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Community Health Nursing Key Informant Summarization

Eliza Baumeister, Baylee Bishopp, Matthew Boyd & Kaitlin Tennant

College of Nursing, University of Arizona

NURS 473: Population Health and Community Nursing

Professor Sandy Kirkpatrick

September 7th, 2022

Assessment of Community Languages

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Within the community, the language spoken most other than English is Spanish. Within

the census tract, 61.2% of homes speak Spanish (Census Reporter, 2020). In an interview with

the Mesa Fire Department crew at station 202, the fire station that serves our census tract, it was

reported that approximately 20% of calls are for patients that are only Spanish speaking (E.

Baumeister, personal communication, September 6, 2022). Two of the four firefighters on this

crew informed us that they both were Spanish speaking. However, they also reported that it was

not always helpful because many homes speak in different Spanish dialects. For example, some

individuals from South America may speak a different Spanish dialect than individuals from

Mexico. The firefighters reported that they do have a translator on call 24/7 for situations such as

this (B. Bishopp, personal communication, September 6, 2022). When interviewing a cashier at

Food City, M. Boyd was informed that many of the customers were Spanish speaking only

(personal communication, September 6, 2022). At one of the clinics we visited, K. Tennant and

E. Baumeister were both informed that approximately 80% of the patient population was Spanish

speaking only and that in order to work there the staff was required to be bilingual (personal

communication, September 6, 2022). While doing our windshield survey there were many signs

in Spanish within the community advertising food, stores, and clinics. This language barrier can

impact how people can understand and implement health information.

Health Literacy Based Assessment of the Community

Some ways to make sure the people within the community are getting the health

information they need is to first ask what language they speak/read or prefer to speak/read

(AHRQ, 2020). After assessing what kind of language interpretation they need, it is important to

give them written information with their preferred language and to potentially set them up with a

translator. It is important to assess what languages a community speaks so that people serving the
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community are well-informed of the language needs. It is a priority for healthcare workers to

have appropriate resources for the community based on the primary languages spoken in that

community. A great example of this is at the clinic location where we conducted our interview,

where it is required for staff to be bilingual. They did a proper assessment of their community

and prepared adequately. Before providing resources to the community it is important to use all

tools possible such as internet exploration and key informant interviews to obtain this

information. Another important component of written resources is to ensure that everything is

written at or below an eighth grade reading level; this is to ensure that even those with low

literacy are able to comprehend and understand the information being provided to them. After

implementing these resources into a community, it is important to evaluate the results of this

implementation. One way to do so is by monitoring the data by going into the community and

directly asking the patients their opinions on the written materials that they were provided with

(AHRQ, 2020).

Learning Objectives

Maricopa County has summers with average temperatures greater than 90 degrees

Fahrenheit for over 130 days per year (Iverson, 2020). Many of the residents in this geographical

location often succumb to heat related illnesses such as heat stroke, heat exhaustion and severe

dehydration. Our overall goal of this project is to inform the general public about the early onset

clinical manifestations related to heat illness that may otherwise go unnoticed, but will later

manifest as more life-threatening conditions as the condition worsens. As a team, we have

developed SMART (specific, measurable, achievable, realistic and timely) goals for this

community based on our health promotion topic.

SMART goal #1
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After posting our fliers containing heat illness information at local Metro Lightrail stops,

we will obtain regular updates from local 911 operators about the number of heat related calls

and there will be a negative trend in the percentage of heat related calls in the remainder of the

calls for the first 30 days after fliers being posted. The objective is to prevent heat illness from

occurring through education to the population that uses public transportation.

SMART goal #2

During our key informant interviews, a cashier at the Food City nearby had told us (K.

Tennant, personal communication, September 6, 2022) that there have been multiple occasions

of people stealing cases or bottles of water. Our goal is that we will see a decrease in the

incidence of water bottle theft from Food City within 30 days of the implementation of flyers

being posted at the Light Rail as reported by Food City security guards.

