1

Community as Partner Project

Cole A. Harmon, Gabrielle T. Haugen, Katya A. Kirkland,

Brooklyn D. Maher, and Taylor K. Petty,

University of Arizona College of Nursing

NURS473

Dr. Acosta

November 15th, 2022

 2

Abstract

Over 5 weeks in our population health nursing clinical rotation, Team E2 evaluated Census Tract

41.18 located in southern Tucson. We identified health concerns within our CT through

windshield surveys, community immersion activities, and interviews with long-term residents,

homeless-shelter workers, community food bank volunteers, fire/police department, general store

employees, and the middle school principal and school nurse. We determined the primary health

concerns were access to fresh food, accessibility to public transportation, and lack of mental

health resources. For our health education project, we decided to address the lack of mental

health resources for grade-school children at the local middle school, Billy Lauffer Middle

School. Our health education project consisted of 5 short videos about improving mental health,

which were played during the students’ morning announcements. Our goal was to provide

children with strategies to improve their mental health as well as to break the stigma against

discussing mental health.

 3

Community Survey

This survey is a comprehensive assessment of the community within our census tract.

After we collected objective data from health department records and online census data, our

team conducted a windshield survey to examine the assigned area.

Insert Pima County Census Tract (CT) # and map here.

CT 41.18

Pima County
Closest PCHD office East PCHD office 41.18
Census Tract #
name and address 6920 E Broadway Blvd Zip 85756, 85713
and Zip Code(s)

Dates of

Assigned PHN Justin Tutaan windshield 08-29-2022

survey

PHYSICAL ENVIRONMENT
 4

CT boundaries

North E Ajo Way East Wilmont, Swan, Contractors Way,

Craycroft

South I-10 West I-10

Housing (Units and Occupancy) Environment

Approx. #
County Units in Approx. #
CT County* CT Make
* Structure Make comments
% % % comments
% (Census)* below
below

Vacant/
Occupied
89 99 Single unit 67% 81% boarded up 2 Vacant lots? 5
units
structures?

Ownership

of Abandoned 4
64 84 Multi-unit 22% 0% Trash/rubble? 3
Occupied cars?

units

Median

value of 3
$199,4 $157,5 New
owner- Mobile home 10% 19% 2 Graffiti?
00 00 construction?
occupied

unit ($)

CT Size (sq. People per sq. 1,0

Boat, RV, Van 0% 0% 6
miles) mile 00
 5

* County= Pima County Census Reporter. (2022). Profile for Census Tract 41.18 Pima,

AZ. (https://censusreporter.org/)

Comments from

above and additional A few communities in this CT were gated, giving more privacy to these residents

comments (e.g.,

noise, smells, A lot of noise in the CT came from the I-10, passing trains and heavy freeway traffic

privacy, light,

gardens, trees, plants

vs. concrete, group

homes/student

housing major

community assets.

COMMUNITY CORE

Demographic U.S. Census data (%)

Total population of Pima

1,047,279 Total Population of CT 6,106
County

Age
County CT County CT Languages spoken County CT
Race & Ethnicity groups
% % % % at home % %
(years)*

White (non- English only

51 25 0-9 11 12 74 73
Hispanic) (5-17)

African American
3 10 10-19 13 24 English only (18+) 72 61
or Black
 6

22 25
Native 2 1 60-69 13 6
Spanish (5-17)

70+ Spanish (18+) 22 33

Asian 3 2 14 7
(add)

Hispanic (of any Median Foreign Born

38 60 38.7 30.9 12.5% 17.4%
race) Age (total %)

Include source of

data: Census Census Reporter. (2022). Profile for Census Tract 41.18 Pima, AZ. (

document title and https://censusreporter.org/) .

data year(s).

Culture and Ethnicity

Ethnic food stores 0

Ricositos Chile Dogos, Food truck, Ajo Way

Ethnic restaurants Chopstix Asian Diner (3820 S Palo Verde Rd)
Polo’s Taqueria Food (4100 S Palo Verde)
El Encanto (4100 S Palo Verde)
Taqueria El Zarape (6849 S Craycroft Rd)
El Amigo (6848 S Burcham Ave)
Signage in other A welcome sign at the Elementary school was in Spanish.

languages In two neighborhoods, the neighborhood signage was in Spanish.

Places of worship Way Family Church, 5385 E Littletown Rd, Christian Church, they offer Sunday service,

(formal name, children’s ministry, and discipleship

address, Family Christian Apostolic Center, 6516 S Burcham Ave, Christian Church, offers Sunday

denomination, and service

community
 7

services)

Art/sculpture Colorful Mural (Contractor Way)

Cultural dress None observed

HEALTH AND SOCIAL SERVICES

Resources (formal name, location, brief list of services and source website link).

