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N4465 Care of Vulnerable Populations COMMUNITY ASSESSMENT, ANALYSIS, and NURSING INTERVENTION Modules 1-3 (Weeks 1 – 3) Assignment Template Use of the Three-Part Course Template ● The use of the three-part template to submit weekly Major Course Paper Assignments goes as follows: ● Week 1: Clinical Experience: Windshield Survey and Key Informant Interviews. Complete the First Section of the course template and submit. (Keep this section attached to Weeks 2 and 3 assignments.) ● Week 2: Statistical Analysis of Community Health Problem. Complete the Second Section of the course template and submit. (Keep this section attached to Weeks 1 and 3 assignments.) ● Week 3: Community Health Nursing Intervention. Complete the Third Section of the course template and submit. By now, you should have Sections 1-3 as one whole document. ● Each section of the course template is submitted on a WEEKLY basis, depending on which week you are working on. DO NOT wait to submit all three sections at the end of the third week. ● Please note that students are not to make any changes to the content of the course template, for example, removal of questions or examples imbedded in the response box of the template. ● Removal of the questions or examples imbedded in the response box of the template is considered tampering with the content and will result in a 10-point grade deduction per assignment. Should removal of the questions or examples imbedded in the response box of the template persist by the student, in addition to the 10-point deduction, the student will be referred to the Office of Student Conduct for final disposition. You are strongly encouraged to be mindful of this course policy. ● The ONLY change students may make to the template is to enlarge the space to make their entries in the response boxes.

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● Should you encounter any difficulties with these course policy guidelines, please consult with your Academic Coach.

Module 2 Module 2 (Week 2) Part Two: Statistical Analysis of Community Health Problem Please complete the following information on this template. If you do not use this template there will be a 10-point grade penalty per assignment, and you will be required to resubmit within 48 hrs. You may increase the size of the block by continuing to type. Use as much space as necessary to provide your answers Name of Community or Zip Code: Arlington Texas Instructions: Enter your response in each category marked below. Provide objective, statistical support for your subjective findings. ● Include all the data listed in the Objective Data Criteria listed below. ● Add supplemental data as needed for your community. ● All statistical data must be reported in NARRATIVE form only. Tables and graphs will not be accepted. ● Compare objective data for your community with local (city), state, and national data. You may increase the size of the block by continuing to type. Use as much space as necessary to provide your answers General Objective Data Criteria for the Community-at-Large 1. Demographics: Total population; age distribution; gender distribution; family characteristics (single parent, multi-family, etc.). Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate. Arlington, Texas, has a total population of 398,112, which is lower as compared to the other cities in Texas state. However, it is one of the largest cities in Texas. Other cities 4465-2020

like Dallas and Fort Worth have a higher population of 1.341 million and 874, 168, respectively. The youths form the highest population in the city. 31% of the population involves individuals below 20 years, 30% involves individuals between 25-44 years, 23% of individuals between 45-64 and 8% individuals above 65 years (Lee & Sohn, 2016). There are more females than males in the city, with 94 males for every 100 females.

2. Racial/Ethnic Characteristics: Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate. There are various ethnic groups in Arlington. Whites are the majority being 61.48% of the total population. Blacks or African Americans are the second largest ethnic group, with a composition of 22.46% of the total population. Asians, Native Americans, and Pacific Islanders form a composition of 6.89%,0.45, and 0.13% of the total population, respectively (Lee & Sohn, 2016). There is a major difference between the racial composition of Arlington with that of other communities n the city like Dallas. In Dallas, 50.7% of the total population is made up of whites, 25% blacks, 0.5% Native American. Asians, Pacific Islanders, other races, and individuals from two or more races form 2.9%, 0.1%, 17.2%, and 2.7%, respectively.

3. Economy: poverty rate, unemployment rates, median income. Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate. The poverty rate in the city is higher than the national average. The poverty rate is estimated to be 17%, a rate that is higher than the national average by 10%. Most of the people in the community are employed (Lee & Sohn, 2016). The community has an unemployment rate of 4%, which is 4% lower as compared to the national unemployment rate. The median income is estimated to be $53,574. The median income is lower as compared to the city average and the national average by 2% and 3%, 4465-2020

respectively.

4. Education: High school completion rates; higher education statistics. Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate. The high school completion rate in Arlington, Texas, is quite high. An estimate of 87% of students receives high school diplomas. The rate of high school dropouts is estimated to be 2.7%. The rate of individuals with an associate degree is 7%, 29.10% college graduation rate, and 8.8% of individuals with professional degrees (Lee & Sohn, 2016). There is a difference in higher education statistics rates in Arlington and other communities like Austin. The rate of individuals with associate degrees in Austin is 5.2%, 45.6% college graduation rate, and 16.6% individuals with professional degrees.

