Developing a Needs Assessment: Developing a Needs Assessment Marline Vignier, MPH Intern


1. Abstract:: 1. Abstract: HIV/AIDS continues to be a growing epidemic infecting many communities all across the globe. Within New York State, HIV/AIDS rates are disproportionately affecting African Americans. According to the New York State Department of Health, as of June 2003, 46% of HIV cases and 45% of AIDS cases were comprised of African Americans. The Capital District serves as the epicenter for AIDS cases in the Northeastern Region for the Albany, Rensselaer, Saratoga, Schenectady, and Troy areas. African Americans make up 20% of the urban population within the Capital District but represent 35% of the AIDS cases and 42% of the HIV cases. Organizations such as CDAACA play an instrumental role with dispelling the myths and misleading information that surrounds HIV/AIDS, its transmission and impact on one’s life. The purpose of conducting a needs assessment will help determine if services and programs meet the needs of CDAACA’s service area, the Capital District, while identifying and building on current programming and community assets. The need assessment will also help identify risk factors and barriers to tailor interventions specific to the needs of the community.


2. Introduction:: 2. Introduction: Needs assessment analyzes: Physiological, behavioral and environmental risks to the community’s health Factors (determinants) that are found to be associated with at-risk behaviors and environmental contributors to the health impact within the community Tables and figures illustrate the impact of HIV/AIDS within the Capital District community


3. Internship Methods and Materials: : 3. Internship Methods and Materials: Literature Review Articles PubMed, Ebsco Text Intervention Mapping, An Intro. to Community Health, and Evaluation: A Systematic Approach Data Collection Data Request (Letter) DOH, AIDS Institutes, Albany County DOH DOH Epidemiological Center Data Analysis of the regional data Interviews (Peers and Staff) Evaluation Tools Survey Questionnaire


4. National Statistics (African  American community):: 4. National Statistics (African American community): African Americans make up 13% of US population, however comprise 49% of AIDS diagnosed cases (According to Kaiser Foundation HIV/AIDS fact sheet, 2004) In 2002, HIV was the 3rd leading cause of death for African Americans compared to the 6th leading cause of death for Whites and Latinos (According to Kaiser Foundation HIV/AIDS fact sheet, 2004) AIDS case rate per 100,000 population for adults/adolescents within the African American community is 72.1 compared to the U.S. rate of 17.1 (According to Kaiser Foundation HIV/AIDS fact sheet, 2004)


5. New York State and Capital  District Statistics:: 5. New York State and Capital District Statistics: New York is among the top ten states with the highest cumulative AIDS reported cases within the United States in 2002 (According to Kaiser Foundation HIV/AIDS fact sheet, 2004) Ranks #1 highest state with estimated prevalence of African Americans living with AIDS in 2004 The Capital District (Albany, Rensselaer, Saratoga, & Schenectady/Troy areas) serves as the epicenter for AIDS cases within the Northeast Region (17 counties) (According to NYSDOH Regional Epidemiological Profile Report 2004) Capital District comprise of 70 - 75% of HIV and AIDS reported cases Within the Northeast Region, Albany County makes up the highest AIDS death rate (According to NYSDOH Regional Epidemiological Profile Report 2004) Approximately 41% HIV cases and 42% AIDS cases


6. Objective of the Need Assessment:: 6. Objective of the Need Assessment: Illustrates why the need(s) should be addressed & how funding should be allocated in response to these needs Help establish & restructure programs Provide information on how to best deliver services & meet community needs Assessment of established programs Are they responsive to needs of target pop. Provide guidance for improvement of programming Evaluation tool: Precede Model


7. PRECEDE Model:: 7. PRECEDE Model: Educational/Ecological Diagnosis Predisposing: - Perceived Benefits & Barriers - Perceived Susceptibility - Self-efficacy Reinforcing: - Social Norms/Beliefs (dispelling myths; denial factor) - Coping Mechanisms (support groups) - Incentives (free meals, money, movie tickets, discounts at beauty salons and barbershops) Enabling: - Cost/funding Behavioral Assessment: Risk-reduction (changes in behavior) - Practice safe sex (increase contraceptive distribution) - Decrease number of sexual partners - SOS/STEPS programs Improved Lifestyle/Living (Healthy Living Program Series) - Changes in diet and behaviors - Mental relaxation (Meditation) - Upkeep of medication and health condition - Exercise Quality of Life and Health Status Health Outcome: HIV/AIDS in the Community - Incidence/Prevalence - Mortality/Morbidity - Community Outreach - Impact within African American Community Quality of Life - Increase mortality morbidity - Psychological/social impact - Lack of support - Impact on individual healthy living - Cost of living (medications)


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13. Findings:: 13. Findings: The “HIV/AIDS Stigma” Causes isolation/segregation (personal/social) Barrier for seeking help (health services or treatment) HIV/AIDS testing can cause fear and denial Programs/services that cater to PLWA are stigmatized as well Program Evaluation Incomplete paperwork Inadequate training of curriculum Curriculum is difficult to comprehend by peers and participants


14. Outcomes:: 14. Outcomes: Reduction in paperwork Revisions in curriculum and trainings Diverse group activities/personal stories Publications Book: Courage My Child Article: “Tales of Women’s Triumphs” Illustrate CDAACA as a vital community information/referral site Demonstrate need for more funding i.e. A Light on a Hill (free HIV testing site) Stipends to support more staff/peers


15. Conclusions:: 15. Conclusions: Needs Assessment specifically identified: Barriers and contributing factors to community health HIV/AIDS impact on a targeted population Implementation of programs tailored to decrease the severity of HIV/AIDS within the community Community outreach to build social networks and support


16. Capital District African American Coalition on AIDS (CDAACA): 16. Capital District African American Coalition on AIDS (CDAACA) Mission: To eliminate HIV infection and other health disparities among people of color; particularly African Americans while promoting community empowerment with an emphasis on individual’s self-determination and self-worth through: Programming to increase awareness & dispel stigma STEPS (Group Intervention) Saving Our Selves (Individual Intervention) Promotion of health education & community outreach Community mapping help engage community members to utilize resources & services CDAACA Directory: Local health services and agencies Employment opportunities Housing agencies Support groups Referrals for additional health services