Assessment of Needs and Capacity
What you must know
Assessment answers two linked questions: what is the gap between current and desired conditions (needs), and what resources exist to close it (capacity)? Know the difference between primary data you collect (surveys, focus groups, key-informant interviews, observations, photovoice) and secondary data that already exists (vital records, census, BRFSS, county health rankings, program records). Understand sampling: probability methods (simple random, stratified, cluster, systematic) permit generalization; nonprobability methods (convenience, purposive, snowball, quota) do not. Distinguish reliability (consistency) from validity (accuracy of measurement). Be able to describe frameworks - PRECEDE-PROCEED phases 1-2 (social and epidemiological assessment), community asset mapping, community readiness, Delphi and nominal group technique for prioritizing - and the social determinants of health that shape inequities.
Traps questions set
- Calling something a need when the item describes an existing strength or resource (that is capacity).
- Generalizing community-wide conclusions from a convenience sample.
- Confusing frequency with priority: prevalence alone ignores severity, community concern, and feasibility.
- Swapping reliability and validity definitions.
- Skipping the step of validating secondary data against local reality.
Rule of thumb
Triangulate: never defend a priority with a single source. State every need as a gap - "X percent of residents report Y, while the Healthy People target is Z" - and rank priorities using at least magnitude, severity, and feasibility.
Worked example: A clinic wants to justify a diabetes program. Clinic records (secondary) show 14% prevalence; a random household survey (primary) confirms 13%; two focus groups reveal transportation barriers. The gap plus the barrier finding, not the prevalence number alone, drives the plan.