U5D1-28 - Determine and Analze the Steps for the Case Study Project. Please follow all instructions and Reading material provided.

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T

PART I

Foundational Knowledge ONE

Conceptual, Theoretical, And Practical Considerations When Undertaking Needs

Assessments “Louis, the foundation that has funded us from the start and was in fact responsible for starting the community agency says it may not be able to fund us anymore because they say we are not making a difference in the community. They cite news reports in newspapers and on radio and TV of incidents of violence, vandalism, and robberies; poverty; and poor education. They use it as evidence that we are not making a difference in the community when in fact we are making a big difference!”

“I know, Mr. De la Rosa, but I have a feeling that maybe our past presentations to them are responsible. Presentations where we painted the same grim picture and pointed to all of the same problems of violence, poor health care, low education, poverty, domestic violence, and elder abuse. Remember? All we are is a resource center that refers people out for services and an afterschool mentorship program. It just seems like when we need money, we promise to take care of all community problems. We have never done a needs assessment to show what the real needs are in the community and what we as an agency can realistically do to help.”

he vignette above points out some of the contemporary challenges that social and human service agencies face in today’s environment. The need for human services has never been greater, yet funds for these

services have been reduced significantly. As a result, obtaining funding has become extremely competitive. Agencies have found it all too easy to promise the world and to use depressing statistics to justify the need for services, programs, and their presence. Factual information and data have never been more critical to agencies that depend on external funding.

The vignette also points out a problem regarding information that funding agencies have to consider, that community perceptions and media attention must be taken into account. Service agencies need to be concerned not only with information they provide to funding agencies but also with information that is available to the public.

Competition for scarce funds makes it critical that human service agencies provide factual and relevant information to funding agencies, steering clear of false promises about the impact of their programs and services. What funding agencies are looking for is objective and informative data on the needs for programs and services and on the possible impact that such services can have on the community. Before funding anything,

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funders want to know that human service organizations understand well the link between their programs and services and the outcomes they purport to have. This includes having a good sense of the theoretical and conceptual justification for their programs and services. One factor that is necessary to consider is the positive characteristics and strengths of communities and their populations. Consequently, more and more human service agencies are including within their community assessments information about community strengths and resiliencies (Minkler & Hancock, 2008), in this way providing a more comprehensive overview of the community’s needs and concerns.

This chapter is devoted to presenting the basic concepts and terms that one needs to consider when planning a needs assessment. We begin by defining what is meant by needs assessments and then distinguish them from other, related efforts, such as program evaluations. We then consider the importance of incorporating a theoretical or a conceptual framework in needs assessments to guide the understanding of community problems and concerns. The chapter also discusses practical considerations, such as limitations on time and resources. Such limits are the reality check, one that in the end determines the focus, depth, and scope of any assessment.

What Are Needs Assessments? Earlier, in the Introduction, we discussed what we mean by needs assessments (NA) on a conceptual level, but now we will look more closely at this concept and its definition. Let us start by defining what we mean by needs. Altschuld and Witkins (2000) suggest that needs assessments are “conducted by organizations (school systems, businesses, social service agencies, government offices) to determine the nature of problems affecting them and to seek ways that the problems can be overcome” (p. 8). In this definition, needs are issues that are revealed through systematic methods we call assessments or studies. Inherent in these efforts is the intention of using the information collected to address the problems or concerns that are revealed through such assessments. Therefore, a needs assessment refers to a well-thought-out and impartial systematic effort to collect objective data or information that brings to light or enhances understanding of the need for services or programs.

Needs assessments are typically conducted by or on behalf of human service agencies or organizations to help them determine services or program needs. More simply said, needs assessments consist of “any systematic approach to setting priorities for future action” (Witkin, 1984, p. ix). An important part of any needs assessment is using the information collected to undertake positive action to address community or population problems or concerns. Objectivity is key to conducting a valid needs assessment, and so is the intent to use the information for action; change; and ameliorating or addressing needs, problems, and concerns that come to light from the collection or gathering of information.

