1. The Community as a Client: Assessment and Diagnosis

2. Community health nurses work with clients at several levels:
as individuals,
families,
groups,
subpopulations,
populations,
and communities.

3. 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

4. Myths Perpetuated by an Individualistic Focus
Location Myth
Skills Myth
Client Myth

5. a community (1) a location, (2) a population, and (3) a social system
(Lynd, 1939)

6. Community Profile Inventory: Location Perspective
Community Boundaries
Location of Health Services
Geographic Features
Climate
Flora and Fauna
Human-Made Environment
Population

7. Community Profile Inventory: Population Perspective
Size
Density
Composition
Rate of Growth or Decline
Cultural Characteristics
Social Class and Educational Level
Mobility

8. 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

10. 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).

12. 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)

13. Community Assets Assessment
(1) specific skills, talents, interests, and experiences of individual community members;
(2) local citizen associations and organizations; and
(3) local institutions

14. COMMUNITY ASSESSMENT METHODS

15. 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).

16. 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?)

17. Community Forums or Town Hall Meetings
is a qualitative assessment method designed to obtain community opinions

18. 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.

19. SOURCES OF COMMUNITY DATA
Primary and Secondary Sources
International Sources
National Sources
State Sources
Local Sources

20. DATA ANALYSIS AND DIAGNOSIS

21. 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.

22. Community Diagnosis Formation

23. 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

24. Planning, Intervention, and Evaluation of Health Care in Communities

25. 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.

26. Interacting With the Community
Need for Communication

27. 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)

30. Types of Evaluations
Structure-Process Evaluation
Outcomes Evaluation

33. The end
Thank you !