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How do I prioritize strategies that would address inclusion for individuals with developmental disabilities and prevent its recurrence. You will have an opportunity to re-visit your prioritization in Week 8 and make any necessary changes based on the feedback you receive from your peers and your Instructor during this Discussion in 300 words.
Reflect on the social problem of inclusion for individuals with developmental disabilities. Then, complete the
Prioritizing Strategies Worksheet
(Parts I and II) located in the Learning Resources.
Post a brief description of inclusion for individuals with developmental disabilities. Then, describe the top five strategies that you prioritized to address the problem and prevent its recurrence. Explain your reasoning for prioritizing these strategies, including how the time and resources it would take to implement each strategy influenced your decision making.
References
Centers for Disease Control and Prevention. (2013).
Community needs assessment participant workbook.
Note: Read pp. 40–51 only.
Document: Prioritizing Strategies Worksheet
Download Prioritizing Strategies Worksheet
(MS Word)
Stroh, D. P. (2015). Systems thinking for social change: A practical guide to solving complex problems, avoiding unintended consequences, and achieving lasting results. Chelsea Green Publishing.
Chapter 4, “Deciphering the Plots of Systems Stories” (p. 45–70)
Hart-Johnson, A. (2020).
The ecology, prevention, and risk mitigation of social change.
Download The ecology, prevention, and risk mitigation of social change.
(PDF)
Human services
COMMUNITY NEEDS ASSESSMENT
PARTICIPANT WORKBOOK |40
Section : Create a Community Action Plan
INTRODUCTION
At this stage of the community needs assessment, you should have
summarized the data the team has collected and are ready to identify the
community assets and needs. In this final section of the workbook you will
learn how to use your summary information to identify areas for
improvement and then transform them into measurable action items.
The outcome of this step is a Community Action Plan which will contain
Specific, Measurable, Attainable, Realistic and Timely (SMART) objectives
and the activities to support those objectives.
You should present your needs assessment findings and obtain approval
from stakeholders and/or community leaders on the strategies before
developing an action plan.
IDENTIFY ASSETS AND NEEDS
You will use the Sector Data Grids to identify focal policy, systems, and
environmental change strategies that are both in place, (i.e., assets), and
missing, (i.e., needs).
Your team should designate a cut-off point–the scores to the right of the
line would be considered assets; those to the left would be the needs, as
shown in Table 7.
Table 7: Sample Needs and Assets: Needs=0-60%, Assets=61-100%
Community-At-Large (CAL)
Community
Component
Low:
0-20%
Low:
21-40%
Medium:
41-60%
Medium:
61-80%
High:
81-100%
Physical
Activity
CALP1,
CALE14
Nutrition CALP1,
CALE1
Tobacco CALP1,
CALE1
Chronic
Disease Mgt
CALE1 CALP1
CALE1: ‘CAL’ = Community-At-Large Sector ‘E’ = Environment ‘1’= Site number (If
you have multiple sites, number them consecutively, 1, 2, 3 and so forth.)
COMMUNITY NEEDS ASSESSMENT
PARTICIPANT WORKBOOK |41
Community
Component
Low:
0-20%
Low:
21-40%
Medium:
41-60%
Medium:
61-80%
High:
81-100%
Leadership
CALP1 CALP1
Now that you have a visual depiction of each sector’s needs and assets
across all the community components, you can then create a list of all the
policy, systems, and environmental change strategies across sectors that
are assets or needs. Table 8 shows an example of a Policy, Systems
and Environmental Change Strategies Worksheet you can use to
record this information.
Table 8: Sample Policy, Systems, and Environmental Change Strategies
Worksheet: Assets and Needs
ASSETS NEEDS
Community-At-Large Sector:
Smoke-free and tobacco-free
policies implemented for indoor
and outdoor places.
Strategies adopted to educate
residents on importance of
controlling high blood pressure
and cholesterol.
Community
Institution/Organization (CIO)
Sector:
All sites instituted healthy food
and beverage options in vending
machines.
