Community health quizzes

Pataasin ang iyong marka sa homework at exams ngayon gamit ang Quizwiz!

The public health nurse is relocating to an area that is currently classified as a medically underserved region. Which situation will the nurse most likely encounter in this new position?

An area with a lack of medical care services as determined by the number of primary medical care healthcare providers per 1,000 population, infant mortality rate, percentage of the population with incomes below the poverty level, and percentage of the population 65 years or older

A 34 year old client is recovering from a below the knee amputation secondary to a motor vehicle accident. The nurse meets with the client to update the care plan, and client states that he knows he will walk again. He asks for physical therapy schedules and timeliness for prosthetics. Which attitude will the nurse determine the client is exhibiting by his behavior when considering the theory of reasoned action?

An enhanced ability to meet his goals on the basis of is intention and behaviors

Response to a disaster is in its final phase. Although still in the recovery phase of the response, an evaluation meeting is arranged. Which purpose is the team attempting to fulfill by planning this evaluation meeting?

Analyze the strengths and weaknesses of the response and submit a plan to improve response in the future

A high school graduate has decided to pursue a career in public health nursing. Which represents the minimum educational credential that this student will need to obtain entry into public health nursing practice?

Baccalaureate

During an ice storm, people in one neighborhood banded together and shared the home of a neighbor who still had power and heat. Other neighbors provided food, water and bedding. In another neighborhood the neighbors did not know one another and weathered the storm alone. Both neighborhoods are part of the same community. What characteristic did the people in the first neighborhood share that made them a subculture that those in the second neighborhood lacked?

Belief in the value of cooperation

The nurse prepares community program objectives that are specific, measurable, achievable, relevant, and time bound (SMART) to help in planning interventions and establishing measurement systems to evaluate programs and outcomes. Which measurable objective should the nurse prioritize?

Blood pressure for children aged 12 to 18 years in Marks School will be reduced by 5% after petting the dog for one day in March 2022

The nurse cares for many clients who have serious illnesses. Which client is the best candidate for hospice care?

Brain cancer who is expected to live three months and who is not pursuing aggressive treatment

The community health nurse meets with families of all types. With each family, the nurse takes the time to discover each member's place and function within the family structure. Which concept is the nurse utilizing with this action?

Predicting the type of family structure

The committee has established the need for a sick child clinic in an impoverished neighborhood. The demographic data have been collected and the committee is ready to meet with a group of local business people who are willing to support the project financially. The plan is for the committee and group to combine to facilitate the establishment of the clinic. Using a transtheoretical model, which level of readiness has the committee achieved?

Preparation

The local clinic is dedicated to the well adult and child. It has evening hours and offers varied programs for the community. The programs include immunizations and classes on fire safety, health education, and car safety, to name a few. How would the nurse best explain the level of prevention used in this setting to your colleagues?

Primary prevention

The nurse has recently been appointed to a community based advisory board of an agency that is interested in providing fiscally sound, high quality care for clients they decide will be their service population. Any profit margin that is acquired is reinvested in the operations of the home healthcare service. Which type of agency is this?

Private/voluntary

Primary, secondary, and tertiary levels of prevention help reduce risk, identify and limit disabilities, and reduce complications of mental health problems. Which exemplifies a tertiary prevention strategy for mental health problems?

Promote support groups for people with mental health disorders

Disciplines that Hospice pays for includes all of the following except

Radiologist

The public health nurse is visiting a new client who is being evaluated for a possible radiologic contamination. Which contaminant would the nurse expect to find is most likely responsible?

Radon

The nurse is preparing a research study on the number of heart attacks in the community and the number of individuals who are actively involved in exercise programs following a heart attack? Which gold standard for a research design should this prioritize?

Randomized control group

A public health nurse is curious if there has been an increase in the need for hospitalization among reported influenza cases. Which factor should the nurse prioritize for researching to answer this query?

Rate

Which duties were expected of community health nurses in the 1800s?

Report facts to and ask questions of physicians

The school nurse works with a 12 year old girl who is obese and has type 2 diabetes. As client advocate, which would be the most appropriate nursing action?

Schedule a conference with the client's parents to discuss how to collectively manage her blood glucose level and encourage her to select appropriate foods in the cafeteria for lunch.

The public health department is concerned there is an increase in violence among the children in the community. Which individual should the department involve in determining which children are most likely to be a victim or a perpetrator?

