Community Health Assessment Model Essay
Community Health Assessment Model Essay
Identify a Community Health Assessment Model. (This document from the CDC lists commonly used community assessment models: https://www.cdc.gov/stltpublichealth/cha/assessment.html ) What are some benefits of using a specific model to assess a community? What agencies should be included with the assessment? What is a reasonable time frame in which to complete a community wide assessment? What is the role of the public nurse in implementation of the chosen model?Community Health Assessment Model Essay
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Needs Assessment A community health assessment is a fundamental instrument of public health practice. Its objective is to depict the health of the community, by presenting information on health standing, community health needs, resources, and epidemiologic and other studies of present local health problems. It seeks to recognize target populations that may be at augmented risk of poor health results and to increase a better understanding of their needs, as well as evaluates the larger community surroundings and how it relate to the health of people. It also identifies those areas where better information is desired, particularly information on health differences amid different subpopulations, quality of health care, and the incidence and severity of disabilities in the population. The Community Health Assessment is the foundation for all local public health development, giving the local health component the instance to recognize and network with key community leaders, businesses and concerned residents about health priorities and concerns.Community Health Assessment Model Essay
A community needs assessment is a vital process in the planning and promotion of health strategies and care in the community, and this process includes analysing and identifying key health problems in the community . A needs assessment also determines the target group in which the purpose of the health strategy is aimed at.
Community needs assessments can take many unique forms, however all community needs assessments are aimed to seek information on the different types of needs of the community which includes gathering information from the community based on the individuals in the community and their personal opinions, their felt, normative and expressed needs, as well as challenges and community assets, which can determine the ability in meeting the needs of the health promotion strategy to be implemented.Community Health Assessment Model Essay
The purpose of a community needs assessment is to determine the strengths and weaknesses of the community and the ability in which the community can and will respond to health promotion strategies and planning .
Different types of needs in a community needs assessment
The definition for a need is anything one can not do without it , however in a health care setting and in a community needs assessment there are different types of needs which should be assessed in order to determine the different types of needs which are being met and which are not . There are four different types of needs in a health care setting which have very different aspects which include:Community Health Assessment Model Essay
Normative Need
A normative need refers to what is expected to be the norm for the community based on expert opinion which is based on research. ,
Expressed Need
An expressed need refers to what can be suggested about the health need of a community by observing the community¿½s use of health services . Expressed needs can be expressed via requests, complaints, petitions or by observation through the use of available services however expressed needs can be misinterpreted, for example long waiting lists at a hospital may be the result of lack of training of the health professional rather than the length of the waiting list and the people seeking treatment .
Comparative Need
Comparative need is determining the need for one area of the community based on the services used within a separate area . Comparative need may be used for a general idea of the services needed in another community without collecting data by observing a similar size community. One of the most common uses of gathering data via comparative need is determining the possible social problems which can exist in another similar area such as alcohol abuse.
Felt Need
Felt need refers to what individuals in the communities which they say, feel, or desire that they need . When assessing and gathering data on felt needs of the community, it¿½s important to understand that there are many obstacles which can distort the data as the felt need of an individual is not always expressed in terms of a need but more of a solution , as well as an individual may be expressing their felt need based on a family member and not themselves.Community Health Assessment Model Essay
What data is sought in a community needs assessment and why
The description, perceptions and ideas of the community and applicable statistics which are needed in order to develop an action plan based on the community needs assessment include: the size of the population, demographic make up, religious beliefs, cultural attitudes and the roles of individuals in the community . This information is valuable as it can affect the roles which the community takes in promoting the health strategies such as male or female nurses in treating an individual, and can evaluate whether the community is open minded to the solutions which are proposed to be implemented.
Needs identified by community leaders and members are gained through surveys and other various methods, as this data can indicate whether there will be local support for the community programs to be implemented. Without support from local community leaders and members it will be difficult gaining support from the rest of the community therefore educating key profile members in the community are a valuable asset to promoting a community assessment .
The current strategy being taken to meet community needs determines the additional action that needs to be taken in order to meet the needs of the community as shown from the expressed, felt and comparative needs. Current action from the community includes existing health promotion programs, government support and funding, organizational support and infrastructure, as well as the current coping of the community with the programs in place. This information based on the current actions can provide valuable feedback in assessing whether the current programs are having any affect on the community, and the extent to how efficient the programs are .Community Health Assessment Model Essay
Local resources available to help meet community needs can include availability of individuals to provide feedback and support for the community needs assessment. The ability to consult the community and individuals plays a vital role in evaluating the needs of the community .
