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Sheila Q. Hartung, PhD, RN Bloomsburg University Bloomsburg, PA

An Academic Nursing, Clinical, and Community Partnership to Identify and Meet Rural Community Needs. Sheila Q. Hartung, PhD, RN Bloomsburg University Bloomsburg, PA. Presenter Disclosures. Sheila Q. Hartung.

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Sheila Q. Hartung, PhD, RN Bloomsburg University Bloomsburg, PA

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  1. An Academic Nursing, Clinical, and Community Partnership to Identify and Meet Rural Community Needs Sheila Q. Hartung, PhD, RN Bloomsburg University Bloomsburg, PA

  2. Presenter Disclosures Sheila Q. Hartung (1) The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: No relationships to disclose

  3. Introduction • Research and collaboration focus of key players • Geisinger Center for Health Research, Dr. Sharon Larson • Sullivan County SHIP, Joan Gruver • Bloomsburg University, Department of Nursing, Dr. Sheila Hartung • Approval and support • Intent – Identify perceived health status and barriers to access • The project and research • Community Needs Assessment (including Focus Groups and Community Survey) – GMC, Center for Health Research • Community Assessment and Insight Interviews – BU, Community Health/Public Health Nursing course • Community Interventions – GMC, BU, and SHIP

  4. Collaboration of GMC Center for Health Research and Sullivan County SHIP Summer 2009 • Responsibilities - Focus groups and community survey • Focus group meetings performed with • Sullivan County SHIP partners • community health and human service agency representatives • educational institutional representatives • mental health consumer support group members • regional EMS council members • County Commissioners’ office • hospital representatives

  5. Intent of Focus Group Discussions • Characteristics of a good community • Areas of community need • Preventative health care programs available • Noted health problems • Access to health and human services • Employment and resources both within and surrounding the county • Access to and availability of transportation services • Demographic profile of county residents • Intended resident survey questions

  6. Bloomsburg UniversityDepartment of NursingCommunity/Public Health Nursing course • Responsibilities – General Community Assessment and Insight Interviews • Course overview • Classroom and clinical components • Public health approach • Health promotion • Disease prevention • Epidemiology

  7. Community Assessment Framework • Systems approach • Objective data • Morbidity and mortality data • Secondary data (i.e., School Health Index) • Subjective data • Observation (i.e., windshield surveys) • Key informant interviews and Insight Interviews • Attendance at community meetings

  8. Students as leaders and collaborators • Group process, theory, techniques, roles • Leadership principles • Followership principles • Collaboration with faculty, community groups, key informants in the community

  9. Analysis of Data • Inferences • Problem identification • Community nursing diagnosis • Healthy People Objectives Intervention • Health Promotion Project implementation • Evaluation • Content • Process

  10. Community/Public Health Nursing courseFall 2009 & Spring 2010 • Course focus in Fall semester • BU IRB approval, contacts and collaboration with Sullivan County SHIP, recruitment of Insight Interview participants, Insight Interview data collection, collection of abbreviated CA parameters (Physical Environment, Demographics, Vital Statistics, Behavioral Risk Indicators, Economics) • Course focus in Spring semester • Insight Interview analysis, dissemination of Insight Interview results to collaborating partners, collection of abbreviated CA parameters (Physical Environment, Demographics, Vital Statistics, Behavioral Risk Indicators, Health and Social Services, Education, Politics and Government)

  11. Community Assessment Highlights of County

  12. Windshield Surveys Spring semester • Dushore • Laporte • Lopez • Bernice/Satterfield • Mildred • Estella • Colley Fall semester • Dushore • Laporte • Lincoln Falls, Shunk, Wheelerville • Hillsgrove • Eagles Mere, Muncy Valley, Beech Glen • Millview • Forksville

  13. Community Assessment Parameters • Physical Environment • Demographics • Vital Statistics • Behavioral Health Indicators • Economics • Health and Social Services • Politics and Government • Education

