Tabia Henry Akintobi, PhD, MPH
Director, Prevention Research Center
Director, Evaluation and Institutional Assessment
Research Associate Professor
Department of Community Health and Preventive
Medicine
Morehouse School of Medicine
Morehouse School of Medicine Prevention Research Center 2013 ©
Objectives
 Detail the elements of evaluation specific to
community needs assessment and program
development
 Describe qualitative and quantitative data collection
and analysis considerations in community contexts
 To discuss the application of evaluation frameworks
applied in community-responsive needs assessment
 To discuss lessons learned, issues and
recommendations in community –engaged practice
Morehouse School of Medicine Prevention Research Center 2013 ©
Prevention Research Centers
 The MSM PRC functions
within the only Historically
Black College and University
funded among The Centers
for Disease Control and
Prevention’s 37 Health
Promotion and Disease
Prevention Research Centers
Morehouse School of Medicine Prevention Research Center 2013 ©
Morehouse School of Medicine
Prevention Research Center (MSM PRC)
 Theme - Risk Reduction and Early Detection in African
American and Other Minority Communities: Coalition
for Prevention Research
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Where the MSM PRC Works
Morehouse School of Medicine Prevention Research Center 2013 ©
MSM PRC Community Coalition Board (CCB)
 The MSM PRC CCB is comprised of:
 Community Residents
 Academic Institution Representatives
 Agencies
within the City of Atlanta Neighborhood
Planning Units V, X, Y and Z.
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Evaluation and Institutional Assessment Unit:
Technical Capacity
Assessments conducted through direct or collaborative acquisition of federallyfunded, private, and local grants and contracts
Morehouse School of Medicine Prevention Research Center 2013 ©
Morehouse School of Medicine Prevention Research Center 2013 ©
Evaluation and Institutional Assessment Unit:
Guiding Principles
•
Evaluations Should be Participatory
•
•
•
Build Evaluation Capacities
•
•
•
Demystify evaluation
Evaluation as essential to program planning, implementation, and measurement
Both Formative and Summative Evaluation is Critical
•
•
•
Partnership between evaluators and stakeholders
Sustained ownership and involvement
Identifying best or promising practices
Defining success and how it is achieved
Evaluations Should Lead to Decision-Making
•
Formulations of recommendations for programmatic improvements,
practice/policy changes, or subsequent research to address identified needs
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Morehouse School of Medicine Prevention Research Center 2013 ©
To guide the process and encourage collaboration
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The Participatory Framework for Designing the
Program and Its Evaluation
Community
Assessment
Report the
Findings
Analyze and
Interpret the
Data
S
T
A
K
E
H
O
L
D
E
R
S
Public
Health
Initiative
Design the
Evaluation
Collect the
Data
Morehouse School of Medicine Prevention Research Center 2013 ©
Engaging Stakeholders
Stakeholders:
– Individuals, groups or organizations having a
significant interest in how well a program functions
and/or in the health topic .
– For instance, those with decision-making authority
over the program, funders and sponsors,
administrators and personnel, clients or intended
beneficiaries
Rossi, Lipsey & Freeman (2004)
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Engaging Stakeholders
Type of Stakeholder
What they do
Who they are
Primary
Daily contact, request
report, major decisionmakers, current program
participants
sponsors, collaborators,
coalition partners, funding
officials, administrators,
managers, and staff
Secondary
Little or no daily contact,
potential program
participants, current
partners
clients, family members,
neighborhood
organizations, academic
institutions, elected
officials, advocacy groups,
professional associations
Tertiary
Potential
partners/funders, target
population
Staff, board members,
administrators, volunteers
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Engaging Stakeholders
 Identify leaders first
 Use “snowballing”
 Understand the role and importance of
potential stakeholders
 To the extent possible, consider all
stakeholder perspectives
 Be inclusive
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Why Needs Assessment?
 Provides a systematic process to
guide decisions.
 Provides justification for decisions
before they are made.
 It is scalable for any size project, time
frame, or budget.
