Reviewing self-reported impacts of community health assessment in local health jurisdictions

A scoping review of community health needs and assets assessment: concepts, rationale, tools and uses

BACKGROUND

Community health needs and assets assessment is a means of identifying and describing community health needs and resources, serving as a mechanism to gain the necessary information to make informed choices about community health. The current review of the literature was performed in order to shed more light on concepts, rationale, tools and uses of community health needs and assets assessment.

METHODS

We conducted a scoping review of the literature published in English using PubMed, Embase, Scopus, Web of Science, PDQ evidence, NIH database, Cochrane library, CDC library, Trip, and Global Health Library databases until March 2021.

RESULTS

A total of 169 articles including both empirical papers and theoretical and conceptual work were ultimately retained for analysis. Relevant concepts were examined guided by a conceptual framework. The empirical papers were dominantly conducted in the  United States. Qualitative, quantitative and mixed-method approaches were used to collect data on community health needs and assets, with an increasing trend of using mixed-method approaches. Almost half of the included empirical studies used participatory approaches to incorporate community inputs into the process.

CONCLUSION

Our findings highlight the need for having holistic approaches to assess community's health needs focusing on physical, mental and social wellbeing, along with considering the broader systems factors and structural challenges to individual and population health. Furthermore, the findings emphasize assessing community health assets as an integral component of the process, beginning foremost with community capabilities and knowledge. There has been a trend toward using mixed-methods approaches to conduct the assessment in recent years that led to the inclusion of the voices of all community members, particularly vulnerable and disadvantaged groups. A notable gap in the existing literature is the lack of long-term or longitudinal-assessment of the community health needs assessment impacts.

Making the Most of Our Community Health Assessment by Developing a Framework for Evaluation

The Health District of Northern Larimer County is a special district delivering community health programs and services in Northern Colorado. Since 1995, we have conducted a community health assessment (CHA) every 3 years. In 2015, we looked at our CHA process to see whether improvements could be made. We gathered information to understand recommended processes and potential impacts of CHA. We then developed a logic model to describe our CHA process and intended outcomes. The model outlined our CHA activities and impacts and informed our evaluation questions. We identified areas for process improvement, including our ability to analyze health inequities and effectively disseminate CHA data and findings. We recommend that others conducting a CHA evaluate their processes and impacts. Developing a logic model can be a first step toward creating an evaluation. While evaluation requires resources, we believe that the practice of CHA could greatly benefit from additional evaluation efforts.

Factors affecting the progress of community health assessment and improvement activities in kansas

CONTEXT

Community health assessment (CHA) and community health improvement planning (CHIP) are important functions for local health departments (LHDs) but may present challenges, particularly in rural settings.

OBJECTIVE

The purpose of this 2-year, mixed-methods study was to identify factors that impede or promote the timeliness and quality of CHA-CHIP completion in Kansas.

DESIGN

Focus group interviews, conducted at baseline (2012) and at 1 year (2013), included 15 and 21 groups, respectively. Scores from a 12-item attitudinal survey that explored participants' confidence to perform CHA-CHIP activities were collected in tandem with focus groups.

SETTING

Kansas counties that planned to conduct a CHA-CHIP process during 2012 and/or 2013 were eligible to participate.

PARTICIPANTS

There were 128 study participants (57 in 2012, 71 in 2013), who were predominantly female (83%), aged 51 years or older (61.4%), and lived in rural areas (84.6%). Public health region representation in 2012 and 2013 was 73% and 93%, respectively.

MAIN OUTCOME MEASURES

Changes in perceptions about CHA-CHIP inputs, process, outputs, outcomes, and self-efficacy to perform CHA-CHIP activities were explored.

RESULTS

Progress in CHA-CHIP implementation was reported in 2013. Most participants perceived the CHA-CHIP process as valuable and enhanced the LHD's visibility. Rural participants reported having completed the CHA phase, whereas urban LHDs had progressed into the planning and implementation stage. Potentiators of the CHA-CHIP process included (1) parallel assessment activities conducted by other community organizations, and (2) for rural counties, a functioning 501(c)3 community health coalition. Perceptions about the importance of partnership and leadership were unchanged. A multivariate regression analysis revealed a significant time effect and rural-urban difference in perceived self-efficacy.

