CHAPTERS 4 8-14 for HS 2250 FINAL.docx

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Health Sciences
Health Sciences 3250F/G
Bill Irwin

CHAPTER 4Needs Assessment The process of identifying analyzing and prioritizing needs or a priority populationEssential in program planning whether a need of the priority population is actual or received Requires finding the most significant health problem and finding out if you have resources assets and capacity to deal with problem and any promising interventions related to the problemNeeds assessment is not necessary if another one had been done recently for a related program planners employed by agency that deals with only a specific problem funding is categorical and must be used on a specific problem What to expect from a needs assessmentA needs assessment should answer certain questions 1 Who is the priority population 2 What are the needs of the priority population 3 Which subgroups within the priority population have the greatest need 4 Where are these subgroups located geographically 5 What is currently being done to resolve identified needs 6 How well have the identified needs been addressed in the pastAcquiring needs assessment dataPrimary datadata that you collect yourself Interactive contact methods those collecting data interact with those whom the data is being collected fromCan be expensive and time consumingDirectly answers the questions that planners want answered by those in the priority populationSecondary dataData already collected by somebody else and available for you immediate useLabeled as no contact methodSince the data already exists this saves a lot of time and moneyInformation might not identify the true needs of the priority populationSources of Primary dataSINGLESTEPCROSS SECTIONAL SURVEYSgather data from one interaction with the individuals usually questionnaires or interviews through phone electronically face to face group etc Self reportsindividuals answer questions about themselves A limitation of self reports is bias Eight steps to increase accuracy of this method of data collection isSelect measures that clearly reflect program outcomesSelect measures designed to anticipate the response problems and that have been validatedconduct a pilot study with the priority populationAnticipate and correct any major sources of unreliabilityEmploy qualitycontrol procedures to detect other sources of errorEmploy multiple methodsuse multiple measuresUse experimental and control groups with random assignment to control for biases in selfreports When people in population cannot respond for themselves a Proxy measure can be doneIt is an indirect measure that provides evidence that a behaviour has occurred The greatest concern associated with proxy measures is making sure that the measure is both valid and reliable In addition to the priority population we can also survey significant othersOpinion leaders individuals who are well respected in a community and who can accurately represent the views of the priority population They arediscriminating users of the mediademographically similar to the priority groupknowledgeable about community issues and concernsearly adopters of innovative behaviouractive in persuading others to become involved in innovative behavior Key informants strategically placed individuals who have knowledge and ability to report on the needs of the priority population They may be bias so you CANT base a whole needs assessment just on them Single Step Surveys can be administered by Written QuestionnairesThe most used method because it can reach a lot of people in a short period of time It has minimum cost and staff time needed Has the LOWEST response rate since the response isnt anonymous there are ways to avoid this Less response bias but a disadvantage in the form of clarification of questionsFor high response make it short easy to understand and explain why youre collecting data also adding incentives for returning it helps a lot Face to Face Interviews This method is time consuming and expensiveHas a high response rateInterviews taught to probe to get more info out of the respondents get to see their actions Variations in interviews and interviewers can cause different result Telephone InterviewsCompared to the other two methods this is an easy way of getting selfreported data at cheap costs Will reach only those who have access to a telephoneOne method to call a randomly selected group of people who have access to a telephone Another method is to select numbers from a random telephone directory not everybody has a listen phone numberOne way to overcome this is by using randomdigit dialing It includes an entire survey of the populationThe interviewer does have the opportunity to clarify questions which is an advantage over the written questionnaire but does not have the advantage of visual cues that the face to face interview offers Electronic InterviewsLow in cost and instantaneousDisadvantagesaccess a limited population lack of anonymity for respondents easily ignored Group Interviews Data can be collected from more people in a shorter period of timeCertain group members may influence the response of other group membersFocus groups is an example can also be used in determining if the program is being implemented effectively MULTISTEP SURVEYThose collecting the data contact those who will provide the data on more than one occasionThe technique used is the Delphi technique a process that generates consensus through a series of questionnaires which are usually administered via the mail or electronic mail May continue for five or fewer roundsCOMMUNITY FORUM town hall meetingBrings together people from the priority population to discuss what they see as their groups problemsneeds MEETINGSGood source of information for a preliminary needs assessment or various aspects of evaluationCost is minimalPossible biases may occur when meetings are used as the sole source of data collectionThere also may be limited input if relatively few participants are included or if one or two participants dominate the discussionFOCUS GROUPSA form of qualitative research that grew out of group therapyUsed to obtain information about feelings opinions perceptions insight etc Rather small compared to community forums 812 peopleNot easy to conduct Major limitation participants may not be representative of the priority population since they are chosen for having certain attributesNOMINAL GROUP PROCESSHighly structured process in which a few knowledgeable representatives of the priority population are asked to qualify and quantify specific needs 57 peopleOBSERVATIONSConsidered a minimalcontact method of data collection since those doing the observations do not interact with those in the priority Direct Observation actually seeing a behaviour Time consuming but has high response rate Observation is generally more accurate than selfreport However when people know they are being watched they may alter their behavior This is referred to as Obtrusive observation Unobtrusive Observation participants are unaware that someone is watching This tends to be less bias but it raises ethical issuesWindshield Tour walkthrough when the observer drives through the area at different times on the lookout for a variety of potentially useful indicators of community health and wellbeing housing conditions social activities noticeable group clusters etc Photovoice a form of participatory data collection Participants are given cameras and are asked to take photos of what they believe are community problems and strengths They then discuss the photos taken and the significance of them It ENGAGES policymakersSELFASSESSMETSexamples are selfchecks for cancer and personal health assessments most useful at identifying major health problems and risk factors in a pop Health risk assessments is the most included in needs assessment It tells the given odds that a person with have certain characteristics will die from a certain cause within a certain number of years based on certain criteria
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