N4465 Population and Community Nursing

COMMUNITY ASSESSMENT, ANALYSIS, and NURSING INTERVENTION

Modules 1-3 (Weeks 1 – 3) Assignment Template

PLEASE NOTE: Submission of any assignment from any prior session of N-4465
without prior permission from course faculty, will receive a zero for the assignment or
a 10 point grade penalty if a new assignment is resubmitted within 48 hours of
notification by academic coach or faculty. After 48 hours the assignment will receive a
zero. 
Use of the Three-Part Course Template
● The use of the three-part template to submit weekly Major Course 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.

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

N4465_Assignments Template_Rev._3-2021_CL
 Clinical Experience: Windshield Survey and Key Informant Interviews

Student Name: __________Dayebga Simon_____________________Dates:

_________________

Name of Community or Zip Code: _____77385________________

Module One (Week One): Part One Windshield Survey and Key
Informant Interviews
Please complete the following information on this template about the community
you have selected. 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.

Elements Descriptors

Physical Make sure you address fully what you observed and NOTE if
Environment something was not found within your community area.

● Boundaries What defines the boundaries? Roads, water, railroads. Is the area
known for a particular name? What area is this community located in?

The boundaries are mostly defined by Interstate highway 45. This is found
north of downtown of Houston. The area is mostly known as Harper’s Trace,
Montgomery County. The community is located in the north of Houston

● Housing and What is the age of the houses? Describe type of construction material,
Zoning appearance, and general condition. Do you see single family housing?
Multi-family housing? There are mostly new houses being constructed using
wood and cement. The community housing are mostly single family housing
with mostly new constructions ranging late 100;s to late early 400. There are

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 no multi-family housing in the neighborhood.

● Common Where do people in the neighborhood hang out? Who hangs out there
Meeting Places and what hours of the day? Movie theaters like AMC and restaurants are
mostly found south of the neighborhood where people hang out. There is also
the urban air trampoline that is family friendly. There is Park called
Wimberly. It is a good size park for people of all ages. There are some
swimming pools like the aquatic center and Harpers landing pool and attracts
the public to hang out.

● Indicators of Is this a "thriving" community or does it look "run down?" Is there new
Growth or Decline or ongoing construction? Businesses and Industries coming to the
area? Are buildings, roadways, and public areas clean and well-kept?
Do you see dirt, trash, or graffiti? The community is a thriving community.
There is H-E-B a retail store that that recently opened up in the community. A
McDonald restaurant, Wendy recently opened. The buildings and roadways
are very clean. You do not see dirt, trash or graffiti on the street

● Employment What places for employment are there in this area? Name the
Opportunities businesses and industries in this area. There are a lot of healthcare jobs.
Houston Methodist, Memorial Herman, ST Luke Hospital and Park Manor of
the woodlands provide employment to a lot of people living in the
neighborhood. Car ride sharing jobs like Uber are also common in this area.
Such elementary school provides teaching jobs and bus driving job too etc

● Transportation How do people get from one place to another? Is public transportation
available? How timely is it? Personal autos? Bikes? Walking?

By personal autos. People can also be seen walking to and from groceries
stores like the H.E.B. Also people use other means of transportation like bikes
and car-sharing rides.

People Make sure you address fully what you observed and NOTE if

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 something was not found within your community area.

● Race and What is the majority racial group represented? What is the majority
Ethnicity ethnic group represented? Describe the distribution of gender,
approximate ages, single families, multiple families, generational
families? Looking at Sushma Elementary School the minority student makes
up 57%. This shows the community is pretty diverse. There seems to be more
women than men in Montgomery county Harper’s Trace. There is
approximately 98 men to 100 women. Harper’s Trace is pretty a new
community with an average age of 35.1 years.

● Cultural What cultural similarities or differences do you observe? Languages

Characteristics spoken? Clothing? Ethnic eating places? Culturally based
celebrations? Signs in languages other than English? Apart from
English there is a strong presence of the Spanish being spoken. This is
because about 26% of the population is Hispanic. There is Mestizos Mexican
Café on Harper’s Trace. There have been culturally celebrations like the
Piñata taking place in the neighborhood.

●Lifestyle What healthy lifestyle behaviors do you observe? Do you see people
Healthy Behaviors exercising, wearing helmets when biking, seat belt usage, using trash
cans for garbage disposal, healthy eating practices? I see people
exercising at the neighborhood. There is lots walking, biking and the use of
seat belt usage, Also the neighborhood is also very clean as people dispose
their trash properly. The crime rate is much lower the average the average zip
code in the USA.

● Lifestyle Risk What unhealthy lifestyle behaviors do you observe? Do you see people
Behaviors practicing risky lifestyle behaviors such as drinking alcoholic
beverages, smoking, fighting? Do you see signs of violence, gang
activity, drug use, criminal activity, and bars on doors and/or windows?
Do you see overweight/underweight persons? Do you see children
unattended playing out in the streets? Describe gender, age, and
race/ethnicity of persons observed. The people of Harper's Trace are less
involved in risky lifestyles. The crime rate is very low with the use of drugs
or violence is very low. .

