ACN 3 Merged

Unit-I: Community assessment
and priority setting
Razia Parveen
Lecturer
LSN,UOL
OBJECTIVES
By the end of session, learners will be able to:
 Define need assessment
 Discuss the importance of need assessment in the

communities.
 Identify the role of a nurse in the community
assessment.
 Identify steps of need assessment in the
community
What is a community?
How do you define your community?
COMMUNITY
The word community has several meanings

that are relevant to the process of assessment.
Community can be a group of people who
live in the same area, or the area in which
they live.
Geopolitical Community
A community described as a specific area

possessing geographic boundaries and
sharing the same governing structure is often
called a geopolitical community.
Phenomenological Community
The term phenomenological community

refers to members of community with
common interests who have interpersonal
and intrapersonal connections. Community
members share common interests, beliefs, or
goals.
Introduction: What is a Community
Assessment?
 Process of collecting, analyzing and reporting
information about the needs, strengths and assets of
a community
 Purpose: to identify unmet needs and plan/prioritize
ways to meet them
 Should be driven by community leaders
 Should actively involve community members
 Also called a “Community Needs Assessment”
Introduction: Why Do a
Community Assessment?
 To identify new community public
health issues
 To better understand known community
public health issues
 To learn more about the priorities, assets, and
concerns of community member
 To offer solutions for addressing unmet health
needs
 To gain community member support for health
improvement solutions
Introduction: Why Do a
Community Assessment?
 To collaborate with essential community
health leaders and partner organizations
 To convince funders to provide you with
needed resources
 To convince policymakers and other decision-makers to
provide your community with needed programs or
services
 Your community asked you to do it
 You have already received funds to conduct a community
assessment
Introduction: What
Resources Will I Need?
 Will depend on your size and focus
 Will depend on the collective resources of your planning
group
 This curriculum emphasizes a collaborative approach to
maximize the collective resources available
 A grant may assist you if you need to do a larger
assessment than you have resources
 If applying for a grant is out of the question, then settle
on a smaller assessment
Step 1: Develop a
Community Partnership
Step 1: Develop a Community
Partnership
 Identify stakeholders
 Form a Community Partnership
 Assess Partnership’s individual and
organizational capacity
 Identify benefits and risks
 Step 1 Planning Worksheet – Community
Partnership Organizational Chart
Step 1.1: Identify Stakeholders
 Stakeholders: Persons or organizations with

a stake in the community assessment
Step 1.1: Identify Stakeholders
 Examples:
– Community leaders or community members
– Policy makers or decision-makers
– Health agencies
– Other community-based organizations, non-profits
– Neighborhood or civic associations
– Voluntary groups
– Religious organizations
– Many others…
Step 1.1: Discussion Questions for
Identifying Stakeholders
1. What defines your community?
2. What social institutions exist in your community? Which
impact health? Which have an interest in health issues?
3. What clubs, associations, organizations, voluntary groups,
support groups and faith-based organizations exist in your
community?
3. Who are respected leaders in your community?
Who do community members go to for support
or guidance?
4. Who influences decisions in your community?
6. Who of the above would have the most
expertise to conduct a community assessment?
7. Who of the above must be involved to conduct a
community assessment?
8. Who of the above would most use the results of
a community assessment?
9. Who has a positive image and respected
reputation in the community?
These are your community assessment
stakeholders.
REFERENCE
Hitchcock,J.E., Schubert,P.E.,&
Thomas,S.A.(2003). Community
Health Nursing: Caring in Action
(2nded.). New York: Thomas/Delmar
Learning
Unit-I: Community
assessment and priority
setting
Razia Parveen
Lecturer
LSN,UOL
OBJECTIVES
By the end of session, learners will be

able to:
 Identify steps of need assessment in
the community
Step 1.2: Form a Community
Partnership
 Community Partnership: A collaboration of
people and/or organizations that work
together while still keeping their separate
identities. Also called a “Collaborative” or
“Collaboration”.
Step 1.2: Form a Community
Partnership
 Community Partner: One member of the
Partnership
 Benefits of engaging stakeholders into a
Community Partnership:
– Pool resources and skills
– Expand the reach and acceptability of the
assessment
– Assures the assessment reflects diverse
community beliefs and meets diverse community
needs
– Make sure results and reports are widely
distributed
Step 1.2: Form a
Community Partnership
 Invite all stakeholders to participate

 Determine what level of participation each wants
to contribute
 Assess collective resources and skills
 Seek out additional community stakeholders if
additional resources or skills would help to plan
and conduct the community assessment
Benefits of keeping an open
invitation to identified
stakeholders
 Controversial relationships and issues can be
addressed openly and early
 The perspectives and values of everyone are
considered
 Stakeholders make contribution to and have
ownership of the plan
 You probably will need all the major players in your
community to conduct a needs assessment
 Opposing views are understood and addressed more
easily
Characteristics of a Successful
Collaboration
 Shared goals and interests
 Inclusive governance
 Shared responsibility and input
 Shared ownership and commitment
 Trust
 Balance of power and influence
 On-going management and support
Characteristics of a Successful
Collaboration
 Clear roles and responsibilities
 Set ground rules for maintaining a safe
atmosphere
 Active participation
 Good leadership
 Good consensus building and conflict
resolution
Step 1.3: Assess Partnership’s
Capacity
 Important to determine the amount of
resources, time and capacity each can actually
provide to this effort
 Important to assess even if your Community
Partnership has already been formed or even
worked together before
 Will identify Partnership strengths and assets
Capacity
 Will identify Partnership limitations
 Will help to overcome limitations or invite more
Partners
 Will help Partnership to see where everyone is
coming from
 Will help to see the potential reach of the
assessment results
Capacity
 Mission – What is their organizational mission?
 Clientele - What community or population(s) do they
serve?
 Funding - Does their current funding situation allow for
them to be involved and at what level? Can they dedicate
any funding or other resources to this effort? Are there
any conflicts of interest?
Step 1.3: Assess
Partnership’s Capacity
 Staffing - Do they have staff who can
dedicate some of their time to the
assessment? If so, what skills do they
possess that could be useful to the
assessment?
 Organizational Support - What role can their
current work play in the assessment
process? What kind of organizational
support can they dedicate to the
assessment? Can they dedicate office
space?
Step 1.3: Assess
 Research - Do they have any data research
capacities? (data collection, data
management, data analysis, report writing,
other)
Capacity
 Technology - Do they have any computer
or other technology that could be useful
to the assessment? Can they dedicate
any of this technology or the use of it?
Capacity
 Media - Can they offer access to the

