1

Community As Partner Project: Addressing the Risk of Untreated Substance Abuse

Disorder in CT12(00) By Educating Local ED Nurses in Free Transportation to a Local

Addiction Treatment Center

Maricruz Chavez-Tinoco, Erika Deianni, Sarah Medeiros, Kiana Wentzel

College of Nursing, University of Arizona

NURS 473: Population Health and Community Nursing

Professor McGuckin

November 14, 2022

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Abstract

The Community As Partner project included an assessment of Census Tract (CT) 1200, in

partnership with the Pima County Health Department. Objective data was collected and

established resources were reviewed within the CT utilizing informatics public data, maps and a

windshield survey. Ten key informant interviews associated with varying subsystems were

conducted to complete the community survey. Community immersion involved taking city bus

routes from the CT to the Community Organization for Drug Abuse Control (CODAC). The

group simulated a first hand encounter with barriers and hardships of a community member

living with substance abuse disorder and homelessness. Systemic factors and social determinants

of health that impact the life of residents within the CT supported the completion of a root causes

map. The Pima County Community Assessment 2021 and the perspectives from the community

immersion experience were used to identify the strengths and stressors of the CT and key

priorities were identified to complete the Data Analysis and Community Resource Tool. After

attendance of a board supervisor meeting, the policy development tool was completed and a

letter to Governor Ducey was drafted to advocate for deflection mandates statewide to address

the drug abuse epidemic prevalent within the CT. An identified need by community survey with

key informant interviews and CODAC request included greater referrals from ED units in

Tucson to achieve transition from overdose to treatment. The Health Education Project Planning

tool was completed to incorporate this need through a plan to educate ED nurses about services

and transportation resources at CODAC for at St. Mary’s Hospital, adjacent to CT 1200, while

the The Health Education Project Evaluation Tool enabled review and assessment of the

education project. A photograph is included of the resources available to patients from CODAC

on the staff lounge board.

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CT 1200 Community Survey

Pima County
Pima County Health
Closest PCHD Census Tract
Department–North Office CT 12
office name and #
3550 North 1st Ave. Tucson, Zip Codes: 85745, 85705
address and Zip
AZ 85719
Code(s)
Dates of
Assigned PHN Debbie Agriesto, RN PHN windshield 08/30/22
survey
PHYSICAL ENVIRONMENT
CT boundaries
North West Grant Rd. East North 15th Ave.
South West Speedway Blvd. Wes North Silverbell Rd.
t
Housing (Units and Occupancy) Environment
Count Units in County Approx. #
CT CT Approx. #
y* %
Structure * % Make comments
Make comments below
% (Census)* % below

Vacant/ 10
Occupie
89% 95% Single unit 67% 62% boarded up 0 Vacant lots?
d units
structures?
Ownersh 5 0
du
ip of Trash/ m Abandoned
64% 45% Multi-unit 22% 32%
Occupie rubble? ps cars?
ter
d units s
Median 5 art pieces
value of
$199, $97,5 New
owner- Mobile home 10% 6% N/A Graffiti?
400 00 construction?
occupied
unit ($)
Boat, RV, CT Size (sq. People per 2,467.3
0% 0% 1.6
Van miles) sq. mile
Census Reporter. (2022). Profile for Census Tract12 Pima, AZ.
* County= Pima County
https://censusreporter.org/profiles/14000US04019001200-census-
tract-12-pima-az/
Comments from
above and ● When driving in Riverview blvd and neighborhoods a few minutes south
additional ○ There were many piles of trash on the curbs and in front yards. (Trash
comments (e.g., included couches, furniture, old house appliances, etc).
noise, smells, ○ An abundance of “beware of dog” signs. Many dogs living in the backyard,
privacy, light, we are not sure if two dogs in a specific residence had water.
 4
gardens, trees, ○ Many houses had plants.
plants vs. ○ No notable foul smells.
concrete, group ○ Low level of noise.
homes/student
housing major
community
assets.
COMMUNITY CORE
Demographic U.S. Census data (%)
Total population of Pima
1,047,279 Total Population of CT 3,882
County
Age
Count
Count CT groups CT Languages County CT
Race & Ethnicity y
y% % (years) % spoken at home % %N
%
*
White (non- 17 English only
51% 0-9 11% 11% 74% 50%
Hispanic) % (5-17)
African
English only
American or 3% 4% 10-19 13% 17% 72% 38%
(18+)
Black
Native 2% 7% 60-69 13% 8%
Spanish (5-17) 22% 48%
70+ Spanish (18+) 22% 55%
Asian 3% 2% 9% 6%
(add)
Hispanic (of any 67 Median Foreign Born
38% 38.7 29.4 12.5% 24.4%
race) % Age (total %)
Include source of
data: Census Census Reporter. (2022). Profile for Census Tract12 Pima, AZ.
document title https://censusreporter.org/profiles/14000US04019001200-census-tract-12-pima-az/
and data year(s).
Culture and Ethnicity
Ethnic food El Rio Carniceria
stores
Ethnic Maru Japanese Noodle Shop
restaurants
No signs in other languages in Joaquin Murrieta Park.
There were signs that included Spanish writing at the Tully Charter School.
Signage in other There were no signs that had Spanish at the El Rio center, but their murals did include
languages Spanish.
There were also signs that were written in Spanish at the Boys and Girls Club.
There were no signs that had Spanish writing at the local grocery store, Albertsons.
Places of worship Adventista Septimo Dia (Protestant Christian)
(formal name, ● 1702 N Mohave Ave, Tucson, AZ 85745
address, Trinity Hope Church of Christ (Christian)
denomination, ● 1218 N Riverview Blvd, Tucson, AZ 85745
and community Trinity Missionary Baptist Church (Baptist)
services) ● 1402 N El Rio Dr, Tucson, AZ 85745
https://www.tmb-church.org/?
fbclid=IwAR0ZIOpcXBUuHtDYC_8Cl6GrfqmrWt3iaCokeHZgZomFHpjjLtxWSYmbdYI
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Spirit of Life Church (Christian)
● 1701 N El Rio Dr., Tucson AZ 85745
● Provides resources to Tully Elementary and west-side Tucson Business’ through
donations.
https://www.spiritoflifetucson.org/
Faithful Word Baptist Church (Baptist)
● 1955 W Grant Rd #230, Tucson, AZ 85745
https://www.faithfulwordtucson.com/
Caring Ministries (Baptists)
● 820 W Calle Sur #5330, Tucson, AZ 85705
● Is a non-profit ministry that provides food, clothing, and other resources to southern
Arizona.
https://www.google.com/url?url=https%3A%2F%2Fwearecaring.org
%2F&sa=t&rct=j&source=maps&usg=AOvVaw0pVCQ0zZm9crsiNt1hCoZI&ved=1i
%3A0%2Ct%3A3443%2Ce%3A11%2Cp%3A44cOY8uxCIDdkPIPnu6AiA8%3A3326
Corazon Ministries (Christian)
● 1955 W Grant Rd # 220, Tucson, AZ 85745
https://corazonministries.org/
Art/sculpture Murals were seen at the Boys and Girls Club (BLM, AZTEC, anti SB1070, farmers, water
rights). Murals and art were also observed all over El Rio Neighborhood Center (AZTEC
art). There were murals that have been preserved since the 1960s that are still a part of
the building.
Cultural dress None seen
HEALTH AND SOCIAL SERVICES
Resources (formal name, location, brief list of services and source website link).
Nearest hospital St. Mary’s Hospital (Carondelet Health Group), 1601 W. St. Mary’s Rd. Tucson, AZ 85745
open to the ● Full service hospital care
general public ● Regional Heart Institute
● Regional Cancer Center
● Regional Neuroscience Center
● Regional Joint Replacement Center
https://www.carondelet.org/locations/detail/st-marys-hospital
Long Term Care MBI Occupational Healthcare, 1661 W Grant Rd Tucson, AZ 85745
and Rehab ● Physical therapy
Facilities (SNF, ● Physical exams
Assisted Living, ● Injury care
Independent ● Tests and screenings
Living) https://www.mbiaz.com

