Park Place Community Assessment

Community Assessment of Park Place
Norfolk State University

Names of People in Your Group
April 29, 2010

INTRODUCTION

This following report provides the results of a community health assessment conducted by Group # 00, Nursing Students at Norfolk State University. The purpose of the Community Health Assessment is to evaluate the health status and quality of life for residents in Park Place Community. The assessment was conducted in April 5, 2010. The assessment will include a synopsis of Healthy People 2010; 25-11, a Wind Shield Survey and Likert Survey.

Healthy People 2010
The social, psychological, and physical danger caused by unsafe sex can be disrupting to life processes and may even be lethal. The Centers for Disease Control and Prevention, Healthy People 2010, 25-11 ,goal is to Promote responsible sexual behaviors, strengthen community capacity, increase access to quality services to prevent sexually transmitted diseases (STDs), and their complications. The study was conducted on a population of 16-to-21 year old students. In this population there are many health and social issues associated with unprotected sex. According to the Virginia Department of Health (2008), Virginians Living HIV/ AIDS there is 26% Female and 73% male. In 2008, Virginia reported Total Early Syphilis (TES) diagnoses increased by 23%, from 407 in 2007 to 499 cases in 2008. Black males represent approximately two thirds of the total reported cases in 2008 (65%). Approximately half of reported cases among Black males were of age 15 to 24 years old (39%). Among Virginians, males are 8 times more likely to be diagnosed with TES than females, and Blacks are 10 times more likely than Whites.
Due to the high incidence of STD’s, a community assessment of the Park Place community was performed. This assessment was conducted to identify the presence of sexual active adolescents, as well as, resources available to teach safe sex practices, and the effectiveness of those resources.
An intense social and political debate continues in the United States regarding sexuality education. Included in the debate are those who favor comprehensive approaches, those who favor abstinence-only approaches, and those who favor no sexuality education. Despite rising rates of sexually transmitted infections and unintended pregnancy, school-based sexuality education remains controversial in the United States relative to other industrialized nations. Large national studies have shown that most parents in the United States favor sexuality education approaches in schools that provide scientifically and medically accurate information on sexual health issues, including condom use, still, minorities of opponents have claimed that discussing condom use will most likely increase risky sexual behaviors. (Dodge, Reece, & Herbenrick, 2009). A research study showed that men who received school-based condom education were less likely to be diagnosed with a sexually transmitted infections (STIs) and were more likely to never being tested for a STI, than men who have never received sex education.( Dodge, Reece, & Herbenrick, 2009). An estimated nine million cases of sexually transmitted infections, including human immunodeficiency virus (HIV), occur in persons aged 15-24 in the United States each year, accounting for 48% of all new cases. Human papillomavirus (HPV), trichomoniasis, and Chlamydia account for 88% of new STD’s among adolescents (Weinstocks, Berman, & Cates, 2005). The Centers for Disease Control and Prevention reported that STI’s is 50 to 100 times higher in the US than in other industrialized nation (CDC, 2007). Short and long-term consequences of STDs may include genital and other cancers, pelvic inflammatory disease, ectopic pregnancy, infertility, pre-term births, and low birth weight. It is estimated that the direct medical cost of STDs among 15-24 year olds in the United States excluding non-medical, indirect, and intangible costs, is $6.5 billion. HIV and HPV engender the highest direct medical costs among STD’s in US youth, accounting for 90% of the total cost burden. (Chesson, Blandford, Gift Tao, & Irwin, 2006). The rate of sexual activity is high and rate of condom use is low among US youth; 47% of high school students report having ever had sexual intercourse, 14% report having had more than four sex partners, and of those who are currently sexually active, 62% report using a condom the last time they had sexual intercourse ( CDC, 2007). Counseling sexually experienced adolescent women about pregnancy and STI prevention is difficult because their sexual encounters are often intermittent, separated by periods of days, weeks or months. These periods maybe said to constitute abstinence, in that no sexual activity occurs and, often, none is planned. However, “abstinence” is poorly defined. There is no consistency in what length of time without sex determines “abstinence,” which behaviors it includes, or whether it is a matter of behavior, intention or motivation. Adolescent sexual intercourse is frequently presented as an entirely opportunity-driven risk behavior. A number of studies demonstrate associations between depressed mood and sexual risk behaviors .The associations between intrapersonal characteristics, such as mood, and sexual behavior warrant attention when counseling individuals after short periods (Ott, Ofner, Tu, et al, 2007.) The causes of adolescent sexual risk-taking are multi-factorial. There is great social pressure to experiment with sex and enticements by the mass media to enhance physical attractiveness, which conflicts with traditional religions and societal expectations for chastity. Easy access to family cars, unsupervised time at home and changing family composition have also contributed to the incidence of sexual experimentation among the adolescent population. (Ott, Ofner, Tu, et al, 2007.) One primary component of effective pregnancy and STI prevention programs is teaching teenagers to negotiate sexual activity and contraceptive use with their dating partner. If they engage in sex, to discuss contraception and STIs with a partner before they do so. In a small survey of undergraduate students, females reported discussing contraception with their partners, and encouraging their first partners to use contraceptives more often than males (Jha, Chaurasia & Jha, 2010). Young people may be afraid of being judged by providers or adult clients, or they may be worried about being discovered by their parents. Even if youth know about contraceptives, such as condoms, they often do not know where to get them or how to use them correctly (Jha, Chaurasia & Jha, 2010). In a nationwide poll of parents of middle school and high school students, tremendous support for such sex education was found. (Milhausen, DiClemenet, Lang, & et. al, 2006).
