+ Brooke, Megan, Anne, Sylvia, Anna Kay, Tayvia, Timika, and Sara Indian Trail Community Assessment Project

+ Assessment of the Community (Windshield Survey) Housing and zoning Less commercial buildings, more houses Older multi family homes Open Space Open fields Transportation No public transportation Streets are in good condition

+ Assessment of the Community (Windshield Survey) Stores Wal-Mart Super Center Food Lion & Dollar tree Street people/Race & Ethnicities Construction workers, highway workers All races & ethnicities Signs of decay Area is well maintained

+ Assessment of the Community (Windshield Survey) Boundaries Signs upon entry, Political boundaries, The developments did have names Common Areas Kate’s Skating Rink, Strip Mall, Walmart Super Center, Golf Courses, “Indian Trail Power Trail” Service centers Plenty of schools, Hospitals/clinics, Airport, social services, employment offices, goodwill, Habitat for Humanity. Religion Most Baptist denomination; few Methodist, One Korean church, and Jehovah’s Witness worship center Most have Sunday school Some have activities for a specific age or gender

+ Assessment of the Community (Windshield Survey)-Cont. Health and morbidity No signs of drug abuse Numerous smokers Leads to COPD, lung cancer, HTN, stroke, etc. Some overweight Could lead to diabetes Politics Several homes with Mitt Romney or Newt Gingrich signs Possibly a large republican population Media Did not see many reading the Newspaper No buses for informational posters

+ 3 Main Needs/Problems in Indian Trail The lack of Public Transportation The lack of sidewalks for pedestrians The lack of tornado sirens

+ Transportation Although there is help in costs when it comes to transportation for those with veteran assistance, and Medicaid and/or social security recipients in terms of taxis, or cabs, other means of public transportation does not exist for the general public. Access to health care? Limited usage for Medicaid/Social Security Recipients.

+ Intervention of Transportation Needs C.A.T.S. Bus Stops through out the Indian Trail Area for access to Charlotte locations Possible discounted cab fare services given to patients with doctors visits in Charlotte area (almost a “network” between Dr. and Cab service) Mobile medical services once monthly to the area until financially Indian Trial can meet transportation needs.

+ Research Says This About Access to Transportation “Transportation can be a major access barrier to timely health care for low income populations. “ “The literature shows two distinct health effects of poor transportation: Less use of preventative and primary care More use of the emergency department” “Studies suggest that provision of reliable transportation services is important to enable patients to have access to regular and preventative care.”

+ Desired Transportation Outcomes Better medical access to community Improved patient outcomes for acute and chronic conditions Better patient compliance with regimes provided by physicians Possibility of increased social and physical interactions due to ability to “get up and go”

+ Sidewalks Sidewalks are limited to “subdivided” areas which makes them exclusive to those residents. Lack of sidewalks limits access to parks and contributes to obesity. Residents are unable to get to stores to make healthy food choices.

+ Intervention of Sidewalk Needs Meetings with town leaders to discuss the benefits of sidewalks on the community City finds funds to finance sidewalk project. Sidewalks built in conjunction with new park project (M. Moore, personal communication, February 16, 2011). The construction of sidewalks, especially in areas that are more populated.

+ Research Says “ There is a significant relationship between environmental characteristics (sidewalks) and physical activity.” “Several authors propose the obesity epidemic is partially the result of drastic environmental transformations that have negatively impacted physical activity.” “Residents of high-walkability neighborhoods tend to accumulate more minutes of physical activity and walk more for recreation and transport and are likely to meet physical activity recommendations than residents of low-walkability neighborhoods.”

+ Desired Sidewalk Outcomes Residents can access outdoor amenities safely. The construction of more sidewalks to increase physical activity. Decreased obesity rates.

+ Tornado Sirens Tornado History from 1950 – 2000

+ Intervention of lack of Tornado Sirens Install Tornado Sirens to alert residents Create a disaster management plan in advance CodeRED: computer-based system for severe weather alerts 24 hours a day Telephone, , text message alerts Location Specific

+ Research Says “Each community should have an up to date Emergency Operations Plan” Each plan should contain: A pre-storm phase: risk assessments, drills, public education A warning phase: a method for receiving weather information and alerts such as weather alert radios or Internet based weather tracking software A response phase: methods to address potential hazards likely to be present after a storm including downed power lines, natural gas ruptures, and weakened structures

+ Desired Tornado Sirens Outcomes Efficient Sirens in place Educated community regarding tornado safety and disaster preparedness Lower fatality rates and injuries resulting from tornados

+ Annotated Bibliography Advameg, Inc. (2011). Indian Trail, NC. Retrieved February 3, 2012, from This website contains a lot of useful information that was used during this project. It contains information regarding Indian Trail’s weather, economy, housing, schools, and so much more. For example, in the section of religion there is a pie chart that shows what religions are more prevalent in this area. Southern Baptism is the most prevalent, with the United Methodist Church coming next.

