Community Health-Task 1
APPLICATION OF COMMUNITY HEALTH & POPULATION-FOCUSED NURSING
Competency 7019.1.1: Epidemiology – The graduate applies principles of epidemiology to the assessment of the healthcare needs of communities.
Competency 7019.1.5: Environmental Health – The graduate assesses the impact of the environment on the health of the community.
Competency 7019.1.8: Cultural Competency – The graduate analyzes social and cultural factors that affect the care of diverse populations.
Introduction:
More emphasis is being placed on healthier communities as changes are occurring in the fields of healthcare financing, policy, and focus. One of the primary roles of a community health nurse is to assess the community or population in order to determine its health status in relation to its assets and needs.
Note: If you are a California student, please contact your course mentor.
Requirements:
A. Identify an appropriate community for which there is published data available (county, state, or national data) that will support the diagnosis.
B. Assess the health needs and risks of the identified community by utilizing the following tools:
Note: The collection of this data should include a variety of data sources, such as focus groups with older adults and/or youth, epidemiological data from the health department or department of vital statistics, investigations of community resources from stakeholders or faith-based organizations, and/or surveys. You do not have to answer every question listed in the assessment tools. Each of these tools can be found either in the web links section or as an attachment to this task.
• Population Economic Status Assessment
• Neighborhood/Community Safety Inventory
• Cultural Assessment Tool
• Disaster Assessment and Planning Guide
• Windshield Survey
• Population Health Scavenger Hunt
Note: The name of each of the six tools should be identified in the needs assessment summary, along with a brief summary of how each of the six tools was used in the needs assessment.
1. Interpret the collected data using concepts of epidemiology and health determinants (e.g., birth rate, death rate, rates of disease, morbidity).
C. Formulate an appropriate community diagnosis for the selected community by doing the following (suggested length of 4–6 pages):
1. Identify the top three problems for the selected community based on the Healthy People 2020 goals.
a. Discuss the problems in relation to the Healthy People 2020 goals.
2. Select one of the problems identified in part C1 that you would like to investigate further, and do the following:
a. Discuss community resources (e.g., Public Health Department, American Red Cross, American Heart) that are available to address this problem.
3. Formulate a primary prevention topic based on the problem you identified in part C2.
Note: See the attached “Approved Topic List” for guidance in formulating your topic.
D. Include all in-text citations and references in APA format.
Note: For definitions of terms commonly used in the rubric, see the Rubric Terms web link included in the Evaluation Procedures section.
Note: When using sources to support ideas and elements in an assessment, the submission MUST include APA formatted in-text citations with a corresponding reference list for any direct quotes or paraphrasing. It is not necessary to list sources that were consulted if they have not been quoted or paraphrased in the text of the assessment.
Note: No more than a combined total of 30% of a submission can be directly quoted or closely paraphrased from outside sources, even if cited correctly. For tips on using APA style, please refer to the APA Handout web link included in the APA Guidelines section.
File Attachments:
1. Approved Topic List
Approved Topic List: Choosing Your Field Project Topic with a Primary Prevention Focus
What is a Primary Prevention?
The Community Health Nursing practicum requires a field project. The project focuses on primary prevention. Primary prevention is the prevention of disease, injury, disability or premature death before they occur.
First Steps in Choosing a Field Project Topic
First, consider what might be an issue of public health concern in your own community. The pertinent questions to consider are:
• What is the biggest contributor to disease (morbidity) and premature death (mortality) in your community?
• What are the controversial community health concerns discussed in your local newspaper?
• What do you believe people in your community are most concerned about related to health?
• What is generating the most visits to the emergency room or hospital admission in your community?
• What do you believe is reducing the quality of life in your community?
