Assessment 1 Instructions: Evidence-Based Patient-Centered Needs Assessment

For this assessment, you will complete an evidence-based patient-centered needs assessment of prospective health care technology that will improve patient engagement. You will write a 4-5 page paper explaining the process and considerations that went into completing the patient needs assessment.

Introduction

Evidence-based practice is a key skill in the toolkit of the master's-prepared nurse. Its goal is that health care practitioners use the best available evidence to improve population health outcomes and make the best clinical decisions (Gallagher et al., 2020). In essence, evidence-based practice is all about ensuring quality care.

For this assessment will begin to apply some of the evidence-based practice strategies you have learned to ensure quality care for an individual patient. The primary strategy that you will utilize to accomplish this is an evidence-based patient-centered needs assessment. A patient-centered needs assessment can help you organize the relationships between ideas, challenges, or terms to utilize the best evidence to plan interventions. The overall goal of the resources and this assessment is to allow you the opportunity to apply evidence- based practice and personalized care concepts in order to improve the health of a single patient.

Reference

Gallagher, F. L., Koshy Thomas, B., Connor, L., Sinnott, L. T., & Melnyk, B. M. (2020). The effects of an intensive evidence‐based practice educational and skills building program on EBP competency and attributes. Worldviews on Evidence-Based Nursing, 17(1), 71–81.

Professional Context

Patient-centered needs assessment is a critical element in nursing care. The findings from the needs assessment can be effective tools for organizing a plan of action, prioritizing patient care strategies, and developing personalized care approaches that improve patient engagement. In addition to organizing care, they can aid in ensuring that the patient's care is individualized to not only their health conditions, but also their familial, cultural, and environmental situations.

Scenario

The purpose of a needs assessment is to identify priorities of a community or patient population. The findings of a needs assessment can be an extremely useful tool to help organize and plan care decisions for a specific patient or group. By conducting a needs assessment, a nurse can then use the best evidence to guide the interventions selected to meet the identified needs and improve patient engagement. 

Instructions

Develop a 4–5 page patient-centered needs assessment to demonstrate how to leverage health care technology to improve patient engagement and outcomes for a specific patient population. This could focus on a disease or a disorder based on the best available evidence that has been individualized to treat your patient’s health, economic, and cultural needs. 

The bullet points below correspond to the grading criteria in the rubric. Be sure that your paper address all of the bullets below, at minimum. If you are having a difficult time choosing a topic, review the Healthy People 2030 topics and try and find a topic that is interesting an relevant to you.

Identify the importance of addressing patient engagement in the management of a patient’s specific health, economic, and cultural needs based on the best available evidence. 

Why is patient engagement necessary to ensure that patients are better able to manage their specific health conditions? What evidence in the current literature(within the last 5 years) supports the benefit of patient engagement?

Explain the potential use and impact of information and communication technology tools needed to improve consumer health literacy for a specific patient population. Consider what type of health care technology modalities are useful to improve consumer health literacy Are there mobile applications, telehealth features, or other technology that can facilitate improving patient care?

Evaluate the value and relevance of the technology modalities that may be used to address the needs identified in the patient population assessment. How does each proposed technology modality encourage patient engagement in an ethical, culturally sensitive, and inclusive way? Ensure that your strategies:

Promote honest communications. Facilitate sharing only the information you are required and permitted to share. Enable you to make complex medical terms and concepts understandable to your patient and their family regardless of language, abilities, or educational level.

Consider how health information exchange and interoperability of technology modalities contribute to their value. Identify innovative strategies for leveraging technology to support quality, ethical, and efficient patient care that is culturally and linguistically appropriate for the identified patient population.

Consider how the selected technology impacts the patient in the most efficient way. Is the selected technology culturally and linguistically appropriate?

Explain how the proposed strategies will mitigate the risk of adverse outcomes due to inequity in access to patient personal health data and technology modalities. What are potential risks that could lead to adverse outcomes for certain members of the population? How will those risks be mitigated? How have your proposed strategies been used previously to address iniquities and risks?

