Running head: PROJECT: GRANDVILLE AVENUE

Project: Grandville Avenue

Andrea J. Crapsey, Lindsay M. Johnson, Kelli A. Kerschenheiter, Marie-Cassandre O.
MacDonnell, Jordan J. Maxwell, Cassie L. Mulder, Lauren A. Nolan
Ferris State University

PROJECT: GRANDVILLE AVENUE

Project: Grandville Avenue

The Roosevelt Park neighborhood of Grand Rapids, Michigan is an inner city
neighborhood with many problems that need to be addressed. The stretch of businesses on
Grandville Avenue consists of restaurants, liquor stores, bakeries, and dollar stores among many
run down houses. Also on this stretch is Clinica Santa Maria, a clinic for patients who are
medically underserved and do not have access to affordable healthcare. This clinic also serves
undocumented immigrants who have sought work in the United States or come to the United
States for a better life for their children; in Roosevelt Parks 34.8% of the population are foreign
born residents (City-Data, 2015). Two of the most prevalent problems seen in this population are
obesity and diabetes. With the lack of healthcare for this population and the lack of adequate
nutrition and education, changes must be implemented so this group of people can live healthier,
more positive lives.
Assessment of Data in Kent County
Within the neighborhood of Roosevelt Park there is an increased level of poverty and
decreased income when compared to those in the city of Grand Rapids. Population density is an
important factor to look at when trying to understand how a city functions. Overall in Grand
Rapids, there are 4,308 people per square mile, while in Roosevelt Park, there are 7,162 people
per square mile (City-Data, 2015). Overcrowding and multiple families in a single home are
prevalent problems in the Roosevelt Park neighborhood. The median household income in 2013
for Grand Rapids was $41,669 while the median household income in Roosevelt Park was $32,
569 - almost $9,000 less overall (City-Data, 2015). Rent for a household in these separate
communities differed as well. In Grand Rapids, the rent for a place to stay averages at $650,

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while rent averages $533 for Roosevelt Park, presumably due to the living conditions these
families encounter (City-Data, 2015).
Aside from income and rent figures, there is data about the type of residents in these
respective communities. The percentage of people in Grand Rapids that do not speak English
well or at all is 4.5%, compared to the 36.6% in Roosevelt Park (City-Data, 2015). This figure
shows the amount of diversity that is seen in these different communities. The percentage of
foreign born residents is also an indication of the different languages spoken. In Grand Rapids,
9.8% of residents are foreign born, while in Roosevelt Park 34.8% of residents are foreign born
(City-Data, 2015). As stated above, many of the residents in Roosevelt Park have come to the
United States, specifically to Michigan to seek work opportunities, and reside together in
Roosevelt Park. Finally, the poverty level is addressed. Grand Rapids has 25.2% of residents
who are living below the poverty level, while Roosevelt Park has 42.5% of residents living
below the poverty level, which is to be expected based on all of the figures above (City-Data,
2015)
Analysis of Assessment Findings
There are various factors that contribute to the assessment findings of Roosevelt Park.
These factors include lack of inexpensive, quality fresh foods available, an abundance of liquor
stores, language barriers, inadequate funds for healthcare, presence of gangs, overcrowded
housing, insufficient education, and lack of citizenship. There are many resources available in
the Roosevelt Park neighborhood. The Neighborhood Association is involved in cleaning up
graffiti, planning community events, and providing resources to help the immigrants with their
transition. Roosevelt Park Ministries offers free english classes, fitness classes, and more. There
is a community garden available for all residents to use. The Cook Library offers free tutoring

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for parents and children. Lastly, there is a food pantry where low income people can come once
a month and receive groceries for free. Although all these resources are available they are not
being fully utilized.
Community nurses are important assets in helping with the nutrition problems in the
community by providing education to residents about methods of obtaining healthier foods, how
to cook food using healthier techniques, and how to utilize produce that can be grown right in
their own window box gardens. Other professionals that can contribute in addressing these
issues are social workers, teachers, nutritionists, doctors, and other healthcare providers. The
community groups that were discussed previously are great resources that are attempting to help
this issue.
Jean Watsons theory of human caring states that healthcare providers must genuinely
care for their patients and understand their culture in order to provide the best care (Watson,
2014). This theory can be directly applied to the Roosevelt Park neighborhood and the
professionals who provide care to them. One study applied the theory to patients perceptions of
care in a multicultural environment. The study found that when a patient is of a different culture
than the nurse, teaching, learning, and trust are compromised and patients report less satisfaction
with their care. This is due to language barriers and cultural differences (Suliman, Welmann,
Omer, & Thomas, 2009). When patients of Roosevelt Park have health care providers from
different cultures they may have a hard time trusting them and understanding their teaching
about issues such as nutrition. It is important for health care providers and nurses to have an
understanding of, and an interest in, the population they are working with to provide optimal
care. Thankfully, for the citizens of Roosevelt Park, Clinica Santa Maria is available. The clinic

