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Community Project for Census Tract 1132.01

Leah Clardy, Hannah Cusick, & Chloe Dinkle

University of Arizona

NURS 473

Professor Kirkpatrick

28 September 2022
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Community Project for Census Tract 1132.01

Community assessment results

Census tract 1132.01 is located within the Garfield Neighborhood of the downtown

Phoenix area. The zip code is 85006 and the north boundary is E Roosevelt St, the south

boundaries are E Van Buren St, the east boundaries is N 16th St, and the west boundary is N 12th

St. The census tract is quite small at 0.3 square miles and has a population of 2,281. The area has

some abandoned cars and vacant lots, but also evidence of renovations occurring. There are 3

large sections of murals and no evidence of other graffiti. The census tract is located near the

main street and so there is quite a bit of nose from ongoing traffic. There is not very much visual

privacy as most homes are located very tightly together and are only divided by small gates and

foliage.

Community strengths and stressors with supporting evidence

When conducting our windshield survey and speaking with key informants, we came

across quite a few strengths and stressors that are affecting this community. Through our

windshield, it was clear that the community does have access to public transportation with about

10 bus stops scattered throughout the census tract. They also have easy access to an elementary

school, Garfield Elementary, as it is located inside our census tract. The community also has

access to multiple religious places of worship and is located near the Maricopa county public

health clinic, although is not inside of the census tract. These are all of the strengths that we

easily identified within census tract 1132.01. Stressors however were pretty high in this

community. Through our windshield survey, we collected that they have low access to healthy

food stores. When speaking with key informants, they mentioned that there is a high homeless

population which brings in crime and also a very high amount of drug use in this area. Key
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informants at the Circle K who were cashiers confirmed this by talking about how most people

steal from them and you can find lots of used needles and syringes out in the community (Key

informants). When collecting data through the Census Tract Bureau, we found that there is a

significantly greater percentage of older homes in this community than the percentage in

Maricopa county. Another stressor that we identified in this community was that an extremely

high percentage of residents in this community speak English less than well. This is a stressor as

they may struggle with employment as they are unable to communicate effectively with the

greater community in Maricopa county.

Community health diagnoses

Census tract 1132.01 is at risk for bloodborne disease among the community in census

tract 1132.01 related to exposed needles as evidenced by “key informant” feedback. We selected

this diagnosis for the community after much deliberation about what the greatest health

complaints were when speaking to key informants. They all mentioned a problem with

homelessness and IV drug use. They also emphasized how you will find needles everywhere on

the ground. This stood out to us as a community health concern since that was the top complaint.

From there we refined this issue to think about why having exposed needles is a concern, and

that is how we settled on this diagnosis.

Community health goal

Our goal is to reduce the prevalence of exposed needles throughout the community by

50% over the next two years. Needlestick injuries from improperly disposed needles pose a risk

of infection from hepatitis B, HIV, or other bloodborne diseases to members of the community. It

has been shown that Syringe Services Programs (SSPs) are successful in decreasing how

frequently needles are shared among people who inject drugs (PWID), thus decreasing infection
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rates of HIV. Some examples of SSPs are pharmacies having sharps containers open to the

public, sharps disposal containers in community disposal sites, providing PWID with proper

portable sharps containers, and educating PWID about proper disposal techniques and infection

reduction practices (Levine et al, 2019).

Community interventions

Our interventions to reduce needlestick injury prevalence and infection rates of HIV and

hepatitis B were to increase the number of sharps containers placed within this community and to

plan a routine clean up crew quarterly to dispose of exposed needles that are not disposed of

properly. Having a team of volunteers appropriately dispose of needles and syringes will

decrease the likelihood of needlestick injury in the community. By increasing the number of

sharps containers placed within this community, more needles will be disposed of properly. This

will prevent needle stick injuries and decrease the risk of contracting a blood borne pathogen.

