Introduction

A comprehensive needs assessment is a research and planning activity that is an important first step in designing and developing an effective public health education program. Conducting this particular needs assessment will help your community to evaluate where it is, compared to where it wants to be, in the area of alcohol use by 9-to- 13-year-olds. The needs assessment process will help you to identify not only those components with which you will need extra assistance in order to make this program a success, but it will also help you to identify the assets your community and agency already possess and can bring to this effort. The assessment will also help to determine the nature and extent of the problem in your community and how the problem is perceived among diverse groups. Having a completed needs assessment will then help your community to develop its outcomes to be achieved and its strategic plan for the Too Smart To Start initiative.

In a social marketing effort such as this, the needs assessment is a process used to determine the needs of individuals or a group of individuals in order to design a program that will respond effectively to those needs and bring about desired changes in behavior. In social marketing, which is consumer-focused, the needs assessment relies not only on epidemiological data, such as the prevalence of alcohol use by 9-to- 13 year-olds, but also on information on the relevant values, beliefs, attitudes, concerns, and practices of community members. Therefore, the information gained from the needs assessment will be useful in designing activities that will appeal to the target audience.

Needs assessment can be both a process and a method. As a process, it can build leadership, group unity, and a sense of local involvement in the community. Some needs assessment techniques, such as surveys and focus groups, provide participants a chance to express their opinions on community issues. As a method, a needs assessment is a tool that helps a community plan for and implement strategies to prevent alcohol use by 9-to- 13 year-olds.

Completing a Comprehensive Needs Assessment

In general, completing a comprehensive needs assessment requires the assessors to:

1. Identify the goals of the needs assessment

2. Conduct a review of past and current prevention programs and activities

3. Identify existing community resources

4. Gather key information from and about the target audience(s)

5. Synthesize and analyze all assembled data.

To be successful in both the short- and long-term, a needs assessment must be comprehensive. In some areas, it may be difficult to collect all of the suggested data, but it is important to assemble as much of it as possible. Following are some suggested activities to help your agency complete the steps for a needs assessment for your community.

Step 1: Identify the Goals of the Needs Assessment

Before beginning any needs assessment, it is important to clearly outline its goals and objectives. Often, as for Too Smart To Start, the goal of the needs assessment is to serve as a precursor to program planning. The objective of this particular assessment is to provide the community with a resource that will inform the development of its underage drinking prevention project.

Step 2: Conduct Review of Past and Current Prevention Programs and Activities

Before proposing new prevention activities, it is imperative to determine whether similar activities already exist. This is a much more effective use of limited resources and enables your agency to learn from the experience of others. A review of existing programs will also determine where gaps exist so efforts can be targeted at the areas of greatest need. Identifying and communicating with staff from recently completed programs will also assist your project in determining the extent to which similar activities have been successful in the past. Again, you can learn from the experiences of others, and identify those program elements that have been successful in your community and those that have not.

In conducting the needs assessment, lead agencies should contact all relevant agencies and organizations, including the following:

• Government agencies including the Departments of Health and Education, Child Welfare Agencies, Office of Juvenile Justice, and your State National Prevention Network Representative

• Youth groups including Boy and Girl Scouts, Boys and Girls Clubs, YMCA, school-based clubs

• Mothers Against Drunk Driving (MADD) chapters

• Parent groups, such as the National Family Partnership, and local Parent Teacher Associations

• Recreational clubs and facilities

• Faith-based organizations

• Community coalitions, such as Community Anti-Drug Coalitions of America (CADCA), Join Together, and Fighting Back.

This review may reveal many relevant programs and activities that are not well publicized or have possible overlaps in services. As part of its strategic plan, an agency could publish a monthly calendar of alcohol-free events, or could devise a strategy to increase collaboration and articulation among the prevention agencies in the community.

Step 3: Identify Existing Community Resources

Every community has resources that will be useful and must be tapped in order to make the prevention project a success.

