Community AssessmentSetting the Stage for Effective Programs

August 2020

Welcome and Presenter Introductions

Cam Escoffery, PhD, MPH, CHESAssociate Director, Emory Prevention Research CenterProfessor, Rollins School of Public Health

Erin Lebow-Skelley, MPH Training and Communications Lead, Emory Prevention Research CenterLead Pubic Health Program Associate, Rollins School of Public Health

Emory Prevention Research Center (EPRC)

• EPRC is one of 25 prevention research centers that conducts research on public health interventions focused on prevention

• It is based at the Rollins School of Public Health under the leadership of Dr. Michelle Kegler

• Our core research is to disseminate a healthy eating intervention among residents in Georgia through the 2-1-1 networks

• Website: http://web1.sph.emory.edu/eprc/

Learning Objectives

1. Define a community assessment

2. Explain the benefits of conducting a comprehensive community assessment

3. Define the three phases of a community assessment

4. Describe methods of data collection for a community assessment

5. Locate data sources for your community assets and needs to inform future planning or grant writing

Introduction to Community Assessment

• Defining community

What is a Community and what are the Community Members?A group of people

• Linked by social ties

• Sharing common perspectives or interests

• Who may or may not share a geographic location

• Common culture or ethnic heritage

• Where they live

• Similar age

• Speak the same language

• Religion

• Communities are not homogeneous and seldom speak with one voice

Healthy Community

• A healthy community is a place where:

• people provide leadership in assessing their own resources and needs

• public health and social infrastructure and policies support health

• where essential public health services, including quality health care, are available

-Institute of Medicine, 2003

What is Community Assessment?

A process by which community members gain an understanding of the health, concerns, and health care systems of the community by identifying, collecting, analyzing, and disseminating information on community assets, strengths, resources, and needs.

This Photo by Unknown Author is licensed under CC BY-NC-ND

Considerations: Planning for your Community Assessment (CA)• What do you want to

know?• What does your

community look like?

• Who should be part of the CA team?

• When do you need the CA results?

Program Planning Model: 1st Step

Community Assessment

Goals and Objectives

Program Planning

Formative Evaluation

Program Implementation

Program Evaluation

Process Evaluation

Dissemination of Results

Why do a Community Assessment (CA)?

• Identify and set priorities based on the need

• Understand the determinants of a health issue

• Identify assets, strengths, and resources in the community that might support a program*

• Outline goals and objectives of a program

• Provide standards for an evaluation of a program

*shift from term “community needs assessment”

Why do a Community Assessment (CA)? (cont)• Identify outside organizations to

help meet needs or provide resources

• Help to decide how to best address a health issue

• Provide a systematic basis for which organizational decisions are made

• Create an awareness of a community concern or problem

Benefits to Conducting CA• Understanding of the needs or concerns in your community

• Strengthening community involvement in decision making

• Better understanding of assets in the community and use of resources

• Improved communication with the public and other organizations

• Sustaining health initiatives when resources decline

Challenges to Conducting CA

• Working across professional boundaries- tackling territorial attitudes preventing power or information sharing

• Lack of shared language between community sectors

• Lack of commitment from key stakeholders or team members

• Difficulties in accessing relevant local data (national data easier to find)

• Difficulties in accessing the target population

• Difficulties in translating findings into effective action

Critical to Understanding Communities

Personal opinions, attitudes, risk or behavior assessment

Ecological or contextual influences on health behaviors or healthy environments

Catalog resources, capacities, or assets available (community strengths)

Three-Phase Plan for Assessing Needs

Exploration Data Collection Utilization

Phase 1Pre-assessment

Phase 2Assessment

Phase 3Post-

assessment

Phase 1: Pre-assessmentExploring and Organizing for Action

Phase 1: Pre-assessment - Exploration

• Set up CA committee

• Investigate what is already known about the needs of the target group

• Determine the focus and scope of the assessment

• Determine specific data to collect and how data will be used

Definitions of Stakeholders, Partners, and Target Population• Stakeholders – key contacts and other key informants in the

community, public health organizations and other related services, target population• Examples: Key agencies, participants, health professionals