media for assessment efforts? These
could mean contacts within radio,
television or newspaper media outlets, or
any other ability to get press coverage.
Step 1.3: Assess
 Allies - Do they have a community advisory
board or highly involved clientele? Can
those allies lend any support or strength to
the Partnership or assessment process?
 Interests - What is their particular interest in
the community assessment? What would
they like to see happen as a result of
participating in this process?
Step 1.3: Assess
 Involvement - How would they like to be
involved in this effort? What level and type
of involvement can they commit?
REFERENCE
(2nded.). New York:
Thomas/Delmar Learning
Razia Parveen
Lecturer
LSN,UOL
OBJECTIVES
By the end of session, learners will be able

to:
community
Step 1.4: Identify Benefits and Risks
 Working well in a Community Partnership is

about maximizing benefits and minimizing risks
Step 1.4: Identify Benefits and
Risks
 Think through ahead of time the potential
benefits and risks for:
– Community partners
– Community residents
– Community leaders and advocates
– Public health professionals and agencies
– Health service providers
– Elected and appointed officials
Risks
 Examples of benefits:
– Greater understanding of health assets and
needs
– Community advocates will have the data they
need to advocate
– Public health agencies will have the data they
need to plan
Risks
 Examples of risks:
– Providers may not share valuable data
– Elected officials may feel findings reflect
badly on them
– Community members may feel hostile toward
Partnership if not included or findings not
used to their benefit
Step 2: Determine Your
Focus
Step 2: Determine Your Focus
 Identify and prioritize community

public health needs
 Define the problem
 Create realistic and
achievable goals and objectives
Step 2.1: Identify and Prioritize
Community Public Health Needs
 The public health issue(s) your Community Partnership
prioritizes will become your community assessment
focus
– Broad focus: general information about disease rates,
available services, or community members’
perspectives on health or health care
– Specific focus: focus on a particular health topic that
your Community Partnership agrees is a priority area
 If resources are limited, assess one topic well and
conduct another assessment later
 Discuss the community health issues your
Partners are most concerned with
 Create a list
 Discuss which of these issues were raised the

most or are the most pressing in your community
 Prioritize health issues to focus your assessment
 If you cannot agree on one or two health topics,
then agree to conduct a broad assessment to
determine the most pressing health issues in the
community
Step 2.2: Define the Problem
 Frame the assessment focus in terms of a public

health problem:
– Unmet needs
– Gaps in health care services or programs
– Lack of community-wide resources or
funding
Step 2.2: Define the Problem
 This will help you:

– Further focus the assessment and data
collection
– Plan for community improvements
– Provide a rationale for community
improvements
– Provide an argument to external audiences
when you seek funding or policy change
What makes good goals
and objectives?
A Goal
 Is a broad statement
 Provides the overall vision, focus and
direction
 Can be more lofty than objectives
Objectives
 Are steps to achieve goal(s)

 Are always active
 Are clear
Objectives
 Are SMART:
– Specific
– Measurable
– Achievable given available time, staffing, and
resources
– Relevant to the goals, needs, and interests of
the community and Community Partnership
– Contain a Time Frame for when it will be
accomplished
REFERENCE
Learning
Razia Parveen
Lecturer
LSN,UOL
OBJECTIVES

to:
community
 Identify relevant and appropriate sources
of information, including community
assets and resources
Step 2.3: Create Realistic and
Achievable Goals and Objectives
 Assessment goals and objectives are different
from program goals and objectives
 They should be specific to your community
assessment
 They should not promise to: create or implement
programs, change policy, change health behaviors,
educate the community, provide services, etc.
Step 2.3: Create Realistic and
Achievable Goals and Objectives
 They could instead promise to: collect/gather/

understand information, examine issues, analyze
data, make recommendations, engage Community
Partners, etc.
Example Goal and Objectives
Goal: To understand community members’

access to health care
1. Gather secondary data from at least 10 local
health care service providers in spring 2008 to
better understand which services are most
utilized by the community, and which are not.
Example Goal and Objectives for
a More Narrowly Focused
Assessment
2. Conduct surveys with 50% of high school
students regarding their at-home and in-school
dietary behaviors before June 2007.
3. Map the locations of fast food and convenient
store outlets before January 2008 near 2 high
school campuses and students’ walking routes.
Step 3: Identify the
Information (Data) You Need
Step 3: Identify the Information
(Data) You Need
 Articulate the primary questions you would like to
answer
 Identify what type of data you will need
 Identify data sources
Step 3.1: Articulate the Primary
Questions You Would Like to
Answer
 Clear questions will further focus your
assessment and drive data collection
 Develop answerable questions
 Number of questions depend on Partnership
interests and assessment scope and focus
Step 3.1: Articulate the Primary
Questions You Would Like to
Answer
 Good rule of thumb: 3-6 questions
 Discuss questions with Partners and prioritize
list of clear questions you can realistically
answer with available resources
Examples of Primary Questions
1. Where do community residents go for health

