Community Assessment, Education, and Program Planning

community assessment

comprehensive approach that emphasizes the community as a client, with the goal of providing health benefit to the people of the area as a whole, rather than to individuals. combined with diagnosis, is the foundation for community-specific program planning. nurses use the nursing process to determine health needs within the community and assist in developing and implementing strategies to meet those needs. begins with defining the community to be studied.

geographic community

community defined by those in a shared place

functional community

community defined by those with a shared or common interest

ecological model

model of population health that can be used as a guide to examine the determinants of health for a population, and for targeting interventions to multiple factors that affect health. includes: -individual traits (age, gender, biological, mental, behavioral factors)-social, family, and community relationships-occupational and home environments-overall conditions created by local, state, national, and worldwide forces and trends

status, structure, and process

what factors should be considered when determining the health of a community?


factor to consider when determining the health of a community, includes epidemiological data, client satisfaction, mental health, and crime rates


factor to consider when determining the health of a community, includes presence of healthcare facilities, service types and patterns of use, and demographic data


factor to consider when determining the health of a community, include relationships, communication, and commitment to and participation in health

demographic factors

components of the community assessment that looks at the distribution, mobility, density, and census data of the population

biological factors

components of community assessment that looks at the health and disease status, genetics, race, age, gender, and causes of death in a population

social factors

components of community assessment that looks at the occupation, activities, marital status, education, income, crime rates, recreation, and industry in a population

cultural factors

components of community assessment that look at ethnohistory, hierarchy and roles, language, religion and spirituality, values, customs, and norms in a population

physical factors (of the environment)

aspects of the environment to assess during the community assessment that include geography, terrain, type of community, location of health services, housing, and animal control in a population

environmental factors

aspects of the community assessment that include the geography, climate, flora, fauna, topography, toxic substances, vectors, and pollutants in a population

social systems

part of the community assessment, includes analysis of health systems, economic systems, education systems, religious systems, welfare systems, political systems, recreational systems, legal systems, communication systems, transportation systems, and other resources and services

data collection

critical community health nursing function used to best identify the health needs of the local community. the nurse must combine several methods such as informant interview, community forums, secondary data, participant observation, focus groups, surveys, and windshield surveys

informant interviews

form of data collection that involves direct discussion with community members for the purpose of obtaining ideas and opinions from key informants. advantages: minimal cost, participants can serve as future supporters, offers insight into beliefs/attitudes of community members, doesn't require reading or writing of participants, and personal interaction can elicit more detailed responseslimitations: built-in bias, meeting time and place required

community forum

form of data collection that involves an open public meetingstrengths: opportunity for community input, minimal costlimitations: difficulty finding a convenient time and place, potential to drift from the issue, challenging to get adequate participation, possibility that a less-vocal person may be reluctant to speak

secondary data

use of existing data (death and birth statistics, census data, mortality and morbidity data, health records, minutes from meetings, and prior health surveys) to assess a problem. the nurse must evaluate the reliability of secondary data if it is obtained from the internet strengths: provides a database of prior concerns/needs of the population, ability to trend health issues over timelimitations: possibility that data might not represent the current situation, can be time-consuming

participant observation

form of data collection that involves observation of formal or informal community activities strengths: indicates community priorities, environmental profile, and power structureslimits: bias, time-consuming, inability to ask participants questions

focus groups

form of data collection that involves directed talks with a representative samplestrengths: possibility of participants being potential supporters, provides insight into community support, doesn't require reading or writing of participantslimits: possible discussion of irrelevant issues, challenging to get participants, requires a strong facilitator, difficult to ensure that the sample is truly representative of the overall community, time-consuming to transcribe the discussion


form of data collection that involves specific questions asked in a written formatstrengths: data collected on client population and problems, random sampling, available as written or online format, contact with participants not requiredlimitations: low response rate, expensive, time-consuming, possibility of collection of superficial data, requires reading/writing abilities of participants

define the community, collect data, analyze data, establish community diagnoses, plan programs, implement programs, evaluate program interventions

what are the steps for a community assessment?