Program Evaluation Versus Needs Assessments

A community-based organization decides to conduct a needs assessment because those funding the agency require it before their grants are renewed. Michael Smith, a program coordinator, is chosen to perform the study, but he is assigned the task only as a collateral duty. Michael has never undertaken a needs assessment and knows very little about conducting a study. “Well, Michael,” asks the agency’s executive director, “how are your plans coming along for the needs assessment?” Michael responds, “Oh, don’t worry. I’ll put together a quick questionnaire asking about how people really like the agency and services it offers. I promise it will make us look good!”

In the preceding example, if Michael fields the questionnaire, will the effort be a needs assessment, a satisfaction survey, or evaluation of the agency? Needs assessments are frequently confused with program evaluation efforts. To some people, having to collect information that would alter an existing agency’s services smacks of program evaluation. A needs assessment may indeed be considered a form of evaluation, because it may suggest that some of the current services are not needed or are lacking. However, it is important to distinguish between needs assessments and program evaluation efforts, as they have very different purposes.

Needs assessments are used to collect data on the need for or current use of services, products, programs, or information. The information gained from needs assessments is typically used to make decisions about the allocation of program resources and services. Program evaluations are more specifically concerned with

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evaluating the effectiveness or impact of an agency, organization, or program. Program evaluations may well suggest unmet needs, but this is not their primary purpose.

Needs assessments can form part of an evaluation, but only when both components are specifically addressed in the effort’s objectives and reflected in the data collection instruments. For example, representatives of a 5- year delinquency reduction program may decide to conduct two needs assessments—one at the beginning and another at the end of the program’s 5-year funding term. If the primary objective of the program is to reduce adolescent delinquency by 50% in that community, the measurement of delinquency in the community should also be made at the beginning and the end of the 5-year program. Prevalence or incidence data regarding delinquency would form the main part of the program evaluation component, while questions about the current use of and need for services could fulfill both evaluation and needs assessment functions.

Even in this example, program evaluations and needs assessments are viewed and treated differently. The information derived from each is intended for different purposes. The program evaluation component would assess the program’s current effectiveness, while the needs assessment component would evaluate the use of and need for services. Readers interested in learning more about program evaluations are referred to Posavac and Carey (2007), McDavid and Hawthorn (2006), and Royse, Staton-Tindall, Badger, and Webster (2009).

Importance of Theory

“Ms. Jones, we did not get the funding for the youth violence prevention program. They said that we had no theoretical justification for why a mentorship program involving college students would help prevent youth violence!”

“But, Mary, I don’t understand. We provided them with compelling findings from a needs assessment showing that over 75% of youth in the community liked the idea of having college students as a mentors and 65% said they would participate in the program.”

The above exchange shows the fact that a proposed program generates enthusiasm among likely participants is sometimes not enough justification to grant it funding. The current scarcity of funds for human service programs concomitant with increased need for them is causing funders to require more detailed justification for proposed programs beyond likely usage or even perceived client liking or felt need. Because of this, sponsors of programs want to know that programs have a theoretical justification that links program activities to intended outcomes.

In the realm of needs assessments, theory is used to guide inquiry, explain observations or findings, or to justify services. For example, a mentorship program can impact a student’s academic achievement or likelihood of dropping out, but do nothing to prevent him or her from becoming involved in violence victimization or perpetration—something a funder may have as its primary objective. In order to justify the link between a particular program and any outcome, it is important to bring to light existing research findings that have previously demonstrated or suggested a link between particular social problems and proposed services (theory). A needs assessment that has a theoretical basis has a previously well-thought-out rationale, sourced from the research literature, linking assessed concerns and problems and need for services. Therefore, the planning of a needs assessment starts with the review of existing findings in the literature that justify the purported relationship between variables. Theories or conceptual models must be researched or developed before undertaking the assessment.