Convey purpose of the assessment narrative in an appropriate tone and style, incorporating supporting evidence and adhering to organizational, professional, and scholarly communication standards. Integrate relevant sources to support assertions, correctly formatting citations and references using APA style.

Submission Requirements

Length of narrative: 4–5 double-spaced, typed pages. Your narrative should be succinct yet substantive.

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Number of references: Cite a minimum of 3–5 sources of scholarly or professional evidence that support your evaluation, recommendations, and plans. Current source materials defined as no older than five years unless it is a seminal work. Be sure you are citing evidence to support that your information is evidence-based. APA formatting: Resources and citations are formatted according to current APA style.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 1: Apply evidence-based practice to plan patient-centered care. Identify the importance of addressing patient engagement in the management of a patient’s specific health, economic, and cultural needs based on the best available evidence.

Competency 3: Evaluate the value, relevance, and ethics of available evidence upon which clinical decisions are made. Evaluate the value and relevance of the technology modalities that may be used to address the needs identified in the patient population assessment.

Competency 4: Integrate evidence based practice, technology tools, and scholarly research to address patient and population needs. Explain the potential use and impact of information and communication technology tools needed to improve consumer health literacy for a specific patient population. Identify innovative strategies for leveraging technology to support quality, ethical, and efficient patient care that is culturally and linguistically appropriate for the identified patient population. Explain how the proposed strategies will mitigate the risk of adverse outcomes due to inequity in access to patient personal health data and technology modalities.

Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with organizational, professional, and scholarly standards. Convey purpose of the assessment narrative in an appropriate tone and style, incorporating supporting evidence, and adhering to organizational, professional, and scholarly communication standards. Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.

SCORING GUIDE

Use the scoring guide to understand how your assessment will be evaluated.

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RESEARCH ARTICLE

A guiding framework for needs assessment

evaluations to embed digital platforms in

partnership with Indigenous communities

Jasmin BhawraID 1, M. Claire Buchan2, Brenda Green3, Kelly SkinnerID

2, Tarun

Reddy KatapallyID 4,5,6*

1 School of Occupational and Public Health, Toronto Metropolitan University, Toronto, ON, Canada,

2 School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada, 3 Île-à-la-Crosse School

Division, The Northern Village of Île-à-la-Crosse, Île-à-la-Crosse, SK, Canada, 4 DEPtH Lab, Faculty of

Health Sciences, Western University, London, ON, Canada, 5 Department of Epidemiology and Biostatistics,

Schulich School of Medicine and Dentistry, Western University, London, ON, Canada, 6 Lawson Health

Research Institute, London, Ontario, Canada

* [email protected]

Abstract

Introduction

In community-based research projects, needs assessments are one of the first steps to

identify community priorities. Access-related issues often pose significant barriers to partici-

pation in research and evaluation for rural and remote communities, particularly Indigenous

communities, which also have a complex relationship with academia due to a history of

exploitation. To bridge this gap, work with Indigenous communities requires consistent and

meaningful engagement. The prominence of digital devices (i.e., smartphones) offers an

unparalleled opportunity for ethical and equitable engagement between researchers and

communities across jurisdictions, particularly in remote communities.

Methods

This paper presents a framework to guide needs assessments which embed digital plat-

forms in partnership with Indigenous communities. Guided by this framework, a qualitative

needs assessment was conducted with a subarctic Métis community in Saskatchewan,

Canada. This project is governed by an Advisory Council comprised of Knowledge Keepers,

Elders, and youth in the community. An environmental scan of relevant programs, three key

informant interviews, and two focus groups (n = 4 in each) were conducted to systematically

identify community priorities.

Results

Through discussions with the community, four priorities were identified: (1) the Coronavirus

pandemic, (2) climate change impacts on the environment, (3) mental health and wellbeing,

and (4) food security and sovereignty. Given the timing of the needs assessment, the com-

munity identified the Coronavirus pandemic as a key priority requiring digital initiatives.