3 out of 4 sites provide routine
screening for cholesterol and
provide counseling and
education about tobacco use
and exposure.
3 out of 4 sites participated in
the last three years in
community coalitions and
partnerships related to tobacco
use and physical inactivity.
Community-At-Large Sector:
No policies in place that ban
local restaurants and retail food
establishments from cooking
with trans fats.
Recent budget cuts for public
shared-used paths or trails.
Community
Institution/Organization (CIO)
Sector:
1 site did not provide any
routine screenings for chronic
diseases management.
No sites promoted stairwell use.
1 site has never participated in
community coalitions and
partnerships related to tobacco
use or physical inactivity.
Health Care Sector:
Health care centers and private
physician’s office do not take
routine body mass index
readings (BMIs) for routine
office exams.
COMMUNITY NEEDS ASSESSMENT
PARTICIPANT WORKBOOK |42
ASSETS NEEDS
Health Care Sector:
Two facilities promoted stairwell
use to patients, visitors, and
staff
Patients referred to smoking
cessation programs at all sites
School Sector:
1 of the schools was initiating a
plan to ensure the playground
equipment meets safety
standards
Work Site Sector:
Employee wellness coalition
developed by local small
business
All sites have designated, safe
walking paths on building
property
4 out of 5 sites implemented a
referral system for tobacco
cessation services
75% of the health care
professionals do not provide
patient education on nutrition or
physical activity
School Sector:
No requirements for physical
activity during school day
2 of the 3 schools offered no
healthy food or beverage
options
Work Site Sector:
No sites promoted stairwell use
No sites offered healthy food or
beverage options in vending
machines
Strategies:
PRIORITIZE NEEDS
If you have identified many community needs, your team should prioritize
those needs. Some criteria you may consider when prioritizing needs
are:
Size of problem
Seriousness of problem
Availability of current interventions
Economic or social impact
Public health concern
Availability of resources
COMMUNITY NEEDS ASSESSMENT
PARTICIPANT WORKBOOK |43
Tip
Please refer to the Prioritize Public Health Problems module for more
information about how to prioritize needs.
DEVELOP STRATEGIES
Using your priority list of community needs, identify a specific community
strategy to address each key need. You do not have to address every
weakness.
When identifying strategies, consider the community’s strengths. For
example, in the sample needs assessment in Table 8 all the community
institution/organization sites offered healthy food and beverage options in
vending machines; however, none of the sites promoted stairwell use.
Since the institutions already have a healthy nutritional environment they
might be more acceptable of incorporating physical activity initiatives.
Your team can also combine similar strategies to streamline activities. For
example, in the sample needs assessment, work sites also did not
promote stairwell use.
The community team can formulate a strategy that
encourages stairwell use at work sites and community
institutions/organizations. The team members responsible for this strategy
can use the same promotional materials (e.g., posters on the benefits of
using stairwells) for both sectors.
After developing the strategies, record them on the bottom section of the
Policy, Systems and Environmental Change Strategies Worksheet. An
example is shown below in Table 9.
Table 9: Sample Strategies (bottom of Policy, Systems, and
Environmental Change Strategies Worksheet)
COMMUNITY NEEDS ASSESSMENT
PARTICIPANT WORKBOOK |44
Strategies:
Work with key stakeholders to formulate and implement a policy
that bans local restaurants and retail food establishments from
cooking with trans fats.
Encourage community institutions/ organizations and work sites to
promote stairwell use.
Encourage health care professionals to provide patient education
on nutrition and physical activity to adults with chronic disease risk
factor.
Require schools to incorporate a minimum of 30 minutes of
physical activity during school day.
Require schools to offer healthy food and beverage options.
