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Identifying our Needs IV:  Conducting and Uses for Native Elder Needs Assessments<br />Twyla Baker-Demaray, M.S. <br />Adm...
Objectives<br />Following this training, you will:<br /><ul><li>Be able to conduct a local needs assessment.
Understand what a needs assessment is.
Understand the reasons for conducting a needs assessment.
Be able to use data collected after conducting a local needs assessment.</li></li></ul><li>National Resource Center on Nat...
Focuses on:
Education, Training, and Research
Community Development & Technical Assistance
Native Elder Health, Workforce, & Policy
Web site: http://ruralhealth.und.edu/projects/nrcnaa/</li></li></ul><li>Center for Rural Health <br />Established in 1980,...
What is a needs assessment?<br /><ul><li>A process where local interests or issues are defined.
A method by which the nature and extent of needs can be both assessed and documented.
A basis for planning that is evidence-based.</li></li></ul><li>Why conduct a needs assessment?<br />
Native Elder Issues<br /><ul><li>Growing elder population with Boom generation
Lower life expectancy
Higher chronic disease rates
Higher health risk factors
Lack of screening
Lack of long-term care services in Indian Country
Changing family structure</li></li></ul><li>Native Elder Population Projections 1990-2020<br />
Regional Variances<br /><ul><li>One size does not fit all
Variation in regard to life expectancy and chronic disease
Ex. California Indian Health Service Area life expectancy at 77.3 years is slightly higher than the nations; however, Aber...
Ex. Alaska Area has a diabetes rate slightly higher than the general population at 16%; whereas, the majority of other reg...
Once you seen one tribe you’ve only seen one tribe</li></li></ul><li>Life Expectancy at Birth, ages 55, 65 and 75 by IHS A...
The Framework<br /><ul><li>The Premise For The Identifying Our Needs: A Survey of Elders:
Provide tribal nations with the opportunity to collect information for their communities.
Provides technical assistance and training opportunities to conduct a needs assessment using an established model.
The NRCNAA model uses:
Academically accepted design and methodology
Random sampling to ensure fair subject selection
Results independent from political influence.
Informed consent, tribal approval, and tribal ownership.
A model developed with input from Native elders and Native elder providers.</li></li></ul><li>Needs Assessment Status per ...
Cycle 1<br />
Cycle 2<br />
Cycle 3<br />
Cycle IV<br />In progress!  <br />More on numbers to be posted to the website.  <br />www.nrcnaa.org<br />NRCNAA is on Fac...
Additional Resources<br />
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Needs assessment training cycle iv

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Needs assessment training for Cycle IV of the "Identifying our Needs: A Survey of Elders" needs assessment - for participating tribes, Title VI, and int

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Needs assessment training cycle iv

  1. 1. Identifying our Needs IV: Conducting and Uses for Native Elder Needs Assessments<br />Twyla Baker-Demaray, M.S. <br />Administration on Aging Title VI Training<br />Funded by Administration on Aging <br />Grant Number 90OI003/02<br />
  2. 2. Objectives<br />Following this training, you will:<br /><ul><li>Be able to conduct a local needs assessment.
  3. 3. Understand what a needs assessment is.
  4. 4. Understand the reasons for conducting a needs assessment.
  5. 5. Be able to use data collected after conducting a local needs assessment.</li></li></ul><li>National Resource Center on Native American Aging <br /><ul><li>Established in 1994, at the Center for Rural Health, University of North Dakota School of Medicine and Health Sciences
  6. 6. Focuses on:
  7. 7. Education, Training, and Research
  8. 8. Community Development & Technical Assistance
  9. 9. Native Elder Health, Workforce, & Policy
  10. 10. Web site: http://ruralhealth.und.edu/projects/nrcnaa/</li></li></ul><li>Center for Rural Health <br />Established in 1980, at The University of North Dakota (UND) School of Medicine and Health Sciences in Grand Forks, ND<br />One of the country’s most experienced state rural health offices<br /><ul><li>UND Center of Excellence in Research, Scholarship, and Creative Activity</li></ul>Focus on:<br />Education, Training, an Resource Awareness<br />Community Development and Technical Assistance<br />Native American Health<br />Rural Health Workforce<br />Rural Health Research<br />Rural Health Policy<br />Program Evaluation<br />Web site: http://ruralhealth.und.edu<br />
  11. 11. What is a needs assessment?<br /><ul><li>A process where local interests or issues are defined.
