Assessing Community Resources Chapter 2 Assessing Community Resources © 2006 Thomson-Wadsworth

Learning Objectives Describe seven steps in conducting a community needs assessment. Develop a statement that defines the nutritional problem within the community. Discuss the contribution of the target population to community needs assessment planning and priority setting. © 2006 Thomson-Wadsworth

Learning Objectives Define the terms incidence and prevalence, and explain how these concepts describe a population’s and the community’s health. Describe three types of data about the community that can be collected, and indicate where these data are found. © 2006 Thomson-Wadsworth

Introduction The process of community nutrition assessment is much like the challenge of producing the “best” photograph of your city. © 2006 Thomson-Wadsworth

Community Needs Assessment Community needs assessment is the process of: Evaluating the health and nutritional status of the community. Determining what the community’s health and nutritional needs are. Identifying places where those needs are not being met. © 2006 Thomson-Wadsworth

Community Needs Assessment It involves systematically collecting, analyzing, and making available information about the health and nutritional status of the community. © 2006 Thomson-Wadsworth

Community Needs Assessment Health status refers to the condition of a population’s health, including estimates of its quality of life and physical and psychosocial functioning. Nutritional status is defined as the condition of a population’s health as affected by the intakes and utilization of nutrients and nonnutrients. © 2006 Thomson-Wadsworth

Community Needs Assessment Any number of factors may trigger the need for a community needs assessment: Existing data are old or data have never been collected on some segment of the population. A mandate by a government agency at the state or federal level. Research findings provide the impetus for taking action. Availability of funding serves as the impetus. © 2006 Thomson-Wadsworth

Community Needs Assessment Organizations approach community needs assessment by first determining its purpose and then planning how it will proceed. The scope of an assessment must be specified because it can be designed to identify the health and nutritional problems of a large population or it can focus on a particular subgroup of the community. © 2006 Thomson-Wadsworth

Community Needs Assessment Regardless of scope, the purpose of the community needs assessment is to obtain information about the health and nutritional status of the target population. No matter what the scope is, there are certain principles and a specific process for conducting a community needs assessment. © 2006 Thomson-Wadsworth

© 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment Step 1: Define the Nutritional Problem The community nutritionist develops a concise statement of the problem of concern. The problem statement is used to help plan the assessment and motivate other agencies to join the assessment team. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 1 The problem statement should indicate: Who is affected by the nutritional problem. How many people experience the problem. The impact of the problem on general health or nutritional status. Areas where there are gaps in the community’s knowledge of a nutritional problem. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 2 Step 2: Set the Parameters of the Assessment Certain parameters or elements must be determined before the community needs assessment is undertaken. © 2006 Thomson-Wadsworth

© 2006 Thomson-Wadsworth

© 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 2 The parameters set the direction for the assessment: Define “Community” Determine the Purpose of the Needs Assessment Define the Target Population Set Goals and Objectives for the Needs Assessment Specify the Types of Data Needed © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 2 Define “Community.” Define “community” which might include the people who represent the target population and live within a certain geographical region. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 2 Determine the Purpose of the Needs Assessment Identify groups who are at risk nutritionally. Identify the most critical needs and set priorities among them. Determine the factors that contribute to a nutritional problem. Determine whether existing resources and programs meet the needs of the population. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 2 Determine the Purpose of the Needs Assessment (continued) Provide baseline information for developing action plans to address needs. Plan actions to improve nutritional status. Tailor a program to a specific population. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 2 Define the Target Population. Define the target population whose health and nutritional status is affected by many community, environmental, and personal factors. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 2 Set Goals and Objectives for the Needs Assessment Goals and objectives determine the types of data collected and how they will be used. Goals are broad statements that indicate what the assessment is expected to accomplish. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 2 Set Goals and Objectives for the Needs Assessment (continued) Objectives are statements of outcomes and activities needed to reach a goal and they generally include a strong verb, such as increase, decrease, or reduce, that describes a measurable outcome. Each objective should state a single purpose. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 2 Specify the Types of Data Needed. Specify the types of data needed, which depends on the purpose, goals, and objectives of the assessment. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 3 Step 3: Collect Data Begin first by collecting data about the community or environment in which the target population lives and works. Next, collect data about individuals who make up the target population. © 2006 Thomson-Wadsworth