+ Annotated Bibliography Liu, S., Quenemoen, L., Malilay, J., Noji, E., Sinks, T., Mendlein, J. (1996). Assessment of a Severe-Weather Warning System and Disaster Preparedness, Calhoun County, Alabama, American Journal of Public Health, 86, This article from the American Journal of Public Health evaluates the effectiveness of Sirens for Warning of Tornados in Calhoun County, Alabama. The study used community surveys of both populations that were hit by the tornado with a siren warning system and populations that were hit by the tornado without a siren warning system. The surveys were found that many factors played a role in disaster preparedness. The other factors included education and shelter-seeking behaviors. Having sirens in place did play a role in warning the population of the Tornados but education on what to do when the warnings are in place need to be apart of disaster preparedness of a community.

+ Annotated Bibliography Kim, J., Norton, E., & Stearns, S. (2009). Transportation brokerage services and medicaid beneficiaries' access to care. Health Services Research, 44(1), doi: /j x In this article, Kim, Norton, and Stearns, explored the effects of transportation and access to medical care. They found that the lack of reliable transportation could be a major barrier to timely health care. Some of the health effects that result from a lack of transportation includes: less use of preventative and primary care, and more use of the emergency department. The study found that reliability in transportation is of value to ensure that patients receive regular and preventative care. Another positive patient and societal outcome is the reduction in health care costs due to the decrease use of emergency services and more use primary preventative measures. These outcomes can be seen as a direct correlation of improvement in access to transportation.

+ Annotated Bibliography Poszywak, T. (2008). Tornado preparedness and public warning systems for the Frederick-Firestone fire protection district. National Fire Academy. Retrieved from: In this article, Poszywak examines tornado preparedness activities and types of tornado warning systems that are available for use. The literature review addresses three questions. First, what tornado response planning and preparedness activities are being used by communities in the United States? Second, what types of public warning systems for tornado threats are being used in the United States? Third, what methods are being used to fund initial purchase and continued maintenance of tornado warning systems? Based on the literature review, Poszywak recommends that each community formulate a tornado preparedness plan in order to minimize the damage done to the community.

+ Annotated Bibliography Russ, S., Garro, N., & Halfon, N. (2010). Metting children’s basic health needs: From patchwork to tapestry. Children & Youth Services Review, 32(9), doi: /j.chilfyouth A reduction in children’s basic needs has a major impact on their health. Low income families result in poor health outcomes for children. Therefore children chronic illnesses are increasing and obesity continues to affect the younger generation. This also leads to increases in developmental, behavioral and mental problems. Unmet needs for children based on living standards have a significant effect on children and their adult life as well. They will have chronic illnesses and other health disparities. There needs to be a new approach to children’s health needs because it is the foundation for long-term well being. This article uses the Life Course Health Development Model that helps develop a framework of factors that consist of genetic, biologic, behavioral, social and economics determinants. Health status is based on multiple risk factors and exposure to these risks during the most crucial time in a child’s development can have great impact on their present and future health status.

+ Annotated Bibliography Suminski, R., Heinrich, K., Poston, W., Hyder, M., & Pyle, S. (2007). Characteristics of urban sidewalks/streets and objectively measured physical activity. The New York Academy of Medicine, 85(2), Retrieved from d This article studied the relationship between environmental characteristics, such as sidewalks, and physical activity. It provided further evidence that environmental characteristics (sidewalks) and walking are related. It discussed how the obesity epidemic is partially the result of environmental transformations that have negatively impacted physical activity. The study concluded that residents of high- walkability neighborhoods tend to accumulate increased physical activity time and walk more for recreation and transport and are more likely to meet the physical activity recommendations and have lower obesity rates than residents of low-walkability neighborhoods. More sidewalks within a community can lead to more physical activity among individuals and therefore, lower rates of obesity.