1

Chapter 1

INTRODUCTION

Background of the Study

Community health nursing aims to promote, protect and preserve the health of

individuals, families, groups, communities and populations where they live, work, learn,

worship and play in an ongoing and/or episodic process.

Community extension program such as community health nursing links student

nurses, families and schools together. The challenges confronting nurses in today’s health

care environment have highlighted the necessity for student nurses to feel both competent

and prepared for practice (Edwards et al., cited by Butler, 2017). This necessity has in

turn emphasized the increasing significance of the nature and quality of student

community health learning experiences. The Community Health Nursing (CHN) course

focuses on the care of individuals, families, population groups and the community as

clients utilizing concepts and principles in community health development. To apply

concepts learned, students are brought to communities for immersion in relation to

learning experiences applying community health nursing. As graduates, they are required

to have adequate knowledge and skills and be able to transform learned competencies

into effective application in the future. The importance of varied real life learning

experiences can be gained in communities; thus, the College of Nursing of DMC College

Foundation has continuously been deploying its students to different communities for

immersion. In the many years that this has been done; however, there has never been any

study conducted to explore the students’ experiences during the said immersions.
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Several studies have indicated the essence and influence of community health

nursing immersion as a learning venue in the development of student nurses’ caring

attributes, nursing skills, knowledge, and professional socialization in the context of

public health. Edwards et al. (2014) described that a supportive community environment

is of greatest importance in optimizing the teaching and learning process and is widely

regarded as essential to the preparation of registered nurses for work. It is during

community health nursing immersion that students are able to develop relevant

knowledge, skills, and competence to develop their capacity to know how and what and

expand their perceptions of their future roles as registered nurses in the community. It

promotes and preserves the health of populations by integrating the skills and knowledge

relevant to both nursing and public health. Providing quality nursing student experience

in the community requires a careful consideration of placement and assignments that

reinforce clinical and community concepts to work in community- based settings (Dalton

et al., 2016)

DMC College Nursing through the years has implemented community health

nursing programs. Several competencies and services have been rendered to community

such health education, vital sign taking and others. As its community engagement

program partner, DMC College Foundation has adopted by Barangay Sta. Isabel. As a

result, its students like the student nurses have been exposed to this barangay for their

community health nursing. However, to date, the impact has to yet to be evaluated. It is

within this context that the researchers wish to conduct a study assessing the impact of

community health nursing programs.

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Theoretical Framework of the Study

This study is principally anchored on Nancy Milio’s Framework for Prevention

which emphasizes the concepts of community-oriented and population-focused care. The

framework challenges the common notion that a main determinant for unhealthful

behavioral choices is a lack of knowledge. According to her, community health nursing

should be coupled by public policy. That is knowledge is just a beginning of a continuum

that must be followed with positive attitude and practices. Further, she stresses that a

community must work together to maintain healthy state to prevent health injury.

Milio’s Model is a fitting theory to this investigation as this investigates the

impact of community health nursing program to the health awareness, nutrition and

disease prevention.

The study is further supported by Health Belief Model (HBM) proposed by

Godfrey Hochbaum et al., as the principal theory for health education. The model focuses

on persuading people to acknowledge their vulnerability and susceptibility to different

health illnesses. The model indicates that health education messages can raise awareness

and participation to community health nursing program brings positive changes in

knowledge and behavior of constituents towards health-seeking.

In developing health education messages, consideration should go beyond the

HBM and focus on control methods that are compatible with the socio-cultural

environment in which control practices are being encouraged. The model consists of five

major conceptual components. Perceived susceptibility is a person’s subjective perception

of the risk of developing a particular health problem. Perceived severity is defined as

concerns about the seriousness of the health problem and its consequences, for example,
 4

death, disability and social restrictions. Perceived benefit refers to the individual’s beliefs

in the effectiveness of actions designed to reduce the severity of the health problem.

Perceived barriers are the perception of potential obstacles such as financial,

psychological or costs, to implementing the desired behavior. Self-efficacy refers to the

confidence that one can successfully practice the behavior required to produce the

outcome.

The theories presented can be summarized that one’s health is dependent on the

available information at hand and the constant application of these information to daily

health-seeking.

The indicators of the study were sourced from Canadian Community Health

Nursing which provides a benchmark that community health nursing is expected to

achieve. These are the five standards of practice: (1) promoting health which includes: a)

health promotion, b) prevention and health protection, and c) health maintenance,

restoration and palliation; (2) building individual and community capacity; (3) building

relationships; (4) facilitating access and equity ; and (5) demonstrating professional

responsibility and accountability.Meanwhile, impact of community health nursing

programs shall be assessed in terms of health awareness, nutrition and disease prevention.

