Final Project on Medicine and Health

Assessment of healthcare needs of Miami Dade County School

The health disparities among the Miami Dade County’s vulnerable and low income populations are documented well. From the high incidences of obesity, lead poisoning, asthma among children to increase of diabetes, cancer, and cardiovascular diseases among the adults to alarming levels. Furthermore, access to prevention and treatment heath care of high quality is usually challenging for the Miami Dade County residents (Fos, Fine & Fos, 2005).

According to Taylor (2011), determining the community’s healthcare needs requires a detailed knowledge of the focus population. The residents and staff of Miami Dade County School community provide to this knowledge base an invaluable content. In assessing the preparedness and healthcare needs of the Miami Dade County residents who are at a risk of  premature death, disability, injury and risk of illness, and would also benefit from the health promotion, the project  assessed the:

  1. Availability of the health services that are essential within the Miami Dade County and the adjacent areas
  2. Services access, that is transportation, natural barriers presence such as rivers and highways
  3. The choice of the provider, that is the availability of the ethnically or culturally competent providers of healthcare or specialists among the Miami Dade County residents
  4. The literacy, culture and language needs of the community, and also presence of other ethnic neighborhoods

Miami Dade County School is the largest in Florida State and also the fourth largest district school in the whole nation. Miami Dade County School in collaboration with the community school providers of health has a school health program that provides health services to the school that protect, appraise and promote the students health during their years in schools from pre-K to the 12th grade (Huber, 2006). Veenema (2007) observed that the health program for the school also provides  school health services that are ongoing, quality assurance, regulatory oversight and technical help to the entire community of the school both non public and public. The school health programs strength is found in its dedication, caring and the competent staff that are making positive impact on the students’ health. Clemen-Stone et al (2002) pointed out that the school health programs assumes a leadership role in risk assessment and fostering collaboration with other agencies and collaborations to improve and integrate services, provide information about needs and issues of health, and to develop policies. The provided services according to Allender & Spradley (2005) include:

  • Administration of medication
  • Vaccine administration
  • Record review of immunization
  • Health record review
  • Nursing counseling
  • Nursing assessments
  • Screening programs
  • Care Plan for student development
  • Home visitation
  • Follow ups and referrals of the health problems
  • Parent consultations
  • Classroom health education

Residents of Miami Dade County historically have been plagued by limited financial resources and high unemployment, complex family situations and crowded living conditions. The conditions are exacerbated often by located neighborhoods in areas of high crime and isolation, furthermore, the period of great recession and financial crisis increased reports of increased incidents of behavioral and mental health related disorders, chronic stress among the residents (Smith, & Maurer, 2000).

The residents of Miami Dade County also have values and value systems that influence community health nursing in different ways. The residents believe in socialization where members of the small community from different ethnic groups converge to brainstorm certain health issues of their areas such as provision of clean water, good sanitation, availability of medical and health centers within their neighborhoods (Adams, 2009). Despite the fact that the community has diverse cultures and ethnic groups, they are receptive to health care services provided to them from the health care facilities and even propose some of the lacking services in their communities (Colasanti et al, 2012).

Miami Dade County School has a well established public health preparedness program which helps the community in preparation and planning of the public health emergencies. () observe d the mission of the Miami Dade County School’s preparedness program is to secure and protect life through collaborative partnerships to mitigate, respond, plan and recover effectively in all situations of hazard. The preparedness program of the public health  coordinates preparedness and planning activities for all public health hazard emergencies for the health department of Miami Dade County School (Frenk & Trinitapoli, 2013). Emergencies of the public health are disasters or events that threaten the health of groups of people or communities (Fos, Fine & Fos, 2005). The Miami Dade County School’s preparedness health program prepares the small community to deal with several emergencies of public health like the natural disasters such as floods, hurricanes, wildfires, disease outbreaks like flu, severe weather like extreme heat, and biological attacks of the terrorists like release of anthrax. Taylor (2011) pointed out that the preparedness program of the public health works alongside many volunteers and professionals from community, clinics, hospitals, non private and private country agencies or organizations, state and region partners. Working together with these partners prepares the preparedness program of the public health of Miami Dade County School for emergencies of public health that can affect the safety and health of the visitors and citizens of Miami Dade County School, Florida state or Dade county. Huber (2006) asserted that public health emergency preparation is a responsibility of all Miami Dade County School citizens. They have to work together to be sure that at all times they are ready for disaster whenever it strikes. It is vital to be prepared for emergency of public health for the community to emerge from the calamity in good health

