NR 442 Case Study 04-Community Assessment Part 1

Name

Chamberlain University

NR-442 Community Health Nursing

Prof. Name

Date

Case Study 04 – Community Assessment Part 1: Shoe Leather/Windshield Survey and Key Informant Interview

Case Study Synopsis

As a public health nurse, you are tasked with conducting a community assessment to contribute to a newly updated strategic plan aimed at preparing a nearby community for future growth and development. This assessment is an opportunity to identify the community’s strengths and weaknesses, as well as provide recommendations for improving the overall health and wellness of the population.

Concepts Covered

• Health promotion
• Health policy

Public Health Nursing Interventions Addressed

• Disease and health event investigation
• Consultation
• Policy development and enforcement

Suggested Readings

• Edelman & Kudzma’s Health Promotion Throughout the Life Span, Ch. 8: Health Promotion and the Community
• Nies & McEwen’s Community/Public Health Nursing, Ch. 6: Community Assessment
• Stanhope & Lancaster’s Foundations for Population Health in Community/Public Health Nursing, Ch. 12: Community Assessment and Evaluation
• Stanhope & Lancaster’s Public Health Nursing, Ch. 17: Community as Client: Assessment and Analysis

Estimated Completion Time

• Case study only: 2 hours
• Plus review questions: + 30 minutes
• Plus discussion questions: + 1 hour
• Total: 3.5 hours

Case Study Objectives

1. Identify relevant and appropriate data and information sources for community assessment.
2. Gather demographic, geographic, governmental, health care, cultural, and socioeconomic data of the community.
3. Conduct a preliminary analysis of data from the windshield survey and community assessment to identify strengths and weaknesses.
4. Propose recommendations for a strategic plan based on community assessment findings.

Introduction

The city manager has requested a community assessment from you as part of a city council initiative to update their 6-year strategic plan. The goal is to prepare for the community’s future growth and development. This is an excellent opportunity to examine the strengths and weaknesses of the community while offering suggestions for improving the health and wellness of the population. You begin by conducting a preliminary search for information about the city.

Population:

• Total population: 22,791
• Female: 52.2%, Male: 47.8%
• Under 18 years: 34.8%
• 19–64 years: 61.2%
• Over 65 years: 4%
• Ethnic composition: 56.8% Caucasian, 9% Black or African-American, 23.4% Hispanic or Latino, 10.8% Other

Location:

• Livability score: 86
• Low crime rate
• Low cost of living
• Temperate weather with warm summers and mild winters
• Local amenities available

NR 442 Case Study 04-Community Assessment Part 1

Primary Industries:

• Manufacturing: Computer technology, hardware, and software
• Non-manufacturing: Public education, government, health care, farming/ranching

Economic Information:

• Per capita income: $73,977
• Persons below poverty level: 7.4%
• Unemployment rate: 3.4%
• Home ownership rate: 65.1%

Educational System:

• One public high school with two public middle schools and six elementary schools
• One Higher Education Center offering workforce readiness programs
• Five private universities and two public universities

Recreation:

• High School football
• Hunting, fishing, hiking, and biking
• Two community parks with swimming pools
• YMCA and various annual events (e.g., Crawfish Festival, Old Tyme Festival)

Health Care Facilities:

• Head Start Program, Urgent Care Clinic, Pediatric Clinic, Primary Care Clinic
• Rehabilitation and Skilled Nursing, Fire Department/EMS, Alzheimer’s/Respite Day Care Center

Air Quality: 70 (National Air Toxic Assessment)
Water Quality: 79 (Water Shed Quality)

Transportation:

• Railroad terminal, taxi service, bus service

Media:

• One storefront radio station, weekly newspaper, public library

NR 442 Case Study 04-Community Assessment Part 1

Scenario and Community Assessment

Windshield Survey

The windshield survey begins by observing the outskirts of the community, taking note of agricultural land, the flat terrain, the river, and the climate. Observations include the presence of crop dusters, raising concerns about the impact of pesticides and herbicides on food and water supplies. This prompts further research into these environmental health risks. Key questions arise regarding the community’s race/ethnicity, housing conditions, homelessness, littering, availability of parks, and presence of a railroad track.