Financial resources of the community also play a major role in the development of an action plan based on a community needs assessment therefore considering the availability of local resources in a community can affect the development of health promotion strategies. Long term sustainability of the strategy by the community is determined by evaluating the socioeconomic status of the community as well as the available resources .
Another question which is asked when gathering data from a community needs assessment is whether the needed services are available and are they accessible by the individuals in the community. Examples of whether services are accessible by the community include the opening hours of the services as many people who need the services may work while the services are open therefore alternative opening hours may need to be considered .Community Health Assessment Model Essay
How data is obtained for a community needs assessment
Interviews
When performing interviews in the community for a community needs assessment it¿½s important to gather information from people who are in a position to know the needs of the community such as community leaders, health and other professionals, as well as other individuals who may be affiliate with particular organizations or agencies which may be involved in the planning or promotion of the community development .
The issue with only consulting health promotion professionals is that they may not be aware of some of the health problems and situations due to the socioeconomic status of the individual or the interests of the individual therefore it may be beneficial to interview individuals who are in the situation in which the community needs assessment is evaluating therefore its valuable to interview different individuals in different positions within the community .Community Health Assessment Model Essay
Background research
Research via census data can provide valuable information based on another community which may present similar problems in the community being assessed . Data can be retrieved from the World Health Organization, Australian Bureau of Statistics and data from other communities.
Surveys¿½
A survey can determine the occurrence of the use of services within the community and gather valuable information based on felt needs of an individual . Surveys can be distributed and gathered in many different forms and methods included handing out at the street, windscreen survey, posting to family¿½s in the mail as well as inserting in the local paper or magazine however many individuals will not provide feedback using this method due to the effort required, however it can give a general idea on the community needs.Community Health Assessment Model Essay
Focus groups¿½
Focus groups involve selecting a small targeted group from the community in order to provide options to the individuals and gather specific feedback. The advantages of a focus group includes: specific and valuable information from a targeted group of individuals, real-time feedback, felt need information, and individual perceptions of community needs .
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Disadvantages of focus groups include but are not limited to a small sample of the community in which there may be individuals in the focus group which may not be interested in the issues being discussed, some individuals may find it harder to communicate in large groups and would prefer to discuss their opinions in another discrete format, focus groups are not specific to finding out facts but more opinions .
Community forums¿½
Community forums are a great way to gain support from the community on the health promotion strategies which are being considered. Community forums involve including the community on the current issues to consult the individuals based on their needs and to ensure that each individual is heard on the current issues and the community needs which are being considered .Community Health Assessment Model Essay
The advantage of a community forum include involving the entire community in the upcoming decisions which are to be implemented in the community, however the disadvantage is a community forum is a very involving and time consuming process therefore support from the community is needed in order for a successful community forum to ensue.
The principles that underpin the steps involved in the process undertaking a CNA.
Community assessment should be an integral part of health promotion work (Talbot & Verrinder. 2010).
An important role in health needs assessment is gathering information from local people about their views on their health needs as well as resources which are available to the individual which allows for any services that may be developed to be based around the needs of individuals and will be more likely to be acceptable by the community .
It¿½s important to realize the value of gaining knowledge from the local population within a community based on what the community has in terms of assets which exist, factors in which individuals believe their health is affected, as well as what is most important within the community to the individual. .Community Health Assessment Model Essay
Community assessment should reflect social view of health (Talbot & Verrinder. 2010).
Understanding the contribution made by social factors rather than seeing health as simply as medical problem or an individual responsibility introduces a diverse concept in which society plays a role in the development of communities. A social view of health allows for different understandings and a diversity of meaning of the health care model, and allows the recognition of the right of each person to improve their own level of health .
Community assessment should involve both formal and informal assessment of needs and resources or assets (Talbot & Verrinder. 2010).
Formal assessment of needs can determine how effective services are to the community and how much of the population is reached with the services provided within the community. Formal assessments are a tool for diagnosing and assessing the accountability of the services that are offered within the community and can be assessed accurately using formal gathering of data .Community Health Assessment Model Essay
Informal assessments of needs can provide quick and valuable information from an individual in the community based on services they have used and the effectiveness of the services. Informal data collection can provide information needed in order to make quick changes to the health care planning process .
