NEEDS ASSESSMENT

Introduction
This chapter provides a brief introduction to needs assessment and its significance as a
tool. Needs assessments are important tools for communities. They can have important
impacts on policy-making decisions, provided they are carried out well and results are
disseminated effectively. There are many different methodologies that can be used to conduct
an assessment, and these will be discussed. It is also possible to conduct assessments on
various subgroups of a community as opposed to the whole community. However, the
importance of using an organized approach in any assessment cannot be overemphasized,
regardless of whose needs are assessed and how they are assessed. This chapter will provide a
background for organizing ones approach to conducting an assessment, and it will provide
useful resources for one interested in doing an assessment in the future.
Definition
Needs assessment itself has been given many definitions. The United Way of America
(1982) defined it as a systematic process of collection and analysis as inputs into resource
allocation decisions with a view to discovering and identifying goods and services the
community is lacking in relation to the generally accepted standards, and for which there
exists some consensus as to the communitys responsibility for their provision. McKillip
(1987) defined it as a process of ordering and prioritization of community needs. Reviere et
al. (1996) take a somewhat different approach in defining needs assessment. They approach
needs assessment from the perspective of utilization of results/outcomes of the research. Their
definition of needs assessment is a systematic and ongoing process of providing usable and
useful information about the needs of a target population- to those who can and will use it to
make judgments about policy and programs. It is a broader and more practical definition.
Their definition is the one that will be used in this chapter, considering the goals of this text,
since their definition has implications on policy-making decisions.
Strategy in Planning a Needs Assessment
Reviere et al. (1996) note that needs assessment should be considered an applied social
research, and that as such it should adhere to social research guidelines involving
methodological design and data analysis. However, they note that methodologies used in needs
assessments are at their beginning stages. Many previous studies have simply used methods
that the researchers deemed sufficient for their goals. Deficiencies in methodology have arisen
for various reasons. Assessments may not have been conducted by well-trained researchers;
the researchers may have been under time pressure to obtain their results; and funding
agencies may have put pressure, whether deliberate or otherwise, on researchers to publish
results consistent with their views in order that they could influence policy-making decisions.
The result has been that many researchers lack guidance in how to conduct a needs
assessment, and that many assessments are conducted ineffectively. Lareau and Heumann
(1982) determined that over three-fourths of a national sample of needs assessments of the
elderly was of such low quality they could not provide meaningful input into planning
stages.
This does not mean that effective and helpful needs assessment have not and can not
be conducted. However, it does speak to the need for adequately trained researchers as well as
careful consideration of methodological issues in the design of an assessment. Planning is

extremely important, and should be one of the first steps in an assessment; it should definitely
be done before actual data collection. It should also be done throughout the assessment, and
planning sessions should be incorporated into the process at regular intervals. Of course,
changes will almost certainly need to be made along the way, and flexibility in the plans is
important. However, as Reviere et al. (1996) note, it is easier to make changes in a plan that
is already in place than to start from scratch each time the unexpected happens. Planning
should involve consideration of funding for the project, goals and objectives of the project,
definitions of individual research staff members roles and responsibilities, necessary supplies,
methodological design issues, what data will be collected, how it will be collected and analyzed,
and dissemination of the results of the assessment.
Further discussion of design issues, including choice of data to be collected and
sampling techniques will follow in the next sections. However, a few brief notes should be made
at this point about others of the above considerations. First of all, a clear statement of the
goals and objectives of a project is extremely important in determining its success. Goals are
abstract, more global statements of desired outcomes, whereas objectives are specific concrete
statements about measurable outcomes. The goals and objectives should be explicitly stated
early in the planning stages. Secondly, clear definitions of staff members roles and
responsibilities helps to avoid confusion and disagreements among members of the research
team. Lack of clear role definitions can ultimately slow the process down and result in
difficulties in transitioning from one phase of an assessment to another. Finally, if the
assessment is to have any impact on policy decisions, results need to be disseminated
effectively and in a timely manner. Results may need to be disseminated to various audiences,
using different manners of dissemination for each specific audience. Many needs assessments
have been conducted without discussion of this step in the final write-up. It is the step of most
interest to readers of the project, and it is the step that is most important in potentially
bringing about beneficial changes that will affect study participants and the community.
