In order to understand where we are going, we need first be aware of where we have been.

The Past...

Randolph County Health Department completed its first formal health needs assessment in 1996. The purpose of this assessment was two-fold: (a) to provide data to public health leaders and community stakeholders in order to identify and prioritize the health needs of the tri-county area, and (b) discover assets in the area available for problem solving. Through a better understanding of actual health needs, along with an understanding of the residents' perception of their needs, the public health leaders of the health department could better serve their community. The public health nurses, following the Community Health Assessment Resource Team (CHART) Model, utilized both quantitative and qualitative methodologies for data collection. Data sources were of two types: archival and communicative process. Data from the archival sources provided for a comparison among the surrounding counties as well as to the state of Missouri. The communicative process included various surveys distributed to community members to gather their opinions of the strengths and weaknesses regarding health issues in the county. After the data was gathered, the stakeholders were asked to select the three priority health issues and the populations to target. The stakeholders considered the following criteria when prioritizing the identified health issues: (a) number of persons currently affected or at risk, (b) quality of life, (c) public perception, and (d) preventability. The top concerns were identified as substance abuse among teens; lack of parenting skills; and chronic health problems among the middle-aged adults. The stakeholders selected substance abuse among teens as the county’s main priority and a decision was made to conduct yet another survey prior to developing intervention. The stakeholders felt that the specific information gathered from this wave of data collection would help guide the strategies as well as identify the targeted population.

In 1998, the survey Search Institute Profiles of Student Life: Attitudes and Behaviors was administered to 1,071 youth in grades 6th through 12th of the five school districts in the county. This survey contained 156 questions focusing on protective factors (assets) surrounding the student as well as at-risk behaviors that the student has experienced. The survey process revealed that only nine percent of our youth had the needed amount of assets in their lives to succeed. It further demonstrated that the fewer the assets in a youth's life, the greater number of at-risk behaviors in which the youth participated. Other startling statistics confirmed the earlier needs assessment results when looking at alcohol, tobacco use, sexual activity, and other at-risk behaviors. In 1999, the Randolph County Report Card was completed. This needs assessment consisted of a collection of archival data regarding environment, health, education, and economics, the Data was compared to Randolph County's baseline information from 1992 and was statistically graded on a scale of A through F, with A being the best. The only areas of improvement proved to be child mental health and communicable disease. In 2000, the Randolph County Health Department, in conjunction with Randolph County Caring Communities Partnership and Horizon Research Services, conducted the Randolph County Family Needs Assessment. This targeted population for this survey consisted of a purchased sample of listed telephone numbers of households that were likely to include children. In order to participate, the respondent had to live in Randolph County, have children age 17 years or younger living in the household, and be the primary caregiver. Questions were cross-tabulated by school district, the age of the respondent, the level of education of the respondent, and the age of the child about whom the questions were answered. A total of 412 individuals completed the survey. The survey centered around seven issues: (a) child care, (b) services for school aged children, (c) health care, (d) safety, (e) employment, (f) housing, and (g) community. The significant findings from this survey included a perceived lack of the following: • quality day cares and after school programs, • adequate law enforcement • access to dental care for adults and children, • eldercare, • substance abuse treatment providers. In addition to the above results, 79% of the respondents stated that a public transportation system was needed. An overwhelming 92% felt that an activity center for youth in their community was greatly needed. In 2002, the Search Institute Profiles of Student Life: Attitudes and Behavioral was repeated to establish trends in the youth of Randolph County in grades 6th through 12th. A total of 1,204 youth volunteered to participate. Mild improvement was noted since the 1998 survey.

The present... In 2005, Randolph County Health Department performed the Randolph County Health Needs Assessment 2005. This multi-step assessment began with a comprehensive review of archival data collected over the past ten years. The purpose for this compilation was to establish trend data which allows the viewer to determine if the need is improving, worsening or maintaining. The viewer is also able to project the possible outcome if interventions are not carried out. Data was collected in the following categories. • demographic • socioeconomic • environmental • safety • maternal and child health • infectious and chronic diseases • nutrition • health care systems and resources The next step in the process was to conduct a thorough analysis of the collected information. Community dialogue began with key community leaders and representatives from the Randolph County Health Department to determine the community's perception of the priority issues. Individuals attending the meetings included representatives from the areas of business, social service, health care, mental health, public schools, consumers, law, and the religious community. Together, these individuals make up the Randolph County Health Department Advisory Committee. The committee members evaluated the information by looking at the most prevalent disparities between the current Randolph County statistics and the county's past statistics, as well as comparing Randolph County to Missouri's statewide figures. Randolph County Priorities of the Future: Maternal/Child Health, Mental Health, Chronic Diseases and Safety.

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