COMMUNITY AS PARTNER REPORT CENSUS TRACT 1

 
 
 
 
 
 

Community as Partner Report Census Tract 000100

 
Chelsea Lovitt, Jaicee Morrow, and Maddie Schaeffer 
 
University of Arizona
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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Community Analysis and Nursing Diagnosis

 
1.  We identified three strengths in CT 000100 as efficient transportation options, access to
recreation, and economic stability. When conducting a windshield survey of the CT, we observed
many individuals utilizing the Sunlink Streetcar as well as the bus transit system. There are many
bus stations throughout the CT and a main bus station called Downtown Ronstandt Center. There
are many facilities which can be utilized for recreation in the CT including four parks and two
plazas (City of Tucson, 2020). Additionally, during the windshield survey, a neighborhood
center, a senior center, three fitness studios, and two yoga studios were identified. According to
the intern with Tucson Police Department (personal communication, October 21, 2020), a
strength of the community are the many local businesses. The presence of stores, restaurants, and
places for employment make this a healthy economy, however many of the people who work in
this community do not live in the CT. 
 
2. Our team identified three critical stressors in CT 000100 as exposure to crime and violence,
poverty, and barriers to accessing health and social services. According to City Protect (2020)
there were 27 reported crimes between August 1, 2020 to August 31, 2020 in the designated CT.
According to the Program Direction of the Tucson Collaborative Community Care (TC-3) at
Tucson Fire Department (personal communication, October 20, 2020), one of the major concerns
in the area is the issue of low income and presence of poverty which he stated leads to various
other problems. The Program Director of TC-3 (personal communication, October 20, 2020) also
mentioned that while there are great programs and services available in the community, there are
not enough “people, money, or resources to reach everyone”. 
 
3. According to our community assessment, the priorities of care for CT 00010 were barriers to
health and social services, inadequate/improper mask wearing, food insecurity, presence of crime
and substance abuse. A table, which prioritizes the community’s problems, is listed in Appendix
A.
 
4. Based on our analysis of community assessment findings, we formulated the following
diagnosis for CT 000100: Risk of contracting and transmitting Covid-19 among the downtown
Tucson homeless population as related to inadequate mask wearing, improper mask wearing, and
limited access to free masks as evidenced by 26,632 cases of COVID-19 in Pima County and key
informant’s voiced concern of the homeless populations’ access to resources during Covid-19
pandemic.
 
 
Community Nursing Program Plan
 
5. We set the community health goal for our intervention as increasing proper mask wearing in
Pima County, AZ.
 
6. We used evidence from a study by Lyu and Wehby called “Community use of face masks and
COVID-19: evidence from a natural experiment of state mandates in the US” to develop our
project.
COMMUNITY AS PARTNER REPORT CENSUS TRACT 1 3

  The study found that there was a greater decrease in COVID-19 cases in states
mandating the use of face masks in public compared to states that did not mandate face
masks (Lyu & Wehby, 2020). Due to this, we were inspired to base our project on masks
and the importance of not only wearing them, but wearing them correctly. Many people
do not wear masks properly, and in the homeless population, they may not even have
access to masks. This is why it was important to provide masks to the homeless
population and also give education about the importance of wearing them and how to
wear them correctly.
 This article is applicable to our project because it discusses how face masks being
mandatory has shown to decrease the number of COVID-19 cases. This article obtained
their data by researching what states had a mandatory face covering orders issued
between April 1st and May 21st, and then observing the number of COVID-19 cases
from March 21st to May 21st (Lyu & Wehby, 2020). They then used an event study to
analyze the data and determine if states with face mask mandates had lower cases of
COVID-19 (Lyu & Wehby, 2020). This was a more large scale study than our health
education project. This study compared data from all states throughout the U.S while we
focused on one part of Tucson, therefore the settings varied between the study and our
project. Additionally, the study’s sample differed from the targeted population in our
project since the study looked at mask wearing in all individuals, while our project
focused on mask usage in the homeless population. 
 According to Melnyk and Fineout-Overholt’s (2011) 7 levels of evidence, this study
would be evidence level 4. This study most closely resembles a correlational study, as the
study is examining the relationship between mask wearing and rates of COVID-19
infection. 
 
