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SET: Learn What Works & Tools to Try

Now that you've accessed some introductory information on needs assessment, it's time to gather tools and other resources.

Use the links below to learn more and access trainings and tools to use for each step of the needs assessment process:

Needs assessment is a systematic process to acquire an accurate picture of the strengths and weaknesses of a state's public health system, and essential to identifying the most appropriate programs and policies to promote the health of women, children, adolescents and their families.  MCH assessments are to be population-based and community-focused and serve as a fundamental element of any program planning activity.1

The needs assessment process includes the collection and examination of information about the state's capacity and infrastructure, needs, and desired outcomes for the MCH population, and legislative mandates, etc. This information is used to determine priority goals, develop a plan of action, and allocate funds and resources. The needs assessment is a collaborative process that should include the HRSA/MCHB, the state Department of Health, families, practitioners, the community, and other agencies and organizations within each state and jurisdiction that have an interest in the wellbeing of the MCH population.

Title V of the Social Security Act requires states to conduct a statewide Needs Assessment every five years with the primary goal of improving MCH outcomes and strengthening state, local and community partnerships.  The following conceptual framework illustrates the continuity of the Needs Assessment process and its relationship to the planning and monitoring functions of Title V and the population that is serves.

Navigator Conceptual Model

 

Introduction

Essential to the needs assessment process is to engage stakeholders early on and throughout the process.1 States need strong partnerships and effective coalitions to assist in all remaining eight steps of the process. It is expected that states will have ongoing communication with stakeholders and partners throughout the needs assessment process and continue to engage with such partners during interim reporting years.

Stakeholders can help to identify the full scope of need, interpret available data or collect new data, sort our priorities, identify and select solutions, build consensus, advocate for needed changes and support overall efforts.1

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Tools to Try

Introduction

Step two involves assessing the needs of MCH population groups with the goal being the identification of community/system needs and desired outcomes by specific MCH population group. Four major data sources used to assess need are:

  • Population-based data (vital records, census),
  • Surveillance systems and survey data,
  • Program or service data and
  • Public forums or focus group data.1

In addition, states are guided to identify needs and desired outcomes for cross-cutting and systems issues. Finally, as part of this step, states will also identify legislative, political, community-driven, financial, and/or other internal and external mandates which may go beyond the findings identified through the needs assessment process but remain priorities for implementation within their respective state.

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Tools to Try

Introduction

The third step in the process involves examining the state’s capacity to engage in various activities such as conducting the statewide five-year needs assessment and collecting/reporting performance data based on the five MCH population health domains.

Specifically, this step entails describing and assessing the state’s current resources, activities, and services as well as the state’s ability to continue to provide quality services by each of the three MCH service levels: 1) Direct Services; 2) Enabling Services; and 3) Public Health Services and Systems.

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Tools to Try

Introduction

In order to select priorities as step 4 of the needs assessment process, each state must examine the identified needs and match them to the desired outcomes, required mandates and level of existing capacity.  States are guided to select seven to ten priority areas for targeted focus in promoting continued improvement and progress.

Priorities identified should address areas in which the state believes there is reasonable opportunity for a focused programmatic effort (e.g., new or enhanced interventions, initiatives, or systems of care) to lead to an improved outcome.  Other factors to consider include: the availability and effectiveness of interventions, economic feasibility, community perception of the problem, and political issues related to the problem.1

As part of this step, consider priority-setting methods used successfully by other states (e.g., Delphi process, public opinion polls, advisory groups, focus groups, specialized research studies).2

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Tools to Try

  • Concept Mapping. A tool used to help stakeholders identify areas of consensus and priorities that are important and actionable.
  • Causal Loop Diagramming. A tool used to help stakeholders identify leverage points/priorities to shift the entire structure and not simply treat the “symptom” of the problem. This tool will help your stakeholders understand the forces shaping the problem, uncover assumptions about the problem, identify unintended consequences, and identify strategies to influence the system.
  • Prioritization Matrix. The last phase of the CAST-5 Process highlights selecting priorities. This document provides an overview and tool for Prioritizing Needs.
  • Impact Matrix. A tool to help groups identify and achieve agreement on activities that can be implemented with maximum impact given the effort invested. This is an easy-to-facilitate tool that can be used when a team (or a group of stakeholders) has many ideas about potential courses of action and wants to consider the impact of all potential solutions before deciding on a course of action.