  12. 12. A method by which the nature and extent of needs can be both assessed and documented.
  13. 13. A basis for planning that is evidence-based.</li></li></ul><li>Why conduct a needs assessment?<br />
  14. 14. Native Elder Issues<br /><ul><li>Growing elder population with Boom generation
  15. 15. Lower life expectancy
  16. 16. Higher chronic disease rates
  17. 17. Higher health risk factors
  18. 18. Lack of screening
  19. 19. Lack of long-term care services in Indian Country
  20. 20. Changing family structure</li></li></ul><li>Native Elder Population Projections 1990-2020<br />
  21. 21. Regional Variances<br /><ul><li>One size does not fit all
  22. 22. Variation in regard to life expectancy and chronic disease
  23. 23. Ex. California Indian Health Service Area life expectancy at 77.3 years is slightly higher than the nations; however, Aberdeen Area is 66.8, a difference of 11.1 years (U.S. Gen. Population – 77.9).
  24. 24. Ex. Alaska Area has a diabetes rate slightly higher than the general population at 16%; whereas, the majority of other regions are at 37% or higher.
  25. 25. Once you seen one tribe you’ve only seen one tribe</li></li></ul><li>Life Expectancy at Birth, ages 55, 65 and 75 by IHS Area<br />
  26. 26. The Framework<br /><ul><li>The Premise For The Identifying Our Needs: A Survey of Elders:
  27. 27. Provide tribal nations with the opportunity to collect information for their communities.
  28. 28. Provides technical assistance and training opportunities to conduct a needs assessment using an established model.
  29. 29. The NRCNAA model uses:
  30. 30. Academically accepted design and methodology
  31. 31. Random sampling to ensure fair subject selection
  32. 32. Results independent from political influence.
  33. 33. Informed consent, tribal approval, and tribal ownership.
  34. 34. A model developed with input from Native elders and Native elder providers.</li></li></ul><li>Needs Assessment Status per Cycle<br />
  35. 35. Cycle 1<br />
  36. 36. Cycle 2<br />
  37. 37. Cycle 3<br />
  38. 38. Cycle IV<br />In progress! <br />More on numbers to be posted to the website. <br />www.nrcnaa.org<br />NRCNAA is on Facebook:<br />http://www.facebook.com/NRCNAA<br />
  39. 39. Additional Resources<br />
  40. 40. Baker-Demaray <br />18<br />Where can I find my population number?<br />Census Data – (2010 Census Data not Available until 2011)<br />Data from the 2000 census can be located at<br /><ul><li>http://factfinder.census.gov/home/aian/sf_aian.html - this site locates data for each of the 539 tribes online. It is a source for getting a demographic profile of your tribe.
  41. 41. For larger groupings containing numerous tribes in a single organization data can be obtained from http://factfinder.census.gov/home/aian/sf2_sf4.html where findings are based on 39 tribal groupings.
  42. 42. The 2000 census data is now 10 years old and to represent the current year you may want to use current estimates, or tribal enrollment numbers.
  43. 43. Estimates for years between censuses can be found at http://www.census.gov/popest/estimates.php , but you might be restricted to obtaining data for counties and not for boundaries that reflect your service areas or reservations.</li></ul>Hawaiian sites should use the Hawaiian Data Center<br />
  44. 44. Identifying Our Needs: A Survey of Elders IV<br />
  45. 45. Baker-Demaray <br />20<br />How do we obtain local data on Elder needs?<br /><ul><li> NRCNAA offers a standardized, self-administered instrument that can be read by optical scanning equipment for your needs assessment.