services?
2. What local health services do residents use the
most? Which do they use the least?
3. Are those services accessible to most people?
(Are the location and hours of operation
convenient? Is there public transportation to the
site?)
4. Which diseases or conditions affect the
community the most?
Examples of Primary Questions
5. How does our community compare to other

communities around health issues?
6. What do high school students know about
eating a healthy diet?
7. What foods are available for high school
students, both on campus and nearby?
What is data?
What types of data
are there?
Different Types of Data
Opinions, priorities
Aspirations, motivations
Level of awareness, knowledge, attitudes or beliefs

Behaviors, practices
Assets, skills
Networks, associations
Needs, fears, problems, concerns
Demographic characteristics
Services or resources provided

Resident utilization of services or

resources provided
Numbers or rates of disease,

illness, disability, injuries
Sales transactions, purchases

Policies
Pictures
Maps
REFERENCE
Learning
Razia Parveen
Lecturer
LSN,UOL
OBJECTIVES

to:
 Discuss methods and tools of data
collection
Step 3.2: Identify What Type of Data
You Will Need
 Many different types of data can answer your assessment
question
 It would be good to collect it all, but you need to
consider the following when identifying what type of
data you need:
– Assessment time frame
– Available resources
– Dedicated staff time and skills
– Assessment goals and objectives
– Problem statement
– Prioritized questions
Which Types of Data Will Best
Answer These Primary
Questions?
services?
3. Are those services accessible to most people?
(Are the location and hours of operation
convenient? Is there public transportation to
the site?)
4. Which diseases or conditions affect the
community the most?
Which Types of Data Will Best
Questions?
6. What do high school students know about eating
a healthy diet?
Step 3.3: Identify Data Sources
 Start first with data that already exists

 Secondary Data: Data that has been collected for
another purpose and can be made available to
you for your data needs
 Ask around your community and ask your
Partners to see what data is out there and what
you can use
 Some local sources of data may include:

– County Health Department
– Vital statistics (birth and death certificates)
– City or County Government
– Schools
– Hospitals or clinics
– Health agencies or advocacy groups
– Universities or community colleges
– Other local surveys or research efforts?
Pros and Cons of Using
Secondary Data
Pros:
It’s cheaper It’s quicker
You can use your resources for data analysis and

report writing
It may have collected data from a large sample

Pros and Cons of Using
Secondary Data
Cons:
 The data may be outdated
 It most likely won’t be exactly what you want
 There may be some sharing/privacy issues
 Often not collected on the local level
 Can’t control the quality of the data

Evaluating Secondary Data
 Make sure any secondary data:
– Comes from a credible source
– Captures what you want to measure
– Is applicable to your community
– Appears to be reliable and bias-free
– Is timely
 No data will be perfect. Balance the pros and
cons of each source and determine which aspects
are most important for your assessment data
needs.
Where Can You Find the Data to
Questions?
services?
3. Are those services accessible to most people? (Are
the location and hours of operation convenient? Is
there public transportation to the site?)
4. Which diseases or conditions affect the community
the most?
Where Can You Find the Data to
Questions?
6. What do high school students know about eating
a healthy diet?
Group Exercise:
Complete Step 3 Worksheet
 Create the primary assessment question(s)
your group would like to answer
 Brainstorm what types of data you would
like to collect to answer those questions
 Brainstorm where you could find or
collect that data
Step 4: Determine How to Get
the Information (Collect Data)
Step 4: Determine How to Get the
Information (Collect Data)
 Identify what new data
will need to be collected
 Select the appropriate
data collection method(s)
 Revisit steps 1-3 to make sure you’re on
track
 Step 4 Planning Worksheet – Data
Collection Plan
Step 4.1: Identify What New Data
Will Need to be Collected
 Look at your Step 3 Worksheet – which data
types cannot be gathered from secondary data
sources?
 These are the data you will need to collect
 New data you collect is also called primary data
 Before selecting data collection method(s), be
sure you need this data to answer your questions
What is
quantitative data?
--------------------------------
What is
qualitative data?
Quantitative vs. Qualitative Data
Quantitative: Qualitative:
 Collected in the form of  Collected in the form of
numbers or percentages words, concepts, themes,
 Closed-ended questions or categories
 Answers who?, what?,  Open-ended questions
when? and where?
 Answers how?, why?
 Can “represent” a
population by collecting  Can provide richer, more
data from a “sample” to in-depth data
approximate the experience  Can provide data in a
of the entire community respondent’s own words
 Cannot collect new ideas or
responses, only those  Can explore new ideas in
considered ahead of time a dynamic and
unstructured way
Step 4.2: Select the Appropriate
Data Collection Method(s)
Data collection methods:
1. Windshield Survey
2. Asset Mapping
3. Focus Groups
4. Key Informant Interviews
5. Surveys
6. Community Forums
7. Rapid Appraisal Techniques
REFERENCE
Learning
Windshield and Walking
Surveys
RAZIA PARVEEN
LECTURER
LSN,UOL
OBJECTIVE

to:
 Discuss methods and tools of data
collection
Copyright © 2014 by The University of Kansas

WHAT ARE WINDSHIELD AND
WALKING SURVEYS?
 Windshield surveys are systematic
observations made from a moving vehicle.
 Walking surveys are systematic observations
made on foot.

