The Claxton Elementary School Health Program was developed to improve the health of a school community in a western North Carolina city of 60,000. Using the principles of Community-Oriented Primary Care (COPC) in fall 1991, a health advisory board composed of interested parents, teachers, and physicians was organized. A comprehensive needs assessment was implemented, including focus groups with teachers and parents, a self-administered health behavior survey for children in grades three-five, and a self-administered survey of parents' health problems. Teachers, children, and parents agreed on perceived problems requiring attention. The Board then prioritized health problems, selecting nutrition and self-concept as the most critical areas in which to develop programs. Using target population members to identify needs can be a valuable approach to the development of community-based programs for improving children's health behaviors.