  46. 46. A copy of the survey can be viewed at http://ruralhealth.und.edu/projects/nrcnaa/pdf/cycleiv_surveyinstrument.pdf</li></ul>Use of this instrument will:<br />Enable you to develop local data for planning and grant applications<br /> Enable you to train volunteers to help with data collection<br /> Expedite data entry, ensuring that you get results quickly<br /> Allow you to gain data at substantially reduced costs.<br />
  47. 47. Cycle IV Needs Assessment<br />
  48. 48. Baker-Demaray <br />22<br />Community Assessment Survey Data<br /><ul><li> General health status of your elders
  49. 49. Indicators of chronic disease
  50. 50. Measures of disability - Activities of Daily Living (ADLs)
  51. 51. Instrumental Activities of Daily Living (IADLs)
  52. 52. Indicators of visual, hearing and dental problems
  53. 53. Tobacco and alcohol use patterns
  54. 54. Diet, nutrition and exercise
  55. 55. Weight and weight control (BMI indicators)
  56. 56. Social support patterns, housing and work
  57. 57. Health care access
  58. 58. Unmet needs
  59. 59. Use and acceptance of services</li></li></ul><li>Baker-Demaray <br />23<br />Why Do We need a Needs Assessment? <br /><ul><li>Community needs assessments:
  60. 60. Identify and assess local community needs
  61. 61. Provide objective data for evaluating the status and needs of your communities elders
  62. 62. Obtain information that permits an unbiased examination of the needs
  63. 63. Provides an opportunity to document these needs for key funding agencies.
  64. 64. You should be aware, however, that this type of systematic community diagnosis might yield results that are upsetting.
  65. 65. While people may talk willingly about their health, an assessment may tell them that they have high risk factors for obesity, inactivity and such.
  66. 66. We often would prefer not to be told that we need to eat better, lose weight and get more exercise. </li></li></ul><li>Baker-Demaray <br />24<br />Why local survey data? Cont…<br />Survey Advantages<br /><ul><li>You are assured of a representative cross section of the community. It allows for broad participation.
  67. 67. The responses of people from the community are often best solicited through an anonymous survey response.
  68. 68. Detailed information about behavior, attitudes, beliefs, attributes and opinions can be recorded.
  69. 69. Cross tabulation can help profile problems and assist in targeting programs.
  70. 70. Surveys are lower in cost and consume less time.
  71. 71. They permit you to reach people who live in more isolated parts of the community.</li></li></ul><li>Baker-Demaray <br />25<br />The Survey<br />Properly conducted Surveys will provide accurate descriptions of<br />your people based either on surveying all or a representative <br />sample of the people from your community. <br />NRCNAA recommends:<br /><ul><li>Face-to-face surveying
  72. 72. Staff or community volunteers trained to ask the questions and fill out the survey for their elders (training materials are available online and in print.)
  73. 73. Sampling may be used – We help you determine your sample size based on your population number
  74. 74. A complete list of the population is critical to the needs assessment process to ensure a representative selection of respondents.
  75. 75. The size of a sample depends on the level of accuracy you require, with larger samples yielding the greatest precision.</li></li></ul><li>Baker-Demaray<br />26<br />How to collect survey data.<br /><ul><li>Face-to-face interviews are recommended because they are likely to yield excellent response rates and more complete responses.
  76. 76. Train the interviewers – practice interviewing each other to become familiar with the questions.
  77. 77. Contact each person on the list. Try different times of the day and days of the week for those not at home or call to arrange a time for a visit. Try each person at least 3 times.
  78. 78. Keep records for each attempt and for each completed interview to avoid duplication.
  79. 79. Always thank people for talking with you and let them know where to look for the results.
  80. 80. As able, offer incentives for completion.
  81. 81. Mail return rate – LESS THAN 20%</li></li></ul><li>Baker-Demaray <br />27<br />Getting the results.<br /><ul><li>Survey data can be computerized and analyzed using statistical programs. The NRCNAA will do this for you; however, you may analyze the data using a PC computer locally.
  82. 82. Sending machine-readable data to the NRCNAA for both analysis and interpretation will reduce your costs substantially while retaining critical inputs from someone who is an expert in survey analysis.
  83. 83. NRCNAA will…..
  84. 84. Code the data for statistical analysis.
  85. 85. Create a data file for your tribe.
