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Six strategic steps for conducting a situational assessment

Contents

I Introduction
II Six strategic steps for conducting a situational assessment
III Conclusion
IV Additional Resources
V References

-Submitted by Allison Meserve, Health Promotion Consultant, Health Promotion Capacity Building Services at Public Health Ontario  

I Introduction

Planning decisions often are made quickly and sometimes in the absence of a thoughtful analysis of the data available. A situational assessment is a systematic process to gather, analyze, synthesize and communicate data to inform planning decisions. Information from a situational assessment can be used to inform the development of program goals, objectives, target audiences, and activities. Situational assessments are carried out to:
Learn more about a population of interest (i.e., who's most affected by your health issue).

  • Anticipate trends and issues that may affect the implementation of your program.
  • Identify community wants, needs, and assets.
  • Set priorities.
  • Inform pending decisions regarding your program.
  • Help write funding proposals.

According to the Core Competencies for Public Health in Canada, all public health practitioners should be able “…to collect, assess, analyze and apply information…to make evidence-based decisions…and make recommendations for policy and program development.” [1]
        
II Six strategic steps for conducting a situational assessment

Situational assessment is the second step in Public Health Ontario’s (PHO) six-step model for planning a health promotion program. [2] As a situational assessment can be a large endeavor, we have simplified the process into six strategic steps.

Step 1: Identify key questions to be answered

The first step in a situational assessment is to determine what you need to know to inform planning decisions. Use the three broad questions and sub-questions below to shape the direction of the situational assessment and develop your research questions.

What is the situation?

  • What impact does the current situation have on health outcomes, quality of life and other societal costs, such as noise and air pollution or increased healthcare spending?
  • What groups of people are at higher risk of health problems and poorer quality of life?
  • What settings or situations are high risk, or pose a unique opportunity for intervention?
  • How do local stakeholders perceive the situation? What is their capacity to act? What are their interests, mandates, current activities?
  • What are the needs, perceptions and supported directions of key influential community members and the community-at-large?

What influences are making the situation better and worse?

  • What high-risk or negative health behaviours by various groups of people are affecting the situation?
  • What underlying causes or conditions are driving these behaviours (i.e., individual, community, organizational or system level causes)? Are there protective factors that can avoid or help to alleviate the situation (such as walkable communities or a strong parent-child relationship)?
  • What strengths and weaknesses are present in your organization that may affect your course of action? What opportunities and threats in your environment may affect your course of action?

What possible actions can you take to address the situation?

  • What are other organizations doing, or have done in the past, to address this situation? Specifically, what local policies, programs and environmental supports are being developed or implemented within the community? What evaluation data is available on these activities?
  • What evidence exists to support various courses of action (i.e., best or recommended practices)?        

Step 2 Develop a data gathering plan

The questions you develop in the first step will determine the data that you will need to gather. Too much data can become overwhelming, however you also want to develop a comprehensive plan.  Creating a data gathering plan will allow you to clearly organize the sources of data, tasks, and persons responsible. Try to ensure that your data gathering plan includes diverse: types of data (e.g., community health status indicators, environmental scans, or best practices); methods of data collection (e.g., surveys, document review, or literature review); and sources of data (e.g., partner organizations, community, or government) for your situational assessment.

Step 3 Gather the data

Now that you have identified your research questions, the next step is to collect the data. There are two types of data collection – primary data collection and secondary data collection.

Primary data is data that you and your situational assessment team collect yourselves, for example through surveys, key informant interviews or focus groups. If you are collecting primary data, it is important to make sure the people collecting the data have the right skills to do it properly. Spend time training your interviewers or observers to be confident they are collecting information correctly and consistently. Ensure that any primary data collection is conducted in an ethical manner, including a mechanism for informed consent.

Secondary data is data that has been collected by someone else, e.g., by the provincial or federal government, a researcher, or a partner organization. If you are carrying out a literature search, ensure that you document your search strategies, terms, and inclusion and exclusion criteria. It is also important to critically appraise the literature you find. The Critical Skills Appraisal Program (CSAP) has developed eight free and publically available critical appraisal tools [3] designed to be used when analyzing research. In addition, the National Collaborating Centre for Methods and Tools (NCCMT) has created evidence search pyramids [4] for major health areas including mental health, injury prevention and environmental health.

Step 4 Organize, synthesize and summarize the data  

The amount of data generated during a situational assessment can be overwhelming. One of the easiest ways to organize the information collected is to arrange the data by each of your original key questions.  For example, if your question was “What groups of people are at higher risk of health and quality of life problems?” organize the findings that answer this question together.

Other ways to organize your data:

  • Focus on the 20% of the information that conveys 80% of the most important findings (known as Pareto’s Law).
  • Use charts and maps (e.g., mindmapping [5]) to present visual representations of the information.
  • Divide each piece of important information by theme.
  • Split up the data among planning committee members. Ask them to review it with a few specific questions in mind, e.g., what priority population should be our focus?
  • Designate one person per research question. Have each person review all data, but look only for answers to their particular research questions.
  • Sort the data based on the relative importance of the source. Then, starting at the top of the pile, prioritize the data based on your time and resources.

In order to better understand your findings, you can use a PEEST, SWOT or Force Field Analysis. A PEEST (Political, Economic, Environmental, Social and Technological) analysis looks at external trends affecting the situation. A SWOT analysis or Force Field Analysis can help you determine facilitators and barriers to improving the situation.

If possible, summarize your findings in a paragraph or five to six bullet points. This will allow others to have a quick understanding of your results and can be used in any communication products that you develop.

Step 5 Communicate the information

A lot of time and effort has gone into your situational assessment. Make sure the results are not lost in a report! Colleagues, partner organizations and decision makers are all interested in your findings. Therefore, it is important to communicate the key findings to each of your stakeholders in a manner that is understandable to your specific audience.

