Exam 2 Community Health: Chapter 6

Defining the community: location in space and time

-The "where" and "when" -Physical location frequently delineated by boundaries and influenced by the passage of time A community is an entity delineated by geopolitical boundaries

Defining the community: aggregate

-The "who" (the people) (a group) -Share personal characteristics and risks (common characteristics) Example: Members may share residence in same city; membership in same religious organization; or similar demographic characteristics such as age and ethnic background

Community assessment components: social systems

-health systems -education systems -religious systems -transportation systems -legal systems

Defining the community: Social system

-the "why" and "how" -interrelationships of aggregates (groups) fulfilling community functions

12 steps in a needs assessment process

1) Identify aggregate (group) for assessment 2) Engage the community (patient) in planning the assessment 3) Identify required information 4) Select method of data gathering (windshield survey, mail survey, etc) 5) Develop questionnaires or interview questions 6) develop procedures for data collection

Community health program planning, development, and management

1) Preplanning 2) Assessment 3) Diagnosis 4) Planning 5) Implementation 6) Evaluation

12 steps in a needs assessment process continued

7) train data collectors 8) arrange for a sample representative of the aggregate 9) conduct needs assessment 10) tabulate and analyze data 11) identify needs suggested by data 12) develop an action plan

A nurse is collecting data to identify health needs in the local community. Which of the following examples should the nurse identify as secondary data? (select all that apply) A) Birth statistics B) previous health survey results C) windshield survey D) community forum E) health records

A) Birth statistics B) previous health survey results E) health records

A nurse is preparing to conduct a windshield survey. Which of the following data should the nurse collect as a component of this assessment? (select all that apply) A) Ethnicity of the community members B) Individuals who hold power within the community C)Natural community boundaries D) Prevalence of disease E) Presence of public protection

A) Ethnicity of the community members C)Natural community boundaries E) Presence of public protection

A nurse is conducting a community assessment. Which of the following data collection methods is the nurse using when having direct conversations with individual members of the community? A) Key informant interviews B) Participant observation C) Focus groups D) Health surveys

A) Key informant interviews

One dimension of a community, which looks at personal characteristics and risks of a group, is called: A) aggregate of people. B) location in space and time. C) social system. D) census tract.

A) aggregate of people.

The steps in the community assessment process for community health nurses are: Select all that apply. A) writing a community diagnosis. B) evaluating the outcomes. C) collecting assessment data. D) identifying the cause of the problem. E) planning community interventions.

A) writing a community diagnosis. B) evaluating the outcomes. C) collecting assessment data E) planning community interventions.

Which of the following sources of information about a community's health would give the community health nurse information about births, deaths, and marriages and aid in providing indicators of population growth or reduction? A) Census tracts B) Vital statistics C) National Health Survey data D) Needs assessment

B) Vital statistics

A nurse is completing a needs assessment and beginning analysis of data. Which of the following actions should the nurse take first? A) determine health patterns within collected data B) compile collected data into a database C) ensure data collection is complete D) identify health needs of the local community

B) compile collected data into a database

Which of the following groups is an example of a community of solution? A group: A) that lives within a specific geographic location. B) concerned with reducing teenage suicides. C) with the same ethnic background. D) in which all members enjoy hiking.

B) concerned with reducing teenage suicides.

Epidemiologic data can be useful in the planning phase of the community assessment process because they: A) help discover the patterns of health and illness distribution in a population. B) help construct benchmarks to gauge achievement of program objectives. C) identify the aggregate at risk. D) explain the nature of the health problem.

B) help construct benchmarks to gauge achievement of program objectives.

Community health program planning, development, and management: Preplanning

Brainstorm ideas -gain entry into community and establish trust

Which of the following methods of gathering data is most effective for remote and vulnerable segments of a community and for those communities with underdeveloped opinions? A) Interviewing community informants B) Community forum C) Focus groups D) Telephone surveys

C) Focus groups

Identify the etiologic or causal statement component of the following community diagnosis: "There is an increased risk for undetected testicular cancer among young men related to insufficient knowledge about the disease and the methods for preventing and detecting it at an early stage as demonstrated by high rates of late initiation of treatment." A) Risk for undetected testicular cancer B) Young men C) Insufficient knowledge about the disease and methods of prevention D) High rates of late initiation of treatment

C) Insufficient knowledge about the disease and methods of prevention

When writing a community diagnosis, the community health nurse notes that the "among" phrase: A) presents a synthesis of all assessment data. B) provides the supporting data. C) specifies the aggregate that will benefit from the nurse's plan. D) describes the cause of the health problem and directs focus of interventions.