 Facilitates community engagement in
defining needs, assets and priorities.
www.worldbank.org/ieg/training/TNA.ppt
Morehouse School of Medicine Prevention Research Center 2013 ©
14
Needs Assessments Help Us Avoid…
 “What we really need is training on XYZ.”
 “But that is the way we have always done it here.”
 Programs that are not aligned with community /
funder priorities
 Answers that are simple, straightforward, acceptable,
understandable… and yet wrong
www.worldbank.org/ieg/training/TNA.ppt
Morehouse School of Medicine Prevention Research Center 2013 ©
Needs Assessment Process
Plan
Coalition
Building;
Consultation
Implement
Data Collection –
Describe Needs /
Assets
Analyze
Prioritize
Assess Data
Strengths/
Weaknesses
Prioritize Needs
Enabling,
Predisposing
Factors
Morehouse School of Medicine Prevention Research Center 2013 ©
Develop
Strategies
http://www.nswphc.unsw.edu.au/pdf/VitalLinks06/
Powerpoints/VanessaTraynorSarahDennis_Demy
stifyingneedsassessment.pdf
Planning - Consideration
 What other needs assessments have been done in this


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

area or with the demographic group?
What questions remain to be answered?
What form of data collection is appropriate to answer
these questions?
What resources are available (money, skills etc)?
What steering / reference groups exist or need to be
established to guide the assessment?
Who else can / should we involve?
http://www.nswphc.unsw.edu.au/pdf/VitalLinks06/Powerpoints/VanessaTraynorSarahDennis_Demystifyingneedsassessment.pdf
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Needs Assessment Method and Plan
Development
 Driven by Objective(s)
– Developed through Review of Literature
– Shaped by Identification of Problem or Issue at the
local level
– May be Driven by a Theoretical Framework
– Developed by Input from Stakeholders and Experts
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2013 ©
What Do You Want to Understand,
Change or Measure?
 Attitudes
 Perceptions
 Preferences
 Knowledge or Skills
 Behavior
 Behavioral Intentions
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What do You Want to Know?
Examples of Evaluation Questions:
 Who needs this program?
 What is the magnitude of the need?
 What should be done to meet the need?
 What are the existing resources or capacity to meet
the need?
Morehouse School of Medicine Prevention Research Center 2013 ©
Needs Assessment Process
Plan
Coalition
Building;
Consultation
Implement
Data Collection –
Describe Needs /
Assets
Analyze
Prioritize
Determine Data
Strengths/
Weaknesses
Prioritize Needs
Enabling,
Predisposing
Factors
Morehouse School of Medicine Prevention Research Center 2013 ©
Develop
Strategies
http://www.nswphc.unsw.edu.au/p
df/VitalLinks06/Powerpoints/Vanes
saTraynorSarahDennis_Demystifyi
ngneedsassessment.pdf
Needs Assessment Process
Plan
Coalition
Building;
Consultation
Implement
Data Collection –
Describe Needs /
Assets
Analyze
Prioritize
Assess Data
Strengths/
Weaknesses
Prioritize Needs
Enabling,
Predisposing
Factors
Morehouse School of Medicine Prevention Research Center 2013 ©
Develop
Strategies
http://www.nswphc.unsw.edu.au/p
df/VitalLinks06/Powerpoints/Vanes
saTraynorSarahDennis_Demystifyi
ngneedsassessment.pdf
Analysis & Next Steps - Considerations
 Analysis
 Prioritization
 “What are the most
 Comprehensive Picture
critical unmet needs?” (for  Identify Needs
whom, etc)
 Identify Contributing
 “What can be changed?”
Factors – Predisposing,
 “What will it take to
Enabling, etc.
address the needs?”
