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- 1. Roberta, GA Community Assessment Autumn Lucas, RN, Carolee Shackelford, RN, Aaron McDaniel, RN
- 2. Roberta - CrawfordCounty
- 3. Community Introduction ✦ Roberta is a small town located west of Macon, Georgia in Crawford County ✦ Rural, as evidenced by < 99 persons/square mile and fewer than 20,000 residents (Stanhope & Lancaster, 2010) ✦ Incorporated on December 8th, 1822
- 4. Population Introduction ✦ Close-knit community ✦ Self-sufficient in nature, as evidenced by neighbors helping neighbors during storm, such as after tornado damage in 2007 per resident recollections and interview with Randall(Guido) Pate, Fire Chief
- 6. The People: Demographics ✦ 12,511 residents ✦ Median age 39 years old ✦ Total population < 18 years old: 18% ✦ Total population > 65 years old: 13% ✦ Population between age 18 and 65: 64% ✦ http://factfinder.census.gov/servlet/ACSSAFFFacts? geo_id=05000US13079&_state=04000US13&pctxt=cr
- 7. Demographics: Race ✦ White Non-Hispanic (72.3%) ✦ Black (23.8%) ✦ Hispanic (2.4%) ✦ Other race (1.8%) ✦ Two or more races (1.0%) ✦ American Indian (0.9%) ✦ http://www.city-data.com/county/Crawford_County-GA.html
- 8. Vital Statistics ✦ Births: 10.6 per 1000 ✦ Deaths: 8.4 per 1000 ✦ Infant Deaths: 8.7 per 1000 live births ✦ Data range: 2000-2006 ✦ http://www.city-data.com/county/Crawford_County-GA.html
- 9. Morbidity & Mortality ✦ Over period of one year, 1 murder reported ✦ Adult diabetes rate: 11.7% (GA: 10.4%) ✦ Adult obesity rate: 30.1% (GA: 27.8%) ✦ Children obesity rate: 13.1% (GA 14.6%) ✦ Top causes of death in rural Georgia, Roberta included: cardiovascular disease, obesity, diabetes, cancer ✦ http://www.city-data.com/county/Crawford_County-GA.html
- 10. Physical Environment ✦ Rural, large amount of wooded areas/farmland ✦ Geographic Isolation ✦ Population: 12,511 in 2009 ✦ Geographic Size of Crawford County: 325 square miles ✦ Roberta is the only city in the county ✦ http://crawfordcountyga.org
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- 12. Health Services ✦ MD Offices in central Roberta: Dr. Balcos and Dr. Gaton ✦ Crawford County Health Department ✦ Dental: Dentures Center only, no acute/preventative care or dental offices within community ✦ Optometrist: None within Crawford County, all eye care done outside of community ✦ No Urgent/Emergency Care, only MGA post ✦ 1 pharmacy in Roberta, only open on week days during daytime business hours ✦ 1 nursing home with 100 beds (Roberta Nursing Home)
- 13. Hospital Distances ✦ Peach Regional Medical Center - Ft Valley 14.5 miles ✦ Upson Regional Medical Center- Thomaston 26.5 mile ✦ Coliseum Medical Center - Macon 28.4 miles ✦ Medical Center of Central Georgia - Macon 29.4 miles ✦ Coliseum Northside Hospital - Macon 29.6 miles ✦ Monroe County Hospital - Forsyth 32.1 miles ✦ Houston Medical Center - Warner Robins 39.9 miles
- 14. EMS Presence ✦ Only community source of urgent care ✦ 2 ambulance stations, only 1 manned by EMS ✦ Middle Georgia Ambulance post located centrally in Roberta, residents can come in for screening if ambulance is present out front ✦ If one ambulance on call, one will be routed
- 17. Social Services ✦ Crawford County Senior Center ✦ Department of Family and Children Services ✦ School Board ✦ Meals on Wheels (via Senior Center) ✦ WIC Nutrition/Food Stamps Services ✦ Georgia Department of Labor (workforce)
- 18. Senior Center =Social Cornerstone
- 20. Communications ✦ Public Service Telephone Company ✦ Flint Cable ✦ Adequate cell towers and public/private antennae presence (per FCC) ✦ Ample TV and Radio (AM/FM) reception ✦ http://www.city-data.com/county/Crawford_County-GA.html
