Program Planning: Community Nutrition Assessment January 25, 2007

Program Planning Basics Systematic process Continual feedback and evaluation Cyclical: based on increasing understandings of the true nature of the situation and the effectiveness of interventions. Starts with an assessment of the current situation

Process Evaluation and Adjustment Assess Prioritize Analyze problem and propose model to address Develop Intervention goals, objectives, implementation plan Evaluate outcomes

Why Do Assessment?

Community Nutrition Assessment: Anchors program/intervention in the reality of the community Essential part of ongoing process: Needs assessment Designing and implementing services Evaluation Improving programs and services Includes community and stakeholders as fully active participants

Community Nutrition Assessment: Based on assets more than deficits Helps to integrate nutrition programs into community-based health programs and plans

Successful Community Assessment Includes: Understanding current conditions of families and individuals Evaluating local capacities for supporting health and nutrition needs Building community support for implementing changes

Models and Protocols for Community Assessment Planned Approaches to Community Health (PATCH) – CDC Assessment Protocol for Excellence in Public Health (APEXPH) – NACHO (National Association of County Health Officials) Moving to the Future: Developing Community Based Nutrition Services – ASTPHND (Association of State and Territorial Public Health Nutrition Directors)

Strategic Planning for Initiatives to Address Local Health Efforts Community Assessment Organize a community planning group Define community boundaries Gather information Statistical profile Qualitative data Community Resources Agency for Health Care Policy and Research

Strategic Planning, cont. Analyze Information Common issues High risk individuals Unmet needs Prioritize Develop and implement community health plan Monitor and evaluate community health plan

Steps to Assessment Convene a planning group Define community Identify Community Assets Identify Perceived Needs Build Demographic Profile Analyze Community Health Status Analyze Community Nutrition Status Identify Community Resources and Service Utilization Identify common issues and unmet needs Prioritize

Community Nutrition Planning Group: Responsibilities Collect data and information Identify health needs and gaps in service Set priorities Develop a plan Help to implement interventions Assist in evaluation Of assessment, planning, and intervention process Of impact of intervention

Community Nutrition Planning Group: Potential Members Community leaders Consumers Health and Nutrition Service providers Health organizations Schools Political office holders or their staff Fitness professionals Representatives from greater community health planning groups

Define the Parameters Public Health Nutrition: Assuring conditions in which people can be nutritionally healthy Community: “A community is any group sharing something in common” Community Tool Box

Community Description Geographic boundaries General history Key people and leaders Demographics Financial & economic information Important issues Morale and involvement levels Key allies and rivals Unspoken rules and norms Attitudes and opinions Strengths and shortcomings

Identify Community Assets Physical structure, place, business Concerned citizens History of successful efforts Organizations Individual and group skills Communications systems Relationships

Identify Perceived Needs WHY? To understand public opinion To become aware of needs the planning group doesn’t know about To gather support & expand group expertise To make decisions about priorities To plan programs in ways that will be acceptable to stakeholders

How do we assess perceived needs? Listening sessions Public forums Key informant interviews Needs assessment survey or survey of concerns

Demographic Profile Economic status: income, employment, % below poverty Education levels Age and gender Race & ethnicity Social factors: homelessness, immigration status, family composition, TANF utilization

Community Health Status Causes of Mortality Hospital discharge data Disease prevalence data Food bourne illness reports Years of potential life lost Infant mortality

Community Nutritional Status Pregnancy related: weight gain in pregnancy Pre-pregnancy weight Anemia Disease prevalence: HIV/AIDS, cardiovascular disease, diabetes Activity levels (BRFSS) Food intake: fat, fruits & vegetables (BRFSS) Dental health Food/dieting related behaviors (YRBS) Food Security (BRFSS)

Community Resources & Service Utilization What resources are available? To what extent are people using them? Sources of Information: Citizens Service providers Tools Existing data Interviews Surveys

Examples of Community Nutrition Resources Food assistance programs (WIC, Basic Food, etc.) Grocery stores with high quality produce Food Service with health promoting food options Educational programs Media Profession and non-profit organizations Nutrition counseling

Criteria for defining/prioritizing community problems Frequency Duration Scope or range Severity Perceptions Root causes (“but why?”) & ability to impact root causes (effectiveness of interventions) Barriers to resolutions Political and financial support

Group Work: Roles Assign roles within a breakout group: Student Parent Teacher School administrator Dietitian in School-based health center

Group Work: Develop Problem List Brainstorm nutrition related issues & problems that arise from these data Choose 5 issues that are of interest to all stakeholders Prioritize these issues using criteria in these slides Establish the one issue or problem that all stakeholders will be comfortable working on for the next two weeks