Nearest hospital Banner University Medical Center South, 2800 E Ajo Way, offers emergency services,

open to the general inpatient hospital services, and outpatient hospital services, www.bannerhealth.com

public

Long Term Care and Sapphire of Tucson Nursing and Rehab (aka Sandstone healthcare group) (2900 E Milber

Rehab Facilities St), offers rehab, pain management, chronic disease management, dialysis, 24-hour skilled

(SNF, Assisted nursing, source: sandstonehc.com

Living, Independent

Living)

Homeless shelters Gospel Rescue Mission (4550 S Palo Verde Rd), homeless shelter offering discipleship

and support. Their mission is “Hope. Shelter. Transformation.”, grmtucson.com

Half-way houses None w/in CT

(drug treatment or Community Medical Services Tucson on Park (3720 S Park Ave), offers drug treatment,

post-prison or jail) communitymedicalservices.org

New Day Addiction Center (outside of CT, Valencia Rd and Swan Rd)

Urgent Care NextCare Urgent Care (outside of CT, 1570 E Tucson Marketplace), offers emergent

health care, sports physicals, or health concerns, solvhealth.com

Pharmacies (note if Banner Family Pharmacy, Walgreens (both at 2800 E Ajo Way), source: google

there is a clinic) “pharmacies near me”

 8

Dispose-A-Med Midtown Substation (outside of CT, 1100 S Alvernon Way) offer disposal of

site(s) expired/unused prescriptions, OTC meds, tablets, capsules, vitamins, and vet prescribed

meds, https://www.tucsonaz.gov/water/medication-disposal

Medical/Dental Banner Health Clinic, Banner University Medicine Family Medicine clinic (3950 S

offices/clinics Country Club Rd), full-service hospital, Bannerhealth.com

Clinica Del Alma Health Center (outside of CT, 3690 S. Park Ave), offer teeth cleaning,

dental exam, etc. mhchealthcare.org

Integrative care None within the CT

modalities (yoga, Yoga: Joanna’s Healing Arts (1567 S Fifth Ave), offer explorations in body, mind, and

energy therapies, spirit, joannasjourneys.com

massage etc.) Massage: Tucson Massage Company (1222 E Broadway Blvd), offer variety of massages

and infrared sauna, tucsonmassagecompany.com

Mental health Crisis Response Center (2802 E District St), offers crisis stabilization, gogole maps

Agencies Banner University Medicine Pediatric Behavioral Health Center (2800 E Ajo Way), offers

outpatient mental health services for children and adolescents,

https://www.bannerhealth.com/locations/tucson/banner-university-medicine-pediatric-

behavioral-health-clinic-ajo

Social Service US Citizenship and Immigration Services (Palo Verde and S Coach Dr), services include

Agencies citizen resource centers and educators, uscis.gov

Luz Social Services, (outside of CT, 3819 S Evans Blvd), offers education and outreach to

youth in community. Education, we provide supplemental support to the two charter

schools which are controlled through our common board, source:

https://www.facebook.com/luzsocial/
 9

Nearest Covid-19 Walgreens (1880 E Irvington Rd), offers pharmacy drive through Covid tests,

testing sites walgreens.com

Food bank/pantry “Thomas Jay Park Community Food Bank”, no online resources listed, no phone number

advertised

Other health/social Arizona’s Children Association (3716 E Columbia St), offers kinship services, foster care

service providers and adoption, behavioral health and trauma response, family education and support, young

adult services, family preservation and reunification, arizonaschildren.org

EDUCATION

Educational Attainment

County CT County CT
High school graduate Bachelor’s degree
% % % %
or higher or higher
89 85.5 33.6 21.7

Census Reporter. (2022). Profile for Census Tract 41.18 Pima, AZ. (

https://censusreporter.org/)

Educational Resources

Formal name, location, brief description of services, source website link.

Love This Day School (outside of CT, 4517 E 29th St), childcare programs, enrichment,

Childcare/ preschool dayschool, no website available

centers Cadence Academy Preschool (outside of CT, 1702 S Craycroft Rd), educational services,

child/infant care, preschool, www.cadence-education.com

Public School This area includes both Sunnyside Unified School District (SUSD) and Tucson Unified

District(s) School District (TUSD)

http://central.tusd1.org/
 10

https://www.susd12.org/

Schools inside CT. All schools listed below are public schools

Identify as public,

private, or charter.

The public school Craycroft Elementary School (5455 E Littletown Rd) SUSD, offers classes for pre K-5th

district elementary, grade, https://www.susd12.org/

middle, and high Cavett Elementary School (outside of CT, 2120 E Naco Vista) TUSD, offers pre K-5th

schools where grade, cavett.lps.org

children in a

particular census Billy L. Lauffer Middle School (5385 E. Littletown Rd) SUSD, offers classes for 6-8th

tract are assigned to graders, https://www.old.susd12.org/

attend (called

attendance zones by Sunnyside High School (outside of CT, 1725 E Bilby Rd) SUSD, offers classes for 9-12th

many school graders, https://www.susd12.org/

districts). Catalina High Magnet School (outside of CT, 3645 E Pima St) TUSD, offers classes for 9-

12th graders, http://catalinahs.tusd1.org/

Public Library in or Quincie Douglas Library (outside of CT, 1585 E 36th St), offers free Wi-Fi, events, and

nearest to CT meeting rooms, open from 10 am to 6 pm, www.library.pima.gov

Other (including any

educational

resources that
 11

remain closed or out

of business)

RECREATION

Formal name, location, brief description of services, source website link.

