The realities of the 21 st century have forced the public health profession to reconsider traditional approaches, apply new technologies appropriately and diversify sources of support. Recognition of social, economic and behavioral influences in disease prevention has highlighted the need to facilitate complex, individual behavior change and community participation. Resource allocation away from social programs has made it necessary to be creative in the search for and allocation of scarce resources. In response to these challenges, there is a need for creative approaches to public health research and practice that maximize existing resources, ensure timely responses to public health crises, build on established knowledge and enhance community participation.
According to the American Public Health Association (APHA), community needs assessment is one of three components of the mission of public health: assessment, policy development and assurance. Assessment is the regular systematic collection, assembly, analysis and dissemination of information on the health of the community. Typically, the assessment process is an inclusive endeavor used to prioritize issues and develop plans to address community needs. The APHA further notes that two of the most popular assessment tools are Assessment Protocol for Excellence in Public Health (APEXPH) and Planned Approach to Community Health (PATCH). APEXPH was developed by the National Association for County and City Health Officials and PATCH was developed by the Centers for Disease Control.
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Based on evaluation studies, the planning process for models such as PATCH is slow and usually requires substantial technical inputs to implement. Another assessment model called Rapid Assessment and Response (RAR) has been useful in quickly assessing emerging public health problems and identifying effective and inexpensive interventions that have a high probability of being adopted, successfully carried out and sustained at the local level.
The World Health Organization has used this model for over 30 years. Recently, it has been adapted to form RARE (Rapid Assessment, Response and Evaluation) to help communities struggling with the devastating effects of AIDS.
Regardless of the model, researchers recognize that a needs assessment is the foundation of any effective planning model and an important first step towards developing successful interventions. They are also cognizant that a key shift in public health in the past few decades has been the growing understanding that environmental factors are an important facet of a comprehensive needs assessment because these factors can inhibit or facilitate individual and community participation in health activities. This is particularly true in urban, poor and minority communities where many health problems are related to behavioral responses to the environment. This reality means the focus shifts the locus of change from the individual to the environment in which the individual resides. Such a shift can provide crucial insight into realistic expectations related to health behaviors and the utilization of health services. By examining environmental or contextual factors, researchers can collect data to guide the design of effective health programs uniquely tailored to the needs of communities.
The environmental scan is a needs-assessment tool that can be utilized to collect program development data. A dearth of information is available about the use and efficacy of environmental scans to address health problems having a devastating effect on racial and ethnic minority communities, such as HIV/AIDS, cancer and cardiovascular diseases. To what degree does an environmental scan involve the community in data collection activities? Does an environmental scan identify new patterns of risk or resilient behaviors to address rapidly changing or emerging public health problems? Does an environmental scan provide information within the social, cultural, religious, political and historical contexts that often shape the emergence of health problems? generic viagra online
The purpose of this study was to elicit lessons learned to maximize the utility of the environmental scan as a tool for public health. This process occurred through the development and implementation of an environmental scan as part of the needs-assessment phase of a project to increase cancer screening among African Americans in Baltimore, MD.