NSG/482 Week 2: Family and Community Assessment, sample paper

Assessing a Neighborhood and One of Its Families: A Windshield Survey, Secondary Data, and a Family Intervention on the East Side of a Midsized City

[Student Name]

University of Phoenix

NSG/482: Promoting Healthy Communities

Week 2 Assignment

[Instructor Name]

[Date]

The neighborhood, family and figures are a composite written for a model paper.

A community health nurse cannot help a family without understanding the place it lives, and cannot understand a place without meeting the families in it. This paper assesses a composite neighborhood on the east side of a midsized Midwestern city of about 180,000 people, then assesses one family who lives there and proposes an intervention for both. The same bus route, the same corner store and the same closed clinic show up in the neighborhood data and in the family's kitchen; the assessment only becomes useful when the nurse notices they are the same problem.

Community Assessment Framework

The assessment follows the community-as-partner model of Anderson and McFarlane (2019), which places the people of a community at its core and surrounds them with eight subsystems: the physical environment, health and social services, economics, transportation and safety, politics and government, communication, education and recreation. The model treats residents as partners in defining their own needs, which shapes both how the nurse collects data and how she plans the intervention.

Windshield Survey Findings

The nurse walked and drove the neighborhood on a weekday afternoon and a Saturday morning. The physical environment is mostly older single-family houses, many divided into apartments, with several boarded properties on two blocks. Sidewalks are present but broken in places, and there are few trees. Health and social services include a federally qualified health center branch that reduced its hours last year, two pharmacies and a food pantry at a church that opens twice a week. Economics are visible in the businesses: two dollar stores, a check-cashing outlet and a convenience store with limited fresh produce; the nearest full-service grocery is about two miles away. Public transit is a single bus line, with a 40-minute gap between buses on weekdays and an hourly Saturday schedule. The neighborhood has a well-used park with a basketball court and a library branch that offers free internet. Communication runs through the church, the library bulletin board and a neighborhood social media group.

Secondary Data

Observation was checked against public data. According to census estimates for the neighborhood's two tracts, about 31% of residents live below the poverty level, compared with 14% for the city. About 22% of households have no vehicle. The county's ranking data show adult diabetes and obesity rates above the state average, and the health department's asthma surveillance places the neighborhood's zip code among the highest in the county for pediatric asthma emergency visits (University of Wisconsin Population Health Institute, 2025). The data confirm what the survey suggested, that distance to food and care is a daily barrier, and add a finding the survey could not show, the burden of childhood asthma.

Residents' Perspectives

The community-as-partner model asks the nurse to hear from the people at the center of the model, not only to observe them. She held brief conversations with the librarian, the food pantry coordinator, a barber and three parents at the park. Their priorities overlapped with the data but were not identical. Parents talked most about the bus: a round trip to the grocery store or the pharmacy with children could take most of an afternoon. The pantry coordinator said that demand for diabetic-friendly food had grown, but donations were mostly canned and boxed goods. The barber, who has worked in the neighborhood for twenty years, said older men avoid the health center because the waiting room is crowded and hours no longer fit their work. None of the residents mentioned asthma first, even though the data show it as a major problem, which suggests that residents experience it as a family burden rather than a neighborhood one. Those conversations shaped the intervention: any plan that required another bus trip would likely fail, and any plan that met people where they already went would have a better chance.

Community Nursing Diagnosis

Risk for poor chronic disease control among residents of the east side neighborhood related to distance from affordable fresh groceries, shortened clinic hours and infrequent public transportation, as evidenced by a 31% poverty rate, 22% of households without vehicles, a two-mile distance to the nearest full-service grocery and above-average rates of diabetes and pediatric asthma emergency visits.

Family Assessment

Within the neighborhood, the nurse met a family through the health center's referral for a child with frequent asthma visits. The family is assessed using the structural and functional areas described by Friedman et al. (2003). Structurally, the household includes a 34-year-old mother who works evenings as a certified nursing assistant, her 9-year-old son with persistent asthma, her 5-year-old daughter and the children's 61-year-old grandmother, who has type 2 diabetes and cares for the children while the mother works. Roles are clearly divided, communication is warm but hurried and the grandmother makes most daily health decisions during the week.

Functionally, the family's strengths are strong ties, the mother's health care knowledge and the grandmother's steady presence. Its stresses are financial strain, the mother's evening schedule and the lack of a car. The son's controller inhaler runs out before refills because the family must take two buses to the pharmacy that carries his prescription, and the apartment has visible moisture damage in the children's bedroom. The grandmother's blood glucose is above target, and she reports that fresh vegetables are hard to get and expensive at the corner store.

Kaakinen et al. (2018) describe family health nursing as working with the family as a system, in which a change in one member's health affects the others. That is visible here: the grandmother's diabetes and the son's asthma draw on the same limited time, money and transportation.

Intervention at Two Levels

At the family level, the nurse arranges three changes with the family. First, she works with the health center to transfer the son's prescriptions to a pharmacy that delivers, which removes the refill gap. Second, she teaches the grandmother, who gives most of the daily care, how to recognize early asthma warning signs using the son's written action plan, and uses the same visit to set one small diabetes goal with her, such as swapping sugary drinks for water. Third, she helps the mother request a repair of the moisture damage from the landlord and connects the family to the city's healthy homes program if the repair does not happen.

At the community level, the family's barriers point to a neighborhood intervention. The nurse brings the assessment to the church food pantry coordinator and the library, both partners the model encourages, and proposes a monthly mobile produce market at the library parking lot, timed with an asthma and diabetes education table staffed by nursing students. The partnership uses places residents already trust and reach on foot.

Evaluation

For the family, the nurse will track asthma emergency visits and missed controller refills over six months and the grandmother's hemoglobin A1c at her next visit. For the community, she will track attendance at the market, the number of families screened or taught at the education table and, over a longer period, the zip code's pediatric asthma emergency visits in health department data.

Conclusion

A windshield survey, public data and a family assessment each showed part of the same picture: an east side neighborhood where distance, cost and time limit access to food and care. Assessing the neighborhood explained the family's barriers, and assessing the family made the neighborhood data personal. An intervention aimed at both, prescription delivery and teaching for the family and a mobile market with health education for the neighborhood, shows how community health nurses work across levels at once.

References

Anderson, E. T., & McFarlane, J. (2019). Community as partner: Theory and practice in nursing (8th ed.). Wolters Kluwer.

Friedman, M. M., Bowden, V. R., & Jones, E. G. (2003). Family nursing: Research, theory, and practice (5th ed.). Prentice Hall.

Kaakinen, J. R., Coehlo, D. P., Steele, R., & Robinson, M. (2018). Family health care nursing: Theory, practice, and research (6th ed.). F. A. Davis.

University of Wisconsin Population Health Institute. (2025). County health rankings & roadmaps. https://www.countyhealthrankings.org