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● Poverty Do you see any signs of homelessness? People living without
Indications adequate shelter or in temporary shelter? Describe gender, age, and
race/ethnicity of persons observed. I do not see any signs of homelessness
in this zip code

Services in Make sure you address fully what you observed and NOTE if
the something was not found within your community area, how
Community far away it is and how people will access it.

● Social Services Do you see evidence of recreation centers, parks, and social services?
For services that are not available, how far must persons travel to
access these services? Describe each. The area has several parks. The
nearest parks include Harpers Landing Park and Montgomery Creel Range
Park

● Health Services Do you see evidence of health (Hospitals, Dr’s Offices, Clinics) and
mental health services? Describe each. Are there any signs of
alternative services in the area, such as healers (curanderos),
herbalists, herbal stores, palm readers, acupunctures, chiropractors?
For services that are not available, how far must persons travel to
access these services? Hospitals found in this area include Houston
Methodist Hospital, St. Luke's Health and Memorial Hermann, which is three
miles away.

● Fire and Do you see any fire and police services/equipment/officers? Where
Police Services are the closest fire and/or police stations? Various emergency services are
available in the area. Doctor's Urgent Care is 0.6 miles away, Needham Fire
& Rescue Co., is 0.6 miles, Woodlands Police Services 5.8 miles away

● Educational Where is the nearest public library? Discuss the Schools and
Resources Universities/Community colleges? South Regional Library is the nearest
public library to the area. It is 6.1 miles away. They're included in this area

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 include Gerald D. Irons Sr. Junior High School, Sushma Elementary school,
Pcal Elementary School etc. There is Lone Star College-University Center,
which is 2.4 miles away.

● Religions What signs of religion do you see? Discuss the types of churches,
mosques, temples. What services are offered by these places of
worship? e.g., Day Care, Mother’s Day Out, Summer Camps,
Languages Classes, Citizenship Classes, Food Banks, Clothing, other.

There are both Christian churches and Mosque at the community. Some of
them include Hosanna Woodlands, Core Church, Wake church, Impact
Church of The Woodlands. Mosque include Masjid Al-Sahabah, Woodlands
Islamic Center etc.

Business & Describe stores and shops available in the community, e.g., grocery
Industry stores, gas stations, department stores. What type of business climate
exists? Manufactures? Light or heavy industry? Large employers?
Small business owners? Retail? Hospitality industry? Do people have
to seek employment elsewhere? Is this considered a "bedroom
community"- where people work outside this community but live here?
Make sure you address fully what you observed and NOTE if
something was not found within your community area.

There is a H.E.B grocery store that serves the community. Kohl’s and other
department stores like Target, Macy’s, JC penny etc. are like 4 to 5 miles
away. People can work in and around the community and do not need to drive
longer distances. They can get jobs with the departmental stores or the
healthcare facilities.

Politics What indicators do you see about politics? Posters? Headquarters?

Make sure you address fully what you observed and NOTE if
something was not found within your community area.

You hardly see people displaying posters showing party affiliation. However,
like in most places in Texas this people here are mostly Republicans.

Media Do you see indicators of what people read? Listen to the radio? Watch
TV? Are there any signs of media language other than English? Make
sure you address fully what you observed and NOTE if something
was not found within your community area.

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 The Houston Chronicle is commonly read here. You can see people are
including magazines when getting groceries at HEB store at Harper’s Trace.
The people seem to enjoy reading about celebrities and also about local news.

Key Interview a fireman or police office.

Informants Also interview a librarian, schoolteacher, school nurse or
administrator.

Ask each person interviewed to share their perceptions of

the following and cite personal communication as appropriate:

1. Interview with fireman or police officer

˃ Community’s Health issues Officer Paul says he thinks the

community is pretty healthy. He says he does not see any
homelessness and dumping of trash in the community which can
affect the health of the community. He says with the footpath it has
also helped to against obesity. Officer Paul

˃ Community’s Safety issues The community most of the

apartment buildings are not gated. This has been a concern with some
petty crimes going on. It is however on the low when compared to the
national average. Officer Paul

˃ Strengths of the Community Officer Paul says their community

pride themselves in reporting any suspicious activities to their
neighbors or call 911. Members of the community look over each
other.

2. Interview with librarian, schoolteacher, school nurse or

administrator

˃ Community’s Health issues Interview with a school 6 grade

teacher states that the kids are healthy and doing well academically,
indicating they are being taken care of at home.

˃ Community’s Safety issues There says there have been some

cases of covid 19 among the students, which shows more need to be
done to help prevent the spread of the disease.

