NURS 340: UNIT 1 - Community as a Client

What makes a group of people a community?

They form a specific population with shared or defined characteristics and live within a particular geographic area.

A community is being described by its members’ ages, income, and occupations. Which dimension is being examined?

People.

A community is defined by its county or ZIP code. Which dimension is being examined?

Place.

A group is identified by what it does, such as nursing students learning together or a workplace pursuing shared goals. Which dimension is being examined?

Function.

A community is defined by city or county boundaries. What type is it?

Geopolitical community.

A group is connected by a shared interest, goal, or common bond, such as a church or workplace. What type is it?

Phenomenological (functional) community.

Residents form a group to address a shared problem in their area. What type of community is this?

Community of solution.

A nurse identifies all elderly residents in a county as a subgroup sharing a characteristic. What is this called?

An aggregate.

A nurse selects elderly residents with hypertension in Baton Rouge for a BP screening program. What is this called?

A target group.

A community has the resources and support needed to meet its residents’ needs. How would you describe this community?

A healthy community.

A community has unsafe drinking water and poor sanitation. Which factor is affecting its health?

Environment.

A community lacks parks and recreational spaces for physical activity. Which factor is affecting its health?

Public services.

A city passes a law restricting smoking in public places. Which factor is influencing community health?

Policies.

A low-income community has fewer healthcare and community resources and more health problems. Which factor is most likely contributing?

Economics.

A nurse reviews HTN rates, mortality rates, and crime statistics to assess a community. Which component is being assessed?

Status.

A nurse examines who lives in the community and what healthcare services are available. Which component is being assessed?

Structure.

A nurse evaluates whether residents communicate, support one another, and participate in health initiatives. Which component is being assessed?

Process.

A PHN works with local organizations to address a community’s health challenges rather than focusing only on individual patients. What is the PHN’s main focus?

The collective health of the community.

A PHN notices a community lacks accessible health services and sanitation resources. What should the PHN do?

Use community strengths, collaborate w partners, & help develop services that address those needs.

Why can an intervention aimed at one person still be important to the PHN?

Improving individual health can ultimately improve the health of the entire community.

A PHN observes how residents respond to a community program & uses those observations to plan future services. What is the PHN doing?

Identifying future services based on community needs & responses.

A nurse uses community data to plan interventions for an entire population. Is this more characteristic of a PHN or bedside nurse?

PHN.

A nurse uses clinical data to provide direct care to one hospitalized patient. Is this more characteristic of a PHN or bedside nurse?

Bedside nurse.

A PHN gathers community data to determine which health problems need attention first. What is the purpose of this assessment?

To identify needs & prioritize problems & solutions.

A health program needs evidence of a community problem to obtain funding & meet accreditation requirements. Why is a community assessment needed?

To validate & quantify the problem & support funding/accreditation requirements.

Before gathering data, a PHN defines who the community is, where it is, and what it does. Why is this important?

It guides what data should be gathered.

Why should PHNs involve community members when conducting an assessment?

It improves data accuracy, builds commitment to change, & uses existing community strengths.

Before collecting data, what should a PHN first establish about the community?

Define the community.

A PHN has defined the community and determined why the assessment is needed. What should happen next?

Develop a data collection plan.

A PHN and community members share leadership and decision-making to address a health issue. What type of partnership is this?

Coalition.

Community members attend meetings only to receive information and have no role in solving the problem. What type of participation is this?

Passive participation.

A mayor is officially responsible for leading a community. What type of leader is this?

Formal leader.

A pastor is trusted by community members and influences local health decisions without holding an official government position. What type of leader is this?

Informal leader.

A community wants to annually collect health data to plan programs and track changes over time. What tool should it use?

CHANGE (Community Health Assessment and Group Evaluation).

Who should be included when forming a CHANGE team?

A diverse group of community leaders, healthcare professionals, & interested community members.

After forming the team, what should they develop before collecting data?

A game plan, including team strategy and subgroups if needed.

What should the CHANGE team examine before compiling data?

The five CHANGE sectors.

After examining the sectors, what happens to the information collected?

The team compiles the data.

How should the team review the compiled data?

Analyze it through team discussion, conversation, & questioning.

How is the CHANGE data entered and organized?

Into a spreadsheet, with a separate data file for each sector.

Why does the team examine the consolidated data?

To identify areas needing improvement.

What is the final step of the CHANGE process?

Create a community action plan with specific objectives & timeframes.

A community assesses walking paths, bike paths, green spaces, and personal safety. Which CHANGE sector is being assessed?

Community-at-large.

A community evaluates faith-based organizations, gyms, adult centers, and universities. Which sector is this?

Community institution/organization.

A community checks whether hospitals, clinics, and health departments are available. Which sector is this?

Health care.

A community assesses the availability of public and private schools from preschool through high school. Which sector is this?

School.

A community evaluates whether residents have opportunities for employment. Which sector is this?

Worksite.

A nonprofit hospital must assess the health needs of the community it serves to meet ACA requirements. What assessment is used?

CHNA (Community Health Needs Assessment).

What information does a CHNA gather to guide community health planning?

Community input and other data on priority health problems, barriers to healthcare access, and vulnerable populations.

A CHNA team includes representatives from multiple organizations and different community subpopulations. What principle is being applied?

Collaborative, representative partnerships.

Why should the CHNA process be open and transparent?

To support evidence-based interventions, ongoing evaluation & improvement, & use of community-wide data from public & private sectors.

A nurse examines how age, education, health status, mental health, and behaviors contribute to a person’s health. Which ecological level is this?

Individual.

A nurse considers the influence of family, a spouse, and close friends on a person’s health. Which level is this?

Relationship.

A nurse examines how a person’s workplace, neighborhood, or school affects health through social interactions. Which level is this?