Key Informant Interviews

You conduct interviews with local health care providers, public officials, and community members to better understand the health concerns of vulnerable populations. One key informant is the school nurse, who shares that the community struggles with high rates of cancer (particularly breast cancer), farm-related accidents, and obesity. These issues warrant further investigation to assess their causes, including environmental factors.

Social Determinants of Health (SDOH)

Further interviews with the school nurse reveal insights into the social determinants affecting student health. Reviewing the Culture of Health website together, you identify prevalent community factors such as air quality, access to health services, and individual behaviors, which contribute to health disparities in the area.

Emergency Health Care Access

During a conversation with the school nurse, a student is brought in following a football injury. The school nurse notes that a nearby railroad track blocks EMS access, which could delay emergency care, especially in time-sensitive situations. This issue becomes a priority for further policy development.

Data Collection and Health Trends

After evaluating various health trends and risk factors, the public health nurse identifies the need to prioritize several community problems. The primary concern is the accessibility of emergency services, with the railroad tracks creating a barrier to timely care. Recommendations are made to address this, including policy interventions aimed at improving emergency response times and potentially building another health care facility on the other side of the tracks.

Public Health Nursing Interventions

Public health nurses play a crucial role in the community assessment by collecting data, identifying health risks, and offering solutions to improve community health. This includes collaborating with local stakeholders to develop policies that address health concerns, such as farm-related accidents, cancer prevention, and obesity. Interventions focus on health promotion, disease prevention, and the strengthening of health systems.

Conclusion

As the community assessment concludes, data has been gathered, and interviews with stakeholders have provided valuable insights. The next steps involve analyzing the data and prioritizing community health needs. Through the assessment process, you have identified potential health risks, environmental concerns, and barriers to healthcare access that require intervention and policy development to improve the community’s overall well-being.

NR 442 Case Study 04-Community Assessment Part 1

References

Cui, E. R., Beja-Glasser, A., Fernandez, A. R., Grover, J. M., Mann, N. C., & Patel, M. D. (2019). Emergency medical services time intervals for acute chest pain in the United States, 2015–2016. Prehospital Emergency Care, 24(4), 557–565. https://doi.org/10.1080/10903127.2019.1676346

NR 442 Community RUA Final

Name

Chamberlain University

NR-442 Community Health Nursing

Prof. Name

Date

Background

Orthodox Jewish communities are known for their conservative views and adherence to traditional ways of life. They are typically resistant to changes in lifestyle, maintaining strong ties to ideology and authority figures. Orthodox Jews in America are predominantly located in the northeastern United States. Many within this community believe in sending their children to religious private day schools as part of preserving their faith and culture.

Congregation Bet Haverim (CBH) is a Reconstructionist Jewish congregation, having separated from conservative Judaism. CBH was originally formed by a group of gay and lesbian Jews and is open to all, regardless of gender identity or race. The congregation welcomes drag queens and kings, transgender, genderqueer, and intersex individuals. Additionally, the synagogue invites people from diverse socioeconomic backgrounds, aiming for inclusivity and acceptance.

Geographic Information

CBH is located in North Druid Hills, Atlanta, Georgia, within Dekalb County. Its geographic coordinates are 33.8168° N latitude and 84.3133° W longitude, with a zip code of 30329. Toco Hills, a neighborhood within North Druid Hills, is known for being home to a multi-generational Orthodox Jewish community with several congregations representing various forms of Orthodoxy. Unlike Orthodox Jews, members of CBH may drive to synagogue instead of walking. Despite its thriving community, there are concerns about safety, particularly for CBH members who have to park across a busy street to attend services. Furthermore, limited parking and difficult traffic conditions near the synagogue pose additional challenges.