˃ Strengths of the Community The school teacher mentions the

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 parents are often willing to participate in the Parent Teacher
Organization meetings which shows the community are more concern
to improve the lives of their kids and also there is considerable
donations to school from the parents to improve the wellbeing of the
kids. Mrs. Ahmed

Enter the information about your interviews with Key Informants

in this space in your template. You will not receive credit if the
Key Informant interviews are inserted elsewhere on this template.

Analysis of Analyze and summarize your observations and the input from key
Windshield informants. Write a 3-paragraph summary of community health (2) and
safety (1) issues for this community and strengthens of the community.
Survey
Remember to cite personal communication as appropriate:

The community Harper’s Trace I have observed is a community that is

expanding with the new construction of buildings. It is a small community
within a large county in Texas It is made up of different cultures, races, and
ethnic groups. There are schools, hospitals, and several restaurants/ fast foods
locations within this area. This community has several recreational parks and
activities throughout the areas. There are pools, trails for walking, and parks
for outdoor activities for all ages. There are few churches within the
community and no mosque. However Muslims can visit the closest mosque
some 6 miles away. Schools encourage kids to participate in indoor and
outdoor activities to keep them fit and healthy. Street lights and speed bump
regulate speeding in the community. There are lots of walk paths in this
community that children and adultsadult-use and police patrols do scope the
area during the day and night to help prevent crimes. .

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 Reference

N4465_Assignments Template_Rev._3-2021_CL
 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: 77385

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 to compare
objective data for your community with local (city), state, and national data.
Remember to cite sources as appropriate.

Conroe is a city in Montgomery County in Texas and is its county seat. As of

2021, it was estimated that Conroe had a total population of 98,081, with an annual
growth rate of 3.70%. Its population is highly diverse in terms of age, gender and race.
Firstly, Conroe has a median age of 33.6 years. However, the working-class population,
ages( 18-65) makes the bulk of its population at 24.0%. Children under five make up 7.5%
of the population, while the aged (ages 65 and above) make 13.3% of the population. The
females are more than men at 50.16% and men at 49.84%. The percentage of multifamily
in Conroe as a percentage of all families is 73.0%, while single-parent families are around
18%. Single people in Conroe make up 27% of those with marriage capacity.

Montgomery County is home to Conroe. It has a population estimate of 642 633 as

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 of 2021. This population is growing at a rate of 2.82%. The age median of this county is
37.7%, with the working-class population ages (18-65) taking the lion's share at 46.1%.
Children under five are 6.6%, those between ages (5-18) are 26.1%, while the elderly (65
and above) are 13.4%. The females are slightly more than men at 50.5%, while men are
49.5% (Hendey et al., 2017). Non-families in Conroe are the most at 30%. The married
follows closely at 25.5 %while single-parent families make up 8% of all families.

Texas is the home state of Conroe. It is the second most populated state in the U.S,
with a population of 29,145,505. Its age distribution is as follows; Under 5 years-6.9%,
Under 18 years-25.5% ages (18-65)- 55.5%, 65 years and over-12.9%. The female
population slightly surpasses that of men. Females make 50.3%, while males make up
49.7% of the population. Texas has a multi-family population of 45% and a single-parent
family population of 30.3%.

Lastly, the U.S as a nation has a population of 331, 449,281 as revealed by the
2020 census. The nation has a bulk young working-age population-36.5%, the older
working population of 26.4%, while the aged, i.e., ages (65 and over) make up 13.5%. In
the U.S, most of its population is female-50.8%, while men make up 49.2%. Also, the U.S
ranks number one globally with single-parent households. While married couples make up
most of the families at 48.2%, single parent families are significant, with 23% of all
children in the U.S under eighteen years of age being raised by a single parent.

2. Racial/Ethnic Characteristics: Remember to compare objective data for

your community with local (city), state, and national data. Remember to cite
sources as appropriate.

White Non-Hispanics are the ethnic majority in Conroe, with a 55.2% population.
Hispanics or Latinos are the second majority with a 27.8% population. Black Americans
come third at 8.09%. Those speaking two or more languages come third at 5.05%, while
Asians have a least 3.05% population.

The dominance of the pure white population is further reflected in the entire
Montgomery County, with a 64.3% population. Latinos make up the distant second largest
population with 22.3%. Black Americans are third with 5.09%, Asians are fourth with a
3.07% population, while those speaking two or more languages make up 2.11% of the

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 population.

Texas has a high pure white population of 41.2%. Latinos are the second majority
making up 39.75 of the population. African Americans are the distant third largest ethnic
group with 12.9%. Asians are fourth at 5.2%, followed by two races at 2.1%, Alaska
natives at 1%, and Native Hawaiians at 0.1%.

The entire nation comprises 60.1% pure whites, 18.5% Latinos, 13.45% African-
American. These three groups form the majority population list. Pure Asians then claim a
distant fourth at only 5.9%, American Indian and Alaska natives then claim the fifth spot
at 1.3%. Those with two races and native Hispanics, together with other Pacific islanders,
take up spots six and seven at 2.8% and 0.2%, respectively.