Create a list of those resources that already exist in the community and lead agency. Think of resources in the following general categories:

• Human resources: A program such as To Smart Too Start  relies on a large variety of skills. Consider as your resources those people with skills in public health, social marketing, program planning, community organizing, program management, financial management, and working with youth.

• Financial resources: Enumerate those financial assets that will be available to help support the initiative, both directly and indirectly.

• Equipment and materials: Generate a list of all equipment, materials and supplies that will be available to support the day-to-day activities of the initiative. These resources need not be owned by the lead agency; they can be any resources to which the community has access.

• Community organizations: Be creative with this category. Think of all agencies, organizations, firms, and institutions within the community that can be considered assets to the community in some way. In thinking about these community assets, include local libraries, faith-based organizations, civic-minded businesses, public parks and recreation facilities, media, community-based nonprofit organizations, social service agencies, volunteer organizations, support groups, and service organizations.

This framework should help you to generate a list of your community’s assets. These assets are what make each community unique; and in considering your community’s needs, always weigh those needs against your community’s existing assets.

Step 4: Gather Key Information From and About the Target Audience(s)

This step is what many people think of when they hear the term “needs assessment.” Traditionally, the term has been used loosely to refer to surveys of populations to identify “deficits.” However, this step is but one of many and actually is only appropriate after having conducted other important fact-finding activities as outlined in steps 1 and 2.

Information from and about the target audiences can be obtained in several ways. However, the first phase is to clearly identify who the target audience(s) should be. In Too Smart To Start, the target audiences are 9- to 13-year-olds and their parents/caregivers. The needs assessors must then determine what sources of data exist that can provide information about and from the target audiences. Data can be primary (collected by the needs assessors for the purposes of the needs assessment) or secondary (existing data collected anytime in the past by others and for other purposes). The major advantage of secondary data is that it is often a cheaper, less-time-intensive process to collect those data; the main disadvantage of secondary data collection is that often the data needed for your needs assessment are not available. Conversely, primary data collection is much more resource-intensive, often requiring more time, personnel, and funds to complete the process. However, the main advantage to primary data collection is that it can be done with your needs assessment in mind, and thus all the required information can be solicited.

In your needs assessment, you will undoubtedly use both primary and secondary data sources. Because primary data collection requires substantial investments of time and resources, it makes sense to examine available secondary data first. Once existing information has been reviewed, the community can determine where gaps exist and can decide which primary data collection methods are most appropriate and feasible.

Secondary data collection. Secondary data collection should be effective and efficient. Because the data are often readily accessible, the tendency is often to collect large quantities. However, collecting information that is unnecessary adds to the cost of the needs assessment and does not improve the results. Therefore, an important task for the initiative is to limit the effort and not collect more data than are needed or will be used.

Following are suggested types of secondary data and data sources that may be useful to your needs assessment. Select the types that are relevant and key to your specific project.

1. Sociodemographics.

• The total population and racial/ethnic breakdown of the State, county, city, or project catchment area

• The number, race/ethnicity, first language, socioeconomic status of youth aged 9 to 13 years

• The proportion of the population that is 9 to 13 years old

• Education, income, family structure, occupation of the parent/caregiver population.

(Sources: Census Bureau, local population offices)

2. Epidemiologic data.

Data on the who, what, where, why, and when of underage alcohol use are critical components of a comprehensive needs assessment. Epidemiologic data are helpful in determining the current extent of the underage alcohol use problem by establishing a baseline, establishing realistic goals for the community, and providing targets against which achievement of the goals may be measured.

(Sources: Alcohol beverage control agencies, school systems, juvenile justice systems, juvenile social service agencies, substance abuse prevention agencies, hospital emergency rooms, public health departments, and CSAP)

3. School data.

• Suspensions, expulsions, and other events related to alcohol use

• Vandalism and/or school disruptions related to alcohol use

• Students referred for counseling, judicial action, or other activity due to alcohol use.

(Sources: School districts, boards of education)

4. Criminal justice data.

• Number of events to which police were called because of reports of underage drinking

• Alcohol involvement in cases involving, for example, vandalism and property damage.