Choice of Data
The data to be collected in a needs assessment will be dictated by many factors. These
factors include who is funding the project and their goals, qualifications and experience of the
research team, the population being assessed, and the goals and objectives of the project. The
key variables of interest to collect should be decided upon in the planning stage, so that the
team can move on to determine sources of the necessary data and how to go about collecting
them. Demographic variables are important in almost any assessment. Demographics to be
obtained will be defined by ones target population but those to consider include gender, age,
race/ethnicity, education, marital status, and employment.
Data can be subdivided into two large categories, primary and secondary data. Primary
data is data that is collected by the research team at the time of the assessment. Secondary
data, on the other hand, is data that has already been collected, often by another organization
or governmental agency. Examples of secondary data include the U.S. census, vital statistics
registers, social indicator data, service utilization records, and data from mandatory health
care/outcome reporting. Secondary data is often very useful and can save time and money;
however, certain considerations should be taken into account when it is used in a project. It is
necessary to consider ease of access to the original dataset (is a fee and/or permission
required?); how the sampling was conducted in the original study; whether or not sufficient
data is available on the population that the current team is interested in; and how the
variables of interest were defined in the original dataset. Adjustments or modifications may

need to be made in order to fit the use of secondary data into the research project. These
adjustments themselves often cost time and money, and the research team should consider if
and how such adjustments will affect the project.
Examples of primary data include surveys and interviews. The benefit of primary data
is that the data collected can be determined specifically based on the goals and objectives of
the project. The main drawback in using primary data is that it is often expensive. There is
usually a longer time frame involved in using primary data as well. Decisions about what data
will be collected, methodology involved in collection, analysis, and staff training are all factors
that can increase the length of time necessary to complete an assessment. Using primary data
offers greater control of the data collected, but it is beneficial for the team to weigh the costs
involved in having greater control.
The above discussion may lead the reader to question whether primary or secondary
data is more important. This is a question that should be answered on a case by case basis, as
there are benefits and drawbacks of using either. The answer may depend on logistical issues
such as cost, time requirements, experience and training of staff, and ease of access to data
sources. However, it should be noted that one is not restricted to using one or the other, and
that both primary and secondary data can be used in an assessment. In fact, resources
permitting, this may often be the best approach. Reviere et al. (1996) comment that there is
no methodological reason to confine any needs assessment to exclusive use of either secondary
or primary data Careful and artful combination of secondary and primary sources greatly
strengthens a research design.
Sampling Techniques, and Mode of Data Collection
This section will provide an overview of collecting primary data from the field, including
sampling techniques and different modes of data collection. Since the most common method
for primary data collection is a sample survey, it is important to understand the different
methods of probability sampling. Lareau (1983) notes that one of the biggest problems with
past needs assessments has been poor sample design. A good sample helps researchers to
draw appropriate conclusions from the study, but a poorly designed sample weakens any
conclusions drawn from the study.
Probability sampling, or sampling in which each individual in the target population has
an equal chance of being selected for inclusion into the study, is commonly used in the social
sciences. There are multiple types of probability sampling, and they are discussed in more
depth by Cochran (1963). Fortunately, sampling techniques have not changed drastically in
the past few decades. The first type of sampling is simple random sampling. Simple random
sampling is a method of sampling where each individual in the population has an equal chance
of being selected. Each individual is assigned a number, and then numbers are randomly
selected until the required sample size is obtained. Cochrans text provides a more detailed
discussion of sample size, but a general rule of thumb for determining sample size is that a
randomly-drawn sample of at least 30 individuals is sufficient. Simple random sampling is the
most widely-used technique in probability sampling. Another type of sampling is
called stratified random sampling. In this case, the population is broken down into two or more
subpopulations of interest, the subpopulations being termed strata. For example, an
assessment of preventive health screening in the elderly may break the population into strata
by type of insurance that the individual has. After the strata have been created, a sample of
each stratum is drawn, each stratums sample being independent of the others. The benefit of
stratified sampling is that it allows comparison of results based on the stratifying variable, and

it may yield higher precision in estimates of characteristics of the whole population. A final
type of sampling used in needs assessments is called cluster sampling. In this case, the first
step of the technique involves numbering and randomly selecting units termed clusters.
