COMMUNITY AS PARTNER REPORT CENSUS TRACT 4068

Community as Partner Report Census Tract 4068

Lora Temyanko, Vivian Harvey, and John Rocco

University of Arizona
COMMUNITY AS PARTNER REPORT CENSUS TRACT 4068

Community Analysis and Nursing Diagnosis

1. We identified three strengths in CT 4068 as accessible transportation, abundance of health

care facilities, and willingness of community members to assist others. According to our

windshield survey of the CT, we were able to identify many means of public transportation

including several bus stops, shuttles for the elderly community, and even shuttles provided by the

library to all community members. Furthermore, there were school buses, and personal

transportation. Many health care facilities exist in the area which is a benefit to the community as

it increases the healthcare accessibility of the residents. St. Joseph’s Hospital, which is a level 1

trauma center is located within the census tract (PimaMaps, 2021). The librarian at the

Murphy-Wilmot Public Library stated, “This area has many willing volunteers that work with us

to provide services for the community such as delivering books to the elderly, participating in

blood drives, and donating foods to the less fortunate of the area.”

2. Our team identified three critical stressors in CT 4068: high poverty rates, high homeless

population, and a lack of food resources that support healthy eating patterns. Poverty is an

important social determinant of health as it limits the resources available to individuals.

According to the U.S. Census reporter (2019), 27.2% of the individuals residing in the CT are

below the poverty line. This is more than Pima County’s average of 16.8%. More significantly,

47% of children within the CT are under the poverty line as opposed to Pima County’s average

of 24% (Census Reporter, 2019). Homelessness is also an important social determinant of health

as it is generally associated with poor health outcomes and food insecurity. During the

windshield survey, there were many homeless individuals, especially near the Speedway Blvd

and Kolb Rd intersection. As well, a business owner had mentioned, “The homeless population
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in this area has continued to grow over the past couple of years, especially in the wake of

COVID-19.” Lastly, the windshield survey emphasized the lack of healthy food resources in the

CT. There were dozens of fast food restaurants and only one grocery store which could

potentially affect eating habits of individuals residing within the CT.

3. According to our community assessment, the priorities of care for CT 4068 were promoting

hand-washing in school children to reduce COVID transmission rates, promoting job

opportunities for the unemployed, promoting healthy eating habits to reduce obesity, and

reducing fall risks. A table, which prioritizes the community’s problems, is listed in Appendix A.

4. Based on our analysis of community assessment findings, we formulated the following

diagnosis for CT 4068: at risk for COVID-19 among elementary school students related to

vaccine age requirements, “poor funding for PPE by the district” (Administrative Assistant),

“insufficient knowledge of personal hygiene practices” (Public School Nurse), and a limited

amount of COVID-19 testing sites in the community as manifested by an “insufficient amount of

appropriately sized PPE” (Public School Nurse), children wearing soiled masks (observed),

overall low vaccination rates within the school since “vaccination cannot be mandated for adult

staff” (Public School Nurse), and the reopening of the COVID unit at St. Joseph’s Hospital

(Hospital Volunteer) due to “increasing transmission rates within the community” (Chief

Fireman).

Community Nursing Program Plan

COMMUNITY AS PARTNER REPORT CENSUS TRACT 4068

5. We set the community health goal for our intervention as an increased understanding of how

to effectively wash the hands by using health teaching to present the World Health

Organization’s (WHO) 11-step hand washing technique.

6. We used evidence from a study by Öncü & Vayısoğlu (2020), to develop a teaching plan for

our Evidence-based Public Health Nursing Practice project. Based on the “Rating System for the

Hierarchy of Evidence,” the study was a level II evidence because the evidence came from a

randomly controlled trial (Melnyk & Fineout-Overholt, 2011). The purpose of the study was to

identify the most-effective handwashing technique for children to understand and utilize. In order

to achieve this, the researchers divided 6 classrooms of students aged 8-11 years old and

randomly assigned them into three groups: WHO’s multi-step handswashing procedure, CDCs

recommended duration handwashing, or a control group which received minimal instruction. The

total sample size was 155 children. The setting of the study took place in a low socio-economic

primary school in Turkey. Through the use of glo-germs in order to assess for proper removal of

germs on the hands, the researchers found that the students who were taught WHO’s multi-step

handwashing program were more effectively washing their hands when compared to the other

two groups. We used the findings and assessment-tools mentioned in the study in order to create

a teaching-plan that focused on emphasizing WHO’s handwashing technique. Our purpose was

to increase the hand-washing effectiveness of the schoolchildren. Our sample was smaller than

the study’s with only 24 students ranging from 8-9 years old. Our setting was also similar as we

did our teaching project inside of an elementary school in the United States.
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7. For our project, we identified that the most applicable Healthy People 2030 overarching goal

is promoting healthy development, healthy behaviors, and well-being across all life stages.

