Community Health Needs Assessment (CHNA)

Cook Children’s Community Health Needs Assessment Process


The data collection and analysis for our 2021 Community Health Needs Assessment are now complete. Please find our full 2021 CHNA report and implementation strategies here.

For more information contact Cook Children's 2021 Community Health Needs Assessment applied academic research standards for both primary and secondary data collection.


Our 2021 Community Health Needs Assessment utilizes the following methodologies:

  • Parent Survey (CCHAPS). Administered to primary caregivers by a combination of mail, phone, or the Internet to a stratified random sample of 25,000 households representative of families with children ages 0 –17 in the primary service area. Surveys are available in English & Spanish.
  • Face-to-Face Survey Interviews. Parent survey available to a purposive sample of homeless caregivers and/or caregivers in families with at least one undocumented member. The target for responses is a minimum of 150 homeless caregivers and 50 undocumented participants.
  • Focus groups or Case Studies. Provide an opportunity for caregivers to provide information not covered in the survey. Priority topics include: Abuse, Asthma, Dental Health, Mental Health, Obesity, Safety / Injury Prevention, COVID-19, and Access to 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.
  • Secondary data. Using from four to eight sources for each of the eight priority geography areas to determine national, state, and if available, local trends.

Our 2021 CHNA partners included

  • CHNA Administrator, Linda Fulmer
  • ETC Institute, Chris Tatham, CEO
  • University of North Texas Health Science Center - School of Public Health

Information about our 2021 CHNA

Frequently asked questions about the CHNA

CHNA is the acronym for Community Health Needs Assessment. Cook Children's conducts an assessment every three years to collect comprehensive data about children's health (ages 0-17) in our now eight-county service region (Tarrant, Johnson, Hood, Parker, Wise, Denton, Grayson, and Collin Counties).

Everything we do at Cook Children's focuses on the Promise we've made to our community to improve the health of every child in our region through the prevention and treatment of illness, disease and injury. 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.

Cook Children's conducts a stratified random sample survey of parents to ask questions about how various health issues impact their children and how easy or difficult it is to obtain care. We also conduct focus groups to provide an opportunity for parents to tell us about issues not included in the survey. The CHNA also includes health data from government and other reliable sources as well as a survey of community leaders. A children's art contest helps us better understand how children feel about their health.

There are multiple obstacles to maintaining good health for many families such as poverty, discrimination, lack of access to good jobs with fair pay, 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.