Healthy People (HP) 2020 support

Healthy People 2020 (HP2020) was put into place by the Office of Disease Prevention

and Health Promotion as a way to enhance the country’s health status by improving access to

healthcare, education, and research. Of their main overarching goals, the most applicable to our

community needs are “Attain high-quality, longer lives free of preventable disease, disability,

injury, and premature death” and “Create social and physical environments that promote good

health for all” (ODPHP, 2021). The most applicable topic area is immunization & infectious

disease. Under this topic area, the most applicable topic area goal was to increase immunization

rates and reduce preventable infectious diseases. The HP2020 objective that covers this

information is IID-25.2: Reduce new hepatitis B infections among high-risk populations

(ODPHP, 2021).
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Identify a current/active policy or legislation that relates to the goal.

Active legislation that relates to our goal, to reduce the prevalence of exposed needles

throughout the community by 50% over the next two years, is house bill 2389. This bill is a

health policy that was first passed in 2018 in the state of Arizona by Governor Doug Ducey. The

legislation was passed 2 years after Ducey announced a statewide health emergency due to the

rise of opioid overdoses in Arizona which resulted in death (Iness, 2018)). In the year 2019,

Arizona averaged two deaths per day from opioid overdoses. This legislation is very important as

allowing needle exchange sites help 4 different aspects of community health (Gibson, 2021).

First, the bill helps reduce the spread of viral hepatitis and other bloodborne diseases in the state

of Arizona. Second, the bill helps reduce needle stick injuries to law enforcement offices and

other emergency personnel. Next, it helps encourage those who are partaking in IV drug

administration to enroll in evidence-based treatment programs if needed. Lastly, it helps by

reducing the number of needles and other hypodermic syringes that are disposed of incorrectly in

public places (the State of Arizona, 2018).

Evaluation plan

In order to evaluate the effectiveness of interventions we implemented into the

community we will have to conduct a thorough windshield survey, along with interviewing key

informants within the community. Key informant interviews will give us an understanding of the

perspective the population has on the intervention in place (Savage, 2019). When interviewing

the key informants it is essential that we interview the correct people as well as ask the proper

questions. Individuals that should be interviewed regarding the implementation of sharp

containers and a quarterly clean up crew include: local law enforcement, fire department,

business owners/workers, recreation centers and schools. Necessary questions to ask the key
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informants are: if they are aware of the intervention in place within the community, if they are

witnessing any changes within the community, positive or negative due to the interventions, and

how we can improve our interventions in the future. Within six months of the intervention, we

hope to see a reduction of exposed needles and syringes in the community by 20%. At one year,

a 35% reduction and at 2 years a 50% reduction and a better idea of what additionally can be

done in the community to eliminate exposed needles and syringes.

Impact of the COVID 19 pandemic on the resources in your community and the

community itself.

COVID-19 has negatively impacted the whole world, especially those of vulnerable

populations. The businesses within our community struggled to stay open, serve the population

and stay healthy through it all. As the pandemic begins to come to an end, businesses are trying

to recuperate from their losses that the virus had on them. The cashier at Rito's Mexican Food

explained how COVID-19 had an impact on the restaurant's functionality in order for them to

stay open. During the pandemic, Rito’s did not shut down but instead they had to set up a stand

outside of their restaurant. They would take orders outside, run inside to tender the transaction,

make the food and then bring the order back out to the customer. The cashier explained that it

was difficult to keep up with the demand and being short staffed. She also mentioned that it was

draining, specifically during the summer months, when outside temperatures increased. Another

key information, a salesman at Boost Mobile, was not aware of any community impacts

COVID-19 had, but expressed that business was extremely slow. The rapid decline in consumer

traffic resulted in many individuals at that store being laid off. While speaking to the cashier at

Circle K, she mentioned that it was “business as usual”, but there were added safety measures in

order to keep customers and employees safe. They had to wear masks, gloves, place plexiglass
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barriers and had to routinely disinfect areas. She also discussed the struggles of being short

staffed since no one wanted to work anymore due to the uncertainty of getting ill.

