Creative strategies to engage diverse communities in service design and delivery

This presentation will describe the methods and processes used to conduct a comprehensive community needs assessment to inform the development and direction of health care services for a large community health center serving a diverse Asian Pacific Islander (API) population. International Community Health Services (ICHS) is a non-profit community health center whose mission is to provide quality, comprehensive health care and health education to a predominantly API patient base (85% of total). Approximately 70% of these are limited English proficient (LEP). As part of a strategic planning process in 2006, ICHS conducted a community needs assessment utilizing: ICHS patient data; focus groups conducted in language for the top 7 API patient groups; an API community leader's focus group; and an online survey for ICHS providers. The focus groups and the online survey assessed perceptions of health, health care and unmet needs. Additionally, ICHS used geo-coding mapping techniques to identify trends in ICHS patient population distribution, API immigration and migration in a 3 county area surrounding the Puget Sound. When available, ICHS patient data was compared to local, county, state and national census and health data.

Results facilitated the organization's strategic planning process to determine the most pressing health issues in the community and set the direction for program and service delivery.  Community input, provider perspective, and actual diagnoses were summarized in a matrix, which succinctly demonstrated where there was overlap and opportunities for enhanced services. The geo-coding of API population distribution and trends was a powerful tool stimulating dialogue among and between the Board of Directors, managers, and staff. ICHS has used the results to drive strategic planning meetings for increased services, including a possible third clinic site and to increase health education funding via grants.  The Community Needs Assessment also helped ICHS better determine its market saturation in regions of King County not previously accessed as well as API communities who were previously unaware of ICHS services.

Challenges included time, money, and coordination of multiple consultant contributions. Following the completion of the needs assessment, both staff and Board members engaged in difficult, though necessary conversations about how to use the information to set a strategic plan. Determining where funds should be allocated based on the needs assessment is an ongoing process.  Additionally, it was necessary to structure the focus groups in such a way that confidentiality and cultural sensitivity issues were addressed.

The validity of the needs assessment results was greatly enhanced by utilizing multiple sources of data and multiple methods.  Collecting and analyzing relevant data was perfected as well as creating a strategic plan.  The information will be used to write a “community health report” as well as position statements for API health issues.