NEEDS ASSESSMENT AND STRATEGIC PLANNING

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CHAPTER 9

• NEEDS ASSESSMENT AND STRATEGIC PLANNING

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HEALTHY PEOPLE 2000

• THREE BROAD GOALS
• INCREASE THE SPAN OF HEALTHY
• LIFE FOR ALL AMERICANS
• REDUCE HEALTH DISPARITIES
• AMONG AMERICANS
• ACHIEVE ACCESS TO PREVENTIVE SERVICES FOR ALL
  AMERICANS

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NEEDS ASSESSMENTS AND STRATEGIC
PLANSDEFINITIONS AND PURPOSES

• NEEDS
• USUALLY DEVELOPED FROM
  NORMATIVE DATA, OR BASED UPON SOCIALLY DESIRABLE
  STATES FOR TARGET POPULATION BEING ASSESSED

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NEEDS ASSESSMENTS AND STRATEGIC
PLANSDEFINITIONS AND PURPOSES

• PURPOSES OF NEEDS ASSESSMENTS
• 1. IDENTIFY GAPS BETWEEN CURRENT
  RESULTS AND REQUIRED RESULTS
• 2. PLACE RESULTING GAPS IN PRIORITY ORDER

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NEEDS ASSESSMENTS AND STRATEGIC
PLANSDEFINITIONS AND PURPOSES

• STRATEGIC PLANNING
• HELPS ORGANIZATIONS MAKE DECISIONS AND
• ACTIONS REGARDING WHAT THE ORGANIZATION
• IS, DOES AND WHY IT DOES IT
• TACTICAL PLANNING
• HOW TO IMPLEMENT THE STRATEGIC PLAN

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REASONS FOR CONDUCTING NEEDS ASSESSMENTS AND
STRATEGIC PLANS

• PROVIDE DESCRIPTIVE INFORMATION CONCERNING THE
  TARGET
• POPULATION
• IDENTIFY TARGET POPULATIONS
• NEEDS AND NON-NEEDS
• ESTABLISH PRIORITIES, GOALS, AND OBJECTIVES

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REASONS FOR CONDUCTING NEEDS ASSESSMENTS AND
STRATEGIC PLANS

• PROVIDE INFORMATION CONCERNING OTHER
  ORGANIZATIONS IN TARGET REGION THAT HELP MEET
  NEEDS OF THE POPULATION
• IDENTIFY TYPES AMOUNTS OF
• RESOURCES USED TO ADDRESS
• PRIORITY NEEDS (INTERNAL AND EXTERNAL)

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REASONS FOR CONDUCTING NEEDS ASSESSMENTS AND
STRATEGIC PLANS

• PROVIDE "BLUEPRINT" FOR DESIGN, DEVELOPMENT
  IMPLEMENTATION OF PROGRAM
• PROVIDE BENCHMARKS TO BE
• USED IN EVALUATION OF A
• PROGRAM
• PROVIDE A SYSTEMATIC BASIS FOR ORGANIZATIONAL
  DECISIONS

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REASONS FOR CONDUCTING NEEDS ASSESSMENTS AND
STRATEGIC PLANS

• PUBLIC RELATIONS TOOL
• CREATE AWARENESS OF HEALTH PROGRAM
• PROVIDE DEFENSIBLE GOALS FOR AN ORGANIZATION

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NEEDS ASSESSMENT AND PLANNING MODELS
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NEEDS ASSESSMENT AND PLANNING MODELS

• DIGNAN AND CARR'S MODEL OF COMMUNITY
  ANALYSIS
• BOUNDARY INFORMATION
• BACKDROP INFORMATION
• COMMUNITY HEALTH STATUS
• COMMUNITY HEALTH CARE SYSTEM
• COMMUNITY SOCIAL ASSISTANCE SYSTEM
• COMMUNITY DIAGNOSIS

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PRECEDE/PROCEED

• PRECEDE
• Predisposing, Reinforcing and Enabling Constructs
  in Ecosystem Diagnosis and Evaluation
• PROCEED
• Policy, Regulating or Resourcing and Organizing
  Constructs for Educational and Environmental
  Development

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PRECEDE/PROCEED
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Social Assessment

• Identify and evaluate the social problems which
  impact the quality of life of a target population
• Community Forums
• Nominal Groups
• Focus Groups
• Surveys
• Interviews

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PRECEDE/PROCEED
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Epidemiological Data

• Helps identify behavioral and environmental
  factors related to the quality of life issues.
• vital statistics
• years of potential life loss
• disability
• prevalence
• morbidity
• incidences
• mortality
• From phase 1 and 2 program objectives are created

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PRECEDE/PROCEED
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Behavioral and Environmental Assessment

• Includes non-behavioral causes (personal and
  environmental factors) that can contribute to
  health problems, but are not controlled by
  behavior.
• age, gender, existing disease, climate, and
  workplace, the adequacy of health care
  facilities, etc.

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Behavioral and Environmental Assessment

• The determination of the importance and relative
  changeability of each behavioral cause.
• Behavioral Diagnosis
• is the analysis of behavioral links to the goals
  or problems that are identified in the
  epidemiological or social diagnosis.
• Environmental Diagnosis
• is a parallel analysis of factors in the social
  and physical environment other than specific
  actions that could be linked to behaviors.
• The Behavioral Matrix
• This helps to identify targets where the most
  effective intervention measures can be applied.