The education level of most residents Miami Dade County  over the past four decades indicates that there has been improvement (Veenema, 2007).when comparison is made between Miami Dade County  to the nation and to the state, the proportion of people with degrees is similar to Florida state and the whole nation of united states. From study conducted by Adams (2009), statistics indicate that 12.7% of the population in Miami Dade County with below 9th grade education is almost double the 6.5% of the nation (Adams, 2009). Similarly, the percentage of the population with below high school degree for the blacks and Hispanics is more than thrice that of the non-Hispanics whites. The percentage for blacks was 29.8%, 27.1% for the Hispanics and 7.8% for the non-Hispanics whites (Adams, 2009). However, the project focused on the educational level of Miami Dade County School where most participants and students have educational level up to grade 12. However, the staff and the teachers are mostly college graduates, degree graduates, and 9th graduates for both the teachers, and the subordinate staff members. In assessing the level of education, survey method was applied where open ended questionnaires were issued to the group participants in educational health classes for the community. Levels of education slot were also available in the survey questionnaire. After analysis of the results, most of people of Miami Dade County School had college level and high school levels of education

Community health nursing diagnosis

Forming a nursing diagnosis needs application of detailed critical thinking, assessment skills and decision making. Clemen-Stone et al (2002) defined hypothesis as a statement that brings together data for assessment. It is descriptive label for a state or a situation, and it implies an etiology and gives supporting evidence to the inference. Allender & Spradley (2005) indicated that that according to North American Nursing Diagnosis Association (NANDA), definition of nursing diagnosis is a family, an individual, or community responses clinical judgment to potential or actual life processes or health processes.

Nursing diagnosis limits the process of diagnosis to the diagnoses that represent responses of individuals to potential or actual health problems that the nurses are permitted to treat. Community diagnosis, on the other hand, differs in that it is focused on a community or an aggregate instead of an individual. It requires action that is multidisciplinary to treat or address, and many determinants must be given considerations when planning interventions (Smith & Maurer, 2000).

In a community diagnosis, there are four parts and they include first, problem description, response and state. Second is the statement of the community, third is the identification of the factor related etiologically to the factors, and lastly are the signs and symptoms that the problem characteristics.

The community health action basis must be an accurate state of health assessment of the entire community. According to Colasanti et al (2012), community health diagnosis is an important precursor to intervention of community health nursing that is acknowledged widely. Assessment refers to collection of data and analysis, and is the first step in the process of diagnosis. Diagnosis applies assessment as the foundation for labeling and decision making that concisely and clearly describes a problem, and completes the process of diagnosis (Adams, 2009).

For the purpose of this project, community was defined as a bunch of people related by one or many characteristics that validates their being regarded as a single system by the community health team. The manner in which community people are related must be specified by a nurse for the development of the community health diagnosis, and to allow for communities comparisons.

According to Frenk & Trinitapoli (2013), epidemiology provides methods and concepts for estimation of the population segments that are most likely to experience mortality and disease in the future. These methods referred to as risk assessment, allows the nurse  to make an identification of the groups at risk, or at high risk such as the specific conditions that are potentially susceptible, or at high risks such as having at least one risk factor known for a specific condition. Lastly is to design interventions for lowering their status for risks, and promotion of their health (Fos, Fine & Fos, 2005).

HIV/AIDS statistics in Miami Dade County 

Statistics indicate that in 2013, there were 26,760 people in Miami Dade County   living with HIV/AIDS (Frenk & Trinitapoli, 2013). This has increased from 2004 to 2014 by 23%. From the diagnostic assessment data, results indicate that as much as the black forms 16% of the general population, the represent 48% and 38% of the HIV/AIDS population in 2014 and 2004 (Colasanti et al, 2012). The Hispanics which form 67% of the general population of the country represents 44% and 51% of cases of HIV/AIDS reported in 2014 and 2004 respectively (Frenk & Trinitapoli, 2013).