PRIORITIZE STRATEGIES
Once you have identified the strategies, your team will need to prioritize
what can be implemented, given the time, resources, and other competing
community priorities. Use any method to prioritize that your team has
agreed upon. One way is to rank each strategy according to each
criterion from 1 to 5 as follows:
Table 10: Example Scale for Ranking Strategy
Time Resources Competing Priorities
1= Large amount of
time needed to
implement strategy
2 = Substantial amount
of time needed to
implement strategy
3 = Some amount of
time needed to
implement strategy
4 = A little amount of
time needed to
implement strategy
5 = Very little amount of
time needed to
implement strategy
1= Large amount of
resources needed to
implement strategy
2 = Substantial amount
of resources needed to
implement strategy
3 = Some amount of
resources needed to
implement strategy
4 = A little amount of
resources needed to
implement strategy
5 = Very little amount of
resources needed to
implement strategy
1= Large amount of
competing priorities
2 = Substantial amount
of competing priorities
3 = Some competing
priorities
4 = A few competing
priorities
5 = No competing
priorities
COMMUNITY NEEDS ASSESSMENT
PARTICIPANT WORKBOOK |45
After ranking each strategy according to time, resources, and competing
priorities, total the scores to determine the highest ranking strategies to
implement. See Table 11 for an example of how to use this ranking
method.
Table 11: Sample Prioritize Worksheet
Strategy Time
(1-5)
Resources
(1-5)
Competing
Priorities
(1-5)
Total
(T x R x C)
Rank
Work with key
stakeholders to
formulate and implement
a policy that bans local
restaurants and retail
food establishments
from cooking with trans
fats.
1 2 2 4 5
Encourage community
institutions/organizations
and work sites to
promote stairwell use.
4 4 3 48 1
Encourage health care
professionals to provide
patient education on
nutrition and physical
activity to adults with
chronic disease risk
factor.
4 3 3 36 2
Require schools to
incorporate a minimum
of 30 minutes of physical
activity during school
day.
3 2 3 18 3
Require schools to offer
healthy food and
beverage options.
2 2 2 8 4
In the above example the top 2 strategies are:
1. Encourage community institutions/organizations and work sites to
promote stairwell use.
COMMUNITY NEEDS ASSESSMENT
PARTICIPANT WORKBOOK |46
2. Encourage health care professionals to provide patient education on
nutrition and physical activity to adults with chronic disease risk factors.
COMMUNITY ACTION PLAN
Your team will develop an action plan for each priority strategy. A quality
plan contains sufficient details to map a clear course of action. Table 12
shows an example of a Community Action Plan.
Notice there are two types of objectives listed in the Community Action
Plan: Project Period Objective and Annual Objective. The project period
objective allows your team to look at a long term perspective of what can
be accomplished over a multiyear period. For example, in Table 11 the
project period objective states: In 5 years, all ministry of health providers
will include NCD counseling to all patients, that includes lifestyle
counseling on physical activity, nutrition and smoking.. There is also
space on the worksheet to record the community component that is the
area of focus, such as nutrition or physical activity.
Annual objectives cover a 12-month timeframe and show incremental
progress toward completion of the project period objective. In Table 12
there is one annual objective: At 12 months, all clinics in district Y will
provide lifestyle NCD counseling to all patients.
Table 12: Example of a Community Action Plan
Policy/Environmental
Change Strategy
Encourage health care professionals to
provide patient education on nutrition and
physical activity to adults with chronic
disease risk factors.
Project Period Objective
Community
Component(s)
In 5 years, all ministry of health providers will include
NCD counseling to all patients that includes lifestyle
counseling on physical activity, nutrition, and
smoking.
Physical Activity
Nutrition
Annual Objective(s): Sector(s)
No. of People
Reached
At 12 months all clinics in district Y will
provide lifestyle NCD counseling to all
patients.
