class 7-8 Flashcards
what does community assessment mean
-the process of critically examining the characteristics, resources, assets, needs and opportunities of a community
-collaboration with that community
-develop strategies to improve the health and well-being of the community
what is a communtiy assessment
a logical systematic approach to:
-clarify concerns
-identifying constraints
-understand the economic, political, and social factors
-examine determinants of health affecting the community
basically: who has a need, how important it is and how many people are affected
approaches to community assessment
-epidemiological approach: statistics/data
-needs based approach: issues/concerns brought forward
-demographic approach: age group
-community health profile: SDOH, age, socioeconomic factors
-community development approach: community tries to take collective action
what is a needs assessment
-systematic, appraisal of the type, depth, and nature of health needs/problems as perceived by clients, health providers (or both) in a community
a comprehensive needs assessment approach
an extensive systematic process to assess all community aspects
a problem-orientated approach
assess a community based on a specific health concern
a single-population approach
an assessment of one population group (aggregate) in a community
a familiarization approach
uses existing data on a community such as a census data, surveys, or health reports
community assessment process
-assessment
-planning
-implementation
-evaluation
data collection, CHN must decide
-what assessment approach is relevant
-what information is most important to collect
-the data sources most appropriate to use
data collection: community as a partner perspective
involves: community participates/collaborates in all stages of assessment through evaluation
CHN’s must have purposeful interaction with others professionals, most importantly, the community members
first step to data collection
CHN must first gain acceptance into the community - biggest challenge of assessment
felt need
what people say they need
-community member opinion
expressed need
what people say they need turn into action
-community member opinion
normative need
needs determined by experts
-professional opinion
comparative need
needs determined by comparing resources or services of one group or area with other similar group or area
-based on precedent
secondary data
reviewing existing, readily available data
e.g. census data
-community assessment assignement
primary data
creating data that do not already exist
e.g. doing a survey, community forum
-windshield survey assignment
assessment of individuals/families - CHNC standards
data is related to the individual and/or family and is collected via interviews, physical assessment & charts with the purpose of addressing immediate need
assessment of groups/communities/populations
-data collection may be related to groups, communities, & systems e.g. epidemiology
-data collection via interviews, surveys, & focus groups or secondary sources for the purpose of collecting info from a variety of health, social, & economic sources to improve the population’s health
quantitative methods - assessment tools
-describe extent of social phenomena
-often utilize close ended questions
-some open ended
qualitative methods - assessment tools
-explore underlying rationale of attitudes/behaviours
-utilize open ended questions
secondary analysis of existing data
-previously gather information
-extremely valuable as it saves time/effort
e.g. public documents, census data, health surveillance, meeting minutes
examples of secondary data (review of existing data)
lit review
social indicators
service use
examples of primary data (creating new data)
windshield survey
participant observation
key informant interviews
focus groups
community forum
surveys
use of a literature review
can highlight needs and strengths of a community similar to the one you are targeting
-can identify programs and services offered elsewhere with similar client groups, and the results of those processes
-can assist in the development of your needs assessment
issues need to be validated
social indicators
-demographic data
-epidemiological data
-family patterns
-social conditions
-found in census data and other reports; local, provincial, and national govt reports & health agency reports
community accounts
-provides users with a single comprehensive source of community, regional, and provincial data
-hundreds of communities included
-neighbourhood accounts available too
databases for social indicators
-the NL centre for Health information(NLCHI)
-Canadian intitute for health information(CIHI)
-stats Canada, census profile
-canadian community health survey
service use
review of agency administrative data
-who does/doesnt use service
-what are most/least used
-referals to/from organization
-wait lists
participant observation
-taking part in and observing life of the community
e.g. engaging in community volunteer activities, notice community norms, beliefs values etc
focus group
-“focused” dicussion with 6-12 individuals
-individuals are specifically chosen
-usually semi-structured