Figure 1 which is found at the succeeding page presents the schema of the study.

The schema shows the three interconnected boxes. The first box contains the independent

variable which is the community health nursing programs. Meanwhile, the second box

encloses the dependent variable of the study which is the impact of community health

nursing program. The two variables are separated by an arrow pointing to the dependent

variable denoting that community health nursing program has an impact.

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COMMUNITY HEALTH
NURSING PROGRAMS
 Promoting Health
- Health promotion IMPACT ON
- Prevention and health
protection  Health Awareness
- health maintenance,
restoration and palliation  Nutrition
 Building individual and
community capacity  Health Prevention
 Building relationships
 Facilitating access and equity

 Demonstrating professional
responsibility and
accountability

PROFILE OF THE

RESPONDENTS

 Gender
 Age
 Family Size
 Monthly income
 Educational attainment

Figure 1 Schema of the Study

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Statement of the Problem

The present study aims to evaluate the impact of community health nursing

(CHN) program to the residents of Sta. Isabel, Dipolog City.

Specifically, it seeks to answer the following questions:

1. What is the profile of the respondents in terms of:

1.1 Gender;

1.2 Age:

1.3 Family Size;

1.4 Monthly attainment; and

1.5 Educational attainment?

2. How do the respondents assess the community health nursing program of the

College of Nursing in terms of the following:

2.1 promoting health;

2.1.1 health promotion;

2.1.2 prevention and health protection; and

2.1.3 health maintenance, restoration and palliation;

2.2 building individual and community capacity;

2.3 building relationships;

2.4 facilitating access and equity; and

2.5 demonstrating professional responsibility and accountability?

3. How do the respondents rate the impact of the community health nursing

program to the following:

3.1 Health awareness;

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3.2 Nutrition; and

3.3 Disease Prevention?

4. Is there a significant relationship between the respondents’ assessments on the

community health nursing program of the College of Nursing and their

perceived impact?

Hypothesis

Ho1: There is no significant relationship between the respondents’ assessments on

the community health nursing program of the College of Nursing and their perceived

impact.

Scope and Limitation of the Study

The study focuses on evaluating the impact of DMC College of Nursing

community health nursing program. Community health nursing program shall be

evaluated in terms of (1) promoting health which includes: a) health promotion, b)

prevention and health protection, and c) health maintenance, restoration and palliation;

(2) building individual and community capacity; (3) building relationships; (4)

facilitating access and equity ; and (5) demonstrating professional responsibility and

accountability. Meanwhile, the impact of community health nursing shall be assessed in

terms of health awareness, nutrition and health prevention.

Data shall be gathered from Sta. Isabel, Dipolog City. The said barangay is the

adopted community of DMC College Foundation. As an adopted community, the

barangay has been the recipients of all the community engagement programs of the

school like the community health nursing program.

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Respondents shall be obtained from 100 randomly selected households. Only one

respondent shall be taken from the chosen households, preferably the homemaker or the

head of the household.

Significance of the Study

The study shall be conducted with the hope that this shall benefit the following:

College of Nursing. Through the results of the study, they shall have a glimpse of

the impact of their community health nursing program. Through the assessment, they can

be guided on which component of community health nursing program must be improved

and which shall be sustained.

Barangays. The findings of the study may inspire them of sustaining their

linkages with the school as the direct recipient of community health nursing program.

Meanwhile, other barangays may also be encouraged to accept partnership with schools

as community engagement and extension program beneficiaries.

Student Nurses. The conclusion of the study may develop their deeper

understanding on the importance of community health nursing program. This may deepen

their appreciation of the nursing program as a whole.

Residents. The outcomes of the study may further lead to their greater cooperation

and participation in community health teaching program which is one of the many

components of community health nursing program.

Future Researchers. The results of the study may become a springboard and a

relevant source of related literature and studies for those who may wish to deepen the

study of the impact of community health nursing.

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Definition of Terms

In the context of the present study, the following terms are operationally defiuned:

Building individual and community capacity. This refers to the mechanisms of

community development principles when assisting the group/community to marshal

available resources to support-taking action on their health issues.

Building relationships. This refers to the mechanisms of using culturally relevant

communication in building relationships.

Demonstrating professional responsibility and accountability. This refers to

the mechanisms of nursing informatics (i.e., information and communication technology)

which includes generation, management, and processing of relevant data to support

nursing practice.