Health Care 250,000
Activities Person
Responsible
Timeline
COMMUNITY NEEDS ASSESSMENT
PARTICIPANT WORKBOOK |47
NCD counseling protocols developed J. Thomas
Month 0-3
NCD counseling monitoring system
developed
W. Lee Month 0-3
Health provider reward/recognition
system established
Month 0-3
NCD physicians/health providers
trained on protocol
W. Lee Month 3
Community interventions including
establishment of exercise locations for
women and the general public, and
cooking classes
J. Thomas Months 6-9
A district-wide, multisectoral NCD plan
will be developed and implemented
W. Lee Months 6-9
All physicians/health providers trained W. Lee Months 6-9
All clinics begin counseling J. Thomas Month 125
It is important to associate each annual objective with a particular sector.
You may develop multiple annual objectives that cut across more than
one sector for a project period objective. In this example, the sector
impacted is health care.
For each annual objective, indicate the approximate number of people
who will be affected by the strategy through its successful completion.
Tip
As you craft the objectives, be sure they are SMART—specific,
measurable, achievable, realistic, and time-phased.
The last section of the Community Action Plan template is where you list
the activities that support the accomplishment of the annual objective.
When listing activities be sure to provide clear descriptions of key
milestones. For each annual objective it is recommended that you list no
5 In reality, more activities would be listed which would include activities for years 2
through 5 (project objective).
COMMUNITY NEEDS ASSESSMENT
PARTICIPANT WORKBOOK |48
more than 10 activities, which may limit these activities to key actions for
completing the annual objective.
Next to each activity that is listed identify the lead or primary contact
person, and estimate the timeline for strategy completion. Be specific and
realistic. If the strategy’s completion depends on actions by several
individuals or organizations, allow time for stakeholder coordination.
Stop
Let the facilitator or mentor know you are ready for the group
discussion.
Activity
TAKE OUT THE ACTIVITY WORKBOOK AND COMPLETE SKILL
ASSESSMENT – ACTIVITY#4.
SECTION 6: KEY POINTS
Tip
Create a list of all the policy, systems, and environmental change
strategies across sectors that are community assets or needs
Use your list of community needs to identify a specific community
strategy to address each key need. You do not have to address
every weakness
After identifying strategies, your team will prioritize what can be
implemented given the time, resources, and other competing
community priorities
On the action plan a project period objective allows your team to look
at a long-term perspective of what can be accomplished over a
multiyear period. Annual objectives cover a 12-month timeframe with
incremental progress toward completion of the project period
objective
COMMUNITY NEEDS ASSESSMENT
PARTICIPANT WORKBOOK |49
Conclusion
IMPLEMENTING THE ACTION PLAN AND SHARING PROGRESS
Although this workbook does not cover implementing the community
action plan or sharing results, it is worthwhile to briefly mention those here.
After completing the community needs assessment and developing a
communication action plan, coordinate your resources to make sure the
activities you have identified are completed on time. Track your progress,
note key successes, and document any obstacles to implementing the
action plan.
You will also want to share the data and accomplishments with community
leaders and other people and organizations that contributed their time and
expertise to the needs assessment. Identify the best venue for sharing
the results. You can organize a community meeting and/or write a policy
brief or one-pager.
Anonymity is important to protect the interests of those who participated in
the assessment. Community teams should not list who they talked with or
provide specific details about data that could specifically link to an
individual or organization. Share data in aggregate for a sector. For
example, when providing results of assessing work sites you may state
that “across the 6 work sites examined by the community team, 2 had
policies requiring healthy food choices in vending machines, 1 was in the
process of formulating a policy, and 3 had no formal policy regarding
vending machine healthy food choices.”
COMMUNITY NEEDS ASSESSMENT
PARTICIPANT WORKBOOK |50
TAKE HOME POINTS
Tip
A community needs assessment should focus on a particular
geographic area, sectors within that area such as health care and
work sites, and community components to assess within each sector
such as nutrition, chronic disease management, and tobacco use.
A combination of 2 or more data-collection methods is recommended
at each site to confirm or support initial findings.
Keep a comprehensive file of all sources of information, key contacts,
and data to review at a later date or to share with coalition members.
Rating the data should be based on a comprehensive review of all
sources and the agreement of the individuals on your team.
