Components of Community Assessment
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Human Biology
1. Composition of population by age, gender, and race
2. Population patterns of longevity
3. Genetic inheritance patterns by gender and race
4. Disease incidence and prevalence compared to prior years, and to state and national statistics
5. Health status indicators (immunization levels, nutritional status, mobility)
Environment
1. Physical environment (urban/rural/suburban, housing, water supply, parks and recreation, climate, topography, size, population density, aesthetics, natural or manmade resources, goods and services, health risks)
2. Psychologic environment (productivity level, cohesion, mental health status, communication networks, intergroup harmony, future orientation, prevalence of stressors)
3. Social environment (income and education levels, employment, family composition, religious affiliations, cultural affiliations, language[s] spoken, social services, organization profile, leadership and decision-making structures)
Community Lifestyles
1. Consumption patterns (nutrition, alcohol) 2. Occupational groups 3. Leisure pursuits 4. Community health attitudes and beliefs 5. Patterns of health-related behaviors in aggregates 6. History of participation in community health action
Health System
1. Health care services available (health promotion, prevention, primary care, secondary care, tertiary care, mental health)
2. Accessibility of promotive and preventive care (low income, homeless, varying racial and ethnic groups)
3. Financing plans for health care
Source: Clark, Mary Jo, Community Health Nursing: Caring for Populations, 4th Edition, © 2003. Reproduced by permission of Pearson Education, Inc., Upper Saddle River, New Jersey.
A community-based action may improve the overall health of the community, but within the community, certain groups may be disenfranchised based on income level or occupation, exacerbating health disparities. Achieving health equality may be at odds with improving the overall health of the community, and priorities must be determined (Institute of Medicine, 2012). The need for transparency is paramount between the decision makers and the community to ensure that the action plan reflects the values and preferences of the citizens.
PRAcTIcE coNsIdERATIoNs IN AssEssING HEALTH ANd HEALTH BEHAvIoR
Use of assessment measures to document areas for improvement to enhance the health status of individuals, families, and communities is an important responsibility of the nurse. Assess- ment data about health status and behaviors provide the basis for clinical judgments and help plan appropriate individual, family, and community interventions. Nurses’ knowledge and influence can ensure that a portfolio of conceptually congruent assessment instruments is available and used in the work setting. The nurse must know how to administer assessment measures and explain the value of conducting systematic assessments to the client. The busy work environment may discourage the use of detailed assessments because they require time to administer and follow up. One strategy to manage the time issue is to seek innovative ways to communicate with clients through videotapes and brochures that explain assessment proce- dures. Information technology has made computerized assessment possible. Thus, clients may be able to complete self-assessments at home, as time allows, with transmission of the informa- tion by computer prior to health care visits.
Practicing nurses must keep up-to-date about new assessment measures and strategies that can be quickly implemented and yield accurate data. Nurses influence the quality of the health promotion plan of the individual, family, and community through a commitment to thorough assessment of health and health behaviors.
opportunities For Research IN HEALTH Assessment
ANd HEALTH Behavior
Research that develops and tests assessment instruments for health and health behaviors of aggre- gates from diverse racial, cultural, and socioeconomic backgrounds is a high priority. Reliable and valid instruments based on theory and research are needed to perform meaningful assess- ments. Community interventions should be developed and tested in subgroups. Accurate knowl- edge of the client, family, and community will facilitate the development and implementation of successful health promotion interventions.
Summary
Health assessment at the individual, family, and community levels is time intensive and costly, so measures must reflect client characteristics and
Learning Activities
1. Go to the My Family Health Portrait website and record a traditional family health portrait. Examine the differences between My Family Health Portrait and the commercial application at Genopro.
2. Develop a list of safeguards to ensure that non- computer users are included in the health care technology environment.
3. Develop an assessment plan based on age-specific instruments for a child, a young adult, and an older adult.
4. UsingTable4–2,determineyourpercentageofbody fat and outline a personal goal based on the results.