Neighborhood Community center at Thomas Jay Regional Park, offers events throughout the year and

centers and hours offers space to be utilized by the public, webcms.pima.gov

Recreation No gyms or recreation centers within the CT

centers/gyms and Closes gym is Jet Sports Training (4221 S Santa Rita), offers personal training, group

hours fitness, speed training, and youth spots training, open 5 am to 9 pm,

tucsonsportstraining.com

Kino Sports Complex, Ajo Way,

Parks/trails/green Thomas Jay Regional Park, Littletown Rd and Craycroft Rd, open dawn to 10 pm, offers a

spaces (include bike path, 2 play structures, multiple baseball fields, 2 basketball courts, 10 picnic tables,

amenities) and 2 covered ramadas, webcms.pima.gov

Various play structures were seen while driving through the residential areas

Other (including Closed Cross Fit and personal training gym within the CT

closed resources)

SAFETY AND TRANSPORTATION

Public Safety: city County Sheriff and Police Officers were seen during windshield survey

police department, Pima County Sheriff’s Department – San Xavier District (2545 E Ajo Way)

tribal police, and/or

county sheriff
 12

Fire District(s) and Rural Metro Fire Station 71 (outside of CT, serves central and East area of CT)

Station #(s) covering Tucson Fire Department station 10 (outside of CT, serves North area of CT)

CT Davis Monthan AFB Fire-Emergency Service

Distance from Rural Metro Fire Station 71: 3-4 miles away

middle of CT to fire Tucson Fire Department station 10: 4-5 miles away

station

Security guards Security guard outside of TEP

A private security company was seen in one neighborhood

Neighborhood Some residential areas included signs denoting “Neighborhood watch”. This, however, was

Watch? not the case for all neighborhoods.

Evidence of No obvious evidence of gang/criminal/drug related activity

gang/criminal

activity/drug use

Zip code 85713 is in the 11th percentile for safety, with a crime rate of 66/1000 people

Significant crime Zip code 85756 is in the 1st percentile for safety with a crime rate of 195/1000 people

statistics if available

(include # and time All data is from crimegrade.org

frame, source(s) of The safest and most dangerous places in 85713, AZ: Crime maps and statistics. (n.d.).

data, i.e. web sites) CrimeGrade. Retrieved August 29, 2022 from https://crimegrade.org/safest-places-in-

85713/

Registered sex 11 as of 08/29/2022 according to citydata.com

offenders (# as

m/d/y, include
 13

source(s) of data, i.e.

web sites

Ajo way
Bus stops (approx. #
Littletown Rd
and general location
Craycroft Rd
in CT; no need to
Palo Verde and Ajo way
list them all)
Most stops are around the business/industrial centers, ~20 total

Designated bicycle
Bike Path at Thomas Jay Regional Park – “The Loop”
paths

Parking Parking is available at many businesses and in the industrial complexes.

(availability)

Walking Path by the elementary school and throughout neighborhood areas

No sidewalks in a few residential areas

Sidewalks
Some city sidewalks had many cracks and ended abruptly

Street conditions

include speed Cracked pavement and potholes throughout less trafficked roads in CT

bumps, roundabouts, Speedbumps spread throughout residential areas

etc.

Potholes spread throughout residential and less trafficked areas

Road hazards There are a few roads prone to flooding, marked with flood signs
 14

Night lighting
Minimal night lighting, lighting is concentrated to urban shopping areas
(optional)

Other risks (i.e. Train tracks ran throughout some areas in the CT, this could pose a risk to drivers, bikers,

dangerous and walkers alike

intersections) or

resources Other possible risks to the public include varying junk yards, industries, and vacant lots

(grocery stores, spread throughout the CT

pharmacies, etc.)

ECONOMICS

Businesses inside Census Tract (enter approx. #)

Bars 1 Convenience 1 Laundry/dry cleaners 0 Neighborhood market 0

Restaurants 8 Discount store 3 Liquor stores 1 Post office/UPS 0

Check cashing 0 Fast food 2 Malls (describe): 0 Supermarket 0

Banks 0 Gas station 8 Thrift/resale store 0

Farmer's market 0 Community Garden 0 Health1/organic food 0

stores

Other businesses. Electric Company 1, Auto supplies 5, Hotels 4, Solar lot 2, Swap Meet 1

Use generic name

only

Temporarily or Empty gas station

permanently closed Empty convenience store

Closed Middle School

 15

businesses/empty

storefronts

U. S. Census Data (% or $) County (% or $) CT (% or $)

Per Capita Income ($) $30,747 $23,058

Median Household Income ($) $55,023 $61,505

Persons below poverty line: 15.9% 12.8%

Children (under 18) (%) 22% 15%

Seniors (65 and over) (%) 9% 0%

Moved since previous year (%) 19.2% 17.8%

*Include source of data:

Census Reporter. (2022). Profile for Census Tract 41.18 Pima, AZ. (
Census document title and data
https://censusreporter.org/)
year(s).

POLITICS AND GOVERNMENT

Names of neighborhoods or “Window Rock East”, “Julian Ranch”, and “Valencia Crossing”

subdivisions

How are neighborhood names Some neighborhood names were displayed on decorative, metal signs outside of

displayed? the specified subdivision

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 Inside city limits

city/town limits?
 16

CT City ward(s) and council Ward 5

member(s) with political party Council member Richard Fimbres, democratic party

designation

CT County district(s) and District 2

supervisor(s) with political Dr. Matt Heinz, Democratic party

party designation

CT state legislative district(s) District 21

and legislators (1 senator and 2 Senator Rick Gray, Republican party

representatives) with political Representative Kevin Payne, Republican party and Beverly Pingerelli,

party designation Republican party

CT US Congressional District 6

District(s) and Senators Kyrsten Sinema, Democratic party

representative(s) with political Representative David Schweikert, Republican party

party designation

Signs of political activity Home signs and bumper stickers for “Biden/Harris” and signage for local