Because our community health goal was targeted towards children at Hudlow Elementary school,

the Healthy people 2030 topic that aligned the best was schools. There is an emphasis on

supporting child and adolescent development in school settings as well as expanding health

education in health professions programs. Under this topic, one objective that stood out was

EH-D01. This objective aims to “Increase the proportion of schools with policies and practices

that promote health and safety” (Healthy People 2030). This objective is at the developmental

level and once there is enough baseline data available on it, it will become a Healthy People

2030 core objective.

8. One policy that relates to our goal is the hand hygiene and respiratory etiquette guidelines

stated on the Arizona Department of Health Services website. This guideline states that proper

handwashing with soap and water should be taught and reinforced with K-12 students. This

public health goal was deemed an important everyday action in schools to help prevent the

spread of COVID-19 (ADHS, 2021).

9. We planned the following health education project to meet our community health goal. Our

overarching target population was elementary age children, but we will be demonstrating to

students in third grade. We plan to do a hand hygiene demonstration by utilizing GloGerm and

evaluating the success of the demonstration with a short ‘quiz’. The ideal setting for this is the

multi-purpose room to accommodate both third grade classrooms. The goal is to address
COMMUNITY AS PARTNER REPORT CENSUS TRACT 4068

COVID-19 and to prevent transmission and infection among young children because this age

group is more vulnerable and not protected by vaccination due to a lack of FDA-approval. Our

whole group will have equal responsibility in obtaining our supplies and talking during the

demonstration. Vivian will make a flyer emphasizing hand washing to post around campus.

Vivian will also be the main liaison between the school and our group to determine date, time,

and location for the demonstration. Lora will make a short quiz for the students to take to

evaluate retention after the presentation, and she will make copies of these. Lora will also

provide a draft script for the group. John and Lora will escort the students to handwashing

stations to reiterate proper handwashing technique and be there as a safety chaperone. Vivian and

Lora will then check the students’ hands for any remaining GloGerm with the black lights. This

intervention was the best for our nursing diagnosis as our target population is very young, and it

is important to keep the students engaged. We have to be extra creative for them to understand

and retain the information, and the GloGerm is a fun activity that also serves as a meaningful

visual for the students.

10. We developed the following SMART Learning Objectives for the project:

· After the health education project presentation, at least 75% of the 3rd grade

students will demonstrate understanding of how long to wash their hands by answering

the first question on the post-presentation survey correctly (Appendix C).

· After the health education project presentation, at least 75% of the 3rd grade

students will be able to list one situation in which they need to wash their hands.
COMMUNITY AS PARTNER REPORT CENSUS TRACT 4068

11. The plan for implementation included the following program activities:

· We will obtain all of our supplies for the GloGerm presentation, including the

Glogerm and blacklights, by September 26, 2021. This is important because if we are

unable to obtain these supplies, we must come up with a different presentation plan.

· We will obtain and finalize a date and time for the health education project at the

elementary school by September 27, 2021. This will be done via email communications

with the school’s health assistant.

· We will finalize a post-presentation quiz that is able to evaluate the students’

knowledge about hand washing by September 27, 2021.

· We will finish our practice script for the presentation by September 28, 2021. This

will give us time to practice our presentation and modify it if necessary in order to fit the

time constraints.

12. We created a written four-item quiz in order to evaluate our two learning objectives. We

planned to distribute the survey at the end of our presentation. See Appendix B for a copy of the

survey. The first question gauges whether the students remember how long they should be

washing their hands for which directly relates to the first learning objective stated above. The last

question asks for an example of when the students should wash their hands which corresponds to

the second learning objective. This survey will be given at the end of the presentation and then

collected and graded afterwards in order to determine the percent of correct answers.
COMMUNITY AS PARTNER REPORT CENSUS TRACT 4068

13. We collaborated with Hudlow Elementary school and their school health assistant via email.

We received supplies from Amazon, WalMart, ACE Hardware, and Hudlow Elementary School

and the children kept any supplies that originated from their school. We also utilized the printer

at the College of Nursing to print out our flyers (Appendix B). Overall, we obtained all of the

necessary resources for a memorable demonstration for our target age-group of third grade

students.