(Sources: Courts, juvenile services, police departments, probation and parole, hospitals, health departments)

5. Injuries and deaths involving underage alcohol use.

• Recreational injuries or death in which alcohol was a factor. Recreational activities include swimming, boating, climbing, rollerblading, skateboarding, and biking.

• Number of alcohol-related emergency room admissions or emergency medical services (EMS) calls for assistance.

(Sources: Hospital emergency rooms, EMS systems, police departments)

6. Alcohol treatment.

• Number of beds in treatment facilities (public and private) available for 9- to 13-year-olds

• Number of beds in treatment facilities (public and private) filled by 9- to 13-year-olds

• Number of alcohol-related admissions by 9- to 13-year-olds.

(Sources: State alcohol and other drug abuse treatment agencies)

7. Other data.

• Current PSAs aired in communication media

• Communication materials available on subject for parents and/or youth

• Alcohol advertising (billboards, commer-cials)

• Geographic distribution of bars.

(Sources: National Clearinghouse for Alcohol and Drug Information (NCADI), Centers for Application of Prevention Technologies (CAPTs), your State’s National Prevention Network (NPN) representative, media organizations, and other local agencies)

Primary data collection. Primary data collection can be conducted to provide data to fill the gaps identified during the review of secondary data. Much of the primary data collection involves methods that are focused on gathering data to better understand consumers. Specifically, underage alcohol use prevention organizations may want to obtain information about youth and their parents’ attitudes toward and beliefs about underage alcohol use, about their knowledge about alcohol and its effects, about their willingness or readiness to make changes in their practices or habits, about what factors influence the decisions youth make about alcohol, and about what types of messages are likely to produce positive responses.

Popular tools for primary data collection include population surveys, focus groups, key informant interviews, and youth forums.

1. Population surveys.

Surveys are questionnaires that are administered to a sample of the target population. The surveys can be administered in many ways, including:

• Mail

• Telephone, often using computer-assisted telephone interviewing tools

• In person, using trained research assistants

• Intercept, that is, administering to people in public locations.

 Response rates vary depending on the method used. For example, mailed surveys tend to have lower response rates while surveys performed over the telephone tend to have higher participation rates. However, although mailed surveys may get lower response rates, that method requires very little time to implement and is easy to coordinate. It is standard practice to provide confidentiality or, if appropriate, anonymity to your survey participants. Reassuring your participants that they will not be identified in reports from the survey may improve willingness to participate.

Information gathered from surveys is only as good as the questions that are asked; thus the phrasing of survey questions is a very important consideration and can have a tremendous impact on the results you get. Surveys employ either open-ended questions that require the participant to write in a response, or fixed-choice questions that ask participants to select from a given set of possible responses. Each format has advantages and disadvantages, and utility depends on the type of information being solicited. For instance, attitudes and behaviors often lend themselves to the fixed-choice format, whereas knowledge questions might sometimes be more appropriate in the open-ended format. The key to designing a successful survey questionnaire is to solicit assistance from persons with experience in survey design and to involve the target audience in the design and pretesting of the instrument. Note that the Underage Drinking Enforcement Training Center has developed a publication called “Guide to Conducting Youth Surveys” that provides the background and rationale for youth surveys as well as practical, step-by-step instructions for administering them. (The Guide and other publications are available at www.udetc.org/Publications.htm.)

Professional polling, advertising, or market research organizations and colleges and universities commonly charge thousands of dollars to conduct surveys. If such an organization exists in your community, you may wish to ask them to consider donating their services as a public service and as a means for generating positive public relations.

2.     Focus groups.

Exploring the “why” behind the numbers is just as important as collecting the data. For instance, determining that most 9- to 13-year-olds are not using alcohol will not tell the whole story. There may be reasons why these youth are not experimenting or using alcohol. The group planning an underage alcohol prevention program needs to know that information.

