Nate St. Pierre, Ed.D CAPT Associate September 6, 2011

1. Applying Community-Based Principles to Needs Assessment A Webinar for Regional Behavioral Health Authorities and Community Organizations in Arizona Nate St. Pierre, Ed.D CAPT Associate September 6, 2011

2. Introductory Information Housekeeping items: • Online post-webinar feedback form • Web portal for PowerPoint slides and resources • Continuing Education Hours – 1.5 Hours • Please mute your phones by pressing *6 on your phone

4. Poll #1 Which of the following do you represent? a. Regional Behavioral Health Authority b. State Department representative c. A community coalition d. A community-based organization e. A tribal organization f. University representative g. Other (please type your response in the chat pod)

5. Webinar Objectives • To recognize how the principles of Community-Based Participatory Research (CBPR) can be applied to SAMHSA’s Strategic Prevention Framework (SPF), specifically SPF Step 1: Assessment • To address assessment issues related to cultural sensitivity • To provide resources, examples, and approaches to community needs assessments

6. A Comment “One of the challenges in conducting a needs assessment concerns the end product. If the needs are determined only on the basis of desire or wish, then the results do not give much of a basis for action. If the needs are measureable and quantifiable, such as gap in services, performance, or attitude, then the result gives a basis for implementation.” Source: Guyette, S. (1983). Community-based research: A handbook for Native Americans. Los Angeles: University of California, Los Angeles.

7. SAMHSA’s Strategic Prevention FrameworkSupports Accountability, Capacity, and Effectiveness Assessment: Profile population needs, resources, and readiness to address needs and gaps Capacity: Mobilize and/or build capacity to address needs Planning: Develop a Comprehensive Strategic Plan Implementation: Implement evidence-based prevention programs and activities Evaluation: Monitor, evaluate, sustain, and improve or replace those that fail

8. Assessment Sustainability & Cultural Competence Evaluation Capacity Implementation Planning Assessment as a Starting Point

9. Assessment • Use of Epidemiology Data to Assess: • Consumption • Consequences • Risk & protective factors • Use of additional data to assess: • Resources & capacity • Gaps • Community readiness

10. SPF Key Principles • Outcomes-based prevention • Public health approach • Data-driven decision making • Lifespan approach Consumption Consequences Risk and Protective Factors Programs Policies Practices Strategies

11. Poll #2 Which of the following would you consider the most effective means to conduct a needs assessment in the communities you work with? • Mail • Email/Internet • Phone • At a community event • Other (please specify your response in chat pod)

12. Question #1 What are some of the challenges to collecting needs assessment data with tribal communities and Latino/Hispanic Communities in AZ? (please identify at least one challenge in the chat pod)

13. Question #2 What are the data gaps for the tribal communities and Latino/Hispanic Communities in AZ? (please identify at least one data gap in the chat pod)

14. Community-Based Epidemiology and Needs Assessment “…it implies working across disciplines, and with the population itself, in defining variables, designing instruments, and collecting data (qualitative and quantitative) that reflect the ecological reality of life in that population, as people experience it. This collaboration is not easy. It calls for cross-disciplinary patience, as well as cultural sensitivity and competence, to overcome the differences of race, class, and age that generally exist between public health specialists and populations we are here to serve. Epidemiologists would not be required to surrender rigor, but they would be required to share power!” Source: Schwab, M., & Syme, S. L. (1997). On paradigms, community participation and the future of public health. American Journal of Public Health, 87,2049-2052.

15. Community-Based Approaches to Needs Assessment • CBPR is a "collaborative approach to research that equitably involves all partners in the research process and recognizes the unique strengths that each brings”. Source: W. K. Kellogg Foundation Community Health Scholars Program, community-campus partnerships for health: Transformation communities and higher education, CBPR . Retrieved June 27, 2011 from http://depts.washington.edu/ccph/commbas.html.

