PHN 652 Why is it necessary to use all levels of assessment when writing a community health needs assessment report?

PHN 652 Why is it necessary to use all levels of assessment when writing a community health needs assessment report?

PHN 652 Why is it necessary to use all levels of assessment when writing a community health needs assessment report?

Week 4 Summary: Public Health Nursing Assessments

This week we were able to apply the public health nursing practice model to a population needs assessment report and assessment. You were able to use the nursing process with a community assessment, prioritizing a community problem list. A community’s health involves aspects that reach far beyond absence of disease. The influence of factors such as environment, public services, and policies, along with simple economics, play a large role in the health of a community. The public health nurse is often in a position to act as an insider in community assessment. Any effective community assessment starts with interpreting and applying essential concepts, including community, community client, community health, and partnership for health.

 

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The Public Health Nursing Assessment tool (PHNAT) is used to locate areas of improvement for needed populations. The PHNAT can be used to identify gaps in the population in need. Social determinates and health priorities can be located in community health needs assessment reports. These reports can draw attention disproportional groups of populations. The multilevel involvement and utilization of identified stakeholders can amend identified gaps (Stanhope & Lancaster, 2019).

Stanhope, M. & Lancaster, J. (2019). Public health nursing: Population-centered health care in the community (10th ed.). St. Louis, MO: Elsevier. ISBN-13: 9780323582247

Association for Community Health Improvement (2017).”Community Health Assessment Toolkit,”

https://www.healthycommunities.org/resources/community-health-assessment-toolkit

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Micro levels assement refer to the level of an individual. As a public health nurse, we begin discussing decisions for assessment at the level of the member of the community. Meso level assessment refers to assessment a group such as a family. And the macro level assessment is the assessment on the level of the whole community, region or country.

According to Lacasse and Ganbrill (2015), assessment set down the groundwork for selecting plans and specify how likely the desired outcome can be achieved. The framework of assessment differs by scope, purpose, and the level to which they have been tested. It also differs from how the gathered data is compatible with regards to how behavior develops, changes, and how it helps the population being serve. It is necessary to include all the levels of assessment when conducting assessments on the community’s health needs because it provides essential information to understand the status of their health or phenomenon. It also provides critical information to identify resources required to address their health needs.

Reference

Lacasse, J.R., & Gambrill, E. (2015). Making assessment decisions: Macro, mezzo, and micro Perspectives (pp. 69-84). In B. Probst (Ed.)., Critical Thinking in Clinical Diagnosis and  Assessment. New York: Springer.

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I agree with you that micro levels assessment focuses on evaluating individual health needs. A community health

PHN 652 Why is it necessary to use all levels of assessment when writing a community health needs assessment report
PHN 652 Why is it necessary to use all levels of assessment when writing a community health needs assessment report

needs assessment report is a detailed document that cover health needs from the individual to the community levels. Therefore, micro, meso, and macro levels of assessment are important in providing different information required to improve healthcare status of the community (Martínez-Martínez & Rodríguez-Brito, 2020). Similarly, these different levels of assessment allow public health nurses to determine particular causes of healthcare complications. The framework of assessment differs by scope, purpose, and the level to which they have been tested. Healthcare professionals conducting community health needs evaluation conduct all levels of assessment to obtain elaborate information about the community health needs status (Rivera et al., 2018). Micro, meso, and macro levels of assessment provides essential information to understand the status of their health or phenomenon. Proper understanding improves intervention and prevention efforts toward healthcare crisis.

References

Martínez-Martínez, O. A., & Rodríguez-Brito, A. (2020). Vulnerability in health and social capital: a qualitative analysis by levels of marginalization in Mexico. International journal for equity in health19(1), 1-10.

Rivera, J., McPherson, A. C., Hamilton, J., Birken, C., Coons, M., Peters, M., … & Stinson, J. (2018). User-centered design of a mobile app for weight and health management in adolescents with complex health needs: qualitative study. JMIR Formative Research2(1), e8248. doi: 10.2196/formative.8248

The micro, meso, and macro levels of community health assessment refers to community assessment at the patient interaction level (micro level); the health care organization and community level (meso level), and the policy level (Macro levels) (World Health Organization [WHO], 2002) that each level of assessments is linked, interacts with each other, and drastically influences each other when the events of one level affect actions and events at the other level.

