Community Health Assessment:Primary Data Collection

Community Health Assessment:Primary Data Collection

LHD TA Project – Learning Collaborative 1

Community Health Assessment

Second Learning Session

Sheena L. Smith, M.P.P.

Kansas Health Institute

October 24, 2012

Why Primary Data?Why Primary Data?

Fill gaps in data from secondary sources

Probe community perceptions Build deeper understanding of health

status and needs in the community Involve the community – hear the

community voice

Approaches to Primary Data Collection

Approaches to Primary Data Collection

Surveys Focus groups Key informant Interviews Health Resources Inventory Asset Mapping Photo Voice

Community Opinion SurveyCommunity Opinion Survey

Discover perceptions of community members about their health status and health of the community

Good to use when the goal is to hear opinions from a wide variety of people and get a representative profile of community

Usually short questions with predetermined response options

Sampling method is important to ensure results can be generalized to entire community

Opinion Surveys - SamplingOpinion Surveys - Sampling

Two approaches:• Non-probability (convenience)

• Survey made available to public through various means

• No control over who responds• Probability (random or systematic)

• Each person in community has a defined probability of being sampled

When done correctly, random samples are generalizable to the community

Opinion Surveys – Sample SizeOpinion Surveys – Sample Size

Probability sample Sample size needed depends upon

• Population size• Prevalence of the outcome of interest• Desired precision of the estimate

For a free sample size calculator:• Open Epi

http://www.openepi.com/OE2.3/Menu/OpenEpiMenu.htm

Opinion Surveys – Sample SizeOpinion Surveys – Sample Size

Convenience Sample Not generalizable to the population –results

represent only the survey respondents Susceptible to bias no matter what sample size No way to estimate reliability or precision of

estimates The sampling strategy varies based on topic,

resources, and desired results Including various groups can ensure all desired

perspectives are represented in the sample

Opinion Surveys – Sample SizeOpinion Surveys – Sample Size

How many is enough? Probability Sample

• As the number of people surveyed goes up, the margin of error goes down

Sample Size Margin of Error

2000 2%

1500, 1000, 900, 800

3%

700, 600, 500 4%

400 5%

300 6%

200 7%

100 10%Source: www.uncp.edu

Opinion Surveys – Sample SizeOpinion Surveys – Sample Size

How many is enough? Convenience Sample

• Attempt to achieve the highest practical number of respondents

• Strategize ways to reach desired audiences• Target specific community groups and

demographics to ensure adequate representation

• Attempt to receive as many responses from each group identified (at least 50)

Opinion Surveys - QuestionsOpinion Surveys - Questions

Less is more (concise and clear questions) Open-ended (use sparingly) Close-ended

Yes/no Multiple choice Numeric answers Rankings Likert Scale (ratings)

Unbiased, non-leading questions Avoid Double-barreled questions Pilot questionnaire and revise as necessary

Opinion Surveys – ExecutionOpinion Surveys – ExecutionSending out the survey Mail Phone Email Web-based (e.g. Survey Monkey)

What method is best? Surveys can be sent using one or a combination of

methods Web-based surveys generally yield lower

response rates than mail or phone, but are more convenient and cost effective to implement

Opinion Surveys - AnalysisOpinion Surveys - Analysis

Identify themes according to responses If analyzing responses from a probability sample

The results can be generalized to the entire community

If analyzing responses from a convenience sample Analyze demographic information to

understand if desired community groups are represented

Integrate results from other primary data collection methods (interviews, objective data)

Focus GroupsFocus Groups

Gather a greater depth and complexity of information

Can yield unanticipated responses Opportunity to get opinions from

diverse groups More difficult and time-consuming

than surveys to organize, conduct and analyze

Focus GroupsFocus Groups

Small groups of 6-12 participants Participants do not know one another Session 1 ½ - 2 hours long Conduct multiple group sessions Same 7-10 open-ended questions asked

of each group Discussion recorded and transcribed Analyze for themes, differing positions that

emerged from discussions

Key Informant InterviewsKey Informant Interviews

Structured conversations with people who have specialized knowledge

A way to collect complex information, and explore a subject in depth

Predetermined question guide based on identified objectives

Interviewees selected based upon what CHA team wants to know

Not representative

Key Informant InterviewsKey Informant Interviews

Information can be analyzed in a variety of ways Based on questions asked Based on groups interviewed

Identify themes Combine results with other primary or

secondary data collection efforts

Health Resources InventoryHealth Resources Inventory

3 Components: Identifies current agencies and

organizations that have some bearing on health

Identifies resources that are needed, but lacking

Narrative to explain how existing resources and needed resources influence health of the community

Asset MappingAsset Mapping

Community asset = a quality, person, or thing that is an advantage, resource of item of value to the community

Asset mapping looks at different types of assets in the community Individuals Institutions and organizations Governmental agencies Physical/ land assets Cultural opportunities

Health Resources InventoryHealth Resources Inventory

Health facilities Health providers Health-related supportive services

Child care, senior centers Law enforcement Parks and recreation Social Services Public transportation

Asset MappingAsset Mapping

Potential areas for assessment: Individuals – personal skills, strengths,

knowledge, experience, leadership skills… Local citizens associations – churches,

neighborhood clubs, service clubs, cultural groups…

Local institutions – schools, hospitals, banks, businesses….

Physical assets – parks, buildings, land, community centers….

Photo VoicePhoto Voice Community participants are given cameras and asked to

take photos of things that represent to them a specified issue or topic in the community

Participants then discuss photos together and develop narratives to go with the photos

Gives voice to members of the community, attempts to bring the perspectives of those "who lead lives that are different from those traditionally in control of the means for imaging the world" into the policy-making process

Often used among marginalized people, intended to give insight into how they conceptualize their circumstances and their hopes for the future.

Questions?Questions?

Information for policy makers. Health for Kansans.Information for policy makers. Health for Kansans.

Kansas Health InstituteKansas Health Institute