7. Our health education project aligned with the following national goals and objectives. 
a) We identified the most applicable Healthy People (HP) 2030 Overarching Goal as
“Promote healthy development, healthy behaviors and well-being across all life stages”
(Office of Disease Prevention and Health Promotion [ODPHP], 2020b). This Healthy
People 2030 Overarching Goal most closely related to our health education project as we
aimed to promote health behaviors through mask wearing. 
b) We identified the most applicable HP 2030 Topic as “Health Care Access and Quality”
(ODPHP, 2020a).
c) We identified the most applicable HP objective number as AHS-2030-08 which states,
“Increase the proportion of adults who receive appropriate evidence-based clinical
preventive services” (ODPHP, 2020a). This is a baseline core objective. 
 
8. We selected the Pima County Face Mask Mandate as an example of a policy that relates to our
community health goal (Pima County Board of Supervisors, 2020). This is a health policy
because it promotes the health of citizens in the community (Anderson & McFarlane, 2019, p.
123). 
 
9. We planned the following health education project to meet our community health goal. We
had the Joel D. Valdez Library in Downtown Tucson be the location for our Mask Education
Poster Presentation on November 5th, 2020. This education presentation was aimed at educating
the homeless population in Downtown Tucson, in addition to giving away free masks. Our poster
COMMUNITY AS PARTNER REPORT CENSUS TRACT 1 4

included information about the importance of wearing masks, how to don and doff masks, who
should be wearing masks, and when masks should be worn. Our group all worked together on the
poster board and collectively educated the population when out in the community. We aimed our
presentation at this population because this is a known at risk population and key informant
interviews expressed concern for this population with COVID-19. In light of COVID-19, social
distancing was observed throughout the duration of the presentation. 
 
10. We developed the following SMART Learning Objectives for the project.
 After viewing the health education project, at least 50% of participants will be able to
identify at least one location in which it is necessary to wear a mask by 12:30 pm.
 After the health education project, at least 50% of the audience will state that they plan to
wear masks properly when social distancing is not possible.
 After participating in the health education program, 100% of participants will
demonstrate how to remove a face mask correctly.
 
11. The plan for implementation included three of the following program activities:
  We will buy all necessary supplies for our poster board and create our poster board by 4
pm on 10/29/2020.
 We will contact the Joel D. Valdez library manager by 4 pm on 10/29/2020 to discuss
setting up our table outside of the library. 
 We will coordinate a time with both the library and Wanda to be able to set up our table
by 4 pm on 11/3/2020.
 
12. The plan for evaluation included the three evaluation methods listed below:
 By using the teach-back method, we will ask participants to name one location in which it
is necessary to wear a mask.
 We created a written one-item survey to evaluate our second learning objectives. We
planned to distribute the survey at the end of each interaction with participants. See
Appendix B for a copy of the survey.
 We created a six-step observer checklist to evaluate if participants properly remove
masks. See Appendix C for a copy of the checklist.
 
13. We collaborated with The Downtown Tucson Partnership. Two members from our group
each reached out to the Joel D. Valdez library manager multiple times, but did not receive a call
back. We also attempted to speak to the manager of Hotel Congress, but did not receive a call
back from her either. We were finally able to partner with The Downtown Tucson Partnership
with the help of our instructor.
 
14. Our health education project addressed the primary level of prevention, as mask wearing
targets a disease before its onset.  This addresses the subclinical stage in the natural history of
disease, which is where risk factors exist (Anderson & McFarlane, 2019, p. 38). This project
could also address the secondary level of prevention which targets an asymptomatic disease. The
secondary level of prevention addresses the stage of early subclinical disease in the natural
history of disease (Anderson & McFarlane, 2019, p. 38). Wearing a mask is to protect those who
are not sick from inhaling droplets from those with the virus, therefore preventing disease before
its onset. However, wearing a mask also prevents those who do have the virus and may be
COMMUNITY AS PARTNER REPORT CENSUS TRACT 1 5

asymptomatic from spreading their droplets to those who are not infected. This is why this
project could affect either the primary or secondary level of prevention.  
 