WHY WOULD YOU CONDUCT
WINDSHIELD OR WALKING SURVEYS?
 Windshield or walking surveys give an objective
view of the community.
 They can be adapted to community-based
participatory action research, inviting
community participation.
 They may allow you to see assets that
community members take for granted or don’t
see.
 They can be the easiest and quickest way to get
an overview of the entire community.
WHY WOULD YOU CONDUCT
 They allow clear comparisons among different
neighborhoods in a city, villages in a rural area,
etc.
 They can be very useful in understanding
specific aspects of a community.
 They give you a “feel” for the community.

WHEN SHOULD YOU CONDUCT
 When you conduct a survey depends on your purpose

in doing so:
 Ifthe information you’re gathering is geographic
or physical – where things are located, what
housing is like – then the survey can be conducted
anytime.

WHEN SHOULD YOU CONDUCT
 If you want to understand how people use the

community, you have to conduct your survey
at times – perhaps a number of different times
– when they’re likely to be engaged in the
activities you’re interested in.
 You may have to do a number of surveys at
different times of the day, week, and/or year to
find out what you want to know.

WHO SHOULD CONDUCT WINDSHIELD
OR WALKING SURVEYS?
 A small urban neighborhood or rural village might
be adequately surveyed in a day by a single person.
 A large city might require several days by several
teams of observers.
 If you’re engaged in participatory research, you
might organize observers in teams, each of which
has representatives of several different stakeholder
groups – different ages, cultures, ethnicities, income
levels, community sectors (business, government,
health and community services), etc.

WHO SHOULD CONDUCT WINDSHIELD
OR WALKING SURVEYS?
 If the survey is to be done within your
organization, you might consider using teams
composed of folks from different parts of the
organization (line staff, administrators, support
staff, etc.) or from different locations.
 Consider safety when assigning particular people
to particular neighborhoods, and when deciding
whether individuals or teams should conduct the
survey.

HOW DO YOU CONDUCT WINDSHIELD OR
WALKING SURVEYS?
General guidelines for both windshield and walking
surveys
 Determine who will conduct the survey.
 Decide on the questions you want your survey to

answer.
 Decide on the areas you’ll include in your survey.
 Decide when you’ll conduct your survey.

HOW DO YOU CONDUCT WINDSHIELD OR
WALKING SURVEYS?
Train the people who are going to conduct the survey in the following
strategies:
 Get well acquainted with your questions, the purpose of the survey, and what
you’re looking for.
 Make and use a checklist to ensure that you address all your questions, and
observe all the areas you want to.
 Try to be unobtrusive.
 Carry identification.
 Take notes as you go along.
 If you’re working in teams, assign roles.
 Discuss your findings as you go.
 Pay attention to safety.

GUIDELINES FOR A WINDSHIELD
SURVEY
 Use a map.
 If you can, try to use a team of at least two.
 Drive at a moderate speed, and avoid unexpected actions.
 Drive both on major and minor streets, particularly in

residential neighborhoods.
 Pull over at regular intervals to make and compare notes.
 Try to be inconspicuous.

GUIDELINES FOR A WALKING
SURVEY
 Study a map beforehand, or do a drive-through so
you’ll know where you’re going.
 Again, it can be helpful to work in teams.
 If you want to experience the community, take part in
everyday activities.
 Go inside public buildings and cultural institutions.
 Sit down in a quiet place to take notes.

WINDSHIELD AND WALKING
SURVEYS
 Sometimes, the best survey can be a
combination of walking and driving.
 Analyze what you’ve seen and decide how to
use the information.

REFERENCE
Basavanthappa, B. T. (2005). Community Health
Nursing (2nd ed.). New Delhi: Jaypee
Brothers

Razia Parveen
Lecturer
LSN,UOL
OBJECTIVES

to:
community
Data Collection Methods:
Asset Mapping
 An inventory of community health assets (resources,
services, facilities, organizations, associations, etc.)
 Usually represented by geographically mapped data
 Builds on existing community resources
 Data can be used to develop, improve or advocate for
additional resources or funding
 Needs community buy-in and participation
 May require a lot of time to survey community and to
verify current addresses
Example of Asset Mapping
Focus Groups
 A series of discussions involving 8-12 people, selected to
share their perceptions of a defined topic
 Stimulates participants to share their opinions openly in a
group discussion
 Captures rich data in participants’ own words
 Flexible to capture new ideas and issues
 Can be difficult to summarize and interpret results across
groups
 Need to be creative when recruiting busy people
Example of Focus Groups
Key Informant Interview
 A survey conducted over the phone or in person during
an interview
 Short answer or open-ended questions
 Allows respondents to share their opinions without the
pressure of the group dynamic
 Allows interviewer to clarify questions and draw out
thoughtful responses
 Selecting the “right” key informants may be difficult so
they represent diverse backgrounds and viewpoints
 Takes a while to administer; difficult to keep respondents
on track
Quantitative Survey
 A survey conducted over the phone, in person, or via mail
 Closed-ended questions (multiple choice, true/false or yes/no,
brief numbered responses)
 Easy to administer
 Large amounts of data can be gathered from many
respondents, and so can collect a larger sample and be
representative of the broader population
 Must be constructed to avoid “leading” or “loaded” questions
 May require additional skills or funding to analyze data
Community Forums
 A series of public meetings focused on a defined topic
 Moderated to ensure that important topics are covered and
time is used well
 Relatively inexpensive and easy to conduct
 Educational
 Allows for community and stakeholder participation in issue
 Allows for the gathering of many perspectives at once
 Participants may not be representative of the larger
population, as those who attend may not reflect the entire
community or target audiences
Example of Community Forums
Rapid Appraisal Methods
 Observations and photography that can help to describe
or visually depict community conditions
 Relatively easy and inexpensive
 Data can be gathered quickly
 Provide descriptions and visual imagery that give
meaning to quantitative data
 Can be difficult to represent the entire community
experience
 Can be difficult to interpret and summarize photographs
and observation notes
Things to Consider as You Select
Your Methods
 What data collection method or methods would best
collect the type of data you need, from the source you
indicated
 Partnership resources:
– Time
– Staffing
– Skills
– Funding
– Computer technology
 Prior experience
 Potential benefits
 Potential challenges
Some Helpful Tips About
Collecting Primary Data
 Be flexible – modify your

