1. Planned Community Change Group Project
Janice Schmuckal, Sofia Warren,
Michol Popp, Heather Nowak
Ferris State University
NURS 340

2. Outline Introduction Problem Statement Community Assessment
Interventions
Evaluation
Conclusion
References

3. Introduction
People in the United States continue to contract diseases that are vaccine preventable, infectious disease remains a major cause of illness, disease and even death (Department of Health and Human Services (DHHS), 2011). Although there have been great strides made in immunization compliance, there is still a great need to improve the follow through of the immunization schedule to ensure the health of our nation’s children. “Despite progress, approximately 42,000 adults and 300 children in the United States die each year from vaccine-preventable diseases” (DHHS).

4. Problem Statement
Risk of communicable vaccine preventable diseases among adolescents in Kent County related to non-compliance and knowledge deficits according to the recommended CDC immunization schedule as evidenced by comparison of Kent County and national statistics.

5. Causative Factors Lack of health insurance Knowledge deficits
Parental resistance to vaccinations
Under vaccination

6. Community Assessment
There are about six million new cases of genital HPV in the United States each year (CDC MMWR, 2011).
HPV prevalence was 24.5% among females (CDC MMWR, 2011).
Adolescent girls receiving all three doses of the HPV vaccine was 32% (CDC MMWR, 2011).

7. Community Assessment cont’d
In Kent County pertussis has gone from 1.4 per 100,000 cases to 3.5 per 100,000 cases in the years (KCHD, 2005).
Pertussis is the only vaccine-preventable disease on the rise in the United States, with increasing incidents in adolescents and adults related to weaning immunity (Brooks & Clover, 2006, p. 604).

8. Community Assessment cont’d
In Michigan, this increase was first observed in 2008, with 315 cases of pertussis that was reported. The rise is continuing and in 2009, there were 902 reported cases and in 2010, there were 1564 cases of pertussis reported (Michigan Department of Community Health (MDCH), 2011).

9. Community Assessment cont’d
“As reported in the 2003 to 2004 National Health and Nutrition Examination Survey, at least one in four adolescents had as least one of the most common STIs – namely, genital wart-associated human papillomavirus (HPV) (18.3%)” (Harkness & DeMarco, 2012, p. 442).

10. “Pertussis is the only vaccine-preventable disease on the rise in the US and it is severely underreported. CDC estimates that, at best, one-third of cases are believed to be reported to the CDC; other estimates place the reported cases at 1 in 10 to 1 in 20 of the true incidence” (Brooks & Clover, 2006, p. 604).

11. Pertussis Infection Rate (all ages), Source: Kent County Data: KCHD Monthly Notifiable Disease Report MI Data: Michigan Department of Community Health US Data: Summary of Notifiable Diseases, Center’s for Disease Control

12. Community Nursing Interventions
Examples of primary prevention of communicable disease among adolescents include:
Immunization
Health education
Sanitation (hand washing, safe food, safe water)
Regular exams
Legislation

13. Community Nursing Intervention
Obtain current immunization records.
Education to the adolescent population on immunization requirements including boosters.
Education to the parent of the adolescent population.
Information regarding access to immunization clinics and applications for free immunizations.

14. The school nurse provides a critical link between the child the family and the education and healthcare systems. One of the screening requirements of a school nurse is immunization review” (Harkness & DeMarco, 2012, p.453).

15. Roles of School Nurse Direct care to students
Leadership for health services
Screening and referral for health conditions
Assessment of acute illness
Promotes a healthy school environment
Health promotion
Leadership role in health policies and programs
Liaison between personnel, family, healthcare professional and the community
Education
Hygiene
Immunizations
Safety
Signs of communicable disease

16. Education:
Education to adolescent can be provided in a number of ways including:
Informational handouts
Internet
Television
Educational sessions

17. Educational Session
Educational sessions will be geared toward middle and high school adolescents
The facility used will be large, such as a school gym or auditorium.
These sessions can be during school hours to ensure a large audience attendance.

18. Education: Education to the parent has proven to be beneficial:
According to one study, parents that received a vaccine information pamphlet (VIP) were twice as likely to want to obtain immunizations for their children. (Clayton & Miller, 1994, p.370)

19. Access to Community Resources in
Kent County, MI

20. Evaluations
The evaluation of the community nurse’s educational session aimed at high school adolescents will be best obtained through the use of a survey.

21. Evaluations
The questionnaire may also include questions on attitudes, on values that may underlie attitudes on the issue, message statements pro and con, demographic and lifestyle questions, and questions on policies and behavior. (Belden, et al., 2004)

22. Evaluations
Surveys are a valuable tool. The results of surveys can provide the information needed to show the effectiveness of the nursing intervention:
Has the audience digested the information?
Has it influenced their thoughts on the issue of vaccination?
Was it a positive or negative response from the surveyed individuals, and why?
Has the intervention motivated actions?
(Belden, et al., 2004)

23. Conclusion
Immunizations of our youth ensure the prevention of communicable disease. With the recent statistics we fall short of the goals. Education of our adolescents and their parents play a large role in compliance and empowers the adolescent to be responsible for their own health. By providing information and resources for immunization we are closing the gap on non-compliance.

24. Conclusion
Immunization will always be an ongoing process as there are new citizens born every minute. Breaking the barriers and empowering people with knowledge is the goal of the community health nurse. Nursing can evaluate the educational process by using a survey as a tool to analyze the feedback to ensure success.

25. References
Beldon, Russonello, Stewart, (2004). Using Survey Research to Evaluate Communications Campaigns. Retrieved from
Brooks, D. A., & Clover, R. (2006, December). Pertussis Infection in the United States: Role for Vaccination of Adolescents and Adults . Journal of the American Board of Family Medicine , 19(6), doi: /jabfm
Centers for Disease Control and Prevention. (2005, December 23). Morbidity and Mortality Weekly Report, 54(50), Retrieved from
Centers for Disease Control and Prevention. (2011, September 16). Morbidity and Mortality Weekly Report, 60(36); Retrieved from
Clayton, E., Hickson, G., & Miller, C. (1994). Parent’s responses to vaccine information pamphlets. Pediatrics, 93, Retrieved from
Dorell, C., Yankey, D., & Strasser, S. (2011, August 19). Parent-Reported Reasons for Nonreceipt of Recommended Adolescent Vaccinations, National Immunization Survery--Teen, Clinical Pediatrics, 1-9. doi: /
Freed, G., Clark, S., & Cowen, A. (2000, October). State-level perspectives on immunization policies, practices, and program financing in the 1990s. American Journal of Preventative Medicine, 19(3), doi: /S (00)
Harkness, G. A., DeMarco, R. F. (2012). Community and Public Health Nursing Practice: Evidence for Practice. Wolters Kluwer/Lippincott, Williams & Wilkins: Philadelphia
Health Promotion Model. (2011, April 15). Retrieved November 10, 2011, from

26. References
Heart of West Michigan United Way. (2011) Retrieved November 10, 2011, from
Merck & Co., Inc. (2011). Gardasil. Retrieved November 2, 2011, from
Michigan Care Improvement Registry. (2011). Retrieved October 27, 2011, from
Michigan Department of Community Health. (2011). Pertussis in Michigan. Retrieved November 1, 2011 from
Public Health Clinic Services. (2011). Retrieved November 14, 2011, from
U.S. Department of Health and Human Services. (2011). Immunizations and Infectious Diseases. Retrieved November 1, 2011, from x?topicid=23