• Partners – Coalition members, advisory board members

• Target Population – people directly affected by the needs assessment process (often termed priority population)

Pre-assessment Steps

• Form a CA assessment committee and gain commitment for all stages of the assessment

• Interview key contacts, stakeholders, and informants

• Conduct community analysis and review of literature

• Identify major areas of need for data collection instrument

• Finalize a community assessment plan

Set up CA Committee

Include voices of the community: Community members

Stakeholders Key Organizations

Health professionals

Staff

Leaders from community organizations

Phase 2: AssessmentGathering What You Need

Types of Date Sources

• Primary Data Sources- information collected directly by you or your organization

For example:

Community health concern survey

Key informant interviews

• Secondary Data Sources- information collected by someone else

For example:

Census data about your population in your city

Emergency room discharge records

Types of Data Collection

1. Key Informant Interviews

2. Group Data Collection

3. Secondary Data*

*Focus on this data collection for this training

Key Informant Interviews

Held with people who are knowledgeable of the community, health topic or organization

Interviews are interactive and allow open dialogue

They are conversations with a reason between 2 people

Help to frame what topics to ask about during data collection

Interviewing Key Informants

Key informantA person in the community or target population

A person working with the community

A person who has access to information about the target population

What are some interview questions that you would want to ask your key informants?For community members

For service providers

For elected officials

Primary Data Sources

Quantitative: Surveys/questionnaires

for key community members (key stakeholders) or target population

Methods:

Surveys

Direct observation of community or people

Qualitative: Professionals or community

members who are knowledgeable about health issue or audience

Methods: Interviews Group

Focus Groups Public meetings or forum

Windshield survey (drive/walk around community)

Types of Questions – Primary Data Collection

Community

• How would you rate your health/health of your community?

• What are your key unmet health needs or concerns?

Health/Social Service Organization• How would you describe the current status of

the organization?

• What are you doing well? (start with assets)

• What are areas in your organization that need improvement? (weaknesses)

• What issues or challenges does the organizations face?

• What are key unmet needs or issues of your participants?

Individual vs Organizational Assets

Individual Assets

Skills, talents, and experience

Individual businesses

Home-based enterprises

Personal income

Gifts of labeled people

Organizational Assets Association of

businesses Citizens’ associations Cultural organizations Communication

organizations Religious organizations

Secondary Data Sources

• Reports about the community from schools, medical systems, health departments, or city governments

• Reports about health topics from Centers for Disease Control and Prevention (CDC) that describe rates and who has diseases

• Literature review

• Health information on websites

• Your agency (services, participation)

Levels of Data for Community Analysis

National

State

Local

National Level

U.S. Census Bureau (people)

Vital Registration System (births, marriages)

National Case Reporting SystemFederal Reporting System

National Health SurveysBehavior Risk Factor Surveillance

System (BRFSS)National Health Information Survey

National Health OrganizationsCenters for Disease Control and

Prevention (CDC)American Cancer Society, etc.

State Level

Bureau of Vital Statistics

State Health Department

State Department of Education

State Department of Justice

Office for Motor Vehicles

Offices of Voluntary and Private Health Agencies

Fact Books

Local Level

Chamber of Commerce

City, county, regional planning offices

Newspaper Offices

Public Libraries

Insurance Companies

School Systems

Hospitals

Public/Private Mental and Public Health Centers

Community Residents Participants in Programs or

Services Neighborhood leaders

Types of Health Data

Health Statistic Definition

Vital Statistics government database recording births and deaths

Mortality the number of deaths in a population (i.e., COVID-19 deaths in a county)

Morbidity number of cases of a specific disease in a population (i.e., diabetes)

Incidence the number of new cases of a specific disease occurring during a certain period in a population at risk