One such way to elicit that type of information is a focus group. The focus group is a guided discussion among a small number of individuals from the target audience, and related populations, designed to elicit opinions and perceptions about a particular product, idea, or issue. As such, there are a number of decisions to make in planning for focus groups. The organization must first determine the composition of the groups and the number of groups needed. Other practical considerations in planning for focus groups are the size of the group, the length of time the group will meet, and the setting for the group.

One early task is to define the target audience. Organizations should consider identifying both a primary target audience (the group whose behavior the program is designed to change) and secondary target audiences (those with influence on the primary audience or those who must do something in order to help cause the change in the primary target audience). In the case of an underage alcohol use prevention group, members of key groups within the community and the organization should be asked to participate in a focus group session. Target groups include:

• Youth ages 9 to 13

• Parents

• Juvenile services agency staff

• Health departments

• Substance abuse prevention and treatment experts

• Educators from primary and middle schools

• Media representatives

• Businesses that employ underage youth

• Civic groups

• Faith community

• Medical community.

The number of focus groups needed depends, in part, on the composition of the groups, and that should be determined by the subject matter that will be discussed. An underage alcohol prevention organization should try to obtain views from at least five of the target groups just listed. Opinions from substance abuse prevention and treatment agencies, youth, and parents are critical in a comprehensive needs assessment, and every Too Smart To Start program will need to target these groups. During these sessions, participants should be encouraged to express their specific concerns about underage alcohol use in the community as well as their recommendations for solutions.

Leading a focus group requires special attributes, and some people may not be appropriate group leaders. The techniques employed differ from those used to lead a group discussion or to chair an organization. An ideal focus group moderator has the following characteristics:

• Is a good listener

• Responds positively to all comments

• Appears to be neutral regarding opinions voiced by group participants

• Does not display any special knowledge of underage alcohol use

• Probes sensitively for reactions and com-ments from group members.

Because the skill of the moderator is pivotal to the success of a focus group, it may be helpful to use professionals. Market research firms, public opinion pollsters, and advertising agencies often have staff members who specialize in conducting focus groups, but their fees may be prohibitive for nonprofit organizations and Government agencies. Sometimes services will be donated, and it may be worthwhile making requests to such firms.

At least two moderators should be available for each focus group. One moderator should lead the group and ask questions while the other functions as a note taker, taking notes during the meeting and observing participants’ body language and expressions, which can be helpful cues when the results of the focus group are interpreted later. Although good notes are vital, focus group sessions should also be taped so that the information that is analyzed is verbatim, and it is possible to confirm information.

A very important step in preparing for focus groups is to prepare a topic guide: a list of topics or question areas that are to be covered in the focus group. To prepare the guide, organizations will find it useful to develop objectives and then write questions that will elicit specific information related to each objective. To be effective, the guide should be tailored to cover just the issues of greatest interest.

3. Key informant interviews.

Key informant interviews, one-on-one interviews with important stakeholders, are ideal for gathering information from community leaders, organization directors, trusted community members, and others who, as individuals, possess information that could be critical to the success of the communications program. Like focus groups, these interviews should be conducted by trained personnel and taped for later analysis. Interviews either can be structured, in which a set of prepared questions is used; or semistructured, in which questions are based on a general topic list but the discussion is guided by answers to previous questions, and interviewers must thus be skilled in following up on key information arising out of the interviewees’ answers.

4. Youth forums.

Young people’s views on underage alcohol use can be obtained through any of the preceding strategies, but professionals have found youth forums to be helpful as well. Involving youth in the needs assessment process gives the process credibility because the people who are affected by the problem are directly involved in the process of developing solutions. Young people can also provide a realistic picture of what is happening in a community with respect to underage alcohol use. Adults may believe these kids are not vulnerable but may reevaluate their position when young people tell them that kids are experimenting.

Suggestions for organizing a youth forum include:

• Selecting participants through an application process or by asking school systems to nominate participants

• Dividing the agenda so that the first part of the conference is a briefing on the problem of underage alcohol use from a variety of experts including school officials, substance abuse prevention specialists, media representatives, and parents

• Developing a process whereby the young people debate the problem of underage alcohol use and develop their own recommendations for solutions

• Announcing these recommendations at a news event and delivering them to other interested parties.

