Community Assessment - PDF

Outlines:  Introduction  Definitions of terms  Dimensions of the Community as Client  Characteristics of community health  Application nursing process component applied to community as a client. 1- assessment  Definition of Community assessment  Purpose of community assessmen...

Outlines:  Introduction  Definitions of terms  Dimensions of the Community as Client  Characteristics of community health  Application nursing process component applied to community as a client. 1- assessment  Definition of Community assessment  Purpose of community assessment  Steps of conducting community assessment  Methods of Community assessment  Sources of community data 2-Data analysis and Community diagnosis 3- planning 4- implementation 5-Evaluation  Roles of community health nurse Introduction A community assessment is a tactical way of analyzing gaps in community services. It determines the strengths and assets available in that community and provides community leaders with a snapshot of local policy, systems, and environmental change strategies currently in place and helps to identify areas for improvement. Definition of Community : - group of people interacting with one another in defined geographical area with common goal and objective. group of people living together in the same locality under the same laws and regulations and having common norms, culture and interest Community as client refers to a group or population of people as the focus of nursing service. Dimensions of the Community as Client (1) Population (2) Location (3) social system (4) Naturality (5) A Particular Name  Dimensions of the Community as Client (1) Population: is the most fundamental element of community. This group may be small or large, because without a group of people we can‘t think of a community. Population variables 1- Size: 2- Density: 3- Composition 4- Rate of growth or decline 5- Cultural difference 6- Social class and educational levels: 1- Size: The size of a population influences the number and size of health care institutions. Knowing community size provides important information for planning. e.g. large Egyptian population size (The population reached 106,843,093 in 2022 and 112, 716, 593 in 2023 according to the Central Agency for Public Mobilization and Statistics (CAPMAS) which increase need of health care services 2- Density: Similarly, when people are spread out health care provision may become difficult. E.g., 95% of Egyptian population centered around the Nile Delta. 3- Composition:  composition of the population often determines types of health needs.  A health community is one that takes full account of and provides for differences in age, sex, educational level, and occupation of its members, all of which may affect health concerns. e.g., population pyramid in Egypt.  Current male population (50.2%)  Current female population (49.8%) (Egypt population pyramid 2023) (Egypt population pyramid) 4-Rate of growth or decline: Rapidly growing communities may place extensive demands on health services. Marked decline in population may signal of poorly functioning community. 5- Cultural difference: can create conflicting or competing demands for resources and services or create inter- group hostility. 6- Social class and educational levels: - social class refers to the ranking of groups within society by income, education, occupation, prestige, or a combination of these factors. Levels of social class; lower – middle - high (2) location A group of people forms a community only when they reside in a definite territory. Six Location Variables 1. Community boundaries 2. Location of health services 3. Geographic features: physical environment affect health of community. 4. Climate 5. Flora and Fauna 6. Human made environment (houses and factories, dump wastes into streams or fill the air with gases, that cause human alterations of the environment and implications for community health). (3) social system: feeling of belonging together. It refers to a sentiment of common living that exists among the members of a locality. (4) Naturality:  Communities are naturally organized. It grows spontaneously.  Individuals became the member by birth. (5) A Particular Name:  Every community has a particular name by which it is known to the world. Members of a community are also identified by that name. For example, people living in Egypt is known as Egyptian. 1- definition of community health Community Community health health is a state of equilibrium, which derives from a balance between the individual and his physical, psychological, cultural and social environment. The concept of community health has three common characteristics or dimensions. They are Status Structure Process. 14  Concept of community health: Status. Process Structure I- Status: It includes three components: Physical component of community health, it is frequently measured by traditional morbidity and mortality rates vital statistics. Emotional component can be measured by consumer satisfaction mental health indices. Social component measured by crime rates, functional level. 16 2) Structure: Refers to the community health services and resources utilization pattern. 3) Process: Process of effective community functions or problem solving well established. 17 Nursing process component applied to community as client 1-community assessment – Definition of community assessment – Process of collecting and evaluating information about community health status to discover existing or potential needs as a basis for planning future actions.  The Purpose of a Community Assessment 1. Establish a baseline for evaluating progress in the community. 2. Identify new ideas, strategies, and resources that can be used in working toward a common goal. 3. Identify and set priorities based on the need. 4. Make decisions about how to improve the community or organization based on needs and available resources. 5. Identify outside organizations or agencies that may help meet the needs or provide resources. 6. Create an awareness of a community concern or problem  PREPARATORY PHASE IMPLEMENTATION PHASE EVALUATION PHASE PREPARATORY PHASE 1. Define and describe the community. 2..Statement of the objectives. 3. Determine Research design 4. Determine the data to be collected. 5. Identify methods & instruments for data collection. 6. Finalize sampling design & methods. 7. Make a timetable.  IMPLEMENTATION PHASE 1. Data collection. 2. Data organization. 3. Data presentation 4. Data analysis.. 5. Identification of health problems. 6. Prioritization of health problems. 7. Development of a health plan. 8. Validation & feedback.  EVALUATION PHASE 1- People 2-Environmental characteristics 3-Social Characteristics 4-Economic Characteristics 5-The channel of communication 6- Vital Statistics 7- Health and health related facilities 8- Community health nursing services and program  Methods of Community Assessment Community Assessment Tools: 1. Survey 2. Focus Group 3. Community Forums or town hall 4. Panel Discussion 5. Asset inventory 6. Daily Activities Schedule 7. Community Café  Methods of Community Assessment 1-Surveys A survey is an assessment method in which a series of questions is used to collect data for analysis of a specific group or area. Is a useful method of obtaining information about knowledge, attitudes, attributes or practice of the general population. The survey method involves self-report, or response to predetermined questions, The survey method can include questionnaires, telephone or in person interviews.  