Community.

A nurse examines how culture, inequality, racism, laws, public policy, and socioeconomic disparities affect health. Which level is this?

Societal.

Why does the ecological model examine health at multiple levels rather than focusing on one factor?

Health issues result from complex, interacting factors across different levels of the environment.

A community wants to determine how its physical environment affects physical activity and health. What assessment tool could be used?

Built Environment Assessment Tool Manual.

What areas can this tool assess to understand the built environment?

Homes, schools, workplaces, open spaces, transportation, and community infrastructure.

A PHN assesses roads, curbs, crosswalks, intersections, public transit, and traffic patterns. Which feature is being assessed?

Infrastructure.

A PHN evaluates sidewalks, paths, roadways, and safety for walking. What feature is this?

Walkability.

A PHN assesses bike paths, streetside bike lanes, and other cycling options. What feature is this?

Bikeability.

A PHN evaluates playgrounds, sporting courts, and green spaces. What feature is this?

Recreational sites.

A PHN assesses access to grocery stores, farmers’ markets, and restaurants. What feature is this?

Food.

A PHN interviews a mayor, conducts focus groups, and attends community events to gather information. What type of data is this?

Primary data.

A PHN uses census data, vital statistics, mortality/morbidity data, and previous health surveys. What type of data is this?

Secondary data.

Why should a community assessment use both primary and secondary data?

Using only one method can result in an incomplete assessment.

A PHN attends community events to directly observe the community. What primary data source is being used?

Observation.

A PHN gathers information from community leaders or other key individuals. What source is this?

Stakeholder input.

Residents and community leaders meet to discuss local health concerns. What data collection method is this?

Town hall meeting.

A PHN gathers about 7 community representatives for a guided discussion about health concerns. What method is this?

Focus group.

Community members take or discuss photos to show health-related issues in their environment. What method is this?

Photovoice/photo elicitation.

A PHN uses maps to identify where health resources, risks, or population groups are located. What method is this?

Spatial data/interactive mapping.

A PHN drives through a community to quickly observe its housing, roads, businesses, and overall condition. What method is being used?

Windshield survey.

Why is a windshield survey often done with two people?

One person drives while the other observes & takes notes; a second tour may be needed to fill in gaps.

What is the main strength of a windshield survey?

It provides a quick descriptive overview without requiring community contact.

Why might a windshield survey provide an incomplete or biased assessment?

It requires a driver, can be time-consuming, relies only on visual observation, provides no community input, & can be subjective.

A PHN directly talks with community members or key informants about local issues, strengths, and concerns. What method is being used?

Informant interview.

Why might a PHN choose informant interviews?

They are low-cost, require no literacy, provide detailed insight into beliefs and attitudes, & may create future community supporters.

What are two limitations of informant interviews?

Participant bias & difficulty scheduling a convenient time & place.

A PHN holds an open public meeting to gather residents’ opinions about a health issue. What method is this?

Community forum.

What are the main strengths and limitations of a community forum?

• Strengths: Community input at minimal cost.

• Limitations: Finding a convenient time/place, staying focused, getting enough participation, & encouraging less-vocal people to speak.

A PHN leads a discussion with about 7 representative community members using open-ended questions. What method is being used?

Focus group.

What are the key strengths and limitations of focus groups?

• Strengths: Generate new ideas, reveal community support, require no literacy, and may create future supporters.

• Limitations: Can go off-topic, be difficult to recruit, require a skilled facilitator, may not truly represent the community, and take time to transcribe.

A PHN sends written or online questions to randomly sampled residents without needing direct contact. What method is this?

Survey.

What are key advantages and limitations of surveys?

• Advantages: Collect population/problem data, allow random sampling, & require no direct contact.

• Limitations: Low response rates, cost and time, potentially superficial data, & require reading/writing skills.

A PHN asks community members to take photos showing health issues from their own perspective. What method is being used?

Photovoice (photo elicitation).

Why is photovoice useful with marginalized groups, adolescents, or people affected by addiction or social media bullying?

It requires no reading/writing & allows participants to express their experiences through an easy group activity.

What practical limitations should a PHN consider when using photovoice?

Camera costs, lack of cell phones, time required, & the possibility of photos being lost.

A PHN observes formal and informal community activities to understand how the community functions. What method is this?

Participant observation.

What can participant observation reveal, and what are its limitations?

It can reveal community priorities, the environment, & power structures, but may be biased, time-consuming, & does not allow the observer to ask participants questions.

A PHN uses census data, birth/death statistics, health records, prior surveys, and meeting minutes to assess a community. What type of data is this?

Secondary data.

Why is secondary data useful, and what should the PHN consider when using it?

It provides past population concerns & allows health trends to be tracked over time, but the data may not reflect the current situation & can take time to analyze.

After collecting community data, what should a PHN do before drawing conclusions?

Combine the data into a composite database, assess completeness, & identify or collect missing data.

How does a PHN determine what the community needs most?

Synthesize data to identify themes & health problems, compare findings with state/national data, & identify community strengths, abilities, needs, & resources.

Who should determine the priority health problems in a community?

The community—not the nurse.

How are identified community health problems analyzed in depth?

Each problem is analyzed individually, often using work groups.

A community discusses health issues, creates a list, and individually ranks them before tallying the results for consensus. Which priority-setting method is this?

Nominal Group Planning.

A community ranks health issues mathematically based on criteria such as magnitude/burden, community consequences, and feasibility of fixing the problem. Which method is this?

Criteria Weighting Method.

A community wants a quick way to choose priorities by having members vote openly or secretly. Which method is this?

Quick and Colorful Approach.

A community compares the strengths and weaknesses of different health priorities before choosing one. Which method is this?

Strengths and Weaknesses (S/W) analysis.