windshield survey

form of data collection that involves a descriptive approach that assesses several community components by driving through the communitystrengths: provides a descriptive overview of the communitylimits: need for a driver so the nurse can visualize and document community elements, can be time-consuming, results based only on visualization and does not include input from community members

people, place, housing, social systems

what are the 4 broad components of a windshield survey?

analysis of data

part of the community assessment process. steps include gathering collected data into a composite database, assessing the completeness of the data, identifying and generating any missing data, synthesizing data and identifying themes, identifying community needs and problems, and identifying community strengths and resources

community health diagnoses

problems identified by community assessments, incorporate information from the community assessment, general nursing knowledge, and epidemiological concepts (especially the concept of risk in a population). often written in a specific format:risk of _______ among __________ related to ______.

age, cultural barriers, poor reading and comprehension skills, language barriers, barriers to access, lack of motivation

what are some examples of barriers to learning and community health education?

behavioral theory

use of reinforcement methods to change learners' behaviors

cognitive theory

use of sensory input and repetition to change learners' patterns of thought, thereby changing behaviors

critical theory

use of ongoing discussion and inquiry to increase learners' depth of knowledge, thereby changing thinking and behaviors

developmental theory

use of techniques specific to learners' developmental stages to determine readiness to learn, and to impart knowledge

humanistic theory

assists learners to grow by emphasizing emotions and relationships and believing that free choice will prompt actions that are in their own best interest

social learning theory

links info to beliefs and values to change or shift the learners' expectations

visual learners

learners that learn through seeing and methods such as note-taking, video-reviewing, and presentations. they think in pictures

auditory learners

learners that learn through listening and methods such as verbal lectures, discussion, and reading aloud. they interpret meaning while listening

tactile-kinesthetic learners

learners that learn through doing and methods such as trial and error, hands-on approaches, and return demonstration. they gain meaning through exploration.

health literacy

an individual's ability to understand basic health information and make decisions. can affect the ability or desire to take action

cognitive domain

domain of learning that involves knowledge and the development of intellectual skills. example: client discusses how sodium intake will affect blood pressure

affective domain

domain of learning that involves a change in attitude and development of values. example: client expresses acceptance of having a colostomy and maintains self-esteem

psychomotor domain

domain of learning that involves the performance of a skill. example: the community nurse teaches a client how to self-administer insulin


step of the community assessment that leads to planning programs for the defined community. the nursing process is repeated to establish and maintain the program


part of the process for planning community health programs. involves brainstorming ideas, gaining entry into the community and establishing trust, obtaining community awareness, support, and involvement, and coordinating collaborations that have similar interests in addressing identified problems


part of the process for planning community health programs. involves collecting data about the community and its members, completing a needs assessment and identifying community strengths and weaknesses, assessing the availability of community resources, listing potential sources for program funding, and evaluating secondary health data


part of the process for planning community health programs. involves identifying and prioritizing health needs of the community, analyzing data to determine health needs, and working with community members, local health professionals, and administrators to develop priorities and establish outcomes


part of the process for planning community health programs in which interventions are developed to meet identified outcomes, possible solutions to meet the health need are determined, resources and interventions required for each solution are compared and the best option selected, goals and objectives established for the selected solution, and strategies/interventions are selected to meet the objectives. this step also involves planning a logical sequence for interventions by establishing a timetable, identifying who will assume responsibility for each intervention, determining available and needed resources to implement interventions, assessing the personnel needed and any special training required for screening or providing education, determining funding opportunities and developing a budget, and planning for program evaluation


part of the process of planning community health programs that involves carrying out the plan. interventions to achieve goals and objectives are initiated according to the program plan and the intervention and response of the community is monitored


part of the process of planning community health programs in which the success of the interventions is examined. involves evaluating strengths and weaknesses of the program, determining achievement of desired outcomes, examining the adequacy, efficiency, appropriateness, and cost benefit of the program, recommending and implementing modifications to better meet the needs of the community, and sharing findings and recommendations with community members and stake holders.