Study Group - Needs Assessment Flashcards
CDC
Centers for Disease Control & Prevention
MMWR
Morbidity & Mortality Weekly Report
BRFSS
Behavioral Risk Factor Surveillance System
YRBSS
Youth Risk Behavior Surveillance System
NCHS
National Center for Health Statistics
AHA
American Heart Association
ACS
Acute Coronary Syndrome
WHO
World Health Organization
USDHHS
United States Department of Health & Human Services
NACCHO
National Association of County & City Health Officials
ACA
Affordable Care Act
What is first step in planning health program?
- Needs Assessment
- Capacity Assessment
Why is needs assessment & capacity assessment important?
- Directs use of limited resources
- Provides focus on priority population
- Ensures priority population needs are being addressed
- Identifies community/target population’s level of capacity
- Establishes “roadmap” for HES
What should be included in a needs assessment?
- Purpose & scope of assessment
- Priority population
- Available resources, policies, programs, practices, & interventions
- Factors & determinants
- Recruit/Engage priority population & stakeholders
Types of Community Assets
- Individual
- Institutional
- Organizational
- Governmental
- Physical
- Land
Models for Conducting Needs Assessment
- Epidemiological (death rates, # of individuals using health services, etc.)
- Public Health
- Social
- Asset
- Rapid
What does Public Health Model for Needs Assessment focus on & consider?
- Specific Populations
- Considers limited resources
What issues does Social Model for Needs Assessment consider?
Social & political issues that influence health
What does Asset Model for Needs Assessment focus on?
Strength of community, organization, or population
When is Rapid Model for Needs Assessment used?
When there is lack of time & money
What should HES collect in Needs Assessment to Understand Health Issues in Community?
- WHAT & WHY health issue is happening
- Health equity & social-ecological factors/influences
- Data to ensure understanding of health influences
Why is Understanding Health Influences during Needs Assessment Important?
To ensure success of knowledge/behavior change (success of program)
What are the types of population needs to be included in needs assessment?
- Expressed
- Actual
- Perceived
- Relative
What are Expressed needs?
- needs that are observed through individual’s use of services
- Revealed through health seeking behavior
What are Actual Needs?
Lack, deficit, inadequate, or excess of services from one community to another
What are actual needs used for during needs assessment?
To determine if need exists within target population
What are perceived needs?
What individuals in community state they want
- Provides sense of lack of services
What are relative needs?
Gap/deficit identified between advantaged & disadvantaged groups or individuals
What do PARTNERS bring to the table?
- Knowledge, skills, & resources
- Willing to share risks, responsibilities, & rewards
Who are stakeholders?
- Those who affect or are affected by health/behavior change
- Those who have interest in results and/or what would be done with results
What are some benefits to partnerships?
- Meeting needs of priority population that CANNOT be met by individual group’s capacity
- Sharing financial resources
- Solving shared problem of priority population
- Bringing more stakeholders to the “table”
- Increase program credibility
- Viewing health problem from multiple perspectives
- Greater response to addressed need (strength in #s)
Why is primary data important?
Allows HES obtain accurate data about health problem, behavior influences, & potential solutions specific to target population
What should primary data collection focus on?
Information gaps from secondary sources
Why is secondary data collection important?
- Helps HES understand existing knowledge on health concern/topic & populations
- Provides opportunity to identify information gaps that need to be a part of needs assessment
What are some credible resources to collect secondary data?
BIOETHICSLINE, ERIC, HAPI, MEDLINE, National Library of Medicine, TOXNET, Cochrane Library, PubMed, SUMSearch
What needs to be considered when using secondary data?
Reliability, Accessibility, Timeliness, Applicable to priority population
What are some types of methods to collect primary data?
Surveys, self-assessment, observations, community forums, focus groups, Nominal Group Process, Delphi Panel, Community Capactiy (Inventory & Asset Map), PhotoVoice
What is Nominal Group Process?