CONCLUSIONS

Workforce development and public health system development issues are central concerns identified by this study. Local health departments with constrained resources and limited staff, despite additional training, are unlikely to develop the capacity needed to effectively support CHA-CHIP, making long-term sustainability uncertain.

Partnership capacity for community health improvement plan implementation: findings from a social network analysis

Background

Many health departments collaborate with community organizations on community health improvement processes. While a number of resources exist to plan and implement a community health improvement plan (CHIP), little empirical evidence exists on how to leverage and expand partnerships when implementing a CHIP. The purpose of this study was to identify characteristics of the network involved in implementing the CHIP in one large community. The aims of this analysis are to: 1) identify essential network partners (and thereby highlight potential network gaps), 2) gauge current levels of partner involvement, 3) understand and effectively leverage network resources, and 4) enable a data-driven approach for future collaborative network improvements.

Methods

We collected primary data via survey from n = 41 organizations involved in the Health Improvement Partnership of Maricopa County (HIPMC), in Arizona. Using the previously validated Program to Analyze, Record, and Track Networks to Enhance Relationships (PARTNER) tool, organizations provided information on existing ties with other coalition members, including frequency and depth of partnership and eight categories of perceived value/trust of each current partner organization.

Results

The coalition’s overall network had a density score of 30 %, degree centralization score of 73 %, and trust score of 81 %. Network maps are presented to identify existing relationships between HIPMC members according to partnership frequency and intensity, duration of involvement in the coalition, and self-reported contributions to the coalition. Overall, number of ties and other partnership measures were positively correlated with an organization’s perceived value and trustworthiness as rated by other coalition members.

Conclusions

Our study presents a novel use of social network analysis methods to evaluate the coalition of organizations involved in implementing a CHIP in an urban community. The large coalition had relatively low network density but high degree centralization—meaning key organizations link organizations otherwise not tightly partnering. Coalition members rated each other highly on trust, a positive sign for future partnership development efforts. Examination of network maps reveal key organizations that can be targeted for future partnership facilitation and expansion. Future network data collection will enable exploration of longitudinal trends and exploration of network characteristics versus health behavior, status, and outcome changes.

Using a Web-based tool to evaluate a collaborative community health needs assessment

Despite the fact that community assessment has been identified as a core function of public health for more than 2 decades, evaluations of the impact of the practice of community health assessment are few in number and have only recently been published. This article describes an evaluation of a 2011-2012 community health needs assessment (CHNA) of Kane County, Illinois. The evaluation customized and used a reliable and valid Web-based survey, the New York State Community Health Assessment Usefulness Survey, to measure Kane County CHNA user perceptions of content, format, and impact utility of the assessment. Survey respondents were community leaders and members from a diverse set of professional backgrounds and were nearly evenly divided between those who had actively participated in the CHNA and those that had not. Respondents were overwhelmingly positive in their evaluation of the Kane CHNA, with an average per item score of greater than 3 on a 4-point Likert scale, although respondents who were not involved in the CHNA process were less positive than those directly involved. Implications for public health practitioners and researchers are discussed.

Methods in public health services and systems research: a systematic review

CONTEXT

Public Health Services and Systems Research (PHSSR) is concerned with evaluating the organization, financing, and delivery of public health services and their impact on public health. The strength of the current PHSSR evidence is somewhat dependent on the methods used to examine the field. Methods used in PHSSR articles, reports, and other documents were reviewed to assess their methodologic strengths and challenges in light of PHSSR goals.

EVIDENCE ACQUISITION

A total of 364 documents from the PHSSR library met the inclusion criteria as empirical and based in the U.S. After additional exclusions, 327 of these were analyzed.

EVIDENCE SYNTHESIS

A detailed codebook was used to classify articles in terms of (1) study design; (2) sampling; (3) instrumentation; (4) data collection; (5) data analysis; and (6) study validity. Inter-coder reliability was assessed for the codebook; once it was found reliable, the available empirical documents were coded.

CONCLUSIONS

Although there has been a dramatic increase in the amount of published PHSSR recently, methods used remain primarily cross-sectional and descriptive. Moreover, although appropriate for exploratory and foundational work in a new field, these approaches are limiting progress toward some PHSSR goals. Recommendations are given to advance and strengthen the methods used in PHSSR to better meet the goals and challenges facing the field.