Disease Prevention. This refers to the impact of community health nursing which

involves on prevention practices on communicable and non-communicable diseases.

Facilitating access and equity. This refers to the mechanisms of taking action,

based on evidence, with individuals/ communities at the barangay level to address service

accessibility issues.

Health awareness. This refers to the impact of community health nursing which

involves on increasing knowledge and capacity to improve health condition.

Health maintenance, restoration and palliation. This is a concept of health

promotion which concerns with facilitating maintenance of health in response to

significant emergencies that negatively impact upon the health of clients.

Health promotion. This is a concept of health promotion which concerns with

addressing root causes of illnesses.

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Nutrition. This refers to the impact of community health nursing which involves

in improving dietary practices and vitamin supplementation.

Prevention and health protection. This is a concept of health promotion which

concerns with application of epidemiological principles in using strategies such as

screening, surveillance, communicable disease response, outbreak management, and

education.

Promoting health. This refers to the mechanisms of advancing health which

includes health promotion, prevention and health protection and health maintenance,

restoration and palliation.

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Chapter 2

REVIEW OF RELATED LITERATURE

This chapter discusses the topics and the variables under investigation. The

literature and studies cited herein provided framework of the study. These were lifted

from books, journals and electronic sites.

Literature

Nurses in all settings play a unique and privileged role in the care of patients and

family members. The diverse backgrounds and perspectives that care providers and their

clients bring to each encounter present challenges for caring and understanding. In a

discussion about nurses’ position of power in the nurse/patient relationship, Benner

acknowledges that caring is always local, specific, and individual. She goes on to note

that very few nursing interventions are successful without mutual respect and genuine

caring between the nurse and patient.

Mitchelson and Latham (2016) state that nurses who lack cultural sensitivity can

alienate the very people they claim to help. Further insight in to which cultural learning

activities within nursing curriculum as well as a better understanding of effective ways of

evaluating preparedness to practice culturally safe care are indicated. Lack of

understanding of how immersion experiences affect care in a multicultural society such

as the United States affects the quality of nursing care.

Though literature exists on the experiences of nursing students who participate in

cultural immersion programs, little is known about the longitudinal impact these

experiences may have on future nursing practice and ability to provide competent nursing

care to clients from diverse backgrounds. Zorn (2016) agrees that the effects of a short-
 12

term immersion experience on a participants’ subsequent personal and professional life

long-term is not well known. The purpose of this study is to increase understanding of

what a cultural immersion experience as a nursing student means to currently practicing

nurses and the care they provide. New understandings of these meanings are uncovered

through the identification of common themes.

Walsh and DeJoseph (2017) conducted an exploratory descriptive study to

identify key experiences that may influence the development of cultural competence for

nurses. Ten students and two faculty mentors were interviewed before and after an

immersion experience in Central America. This study found that short-term international

immersion projects and the resulting appreciation for a differing culture increases the

ability as a nurse to be open to others’ beliefs and values.

In a study of long-term effects conducted by Levine (2017), currently practicing

nurses who participated in multiple international journeys while in nursing school were

interviewed. Using the qualitative research method of topical reflective autobiography, a

thematic analysis of in-depth interviews was conducted. Informants spoke of profound

changes in both personal and professional lives 5, 10, and 15 years later including:

deepened compassion, acceptance of differences, recognizing societal ills, and

willingness to take risks in order to promote societal change.

Through the use of quantitative analysis, St. Clair and McKenry (2016) found a

statistically significant difference in the achievement of cultural self-efficacy between

participants of an international clinical experience and those who did not participate in

these experiences from a sample of 200 undergraduate and graduate nursing students.

Ruddock and Turner (2017) recommended that long-term research be conducted to assess
 13

the impact of international learning experiences on the delivery of culturally sensitive

care after their study found that study abroad programs help aid the development of

cultural sensitivity of nursing students. From a nurse educator perspective, Mill, Yonge,

and Cameron (2015) recognized the value of international clinical practica in integration

of a global dimension and the achievement of cultural sensitivity in nursing curricula and

practice. They explored both challenges and opportunities of international clinical

placements, concluding that the significant opportunities make international placements

desirable and positive for nursing students despite the potential challenges and

complexities.

Cultural competence is nursing competence and vice versa. There is evidence that

suggests that an immersion experience can play a crucial role in the development of

culturally competent nursing care. The awareness of the need for culturally competent

health care practitioners is not a new concept to nursing.

