Conduct a Community Assessment – Chapter Overview

Only when you want to develop successful programs and services. Sometimes health professionals decide unilaterally what people need in the way of health programs and services. And most professionals have developed programs that failed either because no one participated, or the program had no affect on health status. Conducting a community assessment helps you learn what your community needs and, equally important, what your community wants. This information is essential in planning a program that will be used by people in the community and, in this case, that will improve eating habits and physical activity habits. After reading through these Moving to the Future materials on community assessment, some might think that doing a community assessment is only for coalitions looking to do large, well-thought-out interventions like altering planning and zoning regulations to allow more sidewalks, mixed-use developments, and/or walking trails, or changing school policy on foods and beverages available during school hours and at school events. However, even if your team wants to start a farmers’ market in the local town square or at your worksite you are more likely to be successful if you conduct a community assessment. The assessment might be scaled down compared to a community assessment prior to making substantial environmental and policy improvements in a community. But through the assessment you would learn things like locations of other farmers’ markets, city ordinances regarding a market, the potential for starting other farmers’ markets in the community, and interest in a market by farmers, potential customers, or other local organizations. This information should affect how you set up your farmers’ market

Use common sense. Collect as much information as you can given your timeframe and your capacity. At a minimum you should have some information from each of the following categories: data, opinions, and resources and environment. In general, the more information you have the better. However, this MUST be balanced with making this step manageable and with getting the work done in a reasonable amount of time. Asking committee members to analyze a six-inch stack of data will be too overwhelming, and they likely wont do it! You can decide to review some data and information this time and make a list of information to gather during the next community assessment in a year or two. The worksheets in Moving to the Future allow you to collect lots of information. But this does not suggest you have to collect everything called for in the worksheets. These worksheets are designed to be applicable to the vast array of data available in all states and communities across the nation. And they must accommodate community assessments done for a variety of focus areas such as hunger, infants and young children, obesity, health disparities, adolescents, heart disease, etc.

There is not one, single best approach to conducting a community assessment. Do what works best for your coalition. One strategy is to have one person responsible for collecting all the information and bringing it to a multi-agency committee who reviews, discusses, sorts, and analyzes. This is a good strategy if you have someone with the time and/or expertise needed to do this work. Be sure there are measures in place to reduce potential bias in the data- and information-gathering process. Another approach is to break the data-gathering phase into sections and have different people take the lead on different sections. For example, a health department representative could be responsible for gathering all the community data, the fitness center representative could gather community opinion information, and the Extension program representative could gather the information on community resources and assets and the community environment. A multi-agency committee could then review, discuss, sort, and analyze the information as presented by each lead person. This strategy works well if several people want to be involved, or if the workload needs to be shared. Pay attention to possible sources of funding to support community assessment, a comprehensive plan, or a strategic plan. A grant will bring resources, focus and dedication to this task, thereby speeding up the process. Although the data-gathering step takes the most time, be sure to plan adequate time for analyzing and reporting. Analysis is the time when committees start making decisions, so analyzing the data might take more than one meeting. Although prioritizing doesn’t happen right now, data analysis can be political. Involving a neutral facilitator might be useful when your committee analyzes the data and other information. And finally, reporting community assessment results is often forgotten. But this is the time to get buy-in from others in the community and to recruit others to help with future work.

As stated throughout the Moving to the Future materials, multiple agencies should be involved in this work. Many factors affect your final roster of partners. Expertise. You need to include someone who has experience collecting and analyzing community data and information. Even a rural, isolated community should try and involve someone from a university, college, or state health agency that is knowledgeable about data. Their involvement could be as an advisor to provide technical assistance, they wouldn’t have to attend community meetings. Topic. The content focus of the community assessment will also influence who is part of the team. A food security committee will have different people than an arthritis committee. Committee structure. Your committee may involve people at different levels. For example, you might have a working committee of seven to ten people from multiple agencies that meets monthly to review and analyze data. And then every four months there is an open meeting to update anyone who is interested in the projects progress and to solicit comments. Community size. A rural community may have four agencies, total, that work on nutrition and physical activity related issues, whereas an urban or suburban community could have hundreds of agencies offering nutrition and physical activity programs and services. So, in a rural community, everyone is involved, but an urban or suburban community may not be able to get everyone involved. A state-level community assessment, where the community is the whole state, may also struggle to get all relevant agencies involved. Interest. Its hard to believe that not everyone is interested in the work to be done in conducting a community assessment. Some people are uncomfortable with data and some only want to work on implementation. A persons interest in the work should be considered. Grant funding. A funder may recommend agencies or disciplines that should be involved. Philosophy. A group’s philosophy may be to constantly invite new people to participate, whereas another committee might draw up the list of agencies to involve with community assessment and not open up participation until they move to a new phase like implementation. See the How to Involve Partners handout for ideas on including others in conducting a community assessment. Also the Overview of Coalitions section in the Introductory Pages of Moving to the Future provides more guidance on who to involve.

Several factors affect the amount of time it takes to conduct a community assessment. It can take anywhere from a few months to one to two years. The actual work time on the specific tasks is much less, but because this is a process involving several people and committee meetings the time from start to end can be long. Also, other activities, like offering programs and services, don’t stop while a community assessment is done.

Conducting a community assessment can be broken down into small tasks that can be done over time. If you can set aside some time every week or every month you can work your way through this process. This is the way most people get this work done. The steps and worksheets in Moving to the Future can guide you through this process. The “Community Assessment Progress Report” is a two-page form to help you keep track of your progress on conducting a community assessment.

Community health assessments are done by different organizations in a community including health departments, hospitals, physician practices, service organizations, multi-agency coalitions, or even community foundations. An existing community health assessment may have a content focus (HIV, tobacco, teen pregnancy) or a population focus (elderly, children, adolescents, etc.), or it may be a broad-based health assessment. The Moving to the Future community assessment focuses on nutrition and physical activity issues in a community. Often the results and information gathered in this community assessment will complement other community assessments. Sometimes top health concerns identified through the process outlined in Moving to the Future are not discovered in other assessments. If you experience resistance to conducting a community assessment because one has already been done, offer to form a subgroup within a larger community assessment initiative that will focus on nutrition and physical activity issues. In this situation both parties should benefit from the other group’s work.

Maybe, but not necessarily. You may have some problems with the logistics of carrying out a community assessment such as not having local data on nutrition behaviors or physical activity behaviors, or running out of time before doing a thorough review of the community environment and policies relating to nutrition and physical activity. Handling these kinds of problems are addressed throughout the Moving to the Future materials. You may also run into power struggles between people and/or organizations. Remember that conducting a community assessment is a process that involves several people and the outcomes can affect decisions about funding and program priorities. Maybe a key agency to conducting a thorough community assessment refuses to participate, or one community agency leading the effort invites only one or two other organizations to help, or one person or organization takes all the credit for a group effort, or someone wants to exclude some data from the analysis or highlight some data, or a supervisor or employer does not support the work and blocks a release of the results. These situations are frustrating in the least. If you and others can stay focused on the outcome of this work – improving the health of people – you may be able to work through these types of power struggles. If you find yourself in a situation where your community assessment is in conflict with another community assessment, take the time to think through the best strategy for a positive outcome. If the conflict is about which agency releases their results first, consider the benefits of jointly releasing your results. If the conflict has to do with a disagreement in community assessment findings, spend some time with the other agency to find the reason for conflict. Review the data gathered by each agency and review the process each agency followed in conducting the community assessment. If you cannot resolve the conflict, each agency may have to release its own findings.