Tucson politicians

Other data/comments

COMMUNICATION

Closest Newspaper is the Arizona Daily Star (4850 S Park Ave), Tucson Weekly

Newspapers/Newsletters/Flyer (7225 N Mona Lisa Rd), and Arizona bilingual newspaper (101 W Irvington Rd

s Building #3A)

No newspaper distribution

Payphones None in this CT

 17

Closest one is on Kolb and Golf Links

Anti-drug related billboards (marijuana)

Billboards/bulletin boards Fast food advertisements (McDonalds, Canes, Culver’s, Rudy’s)

(include main Recreational billboard (KOA, Casino)

purpose/message) TEP Advertisement Billboard

Billboard for Banner Medical Center

Free Wi-Fi at Pilot gas station (5570 E Travel Plaza Way), Jack in the box (5000
Free Internet/Wi-Fi
E Valencia Rd), Pima Air and Space museum (6000 E Valencia Rd), Java Edge
access/locations
(2800 E Ajo Way), and Kino Sports complex (2500 E Ajo Way)

Other data/comments

ADDITIONAL INFORMATION

Gray highlighted information came from ballotpedia.com

Arizona. Ballotpedia. (n.d.). Retrieved August 30, 2022, from https://ballotpedia.org/Arizona

 18

Key Informant Interview Record

Our team collected subjective data from numerous members of the community through

key informant interviews. Team members recorded the findings of multiple interviews to

examine and compile the public health concerns of this population.

Cole A. Harmon:

Interviewee #1 Interviewee #2

Generic Title: Dollar General Employee Generic Title: Community member – A

veteran
Sub-system(s) Addressed: Health and Social
Services Sub-system(s) Addressed: Safety and
Transportation

Interview Questions: Interview Questions:

1) Do you see regular faces? 1) Do you feel safe in this area?

2) What are the primary groceries you see 2) How do you get around your community?
bought here?
Key Informant Comments/Insights: Key Informant Comments/Insights:

1) He mostly sees the same families on a 1) He said that in all his time in the area, he
regular basis and stated that this was the main has always felt safe. “It is a clean, quiet, and
source of groceries for the nearby small community.” On first drive-through it
neighborhoods. did not appear that way. With an outside
perspective, it seemed dirty and unsafe.
2) When we asked what gets bought the most, However, being in the community and talking
he laughed and said Cheetos. He was not with locals has changed that perspective on
joking. The chip aisle was pillaged. He also this area.
said instant frozen meals, like pizzas, were
popular. 2) The veteran expressed that he has had
some frustration with transportation in the
3) Another thing he said that stuck with me area. It appeared that he had no car and thus
was that he sees a high percentage of relied on bus routes and biking. He mentioned
homeless people coming in for food. This that the bus routes were pretty infrequent,
makes sense in the community, as we saw a visiting every 30 minutes on weekdays and
lot of resources that catered toward homeless every hour on weekends. He also said that the
persons around the area. It seemed to be a hub routes only cover major streets, which can
for homelessness resources. often be hard to get to.
 19

3) The veteran also said he does most of his

food shopping at Circle K. He said that even
Dollar General was too inconvenient to get to
from where he lives. If he was out-and-about,
he would go to other grocery stores, but even
then, it was mainly the Dollar Tree. This
further supports the food desert crisis that is
limiting the nutritional quality of the residents
of this census tract.

Gabrielle T. Haugen:

Interviewee #1 Interviewee #2

Generic Title: Dollar general customer Generic Title: Police officer

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

transportation

Interview Questions: Interview Questions:

1) Where do you grocery shop? 1) Can you tell me about the types of calls
you respond to?

2) Do you shop here out of convenience, and

do you find it hard to find fresh produce or 2) What are the biggest health concerns
meat? within this population that you serve?

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

1) “I grocery shop at the closest Walmart and 1) The police respond to calls within CT
Costco. It’s about a 15 min drive.” 41.18 for domestic violence, keep the peace
civil matter, and welfare checks.
2) “I come to this dollar general to get snacks
and quick pick-up needs.” 2) The police officer said that they respond to
a lot of calls regarding homelessness and
3) “No, it’s not hard to find fresh produce or mental health concerns before this question
meat. The drive is not that bad to go to was asked. The biggest health concerns are
Walmart and Costco, but I wish they would mental health problems, homelessness, and
have built a grocery store in the new house addiction.
construction they are building. It would have
been closer to this area and more convenient.” 3) The main age the police officer serves
within CT 41.18 are 20-40 year old’s and
pockets of elderly.

Katya A. Kirkland:
Interviewee #1
Generic Title: Firemen
Sub-system(s) Addressed: Safety and
Transportation, Health and Social Services
Interview Questions:
1) What calls do you respond the most to?
2) What populations do you serve most?
Key Informant Comments/Insights:
1) Firemen respond mainly to standard health
calls such as chest pain or shortness of breath
as well as drug overdose and mental health
issues.
2) Mainly serve the homeless community and
other residents of low socioeconomic class
areas with many in trailer parks.
3) They believe communities biggest health
need is mental health help for mental illness
and addiction.
Brooklyn D. Maher:
Interviewee #1
Generic Title: School Nurse
Sub-system(s) Addressed: Education, Health Sub-system(s) Addressed: Safety and
and Social Services, Recreation Transportation, Economics, Health and Social
Services
20
Interviewee #2
Generic Title: CT resident/Dollar General
Store worker
Sub-system(s) Addressed: Economics,
health
Interview Questions:
1) Where do you do your grocery shopping?
2) Do you find most costumers are doing their
grocery shopping here?
Key Informant Comments/Insights:
1) Resident mainly shops at Costco or
Walmart outside of CT to obtain groceries
and fresh produce.
2) Most costumers are shopping for snack
type foods, but some costumers buy all of
their groceries (food, house supplies, etc.) at
the dollar general.
3) Resident would have liked for a grocery
store to be opened in the newly built
residential area for easier access/ not having
to drive so far.
Interviewee #2
Generic Title: Pedestrian

