490-4
ASSESSING NEEDS
Key Terms:
Action or Participatory Research: In its truest sense, action research is
characterized by at least four factors: 1) Community
Empowerment (i.e., community members control decision
Making); 2) Collaboration; 3) Acquisition of knowledge through hands-on participation; and 4) A focus of social change. What often results is a scenario where planners invite a few community representatives to participate in assessing needs and setting priorities, but this is rarely representative of the population to be served.
APEX/PH: Assessment Protocol for Excellence in Public Health (a needs assessment instrument for local health departments).
Assessment: Identifying and evaluating the needs of a target group.
Basic Priority Rating (BPR) Process: The process requires planners to
rate four different components of the identified needs and
insert the ratings into a formula in order to determine a rating
between ‘0’ and ‘100’. The components and their possible
scores (in parenthesis) are: A. size of the problem (0 to 10)
B. seriousness of the problem (0 to 20) C. effectiveness of the
Possible interventions (0 to 10) D. Propriety, Economics,
Acceptability, Resources, and Legality (PEARL) (0 or 1) The formula in which the scores are placed is:
Basic Priority rating (BPR) = (A + B) C
3 X (times) D
Scoring the size of the Problem:
Incidence or Prevalence per 100,000 Population Score
50,000 or more 10
5,000 to 49,999 8
500 to 499 6
50 to 499 4
5 to 49 2
0.5 to 4.9 0
Browser: Is special software package that reads the hypertext language and can locate documents at multiple sites on the web.
Categorical funding: This means that funding that supports programs is
earmarked or dedicated to a specific health problem or
determinant (i.e., risk factor). If this is the case, planners will
not assess needs related to what health problem they should
address since this is already predetermined by the funding
agency. Likewise, if a planner works for the American Heart
Association, he or she will not assess needs to determine a
priority health problem—that has already been identified as
heart disease.
Community Analysis/Community Diagnosis: The process by which the planners can determine what health problems might exist in any given group of people.
Delphi Technique: The process that generates consensus through a series of questionnaires, which are usually administered via the mail or electronic mail. The process begins with those collecting the data asking the target population to respond to one or two broad questions.
Eyeballing Data: Informal data collected and analyzed without using a statistical instrument for evaluation; as opposed to formal data evaluation using statistical analysis in the evaluation process.
Focus Group: These groups are used to obtain information about the
Feelings, opinions, perceptions, insights, beliefs,
misconceptions, attitudes, and receptivity, of a group of
people concerning an idea or issue, and usually include only
only 8 to 12 people. If possible it is best to have a group of
people who do not know each other so that their responses
are not inhibited by acquaintance. Participation in the
group is by invitation.
Health Assessment: Any method that accesses and analyzes data about a person’s or population’s health.
Home Page: A computer program on the internet that acts as a starting point for information about a person or organization.
Key Informants: Strategically placed individuals who have knowledge and ability to report on the needs of those in the target population. They are usually respected members of the community, and can affect the support and buy-in for program development or change.
Needs Assessment (community analysis/community diagnosis): These terms are used to describe the process by which those who are planning programs can determine what health problems might exist in any given group of people.
Networking: working with other people who are working in the health care system-that is, communicating with others who may know about existing programs. i.e., personnel working in, local or state health departments, voluntary health agencies, health care facilities, (nursing homes, hospitals, extended care facilities, etc.).
Nominal Group Process: This is a highly structured process in which a
few knowledgeable representatives of the priority population
(five to seven people) are asked to qualify and quantify specific
Needs. Those invited to participate are asked to record their
Responses to a question without discussing it among themselves.
Once all have recorded a response, participants share their
responses in a round-robin fashion. While this is occurring, the
facilitator is recording the responses on a chalkboard or
notepad for all to see. The participants are then asked to rank-
order the responses by importance to the priority population.
This ranking may be considered either a preliminary or a final
Vote. If it is preliminary, it is followed with more discussion and
Then a final vote.
Opinion Leaders: Individuals who are well respected in a community and who have an overall view of its needs. These include:
Active users of the media
Demographically similar to the target group
Knowledgeable about community issues and concerns
Early adopters of innovative behavior
Active in persuading others to become involved in innovative behavior
i.e. Political Leaders, CEOs, Union Leaders, Administrators, etc.
Primary Data: Data the planners have collected themselves through their own surveys.
Priority Population: Target Population, the most important and critical
task of the planning committee is to identify the needs or
problems of those to be served.
Secondary Data: Data that is collected and made available from other sources, such as a national or state agency.
Proxy Measure: Someone (the significant other) is asked to act for another (the person in the target population, who is unable to act for themselves) by providing needs assessment data.
Reliable: Refers to consistency in the measurement process. A reliable instrument gives the same (or nearly the same) result every time.
Search Engine: A search engine indexes the words in web pages on the internet. The index created by a search engine is called a catalog and users query the catalog for keywords that best describes their topic. When using a search engine, a field for typing in keywords is immediately displayed. After submitting a keyword query, a list of Internet resources generated.