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Behavioral and Environmental Assessment
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PRECEDE/PROCEED
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Educational Ecological Assessment

• Predisposing Factors
• any characteristics of a person or population
  that motivates behavior prior to the occurrence
  of that behavior
• knowledge
• beliefs
• values
• attitudes
• Enablers
• characteristic of the environment that facilitate
  action and any skill or resource required to
  attain specific behavior
• accessibility
• availability
• skills
• laws (local, state, federal)
• Reinforces
• rewards or punishments following or anticipated
  as a consequence of a behavior. They serve to
  strengthen the motivation for behavior.
• family
• peers
• teacher

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PRECEDE/PROCEED
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Administrative Policy Assessment

• Administrative Diagnosis
• the analysis of policies, resources and
  circumstances prevailing organizational
  situations that could hinder or facilitate the
  development of the health program.
• Policy Diagnosis
• to assess the compatibility of your program goals
  and objectives with those of the organization and
  its administration does it fit into the mission
  statements, rules and regulations.

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PRECEDE/PROCEED
Phase 6 Implementation
Phase 7 Process evaluation
Phase 8 Impact evaluation
Phase 9 Outcome evaluation
Monitoring Continuous Quality Improvement
Output
Longer-term health outcome
Short-term social impact
Short-term impact
Process
Input
Long-term social impact
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• PATCH PLANNED APPROACH TO COMMUNITY HEALTH
• DEVELOPED BY CDC RESEARCHERS
• COMMUNITY PARTICIPATION
• DATA (WHICH GUIDE PROGRAM DEVELOPMENT)
• DEVELOPMENT OF COMPREHENSIVE HEALTH PROMOTION
  STRATEGIES
• EVALUATION
• CAPACITY BUILDING IN COMMUNITY THAT FACILITATES
  IMPLEMENTATION OF HEALTH PROMOTION PROGRAMS

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• APEX-PH
• CDC/NACHO MODEL
• APEX-PH ASSESSMENT PROTOCOL FOR EXCELLENCE
  IN PUBLIC HEALTH

TWO MAJOR TASKS ASSESSMENT OF ORGANIZATIONAL
CAPACITY OF THE HEALTH DEPARTMENT ASSESSMENT OF
PREVAILING HEALTH PROBLEMS IN THE COMMUNITY
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• BRYSON'S STRATEGIC PLANNING MODEL
• SWOT ANALYSIS
• STRENGTHS
• WEAKNESSES
• OPPORTUNITIES
• THREATS

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TACTICAL PLANNING

• IDENTIFY PEOPLE RESPONSIBLE FOR ATTAINING
• EACH PROGRAM OBJECTIVE
• DESCRIBE METHODS USED TO ADDRESS
• OBJECTIVES (STAFFING, SERVICES,
• SUPPLIES, ALLOCATIONS/REVENUES)
• IDENTIFY EXPECTED TIMING OF ACTIVITIES
• MATCH EXPECTED SOURCES TO USES

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SOURCES OF NEEDS ASSESSMENT AND STRATEGIC
PLANNING DATA

• EXISTING DATA
• ALREADY EXISTS
• MAY BE EASILY ACCESSED
• HIGH QUALITY
• ALLOWS FOR ANALYSIS OF
• LARGE GEOGRAPHIC AREAS

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"RULES OF THUMB" FOR INTERPRETING HEALTH DATA

• INFECTIOUS DISEASE DATA OFTEN
• "UNDER-REPORTED
• REPORTING RATES VARY BY LOCAL
• HEALTH DEPARTMENT
• DIFFERENT STATES MAY REPORT IN
• DIFFERENT WAYS
• COUNTIES OR REGIONS VARY BY
• DEMOGRAPHIC CHARACTERISTICS

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"RULES OF THUMB" FOR INTERPRETING HEALTH DATA

• USE AGE- ADJUSTED RATES WHEN
• COMPARING DATA
• NEVER COMPARE ONE KIND OF RATE
• WITH ANOTHER (AGE-ADJUSTED VS.
• CRUDE RATES)
• SOME INDICES AVAILABLE MAY BE
• QUESTIONED BY DIFFERENT AUTHORITIES

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SOURCES OF NEEDS ASSESSMENT AND STRATEGIC
PLANNING DATA

• INVESTIGATOR COLLECTED DATA
• COLLECTED AND ANALYZED
• SPECIFICALLY FOR
• CURRENT STUDY
• UP-TO-DATE AND RELEVANT

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SOURCES OF NEEDS ASSESSMENT AND STRATEGIC
PLANNING DATA

• INVESTIGATOR COLLECTED DATA
• FOCUS GROUPS
• NOMINAL GROUP PROCESS
• SURVEYS
• CONSENSUS BUILDING

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LINKING THE BUDGET TO THE PLAN

• STRATEGIC PLANS CAN AND SHOULD HELP GUIDE
  BUDGETARY PROCESS
• STRATEGIC PLAN, LISTS OF
• PRIORITIES, TACTICS USED, RESOURCES
• ALL PROVIDE GUIDANCE IN DEVELOPMENT
• OF A BUDGET