Step 5: Synthesize and Analyze All Assembled Data

This is perhaps the most important step of the process because data are just pieces of information until they are placed in context, synthesized, and interpreted. The results of the needs assessment process will depend on who is involved in the conduct of the analysis. It is crucial that the target audience be involved in interpretation of the data.The goals of the analysis should be to:

Conclusion

Conducting a comprehensive needs assessment and developing a needs-based strategic plan is the only way an organization can truly be effective in reducing underage alcohol use in both the short- and long-term. Unfortunately, people often associate needs assessments with surveys that elicit a long list of deficits in the community. However, this should not be the case. Comprehensive needs assessments should begin with a clearly defined goal identified by the community. This must then be followed by an inventory of those community assets and needs that are relevant to accomplishment of the stated goal.

A reading list and a form to assist you in conducting your needs assessment are provided in the pages that follow. Then, by also developing your outcome management/performance target outlines (forms for which follow the needs assessment form), you and your team will be able to create a meaningful and workable strategic action plan. In all phases of the process, it is essential that the target audiences for the program be involved in order to provide validity to the work and to garner support for the initiative.

Sources/References in Print and Electronic Form

For additional reading, you may wish to do literature searches through the Internet and/or your local library. Following are some sources/ references that may be of interest

Green, L. W., & Kreuter, M. W. (1999). Health promotion planning: An educational and ecological approach, (3rd Ed.). Mountain View, CA: Mayfield.

Overview of a substance abuse prevention needs assessment.(1999, July). Paper presented at the Community Readiness Training Session for the Governor’s Prevention Initiative for Youth, New Britain, CT. Available at www.dmhas.state.ct.us/sig/ needassess/default.htm

Sharpe, P. A., & Greany, M. L. (2000). Assets-oriented community assessment. Public Health Reports, 115(2/3), 205.

Southeast Center for the Application of Prevention Technologies. Needs assessment. Available at www.secapt.org/science2.html

Western Regional Center for the Application of Prevention Technologies. Building a successful prevention program. Available at www.open.org/~westcapt/needsas.htm

The purpose of this needs assessment is to help inform the development of the strategic action plan for your project.

This questionnaire should be completed by the person in the lead agency who is most familiar and able to report on the activities and resources of the community. However, the respondent will need to consult with other team members as well as people in other organizations in order to provide answers to the questions.

Section A: Information About the Respondent

Name:Agency:

My job title within the lead agency is:

Role on project:

In my current position, I am responsible for the following activities (please check all that apply):

___ Program planning ___ Program management ___ Program implementation ___ Program evaluation ___ Communication with other organizations, stakeholders, etc. ___ Other: (Please specify)

Based on my knowledge and experience with this agency, I am able to accurately describe the collective assets and needs of the community. (Place X on the line below). 

Strongly agree  ___|___|___|___|___ Strongly disagree

Section B: Information About the Community

1.     One of the keys to designing an effective program is to accurately define the target population. Please answer the following questions that describe your community. The term “community” refers to that area that will be the target of your Too Smart To Start Initiative. Please identify the area(s) that you are defining as your community.

(Note that you may have already collected some of this information for the lead agency application. If so, please reenter on the next page.)

 1. Where did you get your information for the preceding table (list all sources)?

2.  What is known about alcohol use among 9- to 13-year-olds in your community? 

This is a BROAD question, which will undoubtedly require that you refer to multiple data sources. Please indicate the sources of the data that you are citing. Please answer all questions for which data are available. For those categories for which there are no data, indicate this by writing in N/A. Those topics may be ones which may require additional primary data collection activities.

Behaviors. Please indicate what is known about use of alcohol among 9- to 13-year-olds in your community. For instance: What proportion of 9- to 13-year-olds has ever consumed an alcoholic beverage? What proportion of 9-to 13-year-olds has consumed an alcoholic beverage within the past week? month? year? What proportion of 9- to 13-year-olds has not or never consumed an alcoholic beverage?