Think about what information each of your different stakeholders needs to know, and how you can best convey it to them. One strategy is to develop a communication plan which includes your key audience, communication objectives, channels, and communication products. You can sometimes use the same communication products for different audiences – as long as their communication style and your communication objectives for these two audiences are aligned.
 
Step 6 Consider how to proceed with planning

It is now time to utilize your findings and decide on your next steps. Consider:

  • How do you perceive your ability to affect the situation with the available time, financial resources and mandate?
  • What are the gaps in data quality or quantity, relative to stakeholder expectations?
  • How might that restrict your ability to make evidence-based decisions about goals, audiences, objectives, strategies, activities and resources?
  • What are your next steps in the planning process? Will you proceed now, or must you revisit research questions, project scope or resources?    

III Conclusion

A situational assessment, although time consuming, is an important part of planning an evidence-informed program. The steps, highlighted above, simplify the process into easily manageable, strategic tasks.  If you’re looking to start a situational assessment, but would like to have further support or guidance, please e-mail Health Promotion Capacity Building Services (HPCB) at PHO at [email protected] to begin a consultation.

If at this time it is not possible to complete an entire situational assessment, you can think about how to include components of a situational assessment in your next operational planning cycle. An environmental scan of partners, key informant interviews or a focus group with clients can provide valuable information to aid in decision making.

Thank you to Laura Bellissimo and Kim Bergeron for reviewing an earlier draft of this document.

IV Additional Resources

Content for this feature was developed from the Online Health Program Planner (OHPP) [6] and the online Planning workbook [7]. The OHPP is an interactive tool that outlines the steps for planning an evidence-informed program. The section on situational assessments includes five downloadable worksheets.

Some sources of information to help determine community needs include Community Health Status Reports produced by public health units, Rapid Risk Factor Surveillance System (RRFS) [8], Canadian Community Health Survey (CCHS) [9], and the Public Health Agency of Canada (PHAC) Infobase. [10]

Analytic services at Public Health Ontario provides an interactive database, called Snapshots [11], using core indicators developed by the Association of Public Health Epidemiologists in Ontario (APHEO). The online dashboards provide information on indicators across Ontario and within public health unit regions.
 
Some sources of information on what evidence exists regarding interventions include the Canadian Best Practices Portal for Health Promotion and Disease Prevention [12] and Health Evidence at McMaster University [13].

Finally, HPCB will be hosting a webinar on situational assessments in April. More information can be found at: http://www.publichealthontario.ca/en/LearningAndDevelopment/Events/Pages...

V References
    
Public Health Agency of Canada. Core competencies for public health in Canada. Release 1.0. Ottawa, ON: Her Majesty the Queen in Right of Canada, represented by the Minister of Health; 2008; page 4. Available from: http://www.phac-aspc.gc.ca/php-psp/ccph-cesp/pdfs/cc-manual-eng090407.pdf   

Ontario Agency for Health Protection and Promotion (Public Health Ontario). At a glance: The six steps to planning a health promotion program. Toronto. ON: Queen’s Printer for Ontario. 2012. Available from: http://www.publichealthontario.ca/en/eRepository/Six_steps_planning_heal...

Critical Appraisal Skills Programme (CASP) [Internet]. Oxford: CASP UK; 2014; [cited 2015 January 27]. Available from: http://www.casp-uk.net/#!casp-tools-checklists/c18f8

Search pyramids [Internet]. Hamilton, ON : National Collaborating Centre for Methods and Tools; 2015; [cited 2015 Jan 27]. Available from: http://www.nccmt.ca/registry/view/eng/181.html

Mind Tools. Mind Maps: A powerful approach to note-taking [Internet]. London: Mind Tools; 2015[cited 2015 Jan 27]. Available from: http://www.mindtools.com/pages/article/newISS_01.htm.

Online health program planner [Internet]. Toronto, ON: Ontario Agency for Health Protection and Promotion; 2014; [cited 2014 Dec 2]. Available from: http://www.publichealthontario.ca/en/ServicesAndTools/ohpp/Pages/default...

Online planning workbook [Internet]. Toronto, ON: Ontario Agency for Health Protection and Promotion; 2014; [cited 2014 Dec 2]. Available from: https://secure.publichealthontario.ca/en/ServicesAndTools/ohpp/LearningC...

Rapid Risk Factor Surveillance System (RRFS) [Internet]. Oakville, ON: Halton Region Health Department; 2015; [cited 2015 Jan 27]. Available from: http://www.rrfss.ca/   

Canadian Community Health Survey (CCHS) [Internet]. Ottawa, ON: Health Canada; 2015; [cited 2015 Jan 27]. Available from: http://www.hc-sc.gc.ca/fn-an/surveill/nutrition/commun/index-eng.php

Infobase [Internet]. Ottawa, ON: Public Health Agency of Canada; 2015; [cited 2015 Jan 27]. Available from: http://infobase.phac-aspc.gc.ca/

Snapshots [Internet]. Toronto, ON: Ontario Agency for Health Protection and Promotion; 2015; [cited 2015 Jan 27]. Available from: http://www.publichealthontario.ca/en/DataAndAnalytics/Snapshots/Pages/de...

Canadian Best Practices Portal for Health Promotion and Disease Prevention [Internet]. Ottawa, ON: Public Health Agency of Canada; 2015; [cited 2015 Jan 27]. Available from:  http://cbpp-pcpe.phac-aspc.gc.ca/

Health Evidence. [Internet]. Hamilton, ON: McMaster University; 2015; [cited 2015 Jan 27]. Available from: http://www.Health-Evidence.org