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Health Needs Assessment

Pamela J. Biernacki, DNP, FNP – C

Master’s Program Director, Assistant Professor

Department of Family and Community Health

Terms

Needs assessment: evaluation that answers questions about the conditions your program addresses, used to determine whether there is a need for a new program, and to prioritize needs within and across program areas

Key informant: Persons whose personal or professional position gives them a perspective on the nature and scope of a social problem

Terms

Survey: systematic collection of information from a defined population, usually interviews or questionnaires from a sample

Focus group: small panel of people chosen for their knowledge or perspective on a topic of interest

Social indicator: Periodic measurements designed to track the course of a social indicator over time

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Terms

Incidence: Number of new cases over a specified time

Prevalence: Number of existing cases in a specific area at a given time

Population at risk: Individuals or units in a specified area with characteristics judged to indicate that they have a significant probability of having or developing a particular condition

Terms

Sensitivity

  Likelihood of correctly selecting the target who should be in a program in contrast to those who may be selected by the criterion but aren’t appropriate

Specificity

  Correctly excluding people or units that don’t have the condition of concern

Terms

Population in need: Individuals or units in a specific area that have a particular problematic condition

Rate: Occurrence or existence of a particular condition expressed as a proportion of units in the population (eg deaths per 1,000)

Stakeholders: Have something to gain or lose from the program

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Terms

Citizen participation: mobilization of citizens to take action to change or improve a community

Community development: creating conditions of economic and social progress for the whole community with its active participation and initiative

Terms

Community participation: involving people in the institutions or decisions that affect their lives

Empowered community: one where individuals and organizations apply their skills and resources in an effort to meet their needs

Grass-roots participation: Bottom-up efforts of people taking action on their own behalf, blending confrontation and cooperation to meet their needs

Gathering Data

Getting Started

Primary, Secondary and Combined Data

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Sources of Primary Data

 From individuals

 Surveys   Single step (cross-sectional, one time)

  Multi-step (contact on more than one occasion)

 Significant others

 Opinion leaders

 Key informants

Sources of Primary Data

 From groups

 Community forum

  Focus group  Nominal group process

Few knowledgeable representatives of the target population (5-7) qualify and quantify needs

 Observation  Self-directed assessments (health assessments)

Sources of Primary Data

 From Governmental Agencies

 US Department of Commerce  Centers for Disease Control  Census

  Non-governmental agencies

  Existing records

  Literature

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Conducting a

Needs Assessment

Purpose and Scope

Conducting a Needs Assessment  Decide the purpose and scope of the assessment

 What do you want to collect?

 How extensive do you want to be?

 Gather Data

 Decide if you will use primary or secondary data, or combination

Conducting a Needs Assessment  Analyze your data

Formal or informal

“Eyeballing” your data

 Set priorities Most critical need  

Adequate resources to manage

Is the best approach to the problem a health promotion intervention

Can you solve the problem in a reasonable amount of time

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Conducting a Needs Assessment

In setting priorities consider:   A: Size of the problem

Epidemiological rates

Percentages

  B: Seriousness of the problem Economic loss to the community, families, individuals

Involvement of others not initially affected (infectious disease, drugs)

Severity of the problem (morbidity, mortality, disability)

Urgency of solving problem before causes other problems

   C: Effectiveness of the intervention

  D: Determine whether an intervention can be carried out at all

Conducting a Needs Assessment

Identify the factors linked to the health problem

 Economic factors

 Cultural factors

 Values

 Access

Conducting a Needs Assessment

Identify the program focus

 What predisposing, enabling, and reinforcing factors exist?

What programs are available?

What programs are being used? Not used? Why?

How were those program needs determined?

Are the programs accessible?

Are needs being met?

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Conducting a Needs Assessment

Validate your prioritized needs

  Confirm that you’re doing the right thing

  Double checking

  Make sure needs assessment wasn’t biased

  Conduct a focus group with your population to confirm your assessment

  Get a second opinion from other health care providers

Community

Define the Elements

Community

A locale or domain that is characterized by the following elements:

 Membership   a sense of identity and belonging

Common symbol systems language rituals symbols

Shared values/norms Mutual influence Shared needs Shared emotional connections

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Community Organizing

Recognizing the concern

  May happen inside or outside the community

  Outside Local or state health department

  VCU SON DNP Nursing Student

  Inside Grass roots, citizen initiated, bottom-up

Employer

Health System

Community Organizing

Gaining entry

  Gatekeepers   Approach on their terms, play their game

  Know the politics

  Know the power players

  May enter through an established organization   Employer

  Church

  School

Community Organizing

Organizing the people –   “Executive participants”

  Fairly small group

  Choose appropriate leaders

  Choose supportive people

  Choose people affected by the problem

  Identify a leader from the core group

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Community Organizing

 Skills of organizers  Change vision attributes

  Can see a need for change and are committed to making that change

 Technical skills

  Interactional or experience skills  Play well with others

Community Organizing

Assess the community   Identify primary building blocks   Most accessible assets

  Located in the neighborhood/Employment Setting

  Controlled by the neighborhood/Employment Setting

  Small businesses or $$ source

  If outside the employment setting Local expertise

Religious organizations

Citizens’ Associations

Community Organizing

Identify secondary building blocks

  Located in the workplace (?)

  Located in the neighborhood

  Controlled outside the neighborhood

  Higher education institutions

  Hospitals

  Public schools

  Parks

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Community Organizing

  Identify potential building blocks   Resources outside the neighborhood

  Controlled by outside people

  Welfare expenditure

 Final steps   Implement the plan

  Evaluate the outcomes

  Maintain the outcomes

  Change as needed

Needs Services

What are the nature and magnitude of the problem?

What are the characteristics of the population in need?

What are the needs of the population?

How much service is needed, over what time frame?

What service delivery arrangements are needed?

Program Design

What clientele should be served?

What services should be provided?

What are the best delivery systems?

How can the program identify, recruit, and sustain the intended clientele?

How should the program be organized?

What resources are necessary and appropriate for the program?

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Operations and Delivery

Are administrative and service objectives being met?

Are the intended people getting the intended services?

Are there needy but un-served persons the program isn’t reaching?

Do sufficient numbers use/complete services?

Are clients satisfied with services?

Are administrative, organizational, and personnel functions handled well?

Outcomes

Are goals and objectives being achieved?

Do the services have beneficial effects on the recipients?

Are some recipients affected more by the service than others?

Is the problem or situation the services address improving?

Cost and Efficiency

Are resources used efficiently?

Is the cost reasonable in relation to benefits?

Would alternative approaches yield equivalent benefits at less cost?

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