Community assessment should recognize the partnership between people, themselves and health workers in determining their needs and resources, planning action and evaluating any outcomes (Talbot & Verrinder. 2010).
When people feel involved in developing a local health care strategy, they will feel more committed to putting the plan into action therefore it is important that all of the community is involved in the planning and assessment of a community needs assessment .
A nurse should be involved with not only other health professionals but the local community as involving individuals in the planning process involves them in the decisions which will affect their community.
Needs assessment should involve a combination of felt, expressed, normative and comparative need. (Talbot & Verrinder. 2010)Community Health Assessment Model Essay
The concept of ¿½need¿½ used in a community needs assessment incorporates those needs which are felt and expressed by local people within the community, as well as an assessment of needs which have been researched and defined by professionals. A needs assessment which considers all types of needs is beneficial to think outside the box rather than simply focusing on demand .
The research need to generate qualitative and quantitative data regarding a particular community health need is directly proportionate to the impact that the particular health need has on the community and sometimes even the mortality/morbidity generated by the particular health problem. In this regard, in this current assessment we review the health needs of coal mining workers in West Virginia, USA to identify hazards and risk factors pertaining to their health, by virtue of their designated profession.Community Health Assessment Model Essay
Community health needs assessment is a rigorous project that serves the population under study by elucidating the current needs, reflecting the situation which is often not balanced between health providers, insurance schemes, health administration and/or community leaders. It also serves at identifying particular needs that are overlooked by healthcare officials that are either novel or problematical by elucidating perceived and expressed health and wellbeing needs. In other words, it can be a useful means to depict the selected community’s horizon in respect to health needs, healthcare shortfalls and aetiology, all useful areas for the facilitation of better public health management.Community Health Assessment Model Essay
In order to perform an accurate community health needs assessment, research should be grounded on an up to date background study of the selected population’s demographics and census (socioeconomic, workforce and other) data, where available. Moreover, particular health factors should be taken into account by managing information currently disseminated through healthcare officials (such as mortality, disease prevalence, risk factors analysis).
This research would also benefit from an on-site review of environmental and work related conditions, if possible.
The most useful and widely used instrument to conduct a community health needs assessment and subsequent analysis is by means of a structured questionnaire based survey that will employ cross sectional and population specific items targeted at the current health need. Moreover, the instrument should be designed with attention to environment and state specific conditions, such as regulations and laws, insurance coverage and even so, local traditions and unwritten codes of conduct.Community Health Assessment Model Essay
For the above reasons, in this essay we will conduct a review of available information on the community of Coal Mining Workers in West Virginia, USA. After the acquisition and analysis of the pertaining data, we will present a structured survey instrument, aiming to identify health needs with respect to existing health problems and patient satisfaction.
BACKGROUND-RESEARCH
We searched a wide array of online databases and organisations providing demographic and other information for the population in question. We also conducted a MEDLINE search, to draw the picture of already identified health needs and/or needs assessments already conducted in this population. Search terms employed were “coal workers”, “west Virginia”, “health needs”, “pneumoconiosis’, “interstitial lung disease”, “occupational hazard” alone or in combination.Community Health Assessment Model Essay
West Virginia is a state in the Mid-Atlantic section of the USA, capital Charleston. The state is notorious for its mountain composition and significant coal mining industries. The mineral and coal resources in the area are vast, and West Virginia has been considered to have fuelled a great part of the industrial revolution of the developed world. Moreover, coal mining and related work constituted major part of the employment activities of the state, while still in the 21st century, it is believed that mining safety and environmental concerns are amongst the most challenging issues facing the state.
In 2009, West Virginia was inhabited by 1,819,777 people. 5.6% of West Virginia’s population were reported as under 5, 22.3% under 18, and 15.3% were 65 or older. Females made up approximately 51.4% of the population (United States Census Bureau, 2010). Moreover, according to US Census Bureau Data, West Virginia is the third lowest in per capita income state. It also ranks last at median household income. Virginia’s adult population with a bachelor’s degree is the lowest in the U.S. At 17.3%.Community Health Assessment Model Essay
The main economy is coal, and the state is the lead in coal production, second only to Wyoming.From the West Virginia Office of Miners’ Health, Safety and Training we find that the West Virginia Coal Industry provides about 30,000 direct jobs in WV, including miners, mine contractors, coal preparation plant employees and mine supply companies. In particular 20,715 are registered as employees in the 188 active coal mines in WV, while an additional 4,842 work as an independent contractor.