Introduction

In step 5, setting performance objectives consists of two phases. In the first phase, each state will develop action strategies to address their identified priority needs. States will select five National Performance Measures (NPMs), Evidence-based or -informed Strategy Measures (ESMs) for each of the selected NPMs, and State Performance Measures (SPMs).

Secondly, the state will set five-year targets (i.e., performance objectives) for the five selected NPMs, the ESMs and the SPMs. The anticipated results of this stage are the identification of NOMs, NPMs, ESMs and SPMs that directly relate to the state priorities and establish a level of accountability for achieving measurable progress.

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Tools to Try

  • ESM Review & Resources: National Summary. This report serves as a conversation starter as we learn how to strengthen our strategies, work with the Evidence Center, and look toward the next iteration of block grant applications and work.
  • Results Based Accountability (RBA) Tip Sheet. Check out this quick "cheat sheet" to learn about how RBA relates to ESMs and for tips on writing effective measures.
  • Logic Models. Logic Models are simplified graphic depictions of a program, initiative, or strategy. They provide a map of the relationships between the resources, activities, and benefits or changes that result. Logic Models demonstrate the theory of change, and can be useful in program planning, management, communicating with partners, and needs assessment.

Introduction

The next step is to develop an action plan, which involves the planning and identification of specific activities to implement the program strategies developed in step 5. Part of this process is to create the Five-year State Action Plan Table, which at a minimum includes relevant priority needs, key strategies and measures for each of the MCH health domains.

Consider current research and evidence-based practices to select and customize activities aimed at accomplishing performance measures.  It may also be helpful to obtain technical assistance from the Strengthen the Evidence project for information on current research reports and activities that have been successfully implemented in other states and jurisdictions.

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Tools to Try

  • Plan-Do-Study-Act Cycle. A tool used to help stakeholders test strategies and innovations on a small scale in order to learn how to adapt the strategy to fit with the environment in which it is being implemented.  The tool provides a structured way to plan how the test will be carried out, try it, observe and collect data, and adapt the strategy based on what is learned.
  • 30/30 Action Plan: PDF | Word document (editable). A simple way to monitor progress and record future action steps in ongoing work. The idea is that the team meets for 30 minutes every 30 days to discuss progress over the past month. The progress, roadblocks and other relevant ideas are noted on the form, along with an action plan for the following month.
  • Causal Loop Diagramming. A tool used to help stakeholders identify leverage points/priorities to shift the entire structure and not simply treat the “symptom” of the problem.  This tool will help your stakeholders understand the forces shaping the problem, uncover assumptions about the problem, identify unintended consequences, and identify strategies to influence the system. Use Causal Loop Diagramming as a way to  identify activities and develop an Action plan.
  • Simulation. A tool used to predict outcomes based on formulas and selected variables and interventions.  This tool allows stakeholders “test” interventions in a virtual arena and understand the impacts of selected interventions.

Introduction

Following the identification of program activities in step 6, is the allocation of resources. In step 7, the focus is on the funding of planned activities to address state priorities. Inputs include the five-year State Action Plan, current budgets, political priorities, and partnerships.

The anticipated outcome is the development of a program budget and plan that directs available resources towards the activities identified in step 6 as the most important for addressing the state's priorities.

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Introduction

In step 8, states examine the results of their efforts to gauge whether there has been improvement or change. Inputs include NOMs, NPMs, SPMs and ESMs, performance objectives and other quantitative and qualitative information. Potential outcomes may include altering activities and shifting resource allocations to address current levels of performance and availability of resources. Feedback loops between various stages of the process allow for continuous input and re-evaluation of the outputs.

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Tools to Try

  • Measurement Tables. A Measurement table documents your plan to monitor progress toward goals over time. If you have already completed logic models for each domain, a Measurement Table can be used to further flesh out ideas for measuring each activity described in the logic model.

Introduction

This final step ensures accountability to the stakeholders and partners who have worked with the MCH staff throughout the needs assessment process. It also assures the continued involvement of all stakeholders and partners in the ongoing needs assessment processes.

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Tools to Try

  • Data Placemats. Data placemats help stakeholders interpret and draw meaning from data. They can be particularly effective in communicating the current health status of sub-groups, and can be easily customized for sharing data with various audiences.