C) specifies the aggregate that will benefit from the nurse's plan.

Community health program planning, development, and management: Implementation

Carry out the plan

Community health program planning, development, and management: Assessment

Collect data (about community and its members) -assess availability of community resources

A nurse is planning a community health program. Which of the following actions should the nurse include as part of the evaluation? A) determine availability of resources to initiate the plan B) gain approval for the program from local leaders C) establish a timeline for implementation of interventions D) compare program impact to similar programs

D) compare program impact to similar programs

A community health nurse in the assessment phase of the nursing process conducted research to identify the distribution pattern of breast cancer within a population and the associated risk factors. This is called: A) statistical analysis. B) needs assessment. C) census collection. D) epidemiology.

D) epidemiology

One of the first steps in community assessment may involve the community health nurse driving or walking through an area and making observations about such things as environmental layout and location of agencies, hospitals, industries, and so forth. This is called a(n): A) census survey. B) needs survey. C) informant survey. D) windshield survey.

D) windshield survey.

Community health program planning, development, and management: Planning

Develop interventions -establish goals -identify who will assume responsibility for each intervention -develop a budget

What are informant interviews?

Direct discussion with community members for the purpose of obtaining ideas and opinions from key informants •Strengths: -Offers insight into beliefs and attitudes of community members

What are focus groups?

Directed talk with a representative sample

Community health program planning, development, and management: Evaluation

Examine the success of the interventions -evaluate strength and weaknesses of the program

Community health program planning, development, and management: Diagnosis

Identify and prioritize health needs of the community -Analyze data to determine health needs; develop priorities

What is participant observation?

Observation of formal or informal community activities

What is a community forum?

Open public meeting •Limitations: -challenging to get adequate participation

What are surveys?

Specific questions asked in a written format •Limitations: -low response rate -expensive

Nursing Process

The nursing process can be applied to the community as a client. •needs assessment •diagnosing health problems (actual and potential) •planning •intervention •evaluation

What is the primary concern of community health nurses?

To improve the health of the community

What is secondary data?

Use of existing data (birth statistics, death; census data; morbidity data; health records)

Windshield Survey

• Community vitality • Indicators of Social and Economic conditions • Health resources • Environmental conditions related to health • Social functioning • Attitudes towards health and health care

Healthy Communities

•A movement to help community members bring about POSITIVE HEALTH CHANGES •Interconnectedness between people and the public and private sectors is essential to make changes •Each community has its unique perspective

Defining the community (Textbook)

•Aggregate (a group/a selection) of people •Location in space and time •Social system

Assessing the community: Sources of Data

•Census data & other census reports •Vital statistics •NCHS Survey data •Local, regional, and state government reports •locally generated data collection -Analysis of demographic information provides descriptive information about the population

Community assessment components: People

•Demographic: -distribution, mobility, density, census data •Biological factors: -health and disease status, genetics, race, age, gender, causes of death •Social factors: -occupation, activities, marital status, education, income, crime rates, recreation, industry •Cultural factors: -ethnohistory, religion and spirituality, customs, language

Assessing the community: Windshield Survey

•Gain an understanding of environmental layout •Locate possible areas of environmental concern through "sight, sense, and sound" •Gives nurse an opportunity to observe people and their role in the community

Analysis of community assessment data

•Gathering collected data into a composite database •Assessing completeness of data •Synthesizing data and identifying themes •Identifying community needs and problems

Community Assessment Parameters

•Geography •Population •Environment •Industry •Education •Recreations •Religion •Communication •Transportation •Public services •Political organization •Community development or planning •Disaster programs •Health statistics •Social problems •Health manpower •Health professional organizations •Community services

Defining the community (ATI: Community assessment components)

•People •Place or environment •Social systems

Community Assessment Components: Place or Environment

•Physical factors: -geography, location of health services, housing •Environmental factors: -climate, topography, toxic substances, pollutants

Epidemiological studies used through the nursing process

•Support planning by establishing effectiveness of certain interventions in specific aggregates (groups) •construct benchmarks to gauge achievement of program objectives •compare data with other rates •identify objectives of successful programs •document effectiveness with epidemiological data

Assessing the community: Needs Assessment

•used to understand the community's perspective •interview key community informants •use community forums, focus groups, or surveys •12 steps in a needs assessment