15. We required a number of resources for our health education project including a poster board
and educational information from the Center for Disease Control (CDC) and World Health
Organization (WHO). We were able to obtain all the resources required for this project.
Modifications were made for this project to be consistent with CDC guidelines for COVID-19,
including mask wearing, frequent hand washing, and social distancing (Center for Disease
Control and Prevention [CDC], 2020). The group members made sure to stay at least six feet
away from each other, performed frequent handwashing with hand sanitizer, and maintained
distance from each participant. We also posted signs around the table requesting participants to
maintain social distancing and we asked participants to wash their hands before touching the
table.

Implementation of Community Nursing Intervention

 
16. We held our teaching project on November 5, 2020, at 11am.
 We set up a table with our poster board, free masks, hand sanitizer, surveys and pens all
spread out on the table. We set up the table in the plaza of the Joel D. Valdez library
where there were a number of homeless people already in the area. For the most part,
people responded well and we had a few people both from the homeless community and
not from the homeless community interested in what we were doing. A few people
walking by on their lunch breaks stopped to ask us what we were doing and a few
homeless people approached the table to speak with us. 
 Seven people in total viewed our health education project, or spoke with us about what
we were doing. Only two people listened to our entire mask education and filled out a
survey, while the others either only asked us what we were doing then walked away, or
briefly came to the table, took a mask, and then walked away without completing the
survey. 
 We were able to maintain a good distance from each other and the people who
approached our table. Being in an outside location made it easy for social distancing to
occur. Most people who approached were respectful of social distancing and hand
washing before touching anything on our table. 
 A photo of our visual aid is located in Appendix D.
 
Evaluation of Community Nursing Intervention
 
17. Our survey results indicated that participants did not meet any of the 3 of our learning
objectives. For our first learning objective: at least 50% of participants will be able to state at
least one location in which it is necessary to wear a mask by 12:30 pm, the outcome was not met.
Of the 7 participants, one participant stated a location in which it would be necessary to wear a
mask. This is only 14% of participants. For our second learning objective: after viewing the
poster board, at least 50% of the audience will state that they plan to wear masks properly, the
outcome was not met. Of the 7 participants, only 2 participants reported they plan to wear a mask
properly. This is only 28% of participants. Of the two participants who took the survey, 100%
reported that they planned to wear a face mask. For our third learning objective: after
COMMUNITY AS PARTNER REPORT CENSUS TRACT 1 6

participating in the program, at least 100% of participants will demonstrate how to remove a face
mask correctly, this objective was not met. Of the 7 participants, 0 participants correctly
demonstrated the removal of a face mask. Limitations included small sample size and having too
many words on the poster board. The challenges we faced in the evaluation process was not
being able to interact with people due to COVID-19, therefore having to wait for participants to
approach us. Participants were not as willing to approach us as anticipated. 
  
Dissemination of Findings
 
18. We disseminated our findings by contacting the owner of Z Mansion in Downtown Tucson.
We are donating our masks and our poster board to be displayed. This is congruent with our
target population and overall goal of educating about proper mask usage. 
 
 
COMMUNITY AS PARTNER REPORT CENSUS TRACT 1 7

References

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

(8th ed.). Philadelphia, PA: Wolters Kluwer. 

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

(8th ed.). Philadelphia, PA: Wolters Kluwer. 

Centers for Disease Control and Prevention [CDC]. (2020).  Coronavirus 2019. Retrieved from

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html

City of Tucson. (2020). Tucson Parks and Recreation. Retrieved from

https://www.tucsonaz.gov/parks

City Protect. (2020). Incidents. Retrieved from

https://www.cityprotect.com/map/list/incidents/5f4057477226a00f147e9074?

toDate=2020-08-31T23:59:59.999Z&fromDate=2020-08-

01T00:00:00.000Z&pageSize=2000&parentIncidentTypeIds=149,150,148,8,97,104,165,

98,100,179,178,180,101,99,103,163,168,166,12,161,14,16,15&zoomLevel=17&latitude=

32.21926757976544&longitude=-

110.96640683784005&days=1,2,3,4,5,6,7&startHour=0&endHour=24&timezone=

%2B00:00&relativeDate=custom

Lyu, W. & Wehby, G. (2020). Community use of face masks and COVID-19: Evidence from a

natural experiment of state mandates in the US. Health Affairs. doi:

10.1377/hlthaff.2020.00818 

Melnyk, B.M. & Fineout-Overholt, E. (2011). Evidence-based practice in nursing and

healthcare, 2 Edition. Philadelphia: Lippincott Williams and Wilkins

nd
COMMUNITY AS PARTNER REPORT CENSUS TRACT 1 8

Office of Disease Prevention and Health Promotion. (2020a). Health care access and quality.