- 21. $ Economics $ ✦ 2 banks within Roberta city limits ✦ 10 vendors that serve prepared hot meals ✦ 1 grocery store ✦ 4 outlying “country stores” ✦ 2 retail stores (Family Dollar/Dollar General)
- 22. Individual Economics ✦ Crawford County Median Income: $42,447 ✦ Georgia Median Income: $ 47,589 ✦ Estimated Housing Costs: Rent $370 in Roberta area vs. $637 for Georgia overall ✦ Median house price: $146,061(Roberta) vs. $224,856 (GA) ✦ http://www.city-data.com/county/Crawford_County-GA.html
- 23. Median Incomes ✦ Less than high school degree: $23,365 ✦ High school/GED: $30,655 ✦ Some College: $34,905 ✦ Bachelor Degree: $41,444 ✦ Graduate: $67,969
- 24. Education ✦ 1 public elementary school ✦ 1 public middle school ✦ 1 public high school ✦ Satellite campus of Central Georgia Technical College ✦ 2000 students total ✦ School superintendent and 5 board members
- 25. Educational Attainment ✦ Age 18-24: 40% less than high school degree, 26% high school graduates, 31% some college, 2% bachelors degree ✦ Age 25-34: 82% high school graduates, 18% bachelors degree ✦ Age 35-44: 85% high school graduates, 7% bachelors degree ✦ Age 45-64: 76% high school graduates, 11% bachelors degree ✦ Age 65 and over: 61% high school graduates, 11% bachelors degrees
- 26. Safety Volunteer FireDept. *40 members *CPR/First Responders *6 stations *Paid Fire Chief
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- 28. Safety/Police ✦ 1 sheriff ✦ 1 captain ✦ 2 lieutenants ✦ 8 deputies ✦ 1 jail, next to courthouse in central Roberta ✦ http://crawfordcountyga.org
- 29. Sanitation ✦ City water and sewage system in city ✦ Septic/wells outside Roberta city limits ✦ Curbside garbage pickup throughout Crawford County ✦ No curbside public recycling centers ✦ No radon/air pollution due to lack of industry
- 30. Transportation ✦ Personal: vehicle (84%), carpools, 8 registered personal aircraft, no city bus, little bicycling ✦ Taxi: Lizella Safety Cab (13.4 miles away) ✦ Public: Southeast Transportation, Medicaid Transport Van, school buses for children, carpool van for Senior Center ✦ Greyhound Bus Station: Macon (30.6 miles)
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- 32. Politics and Government ✦ Roberta City Government: Annual budget $600,000 (includes waste management, water department, city office, street maintenance) ✦ Mayor and 5 member city council ✦ Crawford Co. Government: 5 member county commission, water departments, building permits, probation court
- 33. Elections/Voting Trends ✦ 2004 Presidential Elections ✦ 65% Republican ✦ 35% Democrat ✦ 2008 Presidential Elections ✦ 65% Republican ✦ 35% Democrat ✦ http://www.city-data.com/county/Crawford_County-GA.html
- 34. Religion ✦ Church facilities serve as disaster relief shelters (per fire chief) ✦ Churches are community centers with outreach programs, food banks, and social activities ✦ 49 churches listed in Crawford County ✦ 63% southern baptist, 32% methodist, 5% other
- 35. Recreation ✦ Crawford Co. Parks and Recreation Dept. ✦ Public Parks (tennis courts, baseball fields) ✦ Public School sports programs ✦ Boys and Girls Club ✦ Lake Tobesofkee (14 miles away), Macon activities (26 mi. away), Warner Robins (30 mi. away), Fort Valley (15 mi. away)
- 36. Population Strengths ✦ Residents know one another, close-knit ✦ Community and government resources all centrally located within one area ✦ Neighbors are likely to help each other in times of need, little outside intervention needed ✦ Vibrant community spirit, small-town pride ✦ Independent citizenry