School nurse

Preventing intimate partner violence (IPV) and recurrence of violence requires targeting efforts at all three levels of prevention: primary, secondary, and tertiary. Which best represents a secondary prevention strategy?

Screening a client for evidence of abuse who has several risk factors for IPV

The nurse meets with a group of fellow nurses. They discuss the number of children who have died in hot cars and how likely they are to gain support from their state legislators to address the problem. Which step of the policy making process are these nurses prioritizing?

Setting an agenda

The community health nurse has limited time for family assessments because of demanding caseloads or staffing shortages. Which activity should the nurse prioritize that will acknowledge the family's strengths?

Share any genograms and ecomaps that illustrate relationships with family members

A nurse working in the rural Southeast United States sees many adolescent girls in the clinic. Which type of substance would the nurse anticipate most likely being misused among this demographic?

Sniffing glue

Demographic characteristics indicate that people in developed countries are living longer, healthier lives. Yet, tremendous health and social disparities exist. Which factor best represents these social determinants of health?

Social conditions in which people live and work

The nurse assesses a homeless adolescent who recently attempted suicide by drug overdose. Which risk factor should the nurse point out is most likely to influence this situation?

Social isolation

The occupational nurse is interested in assisting with lowering the incidents of injury among the local industries. Which injury has the highest incidence rate among occupational injuries and illnesses that result in days away from work?

Sprains

Several levels of public health surveillance are necessary to protect the nation's health. At what level do healthcare providers and health facilities report to for certain infectious disease?

State

The school nurse follows up with a third grader who was recently diagnosed with ADHD to make sure that he takes his prescribed medication. What type of medication would the nurse most predict this client is taking?

Stimulant

Three years after exposure to a virulent form of the flu, a population faces the same flu strain. The public health department determines that these are members of the population who have not been exposed to the flu strain. Which will the public health department predict will occur next?

The unexposed population is not likely to contract the illness

In a 15 minute family interview, after asking a question, the nurse pauses and remains silent while the grandmother, whose English is limited, replies to the question. The nurse makes eye contact with her and nods while she talks. When she is finished, the nurse asks a few follow up questions. Which principle is the nurse utilizing in this session?

Therapeutic conversations

A group of public health nurses are meeting to develop some goals for their community with the main goal of improving the health of their community. Which goal should this group prioritize to achieve this outcome?

To establish a free exercise program at a community center to promote fitness in a low income neighborhood with high obesity rates

The Hospice benefit pays for all of the following except:

Treatment using surgery

Each employee in a small community hospital is informed that he or she needs a tuberculin skin test and of the date the test is due. The kitchen employees tell the nurse that they don't need the test and never had to have it before. Which is the best response by the nurse?

Tuberculosis guidelines require testing of an entire healthcare setting

A nurse is coordinating an initiative in the community to make sure that the healthcare needs of local refugees and asylees are recognized and addressed. Which federal agency should this nurse prioritize contacting to assist with this effort?

United States Department of Health and Human Services (USDHHS)

As an advocate for leukemia research, the nurse along with many others succeeded in urging the US Congress to debate and vote on a bill that significantly increases federal funding for this research. Which system level would such an intervention address?

Upstream

The nurse conducts a community assessment. The community is large and the members range from affluent executives to poor migrant workers. Which approach will provide the most accurate assessment for this nurse?

Use multiple methods or perspectives

The public health team provides care to a community where several chemical manufacturers are located. Which concept should the nurses prioritize when working with these factories and their employees?

Use precautions to prevent contamination of the environment by new substances

The student nurse is creating a poster for a class project which will illustrate the Chain of Infection. Which item should the student nurse point out as a vehicle in this chain?

Water

The Ask Me 3 question strategy that patients can use when talking with their doctor includes all of the following EXCEPT

Who should I get a second opinion from?

Public health nursing is distinguished from other specialties by adherence to eight principles. Which principle will a public health nurse prioritize when providing care?

Will see the population as the client

A community care nurse at a healthcare agency assists in coordinating a plan for providing health services in the most cost effective way possible to a large number of members living in the region. Which type of work is this nurse exhibiting?

Care management

In 1975 the Education for All Handicapped Children Act was passed by Congress. Which impact did that act have on children?