Demographic Information

Toco Hills has a population of 28,410, with 13,796 males and 14,614 females. Employment in the area includes 13,375 white-collar workers and 2,637 blue-collar workers. There are 4,771 family households and 6,737 non-family households. Of these, 2,811 households have children, while 8,692 do not. The average household income is $74,546.50, with a median household income of $51,589.00. Around 6,018 people live below the poverty level, while 21,588 live above it.

In terms of marital status, 11,206 residents have never married, 8,420 are married, 657 are separated, 958 are widowed, and 1,711 are divorced. Smoking rates in Dekalb County are at 26%, while 20% of the population is physically inactive. Additionally, the area reported 644 violent crimes.

Community Health Diagnosis

1. Increased Cardiovascular Disease Risk: The Toco Hills community has an elevated risk of cardiovascular disease due to unhealthy nutritional choices, particularly the high-fat foods consumed during synagogue gatherings and celebrations. Many individuals in this community are overweight, which contributes to the prevalence of cardiovascular issues.

2. Heightened Anxiety and Stress: There is a growing sense of stress and anxiety within the community, primarily driven by concerns over safety. Recent incidents, such as the tragic shooting at the Tree of Life synagogue in Pittsburgh, have led to heightened fears of possible attacks.

3. Decisional Conflict: Members of the community face decisional conflict when their personal beliefs and values come into question. This often arises from the challenge of balancing family activities with synagogue meetings, especially when driving long distances is involved.

Plan for Priority Diagnosis

The priority diagnosis for this community centers around the increased risk of cardiovascular disease, driven by cultural food choices. A short-term goal involves educating community members on healthier ways to prepare traditional dishes, such as baking instead of frying. Nutritional classes can be offered within the next two months, and pamphlets outlining risk factors contributing to cardiovascular disease and obesity can be distributed.

A long-term goal includes reducing the rate of cardiovascular disease in the community by 15% over the next year. To achieve this, health fairs focusing on cardiovascular screenings, along with workout programs and healthier food options, will be introduced to the community. By assessing individual health literacy, the community can adopt healthier practices without sacrificing their cultural identity.

Intervention for Priority Diagnosis

Lifestyle changes are critical in reducing the risk of cardiovascular disease within the Toco Hills community. These changes include increasing physical activity, managing weight, reducing fried fatty foods, and practicing relaxation techniques. According to the American Heart Association (2018), seven factors improve overall health and quality of life. These include reducing blood glucose levels, maintaining a healthy diet, managing blood pressure, stopping smoking, managing weight, increasing physical activity, and keeping cholesterol levels in check. The adoption of these practices can significantly reduce the community’s risk of heart disease.

Evaluation of Priority Diagnosis

To evaluate the effectiveness of the intervention, questionnaires will be administered six months later to assess the community’s progress in achieving health goals. Lipid panels and weight assessments will determine whether cholesterol levels and weight have improved for those at risk. The community’s willingness to engage in lifestyle changes and share their perceptions of health will also be evaluated.

Specific measures used to evaluate the meeting of goals include observing community meals, gathering data from surveys on cooking classes and health fairs, and assessing participants’ knowledge and future plans. An outcome will be achieved when the community verbalizes negative behaviors that can be modified and demonstrates a willingness to embrace healthier eating habits and physical activity.

Community Resources

Several resources are available to the Toco Hills community, including Jewish Family & Career Services (JF&CS) of Atlanta, which offers support services, career services, adult and intellectual disability services, and dental care. Programs like Parent n’ Me, Hebrew schools that celebrate diversity, the B’nei Mitzvah Program, and the CBH Teen Group provide opportunities for community members to bond and learn about Jewish culture. For healthcare, the community can access Emory Main Hospital, the Atlanta VA Medical Center, and Emory at Toco Hills Primary Care.

