Conducting Needs Assessment Using the Comprehensive Participatory Planning and Evaluation Model to Develop Nutrition and Physical Activity Interventions in a Rural Community in the Mississippi Delta

Purpose

• • This article describes a successful partnership between researchers and a poor African-American community living in a small rural community in the lower Mississippi Delta. The two groups worked closely together on a multistage research project that had two aims. These were 1) To identify health problems related to eating and exercise habits within the community, and 2) To identify and rank possible corrective measures.

• • The partnership operated within a framework provided by a research method called the Comprehensive Participatory Planning and Evaluation (CPPE) approach. CPPE emphasizes the direct, active and ongoing participation of community members coupled with a focus upon root causes in addressing lifestyle-related health problems.

• • CPPE research efforts begin with assessments of the key problems. The initial assessments include the development of models to identify the fundamental causes of health problems in a detailed fashion. Only when these causes have been exposed, do participants proceed to identify, rank and choose interventions.

• • This article provides detailed descriptions of how this process unfolded in a rural community in the Mississippi Delta.

Recommendations for Policy and Practice

• • To maximize the odds of success, community members should actively join in the initial stages of planning for any nutrition and health interventions to be tried in their area. Such early, active participation offers major advantages over past approaches to research in which academics set the overarching agenda and only involved community members at later stages (as research subjects rather than as integral partners). Early and intense involvement of community members leads to a better, more appropriate agenda for the research project. The insights that only community members can bring to bear on their health problems also ensure that any attempted interventions are far more likely to prove workable within the community over the long term.

• • Participatory planning models (such as the CPPE model) provide a valuable step-by-step partnership process. Through such a process, researchers can work closely with ordinary people in both identifying the key health problems facing those people's communities and in selecting suitable interventions.

How Findings Support Recommendations

• • This study marks the first use of the CPPE approach within a developed country. Previously its use had been limited to communities in developing nations. CPPE provides a simple, straightforward process for the identification of nutrition and health problems and for the planning of appropriate interventions. By using this planning approach, academic partners readily engaged in a joint research study with citizens of a small, rural community, one rife with factors predisposing its residents to poor health.

• • The CPPE approach stresses the ability of local people themselves to best pinpoint the root causes of health problems afflicting their community. Its collaborative approach to the problem-identification phase of any research project sets the stage for the subsequent development of effective, sustainable interventions that can only arise from a deep understanding of a given community's needs and strengths.

• • Once they had defined their own three top problems, the local participants worked with their university partners to develop causal models for those problems. (The three were 1. intake of unhealthy food; 2. lack of knowledge about nutrition, and 3. inadequate physical activity.) The causal models provided a broad and deeply revealing perspective on each problem. Such a perspective fostered the development of potentially effective, sustainable interventions.

• • Community members exerted a great deal of control over the choice of the intervention approaches that were implemented. They did so through a systematic approach to ranking each proposed intervention strategy against criteria that they themselves had deemed important before the final choices were set.

• • This process stressed the use of community members' knowledge and inside understanding in planning interventions. The process also involved community members working with the academicians to create an objective framework for evaluating and choosing intervention approaches.