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provides free care and the providers speak Spanish. Without the clinic, many residents would
not have access to healthcare.
Community-Focused Nursing Diagnosis
As formulated by an article written by Meucke (1984) titled Community Health in
Nursing, the nursing diagnosis most appropriate for this population is as follows: Residents of
Roosevelt Park Neighborhood are at risk for imbalanced nutrition related to lack of access to
nutritious food and lack of knowledge about a balanced diet as evidenced by high rates of obesity
and diabetes which were reported by the staff at Clinica Santa Maria. Exact statistics about
diabetes and obesity in the Roosevelt Park neighborhood are difficult to obtain because of the
number of residents who are undocumented and do not seek healthcare. However, in Kent
County, 7.5% of Hispanics are living with diabetes (Grand Rapids African American Health
Institute, 2011). After further research was conducted, it was identified that most noncommunicable diseases are a result of four particular behaviors: tobacco use, physical inactivity,
unhealthy diet, and harmful use of alcohol, all of which are prevalent in the hispanic community
(Grand Rapids African American Health Institute, 2011). The highest rate of binge drinking is
among hispanic males (Kent County Health Department, 2014). Minorities, such as Hispanics,
also have higher rates of diseases such as diabetes and obesity, which are preventable (Grand
Rapids African American Health Institute, 2011). Lastly, Hispanics are the most likely cohort to
report not having a personal health care provider and are more likely than Caucasians to say that
cost was a problem (Grand Rapids African American Health Institute, 2011). See Appendix A
for a table comparing obesity among Caucasians, African Americans, and Hispanics.
SMART Goal

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In five years the residents of Roosevelt Park Neighborhood will have an average body
mass index (BMI) between 25-28. This goal was chosen based on the issue of obesity and poor
nutrition in the community. This BMI was chosen because it is a realistic adjustment compared
to their current weight average. The goal is specific, measurable, attainable, realistic, and on a
specific timeline.
Interventions
The community garden in Roosevelt Park Neighborhood is offered for all of the residents
to utilize. This is a place where residents can plant fruits, vegetables, and flowers. Although the
community garden is a great place for growing healthy foods, it is underused. One intervention
that would improve the BMI of the population would be encouraging the use of the community
garden and therefore greater intake of vegetables. To encourage the use of the community
garden, creating one day a week where residents can work together planting foods and learning
new recipes would be beneficial.
As discussed earlier, health promotion would greatly improve the community in the
Roosevelt Park Neighborhood. One of the three schools in the community, Potters House, has a
before-school program that promotes health and wellness in the students. Parents may bring
their children early to school where they are supervised in the gym. The students can participate
in all different activities such as basketball, volleyball, hockey, and jump rope. This program is
utilized by many students that attend the school, but is the only program of its kind in the
neighborhood. Not only does exercise help prevent future issues like cardiovascular disease,
coronary artery disease, and obesity, but exercise performance improves aerobic endurance, joint
flexibility, and muscle strength (Fletcher et al., 1996). If other schools in the Roosevelt Park
community incorporated programs like Potters House does, it could be extremely beneficial for

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the prevention of diseases in future generations. According to Fletcher et al. (1996, pp 23),
schools must teach the benefits of exercise and the development and maintenance of exercise
and exercise conditioning throughout life.
A third intervention for the Roosevelt Park population would be the education of healthy,
affordable, and population-specific nutrition. As a result of a population with dense LatinAmerican roots, it is important to not only promote wellness and balanced nutrition, but to
respect the culture and traditions. Examples of this would be teaming up with Fair Food
Networks different venues of health promotion, such as the Food Insecurity Nutrition Incentive
(FINI). FINI works to promote the consumption of vegetables and fruits amongst SNAP
participants. SNAP, otherwise known as Supplemental Nutrition Assistance Program is a
program through the Department of Agriculture that provides assistance to millions across the
country that are considered to be low-income (United States Department of Agriculture, 2015).
Another example would be to mimic Project Local to connect schools with local farmers to
improve the nutritional content of school lunches (Thompson, 2014).
Less expensive interventions would aim at targeting sources that are already available.
An example of this would be to team up with local area churches to ask for healthy items that are
nutritious and specific to the cuisine of the people of Roosevelt Park. These items could be
simple requests of low-sodium black beans and pinto beans, brown rice, canned tomatoes and
corn, as well as canned papaya/mango. Low-sodium black beans are an excellent source of fiber
and help fight high cholesterol, a problem specific to Roosevelt Park (SixWise, 2009).
Perishable items that could be requested would be avocados (a healthy source of Omega-3s).
Items such as these provide wonderful health benefits, are culturally appropriate, are generally
affordable, and are easy to store in a food bank.

