Chapter One: Community and Public Health Policy
Practical Application: Book Activity
Practical Application
Setting the Scene
Social Determinants of Health: Watch the video at https://youtu.be/u_IoBt7Nicw
Think About It
Imagine you are a community health nurse tasked with supporting the health care of your current community.
- How would you investigate the health policy agendas of your local legislators?
- Drawing on your experience living in the community, what health hazards have you noticed? What would you do to advocate for improvement?
- Develop a set of professional priorities. What social issues would you include?
- Your supervisor has asked you to organize a program to educate the community about the Social Determinants of Health.
- How would you organize this program?
- What would be the key aspects of this program?
- What considerations would you need to incorporate in their community health program design (e.g. health literacy level, language barriers, social or cultural considerations)?
Practical Application: Additional Guidance
Exercise Title
Social Determinants of Health
Objective
This exercise aims to immerse nursing students in the exploration of social determinants of health (SDOH) through critical thinking, community assessment, and program planning.
Preparing for the Exercise
- Introduction: Introduce the concept of social determinants of health and their impact on individual and community well-being. Provide background information on the exercise and its objectives. Use information from the Healthy People website.
- Video Viewing: Direct students to watch the provided video on social determinants of health or access it through the provided QR code. Encourage active engagement and note-taking. If you have access to technology in your courses, you might explore VoiceThread or Perusall as a way to encourage students to record their thoughts in real time.
Exercise Components:
- Community Health Assessment: Task students with investigating the health policy agendas of local legislators. Encourage them to utilize various resources, such as government websites, legislative records, and community forums, to gather information on healthcare-related policies and initiatives.
- Identifying Health Hazards: Prompt students to reflect on their own experiences living in the community and identify health hazards they have noticed. Encourage them to consider environmental, social, economic, and cultural factors contributing to these hazards. Help students identify health hazards in areas where they are involved in community service-learning.
- Advocacy Planning: Guide students in developing a set of professional priorities, including social issues they would advocate for improvement. Encourage them to prioritize issues related to SDOH, such as access to healthcare, affordable housing, education, employment, and food security. Facilitate student’s connection of social issues to direct and indirect health outcomes.
- Community Education Program: Challenge students to organize a program to educate the community stakeholders about social determinants of health. Prompt them to consider key aspects of program design, such as target audience, content delivery methods, interactive activities, and evaluation strategies.
- Considerations for Program Design: Emphasize the importance of considering the community’s health literacy level, language barriers, social norms, cultural beliefs, and values when designing education programs. Encourage students to incorporate culturally sensitive and linguistically appropriate approaches to ensure accessibility and relevance.
Evaluation and Assessment
- Assessment Criteria: Establish clear criteria for evaluating student performance, including the thoroughness of their investigation, the relevance of their advocacy priorities, the effectiveness of their program design, and the inclusiveness of their considerations.
- Assessment Methods: Assessment Criteria: Establish clear criteria for evaluating student performance, including the thoroughness of their investigation, the relevance of their advocacy priorities, the effectiveness of their program design, and the inclusiveness of their considerations.
Integration into Curriculum
- Alignment with Course Objectives: Ensure that the exercise aligns with course objectives related to community health nursing, health promotion, advocacy, and program planning.
- Sequencing: Determine the appropriate timing and sequencing of the exercise within the course curriculum to complement other content and activities.
- Integration of Theory and Practice: Emphasize the application of theoretical concepts to real-world scenarios, fostering the development of practical skills and competencies in community health nursing.
Resources and Support
- Learning Resources: Provide students with access to relevant literature, articles, websites, and multimedia materials on social determinants of health and community advocacy.
- Faculty Support: Offer guidance, feedback, and mentorship to students throughout the exercise, addressing any questions or concerns they may have.
- Community Partnerships: Encourage students to collaborate with local community organizations, healthcare providers, and advocacy groups to enhance the relevance and impact of their advocacy efforts and educational programs.
Conclusion
By following these guidelines, nurse educators can facilitate a dynamic and engaging practice application exercise that empowers nursing students to explore the complexities of social determinants of health, advocate for health equity, and design culturally responsive community health programs.
