executive summary
about this project
The Northwest Arkansas Hometown Health Improvement Project, in collaboration with the Benton County Community Coalition, the Carroll County Resource Council, and the Madison County Health Coalition, conducted a Four-County Community Health Needs Assessment within Northwest Arkansas. This project was funded through a grand awarded by the CommunityCare Foundation. The Northwest Arkansas Health Needs Assessment was designed to accomplish the following goals:
- Establish baseline health need information
- Identify health care needs and trends
- Identify perceived gaps in the current health care delivery system
- Compare perceived health care needs with available health data
- Obtain health need information from underserved groups residing in Northwest Arkansas
The data obtained from the Northwest Arkansas Health Needs Assessment will be utilized by the four Northwest Arkansas Hometown Health Coalitions, health care providers, and local citizens in order to improve the overall health and well being of the residents of Northwest Arkansas. The essential guiding principle of this project supported community participation, community empowerment, and community ownership for the planning, implementation, and effectiveness of health care services within Northwest Arkansas.
The University of Arkansas' Social Work Research Center (SWRC), was awarded a subcontract, in order to provide the following services;
- Consultation for the development of the Health Needs Assessment instrument
- Responsibility for the research design and methodology
- Statistical analysis of the data and interpretation of findings
- Production of the final report
research design
A multi-method research design was employed, in order to obtain baseline information about the health care perceptions of the citizens of Northwest Arkansas. This multi-method research design utilized the Health Needs Assessment Survey instrument, targeted focus groups, and qualitative and quantitative health care data, in order to illuminate the health care perceptions of the residents of Benton , Carroll, Madison , and Washington Counties.
Utilizing a sample of convenience, trained volunteers administered the health needs assessment to 1437 residents of Northwest Arkansas , between September 2003 and January 2004. Data collection sites were determined by members of the Four County Hometown Health Improvement Project teams. Targeted focus groups, consisting of selected members of subgroups of particular interest (first generation Hispanics males, Madame Pastors within the Marshall Islander community, senior citizens, and first care responders), were facilitated by staff members of the Social Work Research Center, during January to March, of 2004. Qualitative and quantitative information, obtained from the Health Needs Assessment Survey, the targeted focus groups, and health data sources (e.g. , Arkansas Department of Health, the United States Center for Disease Control), was utilized in order to validate information obtained from the Health Needs Assessment.
community needs assessment
The development of the Northwest Arkansas Health Needs Assessment Survey, was a collaborative effort, which included members of the Four-County Hometown Health Data Committee and members of the University of Arkansas 's Social Work Research Center. The survey instrument was derived from a comprehensive review of the relevant health needs survey literature information obtained from the Hometown Health Guide (3), and health care items identified by a committee of health care experts. The Health Needs Assessment Survey underwent four major revisions. The final survey instrument was comprised of 72 items, which was divided into six major sections. These sections included the following set of items:
- Medical care costs
- h care services
- Physical health care issues
- Multicultural health care issues
- General questions and demographic information
Surveys were printed in English and Spanish versions. Trained volunteers, utilizing a variety of sites within each of the four counties in Northwest Arkansas , conducted the Health Needs Assessment Survey. The total number of surveys completed in each county, was as follows:
Surveys
Surveys
(by Language)
comparisons to existing health data
The "validity" of survey respondents health care perceptions was compared to existing physical health care data. This comparison provided the opportunity to assess the accuracy of survey respondents with prevalence and morbidity rates for selected physical health care conditions.
focus groups
The Northwest Arkansas Health Needs Assessment utilized four focus groups. These groups were comprised of selected and underserved populations of interest, in order to augment data obtained for the Health Needs Assessment. These focus groups were selected by members of the Hometown Health Improvement Health Data Committee and the Social Work Research Center. These selected subgroups were selected based upon their perceived difficulty in successfully accessing needed health care services and/or due to the unique perspectives they offered, in terms of health care issues which affect Northwest Arkansas. The focus groups selected for participation in the Northwest Arkansas Health Needs Assessment included;
- First Responders
- First Generation Hispanic Immigrant Men
- Marshall Island Women (Madame Pastors)
- Senior Citizens
data analysis
Data obtained from the Health Needs Assessment was analyzed, utilizing several different techniques. These analytical techniques were designed to quantify the representativeness of the sample surveyed, analyze the relationship between salient demographic variables and survey items, assess the relative importance of health care concerns, develop health profiles for each of the four counties within Northwest Arkansas, and to conduct a qualitative and quantitative analysis of health care responses.
Survey items contained within each of the six content areas of the Health Needs Assessment were averaged and ranked ordered, consistent with their perceived importance by survey respondents. A multivariate analysis was utilized to determine the strength of the relationship between survey participant's demographic characteristics and their responses to items on the Health Needs Assessment. This data was analyzed for each of the four counties within Northwest Arkansas, and this information was utilized to develop County health profiles for Benton , Carroll, Madison , and Washington Counties.
A qualitative analysis of narrative responses contained within the survey, a summary of findings obtained from the focus groups, and a comparison of survey responses with selected health care data, was also assessed.
summary of findings
The analysis and synthesis of data derived from the Northwest Arkansas Health Needs Assessment, focus groups, qualitative survey responses and health data, clearly articulated and corroborated the current health care crisis within Northwest Arkansas. Consistent with nationally derived data that ranks Arkansas as one of the least healthy places to reside in the United States , results of the Four County Health Needs Assessment quantified the perceived inadequacy of health care services within Northwest Arkansas.
Consistent with the anticipated goals for this project, baseline health needs information for Northwest Arkansas was established. Health care profiles, for each of the four counties within Northwest Arkansas articulated residents concerns in regard to the costs associated with health care services, difficulties associated with accessing needed health services, the identification of salient physical and mental health issues which are considered to be problematic, and barriers which multicultural populations experience when accessing needed health care services.
Focus groups were utilized to provide supplemental information concerning the health care perceptions of underserved groups within Northwest Arkansas, and to examine the influences that cultural and/or language issues may exert in accessing needed health care serves for the Hispanic/Latino community, Marshall Islanders, and elderly citizens. Physical health care data was utilized to validate and corroborate the health care perceptions of survey respondents.
implications
The Northwest Arkansas Health Needs Assessment has served as the exclusive project of the Four County Hometown Health Improvement Project during the past 2 years.
The overall goal of this project is to utilize the results obtained from the Four-County Community Health Needs Assessment in order to improve the health and well being of the citizens of Northwest Arkansas. The information derived from the Health Needs Assessment will be utilized by health care providers and policy makers in order to enhance health education and outreach effects, address service gaps and inadequacies in the current health care delivery system, effectively serve the unique health care needs of underserved populations, and to develop effective health care interventions and policies.