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PubMed2000

Tuberculosis in Swaziland: a health needs assessment in preparation for a community-based programme.

This study was undertaken to assess the healthcare needs of people with tuberculosis (TB) in the rural district of Lubombo in Swaziland, with a view to improving the delivery of healthcare services. Qualitative and quantitative methodologies were used to describe the knowledge, attitudes and behaviour of TB patients, the epidemiology of TB, and the strengths and weaknesses of the current TB control programme. The incidence of TB is rising rapidly in this rural region of Swaziland. Poor treatment completion rates indicate low levels of knowledge about the importance of compliance with TB treatment among many other factors. If local health services are to cope with future rising demands, then efforts must be made to implement a community-based TB treatment strategy. Key practical steps in establishing such a programme are discussed, and the experience from Lubombo is used to demonstrate the steps in performing a health needs assessment in a developing country.

Adolescent↗
PubMed2005

Development and implementation of a public health workforce training needs assessment survey in North Carolina.

Assessing the training needs of local public health workers is an important step toward providing appropriate training programs in emergency preparedness and core public health competencies. The North Carolina Public Health Workforce Training Needs Assessment survey was implemented through the collaboration of several organizations, including the North Carolina Center for Public Health Preparedness at the North Carolina Institute for Public Health, the outreach and service unit of the University of North Carolina School of Public Health, the Office of Public Health Preparedness and Response in the North Carolina Division of Public Health Epidemiology Section, and local health departments across the state.

Data Collection↗
PubMed1999

Needs assessment for an undergraduate otolaryngology curriculum.

A needs assessment was conducted to determine what family doctors need to know about otolaryngology. A survey was mailed to a group of community otolaryngologists and family doctors. They were asked to rate the importance of 46 otolaryngologic topics. A true needs assessment was carried out with a small group of family practice residents to examine which needs were perceived to be significantly different in importance between these 2 survey groups. A list of important topics was generated from the survey. There were many statistically significant differences between the survey groups, but only 2, vertigo and epistaxis, appeared to be potentially important. The family practice residents (n = 8) were asked to complete a short-answer test about epistaxis management and then to demonstrate placement of an anterior nasal pack. Despite having already faced this problem in 50% of cases, the residents had average scores of less than 30%, indicating a lack of knowledge in this area.

Clinical Competence↗
PubMed1982

Local response to planning mandates. The prevalence and utilization of needs assessment by human service agencies.

Federal and state needs assessment mandates have traditionally been criticized both by their originators and by the local human service agencies that are required to conduct these studies as part of the planning process. This paper presents some preliminary evidence that local opposition to assessment may be shrinking as agencies gain a new appreciation for the varied uses of assessment information. Using data from a sample of Wisconsin agencies the prevalence of assessments between 1979 and 1980 is described and the conditions surrounding the practice of needs assessment are outlined. Particular attention is given to factors that affect the utilization of needs assessment results, including the characteristics of the sponsoring agency, the attributes of the study, and the structure of the assessment process.

Health Services Needs and Demand↗
PubMed1985

Census tract predictors of physical, psychological, and social functioning for needs assessment.

The advantages of census data-based needs assessment cannot be fully realized in the absence of demonstrated relationships between area characteristics and aggregate individual service need. This study sought to ascertain these relationships by using tract characteristics from the 1980 census to predict tract aggregate levels of individually measured social, physical, and psychological functioning. A census tract stratified sample of 3,465 permanent households in eastern Long Island, New York was used for the study. In each household, a randomly selected adult was surveyed regarding physical functioning, depressed mood, and social isolation. Stepwise multiple regression was used to determine which census variables best predicted the tract distributions of each of the functioning measures. Census variables explained from 23 to 30 percent of the variance in tract need level. Study findings have immediate utility for efficient needs assessment and suggest avenues for future improvement of needs assessment methods.

Adolescent↗
PubMed2000

Impairments, disabilities and needs assessment among non-fatal war injuries in south Lebanon, Grapes of Wrath, 1996.

STUDY OBJECTIVE: To examine the impact of non-fatal war related injuries on physical disability in a group of war wounded civilians and to assess their needs. DESIGN: Cross sectional study. Home interviews were conducted using a structured interview schedule around one month after the injury, to assess impairments, disabilities, and needs. STUDY POPULATION AND SETTING: War wounded persons in towns and villages in South Lebanon during the attack "Grapes of Wrath" in 1996. RESULTS: The majority of the study population were young and in their productive age, mostly injured in the street or while hiding in open shelters. Around half of the injuries resulted in impairments, but, there were no age, gender or geographical differentials by severity of impairment. Almost one third (29%) of the students enrolled in schools at the time of the injury reported failure to continue their education and 42% of the working members lost their jobs with no potential for 34% of them to resume their former jobs. The impact of the injury on impairments, motor disabilities and physical independence was highest for injuries to the lower limbs (age and sex adjusted risk ratio (RR) 1.62, 95% confidence intervals (CI) 1.25, 2.10; 2.98, 95% CI 2.09, 4.23; and 2.13, 95% CI 1.39, 3.27, respectively). Despite the acute and early relief services provided by all those concerned at the time of the injury, when asked about unmet needs, the majority of the impaired (66%) reported the need for additional services, mostly medical in nature. The degree of disability was a salient factor for the need for rehabilitative services but not for medical services. CONCLUSIONS: The chronic and diverse needs of people with war injuries are often neglected and underestimated by the governmental institutions and relief agencies. Research funds as well as services should be allocated to tackle the long term and continuous health and social needs of those injured and their families.