Hospital Discharge number of hospital stays and the reason for hospitalization

Risk Factor variable associated with an increased risk for disease(i.e., smoking, unhealthy eating)

Some Useful Web Sites

U.S. Census Bureau: http://www.census.gov

National Center for Health Statistics: http://www.cdc.gov/nchs

State Cancer Profiles: http://statecancerprofiles.cancer.gov (can be accessed through the Cancer Control PLANET Web site, http://cancercontrolplanet.cancer.gov)

American Cancer Society’s Facts and Figures: http://www.cancer.org/docroot/STT/stt_0.asp

Online Analytical Statistical Information System (Oasis)

http://oasis.state.ga.us/

Goal of Phase 2:Data Collection MethodsCollect data and hear voices from the

community

Learn about the communityLearn about assets and perceived needs

Elicit voice of community

Secondary Data CollectionExample of Key Online Community Assessment Resources

U.S. Census Bureau

About the U.S. Census Bureau

• The Census Bureau serves as a primary source of quality data about a community’s people and economy (i.e., # of people in the home, race/ethnicity, adults/children)

• The Census Bureau includes more than just the 10 year Census! • the American Community Survey is an annual survey that provides updated

estimates based on Census data and more detailed information.

• Census data allow for a closer look into information from different geographies: counties, cities, zip codes, etc.

U.S. Census Bureau – Explore Census Datahttps://www.census.gov/en.html

U.S. Census Bureau – Explore Data Main Page

NOTE: American FactFinder has been replaced by Data.Census.Gov!

U.S. Census Bureau – Explore Census Data

U.S. Census Bureau – Albany, Georgia

U.S. Census Bureau – Albany, GA Data Search

U.S. Census Bureau – Maps and Profiles

OASIS

Full of interactive tools that have access to Georgia Department of Public Health’s standardized health data storage

Includes vital statistics (e.g. births, deaths, and pregnancies), hospital discharge, ER visit, population, and behavior risk factor surveillance survey data

Choose data based on certain criteria such as age, race, ethnicity, sex/gender, and health/county district

https://oasis.state.ga.us/

Online Analytical Statistical Information System (OASIS)

https://covid19.emory.edu/

Activity

Explore one of these two sites and find a data point or interesting fact about your county

• https://data.census.gov/cedsci/

• https://oasis.state.ga.us/

County Health Rankings Home Page

About County Health Rankings

• The rankings help measure the health of counties in all 50 states

• Translates complex data into accessible reports and models that helps with understanding community health needs as well as evaluation of improvement efforts

• It offers reliable source of local data to communities that assists community leaders in identifying opportunities to improve the population’s health

Georgia County Health Rankings

Phase 3: Posttest-assessmentAction Items and Dissemination of Results

Post-Assessment Activities

• Review community assessment data or report

• Consider recommendation of actions based on the data reported and placed them into some level of prioritization (i.e., short-term activities vs longer-term activities)

• Discuss ways of sharing the data with your assessment team• Public/Community: newsletter or article, public forum, factsheet, summary

on agency’s website

• Health Professionals: executive summary, full report

Questions?

Next Training:Grantwriting Webinar: September 11th

Check out the EPRC website for more information: http://web1.sph.emory.edu/eprc/

Questions: Contact Erin Lebow-Skelley, elebows@emory.edu

This Photo by Unknown Author is licensed under CC BY-NC

This presentation was supported by Cooperative Agreement 5U48-DP001909 from the Centers for Disease Control and Prevention. The

findings and conclusions in this presentation are those of the authors and do not necessarily represent the official position of the Centers

for Disease Control and Prevention.

Community Toolbox Website

http://ctb.ku.edu/en/dothework/tools_tk_2.aspx

Mission: Promoting community health and development by connecting people, ideas and resources

Provides information for a variety of actions for community health enhancement Including Community Needs Assessments

Outline for conducting CNA

Resources

Examples of CNAs

Community Assessment Handout