Attitudes. Please indicate what is known about attitudes toward alcohol use among 9- to 13-year-olds in your community. For example: What proportion of 9- to 13-year-olds think that alcohol is harmful to their health? What proportion of 9- to 13-year-olds would avoid “hanging out” with other young people who drink? What proportion of 9- to 13-year-olds would agree with the statement “Kids my age should never drink alcohol?” How would 9- to 13-year-olds rank alcohol use in terms of its importance among the issues that persons their age must confront?

Refusal skills. Please indicate what is known about how skilled 9- to 13-year-olds in your community are at negotiating situations related to alcohol. For instance: What proportion of 9- to 13-year-olds feel comfortable refusing alcohol if offered to them by a close friend? by a peer? by an adult?

Communication between 9- to 13-year-olds and others about alcohol. Please indicate what is known about the ways in which 9- to 13-year-olds communicate with others about alcohol. For instance: Do they feel comfortable discussing alcohol with their parents?  Why? Why not? What proportion of 9-to 13-year-olds report that they have discussed alcohol use with their parents/caregivers? their peers? their teachers? other adults in their life? What was the nature of those discussions?  Do they discuss behaviors only? attitudes? negotiation/refusal skills?  Do they feel that the adults “lectured” them or listened to their opinions?

Availability. Please indicate what is known about perceived and actual availability of alcohol to 9- to 13-year-olds in your community. For instance: What proportion of 9- to 13-year-olds feel that they could purchase alcohol if they wanted to?  What proportion of 9- to 13-year-olds has purchased alcohol in the past? What proportion of 9- to 13-year-olds would agree with the statement “I have and/or can have (meaning it’s available but they haven’t accessed it yet) ready access to the alcohol stored in my home?”  What proportion of retailers in your community have “We Card” logos promi-nently displayed in their establishments?

Parents of 9- to 13-year-olds. Please indicate what is known about the parents of 9- to 13-year-olds. For example: What proportion of parents discusses alcohol with their 9- to 13-year-olds?  What do they think is the most important thing that 9- to 13-year-olds need to know about alcohol?  How would alcohol use rank among a list of concerns parents have for their 9- to 13-year-olds?  What proportion of parents believes that alcohol prevention messages are only necessary for the older adolescent age group?

3.  How many of the following activities have taken place in your community within the past 3 years?

For each one, please enter a 0 on the line if there were none.

__ Alcohol-free community picnics, parades, fairs

__ Public health interventions targeting alcohol use prevention among adults

__ Public health interventions targeting alcohol use prevention among 9- to 13-year-olds

__ Highly publicized news events involving the impact of alcohol on some persons’ lives

4.  Please respond to each of the following statements about your community.

Please circle one response for each statement

Strongly Agree (SA)    Agree (A)    Neutral (N)    Disagree (D)    Strongly Disagree (SD)

1. We have a strong faith-based community.    SA    A    N    D    SD

2. Our local economy is strong.    SA    A    N    D    SD

3. Our school policies give a clear anti-alcohol-use message to 9- to 13-year-olds.    SA    A    N    D    SD

4. The local media often actively support public health efforts (e.g., by airing PSAs, sponsoring health promotion activities)    SA    A    N    D    SD

5. We have a strong tradition of volunteerism in our community.    SA    A    N    D    SD

6. Agencies/organizations in our community articulate services and collaborate well.    SA    A    N    D    SD

7. Our community spends a large amount of money on public health.    SA    A    N    D    SD

8. Our school district has clear policies regardingthe use of alcohol on school property.    SA    A    N    D    SD

9. If we organize a communitywide event, we will have high attendance.     SA    A    N    D    SD

10. We have an adequate number of alcohol treatment facilities.    SA    A    N    D    SD

11. We have sufficient options for productive afterschool activities for 9- to 13-year-olds.    SA    A    N    D    SD

5.     Please complete the following table for your community.