Health Services Needs Assessment in Rural North Texas Counties: A Mixed Methods Approach

Background: The St. Joseph Health Care Trust (SJHCT) partners with parishes and community-based organizations to offer medical services to low income individuals at or below 200% of the Federal Poverty Guidelines in the 28 counties of the Diocese in rural North Texas. Utilization of the services and client satisfaction had never been evaluated. It was therefore not known if the services offered met the health care needs of qualifying individuals. The purpose of this needs assessment was to identify gaps in existing health care services to adjust SJHCT programs to ensure the health care needs of low income and impoverished communities were met. Methods: This IRB approved research utilized a mixed methods approach by using focus groups, survey questionnaires, and telephone interviews. Data was collected from three perspectives – parish priests, clients, and healthcare providers. ATLAS.ti software was used for the qualitative data analysis. The descriptive and bivariate data analysis was conducted using SAS. Results: This needs assessment identified some individuals and communities with limited access to services, such as mental health counseling, addiction treatment, and medical screenings necessary to provide continuity of care. There was also a need for health education and culturally appropriate disease prevention to reach non-English speaking communities. Conclusions: This research provided much needed data to assess the effectiveness of SJHCT programs and identified health care gaps. The data analysis was presented to the SJHCT Board of Trustees and resulted in an expansion of services and development of innovative approaches to meeting health care needs.