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Understand the principles of needs assessment, different types of community needs and analysis leading to prioritisation of health needs

Choose a setting such as a community, health service (e.g. hospital, primary health care service) or neighbourhood you know well in Australia.

Overview of Framework

In broad terms, an obese person is one who has excess amount of body fat in his/her body. Obesity is a risk factor for a range of adverse health complications. It is also regarded as a public health issue worldwide. Nearly 1.9 billion adults either come under the category of overweight or obese (World Health Organisation, 2017). The prevalence of overweight and obesity in Australia, is also regarded as a chief public health concern (AIHW, 2017). Government of Australia categorises the Australian youth as obese (aph.gov.au, 2018). The assignment is on Needs Assessment in public health of school-going youth in the City of Melton who are either categorised under overweight or obesity. An assessment of different types of needs (normative, expressed, comparative, felt, etc.) is conducted and prioritisation of findings is done. All the potential barriers for the needs assessment and ways to address them are also discussed. Next, a SWOT analysis, of the proposed program is mentioned. 

Overview of Framework 

Community needs assessment is done using a framework which has three elements; stakeholder analysis, community profile, and community consultation. All the three elements are integrated to inform the community and encourage engagement in collecting data and creating a program plan.

Stakeholder analysis 

For the purpose of consultation key stakeholders are identified which are principals and teachers of schools, parents, the school-going children, and Government and Private Agencies. These stakeholders are consulted so that significant insight can be gained into the concerns which contribute towards the problem and gain their support for the proposed program. The key stakeholders and their roles are enlisted in Table 1.

Table 1 Stakeholder Analysis

Stakeholders

Roles

Government Bodies: Federal Government of Australia, State Government of City of Melton, Department of Education, National Primary Health Care Development Agency and other local support agencies

The Federal and State government bodies can help in collection of data for the proposed plan. In addition, the government bodies at different level can aid the implementation of the plan at all the levels.

WHO, UNICEF, Public and Private School Authorities and community unions

Collaboration can be done so that most current data can be gathered as well as for resource mobilization and sharing results of the plan.

People and communities

Target group which is the school going children will come under this group along with the surroundings which directly or indirectly influence them. So, parents and teachers will also be included in the key stakeholders.

Health promotion services

Their role is to provide information and implement the plan effectively.

 

The community profiling assists in setting milestones, identifying research gaps, explaining the context and recognising the key stakeholders. The basic components of the community profile involve the people, place, community settings and current services. Since the target of this program is high prevalence of obesity among school going children, it is preferred that a mixed method approach is used for profiling the community. So, qualitative research methods that will be used are observations, focus groups, interviews and community forums. The quantitative research methods that will be used are current demographic and census statistics to find out the people, place and current services to identify the needs of the community.

Table 2 Community profile

Data type

Type of needs

Research Methods

Data source

People

(School-going children)

Demographics: age, religion, grade of education, socioeconomic status, health status, health and related service consumption, eating habits, obesity awareness

Comparative and expressed needs

Secondary Data and Community forum

AIHW, data from school and hospital,  community interview, health statistics, restaurants survey

Place

(City of Melton, Australia)

Community layout, household, school and community amenities

Felt, Normative and Comparative needs

Observations, local governments, health workers, Focus groups, interviews, Community forum and Literature appraisal

AIHW, , Interviews with local school members and health workers, ABS and literature search

Community organisations

Schools, health clinics, health promotion programs and interventions and market structure.

Felt needs

Focus groups, interviews, participant observation and community forum

Local governments, community interviews, interventions audits and surveys

Existing health services, resources and provisions

Governmental and Non-Governmental health services, community health policies and programs, Restaurant  chains, etc.

Comparative and felt needs

Focus groups, community forum and literature review

ABS, Australian Government data, surveys, community interviews and policies.

Community consultation will determine the distinctive needs of every stakeholder groups through community meetings.

Lack of strict policies from Government on minimization and prevention of childhood obesity

On Needs assessment, an absence of integrated effort from Federal Government, State Government, Department of Education and the City Council of Melton in either revising the past policies or formulating new policies to remove high caloric temptation and encouraging healthy food habits from school-going children. Like, subsidy schemes on purchasing healthy food items in the form of discounts can be done (An, 2013). Moreover, the fast food restaurants in the school proximity can be zoned by implementing local council bylaws (Nixon & Doud, 2016).

