Overview
Role of CH nurse in community health program planning and evaluation is a collaborative leadership role. Desired outcome is to plan, organize, implement, and evaluate intervention programs, that address the specific health needs of the community.
Communit
Community Assessment: Individual, Family Aggregates
Community assessment is a comprehensive approach that emphasizes the community as a client.
Community assessment and diagnosis are the foundation for community-specific program planning.
CH nurse is key player in assessing the needs of the community. This
Components of a Community Assessment
People
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, recrea
Components of a Community Assessment
Place or environment
Physical factors - Geography, terrain, type of community, location of health services, housing, animal control
Environmental factors - Geography, climate, flora, fauna, topography, toxic substances, vectors, pollutants
Components of a Community Assessment
Social systems
Health systems
Economic systems/factors
Education systems
Religious systems
Welfare systems
Political systems
Recreation systems/factors
Legal systems
Communication systems/factors
Transportation systems
Resources and services
Data Collection
Informant Interviews
Direct discussion with community members for the purpose of obtaining ideas and opinions from key informants
Strengths: Minimal cost
Participants serving as future supporters
Offer insight into beliefs and attitudes of community members
Reading/writing of
Data Collection
Community Forum
Open public meeting
Strengths: Opportunity form community input
Minimal cost
Limitations: 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 b
Data Collection
Secondary Data
Use of existing data (death statistics; birth statistics; census data; mortality, morbidity data; health records; minutes from meetings; prior health surveys) to assess problem
Strengths: Database of prior concerns/needs of population
Ability to trend hea
Data Collection
Participant Observation
Observation of formal or informal community activities
Strengths: indication of community priorities, environmental profile, and identification of power structures
Limitations: Bias
Time-consuming
Inability to ask questions of participants
Data Collection
Windshield Survey
Descriptive approach that assesses several community components by driving through a community
Strengths: Provides a descriptive overview of a community
Limitations: Need for a driver so the nurse can visualize and document the community elements
May be t
Data Collection
Focus Groups
Directed talk with a representative sample
Strengths: Possibility of participants being potential supporters
Provides insight into community supports
Reading/writing of participants not required
Limitations: Possible discussion of irrelevant issues
Challe
Data Collection
Surveys
Specific questions asked in written format
Strengths: Data collected on client population and problems
Random sampling
Available as written or online format
Contact with participants not required
Limitations: Low response rate
Expensive
Time-consuming
Pos
Windshield Survey Components
People
Who is on the street?
What is their general appearance (age, dress, well-nourished, obese, frail, unkempt)?
What are they doing?
What is the origin, ethnicity, or race of the people?
How are the different groups (subgroups) residentially located?
Is there
Windshield Survey Components
Place: Boundaries
Where is the community located?
What are its boundaries?
Are there natural boundaries?
Windshield Survey Components
Place: Location of health services
Where are the major health facilities located?
What health care facilities are necessary for the community but are not within the community?
Windshield Survey Components
Place: Natural environment
Are there geographic features that may harm the community?
Are there plants or animals that could harm or threaten the health of the community?
Windshield Survey Components
Place: Man-made Environment
What industries are within the communities?
Could these pose a threat to the health of community workers or the community itself?
Is there easy access to health care facilities?
Are the roads adequate and marked well?
Windshield Survey Components
Place: Housing
Is the housing of acceptable quality?
How old are the homes?
Are there single or multifamily dwellings?
Is the housing in good repair or disrepair?
Is there vacant housing?
Windshield Survey Components
Place: Social systems
Are there social services, clinics, hospitals, dentists, and health care providers available within the community?
Are there ample schools within the community? Are they in good repair or disrepair?
Are there parks or areas of recreations?
What places of
Analysis of Community Assessment Data
The community health nurse plays an active role in assessment, data interpretation, and problem identification. Steps in analysis of community assessment data include:
Gathering collected data in a composite database.
Assessing completeness of data.
Ident
Community Health Diagnosis
Problems identified by community assessments are often stated as community health diagnoses.
Community nursing diagnoses incorporate information from the community assessment, general nursing knowledge, and epidemiological concepts (especially the concept
Community Health Program Planning, Development, and Management
Preplanning
Brainstorm ideas.
Activities: Gain entry into community and establish trust.
Obtain community awareness, support, and involvement.
Coordinate collaborations that have similar interest in addressing identified problems
Community Health Program Planning, Development, and Management
Assessment
Collect data about the community and its members.
Activities: Complete a needs assessment and identify community strengths and weaknesses.
Assess the availability of community resources.
Evaluate secondary health data.
Community Health Program Planning, Development, and Management
Diagnosis
Identify and prioritize health needs of the community
Activities: Analyze data to determine health needs.
Work with community members, local health professionals and administrators to develop priorities and establish outcomes.
In setting priorities among
Community Health Program Planning, Development, and Management
Planning
Develop interventions to meet indented outcomes
Activities: Determine possible solutions to meet the health needs and select the best option.
Establish goals and objectives for the selected solution.
Objectives are behaviorally stated, measurable, and inc
Community Health Program Planning, Development, and Management
Implementation
Carry out the plan
Activities: Initiate interventions to achieve goals and objectives according to program plan.
Monitor the intervention process and the response of the community in terms of its values, needs, and perceptions.
Community Health Program Planning, Development, and Management
Evaluation
Examine the success of the interventions.
Evaluate strengths and weaknesses of the program.
Determine achievement of desired outcomes.
Examine the adequacy, efficiency, appropriateness, and cost benefit of the program.
Recommend and implement modification
Strategies for and Barriers to Implementing Community Health Programs: Helpful Strategies
Thorough assessment
Accurate interpretation of data
Collaboration with community partners
Effective communication patterns
Sufficient resources
Logical planning
skilled leadership
Strategies for and Barriers to Implementing Community Health Programs: Barriers
Inadequate assessment
Inadequate or misconstructed data
No involvement with community partners
Impaired communication
Inadequate resources
Lack of planning
Poor leadership