Segmenting: Allows program planners to design programs for a specific subgroup of the target population and thus increase the program’s chance of being effective.
Self-directed Assessments: Data collected by those in the target population. These assessments are personal review procedures, which usually include either/or HRAs (health risk appraisals) or HAs (health assessments).
Service Demands: Consists of the things that those in the target population "say they have or are able to do in order to resolve a health problem.
Service Needs: Things that "health professionals believe a given population must have or be able to do in order to resolve a health problem.
Significant Others: Acting on behalf of or for another who is unable to act or respond for themselves.
Standard Measures: Too often in needs assessments, planners compare
apples with oranges. To compare apples with apples, standard
measures such as rates or percentages may be a planner’s most
reliable option. For example, rates can be standardized per
1,000 or per 100,000 people and compared across health
problems. Percentages (i.e., percent of deaths caused by heart
disease verses diabetes, or the percent of people who smoke
versus the percent of people who are obese) also allows for
similar comparisons.
Subject Archive: Organizes information alphabetically by topic and can be found at commercial web sites.
Target Population: A specific sub-group within a group, or community.
Uniform Resource Locator (URL): Is composed of 1) the Internet access protocol (e.g., http://, which stands for hypertext transfer protocol), 2) the location (e.g., www.census, which is the location for the U.S. Census Bureau), and 3) the file name (e.g., stat_abstract, which is the file name for Statistical Abstract of the United States). Entering the specific URL will connect planners with the desired website.
Valid: Confirmation that the need identified is the need that should be addressed. Or “double checking” to make sure that the need is the real need such as:
Rechecking the steps followed in the needs assessment to eliminate any bias.
Conducting a focus group with some individuals from the target population to determine their reaction to the identified need (if a focus group was not used earlier to gather the data).
Getting a “second opinion” from other health professionals.
Website: Is a collection of WWW “pages, usually consisting of a homepage and several other linked pages”.
World Wide Web (WWW): An interactive information delivery service that includes a repository of resources on almost any subject. The WWW or “the web,” uses a technology called hypertext. A single hypertext document on the WWW is called a web page. Hypertext is a method of transparently linking one information resource to another.
Conducting a Needs Assessment:
The needs assessment is often the most critical step in the planning process. Resources used on the need assessment usually pay dividends many times over. The need assessment will often determine whether or not the program will be authorized. The PRECEDE-PROCEED model is often used in the planning process, and closely aligns itself to the six following steps of the needs assessment, however, these six steps can also be applied to any of the models selected to determine a health promotion program.
Step 1: Determining the Purpose and Scope of the Needs Assessment
What is the goal of the needs assessment?
What does the planning committee hope to gain from the needs assessment?
How extensive will the needs assessment be?
What kind of resources will be available to conduct the needs assessment?
Once these questions are answered the planners are ready to begin collecting the data for the need assessment.
Step 2: Gathering Data
Usually both primary and secondary data need to be collected.
Because of the cost and availability, data collection should begin with the collection of relevant secondary data.
Step 3: Analyzing the Data
The analysis of the data may be formal using a statistical analysis instrument.
Or it may be an informal analysis using the eyeballing technique to evaluate the data.
While analyzing the data, planners may find it helpful to ask the following questions:
What is the quality of life of those in the target population?
What social conditions and perceptions are shared by those in the target population?
What are the social indicators (e.g., absenteeism, crime, discrimination, performance, welfare, etc.) in the target population that reflect the social conditions and perceptions?
Can the social conditions and perceptions be linked to health promotion? If so, how?
What are the health problems associated with the social problems?
Which health problem is most important to change?
The planners must determine which health problem need should get the highest priority.
Step 4: Identifying the Factors Linked to the Health Problem
What behavioral and environmental HRAs does the target population have in common with the disease factor?
For example, what is the relationship between lung cancer and smoking ? What is the ratio of lung cancer between smokers and second hand smoke?
Step 5: Identifying the Program Focus
Educational and Ecological Assessment
Program planners should seek to determine the status of existing health promotion programs by trying to answer as many questions as possible from the following list:
1. What health promotion programs are presently available to the target population?
2. Are the programs being utilized? If not, why not?
3. How effective are the programs? Are they meeting their stated goals and objectives?
4. How were the needs for these programs determined?
5. Are the programs accessible to the target population? Where are they located? When are they offered? Are there any qualifying criteria that people must meet to enroll? Can the target population get to the program? Can the target population afford the programs?
6. Are the needs of the target population being met? If not, why not?
Step 6: Validating the Prioritized Needs
Validation means to confirm that the need that was identified is the need that is being addressed.
Validation amounts to “Double Checking,” or making sure that an identified need is the real need. Any means available can be used such as:
Rechecking the steps followed in the needs assessment to eliminate any bias.
Conducting a focus group with some individuals from the target population to determine their reaction to the identified need (if a focus group was not used earlier to gather the data).
Getting a “Second Opinion” from other health professionals.