3. Economy: poverty rate, unemployment rates, median income. Remember to

compare objective data for your community with local (city), state, and
national data. Remember to cite sources as appropriate.

Conroe City has a total labor force of 67.0%. Of this percentage, 73.58% are
employed in white-collar jobs, while 26.42% are employed in blue-collar jobs. However,
the poverty rate in Conroe is still relatively high at 12.2%. The unemployment rate of
7.5% primarily contributes to this. as of 2019. This figure, however, dropped to $46,109
per annum as of 2021, courtesy of Covid 19 and the ongoing inflation. Lastly, the Median
income of Conroe residents was $60,343 per annum.

The entire Montgomery County has a total labor force of 64.9%. This is drawn
from those aged 16 and over. 82.89% and 17.11% of this labor force work in white-collar
and blue-collar jobs, respectively. However, the poverty rate in Montgomery is still
prevalent at 8.2% (Scarbrough et al., 2017). This can be attributed to the significant
unemployment rate of 7.8%. Lastly, the median income of Montgomery County residents
is 80 902 per annum.

Texas has a total labor force of 64.2%, drawn from 16 years and above. Of this
labor force, 76.16% work in white-collar jobs, while 23.84% work in blue-collar jobs.
However, the poverty rates in Texas are pretty significant at 13.4%, and this is despite a

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 low unemployment rate of 5.2%. The median income of Texas residents is $61,874 per
annum, which is significantly higher than the $30,569 that was the median income in
2019. This can be attributed to the stimulus packages the government has been pumping
into the economy and the effective mitigation Covid mitigation strategies.

The U.S official poverty rate as of 2020 was 11.4%. This was an increase from
10.5% in 2019. This can be credited to the Covid 19 pandemic. However, the U.S
package's rolling of the economic stimulus package in March of 2021 is estimated to have
shrunk this figure to 9.3%. The unemployment rates have also been decreasing. For
example, the current U.S unemployment rate is 3.9%, down from 6.7% in 2020, thanks to
economic stimulus packages and the lifting of lockdowns by organizations and states. The
median income, however, did not respond as positively. The current median income is
$67,521 down from $69,560 in 2019. This can be attributed to the Covid induced inflation
that has reduced staff remuneration.

4. Education: High school completion rates; higher education statistics. Remember

to compare objective data for your community with local (city), state, and
national data. Remember to cite sources as appropriate.

Conroe has an average high school graduation rate of 95.5%. This has contributed
immensely to the high rate of high school graduates in the city-80.7%. However, the
college graduation rate is much lower at only 25.60%, a factor that has led to the low
percentage of college graduates in Conroe-26.3%.

On the other hand, Montgomery County has a population with high school
diplomas of 87.7, thanks to the average high school graduation rate of 89.3%. However,
its population with high education status is much lower at only 34.5%. This can be
credited to its college dropout rate of 13%. Of these college graduates, 54.7% have
Bachelor's degrees, 20.5 have Master and 17.9 are professors.

On the other hand, Texas has 83.7% of people who are high school graduates. This
can be attributed to the average state high school graduation rate of 93%. However, its low
college graduation rate of 53.10% can be the key contributor to the 29.9% higher
education graduates. It is estimated that 20% of college students drop out every year.

The U.S, however, remains one of the most literate societies in the world. The U.S

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 has an overall high school graduation rate of 88%, which is far better than that of most
countries. Even better, 72% of the U.S population has college degrees. Again, this is
admirable. The high college enrollment can have contributed to this high figure, e.g., in
2018, around twenty million Americans joined college.

5. Identify two Morbidity and Mortality/Risk Problems: (Based on your

observations from Week 1 subjective assignment, windshield survey and
critical 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 life-threatening health
issues? Remember to compare objective data for your community with
local (city), state, and national data. Remember to cite sources as
appropriate.

The rates of obesity in Conroe are 25%, which is more prevalent among the white
population at 38%. The ages most affected by obesity in Conroe are ages (45-64).
Similarly, obesity is more prevalent in women than men. Obesity can cause or increase
the effects of life-threatening conditions such as asthma, diabetes, high blood pressure,
and depression.
The total rate of obesity in Montgomery County, on the other hand, is 71.8%, and
it is also prevalent among those aged (45-64). Men in Montgomery have an obesity
mortality rate of 36.6%, slightly surpassing their female counterparts, who have a 35.2%
rate. As a result, 58.3% of men and 52.75 of females who are obese have been
recommended for physical exercises. High obesity rates are a significant contributor to
conditions such as cardiovascular diseases in Montgomery at around 38%. Other illnesses
associated with obesity are high blood pressure, depression, and stroke.
The rates of obesity in Texas are also exceptionally high. Texas is ranked as the