Possible Topic Areas to Choose for Field Project
Access to Healthcare
• access to mental health services
• access to dental health services
• access to health services
Alcohol and Drug Use
• responsible alcohol consumption
• prevention of drug abuse, including
– IV drug use
– prescription drug use
Child Health
• prevention of neonatal mortality
• prevention of unintentional childhood injuries, including:
– sudden unexpected infant death (SUID)
– poisoning
– drowning
– motor vehicle related (child safety seat and seat belt use)
– sports related
– pedestrian related
• prevention of child abuse
• promotion of vaccination
Disabled
• promotion of health and well-being, including
– access to disability related services and devices,
– limit barriers to participating in home, work, school, or community activities
Disaster Preparedness
• prevention of adverse health consequences caused by natural and human caused disasters
HIV/AIDS
• prevention of HIV/AIDS, including
– sexual transmission
– prenatal transmission
– IV drug use transmission
Oral Health
• prevention of dental caries
Overweight and Obesity
• prevention of overweight and obesity through healthy nutrition and physical activity
Physical Environment
• promotion of healthy physical environment, including
– air quality
– land quality
– water quality
Seniors
• prevention of falls
• prevention of social isolation
• promotion of vaccination
Social Environment
• safe, affordable, quality housing (prevention of homelessness)
Tobacco
• prevention of tobacco use
• prevention of smoking
Unintentional Injuries
• prevention of workplace injuries
• prevention of motor vehicle related death/injuries
– prevention of pedestrian injury and death (includes bicyclists)
Violence
• prevention of domestic violence/intimate partner violence
• prevention of dating violence
• prevention of gang violence
• prevention of bullying/cyber-bullying
• prevention of suicide/depression
Women’s and Maternal Health
• prevention of unintended pregnancies
• lack of breastfeeding/promotion of breastfeeding
• promotion of vaccination
Resources to Start Your Topic Choice Process
• Task Force on Community Preventive Services
• Healthy People 2020
2. Population Health Scavenger Hunt
Population Health Scavenger Hunt
Visit 10 of the following facilities (within your city/county or just outside county):
? Women, Infants, and Children office (WIC)
? Health department
? Food Pantry
? Meals on Wheels
? Department of human/social services
? Fire Department
? Police Department
? Substance abuse facility
? YMCA
? Senior center
? Community center
? Domestic violence center/shelter
? Crisis child care center
? Homeless Shelter
? Emergency management director
? American Red Cross
? Mental health associations (i.e. NAMI: National Alliance on Mental Illness)
? Boys and Girls Club
? Planned Parenthood
? Chamber of Commerce
When interacting with these service providers in the community the following questions should be considered:
1. Their target population?
2. How they advertise their services to the community or target population?
3. Barriers to service?
4. What written information do they have for take-away?
5. Facility/agency appearance, both internally and externally?
6. Staffing presentation (i.e. appearance, attitude, knowledge of services, diversity)?
7. Language capability?
8. Referral process vs self referral?
9. Fees for services; payment options available?
10. Are they on the internet?
11. Access from all types of transportation options?
12. What services do they provide?
13. (Your Choice)
3. Windshield Survey
Community and Population Health
Windshield Survey
Directions:
This assessment is a foundational exercise for you to learn about your environment and
explore where you live. Take some time to intentionally explore your county. Look at your
county as the home and the place of work for the county residents.
While driving through your community, stop for coffee or have lunch in a neighborhood.
Find a place to eat where you can sit down as part of the community. You may want to walk
around your community as well so that you can explore it from both a driving perspective
and a walking perspective.
Once you have observed the area, write about your impressions of the county in your notes.
Reflect on any surprises and whether the county looks different to you now after taking the
time to note the various elements. What would you like to learn more about related to your
topic and population of interest? You may want to sketch a map related to your topic area
for future reference when writing your community description.
Take notes on the county using the following questions as a guide. These questions are only
to provide guidance; you may discover other areas that you want to note. Include your
findings in the community description section of your paper. You will use this information to
complete task 1 for your “Community Health and Population-Focused Nursing” course.
Collecting this data will help you define your population of interest and prepare for your
practicum experience. You may also want to reference these results in the resources and
partners section of your paper.
ELEMENT DESCRIPTION:
Housing and Commercial Buildings:
? How old are the houses and buildings in the community?
? What materials are the homes and buildings constructed from?
? Are all the houses similar in age and architecture?
? How would you characterize their differences?
? Are the houses detached or connected to each other?
? Are there solar panels? Windmills?
? Do the houses have space in front or behind them?
? What is the general condition of the houses and buildings?
? Are there signs of disrepair (e.g., broken doors or windows, leaks, missing locks)?
