Community Needs Assessment in Gerontology Nursing
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What should program resources focus on during the Epidemiological, Behavioural, and Environmental Assessment phase?

  • Factors that are expensive to change
  • Factors that are most important and modifiable (correct)
  • Factors that are less relevant to the community's needs
  • Factors that only involve institutional policies
  • Which of the following activities is essential for gerontology nursing staff to assess community needs?

  • Conducting interviews exclusively with medical staff
  • Ignoring the input of nursing home residents
  • Assessing the community's capacity and readiness to change (correct)
  • Relying solely on personal opinions of staff
  • Who should be involved in the information gathering process for assessing community needs?

  • Only family members of residents
  • Nursing home residents who smoke and other stakeholders (correct)
  • Community members outside the nursing home
  • Only nursing home staff
  • What is one method that can be used to engage nursing home residents in the assessment process?

    <p>Focus groups to discuss their views and concerns</p> Signup and view all the answers

    Which of the following is NOT a recommended information gathering method mentioned?

    <p>Letter writing campaigns to policymakers</p> Signup and view all the answers

    What is the primary focus of the project mentioned in the applied example?

    <p>Enhancing inclusivity for individuals with disabilities</p> Signup and view all the answers

    Which model was utilized to guide the development of interventions in the project?

    <p>PRECEDE-PROCEED model</p> Signup and view all the answers

    What was a key method used in the planning and implementation of the interventions?

    <p>Involvement of community stakeholders</p> Signup and view all the answers

    What outcome did the project significantly enhance through its interventions?

    <p>Social inclusion for people with disabilities</p> Signup and view all the answers

    What type of study is mentioned as a case study in the project?

    <p>Living lab case study</p> Signup and view all the answers

    What is the primary goal of the program mentioned?

    <p>Improve the academic achievement of registered POH705 2024 students at TMU</p> Signup and view all the answers

    Which type of objective focuses on the expected results of a program?

    <p>Outcome objectives</p> Signup and view all the answers

    What does the 'S' in SMART objectives stand for?

    <p>Specific</p> Signup and view all the answers

    Which level of theory is most appropriate for addressing predisposing factors?

    <p>Individual-level</p> Signup and view all the answers

    What type of objectives focuses on the activities that need to be completed?

    <p>Process objectives</p> Signup and view all the answers

    Which factor is associated with community and organizational change theories?

    <p>Enabling factors</p> Signup and view all the answers

    What characteristic must objectives have to be categorized as time-sensitive?

    <p>They must have a defined completion date.</p> Signup and view all the answers

    In the context of enhancing community support, which strategy is suggested for interpersonal-level reinforcing factors?

    <p>Peer support groups</p> Signup and view all the answers

    What is the primary focus of Phase 3 in the Precede-Proceed Planning Framework?

    <p>Educational and Ecological Assessment</p> Signup and view all the answers

    Which type of factors provides motivation for a behavior according to the Precede-Proceed Planning Framework?

    <p>Predisposing Factors</p> Signup and view all the answers

    What role do reinforcing factors play in the behavior change process?

    <p>They provide continued reward or incentive for the repetition of a behavior.</p> Signup and view all the answers

    Which of the following is classified as an enabling factor that aids in achieving behavioral change?

    <p>Program services and resources</p> Signup and view all the answers

    In the context of reducing blood-borne infections among IDUs, which factor should be prioritized for its importance and changeability?

    <p>Social support systems</p> Signup and view all the answers

    What are the objectives in Phase 3 primarily formulated based on?

    <p>Priorities established by stakeholders</p> Signup and view all the answers

    Which of the following describes the role of predisposing factors in health behaviors?

    <p>They serve as motivations or precursors to a behavior.</p> Signup and view all the answers

    What is a key aspect of enabling factors concerning behavioral change?

    <p>They can facilitate the implementation of a policy.</p> Signup and view all the answers

    What was the primary aim of the physical activity intervention mentioned?

    <p>To promote physical activity and reduce sedentary behavior</p> Signup and view all the answers

    Which model was used as a framework for the occupational physical activity intervention?

    <p>PRECEDE-PROCEED Model</p> Signup and view all the answers

    What was one of the documented outcomes after the 12-week physical activity intervention?

    <p>Sedentary time decreased</p> Signup and view all the answers

    How was the effectiveness of the inclusive environment initiative measured?

    <p>By assessing changes in accessibility and inclusivity</p> Signup and view all the answers

    Which population was targeted in the effort to create an inclusive environment at the shopping center?

    <p>Individuals with physical disabilities</p> Signup and view all the answers

    What evaluation method was NOT used in assessing the inclusive environment project?

    <p>Individual interviews with shoppers</p> Signup and view all the answers

    What is one of the benefits of using the PRECEDE-PROCEED model in health interventions?