5. Identify two Morbidity and Mortality/Risk Problems: (Based on your observations from Week 1 subjective assignment, windshield survey and key informants provide Morbidity, Mortality (M&M), and risk data for your community… Example 1: if you observed obesity in your community then present obesity rates and health conditions associated with obesity [i.e. CVD, HD, Depression, etc.). Example 2: smoking/drinking rates and health conditions associated with smoking [i.e. Lung Cancer, COPD, etc]. These variables may include the following: gender (who does this problem affect the most, men or women); age distribution; ethnicity or racial group(s) mostly-affected; morbidity and mortality rates; any data related to life-expectancy in light of the health issues; is there a geographic area where the health problems mainly exist; is there a relationship between the health issue(s) and environmental health hazards; are these lifethreatening health issues? Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate. Substance abuse is one of the risk problems being experienced in the Arlington community. More than 15% of the population abuse drugs. The problem of substance abuse, especially alcohol abuse, affects males more than females. Alcohol abuse led o 1520 alcohol-related crashes in 2017 (Champagne-Langabeer, Madu, Giri, Stotts & Langabeer,2019). Violence is also another risk problem in the community. The violence rate is quite high in the community. The violence rate is estimated to be 8% higher as compared to the Texas average and 17% higher than the national violence rate.

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6. Other data as needed (air, water quality, crimes rates). Remember compare objective data for your community with local (city), state, and national data. Remember to cite sources as appropriate. The air quality in the Arlington community is 46. The quality is lower than the national average, which is estimated to be 58. The water quality of this community is 90. It is higher than the national average, which is 55 (Shi, Chen, Nie, Zhu & Hu, 2014). The crime rate in the Arlington community is 24% higher as compared to the Texas average and 34% higher compared to the national average.

Analysis of Data 1. Based on your subjective and objective review of your findings, what conclusions have you arrived at? Remember to cite sources as appropriate. 

What impressions from your subjective observations were unfounded/invalid? Poverty levels in the community, especially among the minority groups like the African Americans, have interfered with the quality of healthcare that individuals in these groups receive (Lee & Sohn, 2016). Most people who live below the poverty line are unable to seek quality healthcare, something that has an impact on the health conditions of the individuals.



Given the objective data, what impressions were validated/substantiated? The life expectancy among the minority groups in the community has decreased over time. This is attributed to the fact that they are not able to receive essential services, for example, quality healthcare. In 2013, the life expectancy for black was estimated to be 74 years, which is quite lower as compared to 78 years for the whites.



What cause-and-effect relationships did you discover/identify? Poverty causes a decrease in life expectancy rates. Poor people in the community are at risk of dying early since they cannot afford the services needed to improve their

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living and health conditions.

2. Problem Analysis for Community/Zip Code: Problem: List two (2) problems within your community (for example, Infant Malnutrition, CVD, Lung Cancer, Obesity, Alcoholism, Violence) NOTE: These problems need to be something the Community Health Nurse can impact (for example, a CHN cannot build a sidewalk, repair a street, implement a new bus route, etc.). Remember to cite sources as appropriate. 1. ______________Substance abuse______________________________ 2. _________Violence___________________________________ Select one of these problems and complete the Problem Analysis chart Problem Correlates* Substance abuse

Relationship of Correlate to Problem

Data Supportive of Relationship +

An increase in the rate of substance abuse has resulted in a rise in crime levels as well as substance-related deaths.

In 2018, the number of drugrelated deaths rose by 34%. Also, cases of drug overdose rose to 42% in 2018 (ChampagneLangabeer, Madu, Giri, Stotts & Langabeer,2019). This has led to death of so many individuals not only in Arlington but also in the whole of Texas.

*These are factors that contribute to problem and outcomes. + Refer to appropriate sections of the database and relevant research of the findings in current literature. Data in the third column could be local, state, or national statistics. 3. Community Health Nursing Diagnoses: Based on your subjective and objective assessment findings above for both Weeks 1 and 2, write TWO priority community health nursing diagnoses.

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You must use this format for correctly writing a CH nursing diagnosis (do NOT use NANDA): *RISK OF AMONG RELATED TO Health *Risk/problem of (specific injury, illness, or potential of, complication of, etc) Among (specific population) Related to (supporting evidence from your assessment findings).  Your CHN Diagnoses MUST be something that a community/public health nurse can do something about. See example below.  Note: Poverty is NOT a CHN diagnosis.  Remember do NOT use NANDA Nursing Diagnoses. For example: Risk of asthma complications among children in SE Dallas County related to observations of overcrowded living conditions, lack of public transportation (may result in inability to access health care), high number of animals observed living in homes, poverty indications (may result in lack of access to medications). Community Health Nursing Diagnosis #1 Malnutrition among children is one of the priority community health diagnoses. Malnutrition is quite common among children who come from poor families. Some families, especially the minority groups in the community, cannot afford basic needs such as food and housing, leading to malnutrition among children.

Community Health Nursing Diagnosis #2 Asthma is also another priority community health diagnosis. The problem is attributed to an increase in poverty levels in the community, making quite a big number of people not to afford proper housing (Newcomb & Li, 2019). Most of the children from poor families suffer from asthma due to exposure to too much cold and other extreme conditions.

