Transcript Preventive Services Improvement Initiative

Nuts and Bolts #2
Conducting the Needs
Assessment
2
Objectives
Participants will be able to:
 Understand the key aspects of a needs
assessment and be able to plan and
implement a needs assessment
 Make recommendations based on the
findings of the needs assessment
 Identify the key aspects of school
nurses, parents/guardian, and
confidentiality in school-based health
care services
What is a Community Needs
Assessment?
An accurate appraisal of the current
situation (strengths, concerns, and general
conditions) of a community’s population
A collection of secondary and first hand
information and data from a wide range of
relevant sources and audiences
4
What is a Community Needs
Assessment?
A process for:
identifying needs and resources in a
community
determining gaps between what a
situation is and what it should be
establishing priorities
An opportunity to paint a picture of the
conditions in a community and sharpen your
perceptions of the critical issues children
and families face
5
Why Identify Needs and
Resources?

Better understand the community in which
you will be working

Become aware of needs and concerns you
never knew about

Locate hidden strengths or underutilized
resources that could be developed

Document need

Make sure future actions are aligned with
expressed community needs
6
Why Identify Needs and
Resources?

Garner greater support and involve more
people in subsequent action

Give voice to individuals in the community
who have not traditionally been solicited for
comment

Convince outside funders and supporters

Make decisions based on priorities and
documented needs
7
Planning and Implementing the
Assessment

Step 1: Involve stakeholders

Establish working group to guide the
planning and implementation of
Community Needs Assessments
8
Planning and Implementing the
Assessment
Step 2: Determine the Objectives and
Outcomes of the Assessment

What are you really interested in knowing? Your
questions will flow from this.

What is your vision? How will you use the
information obtained?

Which issues, questions, and behaviors are of
particular interest?

What don’t you know about these issues? What
questions do you need to answer?
9
Planning and Implementing the
Assessment
Step 3: Identify secondary data sources

Find out what outside resources can be used

What public reports exist (examples of
sources: census data, vital statistics, CPS
reports)
–

Have other studies been done?
Are there experts in the community who can
help you?
10
Planning and Implementing the
Assessment (cont)
Step 4: Choose your approach/
approaches for gathering new
information
Most common approaches:
 Key
informant interviews
 Focus
groups
 Public
forums
 Surveys
11
Planning and Implementing the
Assessment

When making your choice of approach,
take into account:
 Purpose
of the study
 Amount of time you have and number of people
assisting you
 Available resources
 Size and characteristics of target population
 Relationship you have with target population
“The
quality of information about a community is only as good as the technique or combination of techniques
used. A single technique may be too narrow; using too many techniques may be costly in terms of time and
dollars. Different techniques are appropriate for different needs. Analyze the situation and then weigh the
advantages and disadvantages. Sometimes a combination of techniques will provide a more reasonable
picture.” (Butler and Howe, 1980)
12
Planning and Implementing the
Assessment
Key Informant Interviews
 Purpose
= to collect information from those
in the community who are in a prime
position to know the needs facing the
community
 How
to implement = compile a list of
participants, create protocol, make
appointments (either telephone or inperson), gather data, identify common
themes
13
Planning and Implementing the
Assessment
Key Informant Interviews
 Advantages




Easy and not expensive
Can discuss confidential issues more readily
Establishes rapport and trust with community
Permits clarification of issues and ideas
 Disadvantages





May be difficult to schedule
May provide a biased perspective
Only represents perceptions – not hard data
Personal relationships may influence outcomes
Should be combined with other methods because may not
represent whole community
14
Planning and Implementing the
Assessment
Focus Groups
 Purpose
= to collect information from those in the
community who are in a prime position to know the
needs facing the community
 How
to implement = compile a list of participants,
decide on location, create protocol, invite participants
(think about food and baby sitting if necessary), use
facilitator and documenter, organize and identify
common themes
15
Planning and Implementing the
Assessment
Focus Groups
 Advantages




Easy and not expensive
Establishes rapport and trust with community
members
Permits clarification of issues and ideas
Easily combined with other techniques
 Disadvantages




May provide biased perspectives
Only represents perceptions – not hard data
Sharing opinions and views in a group setting may
be inhibiting
Should be combined with other methods because
may not represent whole community
16
Planning and Implementing the
Assessment
Public forums
 Purpose
= elicit information from a wide range
of residents in a series of public meetings
 How
to implement = develop list of invitees,
create list of questions, select strategically
located venue (use different sites and hold at
different times), publicize, use facilitator and
documenter, identify common themes
17
Planning and Implementing the
Assessment
Public forums
 Advantages:



Get opinions from a wide range of people
Promotes active involvement, community awareness,
and buy-in
Inexpensive, quick picture of community
 Disadvantages:





Requires good leadership
Opinions limited to those who attend
Lots of advance planning
May generate more questions than answers
May create unrealistic expectations
18
Planning and Implementing the
Assessment
Surveys
 Purpose
= collect information from a wide range of
respondents
 How
to implement = find or create carefully
developed instrument and administer through a
sampling procedure (may be face to face, personal
distribution and collection, self-administered in a group,
telephone, mailed), analyze results
19
Planning and Implementing the
Assessment
Surveys
 Advantages


Best approach for eliciting attitudes of broad range
of individuals
Data usually valid and reliable
 Disadvantages

Costly and requires time and expertise
Needs carefully selected tool and sampling
Subject to misinterpretation

Individuals may hesitate to answer questions


20
Planning and Implementing the
Assessment

Planned Approach to Community Action
(PATCH)
– developed by CDC
– effective model for planning, conducting, and
evaluating community health promotion and
disease prevention programs
– Used by diverse communities in US and other
nations to address health concerns
– PATCH Guide for local coordinator has sample
surveys and data collection tools
– Web site www.cdc.gov/nccdphp/path/index.htm
21
Planning and Implementing the
Assessment
Step 5: Implement Plan

Collect secondary data

Collect primary data (conduct interviews, focus
groups, surveys, etc)

Analyze secondary and primary data

Summarize findings
22
Planning and Implementing the
Assessment
Step 5: Implement Plan

Prepare report

Share with working group, interpret data and
develop recommendations together

Present to external stakeholders as needed

Create action plan
23
Review Anytown’s Needs
Assessment Document
24
Project Work Plan and Design
Example from Chicago SBHC

Convened a planning committee of key community
stakeholders who met regularly to oversee and
guide the process

Gathered existing data
 U. S. Census Bureau (2000)
 Chicago Health and Health Systems Project
(CDPH 2006)
 Healthy Albany Park Assessment (2004)
 Illinois State Report Card (2004 – 2005)
 CPS School Profile (2004 – 2005)
25
Project Work Plan and Design

Collected new data
 Conducted fifteen stakeholder interviews with
school administrators, school personnel,
school nurses, and external partners working
in schools
 Conducted a focus group with community
providers

Analyzed findings

Drafted initial recommendations
26
Make Recommendations
Based on Needs Assessment
Findings
27
Select the School
Elementary
 Middle or Junior High
 K-8
 High School
 Alternative School
 Pre-school

28
Select the Service Delivery Strategy
and Model









Service and Staffing Options
Collaborative Partnerships
The role of the school nurse
Policy and Procedures
Referral Networks
Delivery of Service
Parental Consent/Parental Involvement
Integration of the school-based health center with
existing school and community resources
Confidentiality Issues
29
Services to Consider for
All Grade Levels







Primary Care including
biennial risk
assessment
Immunizations
Health Education
Physical Examinations
Mental Health
Laboratory Services
Medications





Nutrition Counseling
Vision, Hearing, and
Dental Screening
Social Services
Chronic Disease comanagement
Specialty Care
Referrals
30
Services at the MS and HS Levels

Pregnancy testing

STD testing and treatment

Reproductive health care

Group counseling to address issues such as
sexual abuse, depression

Individual mental health counseling

HIV testing and/or counseling

Referral for family planning
31
The Role of the School Nurse

Maintain school nurse mandated functions
(vision and hearing screening,
immunizations, special ed, etc.)

Member of school-based health team
– Identify students for school-based health center
services
– Provide follow-up
– Reach out to parents
– Serve as a liaison between the school-based
health center and school staff
32
Parental/Family Consent / Family
Engagement

The majority of SBHCs have a parental/guardian
consent policy.

Consent form should include:
– Services to be offered
– Statement about confidentiality /HIPAA
– Billing issues
– Statement about the relationship between the
sponsoring organization and any collaborators
including the school district

Review state statutes regarding age of consent for
various health care services
33
Confidentiality

Confidential versus nonconfidential
services

Access to confidential services

Release of information

Providing follow-up information to school
personnel and outside agencies

Informing students of confidentiality
procedures and limits of confidentiality
34
Needs Assessment
Helps you determine where you are at,
existing resources and gaps
 Paints a picture of the school, the
community, the environment
 Helps you determine what the model
needs to be and the types of services
 Necessary to make a solid plan for
implementation