To ensure proper data management there should be only one data
manager, such as the community team’s evaluator, and all data
should be forwarded to this individual.
After your team has reached consensus on the most appropriate
rating for each item within a site, the data should be recorded in a
table or spreadsheet along with any supporting comments. The data
manager should total all the ratings, assign a percentage score, and
then create a summary of all the percentage scores for each site.
Create Sector Data Grids to provide a quick data reference across all
sectors.
Use your list of community needs and identify a specific community
strategy to address each key need. You do not have to address
every weakness.
After identifying strategies your team will prioritize what can be
implemented, given the time, resources, and other competing
community priorities.
On the action plan, a project period objective allows your team to
look at a long term perspective of what can be accomplished over a
multiyear period. Annual objectives cover a 12-month timeframe with
incremental progress toward completion of the project period
objective.
WORKBOOK REVIEW
After completing this workbook, you should be able to:
Plan for a community needs assessment,
Review and rate data collected from a community needs assessment,
Summarize data,
Identify areas for improvement, and,
Develop a community action plan.
COMMUNITY NEEDS ASSESSMENT
PARTICIPANT WORKBOOK |51
Resources
For more information on topics found within this workbook:
Community Health Assessment and Group Evaluation (CHANGE)
data-collection tool developed by CDC’s Healthy Communities
Program in the Division of Community Health at the National Center for
Chronic Disease Prevention and Health Promotion. Available at:
http://www.cdc.gov/HealthyCommunitiesProgram
Centers for Disease Control and Prevention. Healthier Worksite
Initiative, Environmental Audits. Available at:
http://www.cdc.gov/nccdphp/dnpao/hwi/programdesign/enviro
nmental_audits.htm
Community Assessment Guide Book, North Carolina Department of
Health (2002); retrieved on October 19, 2012 from
http://www.schs.state.nc.us/schs/data/databook/2002/GuideBo
ok2002
The Ecology, Prevention, and Risk Mitigation of Social Change
By Avon Hart-Johnson, PhD (2020)
There is no shortage of social problems in the world. Most do not occur in isolation and
are usually connected in broader contexts. Such problems can be viewed through a systems or
ecological framework. The following paper addresses how systems thinking can be integrated
into social change initiatives, including those that focus on preventing the recurrence of social
problems. This paper also includes an explanation of the importance of risk mitigation when
planning for social change.
Prevention
Community experts suggest that it is far easier to prevent problems than it is to fix them
(Nelson & Prilleltensky, 2010). By the time problems have taken hold, it is likely that they have
already affected many other areas. Prevention entails taking steps to reduce or omit the onset of
problems such as adverse community health-related issues or reducing the prevalence of mental
health or human problems (e.g., social, economic, or environmental).
Prevention has its roots in public health (Nelson & Prilleltensky, 2010). The U.S.
Department of Health and Human Services (n.d.) focuses on multiple areas of prevention in
which advanced human services professional practitioners may be directly or indirectly involved:
(1) vaccines and immunizations; (2) nutrition and fitness; (3) health screenings; (4) mental health
and substance use; (5) environment; and (6) lifestyles. When advanced human services
professional practitioners consider fostering strategies for social change in these areas, it is wise
to think about how to prevent related problems and address any risk of recurrence.
Nelson and Prilleltensky (2010) indicated that prevention can be an effective strategy
even if the root cause of the problem is unclear. To illustrate, these authors use the example of
John Snow, a British doctor who traced a public health problem (Cholera) back to a single water-
well located in London, England during an 1854 epidemic. As the story goes, as many as 616
people drank from the same well and got sick and died. As a result, the town enacted
preventative strategies to stop the spread of the disease and future deaths and sickness before
having a full understanding of it.
Ecological Systems and Prevention
Human services prevention strategies should be designed in a manner that considers a
systems approach to well-being. It should be clear that prevention is not just a singular or
individualized approach. Prevention strategies should entail addressing the structural issues
associated with social problems such as policy, local and national political forces, economic
pressures, and so forth. Also, remember that focusing on solving one problem may have
downstream or cascading impacts on other areas (Stroh, 2015). Therefore, it is wise to use a
systems approach.
