Effective community health assessments in King County, Washington.

摘要

BACKGROUND: Community health assessment (CHA) is widely practiced in public health, but its effectiveness has seldom been evaluated. METHOD: We present three examples of successful CHAs, carried out by Public Health-Seattle & King County, with diverse strategies: a quantitative assessment of asthma hospitalizations; Communities Count, a set of social and health indicators paired with qualitative data; and Growing Up Healthy, an assessment using qualitative methods to provide guidance for a statewide media campaign on youth sexual abstinence. FINDINGS: These assessments were successful in attracting new resources, forming and sustaining new partnerships, and/or providing guidance or resources for program and policy development. They also illustrate the difficulties of evaluating the effects of CHA in at least three ways: untangling its effects from other important community and political factors; documenting outcomes that are distant in time from and indirectly related to the assessment; and cultural orpolitical restrictions on collecting sensitive evaluation data. We suggest common characteristics of an effective assessment, potential effectiveness indicators, and evaluation strategies. CONCLUSIONS: Despite barriers to documenting the relative contribution of a CHA, a set of rigorous evaluation methods needs to be developed and tested to document the benefits of a CHA in a competitive funding environment.