(resources, cost,
strategies)
http://www.nswphc.unsw.edu.au/pdf/VitalLinks06/Powerpoints/VanessaTraynorSarahDennis_Dem
ystifyingneedsassessment.pdf
Morehouse School of Medicine Prevention Research Center 2013 ©
Morehouse School of Medicine Prevention Research Center 2013 ©
Evaluation in Context
Planning, Implementation, and Effect of Initiative
Planning
Formative
Evaluation
Implementation
Process
monitoring and
Evaluation
Effect
Outcome and
Impact
Evaluation
Evaluation Continuum
Morehouse School of Medicine Prevention Research Center 2013 ©
What is Evaluation?

A systematic process

Involves data collection

Process for enhancing knowledge and decision-making
Adapted from Russ-Eft and Preskill (2001)
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2013 ©
Role and Importance of
Evaluation Planning
 Guides planning of proposed programs and activities
prior to full implementation of program
 Monitors and documents implementation of
programmatic activities
 Assesses and documents whether activities and
interventions achieve desired outcomes
 Informs programmatic decisions
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Evaluation Planning
Evaluation planning includes:
 Clarifying the purpose of the evaluation
 Decide what to evaluate
 Understand what is involved
 Choose the evaluation type and design
 Gather necessary resources
 Determine how to use the results
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Choosing The Evaluation Design
Selection of Design should be based on:
 Decisions May Be Based on Results of the Needs




Assessment
Key Program Questions, Performance Indicators
Resource (program and evaluation) availability
How the data will be used
Timeline
Adapted from Sharma, Lanum, Suarex-Balcazar (2000). A Community Needs Assessment Guide. Loyola University Chicago
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Choosing The Evaluation Design
Consider stakeholder needs:
 The information needs of key stakeholders and primary
users
 How the information will be used
 Who will use it
 What kind of information will have the most credibility for
the intended users
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Other Evaluation Design Considerations
Consider participant characteristics:
 Literacy
 Geographic dispersion
 Cultural issues (including language)
 Accessibility
 Logistic and contextual constraints
 Alternative sources of information
 Time and resource constraints
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Morehouse School of Medicine Prevention Research Center 2013 ©
The “Evidence” in Evidence-based Interventions is
the Data Collection, Analyze and Interpreted
 May be primary and/or secondary
 Primary Data-you collect as a result of your activities or
research
 Secondary Data-data already collected and independent
of your activities or research
 May be qualitative or quantitative
 Should be systematically collected/ reviewed, analyzed
and interpreted
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of Medicine
Prevention
Research
Center 2010
© 201
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School
of Medicine
Prevention
Research
Center
2013 ©
Data Collection
• Data collection includes:
 Identifying existing data sources (secondary)
 Determining the best data collection method (focus
group, survey, interview…)
 Selecting or creating data collection instruments
 Deciding on the most appropriate procedures for
collecting data
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Frequently Used Qualitative Data
Collection Tools
In-Depth Interviews
 Complex subject matter and
expert respondents
 Highly sensitive subject
matter
 Geographically dispersed
participants
 Aim to diminish peer
pressure or minimize
influence on responses
Focus Groups
 Group interaction to
stimulate richer responses
 Observation of behaviors,
attitudes and language
 Idea generation
 Pre-testing
 Evaluation of message
concepts
 Problem identification
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2013 ©
Considerations
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Frequently Used Quantitative Data
Collection Tools: Surveys
 Self-Administered Surveys
 independently
completed by participant
 Face-to-Face Survey
Interviews
 participant completion
is facilitated by program
staff person
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Considerations
Morehouse School of Medicine Prevention Research Center 2013 ©
Morehouse School of Medicine Prevention Research Center 2013 ©
Frequently Used Qualitative Data Collection
Tools
In-Depth Interviews
 Complex subject matter
and expert respondents
 Highly sensitive subject
matter
 Geographically dispersed
participants
 Aim to diminish peer
pressure or minimize
influence on responses
Focus Groups
 Group interaction to
stimulate richer responses
 Observation of behaviors,
attitudes and language
 Idea generation
 Pre-testing
 Evaluation of message
concepts
 Problem identification
Morehouse School of Medicine Prevention Research Center 201
2013 ©
Morehouse School of Medicine Prevention Research Center 2013 ©
Empowerment Evaluation
 Provides stakeholders with tools and skills to evaluate
their program
 Ensures that the evaluation is part of the planning and
management of the program (Fetterman, 2008).