Advantages of survey Disadvantages of survey 1. Capable of collecting data from a large 1. Expensive. number of respondents 2. Require skills and honesty. 2. Can be developed in less time (compared to other data-collection methods) 3. The result can be biased and 3. Can be administered remotely via online, misleading. mobile devices, mail, email, or telephone. 4. Analysis should be done by someone 4. A broad range of data can be collected (e.g., skilled in survey work and statistics. attitudes, opinions, beliefs, values, behavior, factual). Interviewing Tips: Give survey participants enough time to answer questions thoroughly. Listen carefully to participants’ responses, and respect their opinions. Avoid overly personal questions that may make respondents uncomfortable and less willing to participate. Assure respondents that their answers are confidential, and maintain that confidentiality. Is a conversation with a purpose designed to help in gathering information about people's assumptions of activities in community Allow for more in-depth data  Time-consuming collection and comprehensive  Little quantitative value understanding  Require skills Allow for clarification  Information is hard to Follow up on question summarize.  2-Focus Groups Definition of focus group: focus groups is a qualitative research method like a job interview, conducted in a private setting, with one or two facilitators and someone to record participant that used to determine a community’s preferences and opinions on a particular issue or idea. Criteria of focus group 1. only a small group of participants, usually 5 to 15 people. 2. requires careful planning and someone skilled at facilitating discussions. 3. the ideal amount of time to set aside for a focus group is anywhere from 45 to 90 minutes.  Disadvantages of focus Advantages of focus groups groups 1. May lead to a deeper understanding of 1. Can be difficult to maintain the issues for both participants and the control of the discussion moderator. 2. Difficult to analyze and 2. Engaged participants. organize data 3. Can be empowering for participants. 4. May lead to practical 3. Idea generated not necessarily solutions/changes. prevalent 3-Community Forums or town hall The community forums or town hall is a qualitative assessment method designed to obtain community opinions. Members come from within the community and represent all segments of the community that are involved with the issue. Number of participants is large compared to focus group  Advantages Disadvantages Provides an opportunity for people of A large turnout may prevent diverse backgrounds to share ideas and everyone from speaking and may experiences organization. limit time allowed for each speaker. It helps build new relationships. May generate more questions than It improves communication and performance in people. answers. Useful to identify problems, assess poor advance planning and needs, or to suggest questions requiring advertising may result in limited further study participation. the public setting may restrict information people will reveal.  4. Panel Discussion guided exchange involving several experts on a specific subject. It involve a facilitator who asks pane lists specific questions about the community or a particular issue. Panels generally have four to six experts on a particular issue, for example, a discussion on community health might include: a doctor from a local hospital, a health official from a government health office, a professor from a local university who researches community health issues, a community health care specialist from a local nonprofit or nongovernmental organization). a powerful tool to raise the awareness. to quickly learn about service opportunities from experts.  5. Asset inventory a technique for collecting information about a community through observation community members catalogue assets in their community. best conducted during community meeting. small teams of participants walk around their community identifying people, places, and things they think are valuable. – Team members then discuss their choices, – create a list for the team, – and share it with the larger group.  6. Daily Activities Schedule Finding out about the work habits of community members to learn about a community’s division of labor and perceptions of work, based on gender and age. Help to identify areas where new vocational techniques or tools might be used: to improve a community’s work efficiency.  7. Community Cafe /Public Forum creates the atmosphere of a restaurant or cafe small groups of people from the community discuss issues raised by facilitators. entertaining event and a unique way to learn about a community by engaging stakeholders in a direct dialogue.  Community Cafe /Public Forum Advantages Disadvantages Diverse members can share requires skill/time ideas opinions obtained only from Provides quick look at those who attend community issues may generate more involves local citizens questions or conflict inexpensive  Sources of community data 1- Primary Sources Primary sources data: -Information gathered by the researcher who perform the study(the first hand of the data) Examples:  from community members, leaders and community inhabitant  from talking with people 2- Secondary Sources Secondary sources of data: - include people who know the community well and the records such health team members, client records. Examples:  Census DE JURE/ DE FACTO  Vital statistics  Agency reports  research reports  2-Data analysis and community diagnosis Definition: is practice of working with data to glean useful information, which can be used to make informed decisions. Community diagnoses refer to nursing diagnoses about a community‘s ineffective coping ability and potential for enhanced coping. The statement of community diagnosis must consist of the following three components: 1. The problem faced by the recipient. The risk of 2. The recipient of the care. Among 3. The factors contributing to the problem Related to  Example of Community Diagnosis E.X 1 Risk of infant malnutrition, among families in X community related to lack of breast feeding and weaning. 2 Risk of diarrhea in children under five, among families in town dwellings, related to unhygienic environmental condition / unsafe water supply. 40 3-Planning It is the process of making systematic decisions about what needs to be done, how it has to be done, by whom, and with what resources. 4- Evaluation It is systematic, continuous process of comparing the community‘s response with the outcome as defined by the plan of care. The ultimate purpose of evaluating interventions in community health nursing to determine whether planned actions met client needs, if so, how well they were met, and if not why.