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 state with the tenth highest obesity rate in the U.S It is prevalent among adults ages(45-
64). Ethnic distribution of obesity in Texas is as follows; Blacks-41.2%, Hispanics -
40.5% Pure white-32.5%, Multiracial-32.1%, and Asians at 15.4%. The high rates of
obesity can be attributed to the high blood pressure rate of 35.1%, high diabetes levels-
12.6%, depression-34.2%, and cardiovascular illnesses-7.3%. It is estimated that there are
170.8 deaths in Texas due to obesity.
Lastly, the entire nation has an obesity rate of 42.4%. Women surpass men with a
prevalence of 11.5%, while men are at 6.9%. In the U.S, Obesity ranks highest between
ages (40-59) at 11.5%. Here too, Black adults range highly at 49.6%, Latinos at 44.8%,
White adults at 42.2%, and Asians at 17.4%. As previously mentioned, the average
lifespan of Obese people is 41.36 years. Taking junk food and poor exercising are
considered the leading causes of obesity in the U.S (Walls et al., 2012). Conditions
associated with obesity are asthma-8%, Diabetes-10.5%, Depression-43%, and High
Blood Pressure-32.5%. It is estimated that 33.8% of obese men and 36.1% of their female
counterparts die annually.
Smoking- Conroe has a smoking rate of 15%. This means that around 14,700
people smoke in Conroe. 42.7% of these smokers are pure whites, 21.32 are African
American, American Indians follow closely at 15.4%, Latinos take 14.6%, while other
races take up around 6% of these smokers. Smoking is more prevalent among the
working-class population ages (24-64). While cigarette smoking in Conroe pollutes the
air, the cigarettes themselves pollute the beaches and parks. The cigarettes butts pollute
the air, waterways, and land. For example, cigarette butts on the shores of Lake Conroe.
This kills essential living things like the fish. Similarly, pollution of the ozone layer from
incinerators and regular smoking exposes us, humans, to harmful ultraviolet rays. It is,
however, essential to note that a smoking ban in public places affected in 2009 has
contributed immensely to a reduction in smoking in Conroe.
On its part, Montgomery County has a smoking rate of 15.6%. There are almost
one hundred thousand who smoke in Montgomery. In Montgomery County, cigarette
smoking is prevalent among young working-class ages (25-64) and older counterparts.
(25-65). Smoking in Montgomery is probably diversified among the different ethnic
groups. The smoking rate among men is 20.85, while that of women is 17.3%. Tobacco
and other substance use can be credited or the high substance use mortalities among men
and women in Montgomery of 11.5% and 8.3%, respectively. It has further led to 65.6
and 48.6% lung cancer deaths in men and women, respectively, per one hundred
thousand population. While smoking pollutes, the air cigarette remains to pollute the soil
and water. This release of this waste to water areas like oceans kills the fish and other
living things limiting human food security.
On the other hand, Texas has a total smoker mortality percentage of 37.2. The
men take up the bulk of this group with 22.1%, while the female makes 15.1%.
Considering ethnicity, it is the American Indians who smoke and die most in Texas, with

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 a percentage of 38.3%. The black community takes up a distant second with a 17.1%
score. The pure white population follows closely at 16.8%, while the Hispanics are in
fourth place at 13.1% Lastly comes the Asians at 5%. Here too, smoking is prevalent
among those aged (24-65). The high rates of smoking in Texas can be the primary cause
of mortality through Trachea, Bronchus, and Lung Cancers illnesses of 62.9 and 38.4 in
men and women, respectively, per a one hundred thousand population (Dwyer-Lindgren
et al., 2014). It can also be credited for the Mental and substance use disorder mortalities
of 13.9 in men and 6.4% in women per one hundred thousand population. The burning of
cigarette remains destroys the ozone layer endangering the human species.
The entire U.S population has a smoking rate of just 13.7%. This population
comprises the working class and the elderly, i.e. (25-44) and (45-64). At the helm of the
smokers are American/ Indians at 21.9%. These are followed closely by African
Americans at 16.8%, Hispanics at 10.15, and Asian Americans at 7.0%. The morbidity
rates in the U.S due to smoking are 67%. The mortality rates of smoking are one to five
each year. It is estimated that about 766 571 tons of cigarette remains are released into
the environment every year. This vast amount is released into waterpoints and the soil
resulting in the pollution and death of organisms in the ecosystem. Similarly, fumes
released by incinerators burning the cigarette butts destroy the Ozone layer permeating
harmful U.V rays (Vezzoli & C., 2018).

6. Other data as needed (air, water quality, crimes rates). Remember to compare
objective data for your community with local (city), state, and national data.
Remember to cite sources as appropriate.

Conroe is a reasonably good city to reside in, and its air quality is good with an
AQI OF 20. Conroe gets its water from the Jasper aquifer, Catahala aquifer, and the
surfaces of Lake Conroe. Though Conroe water quality is ranked as good, a recent
independent study revealed that water purifies like Bromodichloromethane, Bromoform,
Chloroform, and Dibromoacetic acid were more than the regulation standards. The crime
rate is also low at 2.05 violent crimes or 184 cases per 1000 residents.