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Empowerment Evaluation Characteristics
 Values improvement in people, programs, and organizations to
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


help them achieve results
Community ownership of the design and conduct of the
evaluation and implementation of the findings
Inclusion of appropriate participants from all levels of the
program, funders, and community
Democratic participation and clear and open evaluation plans and
methods.
Commitment to social justice and a fair allocation of resources,
opportunities, obligations, and bargaining power
Citations: Fetterman, 2008, Wandersman, 2005; Sufian, Grunbaum, Henry Akintobi, Dozier, Eder,
Jones, Mullan, Weir, White-Cooper, 2011
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Empowerment Evaluation Characteristics
 Use of community knowledge to understand the local context and
to interpret results
 Use of evidence-based strategies with adaptations to the local
environment and culture
 Building the capacity of program staff and participants to improve
their ability to conduct their own evaluations
 Organizational learning, ensuring that programs are responsive to
changes and challenges
Citations: Fetterman, 2008, Wandersman, 2005; Sufian, Grunbaum, Henry Akintobi, Dozier, Eder,
Jones, Mullan, Weir, White-Cooper, 2011
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Case Study 1: PAATH-II Community
Coalition
 PAATH-II Community Coalition Board
 Stakeholders - Parents, education professionals, civic leaders,
and representatives from government agencies
 Funded to develop community-led approaches to address youth
substance abuse and violence
 Target Community-Metropolitan Atlanta Zip Code 30318
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Case Study 1: PAATH-II Community
Coalition
 PAATH-II Partnered with MSM-PRC to Evaluate the
Coalition through a Demographic Profile
 Needs assessment
 Consisted of:


Secondary Data
Primary Data
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Case Study 1: PAATH-II Community
Coalition-Secondary Data
• The MSM-PRC reviewed zip code 30318 statistics
(general demographics and other risk factors
associated with violence and substance abuse)
including: racial background, household make-up,
income level, vacant housing, public housing, and
surrounding prison and addition facilities, truancy,
etc.
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Case Study 1: PAATH-II Community
Coalition-Primary Data
 Key Informant Interviews
 To gather insights, opinions and best thinking from the
30318 community on substance abuse and violence
prevention
 Target audience:


adult stakeholders representing community organizations,
healthcare, neighborhood businesses, private practice, public
housing, law enforcement, and the school system
Youth ages 11-16
 Recommendations led to prioritization Youth Mentoring
and Alternative Education goals, evaluation activities, and
outcomes
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Case Study 1: PAATH-II Community
Coalition
 Alternative Education Goal Activities
• Collaboration between the MSM-PRC and the PAATH-II Coalition Board to
develop and administer an Alternative Education Survey (AES) to capture
demographics, perceptions, and recommendations among students, parents, and
stakeholders familiar with alternative education/non-traditional schools in the
Atlanta Public School System (APS)
• Analysis of evaluation data collected through the AES among 24 students, 22
parents, and 12 stakeholders
• To submit and present the AES Report to the PAATH-II Coalition Board
• To provide recommendations on key findings to include in the final presentation
the Atlanta Board of Education
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Participatory Evaluation
 Involves key stakeholders in evaluation design and
decision-making
 Acknowledges and addresses inequities in power and
voice among stakeholders
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Participatory Evaluation Characteristics
 The focus is on participant ownership; the evaluation is oriented
to the needs of the program stakeholders rather than the funding
agency
 Participants meet to communicate and negotiate to reach a
consensus on evaluation results, solve problems, and make plans
to improve the program
 Input is sought and recognized from all participants.