Wolfer (2007) makes a distinction between “ideological theories” and “scientific theories.” In the realm of needs assessments, ideological theories are conceptual explanations for assumed links between community problems and service or program needs, whereas scientific theories are based on empirical research or studies. For example, findings from a needs assessment showing that adolescent youth have low academic achievement and high dropout rates could be used to suggest the need for funding and for implementing mentoring programs. However, if a needs assessment makes little or no mention of past empirical research studies demonstrating a relationship between mentoring and improved academic achievement or dropout rates, then the justification is likely to be based on an ideological theory, which in turn relies on an assumption based on educated guessing or personal observations. Community leaders or agency representatives often use their years of experience to develop such hunches or theories to interpret findings and for determining service needs in their communities. While they are often correct in their assumptions, on a technical basis ideological justifications fail to offer

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objective empirical justification and therefore may be seen as having less credibility, particularly with funders, than do justifications based on scientific theories and empirical support.

Scientific theories, on the other hand, use past research or extant empirical findings to point out likely relationships between phenomena or variables. An example would be findings showing the positive impact of mentorship programs on the academic achievement of participants. Therefore, scientific theories rely on past empirical or research findings to justify assumptions or to interpret findings from a needs assessment. Theories are used with needs assessments at three main points:

1. When planning and determining the focus and scope of a needs assessment 2. When interpreting findings from a needs assessment 3. When planning to use the findings to suggest a need for services or programs

According to Johnson, Meiller, Miller, and Summers (1987), all who contemplate undertaking a needs assessment operate under theoretical beliefs, values, and assumptions that are used to determine the content, scope, and intended purpose of a needs assessment. That is, all who plan and undertake a needs assessment are guided by a sense of purpose that dictates the boundaries around the subject matter of focus. Sometimes the motive is to address all the needs of a community, but more commonly the intention is more specific. Whether the scope is narrow or broad, decisions need to be made about what information will and will not be collected. The use of theory can help one develop a focus. Theory can be formal, existing in the literature, or it can be developed. In other words, ideological or scientific theory or simply assumptions can guide needs assessment planning. Even when using ideological theory or reasoning, however, it is important to plan NAs using objective findings from existing studies on the topic.

For example, a community health center in the Midwest felt that youth in a predominantly Hispanic community were becoming increasingly sexually active and participating in unprotected sex, thus having a need for information about the consequences of risky sexual behaviors. It was thought that increasing information about the harm of sexually transmitted diseases (STDs) could lower the incidence of STDs and unplanned teen pregnancies. This assumption was based on research that suggested information itself can reduce risk-taking behavior (Carey, Senn, Vanable, Coury-Doniger, & Urban, 2010). Existing findings from studies on the rates of STDs and knowledge, attitudes, beliefs, and behaviors for the state, region, and city were used to determine the scope of the information gathered from youth in the area. Studies were identified that would support the importance of providing culturally sensitive and relevant information on the risky behavior, should the findings determine that information was indeed lacking among youth in the area. Hence, the scope and focus of the needs assessment were planned using existing study findings. It is also important to point out that in this example, planners identified studies ahead of time that showed that the provision of information can help significantly to curtail risky behavior among youth at risk for STDs and unplanned pregnancies, if in fact their findings bore out a lack of information and ignorance about STDs and other dangers of participating in risky behavior.

Theory can also help with interpreting the findings of needs assessment. For example, Gilliam, Eke, Aymer, and O’Neil (2001) reported on their needs assessment that utilized interviews with and ethnographic analysis of youth. They collected information about the attitudes, beliefs, and behavioral practices of youth that could put them at risk for human immunodeficiency virus (HIV) or other STDs. After collecting information, they utilized existing health behavior theories to develop the components of an intervention that focused on cultural, knowledge/belief, and skill-building components. Therefore, theory can be used to account for the variables and factors that comprise an assessment.

The steps that Gilliam et al. (2001) took in planning their needs assessment and in utilizing their findings may be helpful for others to follow when undertaking a needs assessment in preparation for action, in this case program development.