Montgomery does not disappoint too. It has a good air quality of AQI 15, and this
air is also very low on Particulate Matter and Sulphur dioxide. Its water quality is also
good, with the hard water being softened to contain only 9 grains per gallon. Montgomery
County, in its entirety, however, has a high crime rate of 14.37 per one thousand people, 7

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 out of 28 being violent.

Texas also ranks somewhat with an AQI of 18. The air has very few components
of Particulate Matter and Sulphur Dioxide. The water quality is also good and has been
established to have met all quality regulations. The crime rate is also low at only 4.2 per
1000 people (Tyson & K., 2015). However, that of the property remains prevalent at 23.9
per 1000 people.

The U.S is ranked tenth in air quality. National air pollution concentration has
been dropping and now is made of 59% lead instead of the initial 78%. The U.S water
quality is generally safe. Around 90% of all water meant for human consumption is
according to the standards described by the Environmental Protection Agency. Lastly, the
U.S crime rates have also been generally decreasing significantly. Current homicides are
at 7.8 per one hundred thousand people. Rape, on the other hand, is at 38.4 for the same
population. The total number of violent crimes per one hundred thousand people stands at
398.5.

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 were impressions from your subjective observations unfounded/invalid?

I thought that the smoking rate of men was much higher than that of women.
However, the study of Montgomery County revealed that while 20% of men smoked,
the women followed closely at 17%. The mortality rate of women due to smoking was
also high at 8.3%. Secondly, I also thought that the aged would be the most obese.
However, the study has revealed that people aged (40-59) are the most affected.

 Given the objective data, what impressions were validated/substantiated?

I always thought obesity affected lifespan, and it is no surprise that the study has
shown obese people have 41.36 years (Walls et al., 2012). I have also found it no
surprise that obesity increases asthmatic effects, heart diseases, and depression in

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 individuals. Lastly, I have confirmed my perception of Texas as a state with high crime
rates, and this is after data depicted high rates, especially in property crime.

 What cause-and-effect relationships did you discover/identify?

I discovered that the failure to undertake physical exercises despite taking food
with high levels of calories by Texas residents, especially the Black community, is the
root cause of obesity. For these reasons, Texas is the tenth ‘fattest’ city in the U.S, with
the black community claiming the lion's share of 41.2%. Despite having great parks and
beaches where many physical exercises can be conducted, Texas residents shun physical
exercises.

2. Problem Analysis for Community/Zip Code: 77385

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. _____Lung Cancer_______________________________________
2. ______Obesity______________________________________
Select one of the problems above and complete the 3 rows of the Problem
Analysis chart below.

Problem Correlates* Relationship of Correlate to Data Supportive of

Problem Relationship +

Ex. Inadequate diet Ex. Diets lacking in required Ex. All infants and children seen at the

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 nutrients contribute to malnutrition local Public Health Clinic are referred
to the nutritionist because of poor
diets (X.Y. personal communication,
date). Of infants measured, 60% were
lower for their weight/height (X report,
date).
1. Lung cancer Tobacco and other substances All people who reached the local
abuse is the primary cause of health center complaining of chest
lung cancer. pains and breathing difficulties
were referred to the pulmonologist
because of their smoking history,
especially men. A test on their
respiratory system discovered 75
% had lung cancers due to tobacco
smoking (Birt et al., 2014).

2.

3.

*These are factors that contribute to problems 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 Weeks 1 and 2,
write TWO priority community health nursing diagnoses.

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 Diagnosis MUST be something that a community/public health nurse

can do something about. See the 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

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(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

Risk of lung cancer complications among adults in Conroe, Montgomery County related
to observations of increased smoking of tobacco and other substances especially among the
working population (May cause inability to work properly and increase in crime), a high number
of people staying at home or just loitering in the streets, signaling joblessness (May result in
difficulty in accessing medication)

Community Health Nursing Diagnosis #2

Risk of obesity complications among adults, especially ages (40-59) in Conroe,

Montgomery County, related to observations of increased taking of calories without subsequent
physical exercises (May result in calorie accumulation in the body). High number of resting on
beaches and restaurants, signaling excess relaxation (May result in lack of interest to access
medication)

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 Reference

Birt, L., Hall, N., Emery, J., Banks, J., Mills, K., Johnson, M., ... & Walter, F. M. (2014).
Responding to symptoms suggestive of lung cancer: a qualitative interview study. BMJ
open respiratory research, 1(1), e000067.

Dwyer-Lindgren, L., Mokdad, A. H., Srebotnjak, T., Flaxman, A. D., Hansen, G. M., & Murray,
C. J. (2014). Cigarette smoking prevalence in US counties: 1996-2012. Population health
metrics, 12(1), 1-13.

County, M. (2018). Healthy Family Child Care Environments in.

