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Best Practices for Conducting a Community Health Needs Assessment in Rural Communities

Kylie Schafer Lattimore, MHSA
Associate Consultant, Strategy

With over 35 completed Community Health Needs Assessments (CHNA) in 2022, and more in process, the QHR Health Strategy team continues to refine our processes to best serve our clients in markets across the country. Through this work, we have identified best practices that help produce meaningful and actionable reports and implementation plans which reflect the communities we serve, ultimately leading to measurable impact on the health of those communities.

QHR Health Community Health Needs Assessments Four Best Practices:

  1. Seek Community Perspectives

A challenge when conducting a CHNA in rural, or even suburban, communities is the limited access to quantitative data on health behaviors and health outcomes. This makes gathering qualitative data through community input extremely valuable to provide insight into the health needs of the community. This is best done through multiple avenues like an anonymous survey, one-on-one interviews and focus groups, which allows for broader reach and insight into the health needs of the community and validation of health priorities. Keep in mind it is important to communicate with the community on the purpose, process and output for the best engagement.

As community feedback is solicited, understanding the best marketing practices across population cohorts is imperative before beginning data collection. Each community is unique when it comes to how residents receive information, whether it be from social media, a local newspaper, television/radio ads or word of mouth.

Evaluate what marketing strategies work best in the community and use this to test the effectiveness of different marketing channels as you recruit survey respondents and focus group participants. Remember that some community subsets may consume marketing messages differently, so ensure a diversified communication approach is employed to reach potential participants of different age groups, racial and ethnic backgrounds, and levels of income.

Additionally, understanding the demographics and workforce of the community can inform the best practices for conducting a CHNA. In a community where the school system is a large employer, survey and focus group participation may be lower in summer months when families travel or have less access to email. Alternatively, a community with a large elderly population may have lower participation in winter months when residents are less likely to venture out of their homes. In communities where significant amounts of the population are employed in farming, weeks or months around harvest may not be ideal for gaining optimal participation. Understanding how and when to conduct a CHNA can increase the quality and quantity of data collected.

  1. Engage Local Leaders

Local leaders – both formal and informal, such as school representatives, city or county representatives, business owners and clergy, are fundamental to engaging residents of rural and suburban communities. These citizens often play a large part and are well connected in the community. They are also often involved in multiple community organizations and have well-established respect in the community.

Engaging these local leaders not only helps to gain a diverse range of perspectives on the community and its health needs, but they are also key to engaging other community members to get involved. The trust and network these individuals have can bolster participation in surveys or focus groups if encouraged. This aids in broader community participation in the CHNA which provides a more accurate representation of the local community by incorporating perspectives of resident populations that are often overlooked.

  1. Identify Community Partners to Have the Greatest Impact

No one organization can address all the health needs in a community, especially in communities where resources and services are limited. It’s important to identify partnerships in order to have the greatest impact on health outcomes. Determine which services and programs are already available in the community to ensure services are not duplicated or cannibalized and foster collaboration to bolster current activities or create new initiatives to meet community needs. This can look like a hospital providing free meeting space for support groups or a transportation service providing free rides to the senior center. These partnerships are essential to serving the needs of the community and making an impact on the priorities identified through the CHNA.

Hospitals and healthcare organizations can often serve as conveners of resources, even for initiatives in which the hospital does not hold a direct position or interest. Despite this, the organization can position to coordinate and build partnerships between other community organizations with an aim towards addressing a health need or health disparity in the community. This role can vary by community based on the unique demographics, backgrounds and particular needs of each individual community – however, healthcare organizations should anticipate being in a leadership role to help define accountabilities and leverage its central role in facilitating the coordination of care.

  1. Utilize Available Resources

Overall, Community Health Needs Assessments are very beneficial for organizations but can be challenging for independent or community hospitals to complete on their own. These challenges typically stem from limited perspective of community resources and limited access to data resources, as well as lack of community awareness, and incomplete data due to small population sizes.

Working with another party to conduct a CHNA, such as another organization, a university, health department or consulting service can be very beneficial. Other organizations that do these assessments more frequently can provide economies of scale, access to more data and insight, perspective and recommendations based on extensive experience, and alleviate the time burden on hospital staff and resources. Frequently, a third-party organization can bring a reliable, tested process to the completion of the CHNA while also helping drive participation and accountability across community organizations.  Additionally, community residents typically feel more comfortable sharing honest perspectives with parties from outside the community and trust that they can stay fully anonymous when participating in the assessment.

To learn more about how QHR Health helps hospitals improve the CHNA, read my last blog: https://qhr.com/resources/community-health-needs-assessment-how-qhr-health-supports-independent-hospitals/.