Family First Assisted Living, 1500 N Yavapai Tucson, AZ 85745

● Assisted senior living services
https://www.caring.com/senior-living/arizona/tucson/family-first-assisted-living-home-llc

Homeless Salvation Army Hospitality House (slightly out of the CT), 1002 N Main Ave. Tucson, AZ
shelters 85705
● Case management
● Medical service referrals
● Support groups
● Employment services
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● Life skills groups
● Religious services
● 24/7
https://www.salvationarmytucson.org/hospitality-house-shelter

Half-way houses La Frontera Grant Road Clinic, 1141 W. Grant Road #100 Tucson, AZ 85745
(drug treatment ● Behavioral health services and drug treatment
or post-prison or ● Crisis drug treatment services
jail) https://lafronteraaz.org/
Urgent Care Northwest Urgent Care at Speedway 1370 N Silverbell Rd. # 170 Tucson, AZ 85745
● Urgent care
● Lab services
● Minor injury care
● Covid testing
https://urgentcarelist.com/provider/northwest-urgent-care-at-speedway-tucson-az-85745

Concentra Urgent Care 2301 Forbes Blvd. Suite 111 Tucson AZ 85745
● Urgent care
● Physical therapy
● Wellness services
https://www.concentra.com/urgent-care-centers/arizona/tucson/tucson-west-urgent-care/?
utm_source=Yext&utm_medium=Referral&utm_campaign=LocalPage#nearbylocations_g
=32.24919|-110.99593&nearbylocations_o=DistanceMi%2CAscending
Pharmacies Albertsons pharmacy 1350 N Silverbell Rd. Tucson AZ 85745
(note if there is a ● Clinic with vaccines
clinic) ● Covid testing
● Blood pressure checks
● Workers compensation
● Prescriptions
● Medication review
https://local.pharmacy.albertsons.com/az/tucson/1350-n-silverbell-rd.html

Dispose-A-Med Not available in CT closest site, Westside Police Service Station, 1310 W Miracle Mile
site(s) https://www.tucsonaz.gov/water/medication-disposal
Medical/Dental Silverbell Dental Care 1370 N Silverbell # 190 Tucson AZ 85745
offices/clinics ● Cleanings
● Crowns
● Dentures and partials
● Extractions
● Fillings
● Laser gum treatment
● Implants
● Root canals
● Teeth whitening
http://www.silverbelldental.com/

SW Smile Center 2025 W Grant Rd. Tucson AZ 85745

● Dental care
● Treatment for children and teens
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● Botox and filler treatment
● Braces
● TMJ treatment
● Multilingual staff
https://m.facebook.com/profile.php?id=154750467896432

Northwest Gastroenterology at Grant 1951 Grant Rd. # 160 Tucson AZ 85745

● Colonoscopies
https://www.nwalliedphysicians.com/gastro?
utm_campaign=gmb&utm_medium=organic&utm_source=local

MBI Occupational Therapy 1661 W. Grant Rd. Tucson AZ 85745

● Occupational health services
https://www.mbiaz.com/locations

ATI Physical Therapy

2500 N Silverbell Rd. Ste. 150 Tucson AZ 85745
● Physical therapy
● Rehabilitation
● Sports medicine
https://locations.atipt.com/tucson-az

Integrative care Take Flight Yoga and Movement 1861 W Grant Rd Unit 107 Tucson, AZ 85745
modalities (yoga, ● Aerial yoga classes
energy therapies, https://www.takeflightyoga.com
massage etc.)
Mental health La Frontera Grant Road Clinic, 1141 W. Grant Road #100 Tucson AZ 85745
Agencies ● Behavioral health services and drug treatment
● Crisis drug treatment services
https://lafronteraaz.org/
Social Service Steve Daru Boys and Girls Club 1375 N El Rio Dr Tucson, AZ 85745
Agencies ● After school programs
● Food access programs
● Education and leadership training
https://www.bgctucson.org

El Rio Neighborhood Center 1390 W Speedway Blvd Tucson, AZ 85745

● Arts and crafts
● Recreation
● After school programs for children
● Senior club
● Nutritional education
● Transportation center
https://www.tucsonaz.gov/parks/ElRioCenter

Nearest Covid-19 Albertsons Pharmacy 1350 N Silverbell Rd, Tucson, AZ 85745

testing sites ● Cold and allergy care
● Rx refills
● Covid testing
● Travel health
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https://local.pharmacy.albertsons.com/az/tucson/1350-n-silverbell-rd.html

No Pima county run testing center in bounds.

Food bank/pantry Meal Program through Pima Council on Aging at El Rio Neighborhood Center, 1390 W.
Speedway Tucson AZ 85745
● Free or 2$ donation meals for adults 60+
https://www.tucsonaz.gov/parks/ElRioCenter
Other No additional
health/social
service providers

EDUCATION
Educational Attainment
County CT County CT
High school % % Bachelor’s % %
graduate or higher 66.6 degree or higher
89% 33.6% 15.3%
%
Census Reporter. (2022). Profile for Census Tract12 Pima, AZ.
https://censusreporter.org/profiles/14000US04019001200-census-tract-12-pima-az/
Educational Resources
Formal name, location, brief description of services, source website link.
El Rio Neighborhood Center 1390 W Speedway Blvd Tucson, AZ 85745
● Child care
Childcare/ ● Preschool- 1st grade
preschool ● library
centers ● Community programs for adults and seniors
● Afterschool programs

Public School Tucson Unified School District

District(s) ● Free meals
● Advance learning experiences/ Gifted talented education
● Dual language programs
● OMA opening minds through the arts
http://central.tusd1.org/
Schools inside Tully Magnet Elementary School (Title I) 1700 W El Rio Dr. Public School
CT. Identify as ● Hiking clubs
public, private, or ● Open access gifted programs
charter. ● Talent development lessons
● Magnet programs
● Preschool inclusive program
● OMA arts program
https://tullyes.tusd1.org/

Arizona State School for the Deaf and Blind Tucson Campus 1200 W. Speedway Blvd.
Public Entity School
● Statewide services (assessments, assistive technology, low vision, transition
services, deaf mentor program)
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● Campus services ( ADL, audiology, case management/counseling, occupation and
physical therapy, orientation and mobility, language and communication
development, preschool services).
https://asdb.az.gov/

El Rio Neighborhood Center 1390 W Speedway Blvd Tucson, AZ 85745

● Nosotros Academy (kindergarten and first grade) - identifies as a public charter
alternative school, main campus south of CT, however KG and 1st grade
classroom overflow located in El Rio Center
● Pima College (offers GEDs and ESL courses) - identifies as a public school
● Library
https://www.tucsonaz.gov/parks/ElRioCenter

The public school Tucson Unified School District

district http://central.tusd1.org
elementary,
middle, and high Possible pathway for students in the CT:
schools where
children in a Tully Magnet Elementary School PK-5 1701 W El Rio Dr. Tucson AZ 85745 (located in
particular census CT)
tract are
assigned to Mansfield Magnet Middle School 6-8 1300 E 6th St. Tucson AZ 85719 (not in CT)
attend (called
attendance Tucson High Magnet High School 400 N 2nd St. Tucson AZ 85705 (not in CT)
zones by many https://maps.pagregion.com/SchoolSearch/Map.aspx (based on community housing inside
school districts). CT next to Tully Magnet Elementary School)