Garcia-Menendez, F., Saari, R. K., Monier, E., & Selin, N. E. (2015). US air quality and health
benefits from avoided climate change under greenhouse gas mitigation. Environmental
science & technology, 49(13), 7580-7588.

Hendey, L., & Posey, L. (2017). Racial Inequities in Montgomery County.

Howard, J. C. (2021). 4. Texas Time: Racial Violence, Place-Making, and Remembering as

Resistance in Montgomery County. In Civil Rights in Black and Brown (pp. 71-90).
University of Texas Press.

Scarbrough, A. W., Hill, J., & Rodriguez, J. (2017). Collaborating to create healthier
communities: how geographical information systems can drive community well-
being. International quarterly of community health education, 37(2), 129-133.

Tyson, K. (2015). Waco Crime Trends, 1930–2013: A Comparative Study of Violent, Property,

and Index Crime Rates (Doctoral dissertation).

Vezzoli, C. (2018). Estimating the Environmental Impact of Products: Life Cycle Assessment.
In Design for Environmental Sustainability (pp. 213-237). Springer, London.

Walls, H. L., Backholer, K., Proietto, J., & McNeil, J. J. (2012). Obesity and trends in life
expectancy. Journal of obesity, 2012.

N4465_Assignments Template_Rev._3-2021_CL
Module 3 (Week 3) Part Three: Community Health Nursing
Intervention

Directions: Please complete each section below, providing the requested

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.

This study seeks to provide civic health nursing intervention for the diagnoses of obesity and
lung cancer that afflicts the population of Harper’s Trace, Montgomery County. Harper’s Trace
is a small community located in the north of Houston Texas. It has a population that records a
high number of persons with obesity, 25% of the population being obese and a significant
population with lung cancer related to smoking. 15% of the population in this community are
smokers. Vulnerability of lung cancer comorbidities among grownups in Conroe, Montgomery
County is associated with enhanced smoking of tobacco and other compounds, particularly
among the working demographic (Hales et al., 2017). This may contribute in an incapability to
function effectively and an upsurge in crime, as well as a high number of individuals remaining
at home or simply roaming in the streets, signaling joblessness. This may also lead in
complexity obtaining medication. Prevalence of obesity issues among individuals in Conroe,
Montgomery County, is associated with assessments of increasing calorie consumption without
accompanying physical activity. This may culminate in calorie buildup in the body. Increased
lounging on beaches and eateries, indicative of excessive leisure, may culminate in a loss of
motivation to seek medicine.

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:

N4465_Assignments Template_Rev._3-2021_CL
 Vulnerability of lung cancer comorbidities among grownups in Conroe, Montgomery
County is associated with enhanced smoking of tobacco and other compounds,
particularly among the working demographic. This may contribute in an incapability to
function effectively and an upsurge in crime, as well as a high number of individuals
remaining at home or simply roaming in the streets, signaling joblessness. This may also
lead in complexity obtaining medication (Hales et al., 2017). Nurses in this community
can serve as examples for patients and households by educating them about nutrition, the
access to care, and obesity-related diseases. CHN’s in Conroe can serve as individualized
counsellors by assisting patients in defining their health objectives and creating action
plans to accomplish them.

2. Why did you select this problem? Provide your rationale 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.

Obesity is a complicated health problem that is caused by a number of different variables,

including behaviour and genetics. Regular exercise, inactivity, food choices,
pharmaceutical usage, and other stressors are all examples of behaviour (Walls et al.,
2012). Additionally, the dietary and physical exercise surroundings, knowledge and
competencies, and food advertising and branding all have a role. Obesity is a significant
condition since it is related with impaired mental health consequences and a decreased
standard of life. Obesity is also connected with several of the globe's major factors of
mortality, notably diabetes, cardiovascular disease, brain hemorrhage, and certain forms
of cancer (Department of Health and Human Services, 2013). Individuals and households
may adopt choices dependent on their surroundings or neighborhood. For instance, an
individual may be unable to walk or bike to the shop or place of employment due to a
paucity of sidewalks or secure bike routes. Daily actions can be impacted by the
community, household, daycare, school, health care, and job environments. As a result, it
is critical to establish surroundings that promote physical exercise and good eating.
Obesity and its accompanying health issues have a major monetary influence on the
United States' Medicare system, both in terms of direct and secondary expenditures.
Direct medical expenditures could include services for prevention, diagnosis, and

N4465_Assignments Template_Rev._3-2021_CL
 medication. Indirect expenses include those associated with illness and mortality, as well
as missed production. Employee absences from employment due to obesity-related
medical problems, lower performance while at duty, and premature mortality and
incapacity are all productivity measurements. Obesity has an effect on military recruiting.
Across the country, 71% of persons between the ages of 17 and 24 are ineligible for
military duty; obesity precludes 31% of them from enlisting if they so want (Walls et al.,
2012).

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 there, or how you plan to
accomplish the goal(s).