14. Our intervention addressed the stage of susceptibility in the Natural History of Disease in that

we are addressing the time period before exposure and infection from COVID-19 occurs. The

level of prevention was ­primary prevention because we were doing health teaching to prevent the

onset of any bacterial or viral illnesses.

15. We required a number of resources for our health education project including a poster board,

an original flyer and copies, GloGerm, black lights, travel bottles, paper quizzes, and pencils.

Some constraints included time and money since we only had a thirty minute window to present

at the end of the school day, and we had to set aside $50 to buy our own GloGerm and

blacklights. We bought the GloGerm from Amazon and got blackilights from Walmart and ACE

Hardware. We had to modify our presentation by cutting out our section on mask-wearing and

mask hygiene due to time constraints.

Implementation of Community Nursing Intervention

16. We held our teaching project on September 30, 2021 at 1:00 pm at the public elementary

school within the CT. We performed a hand hygiene demonstration using WHO’s multi-step
COMMUNITY AS PARTNER REPORT CENSUS TRACT 4068

hand washing technique with both third grade classrooms. The presentation was attended by 24

students, two teachers, and the school’s health assistant. By utilizing Glogerm and black lights,

we were able to simulate germs and demonstrate the effectiveness of hand washing. First, we

taught the students on what germs were and why we are particularly concerned about them

during the COVID-19 pandemic. Next, we guided the students through the 11-step hand washing

program and explained that the process should take at least 20 seconds. As well, we showed the

students how to properly cover a cough or sneeze. Afterwards, we checked their hand washing

abilities by using the black lights to identify any existing GloGerm remaining on areas left

unwashed. The majority of the students had little to no GloGerm after washing their hands using

the 11-step method. At the end, the students took a four question quiz in order to evaluate their

understanding of the handwashing content presented (Appendix B). Additionally, a fall-themed

flyer was made, copied, and distributed to the school’s Health Assistant and the third grade

teachers to post around the campus (Appendix C). The students seemed to be very excited about

the presentation and were very engaged throughout. One unexpected challenge related to

COVID-19 was that a few students were unable to attend because they were at home with

COVID-like symptoms

Evaluation of Community Nursing Intervention

17. Our survey results indicated that the participants met both of our learning objectives. 22 out

of the 24 students, or 91.7%, correctly answered the first question on the survey which asked for

the ideal amount of time to wash the hands with soap (Appendix B). This indicates that the

majority of the students were able to demonstrate understanding of this concept. 20 out of the 24

students, or 83.3%, correctly answered the fourth question which asked for the students to list an
COMMUNITY AS PARTNER REPORT CENSUS TRACT 4068

additional time in which they should wash their hands (Appendix B). Once again, this finding

indicates that the majority of the students were able to demonstrate understanding of when they

should wash their hands.

During the evaluation process, some limitations and challenges arised. One limitation of

the results is that three of the students did not know how to write, and so they were unable to fill

out the last free-response question on the survey. Next time, this can be avoided by performing a

verbal evaluation with each individual student. One challenge that we faced during the

evaluation was that students were sharing answers with each other, and so the results might not

be completely representative of their knowledge. Next time, dividers should be utilized in order

to discourage the sharing of answers. Overall, we learned that the intervention seemed to be very

effective with the age group, but more efforts should be taken in order to keep individualised

responses from the students.

Dissemination of Findings

18. We will disseminate our findings on November 18, 2021 during the Team Research Poster of

Health Education Project Poster Presentation. On November 16th, we will work as a team to

construct a poster which summarizes our health education project and the valuable findings. The

workload will be evenly split between the group members.

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References

ADHS. (2021). COVID-19 in Arizona, Schools (K-12) & Childcare - Guidance.

https://www.azdhs.gov/covid19/index.php#schools-guidance

Census Reporter. (2019). Profile for Census Tract 4068 Pima, AZ.

https://censusreporter.org/profiles/14000US04019004068-census-tract-4068-pima-az/

Melnyk, B.M. & Fineout-Overholt, E. (2011). Evidence-based practice in nursing and

healthcare, 2nd Edition. Philadelphia: Lippincott Williams and Wilkins

Öncü, E., & Vayısoğlu, S. K. (2021). Duration or technique to improve the effectiveness of

children's hand hygiene: A randomized controlled trial. American Journal of Infection

Control.

