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

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

Location and Livability

Primary Industries

Economic Information

Educational System

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

Environmental Health

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.