Children with chronic or complex medical issues were entitled to a public education

The nurse conducts a study that will follow a group of subjects for two decades. It involves one group of subjects who have a risk factor for developing diabetes and another group who do not have a risk factor. The goal is to establish a cause/effect relationship between the existence of the risk factor and the occurance of diabetes. Which study design should the nurse prioritize?

Cohort

The community nurse has been involved with the local community for several years. Which type of assessment is this nurse utilizing as she keeps data which outlines the basic behaviors of the entire community during this time period.

Collaborative model, epidemiological model, functional health pattern

The nurse conducts biomonitoring of residents of a community exposed to mercury vapor from a manufacturing facility nearby. Which form of biomonitoring should the nurse prioritize to determine the exposure to this contaminant?

Collecting blood or urine

A nurse is comparing several research projects which have used in a prospective study approach. Which factor should the nurse most anticipate will be present in these projects?

Cross-sectional or prevalence designs, Descriptive study in which participants are enrolled before the health outcome of interest has occurred, Longitudinal type studies

The nurse is caring for a client who refuses the food as served. He states that the food is foreign to him and will make him ill. All food must be blessed. The personal care attendant is upset by this behavior and states that the client should eat the food anyway. Which is most likely the basis for the client's behavior?

Cultural belief

A class of nursing students is preparing to analyze the Healthy People 2020 to learn more about the goals related to decreasing intimate partner violence (IPV). Which injury prevention objective will this class discover?

Decreased incidents of homicide, child maltreatment and physical assaults

In researching the problem of homelessness in the city, the nurse discovers that the number of mentally ill homeless has steadily grown over the past couple of decades. Which reason can the nurse point out is most likely responsible for this situation?

Deinstitutionalization

The team of public health nurses is working to develop a plan which will evaluate a recent community-level intervention which they started. Which step should the nurses prioritize in developing this plan?

Develop evaluation questions

Nursing students in an enclosed classroom begin to become ill with a gastrointestinal illness. The public health department identifies this occurrence as an emerging epidemic and isolates the population that is ill. Which factor will become apparent among those who survive this disease?

Develop improved defenses against reinfection

A nursing student is preparing a poster of various theories which are utilized in creating changes in the healthcare system. Which will best illustrate the systems theory?

Father being challenged to stop smoking because his daughter learned of the hazards of smoking from a smoking cessation program at her middle school

The nurse has been provided with information concerning a new family and notes they consist of a nuclear family. Which family structure will the nurse anticipate finding when arriving for the first visit?

First degree relatives who live together

Clients respond negatively to the need for a yearly flu shot. They ask why the medical communities don't just create one shot that will last for several years. Which is the best response from the nurse?

Genetic changes make the flu virus resistant to the flu shot from year to year

The nurse decided to use a learning model based on Skinner with a client with diabetes to improve compliance with dietary and blood glucose assessment requirements. Which would be the best way to implement this program?

Give rewards for a lower blood sugar level and a food diary that reflects moderate dietary compliance

The nurse recently learned that more than 100 infants and children in the community have received vaccinations at the health clinic in the past month. These data are an example of which health indicator?

Health service coverage

The nurse assesses a 7 year old girl who has had problems at school lately with her behavior and mood. On a basis of the description provided by the child's mother, the nurse suspects either attention deficit/hyperactivity disorder (ADHD) or bipolar disorder may be involved. Which behaviors when occurring in all spheres of the child's life would most strongly suggest ADHD rather than bipolar disorder in this client?

Hyperactivity vs impulsivity

A public health nurse is preparing to conduct a force field analysis of local healthcare. Which factor is the nurse prioritizing in this process?

Identifying the forces driving the change and those resisting it

There are 12 students with confirmed cases of the H1N1 flu in grades 6 to 8 at the local middle school in the community. The community nurse advises the caregivers of the ill children to keep the children home for a minimum of 5 to7 days. Which should be the nurse's next step?

Implement education in the school setting regarding respiratory and hand hygiene

A family member receives Medicaid. Which factor would the nurse predict will most likely limit access of this person to healthcare?

Inability to find a provider who accepts medicaid

The occupational health nurse at a company has seen three different employees in 1 week who have all reported similar upper respiratory symptoms. Which rate should the nurse prioritize calculating to understand the severity of this problem and to determine whether a cluster or cohort is forming?

