Assessment
What you must know
Assessment answers two distinct questions. A needs assessment identifies the health problem, who is affected, and the factors driving it; a capacity assessment inventories the resources, skills, partnerships, and barriers that determine what can realistically be done. Questions frequently hinge on telling these apart, and on separating assessment from evaluation (assessment precedes programming; evaluation judges it).
Know the primary vs secondary split: surveys, focus groups, key-informant interviews, windshield tours, and observation are primary; census data, BRFSS, YRBS, county health rankings, vital statistics, and program records are secondary. Secondary data are cheap and fast but may be outdated, aggregated at the wrong geography, or collected for another purpose. Prefer secondary first, then collect primary data to fill identified gaps.
Know PRECEDE-PROCEED: social assessment (quality of life), epidemiological assessment (health status and who is affected), behavioral and environmental assessment, educational and ecological assessment (predisposing, enabling, reinforcing factors), then administrative and policy assessment before implementation.
Traps: mixing predisposing factors (knowledge, attitudes, beliefs) with enabling factors (skills, access, resources) and reinforcing factors (feedback from peers, family, providers); choosing a method before defining the question; treating a convenience sample as representative; dismissing a community's perceived needs because they conflict with epidemiological data.
Rule of thumb: Predisposing = why I would; Enabling = whether I can; Reinforcing = whether anyone around me supports it.
Worked example: A coalition addressing teen vaping first pulls state YRBS data (secondary, quantitative, free) to size the problem, then runs three student focus groups (primary, qualitative) to learn why. A parent survey follows only because a gap remains.