Studies

For Tayaben et al (2018), recognizing varied and real life community learning

experiences of students are necessary as they are continuously deployed by the College of

Nursing of Benguet State University for immersion to different placements. Using a case

study approach, they reviewed fifty-two reflective journals and twenty-two student nurses

participated in the study. Participant reflective journal reviews, observations, and focus

group discussions were used as data collection methods. Using thematic analysis, four

themes emerged from the students’ descriptions of their learning experiences: (1)

unforgettable experiences: being with people; (2) facing challenges; (3) contributions to

self and to the community; and (4) impacts on their lives. Real community health
 14

experiences of students should be treasured in nursing education. These can help identify

better strategies in improving community learning experiences.

For Diamond and Freudenberg (2016), community schools influence the health

and education of neighborhood residents though three pathways: building trust,

establishing norms, and linking people to networks and services. Through such services

as schoolbased health centers, nutrition education, family mental health counseling,

violence prevention, and sexuality education, these schools build on the multiple

reciprocal relationships between health and education. By developing closer ties between

community schools and neighborhood health programs, public health professionals can

help to mobilize a powerful new resource for reducing the health and educational

inequalities that now characterize US cities. Their study suggests an agenda for research,

practice, and policy that can build the evidence needed to guide such a strategy.
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Chapter 3

RESEARCH METHODOLOGY

This chapter presents the discussion of the method used, research environment,

respondents of the study, research instrument, validation of the instrument, scoring

procedure, data gathering procedure and statistical treatment of the data of the study.

Research Design

The study shall employ the descriptive method of research with the aid of

standardized intsruments. A correlational analysis shall be utilized in order to determine

the significant relationship between the respondents’ perceived assessment on the

implementation of community health nursing programs and their perceived impact.

Research Environment

The study shall be conducted in Sta. Isabel, Dipolog City. The barangay is the

adopted barangay of DMC College Foundation. As its prime partner in community

engagements, it has been a recipient of the institution’s outreach programs. One of which

is the community health nursing program.

Research Respondents

The respondents of the study shall be the household heads or the homemakers.

The study shall target 100 household heads or homemakers as respondents of the study.

Research Instrument

The main tool in gathering data shall be a questionnaire checklist. The instrument

shall consist of three parts. Part I shall ask the profile of the respondents. Meanwhile, the

Part II shall assess the implementation of the community health nursing program as

perceived by the respondents. It contains eight subparts comprising five major indicators.
 16

The instrument was adapted from the study of Valaitis et al (2014). For suitability of the

locale of the present study, some items shall be revised. On the other hand, Part III shall

assess the impact of community health nursing programs.

Scoring Procedure

To draw out the responses of the respondents on the residents’ assessment on the

implementation of DMC College of Nursing, five-point Likert-type scale was employed

as follows:

5 – Very Much Implemented. This is a rating given to statement where

provisions are very much evident as perceived by the respondents.

4 – Much Implemented. This is a rating given to statement where provisions

were much evident as perceived by the respondents.

3 – Implemented. This is a rating given to statement where provisions are evident

as perceived by the respondents.

2 – Less Implemented. This is a rating given to statement where provisions are

less evident as perceived by the respondents.

1 – Not Implemented. This is a rating given to statement where provisions are

not evident as perceived by the respondents.

Scoring will be done by multiplying “very much implemented” answers by 5;

“much implemented” by 4; “implemented” by 3; “less implemented” by 2; and “not

implemented” by 1. Weighted mean will be described based on the established limit as

follows:
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Scale Range of Means Interpretation

5 4.21 – 5.00 Very Much Implemented (VMI)

4 3.21 – 4.20 Much Implemented (MI)

3 2.61 – 3.20 Implemented (I)

2 1.81 – 2.60 Less Implemented (LI)

1 1.00 – 1.80 Not Implemented (NI)

To draw out the responses of the residents’ assessment on the impact of

community health nursing program, three-point Likert-type scale will be employed as

follows:

3 – High. This is a rating given to a descriptor that creates very significant impact.

2 – Moderate. This is a rating given to a descriptor that creates relatively

significant impact.

1 – Low. This is a rating given to a descriptor in which the impact is slightly felt

to not at all.