References

American Heart Association (2018). Cholesterol Management. Retrieved from https://www.heart.org/

Congregation Bet Haverim. (2019). Youth and Family Education. Reconstructing Judaism: Deeply Rooted, Boldly Relevant. Retrieved from: https://www.congregationbethaverim.org/learning

Country health rankings (2019). Dekalb County: Health behaviors. Retrieved from https://www.countyhealthrankings.org/app/georgia/2019/rankings/dekalb/county/outcomes/overall/snapshot

Engelke, Z. R. M. (2017). Patient and family education: Teaching the patient with cardiovascular disease. CINAHL Nursing Guide. Retrieved from https://search.ebscohost.com/login.aspx?

NR 442 Community RUA Final

Itzhaky, H., & Kissil, K. (2015). “It’s a horrible sin. if they find out, I will not be able to stay”: Orthodox Jewish gay men’s experiences living in secrecy. Journal of Homosexuality, 62(5), 621–643. https://doi.org/10.1080/00918369.2014.988532

Lesser, J., Kerrie, Gayanne, & Julie. (2019, December 6). Verbal communication.

Liu, B.-X., Sun, W., & Kong, X.-Q. (2019). Perirenal fat: A unique fat pad and potential target for cardiovascular disease. Angiology, 70(7), 584–593. https://doi.org/10.1177/0003319718799967

NR 442 Week 7 Vaccine quiz

Name

Chamberlain University

NR-442 Community Health Nursing

Prof. Name

Date

NR 442 Week 7 Vaccine quiz

Annie Omoniyi, a nursing student with ID D41079059, has been tasked with completing a quiz in NR 442 Community/Public Health Nursing on vaccine administration. The quiz is designed to assess knowledge on several aspects of immunization, including the administration process, precautions, and best practices.

The quiz begins by asking which of the options provided is not one of the “Rights” of medication administration adapted for vaccines. The options include the right patient, right vaccine with the right diluent if needed, right documentation, right dosage, right route, needle length and technique, right time, right clinic, and the right site.

Another question covers the screening process for contraindications and precautions before administering vaccines. It emphasizes the importance of screening every time a vaccine dose is administered, not just during the initial visit or when vaccinating infants and young children.

Regarding immunization schedules, the quiz clarifies that these schedules are updated not only when new vaccines are introduced but also when other significant factors come into play. The childhood immunization schedule is recommended for children from birth through 18 years of age, ensuring comprehensive vaccination during early development.

After-care instructions following vaccine administration are critical. These instructions should include guidance on when to seek medical attention and information regarding possible side effects such as fever, injection site pain, and fussiness.

The Advisory Committee on Immunization Practices (ACIP) recommends observing a patient seated or lying down for 15 minutes after receiving a vaccine to monitor for any immediate adverse reactions. The Vaccine Information Statements (VISs) must be provided every time a vaccine dose is administered, not just during the first administration.

Strategies to minimize pain during injections include breastfeeding infants, using distraction techniques, and avoiding aspiration during injections. These strategies aim to ensure a more comfortable vaccination experience for patients.

The quiz also tests knowledge of the vaccine preparation process, including selecting the appropriate vaccine, checking expiration dates, and using new, sterile needles and syringes for each injection. It touches on the administration routes for various vaccines, such as the oral route for rotavirus and the intradermal route for other vaccines.

For intramuscular injections, the recommended needle insertion angle is 90 degrees, whereas subcutaneous injections should be administered at a 45-degree angle into fatty tissue. Additionally, the recommended injection site varies depending on the patient’s age, such as the vastus lateralis muscle for a 9-month-old infant.

Federal law mandates specific documentation for vaccines, including the vaccine lot number, manufacturer, date of administration, and the edition date of the VIS. Best practices to prevent vaccine administration errors include checking expiration dates and screening for contraindications every time a vaccine is given.

The quiz concludes with a scenario where an 11-year-old girl requires multiple vaccines. Before administering them, it’s essential to assess the immunization history, screen for contraindications, and prepare the vaccines.

