Undergraduate baccalaureate nursing students often struggle to select appropriate community assessment project topics due to unfamiliarity with assigned communities and failure to comprehend the target community's diverse culture and needs. Furthermore, students have restricted time to balance working constructively with preassigned groups and adequately assessing remote rural settings. These challenges occur simultaneously with students learning critical population health and community health nursing concepts. Students receive their group and rural county assignment at the beginning of nursing school. Each rural county is geographically located near the university (the county seat is typically within a 20- to 30-mile radius). First-semester activities center on the assessment phase, which includes conducting windshield surveys, site visits, and surveillance of health department data. The second semester includes planning and implementing a health promotion intervention. Third-semester activities include evaluation and dissemination of results or outcomes. Intervention topic selection was challenging for students; instead of addressing target population concerns, students preferred health promotion topics that were of interest or familiar to the student group or contained within a pre-designed list. Because of this gap, faculty piloted a student partnership model using a Civic Engagement Foundation ( https://mathewscenter.org/) and active partnership with a county Cooperative Extension Coordinator (CEC). The goal of the strategy is assisting students in the critical assessment phase—improving quality, relevance, and sustainability of the health promotion interventions. This article details how the students (n = 18) actively engaged in the partnership approach, successfully maximized community needs assessment, and designed interventions that were meaningful, impactful, and tailored to community citizens.
CECs are the primary outreach leaders for the land grant mission in many universities. The mission was designed to prepare students for successful service to the citizens of the state through instructional, research, and outreach programs. An integral CEC strength includes a daily physical presence and credibility with families, communities, education and governmental leaders, and key businesses. Additionally, CECs provide science-based resources and direct education in nutrition, physical activity, and health. Thus, the faculty invited the partnering CEC to meet with three six-member community student groups assigned to the county. The CEC discussed county demographics, shared experiential data regarding extension and service provider resources, activities, needs, and programs. The CEC also provided salient community historical and cultural insights, as well as potential points-of-contact background information to assist them in understanding the assigned community's strengths and challenges. Additionally, students received transcripts from recent Civic Engagement Foundation forums titled The Civic Health Index. This resource, derived from three CEC-scheduled community forum results, assessed citizen engagement, identified priority issues and community strengths, and facilitated community members in constructing solutions to salient community challenges. Forum questions included:
- Where are we now?
- Where do we want to go?
- How do we get there?
Public deliberation forums enable community members to discuss salient, local issues and work together toward collective action. Attendees included community members, school administrators and teachers, service providers, civic members, elected and appointed officials, and clergy. Student evaluation of qualitative data from a five-question community assessment project evaluation tool were overwhelmingly positive. The tool evaluated student perception of the partnership model's effectiveness in meeting course objectives, assisting with increasing confidence in understanding the community, and constructing relevant health promotion interventions. An anecdotal comment included:
From the partnership, I learned the value of collaboration with professionals that have an established active presence within the community.
Student feedback also indicated increased health promotion intervention goal accomplishments, largely by mitigating their sense of “being an outsider.” Student analysis of the community forum data increased student perception of “credibility in speaking with parents, school administrators, teachers, and civically engaged stakeholders regarding prominent community issues.” This model provides opportunities for nursing students to apply the art and science of civic engagement in health promotion interventions.
Libba Reed McMillan, PhD, RN
Linda Gibson Young, PhD, FAANP
Ken McMillan, PhD, CPA