Retrieved from https://health.gov/healthypeople/objectives-and-data/browse-

objectives/health-care-access-and-quality

Office of Disease Prevention and Health Promotion. (2020b). Healthy people 2030 framework.

Retrieved from https://health.gov/healthypeople/about/healthy-people-2030-framework

Pima County Board of Supervisors. (2020). Face Mask Mandate. Retrieved from

https://webcms.pima.gov/cms/One.aspx?portalId=169&pageId=563362#:~:text=Face

%20Mask%20Mandate,over%20the%20age%20of%205.
COMMUNITY AS PARTNER REPORT CENSUS TRACT 1

Appendix A

 Priorities of Care Table

 
ti Identified in Community Nursing Availability Severity of Related Ideas for nursing Total
Pima expression students’ of resources outcome(s) community intervention score
County’s of interest in ability to relevant for without stressors (Use Minnesota
Health addressing address addressing effort to (SDOH and/or Wheel)
Needs problem2 problem problem address human ** The
Assessment1 problem behavior) interventions
listed below
are just
examples.
Students can
use any of the
interventions
from the
wheel.  

Inadequate 2 2 0 1 2  Lack of Referral: Refer 9 

health/social insurance, lack of individuals to
services medical offices, necessary health
lack of or social services
behavioral health or resources in
providers, lack of the community.
homeless shelters

Inadequate or 1 2 2 2 2 Absence of free Collaboration: 9

improper mask Collaborate with
mask distribution, the local library
wearing  observation of within the CT to
limited mask donate/hand out
wearing among masks and
COMMUNITY AS PARTNER REPORT CENSUS TRACT 1 10

homeless exchange
population information via a
poster board.

Food 1 2 2 1 2 Unemployment, Outreach: 8 

insecurity limited homeless Develop a
shelters in CT handout with
information such
as where to find
food distribution
services.  

Safety/Crime 1 2 0 0 2  Homeless people Surveillance: 5 

having a lack of Data collection
food and about crime
resources causing statistics that
them to commit occur downtown
crimes, untreated and examine the
mental illness types of crime
amongst the that commonly
homeless take place.
 

Substance 2 2 0 0 2 Limited detox Health teaching: 6 

abuse  centers and Create flyers or
halfway houses, brochures with
high rates of information
substance use in about the effects
CT substances can
  have, opioid
addiction, and
opioid overdose. 
Note. Score 1 point if consistent with report findings as a concern in Pima County. Score 2 points if 1 of Pima County’s 3 priority areas: Behavioral Health;
1

Obesity & Related Chronic Diseases; Access to Services.  From “Pima County Health Needs Assessment Snapshot”. Community Expression of Interest (second
2
COMMUNITY AS PARTNER REPORT CENSUS TRACT 1 11

column) is double weighted to emphasize its importance. Key: 0 = low, 1 = moderate, 2 = high. Adapted from “Community Health Diagnosis in Nursing” by M.
A. Muecke, 1984, Public Health Nursing, 1, p. 31; and “Community Assessment and Evaluation” by G.F. Shuster, 2010, in M. Stanhope and J. Lancaster (Eds.)
Foundations of Nursing in the Community, Community-Oriented Practice, 3 ed., p. 232. St. Louis: Mosby/Elsevier/Evolve.
rd
COMMUNITY AS PARTNER REPORT CENSUS TRACT 1

Appendix B

Post-Survey: How likely are you to properly wear a face covering in public places
or when social distancing is not possible? (Circle one)

              Not likely      Somewhat likely Very likely

COMMUNITY AS PARTNER REPORT CENSUS TRACT 1 13

Appendix C

Removal of a Mask: Steps Yes No

Unties strings behind one’s head or stretches the ear loops.

Only handles mask by touching ear loops or ties.

Folds outside corners together.

Places mask in trash bin or directly into washing machine if reusable.

Is careful not to touch eyes, nose and mouth when removing mask.

Wash hands with hand sanitizer or soap and water immediately after.

Appendix D
COMMUNITY AS PARTNER REPORT CENSUS TRACT 1 14