NR 442 Week 7 Vaccine quiz

References

Centers for Disease Control and Prevention. (2023). Vaccine Information for Healthcare Professionals. https://www.cdc.gov/vaccines/hcp/admin/downloads/vaccine-administration.pdf

NR 442 Week 4

Name

Chamberlain University

NR-442 Community Health Nursing

Prof. Name

Date

NR 442 Week 1 Community Health Edapt Notes

Name

Chamberlain University

NR-442 Community Health Nursing

Prof. Name

Date

Community Health Edapt Notes

Community health nursing takes a population-focused approach, encompassing planning, implementation, and evaluation of care across various settings for individuals throughout their lifespans, regardless of diverse backgrounds. The primary goal is to protect community health by emphasizing health promotion and maintenance for individuals, families, and groups. Unlike traditional healthcare models that focus on episodic illness care, community health nursing emphasizes proactive identification of at-risk populations and the promotion of general well-being. The health status of communities across the United States varies significantly due to unequal access to preventive services and socio-economic disparities. As defined by the World Health Organization, health is a state of complete physical, mental, and social well-being, rather than merely the absence of illness (Nies & McEwen, 2019).

The scope of public health is broad, encompassing factors such as living conditions, environmental sanitation, personal hygiene education, preventive care, policy development, and control of communicable diseases. Heart disease, cancer, chronic lower respiratory diseases, stroke, and unintentional injuries are the leading causes of premature death in the United States. Health, according to WHO, depends on the collective goals of individuals, families, and societies working together to prevent illness and promote well-being (Nies & McEwen, 2019). Public health protects and enhances community health through education, research, and disease prevention, ensuring an organized, community-driven effort to promote healthy lifestyles and prevent the spread of diseases (Centers for Disease Control and Prevention, 2020).

Community and public health nursing can trace its roots back to Florence Nightingale, who used statistical methods and community assessments to address health issues. Nightingale’s pioneering work laid the foundation for the development of district nursing in England and later influenced public health models in the United States (Nies & McEwen, 2019). Social determinants of health, including access to healthcare, socioeconomic status, environmental factors, and cultural practices, continue to play a crucial role in community health nursing. Nurses must understand these determinants to deliver effective, equitable care.

Table

Community Health Nursing: A Population-Focused Approach

Community health nursing is a population-focused approach aimed at planning, implementing, and evaluating care for individuals across various settings and from diverse backgrounds. The primary goal of community health nursing is to preserve the health of the community by emphasizing health promotion and maintenance for individuals, families, and groups within the community. This approach shifts the focus from illness and episodic care to identifying at-risk populations and fostering overall health. The health status of populations in the United States significantly varies, revealing a disparity in preventive services and social opportunities. Health is defined as a state of complete physical, mental, and social well-being, while a community is seen as a group of individuals sharing a geographic location, common interests, and values. In contrast, a population refers to a group of people with common personal or environmental characteristics.

Public health plays a crucial role in community health nursing, encompassing factors like living conditions, environmental sanitation, personal hygiene, and preventive care. Public health also includes policy development and the control of communicable infections. The leading causes of premature death in adults in the United States are heart disease, cancer, chronic lower respiratory diseases, stroke, and unintentional injuries. As defined by the World Health Organization (WHO), health is more than the absence of disease—it is a state of complete physical, mental, and social well-being. Social health, a critical component of this definition, highlights the strength of communities in collaborating to promote health and prevent illness. Public health focuses on protecting and improving the health of communities through organized efforts, such as health promotion, disease prevention, and responding to infectious diseases (Nies & McEwen, 2019).

Public Health: Components and Historical Background

Public health involves a broad scope of activities aimed at improving the health of communities, such as promoting healthy lifestyles through education, researching disease and injury prevention, and responding to illnesses. A community consists of individuals sharing geographic locations or common values, while a population refers to a group of people with shared personal or environmental characteristics. Aggregates are subpopulations within a community that share similar characteristics or concerns. The Centers for Disease Control and Prevention (CDC) defines public health as an organized effort to improve community health through prevention, education, and policy recommendations (CDC, 2020).