Examples of clusters include counties in a state, or city blocks. After the necessary number of
clusters (generally at least 30) is selected, a simple random, systematic, or stratified random
sample is taken from each of the clusters. Cluster sampling is often used in countries where
there are no complete lists of people in a region, but where maps of the region permit it to be
divided in units that can be randomly selected. The World Health Organization has used
cluster sampling to estimate immunization coverage of their Expanded Programme on
Immunization (EPI). An assessment of their results by Henderson (1982) concluded that the
cluster survey technique performed satisfactorily.
The three main modes of data collection are mail surveys, telephone surveys, and inperson surveys. Each has its own advantages and disadvantages, and careful consideration
should be given to which one or ones will be used in an assessment. In-person surveys are very
expensive and they take time to conduct. However, they offer a more personal method of
collecting data from respondents, and they allow for more direct examination of participants
unmet needs. If respondents view services other than those previously defined as being
necessary, this mode of data collection will be the one to catch them. Telephone surveys are
less expensive than surveying individuals in person. When compared to mail surveys, they
allow researcher to explore respondents attitudes more thoroughly. They are more expensive
and require more time than mail surveys; however, response rates are usually higher with
telephone surveys, and they often permit the collection of more detailed, quality
information. Mail surveys are the least expensive and most basic of the modes of data
collection. They are suited best to collecting straightforward facts and numbers. It is often
necessary to send reminders or repeat survey mailings to participants to obtain the desired
response rate. Reviere et al. (1996) note that researchers may draw a sample that is larger
than the total number that is needed in order to ensure an adequate response rate. In using
this approach, however, the research team should at least question whether there are any
important differences between the groups who do respond versus those who do not. Such
factors can affect analysis and how results of the research are used.
Nothing has been mentioned to this point about the use of new technology in data
collection. Laptop and handheld computers have the potential to facilitate data collection and
data entry, steps that traditionally have taken a significant amount of time. These instruments
could be taken into the field, and either be used to administer surveys to participants by an
interviewer, or they could be set up to allow participants to self-administer surveys. In either
case, the data would be entered into the computer at the time of the survey, and could easily
be transferred into a larger database at a research office. Another benefit of using computers
to collect data is that skip patterns on survey instruments could be built into the program,
which would facilitate data collection in terms of confusion and time. For example, in an
assessment of access to health care among the elderly, suppose a questionnaire had a section
about dialysis. The first question asked participants whether they need access to a dialysis
unit. The following questions in the section then asked about ease of access to the unit. If a
computer program was being used and the participant answered no to the question about
needing dialysis, the program could be designed to skip the remaining questions in that section
and move immediately on to the next section of questions. Obviously, this would make the
survey easier and potentially faster to administer or take. The use of computers in data
collection is likely to become more and more important as cost for these types of instruments

goes down, as researchers become more familiar with their use, and as programs that allow
more flexibility in survey design become more common.
Qualitative and Mixed-Method Approaches
The use of qualitative data in social sciences has recently been achieving more and
more acceptance and popularity. It was not used commonly in the past because many
researchers were not comfortable with the functionality and analysis of qualitative data.
