PHN 652 When writing a community health needs assessment report, the public health nurse will need to include micro, meso, and macro levels of assessment

PHN 652 When writing a community health needs assessment report, the public health nurse will need to include micro, meso, and macro levels of assessment

PHN 652 When writing a community health needs assessment report, the public health nurse will need to include micro, meso, and macro levels of assessment

Micro levels assement refer to the level of an individual. As a public health nurse, we begin discussing decisions for assessment at the level of the member of the community. Meso level assessment refers to assessment a group such as a family. And the macro level assessment is the assessment on the level of the whole community, region or country.

According to Lacasse and Ganbrill (2015), assessment set down the groundwork for selecting plans and specify how likely the desired outcome can be achieved. The framework of assessment differs by scope, purpose, and the level to which they have been tested. It also differs from how the gathered data is compatible with regards to how behavior develops, changes, and how it helps the population being serve. It is necessary to include all the levels of assessment when conducting assessments on the community’s health needs because it provides essential information to understand the status of their health or phenomenon. It also provides critical information to identify resources required to address their health needs.

Reference

Lacasse, J.R., & Gambrill, E. (2015). Making assessment decisions: Macro, mezzo, and micro Perspectives (pp. 69-84). In B. Probst (Ed.)., Critical Thinking in Clinical Diagnosis and  Assessment. New York: Springer.

I agree with your thoughts on assessment and it is the ground work for selecting plans also how the desired outcome will be achieved, American Health Association Community Health Improvement Toolkit (ACHI) identified that public health professionals need to implement proper techniques to identify community needs. This statement I think is absolutely true, because without effective data collecting techniques the real health needs of the community will not be identified. One way of collecting effective data for identifying community health needs is by applying research principles to the community health assessment process (American Hospital Association, 2022). The American Hospital Association identifies that the Community based participatory research (CBPR) method can be applied to the Community Health Assessment process because its principles are aligned with the CHA process. For example, the CBPR principle of disseminating findings and knowledge gained to all partners from the research is related to the CHA process of CHA results being publicly available and widely distributed to participants, stakeholders, and the community at large (American Hospital Association, 2022).

Reference

American Hospital Association. (2022). Community Health Assessment Toolkit: Step 4 Collect and Analyze Data.

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The micro, meso, and macro levels of community health assessment refers to community assessment at the patient interaction level (micro level); the health care organization and community level (meso level), and the policy level (Macro levels) (World Health Organization [WHO], 2002) that each level of assessments is linked, interacts with each other, and drastically influences each other when the events of one level affect actions and events at the other level.

The necessity to include all levels of assessment is vital when writing a community health needs assessment is vital when writing a community health needs assessment report. According to WHO (2002), when all levels work effectively and successfully with each other, health care becomes efficient and patient’s experience better health. An example of how the different levels influence each other can be seen when patients respond to the health system or organization in which they receive care, and the health care system organization or communities responding to policies that in turn influence how care is provided for patients. Not including all three levels of assessment in a community health needs assessment report or having a dysfunction within and among the levels will create waste ineffectiveness in providing patient care (WHO, 2002).

References

World Health Organization, (2002). Chapter 2:Innovative Care for Chronic Conditions

I concur with you that the micro, meso, and macro levels of community health assessment are linked to each other in a community health assessment report. However, the levels of health needs assessment are different and important in providing elaborate health information. Micro level assessment focuses on the individual health needs whereas meso level targets on community level. Macro levels of health needs evaluation examines policies directed towards public health (Babchuk, 2019). Community health needs assessment reports play an important role in decision-making process. Therefore, conducting meso, micro and macro levels of health needs evaluation are important. All levels work effectively and successfully with each other, health care becomes efficient and patient’s experience better health (Abrams et al., 2020). Different healthcare stakeholders depend on community health needs report. Thus, having a detailed health assessment informs critical decision-making process on community health resilience. The breakdown of the assessment into three levels improves clarity in community health needs report.