    <p>It helps tailor interventions to specific community needs</p> Signup and view all the answers

    What type of workers are at a higher risk for obesity and often lack workplace health promotion resources?

    <p>Healthcare and social assistance workers</p> Signup and view all the answers

    What does the Precede-Proceed Planning Framework begin with?

    <p>The desired health outcome</p> Signup and view all the answers

    Which phase focuses on evaluating the impact of an intervention?

    <p>Phase 7: Impact Evaluation</p> Signup and view all the answers

    What is important to prioritize when using the Precede-Proceed framework?

    <p>Targets for intervention</p> Signup and view all the answers

    Which health behavior theory is implemented at the individual level in the framework?

    <p>Health Belief Model</p> Signup and view all the answers

    In which phase of the Precede-Proceed model are community needs and genetic factors assessed?

    <p>Phase 2: Epidemiological, Behavioural and Environmental Assessment</p> Signup and view all the answers

    What do the reinforcing factors in the framework primarily influence?

    <p>Sustainability of health behaviors</p> Signup and view all the answers

    What should the development of a health program be guided by in the Precede-Proceed model?

    <p>A comprehensive needs assessment</p> Signup and view all the answers

    Which of the following is an example of an enabling factor in the Precede-Proceed framework?

    <p>Socioeconomic status</p> Signup and view all the answers

    In the case study of smoking cessation among older Canadians, what was identified as a significant problem?

    <p>Health risks of smoking among seniors</p> Signup and view all the answers

    What role does the administrative and policy assessment phase play in the Precede-Proceed model?

    <p>Aligning policy with intervention strategies</p> Signup and view all the answers

    Study Notes

    Introduction to Program Planning

    • Course: POH705, School of Occupational and Public Health, Toronto Metropolitan University
    • Week: 11

    Lesson Objectives

    • Explore the PRECEDE-PROCEED planning framework
    • Understand how the framework can be used to develop a health education program.
    • Inform health educators on how to plan an efficient program.

    Imagine, as a health educator

    • A problem has been identified, and action is needed.
    • Applying health behavior theories is crucial for effective program design and delivery.
    • The PRECEDE-PROCEED framework provides a structure for applying theories into programs.
    • It is a tool for designing, implementing and evaluating health education/promotion programs.

    The PRECEDE-PROCEED Planning Framework

    • PRECEDE is the diagnostic phase (identifying the problem/need).
    • Educational diagnosis precedes the intervention plan.
    • Interventions are planned to meet demonstrated needs.
    • PROCEED is the intervention/implementation phase focused on social determinants influencing health behaviours.
    • Participation of the target audience is important in defining the problem, goals and solutions.

    PRECEDE and PROCEED

    • PRECEDE:
      • P - Predisposing
      • R - Reinforcing
      • E - Enabling
      • C - Constructs in
      • E - Educational
      • D - Diagnosis
      • E - Evaluation
    • PROCEED:
      • P - Policy
      • R - Regulatory
      • O - Organizational
      • C - Constructs in
      • E - Educational
      • E - Environmental
      • D - Development

    The Precede-Proceed Planning Framework: Overview

    • The framework works backwards, starting with the health outcome to diagnose effective intervention strategies.
    • It involves prioritizing targets, and identifying measurable objectives.

    Precede-Proceed Planning Framework (Diagram)

    • The diagram illustrated various phases with connections between them (e.g., Phase 1 Social Assessment connects to Phase 2 Epidemiological, Behavioral, and Environmental Assessment).
    • It shows relationships between phases.

    Case Study: Smoking Cessation Program for Older Canadians in Nursing Homes

    • Developed to address high rates of smoking among older adults in nursing homes.
    • Used PRECEDE-PROCEED model to guide program development.
    • Based on health behavior theories (e.g., Health Belief Model, Social Learning).

    What is the first step in developing a program?

    • Analyzing the needs and understanding of the community.

    Phase 1: Social Assessment, Participatory Planning, and Situation Analysis

    • Emphasizes broad participation to gain a comprehensive understanding of community aspirations.
    • Multiple data collection activities (e.g., community forums, focus groups, surveys, key informant interviews, secondary data analysis).
    • Identification of community perceptions, needs, challenges, capacity, strengths, resources, and readiness to change is essential.
    • Identifying key stakeholders, like advisory council members, educators, and youth, is important.

    How do we engage and collect this info?

    • Planning committees
    • Community forums
    • Focus groups
    • Surveys
    • Key Informant interviews
    • Secondary data analysis (e.g. StatsCan, population health assessments)

    Example of Community-Engaged Planning

    • Community-based research often starts with needs assessments in order to identify community priorities.
    • Includes using digital tools alongside participatory methods.

    Example: Needs Assessment with Ile-X

    • Identification of priority areas for community health (e.g., COVID-19, climate change, mental health, food security).
    • The methods used for this example are focus groups, key informant interviews.
    • Identifying community perceptions, needs, desires, relevance, timing of issues, capacity, strengths, resources, readiness to change, determining who can lead, and identification of possible resources and existing infrastructure are important for community-based assessment.