Incidence rate

The school nurse is concerned when a student presents to the office with chickenpox. The nurse determines that some of this student's classmates are most likely in which part of the infectious cycle?

Incubation period

The nurse notes a client arrives for an appointment who appears to have a severe upper respiratory infection. Which mechanism of transmission is the nurse most likely attempting to prevent by requesting this client to wear a mask while sitting in the waiting room?

Indirect contact

The nurse is approached by the health department to investigate and assess the rise in developmental disabilities in an isolated section in the community. To begin the assessment, the nurse should gather objective data from which source?

Integrate-aggregate data

The nurse provides care covered by Medicare fora client over two hours during the day , three days during the week, for 60 days. Which type of care is the nurse providing?

Intermittent

An older client is seeking a fourth refill on a prescription for benzodiazepines. The nurse is concerned that the client may be developing a tolerance for the drug. Which comment by the client would most confirm this concern?

Lately I've had to double up on my dose just for it to be effective

The nurse visits the home of a client in a low income community and notices that paint is flaking off the walls and forming a dust in the corners of some rooms. The nurse asks the client when the house was built, and she responds that it was built in 1959. Which contaminant should the nurse expect to find in this home?

Lead

A line operator in a manufacturing facility comes into the onside clinic reporting numbness in his hands after excessive exposure to the toxin benzene. Applying the epidemiologic triad to this scenario, which factor is most likely the host?

Line operator

The nurse performs motivational interviewing with a college student in the university health center regarding the student's history of binge drinking. The nurse hopes to ascertain the student's readiness to change her behavior and encourage her to make better choices related to alcohol use. Which actions should the nurse start the interview with?

Listening empathetically to establish trust

A client arrives at the clinic reporting diarrhea and flu like symptoms. On questioning, the client tells the nurse about a family gathering one attended recently where she had some smoked seafood. Which foodborne illness should the nurse most suspect in this client?

Listeria monocytogenes, Escherichia coli 0157:H7, or Campylobacter

The nurse helps a client who is a victim of intimate partner violence (IPV) with safety planning. The client worries about what to do if the partner becomes violent again. Which location should the nurse point out would be most appropriate if the client is at home?

Living room because there are windows

The nurse researches whether the community would benefit from monthly blood pressure clinics. Which system level would such an intervention address?

Mainstream

A client has been prescribed opioid analgesics. The client asks the nurse how long before the sedation will subside. Which is the best response from the nurse?

24 to 48 hours

A man who lives in a homeless shelter is diagnosed with active tuberculosis. The shelter keeps a list of those who are assigned beds and the majority of those sleeping there are regulars. Which finding would indicate a positive tuberculosis skin test using a two-step process?

6 mm induration

Patient X has a diagnosis of CHF and has been admitted to Hospice. What element of the hospice benefit will be difficult to meet?

6 months prognosis

The public health nurse works in New England during the winter months. An ice storm cripples the city, and electrical outages affect the power grid. Trees and frozen power lines are down throughout the city, and the timeline for restoration of power is seven to ten days. Which classification should the team prioritize of this occurrance?

A natural disaster

The nurse studies the association of lead poisoning with residence in a home that was built before 1970. Which needs to be established to show an association between theses two variables?

A statistical relationship between lead poisoning and residence in a home built before 1970

The nursing student is examining a table which compares the nursing process to the epidemiologic process. Which activity will the student discover is similar to the diagnostic phase of the nursing process?

A tentative hypothesis is formulated

The nurse works at a clinic in Arizona that provides bilingual (English & Spanish) care to low income immigrant workers from Mexico. Which designation most accurately describes the area or the population this nurse serves?

Medically underserved population

The Healthy People 2020 initiatives strive to improve the health of all individuals. Which group is the focus of special attention and creative solutions to counter the health disparities and social injustice against them?

Mentally ill people

The nursing instructor has completed a session exploring the various factors which can contribute to environmental health. Which is the most accurate definition of an exposure pathway for the students to provide at the completion of this session?

Method by which peiople are exposed to an environmental contaminant

The community health nurse is meeting with a client and caregiver, the eldest son. The nurse notes the son is spending approximately 15 hours a week at the parent's home to take care of various tasks. The son lives about 12 blocks away and has tow older adolescent children. Which action should the nurse prioritize in this situation?

