Paul Bunyan Senior Activity Center Community Health Assessment

Running head: COMMUNITY HEALTH ASSESSMENT 1

Babs Borg, Janet Lund, Colleen McKay, Andrew Mock, Karla Pula, and Hannah Peterson

Bemidji State University COMMUNITY HEALTH ASSESSMENT 2

Paul Bunyan Senior Activity Center Community Health Assessment

Introduction (Babs and Karla)

For our Community Health Practicum we identified Paul Bunyan Senior Activity Center

(PBSAC) clients as our population-of-interest, and we conducted an assessment, established community diagnosises, planned and implemented interventions, and evaluated the outcomes of our interventions. The goal of our interaction with the clients at the PBSAC was health promotion and health protection, with health for seniors being defined as "the ability to live and function effectively in society and to exercise self-reliance and autonomy to the maximum extent feasible, but not necessarily as freedom from disease" (Anderson & McFarlane, 2008, p.456).

The Paul Bunyan Senior Activity Center (PBSAC) is a population consisting primarily of adults over the age of 55, but is accepting to clients of any age. The PBSAC’s main mission is to promote independence in older adults and to provide the opportunities necessary for developing and sustaining a role in the community of Bemidji. The purpose of the center is to "meet the needs of seniors for fellowship, learning, information and recreation and to work cooperatively with other agencies in serving the needs of older adults" (PBSAC brochure).

We assessed the PBSAC community during a windshield survey and by using the

Community Assessment Wheel model. As part of our assessment of the PBSAC community, we participated in activities such as conducting research about our population, researching agencies throughout the Bemidji community, conducting interviews with the different organizations that serve our population-of-interest, and by participating in volunteer services. Through our assessment we identified health issues concerning the PBSAC community that we could address COMMUNITY HEALTH ASSESSMENT 3 to promote a better fit and knowledgeable community. Some of the issues identified include risk for social isolation, risk for disability, risk for medication mismanagement, and risk for falls.

Utilizing the information gathered, we collaborated with PBSAC clients and the center’s director to develop a plan to best address the multiple issues. Together we reached the decision to conduct a Senior Community Health Fair for the older adult population, to be held at the

PBSAC. By bring together community resources to address multiple aspects of health, the

Senior Community Health Fair will help PBSAC meet its mission to “provide opportunities for older adults to develop and sustain their potential as individuals and citizens of our community”

(PBSAC procure). Additional PBSAC community needs were addressed by providing computer skills training for adults who were not knowledgeable about computer, and by participating in a

WII bowling league for improved fitness and overall motor function of the older adult community clients.

Throughout this paper, we will be discussing the nursing process we used in our

Community Health Assessment including the findings of our community assessment, the community diagnosises we developed, how we planned and implemented the Senior Community

Health Fair intervention, and how we evaluated our intervention.

Background/Assessment

Health People 2010 Priorities (Hannah)

Healthy People 2010 has established the overreaching national goal to "increase the quality and years of healthy life and to decrease health disparities for all Americans" (Anderson

& McFarlane, 2008, p.454). With respect community seniors, Healthy People 2010 indicates that health promotion strategies should endeavor to "maintain health and functional independence to prevent morbidity and dependence" (Anderson & McFarlane, 2008, p.454). Health People 2010 COMMUNITY HEALTH ASSESSMENT 4 has established several objectives relating to older adults that can help us develop intervention priorities. These objectives include the following focus areas: arthritis, osteoporosis, and chronic back conditions and disorders; educational and community-based programs; heart disease and strokes; immunizations and infectious diseases, injury and violence prevention, medical product safety; mental health and mental disorders; physical activity and fitness; and vision and hearing

(Anderson & McFarlane, 2008).

Community Assessment Wheel

Community core.

History.(Babs)

Demographics. (Babs)

Ethnicity.(Andrew)

Values and beliefs.(Andrew)

Subsystems.

Physical environment.

Health and social services.

Economy.

Transportation and safety.

Politics and government.

Communication.

When assessing the PBSAC, the two forms of communication that were observed were formal and informal communication among the clients and the community. Formal communication included communication outside the community, such as the Buy Line newspaper available to all Bemidji residents, radio stations, commercial TV stations, and home COMMUNITY HEALTH ASSESSMENT 5 mail delivery received by residents of the Bemidji area. Informal communication observed at the

PBSAC include bulletin boards, posters, flyers, brochures, newsletters to notify clients of upcoming meetings and social events, monthly calendars, a website, and the coordination of phone calls and word-of-mouth communication by the PBSAC's director, Diane Engel, and her co-workers. Observed in the PBSAC were TVs, radios, common areas located throughout the center for clients to visit, a dining room for meals and socialization, books, pamphlets, and magazines. These served to meet one of the main purposes of the center by providing avenues for socialization through face-to-face communication.

Education.

Recreation.

Recreation opportunities observed in the local community for clients of the PBSAC vary throughout the year because of the seasonal changes that occur in northern Minnesota. The location of the center is in downtown Bemidji and is located near a lakeside walking path, nearby playgrounds, and there are sidewalks on the streets of downtown Bemidji. Space and area outside is limited in the winter months. Inside the PBSAC are many opportunities for recreational fun and enjoyment. Activities the PBSAC offers are listed in the monthly calendars, brochures, newsletters, and website. These activities include, but are not limited to; greeting card recycling, card games, silver stretchers' exercises, woodcarvers, pancake breakfast, dances, bus trips, craft shows, and Third Street Senior Singers Chorus.

Perceptions.

The residents.

Our perceptions.