References

Abrams, E. M., Simons, E., Roos, L., Hurst, K., & Protudjer, J. L. (2020). Qualitative analysis of perceived impacts on childhood food allergy on caregiver mental health and lifestyle. Annals of Allergy, Asthma & Immunology, 124(6), 594-599. https://doi.org/10.1016/j.anai.2020.02.016

Babchuk, W. A. (2019). Fundamentals of qualitative analysis in family medicine. Family medicine and community health, 7(2). doi: 10.1136/fmch-2018-000040

According to Saylordortorg.github.io (n.d) the micro level which are the smallest levels of interactions are examined and microlevel analyses might include one-on-one interactions between couples or friends. Meso level research is the study of how norms of workplace behavior vary across professions by studying the experiences of groups and interactions between groups, and at macro level sociologists examine social structures and institutions at the broadest level (Saylordortorg.github.io, n.d).

It is necessary to use all types of levels because it helps view an issue or topic from all aspects and angles depending on the level of inquiry.

Lacasse & Gambrill (2015) explain that social workers may have less control over the incentives and constraints that exist in mezzo and macro environments than they do at the micro level, they can nevertheless benefit from examining the mezzo and macro environments in which they practice and examine how their assessment and decision-making process is affected by these factors. This can be the same experience with the assessment report of a community health. The Mezzo and macro levels can have less control in some inducements and limitations.

In an article by Kapiriri, Norheim & Martin (2007) the macro level resource allocation decisions are influenced by politics, public pressure, and advocacy, at the meso-level, hospital priority-setting decisions were made by the hospital managers and were based on national priorities, guidelines, and evidence. Micro-level practitioners considered medical and social worth criteria.

References

Kapiriri L, Norheim OF, Martin DK. Priority setting at the micro-, meso- and macro-levels in Canada, Norway and Uganda. Health Policy. 2007 Jun;82(1):78-94. doi: 10.1016/j.healthpol.2006.09.001. Epub 2006 Oct 10. PMID: 17034898.

Lacasse, J. & Gambrill, E. (2015). Making Assessment Decisions: Macro, Mezzo, and Micro Perspectives. 10.1007?978-3-319-17774-8_4.

Saylordotorg.github.io (n.d) Micro, Meso, and Macro Approaches. Retrieved from https://saylordotorg.github.io/text_principles-of-sociological-inquiry-qualitative-and-quantitative-methods/s05-01-micro-meso-and-macro-approache.html#:~:text=At%20the%20micro%20level%2C%20sociologists%20examine%20the%20smallest,is%20influenced%20by%20his%20or%20her%20social%20context.

Micro, meso, and macro levels should be included in the public health assessment. Nurses in all settings and roles are key contributors to emerging disease prevention, response and management. Nurses in roles at micro-, macro, or meso- system levels bring important expertise, and perspectives to healthcare teams to plan, implement, and evaluate response to emerging disease outbreaks and epidemics (Edmonson et al., 2017). At the micro-level there is the level of patient care, the meso level deals with the healthcare organization and the macro deals with the health policy (Sawatzy et al., 2021). It is important to include all levels in the community health assessment report because they will help to meet and understand the needs of the community at certain levels. The lack of including the three levels will limit the complete understanding of the health needs affecting the population. Each level will contribute to changes in the needs of the community. There are multiple connections among the levels, reinforcing the need to consider these levels in order to understand and better manage the population issues.

References

Edmonson, C., McCarthy, C., Trent-Adams, S., McCain, C., Marshall, J., (January 31, 2017) “Emerging Global Health Issues: A Nurse’s Role” OJIN: The Online Journal of Issues in Nursing Vol. 22, No. 1, Manuscript 2.

