Class 5 - Community Health Flashcards
what is a community
group of people with diverse characteristics who are linked by social ties, share common perspectives and engage in joint action in geographical locations or settings
Which 4 descriptive words align with what a community is
- locus
- sharing
- joint action
- social ties
what is a community, locus:
- a sense of place
- idea of community as something that could be located and described, denoting a sense of place, locale, or boundaries
what is a community, sharing
- common interests and perspectives
- existence of shared perspectives and common interests that contributed to a sense of community
what is a community, joint action
a source of cohesion and identity
what is a community, social ties
interpersonal relationships that formed the foundation for community
Community components
- people (community residents)
- place (refers to both geographic and time dimensions)
- function (the aims and activities of the community
- they are interdependent (mutually reliant)
- function is to meet a wide variety of collective needs
what are the 3 dimensions in community health
status, structure, process
community health, status dimension includes which components
physical, emotional, social
community health, how is physical status measured?
often measure by traditional morbidity and mortality rates, life expectancy indices, and risk factor profiles
community health, how is emotional status measured
can be measured by client satisfaction and mental health indices
community health, how is social status measured
reflected in crime rate and individual and family functional levels
community health, structure dimension
Includes community health services and resources and attributes of the community structure itself, commonly identified as social indicators or correlates of health
community heath, process dimesion
community health is the process of effective community functioning or problem solving
what is a healthy community
one where people, organizations, and local institutions work together to improve social, economic, and environmental conditions that make people healthy (the DOH)
Asset Based Community Development (ABCD)
- defined by Kretzmann and McKnight as “building communities from the inside out”
- occurs when a community is engaged in a dynamic, continuous process of social change that can lead to permanent enhancements in people’s lives
what is community development
- holistic approach grounded in principles of empowerment, human rights, inclusion, social justice, self-determination and collective action
- led by community members at every stage
- explicit focus on redistribution of power to address causes of inequality and disadvantage
community development relies on which approach
stregnth-based approach
community development, asset mapping
identifying community-based initiatives such as community development, strategic planning, and organizational development
community development, sustainability
- maintenance and continuation of established community programs
- more likely to occur when members of the community are involved as partners in the development process
define community health assessment
a dynamic, ongoing process undertaken to identify the strengths and needs of the community, enable the community-wide establishment of health priorities, and facilitate collaborative action planning directed at improving community health status and quality of life
community health assessment aligns with which approach?
nursing process
what are the 4 phases of community health assessment?
assessment, planning, implementation, evaluation
community health assessment description
- ongoing quantitative and qualitative systemic appraisal of the community
- goal is to address the challenges to reduce inequalities, increase prevention, and enhance community coping
- successful only when community is fully engaged and empowered throughout the nursing process
community health vs population health
- community: collaborative, empowering > emphasizing the integration of multiple entities working together
- population health: outcomes, management > outline the methods by which health is managed for a targeted group of individuals
what is the shared mission of community and population health
enhancing disease prevention through the use of upstream health promotion strategies
what is the purpose of community health assessment?
- identify community strengths, resources, assets, capacities, and opportunities
- clarify health concerns
- identify community constraints
- identify the economic, political, and social factors affecting community
- identify the DOH affecting community health
community health assessment; main aspects of assessment stage
- data collection and interpretation
- challenges
- building trust
community health assessment; data collection and interpretation involved in the assessment stage
- gathering or compiling existing data
- identifying missing data
- interpreting data
- identifying community abilities and health concerns
community health assessment; assessment stage tools
- surveys
- key-informant interviews
- focus groups
- community forums
- observation (direct or participant)
- windshield or walking surveys
- asser mapping
- photo-voice
- secondary analysis of existing data
assessment tools, surveys
collecting info through standard questionnaire of open and/or closed-ended question, by mail, phone, face to face, or online
assessment tools, key-informant interviews
one-to-one interviews to gather info from individuals w/ unique insights regarding the community (and the problems faced)
assessment tools, focus groups
series of small group discussion focused on a specific topic and conducted by a trained facilitator
assessment tools, community forums
public meeting focused on defining topic led by a moderator; members discuss issues, identify problems and engage in problem-solving discussions
assessment tools, observation (direct or participant)
- direct observation is an assessment by an outsider looking into the community
- participant observation is done by the community members or by someone engaging in the life of the community
assessment tools, windshield
driving or walking through a community to observe and assess certain aspects about the community
assessment tools, asset mapping
collecting an inventory of assets or strengths in the community and plotting the assets on a map
assessment tools, photo-voice
qualitative data collection process where people use photo or video to share info about their community or POV
assessment tools, secondary analysis of existing data
quantitative analysis of existing data respositories
community health assessment, what are challenges for the assessment stage
- gaining entry or acceptance can be major hurdle to assessment; difficult to open-up
- confidentiality is important but is affected by the legal requirement to disclose info in some cases (e.g. child abuse)
community health assessment, what are the 4 steps in the planning stage
- analyze
- setting health concern priorities
- establishing goals and objectives
- identifying intervention activities
community health assessment, how to anaylze within planning stage
CHN seeks to clarify the nature of the concern, the points at which intervention might be undertaken, and the parties that have an interest in the health concern and its solution
community health assessment, questions for setting health concern priorities within planning stage
- how aware is the community of the health concern?