    PHASE 2: Epidemiological, Behavioural and Environmental Assessment

    • Identifying health priorities.
    • Determining factors influencing health priorities.
    • Translating priorities to measurable objectives and creating program focus.
    • Classifying factors as distal, proximal, or intermediate.
    • Understanding how social and environmental factors influence health outcomes.
    • Using secondary data and may require collection of primary data.

    PHASE 3: Education and Ecological Assessment

    • Identifies precursors and reinforcing factors for desired or undesired behavior change.
    • Identifying predisposing, reinforcing, and enabling factors.
    • Formulates objectives based on priorities.

    Predisposing, Reinforcing, and Enabling factors

    • Predisposing: antecedents related to motivation.
    • Reinforcing: factors that influence behavior repetition.
    • Enabling: antecedents that facilitate or hinder behavioral change.

    What theories are relevant for Phase 3?

    • Individual-level theories (e.g., Health Belief Model)
    • Interpersonal-level theories (e.g., Social Cognitive Theory)
    • Community/Organizational theories (e.g., Organization Change Theories).

    Goal of the Program

    • Broad general statements describing goals and objectives.
    • Provides direction and focus for objectives.
    • Defines the scope.

    SMART Objectives

    • Specific
    • Measurable
    • Achievable
    • Realistic
    • Time-sensitive

    2 Types of Objectives

    • Process objectives: Focus on activities completed within a set amount of time.
    • Outcome objectives: Define expected results, answering who, what, where and when.
    • Short-term objectives.
    • Intermediate-term objectives
    • Long-term objectives.

    Case Study: PHASE 3

    • Identify Contributing factors to smoking rates.
    • Identify encouraging factors that either support or discourage smoking.
    • Recognize Barriers and Facilitators to smoking.

    Predisposing, Reinforcing, and Enabling Factors (in smoking cessation)

    • Predisposing: Attitudes, knowledge, beliefs, personal preferences, skills of smokers and other staff.
    • Reinforcing: Organizational, social, psychological, economic, and cultural factors that influence smoking rates in nursing homes.
    • Enabling: Motivations, environmental factors that influence smoking behaviour.

    Case Study: PHASE 5-8

    • Identifying interventions based on policy and administrative diagnoses.
    • Identifying desired individual and community-level interventions (e.g., smoke cessation counseling, prevent second-hand smoke).

    PHASE 4: Administrative and Policy Assessment

    • Selecting and aligning program components based on priorities and goals (determined by prior assessments).
    • Prioritization of determinants of change.
    • Identifying resources, organizational barriers/facilitators, and policies needed for implementation.
    • Determining the level of alignment between assessment of these factors and selection of interventions.

    Macro level interventions

    • Interventions aimed at predisposing, reinforcing, and enabling factors.
    • Includes individual, peers, and family influences on behavior change.
    • Examples include media, counselling and advocacy.

    Case Study PHASE 4 (Resource/Materials Needed for a Smoking Cessation Program)

    • Human resources: nurses, behavioral therapists, addiction specialists, smoking cessation consultants.
    • Material resources: pamphlets, lecture rooms, and medical supplies.
    • Potential Barriers: (e.g., lack of resources, administration).
    • Potential facilitators: (e.g., community support).

    PHASE 5-8: Implementation and Evaluation

    • Process evaluation: How a smoking cessation program is enacted (following protocols).
    • Impact evaluation: Assessing changes in predisposing, reinforcing, and enabling factors, as well as in behavioral and environmental factors (e.g., smoking rates, exposure to smoke).
    • Outcome evaluation: Determining the effect of the program on health and quality of life indicators.
    • Includes formative, process, impact, and outcome evaluation.

    Applied Examples

    • Diabetes Management: Using the PRECEDE-PROCEED model for identifying health management strategies.
    • Physical Activity Intervention: Using the PRECEDE-PROCEED model for tailoring and evaluating community-based interventions.
    • Creating an inclusive environment: A living-lab case study applied the PRECEDE-PROCEED model to develop and evaluate an inclusive environmental program.
    • Provides examples of applying the framework and potential outcomes.
    • Includes specific outcome measures (e.g., changes in blood glucose levels, measures of physical activity, and inclusivity, measures through surveys and community feedback).

    Canadian Best Practices Portal

    • Resources for planning and evaluating programs.
    • (URLs provided)

    Final Exam:

    • December 4.
    • Consult the D2L announcements for exam details.

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    Description

    This quiz explores the essential components of community needs assessment, specifically in the context of gerontology nursing. It covers key activities, information gathering methods, and approaches to engage nursing home residents during assessments. Test your knowledge on best practices and essential strategies in this critical nursing field.

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