The origins of community and public health nursing can be traced to Florence Nightingale, who used a community assessment to implement statistical methods to meet the needs of the population. Nightingale’s approach was innovative, considering the formal establishment of public health nursing did not occur until the late 19th and early 20th centuries (Nies & McEwen, 2019). Early public health nursing was based on district nursing in England, where care was delivered to disadvantaged families. In the United States, public health nursing developed from this model, addressing the social determinants of health such as access to care, socioeconomic status, and cultural practices.

Determinants of Health and Community Nursing Roles

The health status of a community is influenced by individual, social, economic, and cultural determinants, as well as healthcare services and policy. Nurses must understand these determinants to recognize how they affect disease, death, and disability. According to the CDC, approximately one million Americans die prematurely each year from the five leading causes of death, yet 40% of these deaths could be prevented. Many of these deaths are attributable to modifiable risk factors, and reducing health disparities would help lower mortality rates (CDC, 2014). Social determinants like income, education, and environment play a significant role in shaping health outcomes.

Public health is a holistic practice that focuses on preventing disease, promoting health, and ensuring efficient healthcare systems. Community health nurses are involved in assessing population health, diagnosing health issues, and addressing health hazards. They contribute to policy development and ensure equitable access to care by building a skilled workforce and supporting public health infrastructure. The overall goals of Healthy People 2030 are aligned with these objectives, focusing on improving health equity, promoting quality of life, and preventing premature death (Office of Disease Prevention and Health Promotion, n.d.).

Primary, Secondary, and Tertiary Prevention in Community Health

Prevention plays a crucial role in community health nursing and is categorized into three levels: primary, secondary, and tertiary prevention. Primary prevention focuses on preventing problems before they occur, such as administering immunizations and promoting general health. Secondary prevention involves early detection and intervention, such as screening for sexually transmitted infections. Tertiary prevention aims at correcting or preventing the deterioration of diseases, such as teaching diabetic patients to administer insulin. Community health nurses work with individuals, families, and groups to ensure equitable healthcare delivery across these prevention levels.

Table: Key Components of Public Health Nursing

Population Health vs. Community Health

Community health is a specialty that emphasizes health promotion and disease prevention, particularly for subpopulations. When comparing population health with community health, the main distinction lies in their scope. Community health focuses on smaller populations within a defined geographic area, whereas population health addresses specific populations regardless of their geographic location. Despite these differences, both fields employ a scientific approach to health delivery, assessing the epidemiology of a health issue and considering broad determinants of health, including all levels of prevention.

Collaboration, defined as two or more individuals or organizations working toward a common goal, is essential for enhancing the capacity to promote and protect health. Coalition-building creates alliances among organizations with shared objectives, while delegated functions involve the execution of direct care tasks authorized by health practitioners. Outreach locates at-risk populations, providing information on the issue at hand, available interventions, and how services can be accessed.

Primary prevention entails health promotion and specific protective measures designed to prevent diseases or disabilities before they occur. It emphasizes keeping healthy individuals in good health through actions like vaccination, wearing seatbelts, and using helmets. Secondary prevention focuses on early disease detection, such as screenings for elevated cholesterol or vision and hearing checks, while tertiary prevention aims to minimize complications from an existing disease. Examples of tertiary prevention include cardiac rehabilitation and palliative care.

Population Health Defined

Population health integrates public health efforts with healthcare systems and organizations, promoting a collaborative approach that seeks to improve health outcomes on a larger scale. This interdisciplinary effort shifts the focus from episodic care to the management of specific populations, prioritizing preventive and primary care to maintain health, improve quality, and lower healthcare costs (Ariosto et al., 2018). Unlike acute care, which addresses immediate symptoms and diagnoses, population health examines the broader determinants of health, including individual, social, and environmental factors, along with available health services and policies.

Nurses specializing in population health prioritize aggregate outcomes, emphasizing prevention at the primary, secondary, and tertiary levels. Population health initiatives can occur in public health or clinical settings, with interventions targeting individuals, families, systems, and communities based on the population’s health status. Key determinants of health in population health include individual characteristics (e.g., age, gender, diet), social determinants (e.g., socioeconomic status, education), general socioeconomic conditions, healthcare services, and policies at various governmental levels.