plan as you gain new insight
 Don’t reinvent the wheel – borrow what you can
from similar efforts or get online
 Don’t bite off more than you can chew – collect
fewer data well, rather than many data poorly
 Be humble – ask for input and help
Step 4.3: Revisit Steps 1-3 to
Make Sure You’re on Track
Before you spend any time or resources collecting data, be sure your
community assessment plan so far is:
 Feasible – Is the assessment doable?
 Useful – Will the data you collect be useful? Will it address the
community public health issues you identified?
 Accurate – Will the assessment methodologies collect information
that accurately reflects reality?
 Fair – Will the assessment be conducted with awareness of the
rights of the people involved?
 Responsive – Is the assessment guided by the previous decisions
made by your Partnership throughout the planning process so far?
Completing a Data
Collection Plan
Some important issues to consider :
1. What types of data (identified in step 3) will be collected
with each data collection method?
2. How would you define the source of data for each data
collection method more specifically? In other words,
define your target respondents.
3. Which of your assessment questions will each method
answer? This will ensure that the data you collect through
each method are strategic to answering these questions.
4. What specific activities will need to be accomplished in
order to best plan and perform these proposed data
collection methods? Some activities may include data
collection tool development, data collector training,
respondent recruitment, etc.
Group Exercise:
 Discuss the questions on pages 4-30 and 4-31
 Consider the pros and cons of qualitative and quantitative
data
 Consider the advantages and disadvantages of the
different methods
 Decide which method or methods would be most
appropriate for your community assessment
 Complete the rest of the Step 4 worksheet for each data
collection method selected
Step 5: Determine How to
Understand the Information
(Analyze Data)
Step 5: Determine How to
Understand the Information
(Analyze Data)
 Check the data
 Go back to the primary assessment questions
 Reduce the amount of data
 Analyze the data
 Verify findings
 Interpret findings and draw conclusions
REFERENCE
Learning
Razia Parveen
Lecturer
LSN,UOL
OBJECTIVES

to:
collection
 Apply community assessment tools while
conducting community assessment
Why It’s a Good Idea to Plan
Ahead for Data Analyses
 To determine if the data you collect are practical
for analyses
 To review the appropriateness of your chosen
data collection method(s)
 To inform the data collection instrument(s) you
develop
 To decide if you will need help with analyses
Step 5.1: Check the Data
 Make sure it’s all there

 Make sure it makes sense
 Catch any mistakes that happened while filling out the
survey or entering the data
 Perform data quality checks throughout your data
collection process
 Common mistakes:
– A missing or incomplete response
– An impossible response
– A response unrelated to the question
– A response that contradicts an earlier response
Step 5.2: Go Back to the Primary
Assessment Questions
 Be sure to analyze only the data that will help
you answer your primary question(s)
 Don’t get side-tracked into analyzing other
pieces of data with your limited time and
resources
 It is normal to collect more data than you will
need for your community assessment
 You can return to any other interesting data after
completing your Community Assessment Plan
Step 5.3: Reduce the Amount of
Data
 Save your data in its original form so that
you can return to it if you need to
 Look at it in small chunks at a time

 Eliminate any irrelevant data from your
analysis
Step 5.3: Reduce the Amount of
Data
 Create summary documents to help you
“eyeball” the data more easily to look for
patterns or themes:
– Numeric spreadsheet
– Qualitative summary document
 See also Appendix B: Computer Software to
Compile and Analyze Data
Example of a Numeric Spreadsheet
Example of a Qualitative Summary Document
Health workers’ perceptions of public and

private sector
Public Sector Private Sector
Low pay Good pay
Work time restrictions Hard work
No resources Resources
Training opportunities No training
Job security No job security
Bureaucracy Profit driven
What is the difference between
discrete and continuous data?
Step 5.4: Analyze the Data
Quantitative Data Analysis:
Looking for Patterns in the Data
 Calculate averages
– Used with “continuous” data: infinite number of values
– Add numbered responses
– Divide by number of responses
– 2 + 4 + 6 + 10 = 22 22/4 = 5.5
 Count frequencies
– Used with “discrete” data: set number of response
categories
– Count number of responses
 Number “yes”, number “no”
 Number of choice “A”, Number of choice “B”, etc.

