services
available in your community.
• Behaviors How often do you wear a seat belt when riding in a car?
• Values How important do you think it is to exercise 3 times a
week?
• Environment Do you feel safe walking alone in your neighborhood?
• Resources What are the medical services available within your
community?
 Common Question Types
• Open-ended questions:
– What is the role of your agency in addressing breast
cancer prevention
• Partially Closed-ended
(includes an Other category)
• Multiple choice
– The level of services for families that need health care is:
a) Inadequate b) somewhat adequate c) very adequate
• Most and least importance:
– From the health topics listed below, please check the 3 to
5 most important and least important issues for your
community.
 Common Question Types

• Rating Scale
– Services for drug abuse among teens in Hall
county are: 1 2 3 4 (poor to excellent)

• Ranking
– From the list of 5 concerns, please rank the issues
in order of importance.
 Resources for Data Collection
Questions
• Don’t reinvent the wheel, questions can be taken
from previously conducted questionnaires/
surveys
– Pros: These questions have been tested and have
proven to be valid and reliable
– Cons: You may not find a question that exactly
addresses your problem, may have to adapt a
question to your needs
• If adapting the question to your topic, maintain
the basic structure and wording of the question
 Sources of Health Questionnaires
• BRFSS Questions Archive
– Records of questions used according to year and
topic
[Link]
• National Health Interview Survey (NHIS)
Questionnaires
– Records of all past questionnaires
[Link]
 Sources of Health Questionnaires
• Youth Risk Behavior Survey (YRBS)
– Questionnaires and Item Rationale
– Provides list of questions for High School and
Middle School, and rationale for question
[Link]

• Other studies in scientific journal articles

• Cite all sources – Adds credibility to your

methods!
ACTIVITY 6:
SEARCHING FOR DATA COLLECTION QUESTIONS

Use the resources provided to find questions for your data collection
methods.
Phase 3: Postassessment
Using what you collected
 Phase 3: Postassessment
Decision-
• Conduct prioritization process making

• Determine priorities

• List recommendations for organization/

stakeholders

• Prepare written report and presentation

• Communicate and disseminate report

Using Data to Inform Your Program
• Several priorities will exist as a result of CA

Take the following steps before setting your

program’s priorities.
– Synthesis of data
(thematic analysis)
– Triangulation of data
– Analyses of matrix
– Focus on Utilization
 Triangulation of Data

• Compare findings with those from other

methods
– Multiple qualitative methods (key informant
interviews)
– Comparison of results of qualitative methods with
other data (interviews with community profile;
community profile with data from instrument)
• Matrix of methods and key issues
Focus on Utilization of the Results
• Include data from each step of the analysis
• Refocus on definition of need
– Presentation of “what is” (met)
– Describe data on “what should be” (unmet)
• Perspective
– What does the community need?
• Key stakeholders’ perspective
• From community member’s perspective
• Overall, from everyone’s perspective
 Focus on Utilization con’t
• Interpretation not just Description

– What do the results mean?

– Judgment: what is good or bad about findings?
Relate it back to standards
 CA Data for Grant Writing
or Need Statement
• Background section of grant
– Define health issues and causes
– Description of current programs and services
(identification of gaps)
– Description of what is not known about the health
issues in the community (research gap)
• Methods
– Description of the population
 CA Data for Need Statement
Overview of Community Needs

• Describe the community in which you will be

working and clearly identify the target
population. In your description, discuss the
community-specific need(s) the proposed
project will address, including local statistics.
 Community Toolbox
[Link]
• Mission: Promoting community health and development by
connecting people, ideas and resources
• Provides information for a variety of actions for community
health enhancement
– Including Community Needs Assessments
• Outline for conducting CNA
• Resources
• Examples of CNAs
Use of CA Report by Contact Agencies

• Information needed to make important decision

• Document needs and assets of the community

• Use of data for development of future

programming

• Use of results for grant writing

• Facilitate cooperative action/partnerships

 Conclusion of CA Report
• Conclusions
– Key findings from CA results (existing resources,
needs unmet, priorities identified by various
groups)
– Emphasize key gaps or type of need
 Prioritization
• Identify areas of disclosed needs from
community analysis findings where efforts can
be initially focused

• As more resources are available, more issues

can be addressed
 Simple Approach to Prioritization
• Ranking of some type
– Numerical
– Qualitative (high, medium, low)
– (Rank ordering data by importance, desirability, frequency
selected, etc.)

• Selection of issues
– Voice vote
– Ballot
– Consensus
– Majority
 Sork’s Approach to Priority Setting
• Importance criteria: (rating from 1 to 5)
– Number of individuals affected/impact
– Contribution to organizational goal
– Require immediate attention
– Magnitude of the discrepancy
– Instrumental value of addressing need

• Feasibility criteria:
– Educational intervention
– Availability of resources
– Organization’s willingness to change
 Sork’s Importance and Feasibility
Importance
Low High

High

Low

Feasibility
 Recommendations/Action Steps:
What should be done?
• Recommendations
– Specific programmatic or target group priorities for
the agency
– Should be practical and possible
– Consider agency assets
– Changes/improvements to address needs or issues
– Summary of what your results suggest about
priorities, needs for services, needs for action, etc
– Lead to research gaps for grant writing
Guidelines for Recommendations
• Supported by CA findings

• Distinguish between different kinds of recommendations

(e.g., program, other stakeholders, etc.)

• Consider the cost and risk associated with recommendations

• Focus on easier/changeable tasks first (importance-

changeability matrix)

• Consider different types of recommendations

– Planning and formative (i.e., consider, explore)
– Behavior oriented (i.e., provide training, offer x services)
 Example of Recommendations

• Because a number of key informants and staff members

mentioned the televisions in the waiting rooms as a
untapped resource, it would be important to show
Spanish- language health education videos on the
televisions in the waiting rooms.
 Components of CA Report
• Front Matter
• Title, Executive Summary, Table of Contents, List of
Tables, List of Figures, List of Appendices
• Introduction and Background
• Community Assessment Purpose and Primary
Data Collection
• Back Matter
• References
• Appendices are lettered (A, B, C)
 Community Assessment Report
• Write reports that are understandable- avoid technical
jargon
• Vary reports needed for different audiences
– Policy board
– Decision-makers
– Managers
– Staff
• Include graphic displays (charts and tables)
• Provide copy of instruments, protocols, and data analysis
 Report Writing
• Use objective and non-judgmental language

• Respect the confidentiality of individuals and their responses

(e.g., data in aggregate, no names attached)

• Use descriptive language

• Avoid jargon and define terms lay people may not understand
or not have a common definition for; define terms

• Balance the needs with assets in the language chosen and

space
 Dissemination of Community
Assessment Results
• Important to share data with
stakeholders and community
commonly with a written report
• Discuss methods to share data
with stakeholders
– Executive summary
– 1 page summary
– Presentation with graphs
• Make it a priority to share results
and have dialogue about them
and recommendations
 Why Dissemination is Important
• Educates the audience about the findings and
what is happening in the community

• Gets information in hands of people to plan

for action

• Builds enthusiasm or passion for action and

advocacy
 Questions?

Have you shared your CA results in the past?