Assessment of community needs in a large municipality to drive public health planning and program evaluation: Three administrations spanning fifteen years

Assessment of health and social service needs ensures community input drives strategic planning and programmatic decisions. Currently the 18th largest city in the United States, the City of Fort Worth has been the fastest growing large municipality since 2000. To best serve the needs of the estimated 686,850 residents, the public health department regularly conducts a comprehensive community needs assessment (CNA) at five-year intervals. The survey instrument is the product of a collaborative effort incorporating the input of community partners and additions or revisions to the instrument for subsequent assessments are made to incorporate emerging issues. Using census and land use data within a municipal enterprise geographic information system (GIS) to design the sampling frame, the 2008 CNA will be administered to approximately 3,500 households beginning in March 2008. The design and number of surveys completed assures a highly reliable representative sample of the population. Utilization of a computer assisted interviewing application will streamline the administration process and eliminate many of the temporal and financial costs associated with data entry from paper-based forms. An overview of the implementation of these processes as well as the associated challenges and benefits will be presented in conjunction with preliminary data from the 2008 CNA and data from the two previous assessment efforts. These data, integrated with other traditional measures of morbidity and mortality are used to determine the priorities of the local public health department, conduct trend analyses, evaluate interventions and support the activities of numerous local health and social service agencies.