Google. (n.d.). [CT 4068]. Retrieved September 7, 2021, from

https://goo.gl/maps/z28SYhkwSGUBPDq69
COMMUNITY AS PARTNER REPORT CENSUS TRACT 4068

Appendix A

Priorities of Care

Related Availa Ideas for nursing

Commu Severit T
communit bility intervention
nity y of o
Commu y Identified of (Use Minnesota
expressi Nursing outcom t
nity stressors in Pima resourc Wheel)
on of students e(s) a
health (SDOH County’s es ** The
interest ’ ability without l
vulnera and/or Health relevan interventions listed
in to effort s
bility or human Needs t for below are just
addressi address to c
stressor behavior) Assessm address examples. Students
ng problem address o
ent1 ing can use any of the
proble proble r
proble interventions from
m2 m e
m the wheel.
COMMUNITY AS PARTNER REPORT CENSUS TRACT 4068

limited

internet

access,

as well

as
Advocacy**: Write a
Unempl limited
letter to a legislative
oyment number
representative
of
2 4 0 1 2 supporting 9
(Comm compute
increased funding to
unicatio rs open
install more
n) to the
computers at the
public
library.
(verbali

zed by

librarian

).
COMMUNITY AS PARTNER REPORT CENSUS TRACT 4068

Lack of a

public

gym,

abundant

fast-food Health Teaching**:

Obesity options, Educate on the

10
(recreat only one 2 2 2 2 2 importance of a

ion) grocery balanced-diet and

store, staying active to

poor one’s abilities

eating

habits

1 4 2 2 2 11
COMMUNITY AS PARTNER REPORT CENSUS TRACT 4068

High Majority Screening: Assess

fall rate older individuals’ fall risk

(Health populatio with the Morse Fall

and n, high Scale

social rates of

services substance

). abuse,

high use

of

hypertensi

on

medicatio

ns
COMMUNITY AS PARTNER REPORT CENSUS TRACT 4068

Overgrow
High
th of
Fire Referral and Follow
shrubs
risk Up: Suggest
around
landscaping
housing, 0 2 0 1 0 3
(Physic services, teach basic
understaff
al landscaping, and
ing of fire
environ follow up to check
departme
ment) growth.
nt

Increased Collaboration:
Increas
transmissi Coordinate with
ed
on related school to help raise
transmi 2 4 2 1 2 11
to money for child
ssion of
shortage sized masks and
COVID
of PPE educate on COVID
COMMUNITY AS PARTNER REPORT CENSUS TRACT 4068

-19 in for young specific topics

schools students (handwashing,

and social distancing,

(Educat limited vampire cough, etc)

ion) Covid

testing

sites

High High

Theft unemploy Surveillance: Crime

Rate ment, no watch, community

0 0 0 1 2 3
(Safety police involvement to

and station decrease crime rates

Transpo within CT

rtation)
COMMUNITY AS PARTNER REPORT CENSUS TRACT 4068

Unemplo

yment,

vacant
Social marketing:
stores
High Encourage people
leading to
Poverty to seek jobs and
decreased
Rate 1 2 0 1 2 provide better 6
job
(Econo access to resources
opportunit
mics) such as computers
ies, lack
to enable success.
of

computer

access

Note. 1 Score 1 point if consistent with report findings as a concern in Pima County. Score 2 points if 1 of Pima County’s 3 priority

areas: Behavioral Health; Obesity & Related Chronic Diseases; Access to Services. From “Pima County Health Needs Assessment

Snapshot”. 2Community Expression of Interest (second column) is double weighted to emphasize its importance. Key: 0 = low, 1 =
COMMUNITY AS PARTNER REPORT CENSUS TRACT 4068

moderate, 2 = high. Adapted from “Community Health Diagnosis in Nursing” by M. A. Muecke, 1984, Public Health Nursing, 1, p.

31; and “Community Assessment and Evaluation” by G.F. Shuster, 2010, in M. Stanhope and J. Lancaster (Eds.) Foundations of

Nursing in the Community, Community-Oriented Practice, 3rd ed., p. 232. St. Louis: Mosby/Elsevier/Evolve
COMMUNITY AS PARTNER REPORT CENSUS TRACT 4068

QUIZ

1.) How long should you be washing your hands with soap?

a.) 5 seconds

b.) 10 seconds

c.) 12 seconds

d.) 20 seconds

2.) True or False? You should wash your hands before and after you eat your food.

3.) What is the most effective way to remove germs?

a.) Washing your hands with just water

b.) Using hand sanitizer

c.) Washing your hands with soap and water

d.) Wiping your hands on your shirt

4.) List one more example of when you should wash your hands:

______________________________________________
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Appendix C