Needs assessment training for Cycle IV of the "Identifying our Needs: A Survey of Elders" needs assessment - for participating tribes, Title VI, and int

1. Identifying our Needs IV: Conducting and Uses for Native Elder Needs Assessments Twyla Baker-Demaray, M.S. Administration on Aging Title VI Training Funded by Administration on Aging Grant Number 90OI003/02

3. Understand what a needs assessment is.

4. Understand the reasons for conducting a needs assessment.

6. Focuses on:

7. Education, Training, and Research

8. Community Development & Technical Assistance

9. Native Elder Health, Workforce, & Policy

12. A method by which the nature and extent of needs can be both assessed and documented.

15. Lower life expectancy

16. Higher chronic disease rates

17. Higher health risk factors

18. Lack of screening

19. Lack of long-term care services in Indian Country

22. Variation in regard to life expectancy and chronic disease

23. Ex. California Indian Health Service Area life expectancy at 77.3 years is slightly higher than the nations; however, Aberdeen Area is 66.8, a difference of 11.1 years (U.S. Gen. Population – 77.9).

24. Ex. Alaska Area has a diabetes rate slightly higher than the general population at 16%; whereas, the majority of other regions are at 37% or higher.

27. Provide tribal nations with the opportunity to collect information for their communities.

28. Provides technical assistance and training opportunities to conduct a needs assessment using an established model.

29. The NRCNAA model uses:

30. Academically accepted design and methodology

31. Random sampling to ensure fair subject selection

32. Results independent from political influence.

33. Informed consent, tribal approval, and tribal ownership.

35. Cycle 1

36. Cycle 2

37. Cycle 3

38. Cycle IV In progress! More on numbers to be posted to the website. www.nrcnaa.org NRCNAA is on Facebook: http://www.facebook.com/NRCNAA

39. Additional Resources

41. For larger groupings containing numerous tribes in a single organization data can be obtained from http://factfinder.census.gov/home/aian/sf2_sf4.html where findings are based on 39 tribal groupings.

42. The 2000 census data is now 10 years old and to represent the current year you may want to use current estimates, or tribal enrollment numbers.

43. Estimates for years between censuses can be found at http://www.census.gov/popest/estimates.php , but you might be restricted to obtaining data for counties and not for boundaries that reflect your service areas or reservations.Hawaiian sites should use the Hawaiian Data Center

44. Identifying Our Needs: A Survey of Elders IV

46. A copy of the survey can be viewed at http://ruralhealth.und.edu/projects/nrcnaa/pdf/cycleiv_surveyinstrument.pdfUse of this instrument will: Enable you to develop local data for planning and grant applications Enable you to train volunteers to help with data collection Expedite data entry, ensuring that you get results quickly Allow you to gain data at substantially reduced costs.

47. Cycle IV Needs Assessment

49. Indicators of chronic disease

50. Measures of disability - Activities of Daily Living (ADLs)

51. Instrumental Activities of Daily Living (IADLs)

52. Indicators of visual, hearing and dental problems

53. Tobacco and alcohol use patterns

54. Diet, nutrition and exercise

55. Weight and weight control (BMI indicators)

56. Social support patterns, housing and work

57. Health care access

58. Unmet needs

60. Identify and assess local community needs

61. Provide objective data for evaluating the status and needs of your communities elders

62. Obtain information that permits an unbiased examination of the needs

63. Provides an opportunity to document these needs for key funding agencies.

64. You should be aware, however, that this type of systematic community diagnosis might yield results that are upsetting.

65. While people may talk willingly about their health, an assessment may tell them that they have high risk factors for obesity, inactivity and such.

67. The responses of people from the community are often best solicited through an anonymous survey response.

68. Detailed information about behavior, attitudes, beliefs, attributes and opinions can be recorded.

69. Cross tabulation can help profile problems and assist in targeting programs.

70. Surveys are lower in cost and consume less time.

72. Staff or community volunteers trained to ask the questions and fill out the survey for their elders (training materials are available online and in print.)

73. Sampling may be used – We help you determine your sample size based on your population number

74. A complete list of the population is critical to the needs assessment process to ensure a representative selection of respondents.

76. Train the interviewers – practice interviewing each other to become familiar with the questions.

77. Contact each person on the list. Try different times of the day and days of the week for those not at home or call to arrange a time for a visit. Try each person at least 3 times.

78. Keep records for each attempt and for each completed interview to avoid duplication.

79. Always thank people for talking with you and let them know where to look for the results.

80. As able, offer incentives for completion.

82. Sending machine-readable data to the NRCNAA for both analysis and interpretation will reduce your costs substantially while retaining critical inputs from someone who is an expert in survey analysis.

83. NRCNAA will…..

84. Code the data for statistical analysis.

85. Create a data file for your tribe.

88. Baker-Demaray 30 Title VI Needs Assessment Requirements Release date: September 2010 As the announcement becomes available, the NRCNAA can offer more directed advice and templates to assist you in completing your application

89. Baker-Demaray 31 NRCNAA Data Use Template “Background Information According to the ___________enrollment office, there are presently 853 men and women over the age 55 enrolled and living on or around the ________ reservation. Of the 853, there are 492 over the age of 65. According to the National Resource Center on Native American Aging (NRCNAA), the national Native elder population ages 55 and over are expected to grow by 110% between 2000 and 2020. Clearly the impact of the large cohorts born during post World War II, now known as the Baby Boom generation, will become a major source of change for our tribe.

90. Baker-Demaray 32 NRCNAA Data Use Template Chronic Disease The top chronic diseases found among our elders were high blood pressure, arthritis, diabetes, depression and osteoporosis. Each of these lead to limitations on peoples’ ability to take care of themselves and each are diseases where treatments are available to manage the disease. Nutritional care is particularly important for high blood pressure, diabetes and osteoporosis.

91. Baker-Demaray 33 NRCNAA Data Use Template Data Comparison Comparisons between our tribe and the nation provide documentation of disparities on specific diseases where American Indian people appeared to be at greater risk than others in the nation. This information assists in identifying diseases where health promotion efforts will assist in making significant improvements in health status for our elders. The following table illustrates these differences.

92. NRCNAA Data Use Template More on the Data Use Template is available at our website: www.nrcnaa.org ADLs & IADLs Overweight and obesity Templates and boilerplates for using your findings We also encourage you to use your data innovatively.

94. Strengthening of grant proposals

95. Documentation of health disparities

96. Documentation of need for health promotion, home and community based services, and assisted living

98. Advocating for resources at the state, regional, and national level

99. Developing policy for informing national Native elder organizations

100. Filling the research gap for Native elder related publication

102. Baker-Demaray 38 Needs assessment summary A needs assessment should be conducted every three years to document changes. A needs assessment is required by the Administration on Aging for Title VI projects. AoA, the NRCNAA, and others can assist you with conducting a good needs assessment Data from a needs assessment can be used for planning purposes. A needs assessment is a method to document local needs.

103. Questions? Contact us for more information! National Resource Center on Native American Aging Center for Rural Health501 North Columbia Road, Stop 9037 Grand Forks, ND 58202-9037Toll Free Phone (800) 896-7628http://www.nrcnaa.org