Community Health

Question 1

What is community engagement?

Answer 1

Working collaboratively with and through groups of people associated with a certain geography, of common interests and perspectives, common identity, social ties etc. to affect their well-being. It involves forming partnerships, mobilizing community resources, forming relationships, and serving as a catalyst for change in community programs, policies, and practices

Question 2

What are the core elements of community?

Answer 2

1. Locus: sense of place
2. Sharing: Common interests and perspectives
3. Joint action: identity and cohesion
4. Social ties: Interpersonal relationships
5. Diversity: not ethnic distinction but more socially complex; communities within communities

Question 3

What is public health?

Answer 3

Programs and policy – political guidance level at local, regional, national, and international levels

Question 4

What is community health?

Answer 4

Where the prevention and interventions actually happen

Question 5

How is the nursing process utilized in community health nursing?

Answer 5

ADPIE

Community assessment: collect data about the health of a community / population

Community diagnosis: analyze the assessment findings, prioritize the problems

Planning programs: set goals and objectives based on priority problems

Implementation: use the roles within the Minnesota wheelchair promote health/prevent disease

Evaluation: were the objectives met? What needs to happen next?

Question 6

Why is a community assessment conducted?

Answer 6

Understanding: gain a deeper understanding of the community

Identify assets: identify community assets and key collaborators

Priorities: determine community and organizational priorities

Stakeholders support and trust: engage stakeholders, gain community support/trust

Potential barriers: identify project barriers

Interventions: to guide the community health programming and interventions

Question 7

List the components that should be included in a community assessment

Answer 7

1. Data-gathering: existing and research
2. Data generation: observe, interviews, focus groups, windshield surveys
3. Synthesize Findings / Conclusions: leads to diagnosis

Question 8

Describe the Quad Council

Answer 8

The quad council published the scope and standards of public health nursing practice and core competencies.

Members:

1. Public Health Nursing Section of American Public Health Association
2. Association of State and Territorial Directors of Public Health Nursing
3. Association of Public Health Nurse Educators
4. National Association of School Nurses

Question 9

Define public health nursing

Answer 9

Public health nursing is the synthesis of nursing theory and public health theory apply to promoting and preserving the health of populations.

Population-based

Prevents disease

Promotes the health of a community as a whole

Question 10

What are the components of population-based practice (public health nursing PHN practice)

Answer 10

Focus on entire population with shared characteristics

Grounded in assessment of the population’s health status

Considers the broad determinants of health

Emphasizes all three levels of prevention

Intervenes with the community, its systems, individuals and families

Question 11

What is the health impact pyramid?

Answer 11

From fewest resources and broadest reach, starting from the bottom of the triangle:

Socioeconomic factors

Changing context to make individual default decisions healthy

Long-lasting protective interventions

Clinical interventions

Counseling and education

Question 12

What is the social-ecological model

Answer 12

Circular graph starting from the outside broadest reach towards the middle individualized reach:

Public policy

Community

Organization

Interpersonal: families, friends, social

Individual

Question 13

List the three core public health functions

Answer 13

APA

1. Assessment: data collection on a population, diagnose and investigate
2. Policy: development and planning leadership and policy
3. Assurance: ensuring essential health services are accessible and available to all persons

Question 14

What are the three levels of prevention?

Answer 14

1. Primary prevention: before a health issue occurs
2. Secondary prevention: issue has occurred but can’t be reversed or stopped
3. Tertiary: manages the issue and can slow progress

Question 15

How does the Guide to Community Preventive Services assist in program planning?

Answer 15

It is a resource of evidence-based practices that includes:

1. What programs and policies have proven effective
2. If there are effective interventions for my community
3. Expected cost of an intervention and likely return on investment

Question 16

What is incidence rate?

Answer 16

of new cases of disease during a time period / # of persons at risk for developing disease in the time period

X 100,000

Question 17

What is prevalence rate?

Answer 17

Point and period

of cases existing and new disease in population at a specific time / # of persons in population at that specific time

X 1000

Question 18

What is period and point prevalence?

Answer 18

How many people have disease at any time during a specified period

Some people may have developed disease during the specified period

Every person in numerator had the disease at some point during the specified period

Example of point: Do you have asthma currently

Example of period: Have you had asthma in the last “timeframe”?

Question 19

What is the crude mortality rate?

Answer 19

Occurrence of death in the entire population:

of deaths occurring in one year / midyear population

X 100,000

Question 20

What is the cause specific mortality rate?

Answer 20

Total deaths from a stated cause in one year / midyear population X 100,000

Question 21

What is age specific mortality rate?

Answer 21

of deaths in a specific age group occurring in one year / midyear population of the specific age group

X 1,000

Question 22

What is proportional mortality ratio?

Answer 22

of deaths from a specific cause within a time period / Total deaths in same time period X 100

Question 23

What is case fatality rate (%)

Answer 23

Number of deaths from a specific disease / number of cases of the same disease X 100

Question 24

What is herd community?

Answer 24

A form of immunity that occurs when most of the population is immune to an infectious disease such as through vaccinations, therefore, providing protection to those who are not immune from getting the disease

Question 25

What is sensitivity?

Answer 25

Ability to identify who has a condition, true positives TP/TP + FN

Question 26

What is specificity?

Answer 26

Ability to identify those who do not have the disease, true negatives TN/TN + FP

Question 27

What are the three epidemiologic conceptual models?

Answer 27

1. Epi triangle: agent, host, environment, vector (animate object or fomites)
2. Wheel of causation: model for when many diseases do not have an identifiable agent

• genetic core
• host
• social environment
• physical environment
• biological environment

3. Web of causation: strongest model that represents concept of multiple causation, deemphasizes role of a single agent i.e. chronic disease, chronic illness, drug use

Question 28

Describe the natural history and spectrum of a disease

Answer 28

It is screenable, time to intervene, progression of disease overtime in absence of treatment

1. Pre-pathogenesis: primary prevention
2. Pathogenesis: secondary and tertiary prevention

Question 29

Relate epidemiology to core public health functions

Answer 29

Assessment: Monitoring, surveillance of local health problems and needs

Policy: Emphasizes local needs and equitable distribution of public resources

Assurance: Enforcing regulations, helping people receive services, confident workforce, evaluation

Question 30

Relate epidemiology to the Minnesota wheel

Answer 30

Pink and purple sections:

Surveillance

Investigation

Outreach

Screening