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The Affordable Care Act added requirements for nonprofit hospitals to conduct community health needs assessments. Guidelines are minimal; however, they require input and representation from the broader community. This call echoes 2 decades of literature on the importance of including community members in all aspects of research design, a tenet of community organizing.
We describe a community-engaged research approach to a community health needs assessment in New Haven, Connecticut. We demonstrate that a robust community organizing approach provided unique research benefits: access to residents for data collection, reliable data, leverage for community-driven interventions, and modest improvements in behavioral risk.
We make recommendations for future community-engaged efforts and workforce development, which are important for responding to increasing calls for community health needs assessments. (AmJ Public Health. 2016;106:841-847. doi:10.2105/ AJPH.2016.303050)
The Patient Protection and Affordable Care Act, enacted March 23, 2010, added new requirements for nonprofit hospitals to conduct a community health needs assessment at least triennially.1 Guidelines are minimal; however, they require that hospitals obtain input from persons who represent the broad interests of the community the hospital serves, including leaders, representatives, and members of medically underserved, lowincome, and minority populations and populations with chronic disease needs.2
This call for community engagement echoes 2 decades of public health efforts that articulate the importance of including community members in all aspects of research design, which is called "participatory research,"3 "participatory action research,"4 or "community-based participatory research."5 It has been argued that this approach is critical for understanding and reducing health disparities.6-9 This is particularly important because demographic shifts further complicate efforts to understand community health behaviors and needs,10 and national trends demonstrate that socioeconomic and ethnic disparities in health care access, quality, and outcomes are intransigent.11
Although it can be difficult to measure community engagement and its benefits, recent reviews have demonstrated evidence of the value of community-engaged approaches to research processes and outcomes. These benefits include
1. improved participant recruitment,
2. enhanced capacity among research stakeholders,
3. productive conflict resolution,
4. increased quality of outputs and outcomes,
5. increased sustainability of project goals beyond funding timelines, and
6. new projects and activities, including systems change.3,12
Moreover, community engagement can enhance linguistically and culturally appropriate measures, field testing, and survey administration.3,11
Implicit in participatory research practices...