Community Health Needs Assessment (CHNA)

Cook Children's Center for Community Health conducts a Community Health Needs Assessment (CHNA) every three years to identify the health needs of children in our eight-county service area of Collin, Denton, Grayson, Hood, Johnson, Parker, Tarrant and Wise and determine or confirm community health outreach priorities for action. The center develops strategies for addressing targeted children's health priorities through research and provides an infrastructure that supports effective delivery of community and family services.

Cook Children’s Community Health Needs Assessment Methodology

How CHNA Findings Impact Outreach Strategies and Programming

The data collection and analysis for our most recent Community Health Needs Assessment are now complete. Please find our most recent CHNA reports and implementation strategies below.

View our 2024 CHNA

2024 Fort Worth Service Area Implementation Plan 2024 Prosper Service Area Implementation Plan

View our 2021 CHNA

Cook Children's Community Health Needs Assessment applies academic research standards for both primary and secondary data collection. For more information contact CHNAFeedback@cookchildrens.org.

Find our most recent CHNA Parent and Community Leader survey results by visiting our interactive data dashboard.

Our CHNA partners include

CHNA Administrator, Linda Fulmer
ETC Institute, Chris Tatham, CEO
MHMR of Tarrant County- Evaluation and Outcomes division
UNT Health Fort Worth

Information about our 2024 CHNA

Frequently asked questions about the CHNA

Cook Children’s conducts a Community Health Needs Assessment to collect comprehensive data about children’s health (ages 0 – 17) in our eight-county service region (Collin, Denton, Grayson, Hood, Johnson, Parker, Tarrant and Wise counties). The CHNA helps us fulfill our Promise by providing credible data that guides our strategies for preventing illness and injury to children. The CHNA also meets federal requirements for non-profit hospitals to focus community benefit strategies on the most critical health care needs in the communities we serve.

Suggested Citations:

For Parent/Caregiver Survey results only:
Parent/Caregiver Survey (2024). Cook Children’s Health Care System; Fort Worth, Texas; at https://www.cookchildrenscommunity.org/data accessed (month/year).
For all other CHNA data results:
Community Health Needs Assessment Report (2024). Cook Children’s Health Care System; Fort Worth, Texas; or Cook Children’s CHNA 2024 at https://www.cookchildrenscommunity.org/data accessed (month/year).

There are multiple obstacles to maintaining good health for many families, such as poverty, discrimination, lack of access to good jobs, quality education, housing, and safe environments. Addressing these obstacles requires a collaborative, community approach. One organization cannot act alone and be successful. Effective partnerships create a shared vision and increase the community’s capacity to shape outcomes.

With accurate information representative of the needs of a community, partners can increase understanding about children’s health and the factors that influence it, identify priority needs for community action, develop solutions to address priorities, and evaluate the results of their efforts.

Cook Children’s conducts a stratified random sample survey of parents/caregivers to ask questions about how various health issues impact their children and how easy or difficult it is to obtain care. We also conduct interviews with families to provide an opportunity for parents/caregivers to tell us about issues not included in the survey. In addition, we survey and interview community leaders to understand their perspectives regarding community needs and concerns. The CHNA includes health data from government and other reliable.

• Parent/caregiver survey.Administered annually to primary caregivers by a combination of mail, phone, or the internet to a random sample of 43,500 households representative of families with children ages 0–17 in the primary service area. The survey is available in English and Spanish. Our parent/caregiver survey is formerly known as CCHAPS
(Community-wide Children’s Health Assessment & Planning Survey).

• Face-to-face survey interviews. Parent/caregiver survey is available to a purposive sample of caregivers experiencing homelessness and/or caregivers in families with at least one undocumented member. The target for responses is a minimum of 150 caregivers experiencing homelessness and 50 undocumented participants.

• Family/caregiver interviews. Provide an opportunity for caregivers to share information not covered in the survey. Priority topics include: asthma, caregiver support, healthy lifestyles, oral health, mental health, injury prevention and overall health and well-being.

• Patient family interviews. Provide an opportunity for caregivers of children seeking health care in the service area and who speak a language other than English and Spanish to share their experiences navigating the North Texas health care system, identify obstacles to quality care and provide information on ways to enhance family-centered care.

• Community leader survey. A purposive sample of city, county, government, public agency/health, not-for-profit, school district and business community leaders working in the eight-county region receives an invitation to complete an online survey focused on the community impact of health issues.

