Oak Ridge Reservation: Health Needs Assessment Work Group

Health Needs Assessment Work Group

June 16, 2003 - Meeting Minutes

Needs Assessment Work Group Meeting (Continued)

James Lewis feels that this recommendation will help the group to remain consistent with past work group approaches. James explained that if the recommendation was adopted and an Ad Hoc committee was formed, the Ad Hoc findings would be submitted to the work group, the work group would vote, and the process would continue on to ORRHES.

Theresa NeSmith told the group that it is important that they understand that the focus groups, key resource interviews, and surveys were not separate studies and that all results were compiled together to develop the recommendations and the final report.

Kowetha Davidson stated that it is not appropriate to consider rejecting a document because you do not like the results. James Lewis apologized.

Donna Mosby said that she believes the work group is discussing two separate issues. One issue is providing feedback on the Needs Assessment document while the other issue is the recommendation to form an Ad Hoc committee. Donna then reminded the group that the purpose of tonight’s meeting is to provide feedback on the Needs Assessment document.

James Lewis reminded the group that the Ad Hoc recommendation is similar to the process that is in place concerning the PHA effort.

Kowetha Davidson responded to James Lewis and said that for the PHA, the work group members create individual comments and send the individual comments in so that the comments can be collated. Kowetha added that if the NAWG members would follow the same procedure for the Needs Assessment process, there would be a starting point for the comments.

Donna Mosby and Kowetha Davidson stated that they were under the impression that the individual members would come prepared to this meeting with a list of comments.

James Lewis said that he needs to study and review a document before he will provide comments. James believes the group should follow an approach similar to the recommendation for an Ad Hoc.

Donna Mosby commented that Needs Assessment feedback can not be provided when two different documents are being compared.

Kowetha Davidson stressed the importance of focusing on the Needs Assessment document and not the other documents that were listed in the Literature Review. Kowetha stated that the group needs to look at the methods used in the Needs Assessment document. The group needs to look at the Literature review and comment on whether the document adequately covered the literature to develop the results that are on page 25 of the Needs Assessment. Did Rebecca Parkin miss anything? Kowetha Davidson went on to tell the group that this document should not be compared to another document because they are apples and oranges. Rebecca Parkin could not go through and get each individual concern from each of the documents listed in the Literature Review. However, the group can critique whether or not the Needs Assessment encompassed each major issue of concern. Does the Needs Assessment use the other documents to pull in the broader picture? Kowetha added that for the Key Resource Interviews, questions such as: Did the report cover what it said it would? and Are the results in line with the methods? are all appropriate questions. Kowetha Davidson ended by saying that until the group has focus, the group will never get through the critique.

David Johnson told the group that James Lewis has been raising a concern about confidence and trust. David recommends that the group take the time to digest the Needs Assessment and learn what is going on in the community. David posed the question that if the NAWG or the ORRHES do not understand the Needs Assessment, how can the group sell it? David Johnson said that it is crucial that the group understand what is going on with the community as well as with the Needs Assessment.

Kowetha Davidson agreed with David Johnson. However, Kowetha reminded the group that the group must look at the Needs Assessment as an entity within itself. Kowetha went on to say that a person may not like the document or may not agree with the document but there is information in the Needs Assessment that must be considered. The group should keep its minds open to the document.

James Lewis started the conversation by telling Kowetha Davidson that he does not consider himself totally stupid. James then reminded the group that Theresa NeSmith had briefly discussed survey fatigue and burnout. James said that if a survey was completed during a time when burnout was not an issue and if that same survey contained more information than a survey completed during a period of survey burnout, he would prefer to use the information that was gathered prior to the burnout. Kowetha Davidson responded to James Lewis’s remarks by telling him that the data he is referring to is 10 years old. Kowetha also added that regardless of the previous data, the NAWG still has the Needs Assessment document.

Donna Mosby does not understand how James Lewis expects to fold the Report of Knowledge, Attitudes and Beliefs Survey of an Eight-County Area Surrounding Oak Ridge, Tennessee into the Needs Assessment. Donna said that reviewing this other report will not change the current Needs Assessment document. Donna Mosby wondered how a review of the Report of Knowledge, Attitudes and Beliefs Survey of an Eight-County Area Surrounding Oak Ridge, Tennessee will help with the Needs Assessment.