PLOS ONE

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OPEN ACCESS

Citation: Bhawra J, Buchan MC, Green B, Skinner

K, Katapally TR (2022) A guiding framework for

needs assessment evaluations to embed digital

platforms in partnership with Indigenous

communities. PLoS ONE 17(12): e0279282.

https://doi.org/10.1371/journal.pone.0279282

Editor: Stephane Shepherd, Swinburne University

of Technology, AUSTRALIA

Received: June 1, 2022

Accepted: December 2, 2022

Published: December 22, 2022

Copyright: © 2022 Bhawra et al. This is an open

access article distributed under the terms of the

Creative Commons Attribution License, which

permits unrestricted use, distribution, and

reproduction in any medium, provided the original

author and source are credited.

Data Availability Statement: Data are co-owned

by the community and all data requests should be

approved by the Citizen Scientist Advisory Council

and the University of Regina Research Office.

Citizen Scientist Advisory Council Contact: Mr.

Duane Favel, Mayor of Ile-a-lacrosse, email:

[email protected]; [email protected]

University of Regina Research Office contact: Ara

Steininger, Research Compliance Officer; E-mail:

[email protected]. Those interested can

access the data in the same manner as the authors.

Conclusion

Recommendations for community-based needs assessments to conceptualize and imple-

ment digital infrastructure are put forward, with an emphasis on self-governance and data

sovereignty.

Introduction

Community engagement has been the cornerstone of participatory action research in a range

of disciplines. Every community has a unique culture and identity, hence community mem-

bers are the experts regarding their diverse histories, priorities, and growth [1–3]. As a result,

the successful uptake, implementation, and longevity of community-based research initiatives

largely depends on meaningful community engagement [4–9]. There is a considerable body of

evidence establishing the need for ethical community-research partnerships which empower

citizens and ensure relevant and sustainable solutions [1–3, 10]. For groups that have been

marginalized or disadvantaged, community-engaged research that prioritizes citizens’ control

in the research process can provide a platform to amplify citizens’ voices and ensure necessary

representation in decision-making [11]. Such initiatives must be developed in alignment with

a community’s cultural framework, expectations, and vision [12] to support continuous and

meaningful engagement throughout the project. In particular, when partnering with Indige-

nous communities, a Two-Eyed Seeing approach can provide valuable perspective to combine

the strengths of Indigenous and Western Knowledges, including culturally relevant methods,

technologies, and tools [13–15].

Many communities have a complicated relationship with research as a result of colonialism,

and the trauma of exploitation and discrimination has continued to limit the participation of

some communities in academic partnerships [16]. Indigenous Peoples in Canada experience a

disproportionate number of health, economic, and social inequalities compared to non-Indig-

enous Canadians [17]. Many of these health (e.g., elevated risk of chronic and communicable

diseases) [18–21]), socioeconomic (e.g., elevated levels of unemployment and poverty) [19,

22–24], and social (e.g., racism and discrimination) [19, 22–24]) inequities can be traced back

to the long-term impacts of assimilation, colonization, residential schools, and a lack of access

to healthcare [19, 20, 22–24]. To bridge this gap, and more importantly, to work towards

Truth and Reconciliation [25], work with Indigenous Peoples must be community-driven, and

community-academia relationship building is essential before exploring co-conceptualization

of initiatives [26].

One of the first steps in building a relationship is to learn more about community priorities

by conducting a needs assessment [27, 28]. A needs assessment is a research and evaluation

method for identifying areas for improvement or gaps in current policies, programs, and ser-

vices [29]. When conducted in partnership with a specific community, needs assessments can

identify priorities and be used to develop innovative solutions, while leveraging the existing

knowledge and systems that communities have in place [30]. Needs assessments pave the path

for understanding the value and applicability of research for community members, incorporat-

ing key perspectives, and building authentic partnerships with communities to support effec-

tive translation of research into practice.