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Reference

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Module 3 Module 3 (Week 3) Part Three: Community Health Nursing Intervention Directions: Please complete the following information on this template. If you do not use this template there will be a 10- point grade penalty per assignment, and you will be required to resubmit within 48 hrs. You may increase the size of the block by continuing to type. Use as much space as necessary to provide your answers Introduction: Purpose of the paper, synopsis of community, two CHN diagnoses with supporting evidence, for example, observations, reports from Key Informants, and Statistical data. Remember to cite sources as appropriate. The main purpose of this paper is to explore the most appropriate community health nursing intervention that should be implemented in Arlington, Texas in order to address some of the major community health issues and problems. Also, the paper describes how evaluation of the intervention strategies implemented in the community, will be carried out. Arlington is one of the major communities in Texas, with a high number of women as compared to men (Shi, Chen, Nie, Zhu & Hu, 2014). there are various issues that are common in this community. These include poverty and homelessness, drug abuse, unemployment, and violence, among others. Some of the community health nursing diagnoses in the community include malnutrition among children and asthma. The poverty level, which is estimated to be 17%, is considered to be the greatest cause of malnutrition among children living in this community. Homelessness, which is also caused by increased poverty in the community, has resulted in great rates of asthma due to exposure to cold. There are other factors apart from poverty that have resulted in asthma problems among individuals in the community. Drug abuse, especially smoking of cigarettes, is one of these factors.

Based on the 2 CHN Diagnoses you developed in Assignment 2 or modified, select ONE problem, and develop a CH Nursing intervention. Remember to cite sources as appropriate. 1. CHN Diagnosis/Problem you selected: Asthma is one of the community health diagnosis in Arlington, Texas. The issue of asthma has become quite common in the community, especially among children who are exposed to cold (Newcomb & Li, 2019). The problem is also common among adults, especially those who are homeless, making them live on the streets. Most people

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who live on the streets are aged between 5 years and 60 years, most of them being males. These people, therefore, have a great risk of suffering from certain diseases that are associated with cold, for example, asthma.

2. Why did you select this problem? Provide your rational for selecting this problem in 1-2 comprehensive paragraphs (Consider the problem priority criterion on page 417 Box 18-5). Provide supporting community and scientific/authoritative evidence, for example, Healthy People 2020, CDC, AHA, other. Remember to cite sources as appropriate.

The reason why I selected this problem is because it has become too common not only in Arlington but also in the whole of Texas. The number of deaths and hospitalizations associated with this problem has been increasing each and every. It is, therefore, important to come up with nursing intervention measures of ensuring that this problem is addressed. According to a survey conducted by Texas Behavioral Risk Factor Surveillance System in 2011, there were nine thousand, two hundred and eighty asthma-reported hospitalizations among children between 0-17 years in 2011. This is a clear indication that asthma is a major problem in Texas that should be addressed in order to avoid death of people. Children suffering from this problem end up missing some of the basic activities such as missing school (Newcomb & Li, 2019). Therefore, the problem does affect not only the physical well-being of individuals but also the emotional well-being. Also, the survey carried out in 2011, indicate that the rate of asthma hospitalizations among black children is higher significantly higher than the other races. It is, therefore, clear that there is a great correlation between asthma and poverty levels in the community as well as Texas as a whole. The intention to reduce suffering among children is, therefore, another reason for selecting this problem.

3. Identify two (2) Goals. For example, goals indicate where you want to go. Then, identify two to three (2-3) objectives per goal. For example, objectives should indicate how you plan to get to or accomplish the goal(s). Goal 1: Reduce the rate of deaths associated with asthma

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1. Objective: Provision of corticosteroids medication

2. Objective: Early diagnosis of asthma symptoms Goal 2: Reduce the rate of hospitalizations related to asthma 1. Objective: Comprehensive evaluation and assessment of asthma symptoms 2. Objective: Avoidance as asthma triggers

4. Intervention Objectives Timeline Under Interventions you should have an intervention for EACH objective you list (if you have 4 objectives then you should list 4 interventions; if you have 6 objectives (3 for each goal), then 6 interventions). You can insert rows into that table to accommodate if needed. If one intervention addressed more than one objective, you must make it clear in your paper. See the example in the table. Present Date Objective( Number and Statement) Anticipated Completion Date 30/01/2020 30/01/2020 30/01/2020 30/01/2020

Provision of corticosteroids medication to reach 85% of the victims Increasing early diagnosis of asthma symptoms by 60% improving the level of evaluation and assessment of asthma symptoms by 75% Avoidance of Asthma triggers by 60%

5. Plan of Intervention and Evaluation

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30/06/2020 20/05/2020 30/05/2020 30/06/2020

Date

Intervention Activities

Responsible Agency/Person

01/02/2 020

Community Heath nurse identifies people who should undergo training on the use of asthma medications in the community

Community health nurse

16/02/2 020

Conducting orientation to asthma victims on how to take asthma-related medications

Community health nurse

16/02/2 020

Training members of the community on how to avoid asthma triggers

Selected persons from the community

Community health nurse

Evaluation Measures The selected people will develop strategies for ensuring that the provision of medication is effective. Assessing the number of victims who access medications on a monthly basis Evaluation of the intervention will be based on the cases of asthma hospitalization in the community every month until the intervention goal is achieved The evaluation will also be based on the reported cases of asthma every month until the intervention goal is achieved.

Target...