1. Review the literature on HIV/STDs and on effective interventions. 2. Determine the focus, scope, and type of the needs assessment based on knowledge gained from the

literature review. 3. Use theories to bring meaning and understanding to the findings and to point out implications for program

development. 4. Develop and evaluate the program using needs assessment findings.

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The incorporation of theory starts even before step 1, because this is when the purpose and general scope of

an inquiry are developed. An agency’s forte, capacity, interest, observations, and resources determine the initial focus and scope of the needs assessment. For example, an interest in providing services for returning war veterans could focus on providing them with adequate psychological therapy/counseling, helping them reintegrate into their communities and families, and helping them reacclimatize to the workplace. If the interest finds a focus in helping veterans to quickly reintegrate into society, the initial ideological theory held by an agency may be to focus on treatment for posttraumatic stress disorder (PTSD) and any other mental health disorders caused by the experience of being in combat. In this case, an agency might decide that other areas of possible need, such as vocational training, family reintegration, or marital counseling, are not as important. Again, the initial working ideological theory here is that mental health treatment is the best way to help veterans reintegrate into society.

This would then lead to an initial review of the literature on what we know about veteran reintegration and, specifically, the role that mental health services play in that reintegration. The literature would point out specific scientific theories that either justify or do not justify the initial ideological theory about the priority of mental health treatment and services. From this review, the scope of the needs assessment would be determined, as would the scope of what information would be needed from the targeted population (e.g., experiences in combat, felt need for services, etc.). Scientific theory would then be used again after data were collected to bring meaning to the findings and to suggest programming needs.

Simplicity and Complexity Besides considering theory and past findings, planning for a needs assessment requires consideration of the basic dichotomous choice of simple versus complex needs assessments. Needs assessments range from very simple studies involving small groups (such as focus groups) to very large and costly surveys involving hundreds of participants.

For example, an African American community center in a large Midwestern city decides to conduct a needs assessment to better understand the interests of the community residents so as to increase their use of its facilities and programs. The center may decide to use two needs assessment methods. First, it would use key- informant methodology, gathering a group of other social service agency representatives to obtain their views about how to increase participation. If this method proves inadequate, the center’s staff may decide that only the community’s residents hold the answers. Thus, staff would conduct a community-wide resident study using survey methodology.

The preceding example illustrates how needs assessment methods differ in their level of complexity. However, the complexity of a particular methodology does not necessarily reflect its validity or usefulness. A small-scale study, such as one using a single focus group of only a few respondents, can be as valid for certain purposes as a large-scale survey. An intersection between the specific type of information needed and the most accessible and appropriate method of obtaining that information increases the validity and aptness of the data. For example, the most valid and appropriate method to assess the needs and concerns of Latino youth gang members in Kansas City would not entail a survey of many individuals. Rather, a simpler method, such as the interview method, would provide more accurate and useful information due to the relatively small number of gang members.

Subsequent chapters will discuss a range of methods that differ in complexity. Each of these methods has advantages and disadvantages. However, before discussing them, other critical issues about needs assessments need to be considered:

Understanding the purpose or reason for the assessment Considering the resources available to undertake the effort, including funds and people Knowing the planned application of the study’s findings

In Chapter 4 we discuss the importance of the purpose of the needs assessment, also called the goal of the

study, and key questions or objectives. The purpose or goal of a needs assessment is the statement that articulates the focus and boundaries of the study. The purpose of the study should already have in mind the planned

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application of the study findings. Is the hope that the study will lead to specific services or programs? If so, what are they? The more specific we are about the realistic application of the study findings, the better. Tied to the issue of realism is a knowledge of where the funds will come from to pay for the services or programs. Such knowledge allows for consultation with funders to make sure that the information being collected will have the desired persuasive effect.

Knowing the purpose and application of the findings is important, but knowing what resources will be needed to gain data from the needs assessment is critical as well. Depending on the scope and depth of the effort, the cost of conducting a needs assessment can range from just freeing up the time of a single agency staff member to thousands of dollars if conducting a large probability study. Part of planning a study is to determine what resources are available to conduct it. We cover this issue in greater depth in Chapter 4. However, the following section deals more broadly with the limitations of needs assessments.

