Section 10. Conducting Concerns Surveys

 

It's important to get input from members of the community when working on plans to address health problems or concerns. Actively soliciting the involvement of community members as the process begins and continuing to approach them for input can help them become more interested in your work and more likely to become actively involved. In addition to helping you recruit people for your cause, soliciting community input gives you valuable insight. One effective method for gathering this information is conducting a concerns survey.

What is a concerns survey?

Concerns surveys are a form of community assessment in which people are asked to help identify what they see as the most important issues facing their community. The results can be used to help form strategies to deal with problems and maintain the things that are working well. You can also use the results to rally the community around your cause. It's a useful tool for building consensus in the community.

For example, if you've done a concerns survey and concluded that 85% of the community members who responded think there aren't enough services for older adults in your town, you can then go public with this statistic to build support, increase community awareness, and get people involved in planning for increased services for older adults. Finally, the results can help set the agenda for community work that reflects people's concerns.

Concerns surveys can be used in community needs assessments to identify a community's unique strengths and needs.

Why conduct a concerns survey?

Inform your efforts to be sure pressing concerns are addressed. Additionally:

• It involves community members in the decision-making process early on, which increases their likelihood of getting and staying involved.
• It asks community members to define what they see as most important -- not just service providers and professionals.
• It is a systematic way to gather information and help build consensus.
• It helps coalition members and community members understand how they view their community.
• It provides a useful source of information and direction for initiatives, funders, and participants.
• It helps set the agenda for community work.

Who should you survey?

The survey should reach a broad and appropriate range of local people, especially those affected by the issues. If you want the results to reflect the community as a whole, pay attention not only to how many people respond, but also to whether the people responding represent the different groups and perspectives within the community. 

How should you prepare your concerns survey?

Give some thought before you begin to how many people you hope to reach, how you'll distribute the survey, and what sort of resources and supplies you'll need.

For example, you may want to consider:

• If you will use an online survey mechanism to collect responses,
• How many hard copies will be distributed, and what partners may be able to support distribution,
• Who will be able to help distribute surveys, collect responses, and tabulate the results

Put together a working group to design the survey

Since this is a community survey, it is important that community members help decide what issues are most important to ask about. We suggest you select 8 to 12 representatives from the community. If you're doing a statewide survey, you might want to assemble a somewhat larger group that represents different public agencies, geographic areas, and interests.

The working group will choose items for the survey. To help ensure that relevant survey items are selected, working group members should reflect the people and perspectives represented in the population being surveyed.

For example, if you are interested in general concerns across a community, you will want your working group to reflect the community's diversity. On the other hand, if you are only interested in the issues related to a specific system or organization (e.g., a hospital), you will include a representative group associated with it (e.g., nurses, doctors, patients, relatives). Characteristics to consider in forming the working group include concerns, race and ethnicity, income, sex and gender, age, educational background, employment, and living conditions.

To recruit working group participants, ask advocates, the local health planning council, or people who work for health and human service agencies if they know anyone who might be interested.

Once you've selected working group members, hold a meeting to brainstorm items to include in the survey. You may wish to send them the list of possible categories of questions (see the Tools at the end of this section) in advance so they can think about it ahead of time. If you do this, however, be sure to remind them that the final survey should be kept reasonably short and focused.

Invite selected decision makers to submit additional survey items

At this point, you may wish to invite key decision makers in your community to suggest additional survey items - probably not more than five total. People you may want to approach to do this include the director of the local health department, administrators of local social service agencies, elected or appointed city or county officials, business leaders, and representatives of the boards that make decisions about local funds such as United Way or the Community Development Block Grant Advisory Board.

You'll need to describe to them the process and the intent of the survey. Explain the survey process and why the survey is being done. Ask the decision maker if they have any particular topics or concerns they would like to have appear on the survey. If you can, adapt what's been suggested to what you've already got in the survey so as not to add any new survey items if at all possible.

Let the decisionmakers know when you expect the survey to be completed, and that you'll send them a copy of the final report. 

Prepare your survey

There should be two types of questions for every selected issue: how important the issue is, and how much satisfaction respondents have with the community's efforts on the issue. Items should be written as statements, not questions - for example, "Drug use is a problem in our schools" rather than "Do you feel drug use is a problem in our schools?" You might want to have both ratings listed side-by-side, as in the example below.

