Designing and Implementing a NORC Program
Guiding Principle # 4
A NORC program drills down to identify the component parts of a problem and to set priorities for action.
Actions and Considerations
Learn more about the challenges and risks in your community. Building on data from earlier surveys, interviews, and community forums (see Understanding the Community), assess the scope, contributing factors, and underlying causes of the problems in your community in greater detail. One tool is the Health Indicators survey, which can be used to identify the risks of health problems and social isolation, measure service use, and manage chronic conditions.
With input from your partners and other stakeholders, be sure that you know:
- What has happened before in the community, what has worked, and what has not.
- Results of earlier studies or the track record of activities conducted in communities similar to your own.
- Experiences with any projects previously undertaken by your NORC program.
Set priorities and maintain focus. Ultimately, the issues you choose to emphasize depend on your mission statement, priorities, and information-gathering processes.
Strategic considerations may be relevant as well. Some programs choose to tackle findings with urgent implications for resident health first. For example, the Deepdale CARES NORC program, in Queens, New York, was concerned about emergency room usage due to falls; and the Lincoln Square Neighborhood Center, in Manhattan, New York, took on hunger among its residents. But seeking an easy win to create buy-in and a sense of accomplishment among stakeholders is a legitimate first step, too.
Develop a clear problem statement. A problem statement is a brief summary of the problem in a community, its causes, and whom it affects.
- Identifying the problem tells you what needs to change—for example, high rates of emergency room usage.
- Identifying the cause tells you how change can be achieved—for example, high ER use may be caused by falls, poorly managed chronic conditions, or a lack of access to primary care.
- Identifying the affected population tells you who needs to be included in the project’s activities—for example, the senior residents of a NORC.
To gain buy-in, developing a problem statement needs to be an inclusive process, with input and feedback from your partners and other stakeholders. A clearly specified problem statement will serve as a road map as you design and implement a specific project. Be sure to consider all of its underlying causes—for example, age, medication, physical limitations, and the environment often combine to increase the risk of falls. Each factor contributing to a problem may have to be addressed separately.
Crafting your problem statement is the first step in the logic model, which is a useful tool for program design and evaluation.
Keep in Mind
Seniors vote with their feet. If they are involved early and believe the problem you have decided to address is real, they will be powerful allies. If not, they simply won’t participate. Make sure that their voices are heard and that the issues you take on are ones they care about.
Good planning helps you to stay focused and proactive in responding to identified concerns.
A NORC program needs to keep deepening its knowledge of the community to stay current with its challenges. The findings accumulated during the Understanding the Community phase are necessary, but they may not be sufficient.