  86. 86. Create standard measures (such as Body Mass Index, ADL and IADL limitations, chronic diseases and service uses).</li></li></ul><li>Baker-Demaray<br />28<br />Getting the results (continued).<br /><ul><li>The NRCNAA prepares tabulations for the responses using SPSS (Statistical Package for the Social Sciences). Compare your tribe with national data and with all Native American elders in the combined data for all participating tribes.
  87. 87. You will receive a comparison sheet including your tribe’s data, national data and data for all Native American elders. This helps one determine whether their elders are healthier or less healthy than the norm or whether they have more chronic disease. The comparisons allow a context for interpretation. A sample can be seen at </li></ul>http://ruralhealth.und.edu/projects/nrcnaa/pdf/comparison.pdf<br /><ul><li>Previous participants will also be provided information on changing patterns that may affect their future elders for planning and grant purposes. </li></li></ul><li>NRCNAA Data UseGeneral Templates<br />
  88. 88. Baker-Demaray <br />30<br />Title VI Needs Assessment Requirements<br />Release date: September 2010<br />As the announcement becomes available, the NRCNAA can offer more directed advice and templates to assist you in completing your application<br />
  89. 89. Baker-Demaray <br />31<br />NRCNAA Data Use Template<br />“Background Information<br />According to the ___________enrollment office, there are presently 853 men and women over the age 55 enrolled and living on or around the ________ reservation. Of the 853, there are 492 over the age of 65. According to the National Resource Center on Native American Aging (NRCNAA), the national Native elder population ages 55 and over are expected to grow by 110% between 2000 and 2020. Clearly the impact of the large cohorts born during post World War II, now known as the Baby Boom generation, will become a major source of change for our tribe. <br />
  90. 90. Baker-Demaray <br />32<br />NRCNAA Data Use Template<br /> Chronic Disease<br />The top chronic diseases found among our elders were high blood pressure, arthritis, diabetes, depression and osteoporosis. Each of these lead to limitations on peoples’ ability to take care of themselves and each are diseases where treatments are available to manage the disease. Nutritional care is particularly important for high blood pressure, diabetes and osteoporosis.<br />
  91. 91. Baker-Demaray <br />33<br />NRCNAA Data Use Template<br />Data Comparison<br />Comparisons between our tribe and the nation provide documentation of disparities on specific diseases where American Indian people appeared to be at greater risk than others in the nation. This information assists in identifying diseases where health promotion efforts will assist in making significant improvements in health status for our elders. The following table illustrates these differences.<br />
  92. 92. NRCNAA Data Use Template<br />More on the Data Use Template is available at our website: www.nrcnaa.org<br />ADLs & IADLs<br />Overweight and obesity<br />Templates and boilerplates for using your findings<br />We also encourage you to use your data innovatively.<br />
  93. 93. Baker-Demaray <br />35<br />Community Level Data Uses<br /><ul><li>Renewal of Title VI Native Elder Nutrition and Caregiving Grants
  94. 94. Strengthening of grant proposals
  95. 95. Documentation of health disparities
  96. 96. Documentation of need for health promotion, home and community based services, and assisted living
  97. 97. Knowledge is key!</li></li></ul><li>Baker-Demaray <br />36<br />Local, Regional and National Data Use<br />The applications for data at these levels are<br />numerous: <br /><ul><li>Training for increasing skills for Native elder service providers
  98. 98. Advocating for resources at the state, regional, and national level
  99. 99. Developing policy for informing national Native elder organizations
  100. 100. Filling the research gap for Native elder related publication
  101. 101. Training Native researchers in the aging field</li></li></ul><li>Baker-Demaray <br />37<br />Final Overview<br />
  102. 102. Baker-Demaray <br />38<br />Needs assessment summary<br />A needs assessment should be conducted every three years to document changes.<br />A needs assessment is required by the Administration on Aging for Title VI projects.<br />AoA, the NRCNAA, and others can assist you with conducting a good needs assessment<br />Data from a needs assessment can be used for planning purposes.<br />A needs assessment is a method to document local needs.<br />
  103. 103. Questions? Contact us for more information!<br />National Resource Center on Native American Aging<br />Center for Rural Health501 North Columbia Road, Stop 9037<br />Grand Forks, ND 58202-9037Toll Free Phone (800) 896-7628http://www.nrcnaa.org<br />

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