Interview Questions:
1) What are the student’s eating habits like
during the school day?
2) What kind of health issues do you deal
with most?
Key Informant Comments/Insights:
1) The nurse described how most students
come to school hungry, and their only
guaranteed meal is their school lunch. In the
past, students have left class to come into the
nurse’s office to ask for snacks. After school
programs have been implemented, many of
them offering some kind of snack or food
with their daily activity. Many students have
taken advantage of this recreational
opportunity.
2) The nurse said that her students had
relatively okay hygiene. Kids came to school
in seemingly clean clothes, but she did not
know how frequently showers took place. She
described a lack of health knowledge in the
students, often pertaining to body odor and
deodorant.
3) The nurse said that parents are often unable
to come get their child from school without
leaving work. This makes sending a child
home if they feel unwell very difficult at
times.
Taylor K. Petty:
Interviewee #1
Generic Title: Homeless Shelter Clinic Nurse Generic Title: Principal of middle school
Sub-system(s) Addressed: Health and Social
Services
21
Interview Questions:
1) How do you get around, like if you need to
go grocery shopping?
2) Do you feel safe and supported in this
area?
Key Informant Comments/Insights:
1) This man says that he frequently rides the
bus, but he says that in some areas of the
town, the bus routes are not available. He
complained of the busses taking too long on
the weekends, sometimes taking over an hour
to pick up pedestrians.
2) He said that he mainly grocery shops at the
Circle K across the I-10 because it is walkable
and bikeable. He rarely, if ever, goes to an
actual grocery store (like Fry’s or Walmart).
3) This man said that he feels comfortable and
safe in the area. He says that there have been
increased Veteran related services available in
Southern Tucson that he likes to utilize.
Interviewee #2
Sub-system(s) Addressed: Education
 22

Interview Questions: Interview Questions:

1) How many people do you serve/how many 1) What resources do the kids have access to
people require your services? through the school outside of the classroom?

2) What are people looking for when they

come to your clinic/what do they need? 2) What problems can you see in the children
that you feel need to be addressed?

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

1) Many of the homeless people that come to 1) Eighty-seven percent of the kids in the
the clinic do not live in the area there school are on free and reduced lunch plans.
normally. They come so that they have access The school also offers breakfasts and after
to the resources provided by the clinic and the school programs.
attached shelter.
2) The after-school program uses a grant to
2) The people who live in the area feel as give the kids free access to snacks, tutoring,
though the area is safe and healthy. The nurse exercise, and care. They are able to provide
grew up in the area and continues to live there these services for free.
because she likes it.
3) Mental health resources are needed. The
3) Many of the homeless people have health kids have some of the best counselor to
and dental problems. Diabetes is a problem, student ratios in the state, but the principle
as well as drug use. does not feel like it is enough to fully address
their needs. He explained that COVID took a
massive toll on the mental health of his
students.
 23

Root Cause Map

Knowing that social factors can impact one’s health status, this map considers how social

determinants and other systemic factors influence the lives of individuals living in our assigned

census tract.

Gender
Institutional
Class Oppression Discrimination and
Racism
Exploitation
Single mothers in the
area may face issues
About 60% of our rooted in sexism like
Poverty breeds
CT is Hispanic, and safety and comfort
poverty, in our CT,
the lack of resources using public
there is a large
in the community transportation. In
homeless and
could speak to the general, women using
impoverished
institutional racism. public transportation
community, and
The lack of may feel significantly
there are limited
resources makes it less safe than a man in
resources available
much more difficult the same situation,
to change your own
to address needs for and if you were a
living situation if
the community. young woman with a
you are already
Possible language child, like in our
living in poverty
barriers can reduce immersive experience,
utilizing resources. you would probably
feel terrified.

Power & Wealth Imbalance

Globalizati
Educatio
Labor Housing on & Social Safety Social Tax
n
Markets Policy Deregulati Net Networks Policy
Systems
on
Industrial Limited A middle More Limited safety Neighbors Poverty
and spread- low- school difficult to net. Food bank report tax has
out labor income and find a job and homeless knowing been
markets. If housing. elementa within the shelter one seen,
individuals Very few ry school CT without available another from
did not have rental within industrial within CT. well, and harder
self- propertie the CT. experience, individuals access to
transportatio s. This No high therefore Family/childca feel resources
n, they can make school the re services are connected like
would have it hard to within community available but to their grocery
to plan their find CT. will need to expensive to communiti stores
day around affordabl Accessing travel use which can es. and
 24

bus e housing education outside of affect parents’ pharmaci

schedules. near can be a their abilities to go es to
Waking up where challenge community to work. higher
early and they and a to work. gas
going to bed work, or further prices.
later may be their kids time
unavoidable go to constrain
when using school. t for
public working
transportatio parents.
n.