Additional Activities
Role-playing/Communication Exercise
Scenario Title
Community Health Education and Policy Advocacy
Objective
To enhance students’ communication skills in educating the public about health issues and advocating for public health policy changes.
Roles
- Nurse Educator
- Community Members (diverse backgrounds and varying levels of health literacy)
- Policymakers (local government officials)
Scenario Setup
The Nurse Educator is tasked with presenting information and advocating for a new public health policy related to vaccines to community members and local government officials.
Preparation
- Provide the Nurse Educator with background information on the health issue, current statistics, and proposed policy changes.
- Give Community Members a brief description of their character’s background, beliefs, and concerns regarding the health issue.
- Policymakers receive information on current policy stances, potential benefits, and opposition arguments.
Role-Playing Activity
- Introduction: The Nurse Educator presents an overview of the health issue and the proposed policy change to the community.
- Interaction between Community Members and Policy Makers: Community Members and Policy Makers ask questions, express concerns, and share personal experiences. The Nurse Educator responds to these queries, providing evidence-based information and addressing misconceptions.
Debriefing and Feedback
After the role-play, conduct a debriefing session where each participant reflects on their experience, provides feedback, and discusses lessons learned.
- Discuss what communication strategies worked well and what could be improved.
- Provide feedback on how effectively the Nurse Educator communicated complex health information, addressed concerns, and advocated for policy changes.
- Effective communication strategies for different audiences (public and government officials).
- How to present and advocate for public health policies.
- The importance of addressing diverse perspectives and health literacy levels.
- Techniques for managing difficult conversations and handling opposition.
Reflective Practice
This activity could occur on a discussion board or by uploading a video using Flip or Canvas Studio.
As a public health nurse, you have been tasked to advocate for a state-wide vaccination initiative. What strategies will most effectively communicate the program’s benefits to community members and government officials? How will you address any concerns or resistance?
Interactive Module
Create an interactive escape room using Google Forms that challenges students to solve puzzles related to the chapter topic. These NCLEX-style questions can be a starting point.
- A public health nurse is organizing a vaccination clinic in a rural community with low immunization rates. Which strategy is most effective for increasing community participation in the vaccination program?
- Sending out mass emails to community members.
- Partnering with local community leaders and organizations to promote the clinic.
- Posting flyers at the local grocery store.
- Offering vaccinations only during weekday business hours.
- During a community meeting about a proposed smoke-free ordinance, a nurse encounters strong opposition from local business owners. Which response by the nurse demonstrates effective advocacy for public health policy?
- “This ordinance will be implemented regardless of your opinions.”
- “There are many other communities that have implemented similar ordinances without any issues.”
- “The health department will provide financial compensation for any losses incurred.”
- “The smoke-free ordinance is essential, but I understand your concerns and am here to discuss how we can address them.”
- A nurse is evaluating the impact of a new public health policy aimed at reducing childhood obesity through mandatory physical education in schools. Which outcome would best indicate the policy’s success?
- An increase in the number of children participating in school sports.
- A decrease in the prevalence of childhood obesity rates in the community.
- Positive feedback from parents about the physical education program.
- Increased funding for school sports programs.
- A public health nurse is advocating for a mental health awareness program at a town hall meeting. Which statement by the nurse is most likely to gain support from the community?
- “Mental health issues are not as important as physical health issues, but they still need attention.”
- “Implementing this program will require significant changes to our current budget and resources.”
- “Mental health affects everyone in our community, and this program can provide essential support and resources.”
- “Only those with severe mental illnesses will benefit from this program.”
- A nurse is conducting a health education session about the benefits of the flu vaccine. Which statement by a community member indicates a need for further education?
- “I heard that the flu vaccine can prevent serious complications related to the flu.”
- “I don’t need the flu vaccine because I never get sick.”
- “The flu vaccine helps protect those who cannot be vaccinated due to medical reasons.”
- “Vaccination can reduce the spread of the flu in the community.”
Case Study: Implementing a Community Health Policy for Diabetes Prevention
Background
The small town of Westview has seen a significant increase in the prevalence of type 2 diabetes over the past decade. Recent community health assessments indicate that 25% of the adult population is either pre-diabetic or diabetic. Contributing factors include poor dietary habits, low physical activity, and limited access to healthy food options.