Lack of information and its effect in the spread of HIV

The topic for was chooses because of the following reasons

  1. Growing concern that the youth risk contracting HIV
  2. Lack of proper information on the disease misconceptions and baseless perceptions on how HIV is spread, controlled and sustained
  3. The need to disseminate relevant and accurate information through this community project
  4. To enable the youth prevent themselves from contracting the virus

Goals of the project

The goal of this project is to equip the youth with all the information surrounding HIV and in particular

  1. To acquaint them on what HIV is
  2. Teach on how HIV is contracted
  3. Relay the methods of prevention including Prep and Pep
  4. Disseminate information on how to live with HIV

Location of the project

The location of the project will be Miami Dade School in Dade County in the state of Miami

Target population

The target populations are the students and the staff of Miami Dade School. Emphasis will be placed on the students of both genders



Implementation plan

  1. Identification of all the topics that need to be covered and collecting the relevant material
  2. Acquainting myself with the target population in order to enable me carry out effective grouping
  3. Administering a set of questions to test what they already know before embarking on teaching
  4. Engaging students in discussions during the teaching to gauge their personal experiences and the knowledge they have on particular issues
  5. Demonstrating how to use condom as a means of prevention
  6. Administering a similar test t see if there is an improvement in the quality of responses

Overview of the lesson plans

Week Activity
Week 1 Introduction to HIV
Week 2 Spread of HIV
Week 3 Methods of prevention of HIV
Week 4 The uses of pre Exposure Prophylaxis (PREP) and Post Exposure Prophylaxis (PEP)
Week 5 Living with HIV; Use of ART and ARV’s and Dealing with Stigmatization (Frank& Trinitapoli, 2013)
Week 6 Monitoring and evaluation of the efficacy of the  project achievements, challenges and lessons


Teaching strategies used

  1. Group instructions-in this context, the target population will be divided into groups based on sex and age among other facts
  2. Individual instruction will be employed
  3. Information will be systematically relayed to the participants departing from what they already know to what they do not
  4. Use of visual representations such as charts to show statistics and videos showing the effects of the virus on various body parts

Evaluation method

  1. There will be two assessment tests administered to ascertain progress
  2. Before the implementation of the project
  3. After the implementation of the project
  4. Questionnaires and interviews will also be adopted to seek the opinion of the target population on the success of the project
  5. An improvement in the nature of the response will be enough indication that the goals of the project will have been met. At the end of the project, the target population should be more informed that they were initially





Fos, P. J., Fine, D. J., & Fos, P. J. (2005). Managerial epidemiology for health care organizations. San Francisco, CA: Jossey-Bass.

Taylor, C. (2011). Fundamentals of nursing: The art and science of nursing care. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

Huber, D. (2006). Leadership and nursing care management. Philadelphia: Saunders Elsevier.

Veenema, T. G. (2007). Disaster nursing and emergency preparedness: For chemical, biological, and radiological terrorism and other hazards. New York: Springer Pub.

Clemen-Stone, S., McGuire, S. L., & Eigsti, D. G. (2002). Comprehensive community health nursing: Family, aggregate & community practice. St. Louis, Mo: Mosby.

Allender, J. A., & Spradley, B. W. (2005). Community health nursing: Promoting and protecting the public’s health. Philadelphia: Lippincott Williams & Wilkins.

Smith, C. M., & Maurer, F. A. (2000). Community health nursing: Theory and practice. Philadelphia, PA: Saunders.

Colasanti, J., Nguyen, L., Kiem, J. T., Deeb, K., & Jayaweera, D. (January 01, 2012). Disparities in HIV-treatment responses between Haitians, African Americans, and Hispanics living in Miami-Dade County, Florida. Journal of Health Care for the Poor and Underserved, 23, 1, 179-90.

Adams, G. B. (2009). A case study of specific life-space experiences of academically successful and non-successful intermediate grade level Mexican-American migrant boys in Dade County, Florida.

Frenk, S. M., & Trinitapoli, J. (January 01, 2013). U.S. congregations’ provision of programs or activities for people living with HIV/AIDS. Aids and Behavior, 17, 5, 1829-38.





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