Getting to Outcomes
Step 01. Needs and Resources AssessmentThis step helps you identify and document the need for a program and related existing community resources.
What Is This Step?
To create a fully informed plan for an effective program, it is essential to know what the problems are that need to be addressed (e.g., where the gaps in community preparedness are, who is most at risk, where there are limited resources to improve preparedness) and the resources that are available. A needs assessment is the process of gathering information about the current conditions of a targeted area, or the underlying need for a program. A resources assessment is the process of gathering information about the resources available to address a particular need or risk.
Why Is This Step Important?
A needs and resources assessment of your community and target population can help you identify the most prevalent community risks, hazards and vulnerabilities, gaps, conditions that call for change, and what community resources are available to assist your efforts. Knowing current needs will help with setting realistic goals and desired outcomes.
How Do I Carry Out This Step?
Complete this step by- Gathering information on the problems or needs in your community
- Identifying existing resources that address these needs
- Prioritizing needs to select those you can address
- Specifying your target population
Tools Used in This Step
GTO Step 1 contains three tools that will help you carry out a needs and resources assessment:
Data Catalog Tool
The Data Catalog Tool helps you determine which data source you plan to use and who will be responsible for collecting the data. If your public health department has conducted a hazards and vulnerabilities analysis, this may serve as an important data source because it contains information about community risks and vulnerable populations. Local public health survey data (such as data collected for local monitoring of household preparedness, data on the locations of vulnerable populations, or data reported to the Centers for Disease Control and Prevention (CDC) for state or national emergency preparedness monitoring) may also be useful to understand community risks and vulnerable populations.
Instructions
- Begin by listing all the community problems or needs you intend to tackle and need more information about.
- For each problem or need listed, specify the source from which you will obtain the data.
- Note whether the data exist or you have to collect new data yourself—for example, to determine the percentage of the older adult population that has a seven-day supply of prescription medication. The point is to gather sufficient data to defend the need for a program, inform goal-setting, and point you toward a specific program to use. In the example, the Townville LHD team relied on existing data collected in a survey of older adults.
- Specify the person responsible for collecting the data and a due date for acquiring the information.
Example
- Completed by: Project team/manager
- Date: January
Problem/Need Data Areas | Source of Data | Existing or New Data | Person Responsible / Date Due |
---|---|---|---|
1. Older adults experience more adverse health outcomes during disasters. | R. Li, Advancing Behavioral and Social Research of the Elderly in Disasters, Committee on Populations, National Academies: Washington, D.C., 2009. | Existing | Project manager/month 1 |
2. Older adults are more vulnerable during disasters due to higher levels of disability, chronic disease, and cognitive impairments. | N. Aldrich and W. F. Benson, “Disaster Preparedness and the Chronic Disease Needs of Vulnerable Older Adults,” Preventing Chronic Disease Vol. 5, No. 1, 2008. | Existing | Project manager/month 1 |
3. Few older adults in the U.S. possess emergency plans. Only 23.6 percent of respondents reported having any specific plan, 10.1 percent reported members of their household being registered for disaster help should it be needed, and 43.2 percent knew of a specific shelter location in their community, in case they had to abandon their homes. |
T. M. Al-Rousan, L. M. Rubenstein, and R. B. Wallace, “Preparedness for Natural Disasters Among Older US Adults: A Nationwide Survey,” American Journal of Public Health, Vol. 104, No. 3, 2014, pp. 506–511. National Health and Retirement Survey |
Existing | Project manager/month 1 |
4. Nationally, more than one-third of older adults (age 50 and up) do not possess even a three-day emergency kit. |
T. M. Al-Rousan, L. M. Rubenstein, and R. B. Wallace, “Preparedness for Natural Disasters Among Older US Adults: A Nationwide Survey,” American Journal of Public Health, Vol. 104, No. 3, 2014, pp. 506–511. National Health and Retirement Survey |
Existing | Project manager/month 1 |
5. Low perception of preparedness among older adults in Townville. Only 35 percent of households in which all adults are age 65 or older in Townville feel “mostly” or “completely” prepared. |
Household survey fielded by the Townville Public Health Department in 2011 Survey is being fielded again and updated results will be available by July 2017. |
Existing New |
Project manager/ month 1 As soon as are available |
6. A high prevalence of older adults who take prescription medications do not possess emergency stockpiles. Although 87 percent of 65+ adult households in Townville indicated that they take prescription medications, 25 percent indicated that they do not have a 30-day supply. |
Household survey fielded by the Townville Public Health Department in 2011 |
Existing |
Project manager/ month 1 |
Community Resource Assessment Tool
The Community Resource Assessment Tool helps you identify resources in your community that may support implementation of your program. You will save time and money and avoid duplicating efforts when you determine what is already working and where you can best contribute. Citizen Corps (if there is a program in your area) may have already identified local resources. In addition, in planning for how to improve preparedness capabilities, public health departments are required to assess their current state, which includes identifying resource elements (within their department). Planning, skills and training, and equipment and technology are the resources that CDC and subject-matter experts have determined are the most critical for being able to build and maintain the associated capabilities. You can draw upon your most recent current state assessment data for this tool.