Social Determinants of Health

Education Health Care Neighborhood Social and

Economic
Access & Access & and Built Community
Stability
Quality Quality Environment Context
Banner south
hospital offers a Old infrastructure, Friendly
High expenses wide array of CT very spread out neighborhood, the
to average Two schools high-quality across 6 sq miles. community of
income of the within CT, and care and Lots of people have tight
CT. Housing to no high school services from undeveloped lands. knit relationships,
income ratio is within CT mental health to Limited and and the people
high emergency care, spaced out bus describe it as a
and it is within stops within CT. “small town feel”.
the CT.

Psychological Stress & Unhealthy Behaviors

Consuming fast, easy, and frozen foods. This has resulted in two kids at the middle school with
type 2 diabetes. Far driving distances to grocery stores. Far walking distances to closest bus stop
from residential area. Stress also comes with living in a high crime area.

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

Type 2 diabetes, food desert, less access to public transportation, and mental illness are common
issues in our CT. Addiction is also prevalent with in our CT.

 25

DACR Tool

This Data Analysis and Community Resource (DACR) Tool examines resources within

the census tract to better understand the community and identify priority health concerns among

the population.

Describe your Census Tract, drawing from the Community Profile, Windshield Surveys,
Key Informant Interviews, and Community Immersion:
Census tract 41.18 is an area comprised of industrial sectors such as Tucson electric as well as
residential areas. The CT has a middle school and elementary school. There are no groceries
stores within the CT, rather two Dollar Generals and a few gas stations, which appear to be the
main source of food for many community members. CT 41.18 lives below the county average
for median household income. Economic instability is evident within this area. The poverty
within our CT causes issues including convenient public transportation, access to health
resources, poor nutrition, and high life-stressors leading to poor mental health/substance abuse.
Through immersion into our community, it was clear to us that this community does not
adequately support populations in need, but rather compounds on the stressors that these
populations have to try to overcome.

List at Least Three Community Strengths List at Least Three Community Stressors
• Sense of • Community • Mental illness • Poverty/low
togetherness loyalty • Poor access to income living
• Access to healthy food • High crime
recreational areas • Poor access to • Homelessness
public
transportation
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
Mental Illness Limited Food Access Homelessness

Complete the Community Resource activities in D2L before proceeding.

Community Resource(s) for Community Resource(s) for Community Resource(s) for
Concern #1 Concern #2 Concern #3
Crisis Response Center Community Food Bank & Gospel Rescue Mission:
- Mission: Provide safe Thomas Jay park food bank Homeless Shelter
environment - Mission: Provide food - Mission: Reestablish
regardless of situation to homeless hope for homeless
to provide person- population and people, provide
centered, immediate families struggling to shelter, and transform
behavioral health care afford food their lives to get them
- Funded: Insurance - Funded: donations back on their feet.
money from grocery stores - Funded: donations
and volunteers only
 26

- Services offered: - Services offered: fresh - Services offered:

acute behavioral produce, canned housing up to 45 days,
health, crisis foods, breads, non- recovery program (12-
stabilization, perishables 15mo), help get back
transitions of care, - Cost for services: free into the workforce,
residential treatment, - Population: homeless meal support
social work/referral, and impoverished - Cost for services: free
crisis hotline, people - Population: homeless
medication support - Benefit to CT: - Benefit to CT: helps
and adherence provides nutritious, reduce homeless
- Costs for services: free food population and
cheaper than the ER, - Partnership: unlikely; provides services to
accepts biggest need is get homeless people
access/Medicaid transportation for clean and fed
- Population served: goods (vans) - Partnership: unlikely;
everyone needing needs help finding
mental health support, transportation for the
60% referred from homeless population,
st
police/1 responders and needs volunteers
- Benefit to CT:
Improve mental health
accessibility and
reduce stigma about
mental illness
- Partnership: provide
pamphlets, we’d help
spread the word about
their services and
“988 program”
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
Mental Illness

Target Population within Census Tract that is Impacted by the Priority Concern
Middle Schoolers (11-13 year olds)

Four Part Community Nursing Diagnosis for Priority Concern and Target Population

Risk for Mental Illness among middle schoolers related to community stressors including
poverty, low economic status, poor resource access, and living in a high crime area as
evidenced by lack of mental health resources within the CT, school principal testimony of a
need for mental health resources for students and school nurse report of minimal mental health
and health related education.
 27

Broad Overarching Goal that would help you address your diagnosis with your CT:
Improve and prevent mental illness within the community.

List a Health People 2030 Objective that Relates to your goal above:
Increase the number of children and adolescents with serious emotional disturbance who get
treatment.
 28

Community Availability Severity of Community

Identified Nursing
Community Expression of Outcome(s) Strengths
in County’s Students’
Health Supporting of Interest Resources without Total that can
Health Ability to
Stressor Data in for Effort to Score Help
Needs Address
Addressing Addressing Address Address
Assessment1 Stressor
Stressor2 Stressor Stressor Stressor
KI reports,
Willingness
middle school
to support
principal
treatments,
statement,
Mental understanding
crime rate, 2 4 1 1 2 10
Illness of mental
substance
health needs
abuse, police
and firemen
reports
Poor eating Loyalty to the
Limited food habits, community
access poverty, food results in
0 2 0 1 1 4
insecurity, community
grocery stores run food
in CT banks
Windshield
survey
Access to
observation,
homeless
Homelessness food bank, KI 1 2 0 1 2 5
shelter and
with
food bank
homeless
shelter
Crime rate, Access to
drug recovery
Substance
paraphernalia, 2 4 0 0 2 8 resources
abuse
antidrug (shelter,
billboards CRC)

General Scoring Key: 0 = low, 1 = moderate, 2 = high

• (1) Score 1 point if consistent with report findings as a concern in the county. Score 2
points if stressor is 1 of the county’s priority areas.
• (2) Community Expression of Interest is double weighted to emphasize its importance.
 29

Policy Development Tool

Following our community assessment and analysis of gathered data, we have determined

priority concerns for our census tract. We then began to plan appropriate interventions for the

community.