Highly structured process in which a 5-7 representatives from priority population are asked to respond to specific questions based on what HES need to know
- Each member of group has equal voice in discussion & voting
- Members share opinions by privately ranking proposed ideas & sharing their ranking with groups in round-robin fashion
What is Delphi Panel?
Group process that generates consensus by using series of mailed or emailed questionnaires
- Includes decision makers, staff, & program participants
- Starts with 1-2 broad questions and answers are analyzed
- Successive questionnaires sent to same people based on analysis of responses
- Questionnaires sent out 3-5 times
What is PhotoVoice?
Specific photographic technique to enable people to record & reflect on personal & community strengths & concerns
What should HES consider when choosing method(s) of data collection?
- What questions are being asked
- Participants (their characteristics & preferences)
- Resources available
- Timeframe to complete assessment
- Feasibility among populations to identify disparities
- Potential bias
What are the basic components of collecting primary data?
- Data collection & instrument development
- Data analysis plan
- Findings or results of assessment
- Written report of data
What are the planning stages of collecting primary data?
- Planning survey
- Overall design
- Data collection Method
- Plan data analysis
- Drawing sample
- Construct questionnaire
- Pretest questionnaire
- Revise questionnaire
- Administer questionnaire
- Code preparation
- Verification
- Data entry
- Tabulation
- Analysis
- Record/Report
How do HES improve health status of communities they work with?
Modify social determinants of health (SOH) among individuals & communities
What are SDOH?
Conditions people are born, live, work, play, & age that affect their overall health (WHO definition)
How do SOH affect one’s health status?
Overlapping connection to health disparities & health equity
What does SDOH include? What are they impacted by?
- Includes health risks, daily functioning, & quality of life (QOL)
- Impacted by economics, social policies, & politics
What can HES use to determine goals & objectives of health promotion program? Where can this information be found?
Identify which SOH factors are most important & changeable
Found in:
- Data from needs assessment
- Risk factors (found from secondary data - literature review)
- Surveys (e.g. YRBSS, BRFSS)
Healthy People 2030 Categories of SOH
- Health Care Access & Quality
- Neighborhood & Built Environment
- Social & Community Context
- Economic Stability
- Education Access and Quality
What is the ultimate goal of Healthy People 2030?
Reduce health disparities & achieve health equity
What are health disparities?
Differences among populations in health status, behavior, & outcomes due to multiple influences
What is health equity?
Reducing & ultimately eliminating disparities in health & its determinants that adversely affect certain groups/populations
Why should health disparities & health equity matter when it comes to improving health of communities?
Multiple components are interrelated affecting influences of disease, function, health behaviors, & overall well-being
What are the 5 levels of health behavior influences?
- Individual
- Interpersonal
- Institutional
- Community
- Public Policy
What influences health behavior on individual level?
Knowledge, attitudes, & beliefs
What influences health behavior on interpersonal level?
Association with family, friends, & peers
What influences health behavior on institutional level?
Rules, regulations, & policies
What influences health behavior at community level?
Social networks & norms
What influences health behavior at Public Policy level?
Local, state, & federal policies & laws
What are Systems Strategies?
Changes that impact all elements of an organization, institution, or system that is working as a whole to accomplish overall goal
What is a systems change?
Modification in how collective unit decides policies, program services, decision making & allocation of resources
How can HES determine effectiveness of programs/interventions?
Use recommendations from variety of sources
- Scientific literature
- Program staff, stakeholders, & decision makers
- Systematic reviews & meta-analysis of evidence-based practices
How can HES identify gaps or overlaps in existing programs?
- Communicating with stakeholders in the community
- Looking at services used by clients
- Observing levels & patterns of provided services
Community Guide to Community Preventative Services
- Provides summary of what is known about the effectiveness, economic efficiency, & feasibility of interventions to promote community health & prevent disease
- Includes evidence-based recommendations for programs & policies to promote population-based health
- Evidence on specific topics
When creating health program for priority population, what does HES need to determine that already exists within the community?