From the same source we read that for 2009, fatal accidents were 3, non fatal accidents 1,164 and the accident frequency was estimated to be 2.79%. Involved in accidents are mainly high voltage equipment, and areas in and around river load outs. But apart from fatalities, a major health problem for VW coal mining workers is pneumoconiosis, or ‘black lung’. The CDC has implemented a safety and health chapter regarding occupational Respiratory Disease Surveillance, and especially for coal miners, the Enhanced Coal Workers’ Health Surveillance Program (ECWHSP).Community Health Assessment Model Essay
The ECWHSP includes surveys that include specifically designed standardized health questionnaires, work histories, spirometry testing, radiographic examinations, and collection of other relevant health information, which are gathered in a specially designed mobile examination unit by trained personnel on site.Results of the ECWHSP 2009 survey on mine workers in West Virginia are shown on table 1:
Finding
Examined
Rate
Total
Participation
1,884
20%
9,593
pneumoconiosis (>=1/0 or PMF).
93
5%
1,884
pneumoconiosis (>=2/1 or PMF).
43
2%
PMF
24
1%
advanced pneumoconiosis
35
2%
have a chronic cough.
624
34%
bring up phlegm from their chest.
690
38%
have chest sounds of wheezing.Community Health Assessment Model Essay
613
34%
have had an attack of wheezing
738
41%
have experienced dyspnea on level
741
41%
have experienced dyspnea on a hill
1,119
62%
have chest tightness
672
37%
have chronic bronchitis.
142
8%
have emphysema.
79
4%
have had pneumonia
337
19%
have asthma
132
7%
have tuberculosis.
4
0%
never smoked.
954
53%
former smokers
455
25%
current smokers
393
22%
Although under a lot of argumentation, coal and in general volatiles (dust) have been proven by sufficient evident as causes of respiratory damage. In detail, in coal miners a significant association between the level of FEV1 and dust was found, even after adjustment for age, physique and smoking (Cowie ,1999; Soutar 1989).Community Health Assessment Model Essay
Some more interesting figures arise from the State Health Facts website, shown in Table 2:
Measured index
WEST VIRGINIA
USA
Age-Adjusted Invasive Cancer Incidence Rate per 100,000 Population, 2005
484.2
458.4
Births of Low Birth weight as a Percent of All Births, 2006
9.7
8.3
Number of Deaths per 100,000 Population, 2007
951.7
760.31
Life Expectancy at Birth (in years), 2005
75.3
78.0
Percent of Adults Who Have Ever Been Told by a Doctor that They Have Diabetes, 2008
11,9
8,2
Number of Deaths Due to Diseases of the Heart per 100,000 Population, 2006
236,9
200,2
Asthma prevalence among adults
9.0
8,2
Percentage of Adult Population Aged 21-64 Years Who Reported a Disability, 2007
22,4
12,8
The above figures need to be assessed in caution regarding the high prevalence of “occupation of coal worker” in West Virginia. Apart from the apparent pathophysiology of dust entering the lungs and rendering them chronically inflammatory, with signs of fibrosis and atelectasia or other interstitial pneumonic disease or pneumonoconiasis, health needs of coal mining workers are extended to a variety of diseases that are not as commonly identifiable at the first look.Community Health Assessment Model Essay
Although current screening methods and occupational policies do exist for these workers, they tend to be centred on respiratory diseases. Coal Mining however, is a demanding, time consuming manual labour that is often exigent and causes a variety of clinical manifestations. As such we can consider lower back pain, physical limitations (Galagher,2005) cervical spine degenerative changes, vibration-hazard related body changes, sudden coronary death (Kopytina et al, 1993), skin lesions (Begraca et al, 1991)and mental health changes (Lagunov,1991).
Moreover, the coal mining community often has unmet needs on the level of healthcare access and utilization, that different stakeholders are usually unaware. In a study by Smith et al,2005 a community health needs assessment was the means to the provision of a community nurse and a revision in healthcare provision among former miners in Kent.
Having reviewed the major components of community health needs assessment for mine workers in West Virginia and having conducted the appropriate background review, we propose the following questionnaire as a tool to conducting an effective and fruitful evaluation of perceived and actual health needs, in a community of mine workers.