Sawatzky, R., Kwon, J. Y., Barclay, R., Chauhan, C., Frank, L., van den Hout, W. B., Nielsen, L. K., Nolte, S., Sprangers, M., & Response Shift – in Sync Working Group (2021). Implications of response shift for micro-, meso-, and macro-level healthcare decision-making using results of patient-reported outcome measures. Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 30(12), 3343–3357. https://doi.org/10.1007/s11136-021-02766-9

Community needs assessment consists of three levels; micro, meso, and macro levels of assessment. The micro level involves assessing individuals at the point of patient care. Nurses assess the needs of community members by gathering data from individuals, families, and small groups of people such as patients or clinicians. This level of needs assessment is important because it is the smallest unit in a community that reflects the status quo (Sawatzky et al., 2021). The meso level involves the assessment of groups of people in organizations. For instance, public health nurses can interview healthcare managers, leaders of quality improvement, and administrative staff in different healthcare organizations. The macro level involves assessing an entire healthcare system, decision-makers, and government leaders. Decision makers use the information gathered at the macro level to inform policy making.

It is necessary to use all three assessment levels when writing a community health needs assessment report because they are interrelated. According to Gruber et al. (2019), the macro-level informs and is informed by impacts at the meso- and micro-levels. In addition, the meso level informs and is informed by impacts at the micro-level. It is also important to use all the levels because each level provides varying details. For instance, healthcare facilities’ findings vary from those at an individual level to an entire healthcare system in a specific community. At the implementation phase of community health needs assessment, the system level provides significant benefits. Therefore, failure to include the three levels in a community health needs assessment report results in an incomplete process and unreliable data.

References

Gruber, J. B., Wang, W., Quittner, A., Salyakina, D., & McCafferty-Fernandez, J. (2019). Utilizing Community Health Needs Assessments (CHNAs) in Nonprofit Hospitals to Guide Population-Centered Outcomes Research for Pediatric Patients: New Recommendations for CHNA Reporting. Population health management, 22(1), 25–31. https://doi.org/10.1089/pop.2018.0049

Sawatzky, R., Kwon, J. Y., Barclay, R., Chauhan, C., Frank, L., van den Hout, W. B., … & Sprangers, M. A. (2021). Implications of response shift for micro-,meso-, and macro-level healthcare decision-making using results of patient-reported outcome measures. Quality of Life Research, 30(12), 3343-3357. https://doi.org/10.1007/s11136-021-02766-9

A collaborative communitywide approach to community health needs assessment can increase the likelihood of well-targeted initiatives that address the needs of communities and improve the health of their residents. The level of assessment is micro, meso, and macro approaches and or decision-making they have different purposes when writing community health needs assessments, (Smith et al., 2019).

The micro-level assessment technique is one that involves direct interaction with the community members to air out individual problems. It involves helping people identify their health care and social needs. It is used to build stronger communities and provide a better quality of life for the people. this is patient-level care, (Smith et al., 2019).

The meso-level concerns local health service and community factors, such as attitudes and support from managers and patients. A detailed examination of a specific group, community, or organization, studies certain parts of society. Also referred to as network analysis, this approach examines the patterns of social ties among people in a group and how those patterns affect the overall group examination of society, looks at the broad systems, institutions, hierarchies, and patterns that shape a society, (Smith et al., 2019).

The macro-level considers the social, political, economic, and other forces that impact societies and individuals but might not capture important facets of social interactions that occur on the micro level. At the macro-level were legal, regulatory, and economic barriers and enablers, as well as job availability, (Smith et al., 2019).

Using all three according to Smith et al., (2019) “clearly define and standardize the scope of practice, preferably within a regulatory framework (macro-level); ensure continuing education and the development of support networks (meso- and macro-levels); appreciate the importance of negotiation with neighboring occupational groups (micro-level) and promote the extended role to increase awareness of other health professionals and the community (meso- and micro-level)”. The impact of not using all three levels of assessment in community health needs assessment report, a community is a system, not just the sum of the characteristics of its inhabitants. The community includes factors, people, place, and function, and understanding the many identities of the community is part of the community health assessment report, (Stanhope & Lancaster, 2019).

Reference

Smith, T., McNeil, K., Mitchell, R., Boyle, B., & Ries, N., (2019). A study of macro-, meso- and micro-barriers and enablers affecting extended scopes of practice: the case of rural nurse practitioners in Australia. BMC Nurs 18, 14. https://doi.org/10.1186/s12912-019-0337-z

Stanhope, M. & Lancaster, J. (2019). Public health nursing: Population-centered health care in the community (10th ed.).