Adolescent↗
PubMed1986

Mental health needs assessment. A review of methods.

Mental health needs assessment has been encouraged by federal and state agencies for many years, and became a statutory requirement for some federally funded programs. There is still, however, no consensus on definitions of mental health need, methods for its assessment, or criteria to define successful needs assessment efforts. This review considers the separate components of needs assessment, together with techniques suitable for the measurement of each. Problems in defining the scope and boundaries of mental health need are reviewed, and then two general methods of assessment are described; epidemiologic surveys and social indicator analysis. Techniques, methodological issues, applications and limitations are discussed. Methods for assessment of current services which are needed to derive estimates of unmet need are reviewed. Finally, consideration is devoted to assessment of community desire for services, based on key informant interviews and surveys. In a concluding comment, the use of multiple data sources is recommended, selection of which should be determined by the goals of the particular study being conducted.

Community Mental Health Services↗
PubMed2001

Applying Prochaska's model of change to needs assessment, programme planning and outcome measurement.

A major goal of continuing medical education (CME) is to enhance the performance of the learner. In order to accomplish this goal, careful consideration and expertise must be applied to the three primary ingredients of CME planning: assessing learner needs, programme design and outcome measurement. Traditional methods used to address these three components seldom result in CME initiatives that change performance, even in the presence of sophisticated CME formats and capable learners. In part, performance may not change because the learner is not 'ready to change'. Planners of CME are aware of this concept but have been unable to measure 'readiness to change' or employ it in assessing learner needs, and planning and evaluating CME. One theory that focuses on an individual's readiness to change is Prochaska's model, which postulates that change is a gradual process proceeding through specific stages, each of which has key characteristics. This paper examines the applicability of this model to all components of CME planning. To illustrate the importance of this model, this paper provides examples of these three components conducted both with and without implementation of this model.

Behavior↗
PubMed2001

Health needs assessment and the ecology of care: a research note.

A Health Needs Assessment project was undertaken in 1999 for The Royal New Zealand Plunket Society (Inc.), a voluntary community organisation that provides child and family health promotion to 50,000 new babies each year nationwide. Specially qualified registered nurses, community workers and volunteers deliver the service that includes home visiting as part of universal health care. The aims were to verify and refine criteria for health needs assessment by nurses for the ongoing development of practice. Methods used enabled participatory action by child and family health nurses (Plunket nurses). The context was health promotion for apparently well children and their families as part of the Ministry of Health universal Well-Child Tamariki Ora program. The results included identification of a series of health needs assessment criteria, and direction to further develop practice. As a result of the project, it was possible to incorporate the four major concepts in the 2000 revision of the Plunket Health Record. The challenge for child and family health promotion in New Zealand is to assess health need at a family level with the focus on improving child health outcomes. Nurses who use standard data collection items to assess health needs are also likely to identify subsequent interventions more explicitly. Therefore the main benefit of the project is the potential to improve clinical practice.

Child Health Services↗
PubMed1999

The Northwick Park Care Needs Assessment (NPCNA): a measure of community care needs: sensitivity to change during rehabilitation.

OBJECTIVES: To determine whether the Northwick Park Care Needs Assessment (NPCNA) is sensitive to change occurring during rehabilitation and provides a reliable estimate of care needs in the community, and to compare the NPCNA with the Functional Independence Measure (FIM). DESIGN: Prospective cohort study. SETTING: Postacute neurorehabilitation unit for young patients with complex disabilities. SUBJECTS: Thirty-nine consecutive patients with brain injury admitted over six months. MEASUREMENTS AND METHODS: The NPCNA was assessed on admission and at discharge. Two subsets of patients were also assessed (a) at three-month follow-up in the community (n = 15), and (b) both in hospital and in the home environments at the discharge time point (n = 28). Data were compared with FIM scores on admission and discharge. RESULTS: The median total weekly care hours fell from 52 hours (interquartile range (IQR) 25-66) on admission, to 17 hours (IQR 6-46) on discharge (p<0.001). There was a median reduction of approximate weekly cost of care from 600 pound sterling (IQR 224-824 pound sterling) to 168 pound sterling (IQR 56-280 pound sterling) (p<0.001). These benefits were sustained at follow-up, and the NPCNA measured in hospital at discharge gave a good estimation of the care hours and weekly cost of care in the community at three months after discharge. There was no significant correlation with FIM gain. CONCLUSIONS: In this study the NPCNA, measured while the patient was still in hospital, gave a good estimation of care needs in the community and was sensitive to change occurring during rehabilitation in patients with severe complex disabilities.