This tool comprises of a health needs assessment part, where the answers are left open and views are encouraged for propositions in order to facilitate the analysis of expected health and participation to health concerns. The second part is a standardized demographics and health questionnaire that is used widely in this form, with minor alterations in assessing the perceived health and demographic information of the study population in question.Community Health Assessment Model Essay
Emphasis is given on other diseases that might affect the coal mining community ( participants are requested to count five-5 major health concerns) and on perceived level of attention and care this community is receiving or should be receiving according to its needs. A question regarding their sibling’s health is put in the end to elucidate concerns that are also documented in the literature regarding out of site contamination with dust by coal workers that bring their occupational hazard in the family home or by dispersion in neighbourly areas (Pless-Mulloli et al, 2001).
QUESTIONNAIRE:
We are conducting a review of the Health Needs within the WV coal mining community. Along with statistical data and analysis we are also interested in your viewpoints.
Instructions
Part One: Health Problems
There are several factors that influence or determine whether the people in your coal miner’s community are healthy.Community Health Assessment Model Essay
From the following list, please rank from 1-5 (1 being the highest priority) what you think are the top five health and disability issues affecting your community?
Health Issue
Your Ranking (1-5)
Asthma / Respiratory Disease / Pneumoconiasis
Cancer
Cardiovascular Disease
Depression / Psychiatric Disorders
Diabetes
Disability
Drug and Alcohol use
Nutrition
Obesity
Oral Health
Physical Injury (including violence and accidents)
Self harm / Suicide
Sexual Health
Smoking
Other (please specify below)Community Health Assessment Model Essay
What do you think is needed to address the top three priority issues identified above and what difference will this make?
Issue 1:
Issue 2:
Issue 3:
What is needed?
What is needed?
What is needed?
What difference will this make?
What difference will this make?
What difference will this make?
How much influence do you think the following have as to whether people in your coal mining community are healthy?
Please mark each factor with an X, ranking “influence” from 1-5 following with an X
Influence (1 is most, 5 is least)
Factors
1
2
3
4
5
Cost of services
Ease of access to health services Community Health Assessment Model Essay
Education
Employment
Family support
Housing
Income
Social Isolation
Transport
Community support
Insurance status
Other (please specify below)
Your details
Please provide us with some information about yourself. This will assist us with the analysis of the questionnaire results.
Please mark the following that applies to you with an X
Name (optional)
Ethnic Group
American
German decent
Hispanic
Other
Gender
Male
Female
Age Range
Children (aged 0 – 14)
Adults (aged 25 – 64)
Youth (aged 15 – 24)
Older People (aged 65+)
Where do you live?
metropolitan area
county
How many years have you worked in the coal mining sector?Community Health Assessment Model Essay
( number of years)
Do you consider your self healthy?
Yes
No
What is your principal concern?
How often do you visit a doctor?
List one preventive diagnostic test that you had the previous 6 months: ( colorectal screening, pap test, ECG, CXR, ultrasonogram etc):
Does your employer offer health promotion/wellness programs?
Yes
No
Type of health insurance( state) :
In the following section, select which answer describes you. *Note that N/A stands for not applicable
Always
Sometimes
Never
N/A
You wear a seat belt:
You wear a helmet when riding a bicycle, rollerblading or skateboarding:
You drive the posted speed limit:
You eat at least 5 servings of fruits and vegetables each day:
You eat fast food more than once a week:
You exercise at a moderate pace at least 30 minutes per day, 5 days per week:Community Health Assessment Model Essay
You consume more than 3 alcoholic drinks per day (female) or more than 5 per day (male):
You smoke cigarettes:
You chew tobacco:
You are exposed to secondhand smoke in your home or at work:
You use illegal drugs (marijuana, cocaine, methamphetamine, etc.):
You perform self-exams for cancer (breast or testicular):
You wash your hands with soap and water after using the restroom:
You undergo physiotherapy for lower back pain
You apply sunscreen before planned time outside:
You get a flu shot each year:
You practice safe sex (condom or other barrier method, etc.):
You take vitamin pills or supplements daily:
You spend money on gambling more than once a month:
You attend religious services regularly:
You volunteer in your community (church, schools, civic organizations, etc.):
You donate money to community based organizations (churches, non profit organizations, etc.):
You get enough sleep each night (7-9 hours):
You feel stressed out:
You feel happy about your life:
You feel lonely:
You worry about losing your job:
You feel safe in your community:
You are afraid for your children’s health
You feel that the government is liable for your health
You feel that the government is liable for your children’s health Community Health Assessment Model Essay
