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Developing Culturally Appropriate Needs Assessments and Planning 133

survey depends on survey design and on considering some of the cultural aspects
mentioned at the beginning of this chapter: Can the target population read and write
and if so, at what level and in which language? Do cultural preferences make the target
population more inclined to answer an oral interview or a written questionnaire?
The other methods of collecting primary data are group assessments conducted
through a focus group, nominal group, or community forum. Focus groups consist of
small groups of people (eight to twelve) who are asked preestablished questions
designed to elicit their opinions, perceptions, beliefs, and attitudes about one or more

topics. Nominal group technique is a structured process in which five to seven persons
representing a population of interest are asked to answer questions about specifi c needs
and to rank their responses according to what they consider the priorities for the popu-
lation they represent. The community forum brings persons from the target community
together to express their opinions and concerns on what they consider their priority
needs or problems. In all these three qualitative methods — focus groups, nominal
groups, and community forums — the discussion is guided by a trained and neutral facil-
itator, and all responses are recorded by other person(s); however, the results are not
generalizable (Doyle & Ward, 2001; McKenzie et al., 2005). These methods are most
appropriate for use with populations that are illiterate, have low levels of education, or
are inclined to an oral tradition. It is important to guarantee that participants ’ language

needs are met, that the facilitators and recorders are fluent in the language and dialects
that the group speaks and are familiar with the culture and local dynamics of the target
population. It is best to avoid mixed groups in which the participants speak different
languages because the use of interpreters will slow down the process and also the partic-
ipants might feel intimidated when they hear others speaking in another language they
do not understand. When dealing with low literacy, especially in migrant populations,
Pérez, Pinzon, and Luquis (1999) recommend (among other key issues) having group
members who are familiar to one another, using a small group, having single rather than
multiple data collection points, and selecting a homogeneous group.
Another method of collecting primary data, one often ignored by health education
professionals, is to do ethnographic work with the target population. This means going
out and, through direct observation and interactions, learning what the environment is
in which this population lives, what the local dynamics are, who the local leaders are,
and what kinds of issues affect them.
The method(s) selected will depend on the characteristics of the target population
and also on the resources, time, and expertise of the health education professionals.
A good general recommendation is to combine different methods and select those that
can provide a clearer picture than you had previously of your target population and of
its needs and also of its assets. To illustrate how this can be accomplished, the next
paragraph describes selecting the best approach for conducting a needs assessment of
Triqui immigrants residing on the northern California coast.
Because this population is a Mexican subgroup, using the traditional government
sources of secondary data (such as the Census Bureau, BRFSS, and so forth) will not
be the best approach. It will be more productive to search other types of sources, such

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