Monitor the son for signs of stress and frustration

The nurse as a member of the emergency and disaster preparedness committee for an organization has the key responsibility to head the data collection subcommittee. What are the key areas that would be included in the plan?

Morbidity, mortality, mental health, and infectious disease

A group of nursing students are comparing the various changes in the morbidity and mortality data for the past 150 years. Which change should stand out in the morbidity and mortality rates from 1900 to the present?

Noninfectious diseases have formulated

The client is admitted to the hospital for new onset hypertension and chest pain. During the admission interview you ask the client if she takes over the counter medications and she states no. She adds she routinely visits a folk healer. Which response should the nurse then prioritize after learning this information?

Obtaining a list of the herbs and folk medicaitons that are taken and notifying the healthcare provider

The nurse is locating populations in the region who are exposed to lead based paint and providing them with information regarding the dangers of lead poisoning. Which intervention is the nurse prioritizing?

Outreach

The nurse is passionate about research for a cure for pediatric leukemia and has written to state representatives in Congress to urge them to expand federal funding for this research. Which area of involvement is this nurse prioritizing?

Politics

A client wants to know the best way to avoid STIs. Which actions should the nurse point out will help decrease the risk of becoming infected with an STI?

Abstinence

The nurse desires to become more involved with an organization that has not been created by the government. Which factor will set these types of organizations apart from other types?

Acquires resources to help others from private rather than public sources

A nurse is preparing a project for a local health fair. Which factor should the nurse prioritize when illustrating Smith's eudaimonistic model?

Actualization or realization of human potential

As a member of a disaster team, the nurse responds to a confirmed outbreak of the plague. The nurse understands that the pneumonic plague has a high mortality rate. Which action will best meet the needs of the public on a wide scale basis?

Administration of antibiotics via PODS

The case manager works with a 10 yer old girl who has asthma. Because the client's family has trouble affording inhalers, the case manager researches client assistance programs through which they could receive free medications. Which aspect of case management is this nurse portraying wit this action?

Advocacy

The nurse works with a female client who recently developed an infection of Staphylococcus Aureus while in the hospital. The nurse would determine that S. Aureus is which component in the Chain of Infection?

Agent

The nurse is trying to analyze the various factors within the community that impact health. Which risk factor should the nurse point out that is associated with overall health?

Air pollution

A woman arrives at the clinic for a routine appointment. She has been HIV positive for three years and states she is doing well. She currently is involved in a relationship with a man who is HIV positive. She states that she is not consistent with safe sex practices due to her significant other's preferences and feels uncomfortable asking him to wear a condom. Which is the nurse's best response to promote the client's health?

You will not be protected from other strains of HIV or sexually transmitted infections (STIs)

The nurse cares for a client who has a laceration on her arm and reports moderate aching, throbbing pain from the injury. Which medication should the nurse expect to be ordered first for this client?

acetaminophen

Pain at the end of life is complex and multifactorial, and prevalence varies according to diagnosis and other factors. How is somatic pain typically depicted?

aching, throbbing, or stabbing

A client arrives at the clinic shaky and requesting a refill on a prescription for alprazolam. The nurse suspects that the client might be experiencing substance withdrawal. Which comment by the client would most tend to confirm the nurse's suspicion?

"I ran out of pills a week ago and have felt sweaty and agitated ever since."

The nurse assesses a new client and performs a standard screening for intimate partner violence. Which is the most appropriate question to ask first?

"It is normal for couples to disagree about things. What happens when you and your partner disagree."

The nurse has reported to the triage center where a natural disaster has occurred. After triaging each victim to a category based on his or her wounds, which individuals should the nurse ensure are evacuated as soon as possible?

1

The community health nurse addresses cyberbullying in the local middle schools. Currently, there are no policies in place for this issue. Which is the most appropriate first step for the nurse to prioritize?

Explore current programs to prevent bullying and youth violence

In researching cases of West Nile virus in the community, the nurse explores how the interactions among people injected with this virus, mosquitoes and the environment they share contributes to outbreaks of this disease. Which epidemiologic model is the nurse prioritizing in this case?

Epidemiologic triad

The nurse has heard rumors in the hospital of an Ebola outbreak in the community and decides to investigate further. Which steps should the nurse prioritize when beginning this investigation?

Establish existence of the outbreak

The history of school nursing can be traced back to 1902, when Lillian Wald was working in a New York City public school. Which problem was she predicting would decrease by providing school nursing services?