 Calculate proportions
– Is standardized
– Equation: % = # of responses/ total # of
respondents X 100
– Example: 45 females/ 97 respondents X 100 =
46% of the respondents were female
 Calculate rates
– Similar to proportions; also standardized
– Easier to compare
– Equation: Rate = freq of event in pop/ total pop
X 100,000
– Example: 15 cases of lung cancer/ population of
3,500 X 100,000 = 428 persons per 100,000
have lung cancer
 Compare averages, frequencies,
proportions, rates
 Compare data from different populations:
– County vs. County
– County vs. State
– State vs. US
 Compare data from different segments of a
population:
– Male vs. female
– African American, white, Latino, Asian,
American Indian, etc.
– Children, teens, adults, seniors
– Disabled vs. not
– Different income or health insurance levels
– Married vs. single
– Smokers vs. not
 Present the data in different ways to see
additional patterns and relationships:
– Chart/ table – shows averages, counts,
proportions, or rates side-by-side
– Pie graph – demonstrates percentages of the
whole
– Bar graph – compares quantities
– Line graph – shows trends over time
Example of a Chart/Table
Race/Ethnicity Frequency Proportion

Latino 30 15%
Pacific Islander 20 10%
American Indian/ Alaskan 20 10%
Native
Asian 30 15%
African American 50 25%
White 40 20%
Other 10 5%
Example of a pie graph
25%
35%
Los Angeles
Orange
San Diego
40%
Example of a bar graph
160
135
140
120 102
100
80
60
40
20
0
Non smokers Smokers
Example of a Line graph
40
35
30
25
Men
20
Women
15
10
5
0
January April August
REFERENCE
Learning
Razia Parveen
Lecturer
LSN,UOL
OBJECTIVES

to:
collection
How to Draw Findings from
Tables and Graphs
 What does the table/chart or graph say?
 Look at each of your frequencies, proportions, averages and
rates to describe the responses, characteristics, or health
status of community members
 How do different groups in the community compare?
 Compare the frequencies, proportions, averages and rates
between groups to see if there are any differences
 Each of the above “facts” drawn from a table or graph is a
finding
Example: Proportion of Asthma
Cases in CA, by Race/Ethnicity
American
Indian/
Alaska African
Total Latino Native Asian American White Other
Has asthma 17.7% 10.1% 25.8% 12.7% 22% 15.2% 17.7%

Does not have
asthma 82.3% 89.9% 74.2% 87.3% 78% 84.8% 82.3%
Total 100% 100% 100% 100% 100% 100% 100%

Same Data in Graph Form:
Proportion of Asthma Cases in
CA, by Race/Ethnicity
Diagnosed with Asthma, By Race/Ethnicity
100
90
80
70
Percent
60
50
40 Has asthma
30
20 Does not
10 have asthma
0
Latino American Asian Black White Other
Indian
What is the proportion of asthma
Cases in children 1-18 years old
in California?
American
Indian/
Alaska African
Has asthma 17.7% 10.1% 25.8% 12.7% 22% 15.2% 17.7%

Does not have
asthma 82.3% 89.9% 74.2% 87.3% 78% 84.8% 82.3%
Total 100% 100% 100% 100% 100% 100% 100%

What is the proportion of asthma
Cases in children 1-18 years old
in California?
American
Indian/
Alaska African
Has asthma 17.7% 10.1% 25.8% 12.7% 22% 15.2% 17.7%

Does not have
asthma 82.3% 89.9% 74.2% 87.3% 78% 84.8% 82.3%
Total 100% 100% 100% 100% 100% 100% 100%

Which racial/ethnic group in California
experiences the highest proportion of
asthma cases in children 1-18 years old?
100
90
80
70
Percent
60
50
40 Has asthma
30
20 Does not
10 have asthma
0
Indian
Which racial/ethnic group in California
experiences the highest proportion of
asthma cases in children 1-18 years old?
100
90
80
70
Percent
60
50
40 Has asthma
30 25.8 %
20 Does not
10 have asthma
0
Indian
Exercise 5.4A
 Look at sample survey and sample

spreadsheet in Appendix C
 Answer questions on page 4-51 and 4-52
 Discuss any difficulties or questions
Qualitative Data Analysis:
Looking for Themes in the Data
 Qualitative data analysis can be deceptively trickier
– Qualitative data is by nature “bigger”
– Analysis requires more analytical thinking and interpretation
 Qualitative data is more open to “bias”

– Numbers don’t lie
– Analysts bring their values, assumptions and opinions
– Analysts may think they “know” how people feel
 Include at least 2, preferably 3 people in each stage of
data analysis to avoid bias
 Create as structured of a process as possible to avoid bias
Qualitative Data Analysis:
Looking for Themes in the Data
1. Read through all of the data at least twice
– Stay “close” or “grounded” in the data
2. Create categories
– Focus group or interview questions
– Or specific assessment health issues
3. List themes that emerge from discussion
– Sub-categories
– Ideas
4. Rank order according to frequency of appearance
5. Summarize discussion around each theme
6. Determine your findings
How to Draw Findings from
Qualitative Data
 What are the most frequently occurring themes that
arose across all of your focus group/open-ended
survey questions?
 How do the different themes intersect and relate to
each other?
 Compare the themes discussed by each type of
focus group/survey participant to see if there are
any differences
 Each of the above “facts” drawn from the
qualitative data is a finding
Step 5.5: Verify Findings
 You now have:

– Some patterns and relationships you found in your
quantitative data
– Some themes and categories you found in your
qualitative data
 Based on the results you tallied and summarized, pull
out the main findings of each method you used
 Verify these findings by re-tallying and re-summarizing
the data to make sure you get the same results; correct
any mistakes
 You can also verify your findings by comparing the
results reached by 2 or more analysts independently;
correct any mistakes
Step 5.6: Interpret Findings and
Draw Conclusions
 What possible interpretations, or explanations, could
explain each finding?
 Invite different perspectives in this process, to make
sure one person’s viewpoint does not dominate or bias
the conclusions
 Some things to consider as you draw meaning from
your data findings:
– Is this finding similar to what you expected?
– How/why is it different?
Step 5.6: Interpret Findings and
Draw Conclusions
– What do you think could explain this finding?
– What are all the different alternative
interpretations/ explanations you may have not
considered?
– Is there evidence to support any of the
interpretation or interpretations you have
considered?
– Do you feel comfortable sharing this interpretation
with the general public as a conclusion of your
assessment?
Why is Data Interpretation so
Important in Community
Assessments?
 Interpretation is the effort of figuring out what the
findings mean and is part of the overall effort to
make sense of the evidence gathered
 Uncovering facts regarding a community’s needs is
not sufficient to draw conclusions – those facts must
be interpreted before conclusions can be drawn
 Data must be interpreted to appreciate the practical
significance of what has been learned
 Interpretations (or explanations) can be
strengthened through active discussion and
community participation
REFERENCE
). Community
Health Nursing: Caring
Health Nursing: in Action
Caring
(2inndAction
ed.). New York: Thomas/Delmar
Learning
Razia Parveen
Lecturer
LSN,UOL
OBJECTIVES

to:
collection
Completing a Data Analysis Plan
Some important issues to consider :
1. What is the nature of the data collected with each method –

quantitative, qualitative, or both?
2. What specific activities will need to be accomplished in
order to best plan and perform the proposed data analysis?
3. Determine who in your community partnership has the
experience, interest and time to accomplish each activity.
4. Select a due date or timeline for each activity so that this
planning worksheet can become an achievable Data
Analysis Plan.
Group Exercise:
 List each data source and data collection method
you selected in steps 3 and 4
 Determine whether the data collected with each
method will be qualitative or quantitative (or
both)
 Decide which data analysis activities will be
necessary for each method, as described in step 5
 Decide who in your group has the skills, interest

and time to achieve each data analysis activity
Step 6: Determine How to Use
and Communicate Results
Step 6: Determine How to Use
and Communicate Results
 Identify assessment products

 Identify target audiences
 Present your findings
 Determine next steps
 Celebrate and acknowledge your work!
 Step 6 Planning Worksheet – Ways to Report the
Results to Target Audiences
6.1: Identify Assessment Products
 Before you begin your assessment, it is important to plan

what types of products you would like to use to
communicate your findings to external audiences
 These may take the form of:
– Written reports
– Report summaries
– Presentations
– Recommendations
– Fact sheets/ briefs
– Newspaper articles
– Others
Effective Assessment Products Are…
 Concise - Make it short and to the point. Make it easy to

find information.
 Interesting - Present and discuss the findings that are new
and compelling.
 Responsive - Consider your target audiences and keep
them in mind while writing the report.
 Useful - Write clear conclusions and recommendations.
They will be more usable.
 Attractive - Spend a small portion of your budget to bind
your reports or print products in color to distribute to
your important target audiences.
Tips on Developing Products
1. Get community input on findings and conclusions
2. Make modifications before finalizing
3. Pull out key points
4. Decide carefully how to present data to back up your
findings and conclusions
 Graphs and tables
 Table summarizing main qualitative themes and
descriptions
 Story boxes highlighting quotes
 Maps and Photographs
Putting a Report Together…
1. Cover page
2. Executive Summary
3. Table of Contents
4. Introduction
5. Methodology
6. Main findings
7. Discussion
Design Tips for Easy Reading
 Use clear, readable, and large font

– Times/Times New Roman
– Palatino
– Garamond
– Arial
– Tahoma
 Avoid script, condensed, or narrow fonts
 Use clear, uniform heading formats in bold or bold
italic
 Leave plenty of “white space”
 Include page numbers
6.2: Identify Target Audiences
 Identify strategic “internal” and “external”

audiences to share your results with
 Think about:
– Who will want to hear the findings?
– Who needs to hear the findings?
– What do you think each target audience will
most want to hear?
– Can you tailor your assessment products to be
responsive to the needs/interests of each target
audience?
Example Target Audiences
 Community Partnership members

 Community members and patients
Hospitals, clinics, or other

health centers
 Local businesses and employers
Example Target Audiences
 Health insurance plans

 Other local, regional or statewide
advocacy groups
 Legislators and policymakers
 Elected officials
 Funders or private foundations
Present Your Findings
 Plan your messages for each target audience

 Formulate your argument and anticipate
opposing arguments
 Focus your message around common health care
values:
– Cost
– Quality
– Access
– Equity
– Rights
6.4: Determine Next Steps
Identifying your “next steps” for after the

assessment will help your Partnership be more
strategic throughout the assessment
These might include….

6.4: Determine Next Steps
 Identify additional stakeholders, allies, or partners

 Seek funding
 Identify program or service needs
 Identify necessary policy changes
 Engage in policy change or advocacy efforts
 Mobilize leaders and residents around an issue
 Identify needed research or evaluation activities
 Develop an on-going collaboration with your Partnership
 Develop a longer-term work plan with your Partnership
6.5: Celebrate and
acknowledge your work!
REFERENCE
Learning
1
PRIORITY SETTING
Razia Parveen
Lecturer
LSN,UOL
OBJECTIVES
By the end of session, learners will be able to:
 Define priority setting
 Discuss purposes of priority setting of health
problems
 Identify steps of priority setting
 Prioritize health problems utilizing priority
setting tool
3
Setting Priorities
 Fundamental rationale for planning - inevitable between
available resources and competing uses
 Limited resources best allocation approach
Demand based market mechanism
Need based planning approach
 Priorities are expressed in a hierarchy of objectives –
goals, aims, objective, targets
4
Goals, aims, objective, targets
 Goal - broad statement, one goal for service
 eg. Health for All, MDG
 Aim - a number of aims relating to the goal
- specific to particular health problem
 eg.To raise the nutritional status of women and children
 Objective - a number of objectives relating to the aim
- specified in measurable terms
 eg.To ensure that 95% of children under 5 are adequately nourished by the year 2010.
 Target - a number of targets which specify various points on the way to the attainment of
the objective
 eg.To ensure that 75% of children under five are adequately nourish as pre-defined by
the year 2008.
5
Health needs
 General lack of something, relate directly to the
measurement of health
 Gradation of need - depending on observer
 Viewed predominantly from epidemiological
perspective - emphasis on mortality and morbidity
 Perceived need – needs that is neither a scientific
judgment nor the province of medical profession alone
6
Underlying perceptions of health
 Groups in different positions within health system -
different perceptions
 Different health problems have varying combinations of
effects of ill health