© 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 3 Both qualitative and quantitative data help describe the community, its values, health problems, and needs. Qualitative data include opinions and insights derived from interviews with: Those people who are knowledgeable about the community, called key informants, and with Stakeholders who have a vested interest in identifying and addressing the nutritional problem. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 3 Members of the target population itself can provide information about the community. Quantitative data can be derived from a variety of databases, including Registries of vital statistics Published research studies Hospital records Local health surveys © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 3 Types of data to collect about the community include: Community characteristics Environmental characteristics Socioeconomic characteristics © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 3 Community Characteristics Community organizational power and structures including the key players in local health organizations and media groups. Demographic data and trends such as sex, age, race, martial status, and living arrangements. © 2006 Thomson-Wadsworth

© 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 3 Community Characteristics Community health which can include a variety of health statistics such as the causes and rates of disease, disability, and death and the population’s nutrition problems. Existing community services and programs that can be used to pinpoint gaps where services are needed. © 2006 Thomson-Wadsworth

© 2006 Thomson-Wadsworth

© 2006 Thomson-Wadsworth

© 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 3 Environmental Characteristics Access to medical clinics Access to transportation Access to nutritious foods © 2006 Thomson-Wadsworth

© 2006 Thomson-Wadsworth

© 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 3 Socioeconomic Characteristics Income of families Number of families receiving public assistance Educational level Literacy rate Major industries and occupations © 2006 Thomson-Wadsworth

© 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 3 Sources of Data about the Community Observing the target population in the community setting including where people shop for food and their perceptions of nutritional problems. Networking with colleagues who may be aware of similar assessments done in other areas. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 3 Sources of Data about the Community Interviewing key informants such as formal community leaders like the mayor, religious leaders, or members of the media. Conducting an internet and library search of the literature on the nutritional problem which can locate many types of demographic and socioeconomic data from the U.S. Bureau of Censes, Bureau of Labor Statistics, USDA, and the DHHS. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 3 Collect Data about Background Conditions National policy can affect eligibility for food assistance programs, minimum wage levels, distribution of commodity foods, and other factors important to nutritional status. The broad culture, which is the interconnected web of human knowledge, beliefs, and behaviors that are learned and transmitted to succeeding generations, can also influence food intake and nutritional status. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 3 Collect Data about Background Conditions Background information on the community’s or region’s health status is also important and can be obtained from international agencies such as the Food and Agriculture Organization. © 2006 Thomson-Wadsworth

© 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 3 Collect Data about the Target Population Existing Data Use existing data about health statistics and behavioral information related to your target group. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 3 Collect Data about the Target Population Existing Data Sources National Nutrition Monitoring and Related Research Program Public Health Reports New England Journal of Medicine © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 3 Collect Data about the Target Population New Data In some situations new data may need to be collected about target populations and methods can include nutrition surveys, health risk appraisals, screening tools, or focus groups. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 4 Step 4: Analyze and Interpret the Data Data collected must be analyzed and examined and used to diagnose the community. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 4 Four steps are involved in making a community diagnosis: Step 1: Interpret the state of health of the target population within the community. Step 2: Interpret the pattern of health care services and programs designed to reach the target population. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 4 Community diagnosis (continued): Step 3: Interpret the relationship between the target population’s health status and health care in the community. Step 4: Summarize the evidence linking the target population’s major nutritional problems to their environment. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 4 The summary describes the following: The dimensions of the nutritional problem, including its severity, extent, and frequency. Its distribution across urban, rural, or regional settings and across age groups. Its causes. The mortality and morbidity associated with it. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 4 The summary should also describe: The major strengths of existing community resources and health care services as they related to the target population. The areas where health problems seem to be concentrated. The areas where health care delivery could be improved. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 4 The summary may also provide information about the cost of treating versus preventing the nutritional problem and the social consequences of not intervening in the target population. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 5 Step 5: Share the Findings of the Assessment Sharing the findings with other groups and stakeholders is cost-effective, prevents duplication of effort, and promotes cooperation among organizations. Sharing also enlarges the sphere of awareness about the nutritional problem. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 5 However, releasing the results of the assessment to the community at large, without seeking the support and approval of the stakeholders, can create ill will. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 6 Step 6: Set Priorities When several nutrition problems are identified the question becomes which health outcome is most important. Health outcome refers to the effect of an intervention on the health and well-being of an individual or population. The best health outcome is improvement in the nutritional status of the target population. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 6 The community nutritionist should utilize principles that provide guidance in identifying problems of the highest priority and should compare findings of the community assessment with Healthy People 2010 objectives. © 2006 Thomson-Wadsworth