In response, the local health department has developed a comprehensive diabetes prevention policy aimed at reducing the incidence of type 2 diabetes through community education, improved access to healthy foods, and increased opportunities for physical activity.
Objectives
- Educate the community about diabetes prevention.
- Improve access to healthy foods.
- Increase opportunities for physical activity.
Scenario
You are a public health nurse in Westview tasked with implementing the diabetes prevention policy. Your role includes coordinating community education sessions, facilitating partnerships with local businesses and organizations, and monitoring the policy’s impact on the community.
Questions for Reflection and Analysis
- Assessment
- What specific data would you collect to assess the initial impact of the diabetes prevention policy on the community?
- How would you identify key stakeholders and potential partners in the community to support the implementation of this policy?
- Planning
- What strategies would you use to engage community members in the educational seminars and physical activity programs?
- How would you ensure that healthy food options are accessible and affordable to all residents, especially those in low-income areas?
- Implementation
- Describe the steps you would take to establish a partnership with local farmers’ markets and restaurants.
- What methods would you use to promote the new walking and biking paths to encourage their use?
- Evaluation
- What metrics would you track to evaluate the success of the community education component of the policy?
- How would you measure the effectiveness of the physical activity promotion initiatives?
- Sustainability
- What approaches would you recommend to ensure the sustainability of the diabetes prevention policy in the long term?
- How would you address any potential resistance or challenges from the community or local businesses?
Simulation
Scenario
Community Health Education and Policy Advocacy: Smoking Cessation
Objective
To enhance students’ communication skills in educating the public about health issues and advocating for public health policy changes.
Learning Outcomes
- Effective communication strategies for different audiences (public, media, policymakers).
- How to present and advocate for public health policies.
- The importance of addressing diverse perspectives and health literacy levels.
- Techniques for managing difficult conversations and handling opposition.
Setting
Simulate a community meeting where the Nurse Educator is tasked with presenting information and advocating for a new public health policy related to smoke-free zones.
Roles
- Nurse Educator
- Community Members (diverse backgrounds and varying levels of health literacy)
- Public Health Official
- Media Representative (Journalist/Reporter)
- Policymaker (Local government official)
Preparation
- Provide the Nurse Educator with background information on the health issue, current statistics, and proposed policy changes.
- Give Community Members a brief description of their character’s background, beliefs, and concerns regarding the health issue.
- Provide the Public Health Official with data supporting the policy change and potential challenges.
- Media Representative receives guidelines on asking probing questions and focusing on the impact of the policy.
- Policymaker receives information on current policy stance, potential benefits, and opposition arguments.
Simulation Outline
- Introduction: The Nurse Educator presents an overview of the health issue and the proposed policy change to the community.
- Community Interaction: Community Members ask questions, express concerns, and share personal experiences. The Nurse Educator responds to these queries, providing evidence-based information and addressing misconceptions.
- Public Health Official’s Input: The official discusses the rationale behind the policy, supporting data, and expected outcomes.
- Media Interaction: The Media Representative interviews the Nurse Educator and Public Health Official, asking critical questions and seeking clear, concise information for a news report.
- Policy Advocacy: The Nurse Educator and Public Health Official present their case to the Policy Maker, emphasizing the benefits of the policy, community support, and addressing any opposition or logistical concerns.
Debriefing and Feedback
After the simulation, conduct a debriefing session where each participant reflects on their experience, provides feedback, and discusses lessons learned.
- Discuss what communication strategies worked well and what could be improved.
- Provide feedback on how effectively the Nurse Educator communicated complex health information, addressed concerns, and advocated for policy changes.
Competency Assessment
Activity
Design and implement a public health campaign addressing a specific issue, such as mental health awareness or harm reduction.
Demonstration
Create campaign materials (e.g., flyers, social media posts, educational videos) and evaluate the campaign’s impact on the target audience. Present the campaign and its outcomes to instructors and peers.
Clinical Activities/Opportunities
- The Health Department: students can participate in community health assessments and data collection.
- Policy Advocacy Project: partner with a nonprofit organization focused on public health policy. Students can assist in drafting policy briefs, letters, and other advocacy materials.