? Are there signs of neighborhood pride, such as well-tended yards?
? Is there central heating, modern plumbing, air conditioning?
Open space:
? Is the county primarily rural, suburban, urban, or a mix? How much open space is
there?
? What is the quality of the space (i.e., lush green parks or rubble-filled lots)?
? What is the lot size of the houses, lawns, and flower boxes?
? Do you see trees on the streets or a green island in the center of the streets?
? Is the open space public or private? Who uses this space?
Boundaries:
? What signs are there of where neighborhoods begin and end?
? Are the boundaries natural (a river, a different terrain); physical (a highway, a
railroad); or economic (differences in real estate or presence of industrial or
commercial units along with residential)?
? Do the neighborhoods have an identity or a name? Do you see them displayed? Are
there unofficial names?
“Commons”:
? What are the neighborhood hangouts (e.g., schoolyard, convenience store, bar,
restaurant, park, 24-hour drugstore)?
? What groups of people tend to gather at these hangouts?
? At what time do they typically meet?
? Does the commons area have a sense of territoriality, or is it open to everyone?
Transportation:
? How do people get in and out of the neighborhoods (e.g., car, bus, bike, walking)?
? Are the streets and roads conducive to good transportation and bicycle use and also
to community life?
? Are there major highways running through the county? Who do these highways
serve?
? How frequently is public transportation available?
? Are gas stations available?
? Are there train stations or light rail stations?
Service centers:
? Do you see social agencies, clients, recreation centers, signs of activity at the
schools?
? Are there offices of doctors, dentists, and other such services?
? Are there parks? Are these parks in use?
Stores:
? Where do residents shop (e.g., shopping centers, neighborhood stores, outdoor
markets)?
? How do they travel?
People out and about:
? If you are traveling during the day, who do you see on the street (e.g., an occasional
passerby, a father with a baby)?
? Do you see anyone you would not expect?
? Can you spot the purpose of those that you see, such as a door-to-door salesperson
or a postal worker?
? Is the dress of those you see representative or unexpected?
? What animals do you see (e.g., stray cats, pedigreed pets, watchdogs, birds, wild
life)?
Signs of community vibrancy:
? Is this neighborhood on the way up or down?
? Is it alive?
? How would you decide?
? Do you see any of the following: street vendors, trash, abandoned cars, political
posters, neighborhood-meeting posters, real estate signs, abandoned houses, mixed
zoning usage, people tending their yards, sidewalks in good repair?
Race:
? Are the residents primarily Caucasian, African-American, Asian, of another group, or
is the area integrated?
Ethnicity:
? Are there indications of ethnicity (e.g., food stores, churches, private schools,
information or signs in a language other than English)?
Religion:
? Of what religion are the residents?
? Do you see evidence of heterogeneity or homogeneity?
? What denominations are the churches, temples, and mosques?
? Do you see evidence of these religious facilities being used other than on days of
worship?
Health:
? Do you see evidence of acute or of chronic diseases or conditions?
? Do you see evidence of accidents, communicable morbidity diseases, alcoholism,
drug addiction, mental illness, etc.?
? How far it is to the nearest hospital? To the nearest clinic?
Politics:
? Do you see any political campaign posters?
? Is there a headquarters present?
? Do you see evidence of a predominant party affiliation?
Media:
? Do you see indications of television use such as satellite dishes?
? What magazines and newspapers do residents read?
? What media do you see being sold in the stores?
? What form of media seems most important to the residents (e.g., radio, television,
print, online)?
? What languages are represented in the various forms of media?
Physical Environment:
? Are there indications of an excess of certain types of activities, such as stores that
sell alcohol or fast food restaurants?
? What sorts of billboards are displayed and what do they indicate?
? Are there many cell phone towers or is cell phone access limited?
Web Links:
1. Cultural Assessment Tool– http://lrps.wgu.edu/provision/511120
2. Disaster Assessment and Planning Guide
http://lrps.wgu.edu/provision/511533
3. Healthy People 2020
http://www.healthypeople.gov/
4. Neighborhood/Community Safety Inventory
http://lrps.wgu.edu/provision/511195
5. Population Economic Status Assessment
http://lrps.wgu.edu/provision/511053
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