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
All foods and beverages made available on a The food offered by the school will have to
school campus serving any configuration of comply with Arizona’s nutrition standard,
prekindergarten through eighth grade during with the intent that they are offering healthier
the normal school day are to be consistent options from the school. This is also supposed
with the Arizona nutrition standards. to be beneficial for students who are on free
Sunnyside school district set this requirement. and reduced lunches to give them access to
healthy food. This is an important policy for
our CT because it provides healthy food
options for the students that go to school in
the Sunnyside Unified School District,
especially the students who rely solely on the
school to meet their nutritional needs.
Tucson or Pima County
Ordinance Impact
All food establishments except temporary, This ordinance mandates that food
seasonal, and farmers markets must have a establishments need to meet a certain health
person in charge on the premises during all standard. This policy makes it safer to eat at
times of operation. A person in charge may food establishments, therefore protecting the
obtain a food sanitation certificate from the health of consumers. Our census tract is home
department to satisfy the person in charge to 28 food establishments, and these
requirements. This is a Pima County regulations protect our community.
ordinance.
State of Arizona
Statute or Regulation Impact
Title 36 Section 202 Arizona State The state is required to have facilities
Legislature Statute equipped to handle mental health. It also
The state hospital shall have adequate makes sure that the treatments for people with
facilities and equipment for enlightened and mental illness are regulated. Mental health
scientific treatment of nervous and mental complaints were prevalent in our key
diseases in accordance with approved interviews, and this statute works to provide
methods of mental therapeutics. resources to those in need of mental health
resources.
 30

United States of America

Statute or Regulation Impact
The Children’s Health Act of 2000 Young people are given more resources and
reauthorizes SAMHSA (Substance Abuse and better access to mental health services as well
Mental Health Services Administration) as help with substance abuse from the
programs that work to improve mental health government. Our schools complained that
and substance abuse services for children and their students were not given enough access to
adolescents. mental health help, and this statute is meant to
keep students mentally safe.

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?
We propose that the state creates a policy that requires inclusion of mental health education in
their curriculum for students starting at sixth grade.

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?
We could advocate for our policy by meeting with our state legislators and present our policy
idea. We could also conduct research and community needs assessment to support the need
and effectiveness of our policy. Further, we could meet with partners such as the crisis
response center to gain more widespread support of our policy. Lastly, we could also create
flyers and social media campaigns to distribute around the community and state to educate the
public and any lawmakers on the purpose and necessity of our policy.
 31

HEPP Tool

The Health Education Project Planning Tool was utilized to brainstorm potential

educational ideas to address the determined public health concern in our census tract.

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
• Distribute suicide hotline
information to the
community and the
identified population.
• In-school education about
free mental health
resources/activities.
• Encouraging Cognitive
Behavioral Therapy
(CBT) to middle school
students.
Evidence
• Researchers have found
that using crisis lines has
mostly been on a short-
term, immediate basis.
More research needs to be
done to find out the long-
term benefits and
effectiveness of crisis
lines. For the short-term
results, the studies found
that overall, the crisis lines
are effective and do what
they are intended for.
• Evidence supports the
effectiveness of mental
health education among
students among various
age ranges, developmental
levels, and at different
points on the development-
intervention spectrum.
More research is needed to
better implement at a large • Centers for Disease Control
scale.
• CBT is a type of therapy
that involves changing
maladaptive thoughts and
feelings that negatively
impact children's mental
health. As the child and
therapist identify the
child's thoughts and
feelings, the therapist can
help the child evaluate any
cognitive distortions and
subsequent behaviors. This
Citation
• Hoffberg, A. S., Stearns-
Yoder, K. A., & Brenner, L. A.
(2020). The Effectiveness of
Crisis Line Services: A
Systematic Review. Frontiers
in public health, 7,
399. https://doi.org/10.3389
/fpubh.2019.00399
• Lyon, A.R., Bruns, E.J. (2019).
Evidence to Impact: Joining
Our Best School Mental Health
Practices with Our Best
Implementation
Strategies. School Mental
Health 11, 106–114.
https://doi.org/10.1007/s12310-
018-09306-w
and Prevention. (2022, April
19). Therapy to improve
children's mental health.
Centers for Disease Control
and Prevention. Retrieved
September 19, 2022,
from https://www.cdc.gov/
childrensmentalhealth/parent-
behavior-therapy.html
 32

form of therapy is proven

to be effective when used
directly with the child.
CBT is especially useful in
treating depression,
anxiety, disruptive
behavior, and PTSD in
children.
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, (Specific sub-set of target
Presentation, Group population and special
Discussion, etc.) considerations, e.g. health
literacy)
Short videos and
Billy L. Lauffer Middle posters/flyers Middle school students in our
School across campus. CT