© 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 7 © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 7 Step 7: Choose a Plan of Action Key findings of the assessment should be shared with community leaders and other people who are interested in the health and well-being of the target population. Another action is to use the assessment’s findings to advocate for a change in legislation or public policy that will improve the health potential of the target population. © 2006 Thomson-Wadsworth

Basic Principles of Needs Assessment – Step 7 Releasing the findings to the media is one way to increase awareness of the problem and build support for policy changes that address the problem. A workshop or conference could also be organized to obtain additional information on the problem or the decision might be made to alter an existing program, change a marketing campaign, or change the mechanism for delivering a program. © 2006 Thomson-Wadsworth

The Nutrition Service Project A successful education program that utilizes college students to help adolescents and teens: Distinguish between sound and unhealthful nutrition information in the media Learn fundamentals of good nutrition © 2006 Thomson-Wadsworth

The Nutrition Service Project Goals and Objectives Primary goal = helping children in underprivileged areas learn about health and nutrition Objectives include: Promoting volunteerism in the college environment Helping a community that had limited access to health promotion and education programs Researching nutrition habits and media viewing among middle/high school students © 2006 Thomson-Wadsworth

The Nutrition Service Project Target Audience Students attending grades 7 through 12 in a rural community in Pennsylvania Rationale for the Intervention Health behaviors begin developing in childhood. © 2006 Thomson-Wadsworth

The Nutrition Service Project Methodology College students are trained College students teach nutrition/media literacy during spring break 4 components: Student director Group of students in leadership roles for the project A middle school or high school Financial resources to cover training and program costs © 2006 Thomson-Wadsworth

The Nutrition Service Project Results Contributed approximately 2,500 volunteer hours Reached 230 Pennsylvania youths 2001: 116 intervention students and 60 control students participated © 2006 Thomson-Wadsworth

The Nutrition Service Project Results (continued) Before the intervention, preliminary data demonstrated that participants were not able to identify accurate nutrition information. After the intervention, participants had greater understanding of how to view media critically and how to identify accurate articles about nutrition. © 2006 Thomson-Wadsworth

Entrepreneurship in Community Needs Assessment Community nutritionists can apply the principles of entrepreneurship to community needs assessment by: Developing new strategies for collecting information about hard-to-reach populations. Forging new partnerships with food producers, retailers, distributors, and marketers to collect information about dietary patterns and beliefs at the local level. © 2006 Thomson-Wadsworth

Entrepreneurship in Community Needs Assessment Community nutritionists can apply the principles of entrepreneurship to community needs assessment by: Developing new methods of assessing nutritional needs and problems. © 2006 Thomson-Wadsworth

Entrepreneurship in Community Needs Assessment The COMPASS tool kit developed by United Way of America is an example of entrepreneurship in community assessment. Look for examples in your community of organizations or people who recognized an opportunity and took the initiative to improve the community’s quality of life. © 2006 Thomson-Wadsworth

Getting Where You Want to Go Square 1: Know Yourself Square 2: Define Your Dreams What would you most like, ideally, to be? What would you most like, ideally, to do? What kinds of experiences help you feel complete? In what kinds of situations do you most want and tend to share yourself? © 2006 Thomson-Wadsworth

Getting Where You Want to Go Square 3: Set Goals ("mission statement") Example:* Succeed at home first. Never compromise with honesty. Be sincere yet decisive. Develop 1 new proficiency a year. etc. *Adapted from S.R. Covey, The 7 Habits of Highly Effective People (New York: Simon & Schuster, 1989), p. 106. © 2006 Thomson-Wadsworth

Getting Where You Want to Go Square 4: Develop an Action Plan Develop a picture in your mind’s eye of what you want to do with your life. Pretest your mental picture. Predetermine your alternatives. Learn to Manage Yourself © 2006 Thomson-Wadsworth