Functional Health Patterns Community Assessment Guide Functional Health Pattern (FHP) Template Directions: This FHP template is to be used for organizing community assessment data in preparation for completion of the topic assignment. Address every bulleted statement in each section with data or rationale for deferral. You may also add additional bullet points if applicable to your community. Value/Belief Pattern · Predominant ethnic and cultural groups along with beliefs related to health. · Predominant spiritual beliefs in the community that may influence health. · Availability of spiritual resources within or near the community (churches/chapels, synagogues, chaplains, Bible studies, sacraments, self-help groups, support groups, etc.). · Do the community members value health promotion measures? What is the evidence that they do or do not (e.g., involvement in education, fundraising events, etc.)? · What does the community value? How is this evident? · On what do the community members spend their money? Are funds adequate? Health Perception/Management · Predominant health problems: Compare at least one health problem to a credible statistic (CDC, county, or state). · Immunization rates (age appropriate). · Appropriate death rates and causes, if applicable. · Prevention programs (dental, fire, fitness, safety, etc.): Does the community think these are sufficient? · Available health professionals, health resources within the community, and usage. · Common referrals to outside agencies. Nutrition/Metabolic · Indicators of nutrient deficiencies. · Obesity rates or percentages: Compare to CDC statistics. · Affordability of food/available discounts or food programs and usage (e.g., WIC, food boxes, soup kitchens, meals-on-wheels, food stamps, senior discounts, employee discounts, etc.). · Availability of water (e.g., number and quality of drinking fountains). · Fast food and junk food accessibility (vending machines). · Evidence of healthy food consumption or unhealthy food consumption (trash, long lines, observations, etc.). · Provisions for special diets, if applicable. · For schools (in addition to above): · Nutritional content of food in cafeteria and vending machines: Compare to ARS 15-242/The Arizona Nutrition Standards (or other state standards based on residence) · Amount of free or reduced lunch Elimination (Environmental Health Concerns) · Common air contaminants’ impact on the community. · Noise. · Waste disposal. · Pest control: Is the community notified of pesticides usage? · Hygiene practices (laundry services, hand washing, etc.). · Bathrooms: Number of bathrooms; inspect for cleanliness, supplies, if possible. · Universal precaution practices of health providers, teachers, members (if applicable). · Temperature controls (e.g., within buildings, outside shade structures). · Safety (committee, security guards, crossing guards, badges, locked campuses). Activity/Exercise · Community fitness programs (g ...

1. Functional Health Patterns Community Assessment Guide
Functional Health Pattern (FHP) Template Directions:
This FHP template is to be used for organizing community
assessment data in preparation for completion of the topic
assignment. Address every bulleted statement in each section
with data or rationale for deferral. You may also add additional
bullet points if applicable to your community.
Value/Belief Pattern
· Predominant ethnic and cultural groups along with beliefs
related to health.
· Predominant spiritual beliefs in the community that may
influence health.
· Availability of spiritual resources within or near the
community (churches/chapels, synagogues, chaplains, Bible
studies, sacraments, self-help groups, support groups, etc.).
· Do the community members value health promotion measures?
What is the evidence that they do or do not (e.g., involvement in
education, fundraising events, etc.)?
· What does the community value? How is this evident?
· On what do the community members spend their money? Are
funds adequate?
Health Perception/Management
· Predominant health problems: Compare at least one health
problem to a credible statistic (CDC, county, or state).

2. · Immunization rates (age appropriate).
· Appropriate death rates and causes, if applicable.
· Prevention programs (dental, fire, fitness, safety, etc.): Does
the community think these are sufficient?
· Available health professionals, health resources within the
community, and usage.
· Common referrals to outside agencies.
Nutrition/Metabolic
· Indicators of nutrient deficiencies.
· Obesity rates or percentages: Compare to CDC statistics.
· Affordability of food/available discounts or food programs
and usage (e.g., WIC, food boxes, soup kitchens, meals-on-
wheels, food stamps, senior discounts, employee discounts,
etc.).
· Availability of water (e.g., number and quality of drinking
fountains).
· Fast food and junk food accessibility (vending machines).
· Evidence of healthy food consumption or unhealthy food
consumption (trash, long lines, observations, etc.).
· Provisions for special diets, if applicable.
· For schools (in addition to above):
· Nutritional content of food in cafeteria and vending machines:
Compare to ARS 15-242/The Arizona Nutrition Standards (or
other state standards based on residence)
· Amount of free or reduced lunch
Elimination (Environmental Health Concerns)
· Common air contaminants’ impact on the community.

3. · Noise.
· Waste disposal.
· Pest control: Is the community notified of pesticides usage?
· Hygiene practices (laundry services, hand washing, etc.).
· Bathrooms: Number of bathrooms; inspect for cleanliness,
supplies, if possible.
· Universal precaution practices of health providers, teachers,
members (if applicable).
· Temperature controls (e.g., within buildings, outside shade
structures).
· Safety (committee, security guards, crossing guards, badges,
locked campuses).
Activity/Exercise
· Community fitness programs (gym discounts, P.E., recess,
sports, access to YMCA, etc.).
· Recreational facilities and usage (gym, playgrounds, bike
paths, hiking trails, courts, pools, etc.).
· Safety programs (rules and regulations, safety training,
incentives, athletic trainers, etc.).
· Injury statistics or most common injuries.
· Evidence of sedentary leisure activities (amount of time
watching TV, videos, and computer).
· Means of transportation.
Sleep/Rest
· Sleep routines/hours of your community: Compare with sleep
hour standards (from National Institutes of Health [NIH]).
· Indicators of general “restedness” and energy levels.
· Factors affecting sleep:
· Shift work prevalence of community members

