Performing a Community Health Assessment
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Transcript of Performing a Community Health Assessment
Performing a Community
Assessment:
Curriculum Overview
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 2: Determine Your Focus
Identify and prioritize community public health needs
Define the problem
Create realistic and achievable goals and objectives
Step 2 Planning Worksheet – Issues, Problems, Goals and Objectives
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 Planning Worksheet – Questions, Data Types and Data Sources
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 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
Step 5 Planning Worksheet – Data Analysis Plan
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
Appendices A. Data Collection Methods:
– Asset Mapping– Focus Groups– Surveys– Key Informant Interviews– Rapid Appraisal– Community Forums
B. Computer Software to Compile and Analyze Data
C. Materials for Step 5 Data Analysis Exercises
D. Ethical Considerations in Human Subjects Research
E. Resources
Introduction
What is a community? How do you define your
community?
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
Introduction: How Do I Use This Curriculum?
Complete each of the six step worksheets to create an assessment workplan
Complete the six steps in the order most appropriate for your group and context
Think of this as a dynamic process where the completion of each step informs each of the previous and subsequent steps
If not planning an assessment right away, use this curriculum as a reference for any future assessment or research activities
Introduction: Training Goal
To help participants plan and conduct a community assessment
Introduction: Training Objectives
Upon completion of this workshop, participants will be able to:
1. Develop a Community Partnership to plan and conduct a community assessment
2. Develop goals and objectives to focus the community assessment
3. Identify good sources of secondary (existing) data and determine need to collect primary (new) data
4. Identify appropriate methods for collecting primary data
5. Identify appropriate methods for analyzing data
6. Identify appropriate ways to report results and identify target audiences
7. Complete a community assessment plan
Step 1: Develop a Community Partnership
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?
Step 1.1: Discussion Questions for Identifying Stakeholders3. Who are respected leaders in your
community? Who do community members go to for support or guidance?
4. Who influences decisions in your community?
Step 1.1: Discussion Questions for Identifying Stakeholders
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?
Step 1.1: Discussion Questions for Identifying Stakeholders
Look at the individuals and organizations mentioned in questions 6-9. These are your community assessment stakeholders.
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
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
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
Step 1.3: Assess Partnership’s 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?
Research - Do they have any data research capacities? (data collection, data management, data analysis, report writing, other)
Step 1.3: Assess Partnership’s 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?
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 Partnership’s Capacity
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?
Involvement - How would they like to be involved in this effort? What level and type of involvement can they commit?
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
Step 1.4: Identify Benefits and 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
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
Group Exercise:Complete Step 1 Worksheet
Consider your small group to be the start of your Community Partnership
Complete worksheet for your Partnership using questions on pages 4-7 and 4-8
Identify additional stakeholders if your Partnership lacks necessary resources, staffing or capacities. Answer questions on pages 4-3 and 4-4 to identify new Community Assessment stakeholders.
Step 2: Determine Your Focus
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
Step 2.1: Identify and Prioritize Community Public Health Needs 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
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 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
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.
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.
2. Perform asset mapping in 4 low-income neighborhoods in summer 2008 to determine what services are accessible by what neighborhoods in the community.
3. Survey 20% of residents in summer 2008 about their use of local health care services to better understand community health assets and needs.
Example Goal and Objectives for a More Narrowly Focused
Assessment
Goal: To understand the dietary behaviors of community teens
1. Gather sales data from 2 high school food service directors in 2007.
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.
Group Exercise:Complete Step 2 Worksheet
Discuss the public health issues that concern your group members
Prioritize one issue to focus your community assessment
Frame that selected issue as a problem
Discuss and agree on your assessment goal and objectives
Step 3: Identify the Information (Data) You
Need
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
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
Different Types of Data
Behaviors, practices
Assets, skills
Networks, associations
Different Types of Data
Needs, fears, problems, concerns
Demographic characteristics
Services or resources provided
Different Types of Data
Resident utilization of services or resources provided
Numbers or rates of disease, illness, disability, injuries
Sales transactions, purchases
Different Types of Data
Policies
Pictures
Maps
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?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?
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?
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
Step 3.3: Identify Data Sources
Some local sources of data may include:
– County Health Department
– Vital statistics (birth and death certificates)
– City or County Government
– Schools
Step 3.3: Identify Data Sources
– Hospitals or clinics– Health agencies or advocacy groups– Universities or community colleges– Other local surveys or research
efforts?
Other free online sources of data are listed on pages 4-23 to 4-25
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 Answer These 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?
