NR 442 Case Study 04-Community Assessment Part 1

Case Study 04 – Community Assessment Part 1: Shoe Leather/Windshield Survey and Key Informant Interview

Case Study Synopsis

As a public health nurse, you are tasked with performing a comprehensive community assessment to inform a newly updated strategic plan. This initiative aims to prepare a local community for anticipated growth and development. The assessment provides an opportunity to identify the community’s strengths, weaknesses, and areas for improvement, while also offering recommendations to enhance overall population health and well-being.

Concepts Covered

• Health promotion

• Health policy

Public Health Nursing Interventions Addressed

• Disease and health event investigation

• Consultation

• Policy development and enforcement

Suggested Readings

• Edelman, C. L., & Kudzma, E. C. (2021). Health promotion throughout the life span (10th ed.). Chapter 8: Health Promotion and the Community.

• Nies, M. A., & McEwen, M. (2019). Community/public health nursing (7th ed.). Chapter 6: Community Assessment.

• Stanhope, M., & Lancaster, J. (2020). Foundations for population health in community/public health nursing (5th ed.). Chapter 12: Community Assessment and Evaluation.

• Stanhope, M., & Lancaster, J. (2020). Public health nursing (10th ed.). Chapter 17: Community as Client: Assessment and Analysis.

Estimated Completion Time

Activity	Time Required
Case study	2 hours
Review questions	30 minutes
Discussion questions	1 hour
Total	3.5 hours

Case Study Objectives

1. Identify appropriate data sources for community assessment.

2. Collect demographic, geographic, governmental, healthcare, cultural, and socioeconomic information.

3. Conduct preliminary data analysis from the windshield survey and community assessment to highlight strengths and weaknesses.

4. Develop recommendations for a strategic plan based on findings.

Introduction

The city manager has requested a community assessment as part of a city council initiative to update a six-year strategic plan. The primary goal is to prepare for the community’s projected growth and development. This assessment allows public health nurses to examine community strengths, identify potential weaknesses, and suggest strategies to enhance population health. Initial steps included a preliminary review of publicly available community information.

Population Overview

Characteristic	Data
Total population	22,791
Female	52.2%
Male	47.8%
Under 18 years	34.8%
19–64 years	61.2%
Over 65 years	4%
Ethnic composition	56.8% Caucasian, 9% Black/African-American, 23.4% Hispanic/Latino, 10.8% Other

Location and Livability

Feature	Description
Livability score	86
Crime rate	Low
Cost of living	Low
Climate	Temperate; warm summers, mild winters
Amenities	Local parks, recreational facilities, community centers

Primary Industries

Industry	Type
Computer technology	Manufacturing
Hardware and software	Manufacturing
Public education	Non-manufacturing
Government	Non-manufacturing
Health care	Non-manufacturing
Farming/ranching	Non-manufacturing

Economic Information

Feature	Statistic
Per capita income	$73,977
Persons below poverty level	7.4%
Unemployment rate	3.4%
Home ownership rate	65.1%

Educational System

Level	Facilities
Public high school	1
Public middle schools	2
Elementary schools	6
Higher education center	Workforce readiness programs
Private universities	5
Public universities	2

Recreation and Leisure

• High school football programs

• Hunting, fishing, hiking, and biking activities

• Two community parks with swimming pools

• YMCA and annual community events, including Crawfish Festival and Old Tyme Festival

Health Care Facilities

Facility	Services
Head Start Program	Early childhood care
Urgent Care Clinic	Immediate care
Pediatric Clinic	Child health
Primary Care Clinic	General health
Rehabilitation & Skilled Nursing	Long-term care
Fire Department/EMS	Emergency services
Alzheimer’s/Respite Day Care Center	Specialized care

Environmental Health

Feature	Index
Air Quality	70 (National Air Toxic Assessment)
Water Quality	79 (Water Shed Quality)

Transportation and Media

• Railroad terminal, taxi, and bus services available

• Media: One storefront radio station, weekly newspaper, public library

Scenario and Community Assessment

Windshield Survey

The initial windshield survey involved observing community outskirts, including agricultural areas, flat terrain, rivers, and local climate. Notable observations included crop dusters, prompting concerns about pesticide and herbicide exposure affecting food and water quality. Key factors assessed included race/ethnicity distribution, housing conditions, homelessness, littering, availability of parks, and the impact of a nearby railroad track.

Key Informant Interviews

Interviews with health care providers, public officials, and community members highlighted health concerns affecting vulnerable populations. A school nurse identified prevalent issues including elevated cancer rates (especially breast cancer), farm-related injuries, and obesity. These observations required further investigation to determine underlying environmental and behavioral causes.

Social Determinants of Health (SDOH)

The school nurse provided insights into social determinants affecting student health. Utilizing the Culture of Health framework, common community factors influencing health disparities included air quality, accessibility to health services, and individual behaviors.

Emergency Health Care Access

An incident during the interview process illustrated emergency care challenges. A student injured during a football game highlighted that a nearby railroad track delays EMS response. This barrier to timely emergency care became a priority for policy intervention.

Data Collection and Health Trends

Analysis of community health trends identified priority concerns, particularly limited emergency services access. Recommendations include developing policies to improve EMS response times and considering construction of an additional healthcare facility to mitigate barriers caused by the railroad tracks.

Public Health Nursing Interventions

Public health nurses are central to community assessment, performing tasks such as data collection, risk identification, and proposing solutions. Collaborative interventions involve working with stakeholders to create policies addressing farm-related injuries, cancer prevention, and obesity. Emphasis is placed on health promotion, disease prevention, and strengthening healthcare systems.

Conclusion

The community assessment provided comprehensive data and insights from key stakeholders. Identified health risks, environmental concerns, and barriers to healthcare access warrant further action. Prioritizing strategic policy interventions and targeted community health programs will improve population health outcomes and enhance overall community well-being.

References

Cui, E. R., Beja-Glasser, A., Fernandez, A. R., Grover, J. M., Mann, N. C., & Patel, M. D. (2019). Emergency medical services time intervals for acute chest pain in the United States, 2015–2016. Prehospital Emergency Care, 24(4), 557–565. https://doi.org/10.1080/10903127.2019.1676346

Edelman, C. L., & Kudzma, E. C. (2021). Health promotion throughout the life span (10th ed.). Elsevier.

Nies, M. A., & McEwen, M. (2019). Community/public health nursing (7th ed.). Elsevier.

NR 442 Case Study 04-Community Assessment Part 1

Stanhope, M., & Lancaster, J. (2020). Foundations for population health in community/public health nursing (5th ed.). Elsevier.

Stanhope, M., & Lancaster, J. (2020). Public health nursing (10th ed.). Elsevier.