James Lewis said that there is nothing to change about a generic recommendation. James found detail in the Report of Knowledge, Attitudes and Beliefs Survey of an Eight-County Area Surrounding Oak Ridge, Tennessee . James Lewis stated that the Needs Assessment document is so generic that it is standard practice! Donna Mosby responded to James comments by saying that she feels that the work group should provide specifics to the generic recommendations.

Brenda Vowell told the group that they need to look at the Needs Assessment document as a cookbook. Strategies in the Needs Assessment will be used to develop an educational plan as it relates to the contaminants of concern that have an affect on public health. Brenda said that the Needs Assessment is not a bad document because it provides a cookbook. Brenda also said that an education plan cannot be developed until the specifics are known. Brenda feels that the current document will help the group get into recommendations for Phase II.

David Johnson said that he appreciates the correlation of the Needs Assessment to a cookbook. David said that the work group needs to slow down and learn the cookbook and the recipe.

Donna Mosby said that James Lewis’s idea is completely different than reviewing the cookbook. James Lewis responded by asking the group to please take the time to look at the Report of Knowledge, Attitudes and Beliefs Survey of an Eight-County Area Surrounding Oak Ridge, Tennessee .

Kowetha Davidson told James Lewis that he cannot ignore the Needs Assessment and that he should not make comparisons because comparisons can lead to trouble.

Donna Mosby posed the question of what should be done with the Needs Assessment document. James Lewis replied that ATSDR can look at the document and decide. James is more concerned about information going to the public and thus the public’s interpretation.

Donna Mosby feels that James’s concern is a separate issue from the work group’s task. Donna feels that there are now two separate tasks involving the Needs Assessment. The first task is provide feedback on the draft of the Needs Assessment. The second task is related to the recommendation.

James Lewis told the group that he feels the Report of Knowledge, Attitudes and Beliefs Survey of an Eight-County Area Surrounding Oak Ridge, Tennessee is more statistically valuable than the Needs Assessment. Donna Mosby then suggested that James make comments specific to the document that he considers to be quantitative.

James Lewis stated that the end recipient of the Needs Assessment is ATSDR and those who implement the Health Education plan. If the work group does not get information into the current step, the group will have missed its opportunity. James Lewis feels that if the work group or a member of the work group has relative information, it is crucial that the work group looks at the data and provide their input.

Kowetha Davidson told the group that they cannot compare the Needs Assessment document with the Report of Knowledge, Attitudes and Beliefs Survey of an Eight-County Area Surrounding Oak Ridge, Tennessee because of focus group differences. One organization could target specific people for the focus groups and the other could not.

James Lewis needs to know what will help guide future actions. James still feels that the way to do so is by looking at the Needs Assessment and the sources that were reviewed.

Kowetha Davidson told James Lewis that GWU used the documents as background information and not as part of data. Kowetha added that it is common policy to review literature when doing research. James Lewis then asked Kowetha if researchers ignore the data that they review. Kowetha Davidson told James that Rebecca Parkin did not have to take the document and use it. Kowetha suggested that James look at the literature review and the results to see if there is something that was not referenced. Kowetha added that if James does not feel that the information from the Literature Review was used, then that is his comment.

James Lewis reiterated that before formulating an opinion about the Needs Assessment, he would like the work group to establish an Ad Hoc committee to review the documents and see how they were used in the Needs Assessment.

Kowetha Davidson and Donna Mosby both feel that some people in the group are distracted and are moving away from the task. James Lewis wanted to know what the task is.

Donna Mosby said that the task is to provide feedback on the Needs Assessment. Donna thought that each member would have reviewed the document over the weekend and generated a list of comments. Bill Taylor asked Donna about the type of feedback that she is looking for.

Donna Mosby told the group that she is looking for feedback about the Needs Assessment so that the group will be able to direct specific questions to Rebecca Parkin. Donna Mosby provided the group with some sample questions that she feels came out of the previous NAWG meeting. For example, the group could ask specific questions about the Summary page; questions as to how the Needs Assessment can be folded into the PHA; questions about how the Needs Assessment can be used to help with other tasks; also, specific questions and concerns about the focus groups could also be asked. Donna told the group that they can ask specific questions and then make recommendations based on Rebecca Parkin’s answers.