16. Nine Principles of CBPR According to Israel, et al, CBPR has the following principles: 1) It acknowledges community as a unit of identity. 2) It builds on strengths and resources within the community. 3) It facilitates a collaborative and equitable partnership in all phases of the research process. 4) It fosters co-learning and capacity building among all partners. 5) It achieves a balance between research and action.

17. Principles of CBPR, continued 6) It emphasizes problems of local relevance and ecological perspectives. 7) It involves system development using a cyclical and iterative process. 8) It disseminates findings and knowledge to all partners and involves them in the dissemination of results. 9) It requires a long-term process and commitment to sustainability. Israel, B.A., Schultz, A.J. Parker, E.A., & Becker, A.B. (1998). Review of community-based research: assessing partnership approaches to improve public health. Annual Review of Public Health,19:173-202.

18. Question #3 What are some innovative sources of data that go beyond the collection of numbers, statistics, and demographics? (please specify in the chat pod)

19. Question #4 For the communities you work with, how are community resources determined?

20. Cultural Sensitivity Cultural sensitivity in research is accomplished with an improved awareness of the impact of a culture on: • the persons and/or phenomena being studied • the research process itself, and • the researcher Source: Henderson, D. J., Sampselle, C. M., Mayes, F, & Oakley, D. (1992). Toward culturally sensitive research within a multicultural society. Health Care for Women International, 13(4):339-350.

21. Cultural Humility “Acknowledgement of one’s own barriers to true intercultural understanding. It is the difference between intellectually knowing another culture and being able to truly relate to it”. Source: Wear, D. (2008). On outcomes and humility. Academic Medicine, 83(7): 625-626.

22. Poll #3 From your experience, which of the following would you consider to be the most essential skill for truly relating to the culture(s) of the communities you work with? • Appropriate listening ability • Knowledge of verbal and non-verbal communication differences • Awareness of social etiquette • Awareness of cultural differences • Other (please specify in chat pod)

23. Sustainability • Go beyond search for additional grant funding • Adopt needs assessment process as ongoing practice • Can provide a stable structure for data management • Can continue to build community capacity • Can strengthen partnerships in community • Can help secure financial and other resources over the long-term • Sustain and replicate effective outcomes

24. Sustainability (cont.) • Provides opportunities to be creative • Connected to the CBPR principle of “requiring a long-term process and commitment to sustainability”

25. Essential Understandings • Recognize that there are diverse cultural worldviews, values, and ways of knowing • Bear in mind the social, economic, technological realities • Follow cultural and community protocols • Build and maintain trust • Maintain integrity and honesty • Acknowledge community ownership of process and product • Consider follow through: Is it doable, realistic, reasonable? • Accountability

26. Benefits of Community-Based Needs Assessment • Involvement of grassroots community members strengthens community cohesion • Local cultural and linguistic protocols are considered • Cost effective • Time sensitive • Flexible and adaptable to community dynamics

27. Benefits of Community-Based Needs Assessment (cont’d.) • Can reach and inform many segments of a community • Community ownership of process and data • Strengthens the validity of data collection and use • Increases community-buy in and support • Can contribute to sustainability • Highlights the importance of cultural humility

28. Question #5 After participating in today’s webinar, what are some additional benefits in applying principles of CBPR into needs assessment? (please specify your response in the chat pod)

29. Putting It All Together • Discussion • Questions and answers • Action steps for communities • What are some important lessons you’ve learned about needs assessments that you can share with others? • What other information or training would you like related to needs assessments and CBPR? • Accessing online resources through portal • Conclusion

30. Contact Information Don Maestas, MSW T/TA Specialist SAMHSA’s Center for the Application of Prevention Technologies, West Resource Team University of Nevada, Reno Reno, NV 89557 505-927-4260 dmaestas@casat.org

31. Contact Information Nate St. Pierre, Ed.D CAPT Associate Pullman, WA nrstpierre@gmail.com