Qualitative data is data that is expressed in words as opposed to numbers, and it uses less
structured and more open-ended methods of collecting data. However, the appropriate use of
this type of data can add richness to an analysis. They allow for an issue or question to be
probed more in-depth than with quantitative data. Different techniques are used both to
collect and to analyze qualitative data. It is important to note that qualitative methods do not
usually fit with the assumptions or requirements of probability sampling. Unlike samplesurvey methods, qualitative data collection and data analysis are quite labor-intensive, and
usually focus on examining fewer cases in greater depth, rather than collecting data on large
numbers of cases or respondents. (Reviere et al. 1996)
Techniques in qualitative data collection include focus groups and intensive interviews.
Qualitative data collection can also be incorporated into surveys with the use of open-ended
questions. Of course, the comment above about probability sampling techniques does not
apply to qualitative data used in this fashion. The discussion to follow will be restricted to
focus groups and intensive interviews. Both instruments involve discussion of a specific topic
using a less structured and more open-ended format. The difference between the two methods
is that focus groups involve an interviewer facilitating discussion among a group of
participants, whereas intensive interviews are usually one-on-one situations. In both, a
general outline is followed by the interviewer so that issues related to the topic at hand are
discussed in detail. Interviewers receive training so that they learn to achieve a balance
between directing respondents to say certain things versus allowing them to turn to issues or
topics that are not relevant to the subject matter at hand. The goal is to allow openness and
flexibility in responses without straying too far from the topic being discussed.
Analysis of qualitative data is a separate subject, and will be discussed here only
briefly. It is much more time-consuming than analysis of quantitative data. Miles and
Huberman (1994) have described essentially three important components in the analysis of
qualitative data: data reduction, data display, and conclusion drawing and verification. Data
reduction involves transforming data in field notes or interview tapes so that they will be more
manageable, and so that the elements most critical to the research question are selected. Data
display involves organizing the reduced information into a form of display that will allow the
data to be analyzed. Examples of displays include text, charts, and diagrams. Some analysis
of the data occurs at this time as patterns and relationships between data become more
obvious. The third broad component of qualitative data analysis is conclusion drawing and
verification. This step involves figuring out what the data mean, how they help answer the
research questions, and finally going back into the original data to verify conclusions that are
drawn. Miles and Huberman (1994) comment that the three elements can often overlap in
time. They note that all three occur both during and after the data collection period and
interact in a variety of nonlinear ways. (Reviere et al. 1996)
Disseminating Data
As mentioned earlier, it is important to consider what will be done with the results of
assessments once the phases of collection and analysis are completed. Results sitting on a

shelf do no good, and can even jeopardize future assessments if the study participants feel that
the research has had no beneficial effects. To have an effect on policies, programs, and
delivery of services, the results need to be communicated effectively. Planning on how to
present the results and to whom they should be presented should occur at all stages of the
research project. Stakeholders in the assessment should be able to have input into
presentations. At minimum, a final project report should be written and should include a brief
summary as well as recommendations for change. Often results need to be presented to
various audiences, and the research team is strongly encouraged to include the study
participants as one of the audiences. The party who funded the project should be another
audience. Presentation should be tailored to specific audiences, depending upon the needs,
desires, and understanding of each. The importance of disseminating results effectively using
these guidelines cannot be stressed enough. A needs assessment will have achieved nothing if
the results are not communicated effectively.
Discussion
Needs assessments are important tools for determining if and how changes should be
made, especially in the provision of health care. The current state of the field is exciting
because many opportunities and challenges are presented. Understanding of methodologies
involved is essential in conducting an effective assessment and in using results to advocate for
change. Many assessments in the past have used methods of data collection that are not up to
par with methodologies in other fields. It is important to train researchers in the thoughtful
and appropriate use of diverse methods used in collecting data for an assessment. The use of
qualitative data in needs assessments is achieving more and more acceptance as a method,
and it has the potential to broaden and enrich the field as a whole as well as assessments that
use analysis of qualitative data. Technologic advances, most importantly advances in
computer technology, may be the most important recent changes in the field. They will allow
for greater ease in data collection and potentially more rapid turnover of results that can effect
policy changes. It is hoped that these factors will encourage more researchers to become
involved in needs assessment. Conducting effective needs assessments will allow effective
advocacy for positive community changes.