Public Library in El Rio Library 1390 W Speedway Blvd. Tucson AZ 85745

or nearest to CT https://www.library.pima.gov/locations/elr/

Steve Daru Boys and Girls Club 1375 N El Rio Dr Tucson, AZ 85745
Other (including ● After school programs
any educational ● Food access programs
resources that ● Education and leadership training
remain closed or https://www.bgctucson.org
out of business)

RECREATION
Formal name, location, brief description of services, source website link.
Neighborhood El Rio Neighborhood Center 1390 W Speedway Blvd Tucson, AZ 85745
centers and Hours: 8:00AM-8:00PM
hours ● Arts and crafts
● Recreation
● After school programs for children
● Senior club
● Nutritional education
● Transportation center
https://www.tucsonaz.gov/parks/ElRioCenter
Recreation Crossfit, 1861 W Grant Rd. #107 Tucson AZ 85745
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centers/gyms ● Personal training
and hours ● Intensive crossfit programs
https://www.crossfitnow.com/

Boys and Girls Clubs Tucson, Steve Daru Clubhouse Joaquin Murrieta Park 1375 N El Rio
Tucson AZ 85745 hours depend on time of year
● Education and career (lego robotics, STEM, money matters, club internship
academy).
● National fine arts
● Teen focused programing
https://www.bgctucson.org/

Santa Cruz River Disc Golf Course 8 AM-10 PM 1418 N Riverview Blvd.Tucson AZ 85745
● 18 hole disc golf course
https://www.pdga.com/course-directory/course/santa-cruz-river-park

Camp Abilities Tucson unknown hours camp for children who are blind and deaf at
Arizona State School for the Deaf and Blind Tucson Campus 1200 W. Speedway Blvd.
Tucson AZ 85745
● Private day camp
● Bowling
● Golf
● Strength training
● Soccer
● Tandem biking
● Swimming
● Beep baseball
● Goal ball
https://www.campabilitiestucson.org/

Parks/trails/green Joaquin Murrieta Park 1400 N Silverbell Rd Tucson, AZ 85745

spaces (include Hours: 6:00AM-10:30PM
amenities) ● Baseball fields
● Picnic tables
● Waterfountains
● Bathrooms
https://www.tucsonaz.gov/parks/JoaquinMurrietaPark

El Rio Golf Course 1400 W Speedway Blvd Tucson, AZ 85745

Hours: 6:00AM-6:00PM
● Golf
● Food and drink
https://www.tucsoncitygolf.com/el-rio/

Riverview Park 1600 N Yavapai St Tucson, AZ 85745

Hours: 6AM-4PM
● Playgrounds
● Barbeque
● Picnic tables
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https://www.tucsonaz.gov/parks/RiverviewPark

Santa Cruz River Park 802 W Speedway Blvd Tucson, AZ 85745

https://www.visittucson.org/listing/santa-cruz-river-park/23237/
Hours: 6AM-7PM
● Tucson Loop bike path

Santa Cruz River Disc Golf Course 8 AM-10 PM 1418 N Riverview Blvd.Tucson AZ 85745
● 18 hole disc golf course
https://www.pdga.com/course-directory/course/santa-cruz-river-park

● Joaquin Murrieta Park:

○ Water fountains, trees, cacti, grass, trashcans, no litter, many park lights,
Other (including
little league area.
closed
○ Bathrooms with running water however the men's bathroom was very
resources)
smelly. Neither bathroom has soap. Doors in the bathroom have working
locks, toilets in good condition and clean.
SAFETY AND TRANSPORTATION
Public Safety: No police departments located in CT–nearest is 3.8 miles away which is the Tucson Rillito
city police Police Department at 1310 W Miracle Mile Rd. Tucson AZ 85705
department, tribal
police, and/or
county sheriff
Fire District(s) Tucson Fire Department Station 4
and Station #(s)
covering CT
Distance from 0.8mi
middle of CT to
fire station
Security guards Yes, at El Rio Neighborhood Center 1390 W Speedway Blvd Tucson, AZ 85745
https://www.tucsonaz.gov/parks/ElRioCenter
Neighborhood None
Watch?
Evidence of Alcohol empty containers and bottle caps scattered around Joaquin Murrieta Park 1400 N
gang/criminal Silverbell Rd Tucson, AZ 85745
activity/drug https://www.tucsonaz.gov/parks/JoaquinMurrietaPark
use
Rate (per 1,000 Tucson Metro residents in a standard year):
Assault 3.875
Robbery: 0.8297
Significant crime
Rape: 0.4859
statistics if
Theft: 39.09
available
Burglary: 5.530
(include # and
Drug Crimes: 7.798
time frame,
Vandalism: 13.39
source(s) of data,
i.e. web sites)
CT is in 7th percentile for safety

https://crimegrade.org/safest-places-in-tucson-az-metro/
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7 sex offenders in CT as of 08/30/22
Registered sex
offenders (# as
https://www.icrimewatch.net/results.php?AgencyID=55056&whichaddr=home_addr
m/d/y, include
%7Ctemp_addr&SubmitAddrSearch=1&AddrStreet=1309+W+Yavapai+St&AddrCity=Tucs
source(s) of data,
on&AddrState=3&AddrZip=85745&AddrZipPlus=&excludeIncarcerated=&radius=1
i.e. web sites
Bus stops
(approx. # and
general location 15 (¾ covered, not all with lighting) located throughout the CT
in CT; no need to
list them all)
Designated
Tucson Loop bike path intersects CT along east side of CT just west of the Interstate 10
bicycle paths
Parking
(availability) Handicap parking available in all parking sites
Sidewalks are located along main roads and in overall good condition
Sidewalks
Not many sidewalks in the neighborhoods, some sidewalks are covered in trash
Street conditions
include speed
bumps, Speed bumps on smaller roads (i.e. in park, within neighborhoods)
roundabouts, etc.

Road hazards Potholes everywhere

Car bumpers left on curbs
Night lighting Park and main roads well lit
(optional) Bus stops not lit
No sidewalks in neighborhood side streets.
2 QT gas station and snack stores available and source for homeless youth to seek help
Other risks (i.e. by asking for a resource number of attendants on site both located in the upper east
dangerous corner of the CT along Grant Ave. west of the I 10 freeway.
intersections) or
resources Grocery store: Albertsons 350 N Silverbell Rd. Tucson AZ 85745 with pharmacy and clinic
(grocery stores, inside grocery store same address
pharmacies, etc.)