Instructions
- Make as many copies of the tool as necessary for you and your co-workers to complete this step. Make more than one copy when you are documenting more than three resources.
- Identify local community resources that do or could help address the needs or gaps that you identified in the Data Catalog Tool.
- Note the location or address of the resource or where it is delivered.
- Specify the targets served by the community resource. Note that the answers to these questions may require informal surveys or interviews with providers of the resources you identified.
- Enter the resource availability, including frequency or hours of operation, if applicable.
- Describe who uses the program or resource now.
- Collect any information you can find on the outcomes the resource is producing.
- If the resource is having positive outcomes, try to identify what characteristics are driving those positive outcomes (e.g., clear and simple educational materials on preparedness, outreach through neighbor-to-neighbor networks).
Example
- Completed by: Project team/manager
- Date: January
Assessment Type | Resource 1 | Resource 2 | Resource 3 |
---|---|---|---|
Name of resource and program/service/capabilities | ABC Senior Center | ||
Location | XYZ Street Townville, USA | ||
Target served | Adults age 50 and over. | ||
Hours of operation | M–F, 8 a.m.–4:30 p.m.;
Sat, 10 a.m.–4 p.m. |
||
Who uses it? | Typically older adults from XYZ neighborhood | ||
Community risk factors addressed | Offers activities and services tailored to the interests and needs of adults | ||
Capabilities and community assets being built | Offers activities and services tailored to the interests and needs of adults | ||
Any outcomes produced by the resource? | No outcomes being tracked | ||
What’s working? | Anecdotally, location is accessible to older adults and offers social and educational activities in formats appealing to older adults (e.g., big print, low tech) |
Triaging Among Needs Tool
The Triaging Among Needs Tool helps you identify the gaps in CEP that your program should be designed to target. It helps you identify priority needs that your organization has the capability to address.
Instructions
Now that you have identified all needs, this tool will help you select the community needs not being met elsewhere and that can be reasonably tackled by your team.
The needs and resources data will inform this process. Begin by brainstorming a list of important community risks, hazards and vulnerabilities, gaps, or conditions that call for change, and then reduce the list as described below.
- Make as many copies of this tool as needed for you and your co-workers to complete this task. List additional gaps you are concerned with on extra copies of the tool.
- Decide how you will involve staff and other stakeholders in the filtering process. For example:
- Distribute copies to your co-workers and have them fill it out on their own. Collect the completed copies and have someone collate the answers for each item. You and your co-workers should then meet to discuss the results and decide on the key priorities of your program.
- Bring the co-workers together for a meeting to discuss and develop the priorities.
- The left column, “Process,” provides prompts on how to carry out the filtering.
- Start by identifying the most-important gaps in CEP that need to be addressed, according to your analysis of the problem data.
- Examine the resulting lists, and cross out any that already are being addressed in other programming offered by your organization or other organizations in your community (and note which organization).
- Cross out any that you lack the resources (time and budget) to confront.
- Now, cross out any others that you can’t change or whose changes you can’t measure.
- Strike through any needs on your list that your organization simply chooses not to address at this time.
- Copy those remaining after this sorting process into the space at row 7. These are your priority needs.
- Specify the target population of your program. You should note about how many people you will target and what characteristics define the group.
Example
- Completed by: Project team/manager
- Date: January
Process | Needs: Important gaps in CEP to be addressed | |
---|---|---|
(1) | (2) | |
1. List the gaps in CEP that need to be addressed. | Lack of 7-day supply of medications | Lack of 7-day household emergency supplies and information |
2. List capabilities needed to address the gaps. | Trainers and curriculum to inform how to obtain surplus medication supply | Trainers and curriculum to inform what to obtain and how to store emergency household supplies |
3. Is this gap currently being addressed elsewhere? | No | No |
4. Is this a gap that we lack the resources (time and budget) to confront? | No | No |
5. Is this a gap that we cannot change or whose change we cannot measure? | No | No |
6. Is this a gap that we choose not to address at this time? | No | No |
7. Highlight the remaining gaps with associated capabilities. These are your priority needs. | Clear and feasible instructions for acquiring surplus medications |
|
8. Specify your target population, including their characteristics and the approximate number for which you have resources. | Older adults living independently who take prescription medications | Older adults living independentlys |
Tip 1-1. Links to existing data sources to help you identify needs in your community
- The Assistant Secretary for Preparedness and Response Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE), part of the U.S. Department of Health and Human Services (HHS), provides technical resources on hazard and vulnerability assessment .
- The HHS emPOWER Map is an interactive tool that highlights at-risk individuals using electricity-dependent life-maintaining and assistive durable medical equipment in the United States, sortable by natural hazards, state, county, and ZIP code.