Visual Aids Incentives Advertising

(E.g. Posters, Hand-outs, (E.g. Snacks, Free Passes, (E.g. Word-of-mouth, Social
Pamphlets, Photo Novelas) Coupons, Give Media, News Letters)
Aways/Freebies, Raffle)

Attractive posters/flyers, No incentives offered School news, word of mouth,

fun videos flyers around school

Resources Constraints Partnerships

(Resources Available and (Issues that may make your (Community Resources that
Resources Needed for project more challenging, could contribute to, or
Implementation) e.g. weather) participate in, the HEP)

Videotaping equipment Commanding attention Billy L. Lauffer Middle School

(phone) Facing the ridicule of School nurse
Flyer supplies middle schoolers Crisis Response Center
Dr. Acosta Printing Being taken seriously

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

• Create lesson plan • Are the lesson plans approved?

• Reach out to principal • Videos recorded by the end of next
• Record videos week
 33

• Make posters/flyers for school • Posters/flyers completed by the end of

• Print posters/flyers next week

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)
80% of the students at the school will watch By the second week of implementation,
the student news and report enjoying the students will respond to attached surveys and
information presented via a short survey. report enjoying the information presented.

50% of the students who responded having By the second week of implementation,
watched the videos report wanting to students will respond to attached surveys and
implement the mental health strategy listed. report wanting to implement methods provided.

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)
50% of students will implement at least one At six months post-implementation, student
of the taught mental health activities for six surveys will show that 50% of the students
months and will report via survey having an have implemented one mental health activity
increased happiness level. and report higher levels of happiness.
 34

HEP Photograph

From left to right, Cole Harmon, Taylor Petty, Brooklyn Maher, Gabrielle Haugen, and

Katya Kirkland film short educational videos for the students of Billy L. Lauffer Middle School.
 35

HEPE Tool

This health education project evaluation tool helped us examine the effectiveness of our

project, and we were able to reflect on our experiences.

Evaluation of Process Objectives

Evaluation Mechanism Used Evaluation

Google surveys distributed to all students who We received no surveys from the middle
viewed our HEP. schoolers to evaluate the effectiveness of our
HEP.

Lessons Learned from the Process

Consider how well your team functioned in the planning and implementation of the HEP.
Strengths Areas for Improvement

Our team shared equal passion and
excitement for creating our HEP. We
delegated tasks well and built off each other’s
unique perspectives and creative minds to
create an education project that we were all
proud of.
Our planning and implementation could be
improved by creating a more effective and
accessible evaluation tool for the students to
fill out.

Evaluation of Impact Objective(s)

Evaluation Mechanism Used Evaluation

Conversations with school administration and School administrators were enthusiastic about
staff regarding the impact of our project. our project. They had high hopes the videos
would provide students with helpful mental
health tools that they are currently lacking.

Lessons Learned from the Impact

Consider the impact of your HEP and the learning that took place among attendees.
Strengths Areas for Improvement

Our HEP provided mental health resources to
an age population that rarely gets exposure to
mental health advice or resources. Our goal
for the HEP was help normalize discussions
about mental health.
Our HEP could have had a stronger impact on
the middle school population if we were
physically present during our project
implementation to make it more interactive
and engaging. We also could have answered
questions, talked with children, and better
evaluated the feedback from our project.

Considering Outcome Objectives(s)

 36

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?

We think our HEP would achieve some of these long-term outcomes regarding mental health
in the middle school population. By discussing mental health in a fun and engaging way, we
may create a healthier environment among children revolving their mental health. However,
since our HEP only consisted of 5 short videos over 5 weeks, we anticipate that the full scale
of our outcomes would not be met in such a short time. If given more resources and time, we
may be able to achieve more impactful, long-lasting mental health improvements.

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.

If we were granted $10,000 in funding, we would use the money to make higher quality videos
of our mental health tips. We would also distribute the videos to all middle schools and high
schools in the Sunnyside school district. Further, we would bring in a therapist to every school
to talk about these mental health tips and other resources students can access. The therapist
would also assist in the evaluation of our HEP by having monthly meetings with students to
evaluate their mental health status and progress.
 37

References

Arizona. Ballotpedia. (n.d.). Retrieved August 30, 2022, from https://ballotpedia.org/Arizona

Census Reporter. (2022). Profile for Census Tract 41.18 Pima, AZ. Retrieved August 30, 2022,

from https://censusreporter.org/

Centers for Disease Control and Prevention. (2022, April 19). Therapy to improve children's

mental health. Centers for Disease Control and Prevention. Retrieved September 19,

2022, from https://www.cdc.gov/ childrensmentalhealth/parent-behavior-therapy.html

CrimeGrade. (n.d.) Retrieved August 29, 2022, from https://crimegrade.org /safest-places-in-

85713/

Hoffberg, A. S., Stearns-Yoder, K. A., & Brenner, L. A. (2020). The Effectiveness of Crisis Line

Services: A Systematic Review. Frontiers in public health, 7, 399.

https://doi.org/10.3389 /fpubh.2019.00399

Lyon, A.R., Bruns, E.J. (2019). Evidence to Impact: Joining Our Best School Mental Health

Practices with Our Best Implementation Strategies. School Mental Health 11, 106–114.

https://doi.org/10.1007/s12310-018-09306-w