Limitations of Needs Assessments Though much useful and practical information is derived from needs assessments, no assessment is perfect, and none is able to quantify perfectly the specific service requirements for any agency or program. This gap between the ideal and reality is due to one or a combination of the following reasons:

A reluctance by needs assessment participants to admit to currently using services or to reveal personal concerns tied to the need for services Opposition to disclosing to agencies a need for services, regardless of recognized need for them Lack of access to a representative sample of respondents Unwillingness by some people to participate in any survey or study Purposely deceptive responses Poorly written or confusing questions Erroneous interpretation of responses

Consequently, rather than being conclusive, needs assessments suggest a probable need for services or

programs. Collecting information from people is difficult in itself. Appropriate wording of a question, for example, is critical to collecting valid and reliable information. Consider the following statement to which a respondent is instructed to indicate level of agreement: “Substance abuse services are definitely needed.”

Without further instructions, respondents could easily interpret this question as inquiring about the perception of needs in society in general—outside of the respondents’ immediate environments or families. Yet the researcher, in interpreting the responses to this question, may mistakenly infer that they reflect the perceived need for services in the community or immediate environment. Clearly, questions asked in a needs assessment should have the same meaning for both the respondents and the investigators if the results are to be valid and reliable.

Pretesting Misunderstandings and problems with clarity can be reduced by certain procedures, such as pretesting

instruments. Although pretest procedures differ, they typically consist of having about 10 to 20 respondents, who meet the sample selection criteria, review, complete, and critique a draft of the assessment instrument. A questionnaire or paper-and-pencil test is often referred to as an “instrument.” The keys to effective pretesting are establishing rapport with respondents and allowing them to review and critique the procedures and instructions as well as the wording of the questions. Even when developing a self-administered questionnaire (i.e., one with which subjects do not require assistance), many researchers find it useful to read each question to the respondents during pretesting. After also allowing the respondent to read and respond to each question, the following questions are commonly asked:

What does this question seem to be asking you? How clear is the question? If it is not clear, what would be a better way of asking it?

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Are the response choices and/or the question clear and helpful?

After all questions have been read to participants, they are asked about the questionnaire in general and the

entire procedure. Here are examples of such questions:

Were there questions in the questionnaire that you feel should be left out? If so, why? (For example, a respondent may say certain questions are redundant.) Are there questions not in the questionnaire that should be included, given the purpose of this study? Is there anything else about this study that you would like to comment on or have questions about?

Needs assessment instruments are altered according to the feedback given by the pretest subjects. Significant

alterations or rewording of questions in the instruments may warrant pretesting them again. The pretest sample should always mirror the heterogeneity of the target population. For example, a

community health center conducting a needs assessment in an area that has 30% African Americans, 30% Latinos, and 40% White non-Latinos should include respondents who reflect these demographics. Furthermore, the heterogeneity found in any particular cultural group should likewise be reflected in the pretest sample (e.g., monolingual Spanish-speaking vs. monolingual English-speaking Latinos, low-income populations vs. middle- income populations, elderly vs. children).

Conducting an appropriate pretest before fielding (administering) an instrument will greatly improve the validity of the responses. Even so, as mentioned earlier, research that involves people is always imperfect. The reliability and validity of the findings are influenced by such factors as the wording of the questions, the type and number of respondents, the type of statistical analyses used, and the subjective interpretations of the results. Decisions pertaining to these factors obviously bear on the level of validity and complexity of a needs assessment.