-informal/freedom of expression important
community forum
-general “town hall” meeting
-can be more open/inclusive
-needs to be well-structured
-not representative
-should not be used alone
surveys must consider:
-purpose
-resources/timeframe
-information needed
-format: open ended questions vs closed ended
delivery of surveys
-mail
-email
-in person
-online
-telephone
the planning process of data collection: community health programs should-
-be planned based on the findings of a community health assessment
-have an organized approach to identify and choose interventions to meet specific goals & objectives
-be acceptable, accessible, equitable, efficient, and effective
planning - objectives
-precise statements which indicate the means to achieve the desired outcome or goal
-must be S.M.A.R.T
Communtiy diagnosis
-purpose is to define existing problems, barriers to health, and gaps in services, determine priorities for action, and set the stage for intervention and evaluation
-can also be used to describe wellness attributes and community opportunities
-are action-orientated and aimed at increasing collective competence and community capacity
4 parts of community nursing diagnosis
- issue description, problem, response, or state
- statement regarding the aggregate, population, or community focus
- related factors to the host or the environment
- S&S that are characteristics of the issue, problem, response, or state
planning: prioritizing/ranking
-occurs after identification and analysis of all health concerns
-select the “key issue of concern”
-prioritizing/ranking the health concern that the community and CHN would work on collaboratively
health program
consists of a variety of planned activities to address the assessed health concerns of clients over time
-builds on strengths
-based on assessment
2 social change theories
lewin’s stages of planned change
diffusion of innovation theory
3 stages of lewins theory of planned change
1.unfreezing
2.moving process
3.refreezing
lewins theory of planned change -
#1 unfreezing
identification of need for change
lewins theory of planned change - #2 moving process
identification of problems; consideration of alternatives and adaptation of plan to circumstances
lewins theory of planned change - #3 refreezing
implementation of the plan, stabilization of the situation
diffusion of innovation theory
provides guidance on effective ways to encourage clients to adopt ideas, practices, program, products that are considered “new” and are adopted in a community or society
-individuals adopt innovations at different rates
-conditions should be compatible, flexible, simplistic
diffusion of innovation theory %’s
2.5- innovators
13.5-early adopters
34-early majority
34-late majority
15-laggards
role of CHN as a change agent
-can take a lead role in implementing programs
-if community is overwhelmed with chronic or episodic event, lacking in resources, or there is an imminent risk
role of CHN as a change partner
-works with a community to identify their issues, choose solutions, develop skills, and advocate for change
-enables the community
2 program planning models
PRECEDE-PROCEED model
-program logic model(PLM)
PRECEDE-PROCEED model
9 phases
PRECEDE (phases1-5): assessment & planning
-factors that occur before program implementation
-set direction and objectives
PROCEED(phases6-9): implementation and evaluation
-factors that support program implementation
-program intervention
-evaluation
PRECEDE-PROCEED model emphasizes 2 basic assumptions:
- health and health risks are caused by multiple factors (DOH)
2.efforts to effect change must be multidimensional, multisectoral, & participatory
PRECEDE-PROCEED model phases 1-5(PRECEDE)
1: social assessment
2:epidemiological assessment
3:behavioural and environmental assessment
4: educational and ecological assessment
5:administrative policy assessment
PREDECE-PROCEED model phases 6-9 (PROCEED)
6:implementation
7:process evaluation
8:impact evaluation
9:outcome evaluation
the program logic model
-used in health care as a planning and evaluation framework
-depicts the components of a program in logical sequence from start to end
-clarifies program input, output, and outcomes related to a specific health issue
the program logic model - input
what we invest
the program logic model - output
what we do
who we reach
the program logic model - outcomes
what the short/medium term results are
what the ultimate impact(s) si
the program logic model - assumptions
based on value/success of program implemented
the program logic model - external factors
factors that influence implementation of the plan
Gantt chart
used to visiualize timeline and implementation of SMART goals developed
program evaluation
-the appraisal of the effects of some organized activity/program
-begins in planning stage
-shows relevance, progress, effectiveness, adequacy, efficiency, sustainability
impact evaluation
immediate impact of the program on the target group
-using a tool to measure
primary data in program evaluation
program clients/community
i.e.written surveys, interviews, observations
secondary data in program evaluation
program records
i.e. clinical records, social indicators