Programs, services, and/or policies
What can HES do/use to ensure success & sustainability of health program?
`1. Needs & Capacity Assessments
2. Community-building processes
3. Review of actual & potential resources to ensure realistic programs be implemented & sustained
4. Asset Mapping
What is community-building process?
Identify, nurture, & celebrate community assets
What is asset mapping?
- Maps out community capacity & strengths
- Identifies available programs/interventions
What is the final step in needs assessment?
- Validation needs identified in assessment
- “Double checking” identified needs are actual needs
What are some methods HES can use during final step of needs assessment?
- Rechecking steps of needs assessment to eliminate bias
- Conducting focus groups (if not used during needs assessment)
- Second opinion from other health professionals
How can HES determine priorities for planned intervention?
Synthesize assessment findings/information
What factors should be identified to help HES determine priorities for planned intervention?
- Predisposing
- Enabling
- Reinforcing
What are Predisposing factors?
Individual knowledge & affective traits
What are enabling factors?
Factors that make it possible to change behavior
What are reinforcing factors?
Feedback & encouragement resulting from behavior change
What does HES need to determine in order to prioritize health needs?
- Size/scope of health problem
- Rate degree of importance & changeability for each health problem
How can HES increase capacity of community to ensure needs of priority population are met?
- Tailor programs to priority population
- Use multiple components (multiplicity)
- Provide support
- Inclusion
- Dose
- Recruitment, reach, & response
- Interaction & satisfaction
- Context
How should HES frame recommendations? Why?
Use ‘plain language’
- Ensures priority population can make informed decisions on what needs and/or can be feasibly done
- Provides priority population with enough information to rank recommendations based on highest priority
What should HES decide when disseminated results?
- Who will receive summary of results of assessment
- What format will be used to present the findings
Elements of Community
- People
- Place
- Interaction
What is Community-Based?
Describes where program or service is provided
What is Community-Focused?
Refers to way in which program is designed
What do programs that are community-focused seek to affect?
Community as a whole
What is Community-Driven?
- Involvement of community members in design and implementation
- Includes community’s preferences and need
- Determines how community is involved
Levels of Assessment
- Individuals
- Families/Groups that have interaction
- Communities, neighborhoods: common geographic or interest that may interact
- Aggregates: those who have something in common but do not interact (segment of population)
- Populations
Assessment Challenges
- Those receiving services (easy to survey)will be different from those not receiving services (difficult to survey)
- Act of asking may change responses
- Assessment can be lengths & costly process
Community Analysis & What does it include?
Process of assembling information about target population
- Includes general health & summary and evaluation of available health care
Community Diagnosis & what does it consider in regards to health problems?
Professional opinion of health of individual/community analysis
- Relation of health problems to available health services
Factors that influence health & health related behavior
- Behavioral
- Environmental
- Social
- Biological
- Health & Lifestyle
- Policy
Steps of Needs Assessment
- Assessing information needs
- Policy Assessment
- Administrative Assessment
- Stakeholders (Identification & Analysis)
- Assessing capacity for improving community health status
- Behavioral & Environmental Assessments
Why is training personnel how to collect data important?
To reduce bias
What are topics that need to be covered when training people how to collect data?
- Purpose
- Method
- Rights of those involved
- Timeline
- Legal guidelines
- Ethical issues
- Data storage
MATCH
Multi-level Approaches to Community Health
Steps of MATCH
- Choose goals for health status & report prevalence, change possibility, & resources available
- Choose target population & report prevalence, availability, & interest in program of health issue to target population
- Establish goals for health behavior
- Establish goals for service access, program resources, & any restrictions
interpersonal vs intrapersonal
INTERPERSONAL - Relationships & interactions b/w individuals
INTRAPERSONAL - Individuals internal thoughts, beliefs, attitudes that influences health choices
