Performing a Community Assessment

1. Performing a Community Assessment

2. What is Community Oriented Primary Care (COPC)? Institute of Medicine Definition • A primary care practice providing accessible, comprehensive, coordinated, continuous- over-time, and accountable health services. • A defined community for whose health the practice has assumed responsibility. In this context, community refers to geographic or social communities; groups that form within the workplace, church or schools; or persons enrolled in a common health plan • Follows a Defined Process

3. COPC • Fundamental basis is the community and the ethic of service to drive community health improvement Gardner et al

4. Why is COPC Important? • Managed care • Impact larger community leading to improvements in individual patients • Community involved in every step, better community buy-in/compliance

5. The Process • Define and Characterize the Community • Conduct a Community Diagnosis • Assess defined population’s health needs • Develop and Implement an Intervention • Monitoring the Impact of Intervention • Involve the Community to carry out previous steps (Rhyne et al.)

6. Who is the Team ? • Health professionals-Primary Care Docs, Nurses, PA’s, NP’s, Specialists etc • Community groups/leaders • Community members as defined • Public health professionals • State/local officials • Epidemiologists • Other service providers

7. Define Your CommunityWhat is Community ? • Practice population • Family members of patients • Geographical distribution • Disease based community • Social group • ?Diversity of community

8. Characterize Your Community • Direct approach • Focus groups • Surveys of community members/leaders/health professionals • other community service providers • Study practice data

9. Pitfalls • Inherently biased process if not careful • Careful about giving one group more weight without meaning • Difficulty meeting all groups so forgetting some sectors • Not talking to other practice partners • Too narrow or too broad definition of community

10. Assess Health Needs Define a Health Problem • Data assessment • Strengths and weaknesses of practice • Community needs vs. only what health professional perceives as the needs • What has come up repeatedly in the data gathered • Prioritize health needs

11. Pitfalls • Own or group biases alter prioritization • Choose a problem that cannot be changed in a concrete manner • Choose a problem for which you have no community buy-in • Not getting organization, practice members on board

12. Develop and Implement an Intervention • Create vision and goals for intervention • Timeline • Develop a strategy/ Address foreseeable barriers/ Divide Responsibilities • Decide practice changes to address intervention

13. Intervention Examples • Health Promotion • Health outcome measure • Clinical intervention • Community based screening • Health fairs

14. Pitfalls • Developing intervention on your own and then delegating to community members • Not approaching partners from beginning and assuming they will comply • Not being alert to unforeseeable barriers; not being ready to address such barriers • Ignoring organizational constraints

15. Evaluation • During and after intervention; Epidemiologist • Health organization and community leaders opinions • Review goals • Change in health status, service utilization • If positive results • Can program be improved/expanded • Publicize to community other health professional and grantees • If negative results reassess

16. Pitfalls • Goal was too ambitious or too nebulous to evaluate • Do not count small successes • Not doing evaluation • Not publicizing successes

17. Implementing in your site • How to get group members involved, organizational buy-in • What do you need from your organization? • Funding • What are some of the community agencies you can work with? • Who needs to be involved in implementation? • Using students/residents • Sustainability • Who evaluates and how?