Excessive absenteeism

Which factor could improve the transmissibility of the avian flu world wide (pandemic)?

Antigenic shift

The school nurse is kept busy at the school with the large population of students. Which individual health assessment would a school nurse most likely perform throughout the year?

Assessment of a playground injury

An immigrant form Guatemala, age 47, is admitted to the coronary care unit with congestive heart failure. This is the fourth admission for this client, and the healthcare provider believes that the client's inability to adhere to his diet and medication regimen is the reason for his frequent admissions. The healthcare provider refers the client to the local community health nurse, on discharge from the hospital. Which would be most appropriate for the nurse to include n this client's plan of care

Developing culturally relevant and gender sensitive interventions

A client diagnosed with hypertension is prescribed a no added salt, low fat diet. He agrees and repeats the teaching principles. At the next home visit, the nurse notices salted meat on the counter and the client shows the nurse his food diary. The diet in the past week does not reflect the healthcare provider's orders. What cultural component may have contributed to the noncompliance with the diet order?

Diet may not meet the cultural criteria for food choices

The nurse cares for a client in a community health clinic. The nurse is uncomfortable because the client remains very physically close when communicating. This discomfort makes it difficult to concentrate on the interview. Which concept will have occurred if the nurse backs away the client stops speaking and leaves?

Differing views of personal space

The community health nurse works in a low income country. The nurse's primary concern is to decrease the incidence of malaria. Which intervention should the nurse pursue.

Distribution of and education on the daily use of insecticide treated bed nets

A client has just been pronounced dead. Which action should be prioritized?

Don gloves

Primary, secondary, and tertiary levels of prevention help reduce risk, identify and limit disabilities, and reduce complications of mental health problems. Which exemplifies a primary prevention strategy for mental health problems?

Educate families and community groups about mental health issues, symptoms of stress, and barriers to seeking help

The occupational nurse is evaluating a work site. Which finding exemplifies a physical hazard at this location?

Electric & magnetic fields

A nurse is preparing to travel to Asia to assist with care of clients suffering from chloroquine resistant malaria. Which type of disease occurrence is this nurse becoming involved with if this disease also occurs in most African, the Middle East, and the South Pacific islands?

Endemic

The nurse assesses a 19 yer old client for alcohol use. Which would be the most significant risk factor for alcohol use disorder in this client?

Enrollment in college

The occupational health nurse for a computer manufacturer is required to conduct a physical examination of each new hire. Which is the primary rationale for this action?

Ensure the worker's fitness for the job

The nurse is maintaining a graph which depicts the distribution of Covid-19 cases by the time of onset of Covid-19. Which factor is this nurse creating with this graph?

Epidemic curve

The public health department nurses are concerned the community is experiencing an outbreak of Cryptosporidium. Which criteria must be met to define this outbreak as a water associated disease outbreak?

Epidemiologic evidence implicating drinking water as the probable source of the illness or Two or more people having experienced a similar illness after exposure to water.

The nurse is appraising the sources of funding for the local community health intervention program on smoking cessation. In the federal grant proposal, the nurse elaborates on all the various local organizations and private foundations that have pledged to support the program after initial funding from the grant ends. The nurse also points out the plan for ongoing fundraising efforts for the program for years to come. Which type of funding is the nurse attempting to organize?

Sustainability

A client presents with several ulcerative sores on his penis that are firm, round, and painless. He also has rough, reddish brown spots on his palms and the bottoms of his feet. He acknowledges that he is sexually active with multiple partners and is inconsistent in his use of a condom. Which sexually transmitted infection should the nurse most suspect in this client?

Syphilis

Four employees at a local restaurant have positive purified protein derivative (PPD) tuberculosis skin tests and have been diagnosed with latent tuberculosis. Which employee would the nurse predict to be at the greatest risk for contracting active tuberculosis disease?

Takes immunosuppressants

The nurse examines a client who is taking haloperidol for schizophrenia and notices that she habitually twists her tongue and arms. Which side effect should the nurse document in this client's record?

Tardive dyskinesia

The community health nurse learns that there are statistically high levels of obesity and elevated cholesterol in the community. In addition, the community has a disproportionately high number of fast food restaurants, compared with surrounding communities. Which would be the most appropriate next step based on these data?

Target education and support groups


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