Pillars of Population Health

Population health is underpinned by three primary pillars: clinical healthcare, public health, and public policy. Clinical healthcare delivers direct patient care, while public health addresses community-wide health concerns, such as disease prevention and environmental hazards. Public policy influences both health-related and non-health-related issues that ultimately affect health outcomes. For instance, policies promoting education, affordable housing, and transportation can contribute to better health at both individual and community levels. These pillars require a systems-oriented approach, with leadership and intersectoral collaboration being vital for effective population health initiatives.

In 2013, the Institute of Medicine (IOM) highlighted disparities in health outcomes in the United States compared to other developed nations, despite higher healthcare spending. Factors contributing to these disparities include chronic diseases, socio-economic conditions, and environments that encourage sedentary lifestyles. Health indicators where the U.S. ranks poorly include infant mortality, obesity, and heart disease, among others.

Sustainable Development Goals

Globally, health organizations such as the World Health Organization (WHO) have established Sustainable Development Goals (SDGs) to address key health determinants. These goals, introduced in 2000 as the Millennium Development Goals and updated in 2015 as the SDGs, aim to eradicate poverty and hunger, promote education and equality, reduce mortality, and improve access to healthcare resources. The efforts outlined by the WHO align with U.S. initiatives to address health disparities and promote population health through collaborative, global approaches.

Population-Focused Practice and the Public Health Intervention Wheel

The Robert Wood Johnson Foundation’s support of population-focused practice emphasizes the role of community health nurses in improving health outcomes. Four key areas of knowledge and skills are critical for sustaining population health nursing: practice, research, education, and policy development. The levels of prevention model, which includes primary, secondary, and tertiary prevention, remains a fundamental framework for these practices.

The Public Health Intervention Wheel, developed by the Minnesota Department of Health in 1998, offers a structured approach to population health interventions. The model spans individual, community, and societal levels, with strategies such as surveillance, disease investigation, outreach, screening, and policy development, among others.

Epidemiology and Population Health

Epidemiology serves as the backbone of population health by studying the distribution and determinants of health-related states in populations. Through scientific data collection, analysis, and evaluation, epidemiology informs public health policy and directs interventions. The six core functions of epidemiology—surveillance, field investigation, analytic studies, evaluation, linkages, and policy development—guide population-specific care.

Primary prevention, which includes health education, is a central element of the Public Health Intervention Wheel. Epidemiological data supports surveillance and screening activities for disease prevention, while counseling enhances individuals’ ability to cope with health issues.

Table: Differences Between Community Health and Population Health

Rephrased Text in Paragraph Format

One of the core functions of epidemiology is its contribution to public policy, especially in relation to the prevention and control of diseases and regulations concerning disease surveillance. The epidemiology function that encompasses the ongoing collection, interpretation, and dissemination of health data is surveillance. Surveillance plays a critical role in identifying health needs and guiding action steps to address those needs. Field investigations, often conducted by the public health system, involve an active, hands-on approach within communities to gather detailed information about individuals exposed to disease, clinical progression, risk factors, and other relevant factors. The aim is to determine the etiology of the disease and implement measures to prevent its spread. Epidemiologists also play a key role in evaluating public health interventions and services, contributing to better health outcomes.

In addition, interdisciplinary approaches, such as linkages between different health sectors, are essential for effective disease management. For example, a population health nurse might notice an increase in childhood obesity in a local community. From a population health perspective, the nurse would investigate individual factors such as genetics, dietary choices, physical activity levels, and parental work schedules. While age and gender are not directly linked to obesity, other modifiable factors can be addressed through interventions such as educating families on healthy food choices, parental involvement, and screening for genetic predispositions. Community-level environmental factors also play a role in childhood obesity, including the availability of healthy food options and access to physical education in schools. Legal and policy measures, such as food labeling laws or taxes on unhealthy foods, can also influence community health outcomes. Schools can further reduce obesity rates by implementing strategies such as limiting access to vending machines, providing recess breaks, and establishing food programs to support children from low-income households.