Evidence-Informed Exploration and Rationale

The public health promotion topic that we have chosen to research is community

education on heat illness including signs and symptoms, prevention and what steps to take if you

recognize that you may be experiencing heat illness. The specific audience that we want to reach

with this health promotion topic is the homeless population as well as the geriatric population of

Mesa, AZ. During our key informant interviews, Firefighters with the Mesa Fire Department at

station 202 expressed concern with the elderly population within our census tract (CT). They

stated that when the power goes out, older homes in this CT rapidly increase in temperature

resulting in heat illness, dehydration and sometimes death. Additionally, they stated that the light

rail on E Main St. often brings homeless individuals into this community. The firefighters stated

that they often run EMS calls to the light rail for complaints related to heat illness. Our interview

with a cashier at Food City, she stated that she often sees homeless individuals stealing water
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bottles during the hotter times of the year (E. Baumeister, personal communication, September 6,

2022).

Recognizing and preventing heat illness is a key component to reducing associated

mortality (Iverson, 2020). Evidence shows that of indoor heat-related deaths, the majority of

these deaths are occurring in patients over the age of 65 (Iverson, 2020). Although 99% of

residences in Maricopa County have air conditioning, many residents do not utilize them for a

variety of reasons including the overall cost to run the unit as well as malfunctioning or broken

units that are too costly to repair (Iverson, 2020). The homeless population in Maricopa County

are also at higher risk for developing heat related illnesses. Over 20% of heat related deaths that

occurred between 2006-2016 in Maricopa County were seen in the homeless population

(Iverson, 2020).

Recommendations

Based upon our findings and evidence regarding the census tract, it is apparent that a

common problem includes the prevalence of heat related illnesses. Heat related illness occurs

when the body is unable to regulate the temperature due to excessive heat exposure (Centers for

Disease Control and Prevention, 2022). This disparity can be minimized via promotion of

resources for shelter/water locations and educational handouts regarding heat related illness.

Within the Mesa community, Cooling Centers and Emergency Heat Relief Centers through the

Salvation Army exist as resources to mitigate the dangers of heat related illness (Heat Relief

Network, 2022). These centers exist to the West of this census tract, possibly making

transportation difficult. If transportation is an issue, the Arizona Transportation Hotline can be

reached at “2-1-1” and can assist with free rides to these locations if eligible (Transportation
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Hotline, 2022). These resources can be distributed on educational handouts alongside warning

signs, symptoms, prevention, and treatment regarding heat related illnesses.

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References

211 Arizona (2022). 2-1-1 Transportation Hotline. https://211arizona.org/crisis/heat-

relief/transportation/.

Agency for Healthcare Research and Quality (AHRQ). (2020). Health literacy universal

precautions toolkit: Address language differences: Tool #9 (2nd Ed.).

https://www.ahrq.gov/health-literacy/improve/precautions/tool9.html

Agency for Healthcare Research and Quality (AHRQ). (2020). Health literacy universal

precautions toolkit: Assess, select, and create easy-to-understand materials: Tool #11

(2nd Ed.). https://www.ahrq.gov/health-literacy/improve/precautions/tool11.html

Census Reporter (2020). DP02 selected social characteristics in the United States.

https://censusreporter.org/profiles/14000US04013421602-census-tract-421602-maricopa-

az/

Centers For Disease Control And Prevention (2022). Heat stress - Heat related illness. The

national institute for occupational safety and health.

https://www.cdc.gov/niosh/topics/heatstress/heatrelillness.html#:~:text=Heat%20stroke

%20is%20the%20most,within%2010%20to%2015%20minutes.

Heat Relief Network (2022). 2022 Heat Relief Network. https://hrn.azmag.gov/#/map?

lat=33.41704000000004&lng=-111.83145999999999

Iverson S. A., Gettel A., Bezold C.P, Goodin K., McKinney B., Sunenshine R., & Berisha V.

(2020). Heat-associated mortality in a hot climate. Public Health Reports (1974), 135(5),

631–639. https://doi.org/10.1177/0033354920938006
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