Activities of Daily Living↗
PubMed2003

A needs assessment of medical school faculty: caring for the caretakers.

INTRODUCTION: We conducted an assessment of need for faculty development and mentoring in a medical school to guide program planning and use of scarce resources. METHODS: A multifaceted approach included semi-structured interviews, nominal group process, and a 36-item questionnaire to reach all faculty in the school, including senior administrators. RESULTS: With a 72% response rate, we validated the questionnaire and, using principal components analysis, identified and prioritized the eight interpretable subdimensions: personal growth, achieving balance, teaching, professional networking, research, administrative skills, career progression, and diversity/ethics. All groups of faculty prioritized learning for sustaining their vitality, balancing their personal and professional lives, finding meaning in their work, relationships, and personal growth. Senior administrators prioritized the following for faculty: time management, an institutional outlook, teamwork, and improved performance in teaching, research, and clinical practice. Junior faculty expressed the need for mentoring, scholarship, research, and career planning. DISCUSSION: Attention to faculty humanistic needs and the disparity between the perceived needs by faculty and senior administrators may help explain the attrition of faculty in academic medicine.

Faculty, Medical↗
PubMed1999

Using a dual method needs assessment to evaluate the training needs of public health professionals.

A dual method research approach was used to identify the training needs of the public health professionals in Washington. A mail questionnaire was implemented, followed by focus groups with Washington State Department of Health (DOH) and local health department (LHD) professionals. Focus groups were used successfully to enhance and clarify the survey findings by identifying the specific content of the highest rated training needs (interpersonal communication, cross-culture and cross-age communication, participatory teaching/training skills, and electronic communication) and by pinpointing preference for different modes of training delivery for different training needs.

Communication↗
PubMed2002

Information needs assessment for HIV/AIDS and STIs in the Eastern Mediterranean Region.

We assessed information needs about HIV/AIDS and sexually transmitted infections (STI) in the Eastern Mediterranean Region by surveying a sample of people considered knowledgeable about the subject. Respondents felt that information on certain areas of HIV/AIDS/STIs was much needed. Health care workers were perceived to see a high need for information and services generally. Religious and community leaders were perceived to see less need for some information and services (such as condom promotion, sex education for young people). All groups were perceived to see a need for education and services for people living with AIDS and drug users. Television and radio were considered the best channels for health education while training was seen as the most effective method for information exchange.

Attitude to Health↗
PubMed2006

A population-based needs assessment for mental health services.

A needs assessment was done to objectively evaluate client need and determine gaps between these needs and the services provided by mental health services. The services included were standard case management, assertive case management and residential care across the Fraser Health Region in British Columbia, Canada. Assessments involved collection of data on current symptoms, functioning, and service use and needs. Results showed many specific areas where client needs were under met. A level-of-care planning model was applied to the data and results suggest that a high percentage of clients may be in fact receiving too high or too low a level of care for their needs. This method of performing a population-based needs assessment provided findings that have proved useful for planning purposes in order to ensure that community mental health services better match client need.

Adolescent↗
PubMed1988

A practical approach to needs assessment for chemical dependency programs.

The authors discuss the concept of Needs Assessment within the context of the planning process for chemical dependency treatment programs. The five basic Needs Assessment approaches are critically reviewed, and their application in specific forecasting models is addressed. Practical guidelines for the clinical planner using Needs Assessment techniques are discussed, and recommendations made for the type, timing, and frequency of assessment. The authors note the problems inherent in the multiplicity of methods used by various states, and call for a uniform approach to Needs Assessment.

Health Planning↗
PubMed2005

Adapting developing country epidemiological assessment techniques to improve the quality of health needs assessments in developed countries.

BACKGROUND: We were commissioned to carry out three health assessments in urban areas of Dublin in Ireland. We required an epidemiologically robust method that could collect data rapidly and inexpensively. We were dealing with inadequate health information systems, weak planning data and a history of inadequate recipient involvement in health service planning. These problems had also been identified by researchers carrying out health assessments in developing countries. This paper reports our experience of adapting a cluster survey model originally developed by international organisations to assess community health needs and service coverage in developing countries and applying our adapted model to three urban areas in Dublin, Ireland METHODS: We adapted the model to control for socio-economic heterogeneity, to take account of the inadequate population list, to ensure a representative sample and to account for a higher prevalence of degenerative and chronic diseases. We employed formal as well as informal communication methods and adjusted data collection times to maximise participation. RESULTS: The model we adapted had the capacity to ascertain both health needs and health care delivery needs. The community participated throughout the process and members were trained and employed as data collectors. The assessments have been used by local health boards and non-governmental agencies to plan and deliver better or additional services. CONCLUSION: We were able to carry out high quality health needs assessments in urban areas by adapting and applying a developing country health assessment method. Issues arose relating to health needs assessment as part of the planning cycle and the role of participants in the process.

Censuses↗