Green L W, Lewis F M, Levine D M
J Community Health. 1980 Winter;6(2):79-91. doi: 10.1007/BF01318977.
Survey content is necessarily limited by the investigators' foresight and by prior research on their subject of inquiry. Clinical data must supplement statistical data whenever the prior research is insufficient to delineate exactly what problems to expect. The differing perspectives on needs of patients sometimes set up competing demands. This calls for strategies based on a programmatic or population perspective that identifies the commonalities in patients educational needs from the statistical profiles, while at the same time allowing for the development of interventions that provide for as much tailoring of the educational experience based on clinical judgments as possible. By combining the community health education perspective with a clinical perspective, we were able to design interventions that responded to the educational needs of a population of low-income, black hypertensive patients. A needs assessment process that combined these perspectives began with a historical and community assessment of the problem in its most general terms. A second phase focused on the most important behavioral and organizational points for intervention. A third phase required formal assessment of predisposing, enabling, and reinforcing factors that may be determining the priority behaviors of health care organizational problems. Finally, clinical and administrative judgment sharpened and supplemented the educational interventions that were suggested by statistical data from formal surveys. Behavioral sciences theory was applied usefully in all these phases.
调查内容必然受到调查人员的先见之明以及对其研究主题的先前研究的限制。每当先前的研究不足以准确勾勒出预期问题时，临床数据就必须补充统计数据。对患者需求的不同观点有时会产生相互竞争的需求。这就需要基于规划或人群视角的策略，该策略从统计概况中识别患者教育需求的共性，同时允许开发干预措施，尽可能根据临床判断对教育体验进行量身定制。通过将社区健康教育视角与临床视角相结合，我们能够设计出针对低收入黑人高血压患者群体教育需求的干预措施。将这些视角结合起来的需求评估过程首先从对问题进行最一般的历史和社区评估开始。第二阶段侧重于干预的最重要行为和组织要点。第三阶段需要对可能决定医疗保健组织问题优先行为的诱发、促成和强化因素进行正式评估。最后，临床和行政判断对正式调查的统计数据所建议的教育干预措施进行了细化和补充。行为科学理论在所有这些阶段都得到了有效应用。