One way of better understanding the broader context of a problem is to ask questions
such as: “What happened? What has it been happening? Why?” Also, one might ask: “Why are
these problems occurring? How do the problems relate to much broader public concerns? Who
are the stakeholders (collaborators)? Who has the power and how does this power differential
show up in the context of the social problem? What are the root causes and how might we
prevent the problem from occurring?” Each of these questions could provide greater insights
regarding the social problem.
Many Tools and Templates for Brainstorming
In this course, you will learn about many tools and templates that can be used as a means
of critical analysis and brainstorming. Stroh (2015) uses an iceberg analogy as an annotated
framework for change agents to utilize when inquiring about the depth and breadth of social
problems (see Stroh, 2015, p. 37, Figure 3.2 The Iceberg). Bronfenbrenner’s (1992) ecological
systems framework is another tool that can be used to help better understand the
interrelationships that occur in the context of a social problem. Bronfenbrenner proposed a
framework to explain how individuals are interconnected to a broader set of systems. This
ecological framework can help us to see how an individual’s microsystem includes such
connections as family, peers, church, and educational settings. If a person experiences a problem
such as a mental health issue, they could interact with the exosystem, which may include
accessing healthcare systems, utilizing community resources, and possibly learning about free
human services through the local news or mass media. It is also possible that the broader
macrosystems affect their lives. For example, social stigma is an issue that individuals with
mental health concerns often face. National level public outreach might include introducing or
passing legislation for mental health access for affected individuals.
The ecological systems framework helps us to better understand that individuals are not
islands. They have multiple touch-points with others in their communities as a part of a greater
whole. It is then reasonable to understand that when part of the system is hurting, the greater
whole is also suffering in some way. Therefore, as you consider your social change endeavors,
remember to include a focus on systems, preventative measures, and also risk mitigation.
Risk Mitigation
Risk mitigation entails taking steps to reduce risks. Therefore, critical analysis of
problems that include assessment of risk is important. Stroh (2015) indicated that one should
anticipate and forecast these types of issues. For example, when people are sent to prison, 95%
of them will return back to their communities. However, if they do not have preventative
https://www.rrcc.edu/sites/default/files/early-childhood-education-bronfenbrenner-circles
https://www.rrcc.edu/sites/default/files/early-childhood-education-bronfenbrenner-circles
measures (job, family support, and required health care such as mental health services), then they
are at a risk for recidivism. Mitigating the risk might entail working with people in the entire
ecological systems framework. For example, you could elicit family support for housing
(microsystem), use community centers (exosystem) for job preparation, and ensure that the ban-
the-box legislation is properly followed (macrosystem).
Conclusion
Implementing social change requires careful consideration about how the problem can be
solved effectively. Problems are generally not isolated events, but rather have tenets into many
other social systems and levels of the ecological framework. It is also possible to prevent
problems by implementing strategies that reduce the risk of these problems from taking place.
However, when attempting to affect positive social change, it is wise to implement strategies that
will create sustainable and lasting social change.
References
Bronfenbrenner, U. (1992). Ecological systems theory. In R. Vasta (Ed.), Six theories of child
development: Revised formulations and current issues (p. 187–249). Jessica Kingsley
Publishers.
Nelson, G., & Prilleltensky, I. (Eds.). (2010). Community psychology: In pursuit of liberation
and well-being (2nd. ed.). Palgrave Macmillan.
Stroh, D. P. (2015). Systems thinking for social change: A practical guide to solving complex
problems, avoiding unintended consequences, and achieving lasting results. Chelsea
Green Publishing.
The U.S. Department of Health and Human Services. (n.d.). Prevention & wellness.
https://www.hhs.gov/programs/prevention-and-wellness/index.html
https://www.hhs.gov/programs/prevention-and-wellness/index.html