ECONOMICS
Businesses inside Census Tract (enter approx. #)
Bars 3 Convenience 4 Laundry/dry Neighborhood market N/A
cleaners
Restaurants 11 Discount N Liquor stores 1 Post office/UPS 1
store /
A
Check cashing N/A Fast food 3 Malls (describe): 1 Supermarket 1
Banks 3 Gas station 4 strip mall Thrift/resale store N/A
Farmer's market N/A Community 2 Health1/organic food N/A
Garden stores
Other Auto repair: 6
businesses. Use Salon/cosmetic: 6
 13
generic name Dispensary: 1
only House/utility: 12
Hotel: 4
Gun store: 1
Temporarily or None
permanently
closed
businesses/empt
y storefronts
U. S. Census Data (% or $) County (% or $) CT (% or $)
Per Capita Income ($) $30,747 $15,975
Median Household Income ($) $55,023 $41,818
Persons below poverty line: 15.9% 22%
Children (under 18) (%) 22% 29%
Seniors (65 and over) (%) 9% 23%
Moved since previous year (%) 19.2% 19%
*Include source of data: Census Reporter. (2022). Profile for Census Tract12 Pima, AZ.
Census document title
https://censusreporter.org/profiles/14000US04019001200-census-tract-12-pima-
and data year(s).
az/
POLITICS AND GOVERNMENT
Names of neighborhoods El Rio Neighborhood and small section of Barrio Anita (south west corner)
or subdivisions
How are neighborhood Neighborhood names displayed on signs
names displayed? Neighborhoods within our CT are the El Rio Acres and a small southwestern
portion of Barrio Anita.
Geopolitical Boundaries and Government Elected Officials* (include sources of data) Use Pima Maps for
Geopolitical Boundaries only. Do not use Pima Maps for Elected Officials.
Is CT inside or outside Yes
city/town limits?
CT City ward(s) and Ward 1, Councilmember (Vice Mayor)
council member(s) with Lane Santa Cruz, Democratic Party
political party designation
https://cotgis.maps.arcgis.com/apps/webappviewer/index.html?
id=b07b1470c24648aa94ace298cd88239c
CT County district(s) and District 5 Supervisor
supervisor(s) with political Adelita Grijalva, Democrat
party designation https://webcms.pima.gov/government/board_of_supervisors

CT state legislative District 3

district(s) and legislators
(1 senator and 2 Senator:
representatives) with Sally Ann Gonzalez
political party designation Democrat
https://www.azleg.gov/senate-member/?legislature=55&legislator=1957

Representatives:
Alma Hernandez
Democrat
 14
https://www.azleg.gov/house-member/?
legislature=55&session=125&legislator=2033

Andres Cano
Democrat
https://www.azleg.gov/house-member/?
legislature=55&session=125&legislator=2032

CT US Congressional Raul Grijalva, Congressional District 3, Democrat

District(s) and
representative(s) with
political party designation
Signs of political activity
Other data/comments
Newspapers/
Newsletters/Flyers
Payphones
Billboards/bulletin boards
(include main
purpose/message)
Free Internet/Wi-Fi
access/locations
Other data/comments
https://ziplook.house.gov/htbin/findrep_house?ZIP=85745
No political signs noted
N/A
COMMUNICATION
West Press location in a strip mall.
None seen
Cigna medical; purpose was to convince the community to buy their health
insurance/use their medical services.
Starbucks inside Safeway, El Rio Library (offers computer labs).
N/A

ADDITIONAL INFORMATION

N/A

Key Informant Interview Records

Student: ____Kiana Wentzel _________________Clinical Faculty: _Nancy

McGuckin______________ Date___09/01/2022______

Instructions:

(1) Reflect on the interviews that you led and select two of these interviews to document below.

(2) Include the interviewee’s generic title and the sub-system(s) that the interviewee addressed.
 15
(3) Document two of the most important questions you asked this interviewee.

(4) Document three of the most important comments/insights that the interviewee expressed during

their interview.

Interviewee #1 Interviewee #2

Generic Title: Recreation Coordinator Generic Title: Homeless Resident

Sub-system(s) Addressed: Education/Recreation Sub-system(s) Addressed: Physical

Environment/Safety

Interview Questions: Interview Questions:

1) What are some strengths that the community has? 1) What do you believe are the greatest
weaknesses of your community?

2) What are some problems you are seeing in the

community? 2) How can we as a community help the homeless
population? What services do you believe will best
help you?

Key Informant Comments/Insights: Key Informant Comments/Insights:

1) Community center has many resources for people—
after school programs, day care, schooling, senior
services, and exercise classes. States that services are
affordable and that they offer discounts for those with
lower income. Everyone comes together to help and
support one another. Shared information about
donation center and community garden available to the
community.
1) Stated that people just don’t care, stated that
people pass right by without acknowledging them
as a person. Shares that it would make a difference
just to listen and acknowledge the homeless people
we see, rather than pretending that they do not
exist. States that other homeless people are
careless and leave behind trash, and that they work
hard to clean up after the other homeless people.

2) Many issues surrounding drugs. Shared that after all
staff and participants leave at night, people come onto
the campus to do drugs. States that when they return in
the morning, they see tin foil and syringes littered all
over the campus, and that staff has to go around and
2) States that people should not give money to
homeless people. Believes that if you want to help,
take the homeless person to get a meal. States that
when money is given, homeless individuals often
use this money to purchase drugs. Shared that drug

clean up before children come in for school in the
morning. States that homeless population is prevalent
in the area, and that the center has had problems with
homeless individuals doing drugs at night on the site.
Informed us that drug related arrests don’t seem to
stick; that the individuals are arrested and then released
shortly after. Also states that there are issues with low
participation in programs since the start of the
pandemic.
16
use is prevalent among the homeless community,
and that a lot of these individuals do not want to
seek help for a better life.
3) States that health is a big issue among the
homeless community. Shared that having a place
to call home and a place to work would make a
difference in the mental and physical health of
homeless people.

3) Shared that he has tried to help out homeless people

on site by attempting to hand out fliers for food banks
and homeless shelters, and that the individuals do not
take the fliers and are not interested in getting help.
States that what would help the community’s issues is
more outreach, they would like to see more
involvement by parks and recreation, Tucson Police,
and community nurses. Shared that they have lost a lot
of funding over the years, and no longer provide
sports, and no longer receive donations from the food
bank.
 17

Student: __Erika Deianni_____________________Clinical Faculty: Professor McGuckin Date:

9/1/2022

Instructions:

(1) Reflect on the interviews that you led and select two of these interviews to

document below.

(2) Include the interviewee’s generic title and the sub-system(s) that the

interviewee addressed.

(3) Document two of the most important questions you asked this interviewee.

(4) Document three of the most important comments/insights that the interviewee

expressed during their interview.

Interviewee #1 Interviewee #2

Generic Title: Neighbor and Generic Title: Local business

grandmother of children at Tully owner/consultant
Elementary
Sub-system(s) Addressed: Economics,
Sub-system(s) Addressed: Education, Health and Social Services
Safety and Transportation, Health, and
Social services

Interview Questions: Interview Questions:

1) What do you think are the strengths in 1) What do you think are the strengths in
your community? your community?

2) What are your concerns in the

community and how would you like to 2) What are your concerns in the
see those addressed? community and what do you believe
would make a difference to address these
concerns?

Key Informant Comments/Insights:
1) “Community is strong and takes care of
one another, when lights go out or water is
contaminated all the neighbors help one
another and looks out for one another.
When I didn’t have water access my
neighbor made sure I had what I needed”
2) Interviewee reported safety as a concern
in the neighborhood. They mentioned that
they no longer feel safe walking too far
with their dog near the park as some violent
incidences have occurred over the past few
years and that people who are using drugs
outside or nearby make them anxious and
they worry about their grandkids being in
the park or going to Tully school only a few
blocks away. They stated they don’t feel
safe the way they used to in this
neighborhood.
3) Interviewee mentions that they would
like to see some services for people who are
homeless and using drugs, like basic needs
services and mental health services as they
stated that some of the people who are
homeless are having mental health
challenges and they need help getting
medication and other services. They
reported that they would feel safer and feel
that their grandchildren would be safer if
they knew that the homeless people who
are using drugs to self-medicate had
resources instead of being in the local parks 3) Interviewee believes that the community
and on drugs and that this would change the needs a stable and reliable site where
neighborhood.
18
Key Informant Comments/Insights:
1) The interviewee mentioned business
patrons know one another and have a strong
sense of community. All seem to know
each other and enjoy laughing and being
together when they run into each other in
the owner’s shop as well as doing what they
can to support each other. And the
interviewee mentioned all seem to have
similar ideas about what is going on and
being aware of their community as well,
whether positive or challenging things.
2) Interviewee reported homelessness and
drug use a major concern in the
neighborhood and stated that in the
morning before the business opens, drug
paraphernalia including used needles,
syringes, and foil are found often in the
parking lot area. Interviewee self-reports
former drug use and homelessness and
reports safety and well-being concerns for
all in the community due to an
understanding of the difficulties of
homelessness and drug use and how it
affects everyone. Interviewee shared that
the other neighboring shop owners often
share concerns about the safety of both
those who are homeless and those who are
not due to lack of access to resources like
showers, food, lack of sleep, drug use, and
lack of behavioral health services.
homeless community members may access
basic needs services including food,
clothes, showers, possibly a place to sleep
and somewhere to access supplies for harm
reduction like safe needles. Interviewee
 19
reports having a long-term goal to open a
resource center for this purpose.
Interviewee states that without access to
this, safety will continue to be an issue.
 20
Student: __Maricruz Chavez-Tinoco___Clinical Faculty: _Nancy E. McGuckin, MPH, MBA,
MSN, RN___ Date___9/1/2022___
Instructions:

