datasets for CHAs (Asaro et al., 2001; Friedman and Parrish, 2006; Love and Shah, 2006; Rooney and Thompson, 2009).8 Despite this progress, additional capacity enhancements are needed to enhance data dissemination tools (e.g., better trend analyses, benchmark support), improve the timeliness of available data, expand epidemiology-support capacity provided at the state level, and augment the analytic skills of local health officials (Friedman and Parrish, 2006; Love and Shah, 2006).
Improved Community Outreach and Engagement
Ideally, CHAs provide an initial basis for broad community involvement and sets the stage for the active participation of community residents and partner organizations throughout the course of the community health improvement planning process (CDC, 2010; Jacobs and Elligers, 2009). Significant community outreach, local data collection to assess perceived community health needs, and a participatory assessment process facilitate the engagement of residents and other stakeholders in the community health assessment (Cheadle et al., 2008; Kegler et al., 2009; Keller et al., 2002; Parker et al., 2003; Running et al., 2007; Spice and Snyder, 2009). These interactive activities also increase the staff time commitments and other costs associated with conducting CHAs and may demand an orientation and set of skills not commonly found within public health agencies. Additional investments are needed to identify effective techniques for outreach and engagement, disseminate this evidence, and train public health personnel in the application of these methods.
Enhanced Leadership and Communication Skills to Support Priority Setting
Priority setting requires a special set of skills and competencies related to the interactive nature of group facilitation and consensus building. The literature surrounding these capacity requirements is less robust than that pertaining to community assessment, which may further substantiate the extent to which community priority setting falls outside of conventional public health practice.
Public health lacks clear, widely accepted criteria for prioritizing community health needs (Michaelis, 2002). A variety of factors may be considered when establishing community health priorities, including the number of people affected, severity of the problem, perceived urgency of issue, efficacy
8Since 1992, funding through CDC’s Assessment Initiative has supported 19 states (Arkansas, Florida, Illinois, Iowa, Maine, Massachusetts, Minnesota, Missouri, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oregon, Rhode Island, Texas, Utah, Virginia, and Washington) to improve state and local capacity for conducting community health assessments.