The necessity to include all levels of assessment is vital when writing a community health needs assessment is vital when writing a community health needs assessment report. According to WHO (2002), when all levels work effectively and successfully with each other, health care becomes efficient and patient’s experience better health. An example of how the different levels influence each other can be seen when patients respond to the health system or organization in which they receive care, and the health care system organization or communities responding to policies that in turn influence how care is provided for patients. Not including all three levels of assessment in a community health needs assessment report or having a dysfunction within and among the levels will create waste ineffectiveness in providing patient care (WHO, 2002).

References

World Health Organization, (2002). Chapter 2:Innovative Care for Chronic Conditions

https://www.who.int/chp/knowledge/publications/iccc_ch2.pdf#

I concur with you that the micro, meso, and macro levels of community health assessment are linked to each other in a community health assessment report. However, the levels of health needs assessment are different and important in providing elaborate health information. Micro level assessment focuses on the individual health needs whereas meso level targets on community level. Macro levels of health needs evaluation examines policies directed towards public health (Babchuk, 2019). Community health needs assessment reports play an important role in decision-making process. Therefore, conducting meso, micro and macro levels of health needs evaluation are important. All levels work effectively and successfully with each other, health care becomes efficient and patient’s experience better health (Abrams et al., 2020). Different healthcare stakeholders depend on community health needs report. Thus, having a detailed health assessment informs critical decision-making process on community health resilience. The breakdown of the assessment into three levels improves clarity in community health needs report.

References

Abrams, E. M., Simons, E., Roos, L., Hurst, K., & Protudjer, J. L. (2020). Qualitative analysis of perceived impacts on childhood food allergy on caregiver mental health and lifestyle. Annals of Allergy, Asthma & Immunology124(6), 594-599. https://doi.org/10.1016/j.anai.2020.02.016

Babchuk, W. A. (2019). Fundamentals of qualitative analysis in family medicine. Family medicine and community health7(2). doi: 10.1136/fmch-2018-000040

According to Saylordortorg.github.io (n.d) the micro level which are the smallest levels of interactions are examined and microlevel analyses might include one-on-one interactions between couples or friends. Meso level research is the study of how norms of workplace behavior vary across professions by studying the experiences of groups and interactions between groups, and at macro level sociologists examine social structures and institutions at the broadest level (Saylordortorg.github.io, n.d).

It is necessary to use all types of levels because it helps view an issue or topic from all aspects and angles depending on the level of inquiry.

Lacasse & Gambrill (2015) explain that social workers may have less control over the incentives and constraints that exist in mezzo and macro environments than they do at the micro level, they can nevertheless benefit from examining the mezzo and macro environments in which they practice and examine how their assessment and decision-making process is affected by these factors. This can be the same experience with the assessment report of a community health. The Mezzo and macro levels can have less control in some inducements and limitations.

In an article by Kapiriri, Norheim & Martin (2007) the macro level resource allocation decisions are influenced by politics, public pressure, and advocacy, at the meso-level, hospital priority-setting decisions were made by the hospital managers and were based on national priorities, guidelines, and evidence. Micro-level practitioners considered medical and social worth criteria.

References

Kapiriri L, Norheim OF, Martin DK. Priority setting at the micro-, meso- and macro-levels in Canada, Norway and Uganda. Health Policy. 2007 Jun;82(1):78-94. doi: 10.1016/j.healthpol.2006.09.001. Epub 2006 Oct 10. PMID: 17034898.

Lacasse, J. & Gambrill, E. (2015). Making Assessment Decisions: Macro, Mezzo, and Micro Perspectives. 10.1007?978-3-319-17774-8_4.

Saylordotorg.github.io (n.d) Micro, Meso, and Macro Approaches. Retrieved from https://saylordotorg.github.io/text_principles-of-sociological-inquiry-qualitative-and-quantitative-methods/s05-01-micro-meso-and-macro-approache.html#:~:text=At%20the%20micro%20level%2C%20sociologists%20examine%20the%20smallest,is%20influenced%20by%20his%20or%20her%20social%20context.