(1) Reflect on the interviews that you led and select two of these interviews to document below.
(2) Include the interviewee’s generic title and the sub-system(s) that the interviewee addressed.
(3) Document two of the most important questions you asked this interviewee.
(4) Document three of the most important comments/insights that the interviewee expressed during their interview.

Interviewee #1 Interviewee #2

Generic Title: Librarian Generic Title: Community Member

Sub-system(s) Addressed: Core, economics, recreation, Sub-system(s) Addressed: Physical environment,

education, safety & transportation, health & social safety & transportation, health & social services.
services.

Interview Questions: Interview Questions:

1) What are some of the strengths of your community?
2) What are some of the weaknesses of your community?
1) What are some issues facing your
community?
2) What are some initiatives/programs you feel
your community could benefit from?

Key Informant Comments/Insights: Key Informant Comments/Insights:

1) The community member feels the strength of the
community derives from shared struggles and
history. Most members of this community are
Mexican-American and have a strong political
cohesion. They are very protective of their
community and there is a lot of neighborhood
participation during events.
1) The community member feels violence in
the community is one of the biggest issues.
He told me there was a person killed in the
park. There is a fentanyl problem too.
“When I take the bus, I sometimes see drug
paraphernalia on the floor. The bus driver
says he can’t do anything about it.”

2) The community member doesn’t like the

2) The community member expressed that the hospital in his community [Saint Mary’s],
weaknesses of this community include he feels it’s not a quality hospital. His wife
transportation, gentrification, accessing healthcare, went there and did not get a timely

and accessing information. Someone came into the
library to ask for help researching the care they
would need after receiving back surgery. People in
this community also lack information for chronic
health problems.
3) The community member feels another weakness is
instability. This community had an elementary
school close a few years ago, has had property tax
increase because of gentrification, and almost lost
their senior center this year.
21
diagnosis or treatment. She was diagnosed
with stage four liver cirrhosis at another
hospital and received treatment there. The
community member knows 6 others who
went to St. Mary’s and did not have good
experiences either.
3) The community member feels the
community could benefit from more
accessible food banks and food drives.
There used to be a mobile food bank and
clinic run by La Frontera, but they stopped
due to the pandemic and never started back
up again. There are no food banks close by.
He feels programs for the homeless and
detoxing programs would also benefit the
community.
 22

Student: Sarah Medeiros Clinical Faculty: Professor McGuckin

Date: 9/1/22
Instructions:

(1) Reflect on the interviews that you led and select two of these interviews to document below.
(2) Include the interviewee’s generic title and the sub-system(s) that the interviewee addressed.
(3) Document two of the most important questions you asked this interviewee.
(4) Document three of the most important comments/insights that the interviewee expressed during their
interview.

Interviewee #1 Interviewee #2

Generic Title: Albertsons clerk Generic Title: Security guard at El Rio

Sub-system(s) Addressed: Economics Sub-system(s) Addressed: Safety and

Transportation

Interview Questions: Interview Questions:

1) Do you live in this community and if so, how long 1) What are the greatest strengths of your community?
have you lived here for? What are some strengths that How does this impact the El Rio Center?
stand out to you in this area of town?

2) What are some weaknesses from the community? 2) What are some struggles that you have observed
within this community? Do these issues impact the
center as well?

Key Informant Comments/Insights: Key Informant Comments/Insights:

1) She has lived in this community her entire life and
has worked at this Albertsons for 23 years. She feels
that the community is very good at supporting one
another. The community is very close, and she loves
that about her home.
2) The largest issue within this community is the
homeless population. She stated that in her opinion,
over the last few months the homeless community has
1) People come together within the West side
community. There is a local garden across the street
from the El Rio community center where people can
leave donations out front of the garden. Donations are
anything from used furniture to new clothes. The
Pima County police are very involved in the
community and have helped greatly with the homeless
population.

grown much larger. She feels that more homeless
shelters and food banks need to be established within
this community. The homeless people are desperate
for help and there are not enough resources available
to them.
3) She also feels that the amount of trash throughout
the community is unacceptable. She said that all the
homeless camps are covered in trash and the city
needs to do more to keep this community clean.
Between the lack of trash pick-up in the
neighborhoods and the homeless camp sites this area
has tons of trash laying out on the streets.
23
2) The largest issue has been the lack of trash pick-up
by the city. There is trash everywhere which is
becoming a hazard and very unsanitary. The security
guard is trying to get in contact with Tucson city
officials to deal with this problem more effectively.
3) There also used to be a very large homeless
population that came onto the El Rio community
center property that has now been dealt with more
efficiently. The security guard has been in constant
contact with the Pima County sheriffs regarding the
local homeless population. There is a duplex across
the street where homeless people gather to sell
fentanyl pills to each other and there was a recurring
issue where those individuals would come to the
community center stairwell to take their pills. The
stairwell is now checked numerous times throughout
the day as a safety precaution.
 24
Root Causes Map

Gender Discrimination
Institutional Racism Class Oppression
and Exploitation
● Stigmatism
● Racist/
against ● Women less safe at
discriminatory
homelessness, bus stop, possible
housing policies
people ignore physical, verbal,
put inplace in
homeless emotional assault
during the 20th
individuals/prete ● Less access to
centrury
nd they do not necessary
● Section 8 housing
exist healthcare services
discrimination
● Less resources (ie: reproductive
● Lack of health
for those in health care, STI
care access for
poverty (i.e. no care etc.)
Undocumented
food banks, no ● Homeless women
folks
shelters) may feel obligated
● Ideology enacted
● Gentrification of to exchange sexual
in legislation of
the housing favors for safety
no handouts for
market ● Overturned Roe V.
*undeserving*
● Public health Wade 2022
(racist, sexist,
policy in favor of ● Anti-trans bills
classist) policies
monetary ● Gender pay gap
interests

Power & Wealth Imbalance Power & Wealth Imbalance

Social Safety
Housing Education Globalization & Social
Labor Markets Net Tax Policy
Policy Systems Deregulation Networks

● $13/hr ● Out-of- ● Larger fast ● La Frontera ● The El ● High

minimum state ● Disinvestm food (for teens in Rio property
wage housing ent in corporation CT) center is tax (3rd
passed in develope education s (Arby’s in ● CODAC a great highest in
April 2022. rs (the lower our CT) take (access is place for state)
● Covid has ● Section 8 property away from difficult due many ● High sales
heavily discrimin tax and smaller to resource tax (8.7%)
impacted ation income locally transportati s and (Tucson
Tucson’s communiti owned on) social tax 2.6%,
 25
es have
the lowest
restaurants
investmen
● Amazon
t in
local trucks are
schools)
economy taking away
https:// interacti
because business
www.ar ● No food ons
working from ma
izonaea banks, or ● Tully
remote has and pa Pima
.org/ other basic Element
become a shops county
student needs ary
very within the 0.5%,
- supplies in School
popular CT State tax
success CT available (families
option ● Uber/Lyft/ 5.6%=
/smart- ● No + staff)
(where you rideshare 8.7%)
just- homeless ● Defunde
live may apps
policies shelters d social
not be decrease
/full- program
where your the use of
educati s
job is public
on-
located) transportati
funding
on within
/
the city
investin
az