Example Questions	Importance	Satisfaction
	Not               Very	Not           Very
Affordable pre-natal care for all people who are pregnant in our county.	0    1    2    3    4	0    1    2    3    4
After-school recreation programs for adolescents in our schools.	0    1    2    3    4	0    1    2    3    4
Free transportation services for all community members with disabilities in our county.	0    1    2    3    4	0    1    2    3    4

 

Make up a list of questions. Things to ask about:

• Specific conditions: For example, air quality
• Services: Accessibility and affordability
• Skills: For example, whether people have the skills needed to obtain employment
• Programs: For example, quality early-childhood education programs

To make it easier to develop a survey, indices of properly worded items that can be included in the survey have been developed.

Here are links to several such indices that might give you some ideas as to how survey items should be worded and what sort of areas to cover:

• Basic Needs and Vital Services Index
• Community Health Concerns Index
• Neighborhood Concerns Index
• Concerns Survey - sample template

Now narrow the questions down. Try to keep the survey as short as possible - the longer and more complicated the survey is, the less likely people may be to complete it. Around 30 items may be workable in some settings, but the appropriate length depends on the complexity of the questions, how the survey is administered, and the people you are trying to reach. Demographic questions should also be limited to information you actually need.

Decide what type of demographic information (age, sex and/or gender, race and ethnicity, number of children, income, level of education, type of job, etc.) is important to include in your survey. Only ask for information that will help you understand the results or determine whether important groups were represented.

How should you distribute your concerns survey?

There are several strategies for distributing surveys. You may want to use a combination of methods so that people have different ways to participate.

• Go to where people are: Where are the people you are trying to reach already gathering? Where are they receiving services? Make the surveys available in waiting rooms in public places. Volunteers can help people complete surveys at community events. Set up a booth or table at your local library. This also provides some exposure for your organization.
• Mailings: You can directly mail the survey to people whose addresses are known. Good resources might be the public health department or relevant United Way agencies, when appropriate and permitted.
• Drop boxes: At agencies that have relatively frequent contact with community members, such as once a month, setting up a drop box in their offices may be a useful way to distribute and collect surveys. If you use this method, use at least one other method of distribution, because this only reaches people who are already accessing those services.
• Media distribution: For general distribution, publishing a link to a survey in the local paper or attaching a survey to your newsletter might be a good idea.

Examples of gatherings where you might want to distribute your concerns survey would include: immunization clinics, food pantries or commodity food distribution sites, health fairs, and meal sites for older adults. If you want to give your survey out at some sort of group meeting or gathering, get the group's director to put you on the agenda. At the meeting, introduce yourself and explain the purpose of the survey. Then distribute the survey, answer any questions, collect completed surveys, and thank everyone for their participation.

• Door-to-door canvassing: For people who have difficulty reading or using printed or online materials, or who may not be reached through agencies and public events, going to their homes may be an appropriate way to make participation possible. If your organization serves an area where some community members face literacy, language, disability, technology, or transportation barriers, door-to-door outreach can help make sure their concerns are included in your survey.

Collecting the surveys

Here are the steps you should take to collect your surveys:

• Gather incoming surveys collected at participating sites. A representative of your organization should collect incoming surveys as they arrive in the mail or your drop box. Call or stop by collection sites from time to time to pick up any surveys that have been dropped off.
• Review returned surveys. Check for incomplete surveys and decide in advance how incomplete responses will be handled in the analysis. If any mailed surveys were returned because of an improper address, try to find the correct address and mail it out again, if you can.
• Promote the survey on social media.
• Consider hanging flyers with QR code links to the survey in public places, like the library, coffee shops, and grocery stores.
• Send a reminder to people.
• Contact the local newspaper and request an article on the survey, submit a letter to the editor about it, or publish an announcement about the survey.
• Contact radio stations to run announcements inviting people to take part in the survey.
• Invite community members to participate in the survey through announcements online, in local agency newsletters, consumer group meetings, and public community events.

How do you analyze and compile the results of your concerns survey?

Once you've gathered the completed surveys, you'll need to summarize the importance and satisfaction reported for each item.