For rural, remote, and northern communities within Canada, issues related to access (e.g.,

geographic location, transportation, methods of communication, etc.) pose significant barriers

to participation in research and related initiatives [31]. Digital devices, and in particular, the

PLOS ONE Embedding digital tools with Indigenous communities

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Funding: TRK received funding from the Canadian

Institutes of Health Research (CIHR) and the

Canada Research Chairs Program to conduct this

research. The funding organization had no role to

play in any part of the study implementation of

manuscript generation.

Competing interests: The authors have declared

that no competing interests exist.

extensive usage of smartphones [32] offers a new opportunity to ethically and equitably engage

citizens [33]. Digital platforms (also referred to as digital tools) are applications and software

programs accessible through digital devices. Digital platforms can be used for a variety of pur-

poses, ranging from project management, to healthcare delivery or mass communication [34].

Digital infrastructure–the larger systems which support access and use of these digital plat-

forms, including internet, satellites, cellular networks, and data storage centres [34]. The Coro-

navirus (COVID-19) pandemic has catalyzed the expansion of digital technology,

infrastructure and the use of digital devices in delivering essential services (e.g., healthcare)

and programs to communities [35, 36].

While digital platforms have been used in Indigenous communities for numerous initia-

tives, including environmental mapping initiatives (e.g., research and monitoring, land use

planning, and wildlife and harvest studies) [37, 38] and telehealth [39], there has largely been

isolated app development without a corresponding investment in digital infrastructure. This

approach limits the sustainability of digital initiatives, and importantly does not acknowledge

an Indigenous world view of holistic solutions [39].

Thus given the increasing prominence of digital devices [39, 40], it is critical to evaluate the

conceptualization, implementation, and knowledge dissemination of digital platforms. To

date, there is little guidance on how to evaluate digital platforms, particularly in partnership

with rural and remote communities [41]. A review of recent literature on community-based

needs assessments uncovered numerous resources for conducting evaluations of digital plat-

forms, however, a key gap is the lack of practical guidance for conducting needs assessments in

close collaboration with communities in ways that acknowledge existing needs, resources, sup-

ports and infrastructure that also incorporates the potential role of digital platforms in address-

ing community priorities.

This paper aims to provide researchers and evaluators with a framework (step-by-step

guide) to conduct needs assessments for digital platforms in collaboration with Indigenous

communities. To achieve this goal, a novel needs assessment framework was developed using a

Two-Eyed Seeing approach [13–15] to enable the identification of community priorities, barri-

ers and supports, as well as existing digital infrastructure to successfully implement digital

solutions. To demonstrate the application of this framework, a community-engaged needs

assessment conducted with a subarctic Indigenous community in Canada is described and dis-

cussed in detail.

Framework design and development

This project commenced with the design and development of a new framework to guide com-

munity-based needs assessments in the digital age.

Needs assessments

Needs assessments are a type of formative evaluation and are often considered a form of strate-

gic or program planning, even more than they are considered a type of evaluation. Needs

assessments can occur both before and during an evaluation or program implementation;

however, needs assessments are most effective when they are conducted before a new initiative

begins or before a decision is made about what to do (e.g., how to make program changes)

[29]. Typically, a needs assessment includes: 1) collecting information about a community; 2)

determining what needs are already being met; and 3) determining what needs are not being

met and what resources are available to meet those needs [42].

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Framework development

Based on existing literature, community consultation, and drawing expertise from our team of

evaluation experts who have over a decade of experience working with Indigenous communi-

ties on a range of research and evaluation projects, a novel framework was developed to guide

community-based needs assessments focused on the application of digital platforms.

This framework (see Fig 1) is driven by core questions necessary to identify community pri-

orities that can be addressed by developing and implementing digital platforms. Through team

discussion and community consultation, five key topic areas for the assessment of community

needs were identified: i) current supports; ii) desired supports; iii) barriers; iv) community

engagement; and v) digital access and connectivity. A series of general questions across the five

needs assessment topic areas were developed. Thereaf