  14. Leading Cause of Death per County Annual Average Rate per 1000 Residents 2003-2008

  15. Heart Disease Death Rates Per 100,000 (2007) (Age Adjusted) (Pennsylvania Department of Health, 2007, a2)

  16. Mortality: All Cancers Mortality Rate from cancer among All Ages across 3 different 3 year time spans per 100,000. (Pennsylvania Department of Health, 2008, e4, f4)

  17. Percentage of Healthy Weight Adults 2003-2005 (BMI of 18.5-24.9) (Pennsylvania Department of Health, 2005, b1)

  18. Adults Who Admit to Currently Smoking:2005-2007 Results by Age Group PA DOH, Epidemiologic Query and Mapping System. http://www.portal.state.pa.us/portal/server.pt?open=514&objID=596553&mode=2 (2005-2007)

  19. Percentage of Suicide 2000-2007 (Pennsylvania Department of Health, g7)

  20. Educational Attainment: Population 18-24 years (US Census 2000)

  21. Median Household Income 2007

  22. Insight Interviews

  23. Data Collection – Fall 2009 • IRB approval for Insight Interview • Connection and presentation at SHIP meetings • Recruitment process • Health and human service partners approached residents • Gave summary/intent of research • If participant agreed, gave participant contact name and number to study investigator

  24. Data Collection – Fall 2009 • Study investigator gave contact name and number to BU student pair to contact for interview • Structured and semi-structured interviews of 9 residents performed by BU senior student pairs in the resident’s home or other convenient location • Interview guide and script • Roles of interview pair • Field notes • Identifying information • Submitted detailed field notes and beginning analysis conclusions to study investigator

  25. Analysis – Spring 2010 • Small group of 6 students within the course volunteered • Orientation meeting of small group • Small group coded and analyzed one interview together manually • Coded remaining 8 Insight Interviews using QDA software (ATLAS.ti) • Themes and commonalities from data collected • Community, Family, Health, Work • Developed subcategories for each theme • Gave examples for each category • Conceptual model to illustrate life in Sullivan County

  26. Bloom in Sullivan County

  27. Health Promotion Projects

  28. Health Promotion ProjectsFall 2009 • All collaborative partners • Health Fair (Oct.) • All populations • Immunizations, health screenings, diet/nutrition, resources, chronic disease, exercise/activity • Location/venue: elementary school • BU, DON • Health Fair “Flurries of Health” (Dec.) • Adult to older adult population • Heart disease, diabetes and obesity, cancer, mental health and wellness, risky behaviors • Location/venue: church hall in conjunction with holiday craft fair

  29. Health Promotion ProjectsSpring 2010 • BU, DON • Rotating stations “Hunt for Health” (April) • Adolescent population • Environmental health, mental health and wellness, safe sexual practices, drug and alcohol use and abuse, healthy lifestyles • Sullivan County Junior/Senior High School, Laporte

  30. Lessons Learned • Undergraduate students can be active participants in collaborative research or projects with specific delineated roles. • As an essential component of baccalaureate education, students are able to gain needed practical application of the core functions of public health, health promotion and disease prevention, leadership and management principles, and effective group process with large and small groups. • Illustrates for students the concepts basic to nursing practice: community and partnership for health. • Further solidifies the contribution and benefit to the community and its residents through a connection with both the academic institution and a major health system.

  31. Lessons Learned (cont’d) • Continued contact in the rural area beyond the research timeframe is challenging due to the rural location and distance from educational and clinical institution • Planned and sustained contact for ongoing assessment and health promotion is needed during the planning phases of the partnership

  32. Recommendations • Continue collaboration within the community • Look for “do-able” research and project components • Greater student preparation for qualitative data analysis and coding • Accessible QDA software package and common files on-campus for faculty and students during project • Increase time allotted to analyze as a small group • Allow time to incorporate findings and analysis of interviews into survey data • Disseminate analysis to collaborating partners more quickly

  33. Questions?? Thank You!

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