- The CDC Behavioral Risk Factor Surveillance System (BRFSS) provides state data from telephone surveys on health-related risk behaviors, chronic health conditions, and use of preventive services.
- The California Health Interview Survey (CHIS) is from the UCLA Center for Health Policy Research.
- City-Data creates profiles for every city in the United States down to the neighborhood level
- Healthy City provides data on California cities .
- American FactFinder is a U.S. Census Bureau source for data on communities
- The Federal Emergency Management Agency (PDF) (FEMA) National Household Survey, 2015.
- The Vulnerable & At-Risk Populations Resource Guide assists state and local public health agencies, emergency management, hospitals, and other agencies with improved local mapping options.
- The CDC created Public Health Preparedness Capabilities: National Standards for State and Local Planning.
- This toolkit from Ready.gov contains detailed community preparedness information.
- HealthData.gov provides many national- and state-level health statistics.
Tip 1-2. Collecting Your Own Needs and Resources Assessment Data
Most of the information you collect will likely come from existing data (e.g., the CDC, state and local public health departments). You may need to do some additional data collection on your own, however, to have a fuller picture of the needs in your community. This section provides a brief overview of the types of data that you might consider collecting. You might be able to implement certain data collection efforts on your own, but if you have funding it may be best to hire or consult with an experienced research organization, university, or outside technical assistance provider who can ensure that these efforts are done well and get you the information that you need. Some different types of data that might be useful to collect are discussed below.
Qualitative data: interviews, meetings/forums, and focus groups Qualitative data are typically collected by asking open-ended questions, which encourage respondents to answer using their own words. For example, you might ask, “What services are currently available in your community to assist older adults in emergencies?” Qualitative data collection methods include the following:
- Key informant interviews: Interviews are conducted with individuals who are important leaders (e.g., mayor, police chief, local pastor) or representatives in their communities. They are knowledgeable about the community and are likely to be aware of many issues. Interviews can also be conducted with target population members (e.g., residents in senior communities or members of senior social clubs) to learn more about the service itself and about what other services may be needed (e.g., training).
- Community meetings/forums: Various community individuals are invited to a series of meetings and are asked about their opinions and perceptions of the needs in their community. Although key leaders are often present, the meetings are held to obtain information from the general public.
- Focus groups: Focus groups may be particularly useful if you need to get information quickly or when you want an opinion from an established group. They are considered an ideal format for getting at underlying attitudes, feelings, beliefs, and behaviors of a group. Besides being more efficient than interviews, focus groups allow for discussions that would not occur in one-on-one interactions and are effective in getting participants to identify false or extreme views. In a focus group format, 6–12 individuals convene and answer a predetermined set of open-ended questions posed by a facilitator. You can recruit a variety of people for each focus group. Or, it is sometimes preferable to convene participants for each group who have similar characteristics, such as parents, teachers, or law enforcement officials.
Showing that you care about what community members and other stakeholders think about these issues can build public good will and community buy-in, which may prove valuable later when you seek financial, political, and collaborative support.
Quantitative data: surveys
Quantitative means that the data include numbers. Surveys are a common way to systematically collect quantitative information from a number of individuals. Collecting your own survey data can be a demanding task, so you should check first to see whether you can use existing data before you embark on designing and implementing a survey.
Surveys often ask a standardized set of questions or offer statements (for example, “Families have a wide range of supports in this community to successfully take care of older adults”) to which respondents typically choose a response from a number of choices (for example, “strongly agree, agree, disagree, or strongly disagree”). Commonly, surveys are addressed to the following groups:
- Service providers: Service and treatment providers possess knowledge about the nature of problems in a community, what programs and resources are available, and who is and who is not being served.
- Clients or participants: Clients and program participants are excellent sources of information on what needs are being met and what more should be done.
- A targeted population: Self-report surveys completed by those targeted by the initiative (e.g., public health workers) provide useful information on their attitudes and beliefs. Because assessing problem behaviors in a survey can be a sensitive topic, it is best to use questions that have already been written and tested. If you plan to administer surveys among your target population, it is best to consult with a person or organization experienced in administering surveys.
Online resources can help you identify high-quality survey questions that have already been tested. See the resources in Tip 1-1.
Step Checklist
When you finish working on this step, you should have:
- Completed the three Step 1 tools
- Reviewed available data sources
- Conducted a needs and resources assessment
- Reviewed the findings of the needs and resources assessments
- Selected priority needs that emerged from your assessments
Before Moving On
Now you’ll move on to using the information you’ve gathered and the priorities you’ve identified to develop specific goals and desired outcomes. The priorities from Step 1 and the goals and desired outcomes you develop in Step 2 will form the basis for selecting the programs and strategies you could implement as well the outcomes you eventually plan to measure.
As a note - It is okay if at this step you have realized that implementing the program you had in mind is not your community’s first priority or would be redundant with other efforts already underway.You can continue to use this guide and the GTO 10-Step approach to address any alternative needs that emerged as more pressing during your needs and resources assessment.