Community Health Assessment Toolkit

Assure respondents of confidentiality.
Collect race, ethnicity and language data in a culturally appropriate manner.
Ensure that survey questions are culturally appropriate and at a literacy level and language that respondents can understand.
Review the survey draft with community members to see what needs to be modified.
Provide versions of the survey in the languages spoken by community members.
Consider using or modifying a validated survey instrument or questions.
Assess regularity of health care usage as frequent users may have a unique perspective.
Allow space for qualitative answers.
Provide the option for respondents to be contacted for further involvement in the CHA process.
Distribute the survey online, on paper or both. Consider using both methods if there are major segments of the community’s population who do not have internet access.

Consider oversampling vulnerable populations since interventions would likely need to be focused on the needs of those groups.
Distribute the survey where people live, work, learn and play—at churches, local businesses, health fairs, etc.
Widely advertise the survey using social media, newspaper advertisements, etc.
Engage community leaders to encourage participation in the survey among their constituents.
Consider specifically surveying the patient population.

Consider whom to interview:

• Interview stakeholders from a variety of sectors in the community.

• Engage clinicians—including physicians, nurses, community health workers, etc.—for interviews as they likely have insights into the health needs of patients in the hospital.

• Interview individuals representative of the community, including subgroups experiencing health disparities.

Supplement topic areas with sparse secondary data by interviewing community stakeholders knowledgeable in that area.

Find innovative ways to recruit for stakeholder interviews:

• Ask community leaders if they know and could provide connections to potential participants with the characteristics being targeted.
• Engage clinicians in hospitals or any associated medical groups and practices to identify patients for interviews.
• Talk to hospitals’ patient and family advisory councils (PFACs).

Make the location easily accessible; consider factors such as proximity to public transportation, time of day, availability of parking, child care, etc.
Hold the interviews in a neutral space (i.e., not the hospital).
Consider online or phone interviews to reduce barriers to participation.

Ensure that the interview facilitator is culturally competent and speaks the language(s) spoken by the interviewees.
Use a facilitator who is well trained in moderating interviews, including keeping participants on topic and maintaining a neutral position.

Develop an interview guide so the same questions are asked across all interviews.
Ask short and open-ended questions to encourage dialogue on various topics.
Review the list of questions ahead of time with community members to ensure that questions are culturally appropriate and at a level that participants would be able to understand.
Be aware that the interview facilitator cannot ask people to identify their health conditions.
If possible, provide the questions to attendees ahead of time.

Explain to participants how their input will be used.
Establish confidentiality of the participants’ responses. Especially in small communities, participants may be worried about their names being attached to their comments.
Provide an estimated timeline of when final results will be shared.
Ask whether the individual would like to be involved in future stages of the CHA and set the process for continued engagement.
Establish realistic expectations for what the hospital and partners can do to address community needs.

Consider whom to sample: a cross-section of the whole community and/or more targeted groups?
Contemplate recruiting from existing groups (e.g., PFACs, church groups).
Find innovative ways to recruit for focus groups where people live, learn, work and play (e.g., advertisements on social media, in newspapers, on the radio, at churches, local businesses, etc.).
Engage clinicians to identify patients for focus groups.
Consider members of the community who may not be easily reached and brainstorm how they can be recruited.
Encourage attendance through reminder notices.
Limit focus groups to 10 or fewer participants to ensure that everyone’s opinions can be heard.

Make the location easily accessible for community members. Consider factors such as proximity to public transportation, time of day, availability of parking, child care, etc.
Hold the focus groups in a neutral space (i.e., not the hospital).
Consider holding virtual or phone focus groups to reduce barriers to participation.
Focus groups should typically last no longer than 90 minutes.

Use a facilitator who is well trained in moderating focus groups, including keeping participants on topic, maintaining a neutral position, and making sure that everyone participates and is listened to.
Ensure the facilitator is culturally competent and speaks the language(s) spoken by attendees.
Consider using a facilitator from a neutral third party, so participants feel more comfortable.

Develop a focus group question guide, so the same questions are asked across multiple focus groups.
Ask short and open-ended questions to encourage dialogue on various topics.
Review the list of questions ahead of time with community members to ensure that questions are culturally appropriate and at a level that participants would be able to understand.
If possible, provide the questions to attendees ahead of time.
Refrain from asking very sensitive questions that individuals would not want to share in a group.

Establish confidentiality of the participants’ responses. Especially in small communities, participants can be concerned about their names being attached to their comments.
Explain to participants how their input will be used.
Give participants an estimated timeline of when results will be shared.
Establish realistic expectations for what the hospital and partners can do to address community needs.
Ask whether the individual would like to be involved in future stages of the CHA and set the process for continued engagement.

Advertise the meetings where people live, work, learn and play using social media, newspapers, radio, announcements and flyers, local organizations, support groups, PFACs, etc.
If possible, offer child care for participants.
Explain why the CHA is relevant for the whole community.

Make the location easily accessible for community members. Consider factors such as proximity to public transportation, time of day, availability of parking, child care, etc.
Hold the meetings in a neutral space (i.e., not the hospital).
Consider coordinating the meeting with existing community or town meetings.

Ensure that the facilitator is culturally competent, speaks the languages spoken by community members and is sensitive to attendees’ needs.
The facilitator should be well trained in moderating community meetings, including keeping participants on topic, ensuring that louder voices do not drown out others, and maintaining a neutral position.

Develop a draft agenda and questions and, if possible, distribute them to attendees ahead of time.
Ask participants open-ended questions to encourage dialogue about various topics.
Review the list of questions ahead of time with community members to ensure that questions are culturally appropriate and at a level that participants would be able to understand.

Tell all participants how their feedback will be used and when results will be shared.
Consider using voting devices (clickers, cell phone apps, etc.) to gain input from more community members, especially those who may not feel comfortable speaking up in a public setting.
Establish realistic expectations for what the hospital and partners can do to address community needs.
Provide the option for participants to be contacted for further involvement in the CHA process; this is an easy way to identify individuals who desire increased engagement.