 The emphasis is on identifying lessons learned to help improve
program implementation and determine whether targets were
met
Citations: Patton, 2008; Sufian, Grunbaum, Henry Akintobi, Dozier, Eder, Jones, Mullan, Weir, White-Cooper, 2011
Morehouse School of Medicine Prevention Research Center 2013 ©
Participatory Evaluation Characteristics
 The evaluation design is flexible and determined (to the extent
possible) during the group processes
 The evaluation is based on empirical data to determine what
happened and why
 Stakeholders may conduct the evaluation with an outside expert
serving as a facilitator
Citations: Patton, 2008; Sufian, Grunbaum, Henry Akintobi, Dozier, Eder, Jones, Mullan, Weir, White-Cooper, 2011
Morehouse School of Medicine Prevention Research Center 2013 ©
Case Study 2: 2 HYPE Abstinence
Education Club
 The 2 HYPE Abstinence Education Club (2
HYPE "A" Club) is a co-educational
intervention targeting African American
youth ages 12-18 in Fulton, DeKalb and
Clayton counties within Metropolitan
Atlanta
 The program serves youth in communitybased settings, schools and juvenile
facilities, including probationary and longterm detention centers
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Case Study 2: 2 HYPE Abstinence
Education Club
 Comprehensive Approach Including:
 promotion of delayed sexual activity
 violence prevention
 stress reduction &
 understanding of abstinence benefits
 Creative Arts Reinforce Abstinence Curriculum
 Club Activities i.e. Hip Hop Café (hip-hop rap,
poetry, & dance performances)
 Peer Educator Training
 Parent Workshops
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Case Study 2: 2 HYPE Abstinence
Education Club
Youth
Participants
Wholistic
Stress
Control
Institute
Morehouse
School of
Medicine
Prevention
Research
Center
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Case Study 2: 2 HYPE Abstinence Education Club
Needs Assessment
Survey Development
 Literature Review
 Comparable Programs
 Tools, Instruments – Validity,
Survey Pilot Testing
 Four focus groups
 30 African American youth
ages 12 to 19
Reliability, Cultural Context
 Identified Trends in Program
Data
 Process Evaluation Measures
 Evaluation Advisory Group
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2013 ©
Case Study 2: 2 HYPE Abstinence
Education Club-Results
 Expanded understanding of how African American youth
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conceptualize of marriage, family and their futures
Evaluation Implications:
Findings signal the need for an expanded approach to
implementing and assessing programs designed to reduce
adverse sexual health outcomes among African American
youth in urban settings
Survey Revision
Context for Interpretation of Results
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Evaluation Plan Development Basics
Consider Reporting/Dissemination
 Who will you share results with?
 Will you share results with your community or
selected stakeholders? Who? How? When?
 Why will this reporting/dissemination activity be
important?
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Questions to Consider When Evaluating
Community Engagement
• Are the right community members at the table? This is a question that needs to be
reassessed throughout the program or intervention because the “right community
members” might change over time
• Does the process and structure of meetings allow for all voices to be heard and equally
valued? For example, where do meetings take place, at what time of day or night, and
who leads the meetings? What is the mechanism for decision-making or coming to
consensus; how are conflicts handled?
• How are community members involved in developing the program or intervention? Did
they help conceptualize the project, establish project goals, and develop or plan the
project? How did community members help assure that the program or intervention is
culturally sensitive?
Citations: CDC, 2009; Green et al , 1995; Israel et al , 1998; Sufian, Grunbaum, Henry Akintobi, Dozier, Eder, Jones, Mullan, Weir,
White-Cooper, 2011.
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Questions to Consider When Evaluating
Community Engagement
•How are community members involved in implementing the program or
intervention? Did they assist with the development of study materials or the
implementation of project activities or provide space?
• How are community members involved in program evaluation or data analysis?
Did they help interpret or synthesize conclusions? Did they help develop or
disseminate materials? Are they coauthors on all publication or products?
• What kind of learning has occurred, for both the community and the
academics? Have community members learned about evaluation or research
methods? Have academics learned about the community health issues? Are there
examples of co-learning?
Citations: CDC, 2009; Green et al , 1995; Israel et al , 1998; Sufian, Grunbaum, Henry Akintobi, Dozier, Eder, Jones, Mullan, Weir, WhiteCooper, 2011.