Social Determinants of Health Social Determinants of Health

Education Access & Health Care Access & Neighborhood and Social and
Economic Stability
Quality Quality Built Environment Community Context
● Lower ● Limited ● One hospital close ● Neighborhoods ● Solid sense of
homeowners schools to CT but out of crowded and community (El Rio
hip affects within our bounds littered with was built after
lower taxes CT, only ● Private trash. community march
for elementary emergency care ● 45% residents are after golf course
community schools centers in homeowners was built)
● Median ● No middle ● No mental health ● Informants
income school or resources for reported strong
$41,818 high school adults community
● $15,975 per available ● No homeless (helping
capita ● Only 66.6% shelters, food neighbors)
income attain banks, or ● Since COVID lost
 26
funding and lost
community
● 22% of participation
individuals ● Community
highschool
below concerned about
diploma or donation centers
poverty line increasing
higher
homeless
community and
drug use by teens
and adults

Psychological Stress & Unhealthy Behaviors

● Stress regarding safety
● Drug use
● Poor hygiene care due to lack of resources
● Difficulty finding shelter, transportation, food
● Lack of medical care due to financial situation
● Living of the streets in extreme heat (no water available can lead to dehydration)
● No accessible phone
● Economic stress
● Streets filled with trash due to minimal trash pick-ups by the city

Disparities in the Distribution of Disease, Illness, and Well-being

● Higher drug abuse, potential overdose, risk for STI

● Lower life expectancy
● High risk behaviors (drug use, prostitution)
● Homlessness→ higher stress→ sanitation concerns—> behavioral health problems, food insecurity, and basic
needs to maintain well being
● All of these struggles can lead to more serious health problems
 27
Data Analysis and Community Resource Tool

Describe your Census Tract, drawing from the Community Profile, Windshield Surveys, Key
Informant Interviews, and Community Immersion:
CT # 12 is largely residential, with two large parks, a golf course, a community center and library, and
shopping centers scattered throughout. The parks and golf course are well maintained, with little
trash and ample amounts of space for community recreation. The community center and library are
open to the public and offer many resources to the community; they are well maintained. Public
transportation is available throughout the CT, with several bus stops (covered and uncovered). There
is one grocery store within the CT, and there are several fast-food chains, and there are many
contract business buildings. Demographic data indicates that the income is less than that of the
county, and there is a large population of middle aged adults in this area. Neighborhoods are not well
kept, and there are large piles of bulky trash out on the sides of the road. Many homes had greenery
and lots of plants. Homelessness is a large issue within the area as observed and also according to key
informants, and minimal basic needs resources are available to them. Key informants revealed that
there are also issues with drug abuse within the CT, and drug paraphernalia was strewn in parking
lots, in front of businesses, and found littered around the community center. There are not many
resources nearby for rehabilitation or within the CT.
List at Least Three Community Strengths List at Least Three Community Stressors
● Close knit ● Community venue ● Low income ● Drug use
community, for all ages (el Rio) ● Safety ● Large homeless
support one population
another
● Ample green
spaces (parks)
Plot your Community Stressors on the Priorities of Care Table (see Appendix), leaving the blue
columns blank. Obtain a preliminary total score and list your top three concerns below.
Concern #1 Concern #2 Concern #3
Substance Use Homelessness Untreated mental health
conditions

Complete the Community Resource activities in D2L before proceeding.

Community Resource(s) for Community Resource(s) for
Concern #1
Name: CODAC
Purpose: to provide tools, support
and services to individuals, families
and communities so they may live
with dignity, free from the harmful
effects of mental illness, substance
use disorders and trauma.
Funding: State and federal Grants,
Community Resource(s) for
Concern #2 Concern #3
Name: The Salvation Army Name: La Frontera Center
Hospitality House Purpose: Providing innovative
Purpose: Provide essential services solutions to complex problems ,
to meet human needs in the name working with community partners
of Jesus Christ without to build safe, strong and healthy
discrimination. AZ, Residential and outpatient
Funding: Donations, thrift store mental health and substance use
revenue, partnership with other treatment services

individual and corporate donations
Services: Substance abuse
treatment, withdrawal medication,
counseling, womens care, holistic
care
Cost for: Free with grants for
individuals who cannot afford it,
contracted with some health
insurances
Population: Pima county members
with substance abuse disorders
and families of those with
substance abuse disorders
Benefit: Increase awareness and
education within CT, prevent drug
abuse and possible ODs
Partnership: pamphlets,
community outreach
organizations, and Tucson city
grants.
Services: 24/7 emergency 100-bed
shelter that provides meals,
showers, access to facilities, and
scheduled activities (bible study,
skill workshop, coat and blanket
distribution, support groups).
. The shelter provides vouchers to
motels for families in need.
Cost for: Free
Population: Homeless identified
individuals.
Benefit: Provides housing and
resources to homeless individuals,
families, individuals with special
needs, and veterans.
Partnership: community outreach
and distribution of resources to
homeless individuals in our CT.
28
Funding: state and federal grants,
individual donations and
fundraising events
Services: outpatient and inpatient
mental health and drug treatment
services (case management,
prevention, diversion, employment
services, crisis intervention 24/7,
counseling and opioid treatment)
Cost for: Free with AHCCCS health
insurance, other funding accepted,
sometimes limited co-pays
Population: children, youth and
adults in need of mental health or
substance use services
Benefit: in CT for teenagers, other
sites outside of CT offer services to
other populations
Partnership: distribution of
information regarding services
within the CT

For each Community Resource include: Resource Name, Mission/Purpose, Funding, Services Offered,
Cost for Services, Population Served, Potential Benefit to CT, Partnership Potential.
Now complete the blue columns in the Priorities of Care Table (see Appendix) and determine your
priority (top-ranking) concern.
Priority Concern for Census Tract
Substance Use
Target Population within Census Tract that is Impacted by the Priority Concern
Pima county members with substance abuse disorders

Four Part Community Nursing Diagnosis for Priority Concern and Target Population

Risk for drug related adverse effects among Pima county members with substance abuse disorders related to
poor coping, limited resources for abuse disorders, and easy access to substances as evidenced by key
informant reports of apparent drug use within CT, drug paraphernalia littered in the community, and crimes
specific to drug use.

Broad Overarching Goal that would help you address your diagnosis with your CT:
Increase awareness and education of drug abuse resources within CT
 29

List a Health People 2030 Objective that Relates to your goal above:
Increase the proportion of people with a substance use disorder who got treatment in the past year–
SU-01
 30

Community
Community Identified in Nursing Availability of Severity of Community
Expression of
Health Supporting County’s Students’ Ability Resources for Outcome(s) Total Strengths that can
Interest in
Stressor Data Health Needs to Address Addressing without Effort to Score Help Address
Addressing
Assessment1 Stressor Stressor Address Stressor Stressor
Stressor

La Frontera is located
within the CT, and
offers substance
abuse and mental
health help for youth.
CODAC located 4.5
Drug miles from CT–is
paraphernalia 2 accessible by bus–
, reported offers services for
Substance
drug use in 2 4 1 2 11 substance abuse
Use
parks and at We can provide rehabilitation.
community narcan, drug Community members
sites education, offer are interested in
resources for addressing substance
addiction centers use problems.

