225483 Beyond the volcanoes: Community assessment and action to improve health equity in rural Nicaragua

Monday, November 8, 2010 : 4:50 PM - 5:10 PM

Amy C. Cory, PhD, RN, CPNP , College of Nursing, Valparaiso University, Valparaiso, IN
Kerstin Kost , College of Nursing, Valparaiso University, Avon, IN
Katherine Thomas , College of Nursing, Valparaiso University, Evanston, IL
Brittany Popa , College of Nursing, Valparaiso University, Valparaiso, IN
Tricia Erdmann , College of Nursing, Valparaiso University, Racine, WI
Background: Health inequities related to gender, ethnicity, socioeconomic status, and geography exist in rural Nicaragua. The purpose of this ongoing research is to improve health equity in rural Nicaragua through social transformation using community-based participatory action research. Bronfenbrenner's ecological model of human development, school health, and primary health care theories provided the framework for this research.

Methods: Community-based participatory action research involves six phases: partnership, assessment, planning, implementation, evaluation, and dissemination. After the partnership, assessment, and planning phases; community members determined they would like to reduce the incidence of respiratory diseases by improving indoor air quality by decreasing the use of biomass fuel and open ventilation cooking methods. Community partners developed a focused community health assessment survey. This survey ascertained demographics; stove type, stove location, stove use, and fuel use; individual exposure to stoves; incidence and severity of respiratory symptoms; ability to perform activities of daily living; and absenteeism rates from school and work.

Results: One hundred and two community members completed the survey. The majority of respondents were women (75%) who reported cooking over open fire (82%) in a common room (78%). Although absenteeism rates from school (10%) and work (12%) were low, respondents reported a high incidence of respiratory symptoms in the past 30 days (72%).

Conclusions: Results from the focused community health assessment were used by community members to guide planning for a participatory educational intervention aimed at health promotion and respiratory disease prevention to reach the community's health-related goals. In addition to a participatory educational intervention, community members are working with researchers to redesign open fire stoves to improve ventilation and reduce respiratory disease in planning for community action. Partnership in community health assessment, education, and action provides a mechanism to engage community members in working toward a common goal—health for all.

Learning Areas:
Diversity and culture
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related education
Public health or related nursing
Public health or related research

Learning Objectives:
By the end of the presentation, participants will be able to: 1) Describe the use of a focused community health assessment in facilitating action in communities in Central America. 2) State two key findings from the use of a focused community health assessment in identifying baseline characteristics of respiratory illness and exposure to indoor air pollution in communities in Central America. 3) Evaluate the effectiveness of using a focused community health assessment with Latino communities.

Keywords: Community-Based Health Promotion, International Public Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: After completing my dissertation under the guidance of the Director of the World Health Organization Collaborating Center at University of Illinois at Chicago in nursing science/public health nursing, I engaged in this community-based participatory action research project. The project is in its third year. I have acquired both internal and extramural funding for the research. I have also received awards and honors for my research in rural Central America.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.