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Challenges in Community Needs Assessment
Partnership Development, Relationship, Formation
and Maintenance
 Different Individual and Organizational Cultures
 Values –Practical vs. Statistical Significance
 Varying Understanding of the Evaluation or Research
Process
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Key Steps in Community Partnership Development,
Relationship, Formation and Maintenance
 Clearly Define Target Population
 Provide Detailed Descriptions of Process and Outcomes
 Specify the Measures and Instruments for Data Collection
 Clarify Timeline for Conducting all Evaluation Activities
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Benefits in Community Evaluation Partnership
Development, Relationship, Formation and
Maintenance
 Community Credibility
 Increased Recruitment
 Sustained Retention
 Expanded Funding and Human Resources
 Collaboration in Dissemination of Emerging Models,
Best Practices and Outcomes of Community
Engagement and Associated Research
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Community Engagement & Evaluation
 Blumenthal, D. “How do you start working
with a community?” Section 4a of “Challenges
in Improving Community Engagement in
Research,”
 Henry Akintobi, T, Goodin, L., Trammel, E.,
Collins, D., & Blumenthal, D. “How do you set
up and maintain a community advisory
board?” Section 4b of “Challenges in
Improving Community Engagement in
Research,”
 Sufian, M., Grunbaum, J., Akintobi, T., Dozier,
A., Eder, M., Jones, S., Mullan, P. Weir, C.R., &
White-Cooper, S. Program Evaluation and
Evaluating Community Engagement
http://www.atsdr.cdc.gov/communityengagement
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Benefits in Community Evaluation Partnership
Development, Relationship, Formation and
Maintenance
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Akintobi, T.H., Trotter, J.C., Evans, D., Johnson, T., Laster, N., Jacobs, D., & King, T. (2011). Applications in
Bridging the Gap: A Community-Campus Partnership to Address Sexual Health Disparities Among AfricanAmerican Youth in the South. Journal of Community Health, 36, 486-494. PMID: 21107895
Mayberry, R., Daniels, P., Yancey, E., Henry Akintobi, T., Berry, J., & Clark, N. (2009). Enhancing communitybased organizations' capacity for HIV/AIDS education and prevention. Journal of Evaluation and Program
Planning, 32(6), 213-220. PMID: 19376579
Mayberry, R., Daniels, P., Henry Akintobi, T., Yancey, E., Berry, J., & Clark, N. (2008). Community-based
organizations’ capacity to plan, implement, and evaluate success. Journal of Community Health, 33(5).
PMID: 18500451
Henry Akintobi, T, Goodin, L., Trammel, E., Collins, D., & Blumenthal, D. (2011). How do you set up and
maintain a community advisory board? Section 4b of “Challenges in Improving Community Engaged
Research,” Clinical and Translational Science Award Community Engagement Key Function Committee Task
Force on the Principles of Community Engagement (Chapter 5, Section 4b). Principles of Community
Engagement, 2nd edition. Washington, DC: U.S. Department of Health and Human Services.
Sufian, M., Grunbaum, J., Akintobi, T., Dozier, A., Eder, M., Jones, S., Mullan, P. Weir, C.R., & White-Cooper,
S. (2011). Evaluating Community Engagement. Chapter 7 of Clinical and Translational Science Award
Community Engagement Key Function Committee Task Force on the Principles of Community Engagement.
Principles of Community Engagement, 2nd edition. Washington, DC: U.S. Department of Health and Human
Services, 2011
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Lessons Learned
•
•
•
•
•
•
•
Document Progress
Watch and Learn
Communication
Patience
Remembering Your Role
Finding Mutual Benefit
Community As a Partner
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Contact Information
 Morehouse School of
Medicine Prevention
Research Center
720 Westview Dr., SW,
Atlanta, GA 30310
 Phone: 404-752-1022
 Email:
takintobi@msm.edu
Website:
www.msm.edu/prc
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2013 ©