Homeless 2 4 2 1 2 11 The community is

individuals very involved and
Homeless- spotted on Nursing students willing to support
ness most streets can advocate for one another.
throughout more homeless Community
the CT, shelters, food members contribute
homeless banks, donation to holding donation
camps centers drives and bring
 31
surrounding
freeway
items to donate.
underpass,
Community
reported
members report
homeless
interest in bringing
population
a food bank and
gathering
other basic needs
on El Rio
services to the area
campus
to support their
after hours
homeless
and
neighbors.
throughout
CT
Informants
reported
feelings of
fear due to
crime in the
area, F Tucson and Pima
crime PD are very
Safety rating, lack involved with the
of lights on 2 4 1 0 2 9 area. Community
streets members look out
outside of for each other and
main roads, their homes,
reported
lack of
safety on
bus, road
hazards
Lack of 2 4 1 1 2 10 La Frontera is
mental located within CT
Mental health **La Frontera and offers mental
health resources in is a resource for health resources for
 32
CT,
youth. Key
Community
informants reported
members
interest in
reported
supporting
that many
community
individuals
members with
wander the mental health
challenges mental health
streets or but it is
challenges and
use public explicitly for
stated an
transportati teens
understanding that
on and
behaviors related to
appear to
mental health are a
have
result of a lack of
untreated
services and not an
mental
individual choice.
conditions.
 33
Policy Development Tool
List Policies at the Organizational, Local (City or County), State, and National Level that may impact
your Priority Concern (as previously identified on the DACR Tool).
List at least one policy at each level and describe its impact.
Organizational
Policy/Procedure Impact
● CODAC Confidentiality Policy prevents ● The Confidentiality Policy prevents the
the sharing of records, unless the patient patient’s information from being shared
gives permission in writing, the disclosure with family and workplace–can prevent
is court ordered, or is disclosed to fears of judgment and stigma.
medical personnel in the case of an ● Allows the patient to confidentially seek
emergency. treatment.
https://www.codac.org/about-codac/ethics-
confidentiality/

Tucson or Pima County

Ordinance
● United Medication Assisted Treatment
Targeted Engagement Response
(UMATTER) Tucson Police program offers
a program that is drug treatment with a
referral to CODAC services specifically
with peer support instead of arrest for
those arrested with possession of
narcotics (heroin or meth) and cannot
have a warrant for violent crime or
domestic violence.
Impact
● Between July 2018 and December 2020
1100 deflections were completed and
reported to Southwest Institute for
Research on Women at UA.
● Deflection allows for someone with drug
misuse to seek treatment and reduce
incarceration which will not allow for
rehabilitation. Rehabilitation and
treatment will be more likely with this
program in place.

State of Arizona
Statute or Regulation Impact
● According to Arizona Law a citizen can
not knowingly possess or be under the ● Individuals with previous criminal
influence of illegal drugs. An individual records can be discriminated against
can be charged with felony drug when looking for housing.
possession. ● Employment options are limited when an
individual has a criminal record.
Arizona Revised Statutes Title 13, Chapter 34,
Sections 3401 - 3421 et. seq.
United States of America
Statute or Regulation Impact
● US Department of Housing and Urban ● With additional federal emergency
 34
Development, Amendment No. 2 to funding for people in need of rental
provide CARES Act Emergency Solutions assistance, CODAC can refer customers at
Grant and extend grant term to 9/30/23 risk of homelessness to rental assistance
and Family Housing resources, to provide funding to reduce loss of housing and
for the Emergency Rental Assistance reduced risk of relapse.
Program, US Dept of Treasury,
Emergency Assistance 2 Fund CT-CR-23-
45.
What change or new statute/regulation at the state level would you propose that would target
your priority concern and enhance the health of your Census Tract?

Our proposition is to have all Arizona Police Departments deflect any person who is found in
possession or under the influence of drugs, in the absence of a violent crime, to a substance abuse
treatment center in place of an arrest. If the person does not want to receive treatment, they do still
have the option to opt for an arrest. If numerous repeated possession or influence instances occur,
the suspect will be taken into custody.
Today you will be writing a Professional Advocacy Letter to advocate for this policy. Aside from
writing a letter, what other ways could you advocate for this policy?
Besides writing a letter, we could personally communicate with all Arizona Police Departments to
have their input and cooperation with this proposed ordinance.
 35
Doug Ducey, Governor of Arizona
Governor's Office
1700 West Washington Street
Phoenix, AZ, 85007

Dear Governor Ducey,

We are fourth semester nursing students at the University of Arizona completing our public health
course. Through our community assessment in an assigned Census Tract-12 in Tucson, we found that the
biggest issue revolves around substance abuse and lack of resources and support for treatment for substance
abuse disorders. We are advocating for influential change within CT-12 and the State of Arizona to address the
epidemic of opioid use in AZ as declared by you in 2017, by altering the approach to those impacted by
substance abuse disorders. We propose a mandate throughout the State of Arizona that treatment resources be
offered in the place of arrest in the case of drug possession and influence without the occurrence of a violent
crime. This mandate would be similar to the UMATTER program in place within the Tucson Police
Department, which has demonstrated significant change in drug use patterns in our city. By advocating for a
statewide mandate of this program, rehabilitation is prioritized over punishment, and we can address this opioid
crisis and improve all communities in Arizona.

Through evidenced based research, touring the community, and key informant interviews we identified
that drug addiction is the most significant public health issue in the community. This issue impacts all aspects of
community life, as paraphernalia left by drug users in community spaces and parks create safety concerns for
community members as reported by key informants and witnessed through our tour of the community. Drug use
impacts one’s ability to care for themselves and their family. In AZ between the years 2017 and 2021, 11,077
suspected opioid overdose deaths were identified, ultimately disturbing community health and peace.
Emergency Departments (ED) are overwhelmed by opioid overdoses, the ADHS reported that so far this year
there have been 5,415 emergency department opioid overdose visits. According to the SmartJustice Arizona
report in 2018, 90% of incarcerated persons in AZ demonstrate need for substance abuse education. Due to this
high correlation, our proposed recommendation would address both these issues simultaneously.

Arizona residents are being gravely impacted by substance addiction, we as health professionals urge
you to consider our proposition as it would be a great initiative to help your constituents who struggle with
addiction. These individuals deserve policies that can help them access stigma-free drug addiction
rehabilitation.

