Internal Revenue Service (IRS) regulations require tax-exempt hospitals to conduct a community health needs assessment (CHNA) and implement plans to address priorities every three years. Generally, community health assessment and planning approaches include some form of community participation. While the IRS regulations require hospitals to solicit input from governmental public health and representatives or members of medically underserved, low-income, and minority populations, there was wide variation in the types of stakeholders involved, level and intensity of involvement, and stages at which they were involved, during the first 3-year cycle in Texas. CHNA processes in Texas, under the draft IRS regulations, generally lacked meaningful collaborations with health departments, community-based organizations, and community members.
The findings suggest many hospitals engaged community stakeholders in certain aspects of the assessment process, but very few engaged a broad array of community stakeholder and community members in meaningful participation throughout the community health needs assessment and planning process. Practice implications included expanding community engagement and participation by stakeholder- and activity-type and using a common community health improvement model that better incorporates community participation and aligns hospital CHNA planning processes with other organizations and agencies. Recommendations were made for further research. The paper, A Mixed-Methods Approach to Understanding Community Participation in Community Health Needs Assessments, was published in Journal of Public Health Management and Practice.