Health Needs Assessment
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?
