1) Nursing students were asked to complete a community assessment project to understand the social determinants of health in a given community. Previously, students conducted a "windshield survey" by driving through the community, which did not provide a deep understanding. 2) The author proposed enhancing the project by having students use camcorders to document their walks through the community. This allowed students to more fully observe how social factors like access to transportation and healthcare affected community health. 3) Student surveys found that using camcorders significantly improved their understanding of social determinants and how they influence health outcomes. Students planned to apply this knowledge to provide more culturally-competent, holistic nursing care.

1. Using Camcorders to Increase Awareness and Understanding of the Social Determinants of Health
Kelly Brittain PhD, RN
Background
NUR 470: Community Health and Population Nursing is the students’
first comprehensive view of caring for individuals in the context of the
community. Understanding the social determinants of health is
particularly important to nursing students. Social determinants of
health are conditions in the environments in which people are
born, live, learn, work, play, worship, and age that affect a wide
range of health, functioning, and quality-of-life outcomes and
risks. In the NUR 470 clinical sections, students work in small groups
to complete a community assessment/analysis project. The purpose
of the assignment is to demonstrate the ability to apply the nursing
process within a specific community (geography or population) in order
to assess its strengths, risk and health care needs using subjective
and objective data.
The Problem
Part of collecting subjective data, students conduct a “windshield”
survey. A windshield survey entails the students driving through the
community and making notes of what they see. However, driving
through a community does not lend itself to truly understanding the
strengths and opportunities of the community. Students do not
complete the project with an appreciation of the social determinants of
health and how to incorporate the community assessment experience
into their care of hospitalized patients.
The Opportunity
Enhancement of the Community Health Assessment project will more
fully develop the students’ views of the social determinants of health,
increase how they value the relationship between the social
determinants and health outcomes and further develop the students’
ability to provide culturally competent care.
Insights
Students have a basic understanding of camcorder use which is sufficient for this type
of project. Time was allotted for a tutorial on editing for those who have not edited
pictures into a video. However, more time on editing may be necessary for some
students.
Methods
Seven students, divided into two groups, worked together on the
community assessment.
The video and other data (Census, Center for Disease Control, Michigan
Department of Community Health, etc.) was edited, narrated and
formatted into a brief (10 minute) community assessment/analysis video
the students presented to their fellow Senior Nursing students at the end
of the Fall 2012 semester.
Tools & Measures
•Pre-assignment & post-assignment survey: Administered via
SurveyMonkey to assess the students ’ understanding of the social
determinants of health. Post survey asked the same question with the
addition of questions related to the use of the camcorder, the experience
and how the experience would effect their nursing practice.
•Samsung Digital Camcorders (n=9) were purchased at Best Buy.
•Shooting script: The “shooting script” of the social determinants of
health guided the students’ data collection and created consistency of the
subjective data collected.
Results: Social Determinants of Health
Next steps
Work with other faculty in NUR 470 to assess willingness to adopt this strategy as a
component of the “Community Health Assessment” project as well as present and
publish the results of this study.
How did the camcorder help you examine the social determinants of health in
your assigned community? (selected comments)
“I think it helped me to be more interested in making the video and recording an
accurate picture of our community--so, by trying harder and being more interested I
was paying more attention to my surroundings and the resources of the
community.”
“It helped to see what the community contained, the access to health care, and the
access to transportation within the community. I am able to look up information on
the Internet all day, but to get out in the community and actually observe it makes a
big difference, a difference for the better.”
“The requirement of taking pics/videos forced us to explore various aspects of the
community that may have been overlooked without completing the photo/video
scavenger hunt (shooting script).”
The students (N=7; average age: 22) ability to list social
determinants of health expanded from pre-assignment to post-
assignment.
Results: Use of the camcorder
100% of the students would recommend using cameras/camcorders as a way
to increase student awareness of the social determinants of health in
community/public health nursing.
Acknowledgements: This project was supported by the Lilly Teaching Fellowship Program (MSU Office of Faculty & Organizational Development) and the College of Nursing.
Thank you to: my project mentor, Darcy Greene, Associate Professor, College of Communication Arts & Sciences; Dean Mundt. Dr. B. Smith and Dr. B. Given for their support and to Deb DeZure and my Lilly cohort for their support during our amazing year.
Results: Nursing practice
How will you integrate your awareness of the social determinants of health
into your nursing practice?(selected comments)
“I will use what I have learned to be a resource for my patients as well as deliver
non-judgmental, holistic care.”
“I think this semester has made me more aware of the health disparities that exist
even within one community. I will think of this when I start working because it will
remind me to be non judgmental and understand that people do not always have
the same opportunity for health care or education.”
“I think I will definitely be more aware of health disparities in the community as well
as strengths and weakness through my observations and interactions with others in
the community.”
“In my nursing practice, I will be able to provide patients with resources that they
can utilize in their community to improve their health and reach their health potential
goals.
“I understand that it is important to understand the issue in a community in order to
make appropriate referrals and implement interventions that are tailored to the
individual/family.”
The photos above were taken by the students examples of a social
determinant of health. Combined, the students took over 300 photos and a
few hours worth of video.
Photos taken by the students
Post-Assignment Survey
Windshield approach Walking approach