Let's say this question from the last example appeared on your concerns survey:	How important is this issue to you?	How satisfied are you with the community's efforts in this area?
	Not               Very	Not               Very
Affordable pre-natal care for all people who are pregnant in our county.	0      1      2      3      4	0      1      2      3      4
15 people answered this question. Here are the number of responses for each rating (e.g., in the first column, 1 person answered with a rating of 0, 3 people answered with a rating of 1, and so on)	1      3      2      5      4	2      6      4      2      1
Now, multiply the number of people who responded with each rating by the value of that rating (e.g., in the first column, 1 person answered 0, so that would be 1 x 0; 3 people answered 1, so that would be 3 x 1, and so on)	1 x 0 = 0 3 x 1 = 3 2 x 2 = 4 5 x 3 = 15 4 x 4 = 16	2 x 0 = 0 6 x 1 = 6 4 x 2 = 8 2 x 3 = 6 1 x 4 = 4
Add these figures up for each question. As you see, the numbers are 38 and 24. The overall possible score for each question is 60 (15 people responding x the total highest possible value of each question, which is 4).	0 + 3 + 4 + 15 + 16 = 38 (out of 60 possible)	0 + 6 + 8 + 6 + 4 = 24 (out of 60 possible)
Divide the total for each question by the total possible for each question, and this gives you your percentages.	38/60 = .63333, or 63.3 %	24/60 = .4, or 40%

 

What do these numbers mean? Well, you will need to look at the overall survey to see how each percentage compares with the others. Generally, you'll want to identify items with high importance ratings. Then, for each of those, look at how satisfied respondents are with the community's efforts in those areas. Strengths may be items that receive high ratings in both importance and satisfaction, while priority concerns may be rated high in importance but low in satisfaction.

The next step is to write up a brief report summarizing the strengths and concerns, as well as the overall pattern of satisfaction across items (an example of this sort of report appears with the other examples at the end of this section). In your report, identify five to ten strengths and five to ten priority concerns in your community. Look for any patterns by geographic area and sociodemographic characteristics, while being cautious about drawing conclusions from groups with very small numbers of respondents.

Ask yourself some of these questions in writing this report:

• Does your community have its core needs met?
• Do your available resources match your community's problems?
• Are there gaps in your community's resources?
• How can your community's existing services be better utilized to improve and promote the health and well-being of community members?
• What are the most important or pressing concerns? How should they be prioritized?

Share the above information with partners. Get their feedback and discuss whether any further surveying needs to be done before completing the report. Compare the characteristics of the people who responded to the survey with those of the community as a whole to see which groups may be underrepresented or missing. You may decide you need additional outreach or more surveys from particular parts of the community. 

What do you do next with the results of your concerns survey?

Doing a concerns survey is just one part of the concerns report method for community needs assessment. To fully use the concerns report method, you will also conduct a public meeting to share results, come up with some plan of action for addressing strengths and issues, and write a concerns report.

Conduct a public meeting

Set up a public meeting and invite members of the community to discuss the results of the concerns survey and suggest alternatives for preserving the main strengths and addressing the main problems that were identified.

At the meeting, review main strengths and problems that you compiled from the concerns survey. Being sure to take detailed notes, lead a separate discussion on the details of each important issue, focusing the discussion on these aspects:

• The dimensions of the issue
• Potential barriers to solving the problem or issue
• The alternatives that might be used to enhance the strengths or alleviate the problems
• Available resources

After the meeting, write up a one-page narrative for each issue discussed by the group. This narrative will make up part of the final concerns report.

Prepare a concerns report

A concerns report should be made up of a set of community concerns that can be used to set an agenda or guide action plans.

Your concerns report should consist of the following:

• Executive memo: one or two pages summarizing main strengths, problems, and ideas for improvements from the perspective of community members who participated.
• Brief report: one-page data report summarizing the importance and satisfaction ratings for the main strengths and problems and including a graphic display of the overall pattern of satisfaction in the community. This will basically be the same as the preliminary report that you made up upon finishing the surveys.
• Data table: a table displaying the ranking of all items by average satisfaction.
• Problem-solving discussion report: Summary in outline form of the discussion that took place in the public meeting. Each idea or issue that was discussed is summarized separately.
• Demographic data and other displays: Shows who has responded to the survey.
• Suggestions on how to use the report in the planning process