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?
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 4.1: 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 What is
quantitative data?quantitative data?
----------------------------------------------------------------What is What is
qualitative qualitative data?data?
Quantitative vs. Qualitative Data
Quantitative: Collected in the form of
numbers or percentages
Closed-ended questions Answers who?, what?,
when? and where? Can “represent” a
population by collecting data from a “sample” to approximate the experience of the entire community
Cannot collect new ideas or responses, only those considered ahead of time
Qualitative: Collected in the form of
words, concepts, themes, or categories
Open-ended questions Answers how?, why? Can provide richer,
more in-depth data Can provide data in a
respondent’s own words Can explore new ideas
in a dynamic and unstructured way
Step 4.2: Select the Appropriate Data Collection Method(s)
Appendix A contains information on how to perform these data collection methods:
1. Asset Mapping2. Focus Groups3. Key Informant Interviews4. Surveys5. Community Forums6. Rapid Appraisal Techniques
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 Example of Asset MappingMapping
Data Collection Methods: 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 Example of Focus GroupsGroups
Data Collection Methods: 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
Data Collection Methods: 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
Data Collection Methods: 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 Example of Community ForumsForums
Data Collection Methods: 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:Complete Step 4
Worksheet 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)
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 Example of a Numeric SpreadsheetSpreadsheet
Example of a Qualitative Example of a Qualitative Summary DocumentSummary 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 What is the difference between discrete and between discrete and
continuous data?continuous data?
Step 5.4: Analyze the DataQuantitative 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.
Step 5.4: Analyze the Data
Quantitative Data Analysis: Looking for Patterns in the
Data 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
Step 5.4: Analyze the Data
Quantitative Data Analysis: Looking for Patterns in the
Data Compare averages, frequencies, proportions, rates
Compare data from different populations: – County vs. County– County vs. State– State vs. US
Step 5.4: Analyze the Data
Quantitative Data Analysis: Looking for Patterns in the
Data 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
Step 5.4: Analyze the Data
Quantitative Data Analysis: Looking for Patterns in the
Data 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/TableExample of a Chart/Table
Race/Ethnicity Frequency Proportion
Latino 30 15%
Pacific Islander 20 10%
American Indian/ Alaskan Native
20 10%
Asian 30 15%
African American 50 25%
White 40 20%
Other 10 5%
Example of a pie graphExample of a pie graph
25%
40%
35%
Los AngelesOrangeSan Diego
Example of a bar Example of a bar graphgraph
135
102
0
20
40
60
80
100
120
140
160
Non smokers Smokers
Example of a Line Example of a Line graphgraph
0
5
10
15
20
25
30
35
40
January April August
MenWomen
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
Total Latino
American Indian/ Alaska Native Asian
African 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/EthnicityDiagnosed with Asthma, By Race/Ethnicity
0102030405060708090
100
Latino AmericanIndian
Asian Black White Other
Per
cen
t
Has asthma
Does nothave asthma
What is the proportion of asthma Cases in children 1-18 years old in California?
Total Latino
American Indian/ Alaska Native Asian
African 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%
What is the proportion of asthma Cases in children 1-18 years old in California?
Total Latino
American Indian/ Alaska Native Asian
African 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%
Which racial/ethnic group in California experiences the highest proportion of asthma cases in children 1-18 years old?
Diagnosed with Asthma, By Race/Ethnicity
0102030405060708090
100
Latino AmericanIndian
Asian Black White Other
Per
cen
t
Has asthma
Does nothave asthma
Which racial/ethnic group in California experiences the highest proportion of asthma cases in children 1-18 years old?
Diagnosed with Asthma, By Race/Ethnicity
25.8 %
0102030405060708090
100
Latino AmericanIndian
Asian Black White Other
Per
cen
t
Has asthma
Does nothave asthma
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
Step 5.4: Analyze the Data
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
Step 5.4: Analyze the Data
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 theme6. 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
Exercise 5.4B
Look at sample focus group discussion transcript in Appendix C
Answer questions on page 4-56
Discuss any difficulties or questions
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?– 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
Exercise 5.6
Look at the secondary data tables in Appendix C
Answer questions on page 4-59
Discuss any difficulties or questions
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:Complete Step 5
Worksheet 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
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 (Exercise 6.3 on page 4-68)
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!
Group Exercise:Complete Step 6 Worksheet
Identify some strategic assessment products
Identify target audiences for each
Identify what type of findings or data you will highlight for each target audience
Determine product development activities and assign timelines and responsibilities