- is the community motivated to resolve or better manage concern?
- is the CHN able to influence a solution?
- are experts available to solve the concern?
- how severe are the outcomes if the concern is unresolved?
- how quickly can the concern solved?
community health assessment, what are goals and objectives within the planning stage
- goals: broad statements of desired outcomes
- objectives: precise statements indicating the means of achieving the desired outcomes
SMART goals
Specific, Measurable, Achievable, Relevant, Timely
community health assessment, what are intervention activities within planning stage
strategies used to meet the objectives, the ways in which change will be effected, and the ways in which the health concern cycle will be broken
community health assessment, what factors are influencing implementation stage
- CHN’s role
- community health concern and the CHN’s role and personal choices
- the social change process and how receptive the community is to innovation
community health assessment, describe evaluation stage
- appraisal of the effects of some organized activity or program
- begins in the planning phase of community action, when goals and measurable objectives are established, and goal-attaining activities are identified
community health assessment, describing the program within the evaluation stage includes the following…
clear description of the program including:
- need and rationale for the program
- program’s goals, audience, activities, indicators, inputs, outputs, and outcomes
community health assessment, which models can be used for the evaluation stage
- program logic model
- PRECEDE-PROCEED model
describe the Program Logic Model
- illustrates the relationship between a program’s inputs and the desired outcomes
- clarifies logical linkages of program inputs, outputs, and outcomes related to a specific health concern or situation
Program Logic Model diagram
- inputs resources
- activities > outputs
- short-term > outcomes (impact intermediate) > long-term
Describe the PRECEDE-PROCEED Model phases
- PRECEDE (phases 1-5): set the direction and objectives for the ensuring phases
- PROCEED (phases 6-9): address the need for health promotion interventions and approaches used to change unhealthy behaviours
PRECEDE-PROCEED Model diagram: PRECEDE
Phase 1 - social assessment: define quality of life for priority population.
Phase 2 - epidemiological assessment: identify health problems and determine/prioritize individual and behavioral risk factors associated with health problem.
Phase 3 - behavioural and environmental assessment
Phase 4 - educational and ecological assessment: determine predisposing (beliefs), enabling (skills), and reinforcing (feedback and encouragement for positive behavior) factors.
Phase 5 - administrative policy assessment: determine the resources (staff, money, etc) available for the program.
PRECEDE-PROCEED Model diagram: PROCEED
Phase 6 - implementation: select strategies and activities; begin program.
Phase 7 - process evaluation: document program feasibility.
Phase 8 - impact evaluation: assess the immediate effect of an intervention.
Phase 9 - outcome evaluation: determines whether long-term program goals are met.
community health assessment, process of evaluation stage
- identify and engage partners
- determine timelines and available resources
- develop evaluation questions
- select measurement methods and procedures
- create the evaluation plan, collect data, process and analyze data
- interpret and disseminate results
- apply evaluation findings
Evaluation stage - identify and engage partners
- identify who will be impacted
- consider interests and expectations of each
- how they will use the eval results
- ways to engage them in eval process
Evaluation stage - determine timelines and available resources
- who will complete eval
- are there reporting timelines
Evaluation stage - what are evaluation questions based on
- process evaluation (formative assessment)
- outcome evaluation (summative assessment)
Process evaluation (formative assessment)
determines whether program activities have been implemented as planned/intended
Outcome evaluation (summative assessment)
- focuses on the more downstream outcomes of a program
- measures the effects of the program on the audience by assessing the progress in achieving the planned goal
Health program evaluation criteria
- Relevance: The need for the program
- Adequacy: The extent to which the program addresses the entire problem defined in the needs assessment
- Progress: The tracking of program activities to meet objectives
- Efficiency: The relationship between program outcomes and costs
- Effectiveness: The ability to meet program objectives and the results of program efforts
- Impact: Long-term changes in the client population
- Sustainability: Enough resources to continue the program