The vast majority preferred that a wide variety of topics be included in the curriculum, including information on STI transmission, how to use and where to get contraception, masturbation, and oral sex. Most parents and adolescents do not see sex education that stresses abstinence while also providing information on protective sexual behaviors (like using contraception) as a mixed message (Milhausen, DiClemenet, Lang, & et. al, 2006).
Windshield Survey
The Park Place in Norfolk, Virginia is an immensely mixture of an old neighborhood as well as newly reconstructed neighborhood located north of the downtown area, and North Ghent Historic District, and immediately south of Colonial Place Historic District. The area is 0.644 square miles with a large population of African- Americans. This information was obtained by either the community records, vital statistics, or from the health department to further understand or evaluate the specific needs and problems of this community. These tools can also be used by nursing professionals in order to identify how some particular needs may affect the community and their families. The neighborhood is significant to Norfolk because of its close proximity to downtown businesses in the city of Norfolk; Park Place is surrounded by several Historic Districts (Ghent, Riverview, Colonial Place, and Lafayette-Winona and Larchmont at a further distance). The neighborhood consists of multi- and single-family residences, and some small businesses, 1 or 2 industrial buildings. As previously mentioned the Park Place neighborhood encompasses several neighborhoods originally known as Park Place, Kensington Place, Virginia Place and Old Dominion Place.
These areas are also predominately residential. The typical structures are modest frame bungalows and Queen Anne 's. There are also two- to four-story apartment complexes, which were built in the early 1900 's. Ruminants of small abandon businesses are in this area also, Commercial and industrial buildings are concentrated along the boundaries of the neighborhood, along 35th Street and along Colley Avenue. Monroe Elementary School is next door, to Park Place Recreation Center, Inside of the Recreational facility which includes social services, a Public library also Dental Clinic and after school daycare program this facility was built in the 1970 's. Its location is at the point where the grid formation changes, creating a triangular-shaped center for the neighborhood. Many older structures have been demolished, some replaced with newer structures during various eras. Others were demolished and their lots left empty. To the north of the school between Colley and Colonial Avenues on 38th Street are recently built single-family frame homes. Although these homes are newer, the architecture blends with the original architecture of the neighborhood, as does the landscaping and street lighting. Mature trees and perennials dominate the landscape of the residential areas. The majority of streets have sidewalks. There is significant open space in the form of play area surrounding the school and a park at 26th and Munson. There are some houses that appear to be damaged and yet some are being renovated. There are a few apartment complexes in the community that seem to be run down. Upon entering Park Place Park area around 29th Granby going towards Colley, the community was inhabited mainly by African-Americans busily engrossed in activities of their daily lives. The common characteristic this neighborhood in comparison to other areas is the clear dividing lines between higher economic status citizens and lower income citizens. As we ventured further out within the two mile radius from the Park Place Park near 35th and Granby going towards Ghent, we noticed that the homes and properties were becoming more lavish, bigger, and well manicured newer models. We noticed more Caucasian persons walking their dogs and jogging. Better maintained churches and restaurants were there as well. We even noticed more historical buildings and architecture especially closer to the downtown area in Norfolk. These sites seemed as if they were in another city in relation to the community around Park Place Park. There was one police service center on 35th street that serviced Park Place due to the history of problem concerning the high crime rate in the past. Some areas in the neighborhoods were being reconstructed and some streets needed repair. Park Place doesn’t have its own fire station but the one in nearby Ghent services this area, there is a food pantry nearby, CVS Pharmacy and other small businesses such as a liquor stores, small Chinese restaurant, shopping centers, and several mini-markets a 7-11 store, and check cashing facilities as well. One of the two health clinics is located around the corner from the community center on 38th Street which serves the entire neighborhood of Park Place; these services are geared toward low income citizens. There were only two schools mostly elementary schools starting from pre-kindergarten and ending in the 6th grade, one middle school in one of the close by areas, and the high schools crossed into the area of Ghent. In addition to educational services for the population the Community has 1 police service center. With the high incidence of STI’s in this community, it is noteworthy to see the dedication of community officials ensuring that health services are available to the citizens in that community.
Politics and media are not well represented in this community as evidenced by the lack of political signs in the area. Throughout the windshield survey, only one posted political sign to vote for a Mayor Candidate and that sign was located in the area toward Ghent. There is no evidence of any predominant political party represented. Television satellites were seen in certain areas of the community and there were few newspaper stands just outside of the corner stores. Transportation for these citizens was Metro bus, bikes, and cars and a large amount of walkers. The community was lively and active with many people out in the day time.
Religious and spiritual life is diverse and well represented in this community. Among the many churches located in there over fifteen Baptist denominations, the Pentecostal Church, and nondenominational churches were also noted. The churches are small and not every building appears to be used regularly. With many of the members of the community being of African-American descent, Christian Baptist appears to be the prevailing religion represented.
Religious Organizations near Park Place: Views on having Sex between the Ages of 16-21

