Nuts and Bolts #2 Conducting the Needs Assessment

1. Nuts and Bolts #2 Conducting the Needs Assessment

3. 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

4. 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

5. 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

6. 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

7. 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

8. Planning and Implementing the Assessment • Step 1:Involve stakeholders • Establish working group to guide the planning and implementation of Community Needs Assessments

9. 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?

10. 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?

11. 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

12. 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)

13. 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 in-person), gather data, identify common themes

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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 sitewww.cdc.gov/nccdphp/path/index.htm

22. 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

23. 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

24. Review Anytown’s Needs Assessment Document

25. 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)

26. 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

27. Make Recommendations Based on Needs Assessment Findings

28. Select the School • Elementary • Middle or Junior High • K-8 • High School • Alternative School • Pre-school

29. 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

30. 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 co-management Specialty Care Referrals Services to Consider for All Grade Levels

31. 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

32. 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

33. 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 regardingage of consent for various health care services

34. 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

35. 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