Conclusion In this chapter we defined the needs assessment and distinguished it from program evaluation. We considered the importance of having a theoretical or conceptual framework that guides the understanding of the relationship between the variables or factors that will be included in a needs assessment. We considered the fact that needs assessments can be complex or simple depending on the focus. We further discussed the inherent limitations in the purpose of the assessment, the resources devoted to conducting the assessment, and the application of the findings. We also dealt with limitations that are tied to factors including access to representative respondents, their receptivity to participating, their willingness to give truthful responses, and the clarity and quality of the questions being asked. Finally, pretesting as a concept was introduced. Pretesting is important when conducting needs assessments to ensure that data collection instruments, such as questionnaires, are clear to diverse but representative respondents. The following chapter on sociopolitical and economic issues considerations continues to discuss various constraints on needs assessments.

Exercises Confusion often exists about the difference between needs assessments and program evaluations. While they may share methodologies, they differ significantly in objectives. Following are examples of needs assessments, followed by examples of program evaluations and then by examples of initiatives that can serve both needs assessment and program evaluation.

Examples of Needs Assessments Example 1: Management–Employee Relations

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Job morale and work performance have declined steadily in the membership recruitment division of a large not-for-profit organization. Division managers suspect a need exists to improve supervisor– employee relations and to provide better training in the use of computer equipment and desktop publishing software. To address the needs of the division, management has commissioned a one-time needs assessment that focuses on training needs and employee–supervisor relations. There are no plans to evaluate changes of the same needs over time. This, then, cannot concurrently be a needs assessment and an evaluation project. Management has a genuine desire to understand any training problems and is committed to instituting changes based on the study findings. Hence, there is a good possibility that the needs assessment will not be simply an intellectual exercise but an information-gathering effort leading to significant improvements in the division.

Example 2: Youth Violence

The government’s recognition of increased youth violence has resulted in new federal monies becoming available for cities to use in addressing this problem. Cities must demonstrate a clear need, along with a plan to address this need, to obtain these funds. A Midwestern city decides to conduct a city-wide needs assessment, which will be triphased. The methodology chosen includes collecting information from (a) law enforcement and school representatives, to document problems with youth violence in communities and in the schools; (b) a representative sample of city residents, to assess the public’s concern and experience with youth violence; and (c) existing service providers, to indicate a need for more and improved services.

Information from the needs assessment will be used to justify the improvement and increase of existing services. The data will highlight the problems resulting from youth violence and point to specific services needed to address these problems. This is a one-time assessment, with no immediate plans to repeat it. County government officials are working closely with city officials and are prepared to propose changes in services based on the findings. Hence, there is a good probability that the needs assessment will result in an improved understanding of youth violence and of service needs in the city.

Examples of Program Evaluations Example 1: Illegal Drug Use Among Youth

A coalition of agencies received a 5-year community grant from a federal agency concerned with funding programs to reduce illegal drug use. The coalition was composed of law enforcement, school, and city health programs. The coalition focused on reducing illegal drug use among adolescents through school- based presentations that attempted to scare teenagers away from using drugs. Law enforcement officials used graphic depictions of victims of violence linked to drug use and sales. They also brought in prisoners to warn youth of the consequences of being caught using drugs. Two comparable schools were chosen to participate in the evaluation. One school participated in the coalition’s program, while the other participated in the “Just Say No” program, which focused more on informing youth about the dangers of drug use. Over the 5 years, the number of adolescents from each school who were charged with drug use, referred to drug treatment programs, or sent to a counselor for possible drug use was recorded and served as the primary evaluation criteria.

This effort clearly focuses on evaluation. The information is being collected simply to evaluate the effect of the experimental program conducted by the coalition. None of the information collected can serve to assess the service needs of adolescent youth in the schools, though there may well be unmet service needs.

Example 2: Patients With Chronic Depression

A community residential home has been housing the same 15 patients for 2 years as part of a 3-year demonstration project. The residents are chronically depressed patients and have been previously

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hospitalized for catatonic depression. The program was designed to increase patient independence and self-sufficiency by providing individual and group therapy from licensed clinical social workers. Empirical data on the program’s impact were needed to obtain continued funding for the project. The evaluation study team assessed the patients’ (a) depression scores, (b) sense of independence, (c) employment status and earnings, and (d) sense of preparedness to move out of the group home and set up their own residences.