Best Regards,

Sarah Medeiros Kiana Wentzel

Maricruz Chavez-Tinoco Erika Deianni

Health Education Project Planning Tool (HEPP)
Brainstorm Potential HEPs for your Target Population and Priority Concern. Locate evidence (an
article, a study, a current program, etc.) that supports each HEP that you consider. List AT LEAST three
potential HEPs with evidence (including a citation).
Potential HEP
● Educate nurses at St.
Mary's ED about CODAC
● Increase participation at
CODAC
● Educate individuals
using drugs on
resources to help with
addiction
36
Evidence Citation
● Nurses who ● Increasing RN Perceived
participated in this Competency With
basic substance abuse Substance Use Disorder
disorder training Patients
demonstrated a
statistically significant
increase in perceived
confidence related to
treatment and
knowledge of resources
available to patients
with substance abuse
disorders (Russell et
al.,2017).
● In this study, 66% of ● Identification of
patients in the ED with emergency department
a substance abuse patients for referral to
disorder were identified rapid-access addiction
as having high enough services | Canadian
risk to be referred to a Journal of Emergency
rapid-access clinic Medicine | Cambridge
referral, if one was Core
available to the
hospital. The concludes
there is a gap in
collaboration between
the hospital and
community care (Hann
et al., 2020).
● Consultation in the ● Inpatient Addiction
hospital and linkage to Consultation for
ongoing treatment Hospitalized Patients
resources after Increases Post-
discharge increases the Discharge Abstinence
number of days of and Reduces Addiction
abstinence in the first Severity
month of hospital
 37
discharge (Wakeman et
al., 2017)
● Additional resource: use
of an infographic flier additional resources:
increased awareness ● The Impact of Flier with
about a project with Infographics on Public
statistical significance over
Awareness and Interest
a flier with no infographic
to Transportation
Project

Consider your budget, assistance that may be available from partnering organizations, time
constraints, and team expertise. Then select an HEP that can be implemented on Day 10. Highlight
your selected intervention in yellow in the “Potential Intervention” column above.
Fill-in the Spaces below to provide an overview of the selected HEP.
Setting Modality Audience
(Location/Time) (E.g. Demonstration, Presentation, Group (Specific sub-set of target population and
Discussion, etc.) special considerations, e.g. health literacy)
● Hanging flyers in the ED The registered nurses in the
St. Mary’s Emergency breakroom emergency department at St.
Department, 9/15/2022 at ● Providing the ED charge Mary’s hospital.
12:00 nurse with an
informative powerpoint
on CODAC to share with
her unit
● Sharing CODAC cards
with Nurse Manager at
ED
● Distributing (18)
laminated badge tags
with CODAC
information for all ED
nurses at St. Marys
Visual Aids Incentives Advertising
(E.g. Posters, Hand-outs, Pamphlets, Photo (E.g. Snacks, Free Passes, Coupons, Give (E.g. Word-of-mouth, Social Media, News
Novelas) Aways/Freebies, Raffle) Letters)
Flyers, informational cards and a
Posters, informational cards, Candy! powerpoint presentation.
and badge tags that provide
information on CODAC’s
services

Resources Constraints Partnerships

(Resources Available and Resources Needed (Issues that may make your project more (Community Resources that could
for Implementation) challenging, e.g. weather) contribute to, or participate in, the HEP)
 38
CODAC’s website, printer, The nurses are busy and are CODAC
CODAC informational cards, call unable to come to the meeting
CODAC and ask questions, visit to watch the CODAC
ED at St. Marys. presentation. The charge nurse
is not available when we get
there. No one reads the flyers in
the breakroom.
Process Objectives
These are objectives that are used to keep your team on track as you plan your HEP.
Process Objective List Evaluation Plan for Process Objectives
● Interviewed Key Informants in CT to gain The St. Mary’s emergency department nurses
further insight into issues within CT. were able to gain further information about
● Toured CODAC and received information CODAC. Our process worked and the
about services. interventions we performed proved successful.
● We got in contact with Liliana in regards The nurses shared their appreciation for the
to obtaining flyers with information resources and expressed excitement about using
about CODAC to hand out to the CODAC.
registered nurses in the St. Mary’s
emergency department.
● We designed badge cards with CODAC’s
phone number and a brief amount of
information on the clinic.
● We went to St. Mary’s ED and spoke with
the charge nurse about hanging up
CODAC flyers in the break room.
● We hung up two flyers in the break room
and left a stack of flyers on the charge
nurse’s desk.
● We handed out flyers to a few nurses
who were sitting at the nurse’s station
charting.

Impact Objective(s)
These are SHORT-TERM SMART goals that your learners should achieve following HEP attendance.
Impact Objective List Evaluation Plan for Impact Objective(s)
After sharing information about CODAC to RNs at When we go back to St. Mary’s ED to drop off the
St. Mary’s on 9/15/22, 80% of RNs state they are badge cards we will have each nurse working fill
aware of at least two services that CODAC out a survey where they list two services that
provides. CODAC provides.

Outcome Objective(s)
These are LONG-TERM SMART goals that your learners should achieve following HEP attendance.
Outcome Objective List Evaluation Plan for Outcome Objective(s)
 39
After educating the RNs in St. Mary’s ED on CODAC can count the number of referrals
9/15/22, CODAC reports a 20% increase in the received from St. Mary’s ED nurses and share
number of referrals received from the ED nurses. those statistics with us.
 40
Health Education Project (HEP) Photograph

Health Education Project Evaluation (HEPE) Tool

Evaluation of Process Objectives

Evaluation Mechanism Used Evaluation

We created a check-list that contained each step
of our plan to gaining CODAC flyers and
successfully get them passed out in St. Mary’s
emergency department. We crossed off each task
as we went throughout our process and
completed it.
Lessons Learned from the Process
Consider how well your team functioned in the planning and implementation of the HEP.
Strengths
● We communicated well among each
other and had designated roles.
● Everyone collaborated and contributed
to generating ideas for our project.
● Group members communicated in a
timely manner with one another and with
all organizations involved in the project.
41
After completing each task, we checked off the
item on the checklist. We completed each task
necessary to complete the process.
Areas for Improvement
● We could have initiated contact earlier
with CODAC to discuss details of our
preferred education plan to ensure we
had all materials so we would not have
had to return to CODAC for materials a
second time.
● Our time management could have also
been improved by printing at UA CON
instead of in the neighborhood of St.
Mary’s

Evaluation of Impact Objective(s)

Evaluation Mechanism Used Evaluation
We provided registered nurses in the St. Mary’s We determined that the initial written survey was
ED with a survey that asked each individual to not going to be as practical and therefore
state two services at CODAC. updated to a new option of a verbal survey.
Ask questions verbally:
Question 1 Can you list 1 new thing you learned
about CODAC today?
Question 2 What would make this more helpful
to you?

Lessons Learned from the Impact

Consider the impact of your HEP and the learning that took place among attendees.
Strengths
● Participants (RNs at St. Mary’s ED) stated
that they were very enthusiastic to learn
about the transportation available to
potential CODAC customers from the ED
and that they would “definitely be using
the resource to refer patients.”
● RN charge nurse at St. Mary’s ED posted
the flier of CODAC services in the break
Areas for Improvement
● We could have benefitted from coming to
the ED a bit more prepared with a wider
variety of flyers and CODAC cards.
● More time may have allowed us to create
a badge tag that CODAC’s marketing
team was able to approve of.
● If we were able to go to St. Mary's
change of shift time we would be able to
 42
room for other nurses to see and said increase the number of attendees (nurses
that this would be an important resource at St. Marys) who would have received
for patients utilizing St. Mary’s ED. the information first hand from our
● We utilized CODAC approved resource public health CT team.
materials that have infographics, colors,
and appropriate necessary information.
Considering Outcome Objectives(s)
You won’t actually be able to evaluate these long-term objectives, but consider these questions:
Do you think your attendees would meet these objectives if you were to follow through on the
Evaluation Plan? Why or Why not?
Yes, with all of the resources that we provided at the ED I do feel that each of the RNs at St. Mary’s
would be able to state two services that CODAC provides. Each flier contained an amplitude of
information about the center and was posted in the break room to be seen by all the nurses.

Imagine that you were granted $10,000 in funding over the next year to make your HEP a sustaining
project. Describe how you would use the funding and what changes you might make to your HEP.
We could use the funding to produce more CODAC resources and spread outreach from beyond St.
Mary’s to other hospitals in the Tucson area.

Potential options:
● Tucson bus advertisements of CODAC services
● Advertisements on company cars
● Creating CODAC approved ED nurse badges for all ED nurses in Tucson
● Community fairs at el Rio and other community centers
● Begin a program that focuses on ED nurse education regarding CODAC serves for smooth and
seamless patient referrals to CODAC.