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Development and Validation of the Primary Care Needs Assessment (PCNA) Questionnaire: A Participatory
Eleni Papakosta-Gaki1, Anastasia Zissi2, Andreas Tsounis3
1Laboratory of Primary Health Care, General Medicine and Health Research Services, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
Healthcare (Basel, Switzerland)
|May 27, 2026
Summary
A new questionnaire, the Primary Care Needs Assessment (PCNA), effectively measures community health needs by considering social and contextual factors. This tool supports better planning for person-centered primary health care (PHC).
Area of Science:
- Health Services Research
- Community Health
- Psychometrics
Background:
- Traditional primary health care (PHC) needs assessments often use limited biomedical or service-centered frameworks.
- These frameworks may not fully capture the complex, context-dependent nature of population health needs.
- There is a need for a more comprehensive and community-inclusive approach to assess healthcare requirements.
Purpose of the Study:
- To develop and validate the Primary Care Needs Assessment (PCNA) questionnaire.
- To create a participatory, multidimensional, and context-sensitive instrument for assessing unmet healthcare needs in PHC settings.
- To identify contextual determinants influencing health needs within communities.
Main Methods:
- Sequential mixed-methods design incorporating qualitative (focus groups, interviews) and quantitative phases.
- Item generation informed by PHC professionals and community members.
- Exploratory and confirmatory factor analyses (EFA, CFA) for psychometric validation on a large sample (n=817).
Main Results:
- EFA identified a 10-factor structure; CFA supported a refined 9-factor model with good fit indices.
- The PCNA demonstrated satisfactory internal consistency (Cronbach's alpha = 0.76).
- Significant unmet needs were identified in mental health, access to specialized services, and structural barriers (e.g., cost, distance).
Conclusions:
- The PCNA is a valid and reliable instrument for assessing multifaceted health needs in primary health care.
- It effectively captures individual, social, and contextual factors influencing health.
- The PCNA offers a practical tool for evidence-informed planning of responsive, person-centered PHC systems.
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