Rationale for Involvement (Karla) COMMUNITY HEALTH ASSESSMENT 6

"The term epidemiology originates from the Greek terms logos (study), demos (people), and epi (upon)---literally, 'the study of what is upon the people" (Anderson & McFarlane, 2008, p. 19). When considering the evidence which supports the rationale for involvement with our population-of-interest, we first want to look at what it is our population is facing, and what they see as their needs for improvement and/or change. We selected the main issue of importance to our population through informally interviewing the community core, the clients of the PBSAC.

After assessing what the client's saw as needing change and/or improvement for their overall health and enjoyment, we started to formalize ideas that could help assist our population-of- interest in meeting those needs. A health fair for the senior population was the end result, where we were able to meet the main issues of importance to the population in which they viewed as needing improvement, not what we saw as needing improvement. The PBSAC client's needs, or issues of importance, were centered around their physical environment, education, safety and transportation, politics and government, health and social services, communication, economics, and recreation. These subsystems, which can be found in the Anderson & McFarlane's

Community Assessment Wheel, were addressed at the Senior Community Health Fair.

Use of Literature

WII. (Babs)

Health fair for seniors. (Janet)

Interviews

Public health nurse. (Janet,)

County Board Meeting. (Hannah)

Our group attended a Beltrami County board meeting on September 7th, 2010 to learn about the process of implementing a systems level intervention for our population-of-interest at COMMUNITY HEALTH ASSESSMENT 7 the county level. The board meeting began at 5 pm in the County Board Room at the County

Administration Building in Bemidji, Minnesota. There was four county commissioners present and one absent. The meeting began with a call to order, a roll call, and the reciting of the pledge of allegiance. Then citizens were given the opportunity to address the board. It is at this time that a Community Health Nurse could address the board concerning a population-of-interest. During the next part of the meeting the commissioners formally approved proposals that had been worked on in a county work session. If a Community Health Nurse wanted to collaborate with

County Commissioners on an intervention that would impart a population-of-interest the health nurse would need to get on the agenda for a work session where the details of a proposal could be worked out and then formally approved during a County Board meeting. Next, the

Commissioners moved through the agenda, discussing an issue and then voting on the issue or tabling it for further discussion. If a Community Health Nurse was to place a topic of concern on the agenda, than a Health Nurse could speak at a board meeting advocating for a population-of-interest and influence the decisions of the Commissioners.

Human serves organization director. (Andrew, Adult Day Services)

Community facility that interacts with population. (Andrew, Soup Kitchen)

Community clinic. (Colleen, SBHU)

Organization that serves population. (Babs, RSVP)

Members from population. (Janet)

Homeless shelter. (Karla)

An interview with Bemidji's People's Church owners, Robert and Carol Kelly, provided us with information about their services to the homeless community, how they initially got started, the population of people they serve, and what their role is in the community. Carol is a COMMUNITY HEALTH ASSESSMENT 8 public health nurse, and the initial start to their investment in the church was not only for

Robert's preaching sermons, but also for Carol's effort in providing nursing care to those who are unfortunate enough to receive medical care on their own in hospitals and/or clinics. From there, they started providing the church as a shelter to those who do not have homes. Robert and Carol were very open and informative about what they do to help in the community, and made valid points to us all about how we can also help, and how to be openly competent to those whom we will serve in our future medical careers. By interviewing Robert and Carol Kelly, we have become more knowledgeable about what they do to help serve the homeless population by providing shelter, food, clothes, support, communication, and care. Through interviewing them, we were also able to see how one community within a community can come together for the sake of human kind. The experience was eye-opening and very worthwhile.

WIC clinic. (Hannah)

Our group interviewed an employee from the Women, Infants, and Children (WIC)

Clinic to learn about how this program could be used by or impact our population-of-interest.

The WIC program provides primary prevention to mothers and their young children by providing supplemental nutrient rich food. Although this program targets mothers and young children, this program may be utilized by seniors who are parenting grandchildren. The United States Census

Bureau (2010) reported that in 2008 9% of grandchildren lived with and were cared for by grandparents. A senior who was grand-parenting a young child could utilize this program and acquire supplemental food for the child. This could be very helpful for a retired senior who is trying to raise grandchildren while living on a low and fixed income.

School nurse. (Karla) COMMUNITY HEALTH ASSESSMENT 9

When interviewing the St. Phillip's school nurse, Heidi Fladeboe, we were able to view the community in a more holistic perspective. Even though an interview with a school nurse is not directly relative to our population-of-interest, the school community can also have an impact on other populations. For instance, a client of the PBSAC may have a grandchild in one of the surrounding schools, and could need some assistance or information on the school systems, or vise versa. Collaboration within all subsystems of the community is essential in order to provide competent care to those individuals of the providing areas. Heidi was able to inform us on their educational system, programs, her role in providing nursing care to the school-aged children, what her standards are to go by, who her contacts are, the meetings she attends within the school district, what she sees of children on a day-to-day basis, and what she views as being most valid and challenging to the health of the school population. Community Health Nursing is a holistic perspective where all subsystems within a community should be included.

Diagnoses (Hannah)

Planning and Implementation (Colleen)

Evaluation (Janet)

Conclusion (Who wants to do this)

References

Anderson, E.T., & McFarlane, J. (2008). Community as partner: Theory and practice in nursing

(5th ed.). Wolters Kluwer/Lippincott Willioams & Wilkins, Philidelphia, PA.

Paul Bunyan Senior Activity Center. (n.d). [Promotional pamphlet].

Keller, L., & Strohschein, S. (2001). Public health interventions: Applications for public health

nursing practice. Minnesota Department of Health, St. Paul, MN:.

U.S. Census Bureau. (2010). Facts for features: Grandparents day 2009. Retrieved COMMUNITY HEALTH ASSESSMENT 10 fromhttp://www.census.gov/newsroom/releases/archives/facts_for_features_special_editi ons/cb09-ff16.html.