Scoring will be done by multiplying “high” answers by 3; “moderate” by 2; “low”

by 1. Weighted mean will be described based on the established limit as follows:

Scale Range of Means Description

3 2.34 – 4.00 High

2 1.67 – 2.33 Moderate

1 1.00 – 1.66 Low

Data Gathering Procedure

Prior to the actual data gathering, a permit to gather data outside the campus will

be obtained from the Dean of the College of Nursing. After which, a transmittal letter will
 18

be sent to the different Barangay Captain of Sta. Isabel, Dipolog City. The moment the

request is granted, the researchers shall immediately field out the questionnaires.

The researchers shall personally distribute the questionnaire to the respondents

and the same will be immediately retrieved. After the retrieval, the responses will be

tallied, computed and interpreted.

Statistical Treatment

The responses of the respondents will be treated as a raw data in this study. The

said data will be collated, tabulated, analyzed and interpreted carefully using the

descriptive and inferential statistics.

Frequency counting and percentage. These shall be used for descriptive

statistics specifically on describing the profile of the respondents.

Weighted Mean. This will be used to describe the respondents’ assessments on

the implementation of community health nursing programs and their impact.

The formula below will be used:

∑ fw
X N=
N

Where:

Xn = Weighted Mean

f = frequency

w = weight
N= number of respondents
Pearson r product-moment coefficient of correlation. This will used to

determine the extent of relationship between variables.

The formula found below will be used:

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n∑ xy −∑ x ∑ y
r=
[ n ∑ x −(∑ x)2 ] [ n∑ y 2−(∑ y )2 ]
2

Correlated t-test. The r-result will be subjected to t-test to test the relationship

between the respondents’ assessments on the implementation of community health

nursing programs and their impact.

The following formula will be used:

t =r
√ n−2
1−r
2

Where:

t = t-value

r = correlation coefficient

Ethical Consideration

To avoid any harm especially to the study participants, the researchers shall fully

disclose the objectives of the study. It shall be made clear during the recruitment of the

respondents that participation in the study is purely voluntary. They shall be informed

also that they can withdraw their participation at any point prior to data analysis. The

researchers shall make sure that anonymity and confidentiality of the participants shall be

fully observed. Moreover, the data shall be disposed after the completion of the study and

that the data shall not be used against the participant in any way.

BIBLIOGRAPHY
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Butlers, S. (2017). Nurses as intermediaries in the promotion of community health

nursing. Exploring their roles and challenges. Building Healthy Neighborhood
Series

Edwards (2014). Nursing Scope of Practice

Mitchelson and Latham (2016). Comparative Analysis of Cultural Competence. Journal

of Health Science. Vol 13 (2)

Tayaben et al (2018). Reflections and Learning: A Case Study on Students’ Community

and Health Nursing Immersion. Mountains Journal of Science and Interdisciplinary
Research 78(1)

QUESTIONNAIRE ON THE IMPACT OF COMMUNITY

HEALTH NURSING PROGRAMS

Part I. Implementation of Community Health Nursing Programs

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Directions: Please the appropriate box which corresponds to your assessment on the
implementation of community health nursing programs of DMC College of
Nursing. Please use the scale below:
5 – Very Much Implemented
4 – Much Implemented
3 – Implemented
2 – Less Implemented
1 – Not Implemented
Health Promotion
5 4 3 2 1
The community health nursing of DMC College of Nursing:
1. Uses research data/findings in deciding priority programs.
2. Addresses root causes of illness and disease.
3. Uses social marketing strategies to shift social norms.
4. Evaluates population health promotion programs
systematically.
Prevention and Health Protection 5 4 3 2 1
1. Utilizes harm reduction principals to reduce risk factors.
2. Engages in collaborative intersectoral partnerships to
address prevention issues.
3. Evaluates collaborative practice (i.e., personal, team, and/or
intersectoral) in achieving individual/community health
outcomes.
4. Applies epidemiological principles in using strategies (such
as, a) screening, b) surveillance, c) communicable disease
response, d) outbreak management, and e) education).
Health Maintenance, Restoration & Palliation 5 4 3 2 1
1. Recognizes trends in epidemiological data.
2. Facilitates maintenance of health in response to significant
emergencies that negatively impact upon the health of
clients.
Building Individual and Community Capacity
1. Engages the individual/community in a consultative
process.
2. Uses community development principles when empowering
strategies (such as mutual goal setting, visioning, and
facilitation).
3. Uses community development principles in facilitating
skills to support group development.
4. Uses community development principles when assisting the
 22