Key informants expressed that issues regarding homelessness, mental health, drug abuse,

and food and job insecurity were already prevalent within the community. When COVID-19 hit

it exacerbated the issues and now the community is having a hard time recovering. The pandemic

caused an increase in the amount of individuals experiencing homelessness, a decline overall in

mental health, an increase in the prevalence of drug abuse, and an increase in the amount of

people experiencing job and food insecurity. There are not many resources available within the

community, thus individuals in need of essential services are forced to fend for themselves or

find ways to obtain resources outside of their community.

Dissemination

In order to make our primary intervention, increasing the number of sharps containers

placed within the community accessible to the population, we need to get in contact with the

Banner Family Pharmacy near our census tract. Pharmacies generally supply sharps containers

for free in order to help reduce the risk of injury and infections from sharps (Center for Devices

and Radiological Health, n.d.). After obtaining 10 sharps containers, we will secure the

containers at 10 different bus stops locations within our census tract. There will also need to be

signage located within the community to inform everyone of the container locations. Since the

bus stop attendant will be in charge of disposing and changing out the containers. It is imperative

that bus stop attendants are properly trained and equipped in emptying and disposing of the

sharps appropriately.

For our secondary intervention, carrying out a quarterly cleanup crew to dispose of any

exposed needles that are not disposed of properly, we will have to advertise for and recruit
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volunteers. The volunteers must be willing and able to go out into the community to clean for a

couple hours every 3 months. In order to advertise the need for volunteers, we are going to

partner with the Garfield community church and recreation center to help assist in the

recruitment process. Once volunteers are established, meeting times that work best with

everyone will be scheduled, volunteers will be briefed, and provided with sharps approved trash

bags and gloves. Individuals will walk around the community for approximately two hours,

cleaning up any needles and syringes that are found.

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References

Bureau, U. S. C. (2022). Census Tract Bureau. Explore census data. Retrieved September 27,

2022, from

https://data.census.gov/cedsci/table?g=0400000US04_0500000US04013_1400000US040

13113201&d=ACS+5-Year+Estimates+Data+Profiles&tid=ACSDP5Y2020.DP02

Center for Devices and Radiological Health. (n.d.). Sharps Disposal Containers. U.S. Food and

Drug Administration. Retrieved September 27, 2022, from

https://www.fda.gov/medical-devices/safely-using-sharps-needles-and-syringes-home-wo

rk-and-travel/sharps-disposal-containers

Gibson, E. (2021). AZPM. Arizona Public Media. Retrieved September 27, 2022, from

https://www.azpm.org/s/87081-arizona-legalized-clean-need-exchange-sites/

Offices of Disease Prevention and Health Promotion. (2021). Immunization and Infectious

Diseases. Retrieved September 27, 2022, from

https://wayback.archive-it.org/5774/20220414033335/https://www.healthypeople.gov/20

20/topics-objectives/topic/immunization-and-infectious-diseases/objectives

Innes, S. (2018, December 28). State bill could decriminalize Pima County's longstanding

Needle Exchange. Arizona Daily Star. Retrieved September 27, 2022, from

https://tucson.com/news/local/state-bill-could-decriminalize-pima-countys-longstanding-

needle-exchange/article_4a08748c-efc0-5869-ae98-2409e2578610.html

Levine, H., Bartholomew, T. S., Rea-Wilson, V., Onugha, J., Arriola, D. J., Cardenas, G., Forrest,

D. W., Kral, A. H., Metsch, L. R., Spencer, E., & Tookes, H. (2019). Syringe disposal

among people who inject drugs before and after the implementation of a syringe services
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program. Drug and alcohol dependence, 202, 13–17.

https://doi.org/10.1016/j.drugalcdep.2019.04.025

Savage, C. L. (2019). Public/ community health and nursing practice: Caring for populations

(2nd ed). F.A. Davis Company.

State of Arizona. (2018). HB 2389. HB2389 - 532R - H ver. Retrieved September 27, 2022, from

https://www.azleg.gov/legtext/53leg/2R/bills/HB2389H.htm