Engaging hard-to-reach communities in community health assessments: Can we do it better?

With increasing diversity in communities throughout the US, community assessment projects are challenged to collect sufficient and accurate information regarding the health status and needs of all subgroups within state populations. Arkansas' Assessment Initiative project is developing a comprehensive set of strategies for community health assessment, identifying methodologies to obtain valid and reliable information from population subgroups within diverse communities, and developing and testing methods to assess health needs in hard-to-reach population subgroups. An Assessment Planning Team, including representation from academic and community sectors, is working to develop culturally, linguistically and scientifically appropriate plans, methods, and tools for community health assessment in communities with hard-to-reach populations (in Arkansas, Hispanic/Latinos and Pacific Islanders). Strategies address language, access (e.g., difficulty reaching samples by phone, difficulty obtaining consent to participate due to undocumented respondents' concerns about being turned over to law enforcement and immigration authorities, distrust of governmental agencies), and cultural barriers that have limited the effectiveness of previous assessment methods. This presentation will outline the issues under consideration, the participatory process employed, and the strategies identified to date by the Assessment Planning Team to complete community health assessments in diverse and challenging communities. Strategies for adapting the lessons learned and strategies identified by this project to issues faced in other states and communities will also be discussed.