Goal 1: Decrease obesity by 10% in Conroe

1. Objective: Promote appropriate dietary habits

2. Objective: Encourage regular physical exercise

3. Objective: Increase awareness on risk factors of obesity

Goal 2: Promote diabetes screening

1. Objective: Encourage community members to find out more on their diabetes

status.

2. Objective: Liaise with local agencies to promote Diabetes screening.

3. Objective: Educate the community on risk factors associated with diabetes as a

predicator of Obesity.

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

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 Completion Date

Enter Date Ex. Eighty percent (80%) of infants seen by health Enter Date
departments, neighborhood health centers, and private
physicians will have developmental levels assessed.
26/1/2022 Promote appropriate dietary habits 28/1/2022

26/1/2022 Encourage regular physical exercise 31/1/2022

26/1/2022 Increase awareness on risk factors of obesity 3/2/2022

26/1/2022 Encourage community members to find out more on their 6/2/2022

diabetes status.

26/1/2022 Liaise with local agencies to promote Diabetes screening. 13/2/2022

26/1/2022 Educate the community on risk factors associated with 22/2/2022

diabetes as a predicator of Obesity.

Refer to textbook for additional examples.

5. Plan of Intervention and Evaluation

Date Intervention Responsible Evaluation Target Date of

Activities Agency/Person Measures Completion
Enter Ex. Community Health Ex. Community Ex. • Lay advisors will Ex. Lay advisor
start Nurse identifies and Health Nurse be able to verbally training completed
date. trains lay advisors in (CHN) describe case-finding by
community as case methods to CHN enter date of
finders • Number of new WIC estimated
cases will be tracked completion.
by CHN on monthly
basis for 1 year to
determine if goal of
80% has been met
Community Health Community Health Advisers working Community
Nurse in Conroe Nurse (CHN) with the CHN shall awareness and
shall serve brief the CHN on all education timeline
as examples for the factors expected to be
patients and contributing to the completed by
households by increased cases of 23/2/2022
educating them obesity in the
about nutrition, the locality based on
access to care, and their assessment.
obesity-related

N4465_Assignments Template_Rev._3-2021_CL
 Date Intervention Responsible Evaluation Target Date of
Activities Agency/Person Measures Completion

diseases. The CHN shall then

undertake the
appropriate
measures including
planning for a
community
awareness day to
raise awareness on
the issue of obesity
and related health
complications

Summary/Conclusion: Summarize your assessment findings, your proposed

community health nursing intervention, and the community public health outcomes that
you anticipate as a result of the intervention. This can be one or two brief paragraphs.
Remember to cite sources as appropriate.

In Conroe, 25% of the population is obese for obvious factors. Most of the population have poor dietary
habits and engage in little to no physical exercise. Emotions have an effect on some person's food
patterns. Numerous individuals overeat in reaction to negative feelings such as boredom, sorrow, tension,
or rage. While the majority of overweight persons experience no more mental distress than those of
ordinary weight, over 30% of individuals seeking assistance for significant weight concerns struggle with
binge eating. Conroe, Montgomery County, is associated with assessments of increasing calorie
consumption without accompanying physical activity. This may culminate in calorie buildup in
the body. Increased lounging on beaches and eateries, indicative of excessive leisure, may
culminate in a loss of motivation to seek medicine (Scarbrough, Hill & Rodriguez, 2017). Nurses
in this community can serve as examples for patients and households by educating them about
nutrition, the access to care, and obesity-related diseases. CHN’s in Conroe can serve as
individualized counsellors by assisting patients in defining their health objectives and creating
action plans to accomplish them. Implementing all the necessary actions, it is expected that the
population with obesity in Conroe shall drop from 25% to less than 10% in less than two years.
Most importantly, the population in this community shall have learned the most befitting dietary
habits and exercising to ensure that they stay safe from obesity associated diseases and risk
factors.

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N4465_Assignments Template_Rev._3-2021_CL
 Reference

Hales, C.M., Carroll, M.D., Fryar, C.D., & Ogden, C.L. (2017) Prevalence of Obesity Among

Adults and Youth: United States, 2015-2016. National Center for Health Statistics Data

Brief. Retrieved from https://www.cdc.gov/nchs/data/databriefs/db288.pdf  [PDF - 603

KB]

Scarbrough, A. W., Hill, J., & Rodriguez, J. (2017). Collaborating to create healthier

communities: how geographical information systems can drive community well-

being. International quarterly of community health education, 37(2), 129-133.

U.S. Department of Health and Human Services. (2013). Managing Overweight and Obesity in

Adults. Retrieved from https://www.nhlbi.nih.gov/health-topics/managing-overweight-

obesity-in-adults  [PDF - 6 MB]

Walls, H. L., Backholer, K., Proietto, J., & McNeil, J. J. (2012). Obesity and trends in life

expectancy. Journal of obesity, 2012.

N4465_Assignments Template_Rev._3-2021_CL