Stakeholder analysis

School authorities must place robust organizational policies for school canteen policies about vending of healthy food items at cheap prices and decreasing the availability of high calorific value items (Raulio, Roos, & Prättälä, 2010). School authorities also fail in planning and doing innovative obesity awareness sessions, classes and workshops. A lack of focus on obesity prevention in school modules, school newsletters and magazines is also identified. These issues are responsible for the ignorance about the consumption of high calorie food and disapproving. Moreover, a chance to raise awareness among parents is also missed.

As parents are not adequately and accurately aware about childhood obesity, they are not able to understand that their child is obese or overweight (Kruk, Kortekaas, Lucas, & Jager-Wittenaar, 2013). As they fail to detect the issue, they also fail to take required measures at home to guide their children regarding healthy food habits. Parental supervision is vital in reducing the prevalence of childhood obesity (Pandita, et al., 2016).

Apart from the personal preference of children towards junk food, it is also identified that the unhealthy food habits can also be attributed to the easy, abundant and cheap availability of such food items to the children (Seburg, et al., 2014).

Several communities showed low awareness and reduced health literacy rates among children and parents about the short and long-term adverse effects of consuming high calorie food.

Prioritisation process and the prioritised issues

The issues which were identified through needs assessment are prioritised. For effective prioritization of issues, analysis was done against 5 criteria which were cost-benefit ratio, benefit, feasibility, timeliness, population percentage effected. The five identified issues are scored out of 5 and the top issues impacting the prevalence of obesity was identified. The three chief issues were lack of strict policies from Government on reduction and prevention of childhood obesity, lack of awareness and poor school structure.

Challenges to proposed program plan 

Residents of City of Melton come from diverse background so the cultural barriers including communication and other ethnic challenges will cause a barrier in implementing the program plan effectively. The plan may receive opposition from the community due to various factors. For example, if implementation of an instore nutritionist is recommended, community may find issues such as lack of funding to hire staff, idea that customers would not be interested in having an in-store nutritionist), etc. The effectiveness of the proposed plan is also based on the availability and continuation of the funding over the long term.

Strength

· The program will assist in spreading awareness about the prevalence of obesity in youth and its adverse health risks complications in their subsequent life.

· The program will also decrease the Government healthcare expenditure by adopting a preventative approach.

Weakness

Collaboration among different bodies working at high to low level which becomes tedious and long process to manage.

Opportunity

The program will provide an opportunity to close the knowledge gaps identified during the needs assessment regarding the lack of knowledge about childhood obesity among parents and their consequent failure at the needed guidance. 

Threat

There is an uncertainty in Government plans which may result in poor community engagement and weakened or wrongful interpretation and acceptance of the proposed plan.

The program can be particularly used to lower the likelihood of chronic metabolic disorder which are linked with obesity among children in their later life. This aspect can be prioritized as it will provide an opportunity to close the age-group based health outcomes among the population of Australia.

Conclusion

The proposal plan will formulate a sound, community engaging action plan to address the issues that will be identified related to the prevalence of obesity among the youth of City of Melton. The developed project plan will decrease the prevalence of obesity in this community.

References

An, R. (2013). Effectiveness of subsidies in promoting healthy food purchases and consumption: a review of field experiments. Public Health Nutrition, 16(7), 1215-28.

aph.gov.au. (2018). Overweight and Obesity in Australia. Parliament of Australia.

Australian Institute of Health and Welfare. (2017). A Picture of Overweight and Obesity in Australia 2017. Canberra: Australian Institute of Health and Welfare.

Kruk, J. J., Kortekaas, F., Lucas, C., & Jager-Wittenaar, H. (2013). Obesity: a systematic review on parental involvement in long-term European childhood weight control interventions with a nutritional focus. Obes Rev, 14(9), 745-760.

Nixon, & Doud. (2016). Do fast food restaurants cluster around high schools? A geospatial analysis of proximity of fast food restaurants to high schools and the connection to childhood obesity rates. Journal of Agriculture, Food Systems, and Community Development, 2(1), 181-94.

Pandita, A., Sharma, D., Pandita, D., Pawar, S., Tariq, M., & Kaul, A. (2016). Childhood obesity: prevention is better than cure. Diabetes Metab Syndr Obes, 9, 83-89.

Raulio, Roos, & Prättälä. (2010). School and workplace meals promote healthy food habits. Public Health Nutrition, 13(6A), 987-92.

Seburg, Kunin-Batson, Senso, Crain, Langer, Levy, & Sherwood. (2014). Concern about Child Weight among Parents of Children At-Risk for Obesity. Health Behav Policy Rev, 1(3), 197-208.

World Health Organisation. (2017). Obesity and Overweight. Geneva: WHO.

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