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Another factor that is important to consider when planning interventions and

communicating educationally would be the interpretive differences and abilities. While many
patients at Clinica are fluent in Spanish, there are many indigenous dialects as well as illiterate
clients who struggle to efficiently communicate. While promoting nutrition, visual handouts and
displays such as the MyPlate would be effective as they are not wordy, contain pictures, and are
available in Spanish (United States Department of Agriculture (About MyPlate, 2015).
The final intervention that would be incredibly useful for the community would be using
bus lines to transport residents to Meijer. There are two Meijer locations near Grandville Avenue
one on 54th street, and the other on Alpine Avenue. The Rapid could come to Grandville Avenue
and stop near major intersections such as Clyde Park and Grandville Avenue, and Franklin St.
and Grandville Avenue. This would provide people the transportation they need, as well as better
options for healthier, more reasonably priced food choices. Not only would Meijer provide a
greater variety of healthy food choices but they also accept the Bridge card.
Evaluation
In order to ensure that the interventions are successful and incorporated into the
community effectively, the neighborhood needs to be revisited. Annually for the next five years,
students will return to reevaluate the community. They will check the garden and assess whether
it is being utilized to the full potential. Also, they will evaluate the use of The Rapid
transportation and review whether it is being taken advantage of by community members. The
stops the bus makes should be reevaluated as well, to ensure the best locations possible for
easiest access are being used.
According to our SMART goal, the BMI of this population should be decreasing steadily.
In order to review if that is happening, people of the community will be encouraged to have their

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BMI checked at their annual check-up. Healthcare personnel will then report the BMI of their
patients to obtain an average in the community. As stated previously, diabetes, gestational and
non-gestational, are very prevalent issues in the community. The rates of diabetes in Kent
County are high, 7.5%, but incorporating the interventions above should help decrease future
rates (Grand Rapids African American Health Institute, 2011). The statistics for diabetes and
obesity in this community will be reported, and upcoming interventions will hopefully have a
positive influence on the future statistics.

References
City-Data. (2015). Grand Rapids, Michigan. City-Data.com. Retrieved from http://www.citydata.com/city/Grand-Rapids-Michigan.html#

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Fletcher, G. F., Balady, G., Blair, S. N., Blumenthal, J., Caspersen, C., Chairman, B., Pollock,
M. L. (1996). Statement on exercise: Benefits and recommendations for physical activity
programs for all Americans. Circulation, 94, 857-862. doi:10.1161/01.CIR.94.4.857
Grand Rapids African American Health Institute. (2011). 2011 minority health report [Data
File]. Retrieved from
http://www.graahi.org/Portals/0/Documents/2011MinorityHealthReport.pdf
Kent County Health Department, . (2014). 2014 behavioral risk factor survey. Kent County
Health Department, 1-34. Retrieved from
https://www.accesskent.com/Health/pdf/BRFSS.pdf
Muecke, M. (1984). Community health diagnosis in nursing. Public Health Nursing. 1(1), 23-35.
Retrieved from https://fsulearn.ferris.edu/bbcswebdav/pid-1013964-dt-content-rid6532286_1/courses/81775.201508/81775.201508_ImportedContent_20150818014818/m
euke%20article.pdf
SixWise. (2009). What is the healthiest of all beans?. In SixWise.com. Retrieved from
http://www.sixwise.com/newsletters/06/12/13/what-is-the-healthiest-of-all-beans.htm
Suliman, W., Welmann, E., Omer, T., & Thomas, L. (2009). Applying Watsons nursing theory
to assess patient perceptions of being cared for in a multicultural environment. National
Institute of Health. doi: 10.1097/JNR.0b013e3181c122a3.
Thompson, A. G. (2014). Project local. Black Family Development, Inc.. Retrieved from
http://www.blackfamilydevelopment.org/about.html
United States Department of Agriculture. (2015). About MyPlate. ChooseMyPlate.gov.
Retrieved from http://www.choosemyplate.gov/about

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United States Department of Agriculture. (2015). Supplemental nutrition assistance program.

United States Department of Agriculture: Food and Nutrition Service. Retrieved from
http://www.fns.usda.gov/snap/supplemental-nutrition-assistance-program-snap
Watson, J. (2014). Jean Watson's theory of human caring. 321-340. Retrieved from
http://watsonibb.erciyes.edu.tr/wp-content/uploads/2015/01/3312_Ch18_321-340.pdf

Appendix A

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