The Community as
a Client: Assessment and
Diagnosis
Community health nurses work with clients at
several levels:
as individuals,
families,
groups,
subpopulations,
populations,
and communities.
First, the community directly influences the
health of individuals, families, groups,
subpopulations, and populations who are a part
of it
Second, provision of most health services
occurs at the community level. Community
agencies help develop specific health programs
and disseminate health information to many
types of groups and populations
Myths Perpetuated by an
Individualistic Focus
Location Myth
Skills Myth
Client Myth
a community
(1) a location,
(2) a population, and
(3) a social system
(Lynd, 1939)
Community Profile Inventory:
Location Perspective
Community Boundaries
Location of Health Services
Geographic Features
Climate
Flora and Fauna
Human-Made Environment
Population
Community Profile Inventory:
Population Perspective
Size
Density
Composition
Rate of Growth or Decline
Cultural Characteristics
Social Class and Educational Level
Mobility
Community Profile Inventory:
Social System Perspective
Health system
Family system
Economic system
Educational system
Religious system
Welfare system
Political system
Recreational system
Legal system
Communication system
Three factors in particular affect
community dynamics:
(1) citizen participation in community health
programs,
(2) the power and decision-making structure,
and
(3) collaborative efforts of the community
(Lynd, 1939).
TYPES OF COMMUNITY NEEDS
ASSESSMENT
Familiarization or “Windshield Survey” (involves
studying data already available on a community, and
gathering a certain amount of firsthand data, to gain a
working knowledge of the community)
Problem-Oriented Assessment
Community Subsystem Assessment
Comprehensive Assessment
Community Assets Assessment (which focuses on the
strengths and capacities of a community rather than
its problems)
Community Assets Assessment
(1) specific skills, talents, interests, and
experiences of individual community
members;
(2) local citizen associations and
organizations; and
(3) local institutions
COMMUNITY
ASSESSMENT
METHODS
Surveys
1. Planning Phase
a. Determine what information is needed and why.
b. Determine precise data to be collected.
c. Select population to be surveyed (eg, individuals, a household, a city block).
d. Select survey method or instrument to be used (eg, interviews, telephone
calls, questionnaires).
e. Determine sampling size (eg, a percentage of the total population in
question).
2. Data Collection Phase
a. Identify and train data collectors (eg, interviewers).
b. Pretest and adjust instrument.
c. Supervise actual collection, including plans for nonresponses or refusals.
3. Data Analysis and Presentation Phase
a. Organize data for tabulation and analysis.
b. Apply appropriate statistical methods.
c. Determine relationships and significance of analysis.
d. Report results, including implications, recommendations, and next steps
needed; provide feedback to the population surveyed through a community
forum (discussed later).
Descriptive Epidemiologic Studies
examines the amount and distribution of a
disease or health condition in a population
by person (Who is affected?),
by place (Where does the condition occur?),
and by time (When do the cases occur?)
Community Forums or Town Hall
Meetings
is a qualitative assessment method designed to
obtain community opinions
Focus Groups
First, there is only a small group of
articipants, usually 5 to 15 people
Usually the group meets for 1 to 3 hours, and
there may be a series of meetings.
Major advantages of focus groups are their
efficiency and low cost, similar to the
community forum or town hall meeting
format.
SOURCES OF COMMUNITY DATA
Primary and Secondary Sources
International Sources
National Sources
State Sources
Local Sources
DATA ANALYSIS AND
DIAGNOSIS
The Process of Analysis
(1) data can be rechecked by the community
assessment team,
(2) data can be rechecked by others,
(3) subjective and objective data can be
compared, or
(4) community members can consider the
findings and verify them.
Community Diagnosis Formation
WHAT IS A HEALTHY
COMMUNITY?
1. Collaborate effectively in identifying
community needs and problems
2. Achieve a working consensus on goals and
priorities
3. Agree on ways and means to implement the
agreed-upon goals
4. Collaborate effectively to take the required
actions
Planning, Intervention, and
Evaluation of Health Care in
Communities
Three characteristics support the use of the nursing
process in community health nursing.
the nursing process is a problem-solving process that
addresses community health problems at every
aggregate level with the goalsof preventing illness
and promoting public health.
It is a management process that requires situational
analysis, decision-making, planning, organization,
direction and control of services, and outcome
evaluation
it is a process for implementing changes that improve
the function of various health-related systems and the
ways that people behave within those systems.
Interacting With the Community
Need for Communication
Forming Partnerships and Building
Coalitions
Partnerships are agreements between people
(and agencies) that support a joint purpose.
A coalition is an alliance of individuals or
groups that work together to influence
outcomes of a specific problem (Green,
Daniel, & Novick, 2001)
Types of Evaluations
Structure-Process Evaluation
Outcomes Evaluation
The end
Thank you !