4. · Environment (noise, lights, crowding, etc.)
· Consumption of caffeine, nicotine, alcohol, and drugs
· Homework/Extracurricular activities
· Health issues
Cognitive/Perceptual
· Primary language: Is this a communication barrier?
· Educational levels: For geopolitical communities, use
http://www.census.gov and compare the city in which your
community belongs with the national statistics.
· Opportunities/Programs:
· Educational offerings (in-services, continuing education,
GED, etc.)
· Educational mandates (yearly in-services, continuing
education, English learners, etc.)
· Special education programs (e.g., learning disabled,
emotionally disabled, physically disabled, and gifted)
· Library or computer/Internet resources and usage.
· Funding resources (tuition reimbursement, scholarships, etc.).
Self-Perception/Self-Concept
· Age levels.

5. · Programs and activities related to community building
(strengthening the community).
· Community history.
· Pride indicators: Self-esteem or caring behaviors.
· Published description (pamphlets, Web sites, etc.).
Role/Relationship
· Interaction of community members (e.g., friendliness,
openness, bullying, prejudices, etc.).
· Vulnerable populations:
· Why are they vulnerable?
· How does this impact health?
· Power groups (church council, student council, administration,
PTA, and gangs):
· How do they hold power?
· Positive or negative influence on community?
· Harassment policies/discrimination policies.
· Relationship with broader community:
· Police
· Fire/EMS (response time)
· Other (food drives, blood drives, missions, etc.)
Sexuality/Reproductive
· Relationships and behavior among community members.
· Educational offerings/programs (e.g., growth and
development, STD/AIDS education, contraception, abstinence,
etc.).
· Access to birth control.

6. · Birth rates, abortions, and miscarriages (if applicable).
· Access to maternal child health programs and services (crisis
pregnancy center, support groups, prenatal care, maternity
leave, etc.).
Coping/Stress
· Delinquency/violence issues.
· Crime issues/indicators.
· Poverty issues/indicators.
· CPS or APS abuse referrals: Compare with previous years.
· Drug abuse rates, alcohol use, and abuse: Compare with
previous years.
· Stressors.
· Stress management resources (e.g., hotlines, support groups,
etc.).
· Prevalent mental health issues/concerns:
· How does the community deal with mental health issues
· Mental health professionals within community and usage
· Disaster planning:
· Past disasters
· Drills (what, how often)
· Planning committee (members, roles)
· Policies
· Crisis intervention plan

7. PAGE
© 2011. Grand Canyon University. All Rights Reserved.
Community Teaching Work Plan Proposal
Planning and Topic
Directions: Develop an educational series proposal for your
community using one of the following four topics:
· Bioterrorism/Disaster
· Environmental Issues
· Primary Prevention/Health Promotion
· Secondary Prevention/Screenings for a Vulnerable Population
Planning Before Teaching:
Name and Credentials of Teacher:
Estimated Time Teaching Will Last:
Location of Teaching:
Supplies, Material, Equipment Needed:
Estimated Cost:
Community and Target Aggregate:
Topic:
Identification of Focus for Community Teaching (Topic
Selection):
Epidemiological Rationale for Topic (Statistics Related to
Topic):
Teaching Plan Criteria
Your teaching plan will be graded based on its effectiveness and

8. relevance to the population selected. This assignment uses a
rubric. Please review the rubric prior to beginning the
assignment to become familiar with the expectations for
successful completion.
Nursing Diagnosis:
Readiness for Learning: Identify the factors that would indicate
the readiness to learn for the target aggregate. Include
emotional and experiential readiness to learn.
Learning Theory to Be Utilized: Explain how the theory will be
applied.
Goal: Healthy People 2020 (HP2020) objective(s) utilized as the
goal for the teaching. Include the appropriate objective number
and rationale for using the selected HP2020 objective (use at
least one objective from one of the 24 focus areas). If an
HP2020 objective does not support your teaching, explain how
your teaching applies to one of the two overarching HP2020
goals.

9. How Does This HP2020 Objective Relate to Alma Ata’s Health
for All Global Initiatives
Develop Behavioral Objectives (Including Domains), Content,
and Strategies/Methods:
Behavioral Objective
and Domain
Example – Third-grade students will name one healthy food
choice in each of the five food groups by the end of the
presentation. (Cognitive Domain)
Content
(be specific)
Example – The Food Pyramid has five food groups which are….
Healthy foods from each group are….
Unhealthy foods containing a lot of sugar or fat are….
Strategies/Methods
(label and describe)
Example – Interactive poster presentation of the Food Pyramid.
After an explanation of the poster and each food category, allow
students to place pictures of foods on the correct spot on the
pyramid. Also, have the class analyze what a child had for lunch
by putting names of foods on the poster and discussing what
food group still needs to be eaten throughout day.
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Creativity: How was creativity applied in the teaching
methods/strategies?
Planned Evaluation of Objectives (Outcome Evaluation):
Describe what you will measure for each objective and how.
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· Planned Evaluation of Goal: Describe how and when you
could evaluate the overall effectiveness of your teaching plan.
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· Planned Evaluation of Lesson and Teacher (Process
Evaluation):
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· Barriers: What are potential barriers that may arise during
teaching and how will those be handled?
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· Therapeutic Communication
4.2 Communicate therapeutically with patients.
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· How will you begin your presentation and capture the interest
of your audience? Describe the type of activity will you use
with your audience to exhibit active listening? Describe how
you applied active listening in tailoring your presentation to
your audience? How will you conclude your presentation? What
nonverbal communication techniques will you employ?