NR 442 Week 1 Community Health Edapt Notes

Tertiary prevention strategies for school-aged children diagnosed with obesity involve managing the disease and preventing its progression. This may include continuous dietary education and regular screening for related conditions such as hyperlipidemia. It is important to measure and monitor children’s body mass index (BMI) more frequently than every two years. Evaluating the effectiveness of obesity prevention programs requires examining data points such as average BMI, physical education class participation, and the availability of healthy food options in school cafeterias. Parental education levels, while important, are not easily modifiable factors in addressing childhood obesity rates.

In cases of foodborne illness outbreaks, such as salmonella, the pillars of community health play a crucial role in managing and preventing future outbreaks. Clinical healthcare providers diagnose and treat individual cases, while public health systems offer disease investigation, ongoing surveillance, and contact tracing. Epidemiologists identify the source of the outbreak and work to control it, with the goal of preventing recurrence. Public policy can also influence food safety regulations, further reducing the risk of future outbreaks.

Community health nurses conduct comprehensive assessments to identify health risks and promote wellness. These assessments can focus on various groups that constitute a community, such as those who live in the same geographic area, attend the same church, or share a common health trait. Community assessments often begin with windshield surveys, where nurses drive or walk through neighborhoods to gather data about the environment. Additional data collection methods include interviews with key informants, community forums, and the analysis of secondary data like census reports. After collecting and analyzing the data, nurses diagnose the health needs of the community, plan and implement interventions, and evaluate the outcomes.

Windshield surveys help nurses identify key social, economic, and environmental conditions affecting the community’s health. For example, observations may reveal evidence of substance use or homelessness, indicators of economic hardship, or the presence of health resources such as hospitals and clinics. Additionally, census data and vital statistics provide valuable demographic and socioeconomic information. Secondary data is particularly useful for assessing public health issues such as low birth weight or the prevalence of diabetes.

The nursing process in community health involves defining the community, collecting and analyzing data, formulating diagnoses, and planning and implementing interventions. It is also essential to prioritize identified health problems before proceeding with the development of community health programs. Nurses must collaborate with community members and leaders to create sustainable health solutions. By using comprehensive assessments, nurses ensure that interventions are appropriately targeted and that health disparities are addressed in a meaningful way.

Rephrased Text in Row and Column Table Format

References

Authoritative sources for this text should include:

Centers for Disease Control and Prevention (CDC). (n.d.). Epidemiology and Public Health. Available at: https://www.cdc.gov.

American Public Health Association (APHA). (2020). Obesity Prevention Strategies. Retrieved from https://www.apha.org.

World Health Organization (WHO). (2021). Foodborne Disease Surveillance and Control. Available at: https://www.who.int.

Ariosto, D., Billioux, A., & Conway, P. (2018). Population health: A guide for healthcare organizations and providers. New England Journal of Medicine, 379(11), 1055-1062.

Centers for Disease Control and Prevention (CDC). (2020). Population health: Improving health outcomes and reducing healthcare costs. CDC Report.

Institute of Medicine (IOM). (2013). U.S. health in international perspective: Shorter lives, poorer health. The National Academies Press.

Minnesota Department of Health Division of Community Health Services Public Health Nursing Section. (2001). Public Health Intervention Wheel.

NR 442 Week 1 Community Health Edapt Notes

Centers for Disease Control and Prevention. (2014). The leading causes of death in the United States. Retrieved from https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Centers for Disease Control and Prevention. (2020). Public health and community nursing. Retrieved from https://www.cdc.gov/publichealth/nursing.htm

Nies, M. A., & McEwen, M. (2019). Community/public health nursing: Promoting the health of populations (7th ed.). Elsevier.

Office of Disease Prevention and Health Promotion. (n.d.). Healthy People 2030 framework. Retrieved from https://www.healthypeople.gov/2030