A Guiding Framework for Needs Assessment Evaluations to Embed Digital Tools with Indigenous Communities

In community-based participatory projects, needs assessments are one of the first steps to identify priority areas. Access-related issues often pose significant barriers to participation for rural and remote communities, particularly Indigenous communities which have a complicated relationship with academia due to a history of exploitation and trauma. In order to bridge this gap, work with Indigenous communities requires consistent and meaningful engagement. The prominence of digital devices (i.e., smartphones) offers an unparalleled opportunity to ethically and equitably engage citizens across jurisdictions, particularly in remote communities. We propose a framework to guide needs assessments which embed digital tools in partnership with Indigenous communities. Guided by this framework, a needs assessment was conducted with a subarctic Métis community in Saskatchewan, Canada. This project is governed by a Citizen Scientist Advisory Council which includes Traditional Knowledge Keepers, Elders, and youth. An environmental scan of relevant programs, key informant interviews, and focus groups were conducted to systematically identify community priority areas. Given the timing of the needs assessment, the community identified the Coronavirus pandemic as a key priority area requiring digital initiatives. Recommendations for community-based needs assessments to conceptualize and implement digital infrastructure are put forward, with an emphasis on self-governance and data sovereignty.

Congregations as Health Connectors – Addressing Health and Social Needs of Neighbors Through Conversations, Not Surveys

Background and Hypothesis: Social determinants of health (SDOH) directly affect health outcomes and indirectly limit access to resources needed to maintain individual health. In an effort to address the negative impacts of SDOH on the urban communities of Indianapolis, four congregations have employed Site Connectors to directly form relationships with neighbors, learn about their health journey, and connect them to resources addressing expressed needs. It is our hypothesis that through research of similar models and discussion with community partners, an optimized model for fostering relationships and assessing the health and social needs of neighbors can be developed for use by the Site Connectors. Project Methods: A search was performed for examples of health and social needs assessments utilized by established care providers, and thirteen were identified. The items within these assessments were then organized into six groups based on SDOH topic (ie. Housing, Transportation, etc.). Additionally, six interviews with community partners performing similar work were conducted utilizing a fixed set of questions. Results: It was determined that the best format for our assessment would not be a survey, as in the example assessments, but rather a visual aid resembling a concept map. This model lends itself more to the nature of relationship-building by guiding Connector-Neighbor conversations rather than dictating them, with three starter questions at the center and six offshoots covering each of the SDOH topics. A post-encounter checklist was also developed for Connectors to retroactively record priority items from their conversations. Potential Impact: It is yet to be determined whether our model will be useful in practice, as the Connectors begin their work in August. However, it is our hope that we have developed a novel format for assessing needs that more holistically addresses the impacts of SDOH through respecting the vulnerability and energy required for relationship-building.

Harnessing Community Resources to Enhance Student Learning and Development

One of the most important ways in which school social workers can support students, families, and staff is by acquiring, developing, and distributing community resources. This chapter will discuss identifying needs, assembling resources, empowering students and families to access resources, and building staff and program capacity to meet community needs. Discussion will focus on needs assessments during the overlapping pandemics of COVID-19 and racial inequities. Strategies for conducting needs assessments, mapping assets, and investigating potential community partners are offered. Finally, the chapter covers the importance of collecting and reporting data to evaluate the success of the programs that the school social worker develops.

Direct-to-Consumer or On-Demand Telehealth

Direct-to-consumer (DTC) or on-demand telehealth describes a patient-initiated medical encounter using technology in real time—mostly related to acute care or urgent complaints. Initially created and offered by private companies, DTC telehealth is now more ubiquitous, as it has been offered by hospitals, medical centers, multi-specialty practices, and insurers. On-demand telehealth services are implemented in an effort to increase health care access, improve satisfaction and efficiency, as well as drive new revenue. This chapter outlines the types of DTC telehealth, considerations when conducting a needs assessments, implementation, business models, and quality assurance.

Probation Officers, Discretion, and Participatory Management

Probation officers (POs) are perhaps the correctional workers with the greatest reach, since more people are under probation supervision relative to every other correctional branch (i.e., jail, prison, and parole). The individuals under probation supervision and the community-at-large depend on POs to do their job well. However, POs have a job that requires them to make numerous decisions within an organization with conflicting goals and ambiguous roles, often with great discretionary power and little oversight. This relatively autonomous discretionary power often produces racial disparities in probation outcomes, the misuse of evidence-based tools such as risk and needs assessments, and ultimately the inability of probation organizations to effectuate change. These effects have negative consequences for probation organizations, probationers, and POs themselves. Participatory management produces an organizing framework that calls for hierarchical organizations to take a balanced approach to decision-making by increasing information sharing throughout the organizational hierarchy. This organizational structure carries the potential to remedy these aforementioned problems. By increasing oversight and accountability for POs via participatory management, POs’ discretionary power may be managed without limiting decision-making. Participatory management may create additional benefits such as increasing the efficiency of probation organizations, improving client outcomes for probationers, and increasing occupational satisfaction for POs. There are numerous potential threats to participatory management and several solutions for overcoming them. The main solution calls on probation agencies to make participatory management as effective as possible by constructing an equal balance between a loosely and tightly coupled organizational implementation of policies and practices.

Documenting Behavioral Health Needs in an Urban Setting

Most local communities lack the capacity to conduct behavioral health needs assessments. The purpose of this paper is to describe a mixed-methods approach to estimate the behavioral health needs in St. Louis, MO. Data were drawn from multiple sources including local and state government prevalence estimates, medical records, and key informant interviews. The most prevalent behavioral conditions were depression, alcohol, and drug abuse. Priority populations were residents with co-occurring disorders, youth transitioning into the adult behavioral system, and homeless individuals with behavioral health needs. Treatment rates for behavioral health conditions were low, relative to identified needs. There are significant provider shortages and high staff turnover, which extend wait times, diminish the quality of care, and contribute to the use of emergency departments for behavioral health care. The data and methods described in this paper could be helpful to other municipalities that are looking to conduct behavioral health needs assessments.