 Injury - pain and discomfort
 polio - disability
 cholera - death
 alcoholism - social effects
 Setting priority – depend on attitudes towards the particular
effects of different health problems

7
Who should set priorities
 Provision of information – health & other professionals
 Decision on needs
 National level - d/p on political structure
 Local level - community involvement
 Central - to ensure equity of resource availability, maintenance

of standards, provision of framework for determination of
local needs
 Relationship between political structures at the national level
and those at community level
8
Criteria for priorities
 maximum feasible health gain within available
resources ( efficiency )
 effects on equity
 level of public demand
9
Priority setting
 Determination of ‘what it wants to achieve’
(hierarchy of objectives)
 To ensure feasible within the social and political
climate, available resources
 Clear criteria for selection are needed
 Allow broad view of health
 Balance decision making at national and local
 Transparent process
 Needs to end up with objectives that are feasible

10
Prioritize the problem
 effect on the majority of population
 effect mothers and children
 has high mortality
 has a solution & can be solved with available resources
 the community accept as a problem
 the community participate in solving it
11
Priority assessment of
Health problems and needs
 Prevalence / Incidence
 Severity of problem
 Effective Intervention
 Acceptability / Feasibility
 Community involvement
 Cost and Resources
12
Prioritization of health problems was based on
Objective criteria : morbidity, mortality, trend
Subjective criteria: Political concern, community

concern, availability of preventive technology,
availability of curative technology, socio economic
impact
13
Prioritization technique
Prioritization = MIV/C
M = magnitude of the health status effected by the
problem i.e., morbidity, mortality and disability
I = importance/ extent of problems, area, risk
group, impact of disease
V = Vulnerability
C = Cost
14
Techniques for priority setting
 Economic appraisal
Combine consideration of health gain &
resources
Use cost per DALY
Applicability ?? Lack appropriate data in
developing countries
 Multivariable decision matrices
15  Delphi technique
Hypothetical example of a multi-
variable decision matrix
Weighting of criteria Criteria
Cost per DALY Public demand Mortality rates Disability rates
Allocated score
4 Measles AIDS AIDS Polio
3 TB Alcoholism TB Alcoholism
2 Malaria Malaria
1 Gastro-enteritis
Scoring
AIDS 8
TB 6 Measles 4
Alcoholism 6 Malaria 4
16
REFERENCE
Hitchcock,J.E., Schubert,P.E.,& Thomas,S.A.(2003).
Community Health Nursing: Caring in Action
Learning
18

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Unit-I: Community assessment

and priority setting

 Discuss the importance of need assessment in the

The word community has several meanings

A community described as a specific area

The term phenomenological community

 Stakeholders: Persons or organizations with

By the end of session, learners will be

 Invite all stakeholders to participate

 Media - Can they offer access to the

By the end of session, learners will be able

 Working well in a Community Partnership is

 Identify and prioritize community

 Discuss which of these issues were raised the

 Frame the assessment focus in terms of a public

 This will help you:

 Are steps to achieve goal(s)

By the end of session, learners will be able

 They could instead promise to: collect/gather/

Goal: To understand community members’

1. Where do community residents go for health

5. How does our community compare to other

Level of awareness, knowledge, attitudes or beliefs

Needs, fears, problems, concerns

Services or resources provided

Resident utilization of services or

Numbers or rates of disease,

Sales transactions, purchases

By the end of session, learners will be able

 Start first with data that already exists

 Some local sources of data may include:

It’s cheaper It’s quicker

You can use your resources for data analysis and

It may have collected data from a large sample

 It most likely won’t be exactly what you want

 There may be some sharing/privacy issues

 Often not collected on the local level

 Can’t control the quality of the data

By the end of session, learners will be able

Copyright © 2014 by The University of Kansas

Copyright © 2014 by The University of Kansas

Copyright © 2014 by The University of Kansas

 When you conduct a survey depends on your purpose

Copyright © 2014 by The University of Kansas

 If you want to understand how people use the

Copyright © 2014 by The University of Kansas

Copyright © 2014 by The University of Kansas

Copyright © 2014 by The University of Kansas

 Decide on the questions you want your survey to

 Decide when you’ll conduct your survey.

Copyright © 2014 by The University of Kansas

Copyright © 2014 by The University of Kansas

 If you can, try to use a team of at least two.

 Drive at a moderate speed, and avoid unexpected actions.

 Drive both on major and minor streets, particularly in

 Pull over at regular intervals to make and compare notes.

Copyright © 2014 by The University of Kansas

Copyright © 2014 by The University of Kansas

Copyright © 2014 by The University of Kansas

Copyright © 2014 by The University of Kansas

By the end of session, learners will be able

 Be flexible – modify your

By the end of session, learners will be able

 Make sure it’s all there