• Community leader interviews. Community partners and program staff within the Center for Community Health help recruit participants based on their expertise and diverse roles within the community. The interviews provide an opportunity to collect firsthand knowledge about pressing issues or concerns in the community.

• Secondary data. Using four to eight sources for each of the eight priority geography areas to determine national, state, and if available, local trends.

Cook Children’s conducts a comprehensive Community Health Needs Assessment (CHNA)
every three years to understand the evolving health needs of children (ages 0–17) across our
eight-county service area: Collin, Denton, Grayson, Hood, Johnson, Parker, Tarrant and
Wise counties.

Everything we do at Cook Children's focuses on the Promise we've made to our community to improve the well-being of every child in our care and our communities. The CHNA helps us fulfill this Promise by providing credible data that guides our strategies for preventing illness and injury to children. The CHNA also meets federal requirements for non-profit hospitals to focus community benefit strategies on the most critical health care needs in the communities we serve.

Frequently asked questions about the parent/caregiver survey (formerly CCHAPS)

Parent/caregiver survey is the acronym for Community-wide Children's Health Assessment and Planning Survey. Parent/caregiver survey plays a key role in our Community Health Needs Assessment (CHNA) and is a household survey of parents and caregivers of children ages 0 -14 to assess the caregiver's perspective about children's health in our service region of Denton, Hood, Johnson, Parker, Tarrant, and Wise Counties. Our 2021 survey will also include Collin and Grayson Counties and has been extended to households with children ages 0-17.

Parent/caregiver survey was administered by ETC Institute on behalf of Cook Children's Health Care System.

All forms of research have limitations which is why methodology is especially important. Cook Children’s contracts with research experts to collect our CHNA data so that high standards of methodology are practiced, mitigating limitations as much as possible. Some limitations of our CHNA research include:

Survey provides the parent or caregivers perspective. Responses to this survey reflect the parent’s or caregiver’s point of view, and are descriptive, not causal. Parents may be unconsciously concerned that certain responses may not reflect well on their parenting practices, or they may not actually have first-hand knowledge of certain behaviors/situations. However, for the purposes of community education and awareness efforts it is sometimes helpful to know the level of knowledge respondents have on a particular issue.

Survey data is descriptive. Survey research is a descriptive research design since the questions are only asked once at a particular point in time. Therefore, while analysts may draw associations between variables when appropriate, conclusions about a cause-and-effect relationship require an experimental research design.

Family/caregiver and patient family interview findings are contextual. The sample size of families participating in interviews is considerably smaller than the parent/caregiver survey sample size. For this reason, the findings from these methods should serve as additional qualitative insight into the parent/caregiver survey findings rather than a statistically valid comparison. Limitations of interview methodology in general may also affect data quality.

The overall results for questions that are included on the survey for the random sample of households have a precision of at least +/-1.2% at the 95% level of confidence.

Margin of Error. How much error we can live with --the number of people who respond a certain way will always fall within a range of 1.2% less or more than the statistic quoted.
Confidence level. How sure we can be --if we repeat the survey 100 times, we would expect the same answer 95 out of 100 times.

The sample size is very large (6,000+) to ensure our data are representative of the diverse population within our region—representative in each county and representative for different race/ethnic groups, etc. Our sample is address-based and selected at random from households that are likely to have children under age 18. The number of households selected for the survey will initially be 5x the goal for each area. We also oversample respondents in hard-to-reach areas and less responsive demographic groups.

For comparison purposes, the 2022 National Survey of Children’s Health utilizes a representative sample size of 800 for the state of Texas.

We believe our data accurately reflect what parents report despite limitations inherent in all research. Sometimes there are logical explanations for why data doesn’t seem to reflect what we “know” to be true. Sometimes it’s easy to assume that the population in a particular work setting represents the total population of children. Our CHNA survey
is representative of all caregivers in the region with children ages 0 – 17 (not just those with a particular health issue or those with low incomes, etc.).

Contact us

For questions or information on our data, please email lauren.purvis@cookchildrens.org

Access free resources

The Center for Community Health is committed to providing free education and access to our data.

Resources Access our data

Community Health Needs Assessment (CHNA)

Our CHNA partners include

Frequently asked questions about the CHNA

About the CHNA

How does this data help our community?

How is CHNA data collected?

Methodology

What is a CHNA?

Why conduct a CHNA?

Frequently asked questions about the parent/caregiver survey (formerly CCHAPS)

What is CCHAPS?

Who administers the survey?

What are the limitations of the survey?

Precision and accuracy of the survey?

Is the sample size large enough?

Contact us

Access free resources