A participatory needs assessment: Formulating contextually relevant and sustainable community improvement

Background: A participatory needs assessment process gives voice to health issues of local populations while creating the capacity for sustainable community dialogue on development and evaluation of interventions, and re-assessment of needs. Such a comprehensive model is rarely used in practice, and its effectiveness unknown. We therefore implemented and tested a comprehensive needs assessment framework in partnership with a local health coalition. Methods: Methods of data collection, summarization, prioritization, dissemination, and strategic planning maximized community input. Quantitative data summarized at regional and city levels were from major sources (UHDDS, BRFSS, Census, ACS, YRBS) and stratified by population demographics. Qualitative data were analyzed from 19 key leader interviews and 13 focus groups, including 115 individuals representing vulnerable populations. Indicators were summarized, first by strategic imperatives based on Healthy People 2010, then by Evans and Stoddart Field Model health domains. Qualitative data added depth and validated quantitative findings. A community committee summarized key issues and disseminated findings. Results: Assessment provided a snapshot of the population's health summarized by age cohort, health system, neighborhood, and emerging health threats. Quantitative data identified poverty and its geography as a target for public health intervention. Key leaders and community members converged on the need for intentional community design for heath improvement and neighborhood enhancement through building of social capital. Conclusion: A comprehensive needs assessment invites resident input at every stage, exemplifies the principles of community-based participatory activities, provides a vehicle for sustaining public health initiatives, and sets a contextually relevant framework for program implementation and evaluation