- 37. Population Weaknesses ✦ Only source of urgent care is EMS ✦ Lacking in satellite resources ✦ Geographic isolation from hospitals, specialists ✦ Grandparents raising grandchildren(292) ✦ Poverty (20.1% is double US rate of 9.9%)
- 38. Top Health Risks ✦ Diabetes (11.7% vs 10.4% in GA) ✦ Obesity (30.1% vs. 27.8% in GA) ✦ Cardiovascular Disease (leading cause) ✦ Lack of urgent care and increased distance to acute care = higher risk of poor outcomes with accident/ injury/illness ✦ Lack of health insurance coverage (16%) ✦ http://emergency.cdc.gov/snaps/data/13/13079.htm
- 40. Evidence of Intervention ✦ Education project targeting the functional elderly residents of Roberta, GA ✦ Topic: Basic Nutrition Improvements for a Better Life Now and a Longer Life Later ✦ Objectives: choosing fresh foods over processed foods, healthy seasoning of foods, lowering intake of daily sodium, making personal connection between food intake and physical health ✦ Materials: magnetic modified food pyramid, handouts, survey, posters
- 41. Crawford Co. SeniorCenter
- 42. Educational Approach/ Implementation ✦ Cognitive/Affective foundation in objectives and goals ✦ Health Promotion Model ✦ Positive education with emphasis on making healthy modifications to diet on a daily basis rather than abandoning all current preferences ✦ Educational method appropriate for age group by offering key components of positivism and personal health education (Boulton-Lewis, 2010, p. 218-219)
- 43. Supporting Data ✦ Nutritional priority need identified during interview with Pat Jenkins, coordinator of senior center, on 2/23/2011. ✦ Current studies depict that rural elderly populations are vulnerable to nutrition-related health concerns, obesity, and poor eating habits, with health outcomes worsened by low- economic status (Beebout, 2006, p. 58)
- 45. Project Evaluation ✦ Direct feedback from the participants by verbal engagement during lecture ✦ Seniors prompted to choose healthy food when presented with multiple options ✦ Administration of health belief survey ✦ Networking and informal one-on-one conversation r/t individual needs/beliefs
- 46. Evaluation Continued ✦ Data collection for project by direct interviews with local residents and community officials, windshield survey, observation, grocery store tour, and professional literature search ✦ Positive feedback from participants and nurse educator course leader’s evaluation ✦ Goal met by verbal commitments to personal health from participants
- 47. Lessons Learned ✦ Setting (senior center) was appropriate and convenient for participants, but noise level was high due to staff in facility kitchen ✦ Some verbal dominance by one listener, but speaker able to incorporate comments into group learning opportunity ✦ More active engagement from audience needed (less lecture, more Q&A, diversity)
- 48. Community Recommendations ✦ More urgent care presence (no resources after hours except 1 EMS station) ✦ Need for affordable and reliable public transportation ✦ Increased awareness and access to GA public assistance for grandparents raising grandchildren ✦ Personnel to staff more than one EMS station ✦ Public safety to inspect personal care homes ✦ Community-wide public recycling initiative
- 49. References ✦ Beebout, H. S. (2006). Nutrition, Food Security, and Obesity. Gender Issues, 23 (3), 54-64. ✦ http://www.city-data.com/county/Crawford_County-GA.html ✦ http://factfinder.census.gov/servlet/ACSSAFFFacts? geo_id=05000US13079&_state=04000US13&pctxt=cr ✦ http://crawfordcountyga.org ✦ http://emergency.cdc.gov/snaps/data/13/13079.htm ✦ Stanhope, M. & Lancaster, J. (2010). Foundations of nursing in the community (3rd ed.). St. Louis: Mosby.