Determinants of successful community health system planning.

Needs assessment and other community health planning projects are being conducted in many parts of the country. Whether these projects are successful, in that they lead to implementation of recommendations, has not been systematically assessed. This study describes how local public health officials in Iowa view the planning projects that were conducted in their communities. Planning projects occurred in over half of the counties in the state. Most were led by local public health agencies. Hospitals were participants in three-fourths of the projects. Successful implementation was associated with the number of planning techniques used and the breadth of representation on the steering committee. The most common recommendations related to the expansion of prevention/promotion services and community health nursing. Public health nursing had been integrated with local hospitals in one-third of the counties, with no reductions in performance.