Bill Taylor commented that he feels that the group should be giving feedback to ATSDR and not Rebecca Parkin. Donna Mosby replied to Bill Taylor that the group wanted to ask Rebecca Parkin questions to help formulate feedback that the NAWG would provide to ATSDR through the ORRHES.

Kowetha Davidson has comments about the Action Plan portion of the Needs Assessment. Kowetha pointed out that beginning on page 57, under section C, the bullets are confusing. Kowetha would like to see the bulleted items be stated more clearly.

Bill Taylor added that he feels he would have understood the project plan better if the action plan was not generic. Bill feels that the Action Plan proposed in the Needs Assessment is not an action plan at all; the Needs Assessment Action Plan should be much more detailed. In fact, Bill Taylor stated that he feels the Needs Assessment is incomplete because it proposes to present an Action Plan but it does not.

Both Bill Taylor and Kowetha Davidson cannot see the connection between the Results section, the Action Plan section, and the Recommendation section of the Needs Assessment.

David Johnson observed that a laundry list of concerns about the Needs Assessment has been created. David feels that the reason for this list is because the group does not understand what is going on. David Johnson posed the question of how can the NAWG rationally provide feedback to Rebecca when the group does not understand what is going on. David also wanted to know where the NAWG comments will go. Donna Mosby stated that the comments will go to ATSDR.

David Johnson said that GWU is the subcontractor so he understands that ultimately the comments will go back to ATSDR. However, David wants to know who the ORRHES will go back to if the group is not satisfied with the product. Would the group go back to the general contractor, ATSDR or the subcontractor, GWU?

James Lewis stated that the purpose of the Needs Assessment document is to help clarify things and to tell the group how to present information. The Oak Ridge Needs Assessment document does not accomplish its purpose. James received applause for his comment because it was a comment that was specific to what Donna Mosby perceives as the task at hand.

Kowetha Davidson and Bill Taylor stated once again that the Action Plan in the Needs Assessment needs to be more specific because it is difficult to see how the Needs Assessment goes from A to B to C.

James Lewis wants to know what the group needs to do to clarify the document for ATSDR. James Lewis believes that the group should not be doing this type of work for ATSDR. James Lewis would like to know if the Needs Assessment is acceptable to ATSDR.

Kowetha Davidson believes that ATSDR’s opinion should not be stated because the NAWG still needs to create a list of comments.

Donna Mosby said that it is clear that ORRHES asked for the responsibility of reviewing the Needs Assessment. Theresa NeSmith concurs with Donna Mosby in that the Subcommittee wanted the opportunity to review the document.

Kowetha Davidson stated that the research is done and the results are in and like it or not, the group cannot change anything from the surveys or the key resource interviews.

Donna Mosby summarized that the group feels that the Action Plan portion of the Needs Assessment needs to be reviewed because the group does not feel that it is a plan. The group also has questions about the Summary page of the Needs Assessment as well as questions about the Recommendations portion of the Needs Assessment. Donna feels that the NAWG can ask Rebecca Parkin about these types of issues when she is on the telephone.

The group decided that the next NAWG meeting will be held on June 30, 2003 in the Field Office at 6:00 p.m. The purpose of the next meeting will to bring individual specific concerns and questions so that a larger list of concerns can be developed to be used in the July 7th call with Rebecca Parkin.

The group decided that the NAWG will have a discussion with Rebecca Parkin via telephone on July 7, 2003 from 7:00 p.m. to 8:30 p.m. The discussion with Rebecca will be strictly about concerns relating to the Needs Assessment. Prior to meeting with Rebecca Parkin the NAWG will have developed a list of concerns and the list of concerns will lead the July 7th discussion.

Regarding the Recommendation by James Lewis, it was decided that each member would take home a copy of the recommendation and think about the outcome of the approach and what the approach should accomplish. Action regarding the recommendation will be taken at the end of the June 30, 2003 meeting.

The meeting was adjourned at 9:00 p.m.