group/community to marshal available resources to support

taking action on their health issues.
5. Uses a comprehensive mix of community/population based
strategies (such as coalition building, intersectoral
partnerships, and networking) to address issues of concern
to groups/populations.
6. Uses principles of social justice to support those who are
unable to take action for themselves.
Building Relationships 5 4 3 2 1
1. Is aware of culturally relevant communication in building
relationships.
2. Builds harmonious relationships with community clients.
Facilitating Access and Equity 5 4 3 2 1
1. Provides culturally relevant care in diverse communities.
2. Takes action, based on evidence, with individuals/
communities at the barangay level to address service
accessibility issues.
3. Advocates for healthy public policy, by participating in
legislative and policymaking activities that influence health
determinants.
Demonstrating Professional Responsibility and Accountability 5 4 3 2 1
1. Uses nursing informatics (i.e., information and
communication technology) which includes generation,
management, and processing of relevant data to support
nursing practice.
2. Uses available resources to systematically evaluate

community health nursing practice (e.g., availability,

acceptability, quality, efficiency, and effectiveness.

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Part II. Impact of Community Health Nursing

Directions: Please the appropriate box which corresponds to your assessment on the
impact of community health nursing programs of DMC College of Nursing.
Please use the scale below:
3 – High
2 – Moderate
1 – Low
Health Awareness 3 2 1
The Community Health Nursing program of DMC College of
Nursing leads to
1. Higher understanding of communicable and non-
communicable diseases.
2. More effective mitigation practices against dengue.
3. Higher knowledge about maternal and child care.
4. Higher preparation for health hazards.
5. More informed of the status of their vital signs.
Nutrition
1. Higher frequency of balanced meal eating.
 24

2. Higher compliance of vaccination and vitamin

supplementation.
3. Increased deworming rate.
4. More healthy preparation of meals.
5. More nutritious food choices including snacks.
Disease Prevention
1. Lesser occurrence of common diseases like fever, flu
and cough.
2. Reduction of dengue cases.
3. Higher compliance of non-smoking.
4. More active activities through sports, recreation and
exercise.
5. Lesser incidence of communicable diseases.

APPENDIX B

LETTER TO THE DEAN

DR. MARIA GRACE F. GURDIEL, RN, MAN

Dean, College of Nursing
DMC College Foundation

Madam:

A group of senior BS Nursing students led by the undersigned and are currently
undertaking a study entitled “IMPACT OF COMMUNITY HEALTH NURSING
PROGRAMS OF DMC COLLEGE FOUNDATION- COLLEGE OF NURSING”,
as a requirement leading to the degree Bachelor of Science in Nursing. The study seeks to
ascertain the impact of community health nursing programs of the school to the health
awareness, nutrition and disease prevention.

In line with this, we humbly request your approval and endorsement for us to proceed to
data-gathering at Sta. Isabel, Dipolog City.

Your positive feedback on this request shall contribute much to the success of this
undertaking.

Thank you very much.

Respectfully yours,
 25

MELVIN DIOSMA
Lead Researcher

Noted:

HENRY P. OGOC, RN, MN

Research I Professor

APPENDIX C

LETTER TO THE BARANGAY CAPTAIN

THE HONORABLE BARANGAY CAPTAIN

Barangay Sta. Isabel
Dipolog City

Dear Hon. _________:

A group of senior BS Nursing students led by the undersigned and are currently
undertaking a study entitled “IMPACT OF COMMUNITY HEALTH NURSING
PROGRAMS OF DMC COLLEGE FOUNDATION- COLLEGE OF NURSING”,
as a requirement leading to the degree Bachelor of Science in Nursing. The study seeks to
ascertain the impact of community health nursing programs of the school to the health
awareness, nutrition and disease prevention.

In line with this, we humbly request your approval for us to distribute the research
questionnaire to your constituents. Rest assured that their identity shall be kept
confidential and that their responses shall be used solely for this study.

Your positive feedback on this request shall contribute much to the success of this
undertaking.

Thank you very much.

 26

Respectfully yours,

MELVIN DIOSMA
Lead Researcher

Noted:

HENRY P. OGOC, RN, MN

Research I Professor

DR. MARIA GRACE F. GURDIEL, RN, MAN

Dean, College of Nursing

GANNT CHART

Activity Feb March April May July Aug Sept Oct Nov Dec
Proposal
Writing
Proposal
Defense
Proposal
Editing
Review of
Proposal
Instrument
Validation
Data-
Gathering
Data
Processing
Analysis
Writing
Final
Defense
Editing
 27

Cost Estimate

Particulars Cost
School Supplies and Printing 2,000
Transportation 1,000
Consultation Fee 3,500
Binding 1,000
Total 7,500