Religious Organization Views On Sex
Baptist Ministry Should practice abstinence
Pentecostal Should practice abstinence
Catholic Ministry Should practice abstinence
Muslim Forbidden until marriage
Presbyterian Ministry Abstinence suggested

Lastly, signs of alcoholism and mental illness were observed throughout the windshield survey. The presence of multiple liquor stores and may suggest there is a problem of alcoholism. Young African-American men were the main residents standing inside and outside of the stores. Individuals were also seen presenting themselves in manners that are not socially acceptable, which may also show evidence of mental illness.
Below are figures that break down the following information: the heterogeneous population in Park Place represented in 1) figure 1: Races in Park Place in Norfolk, Virginia, 2) figure 2 the distribution of ages of citizens in that area, 3) figure 3 the household distribution from 2008, 4) and figure 4 shows the rent paid by the renters in the area.

Figure 1

Figure 2

Median household income 2008:
Park Place: $28,564
Norfolk: $40,416
Figure 3

Median rent in 2008:
Park Place: $595
Norfolk: $670

Zip codes: 23517, 23504, 23508.
Figure 4

Physical Environment
The Park Place Community has a recreational center and it provides a variety of activities for the youth. Lafayette Park is a family-oriented, free, recreational area. It is designed to foster a sense of unity among residents through socialization, trust, and team work. The park is open to the public and the people of the community share the enjoyment of playing sports, and allowing kids on the playground. The housing in the area consists of mostly colonial style homes. There are several apartments and duplexes in the area. There is a huge population of young African American males that appear to be loitering or just creating the suspicion of illegal activity at many corner stores and other areas in the neighborhood.
Health and Social Services
Another positive attribute in the community is the Park Place Community Outreach Center. Within this organization, tutoring for academic enrichment is offered along with social services and recreational activities. Some of the social services provided are emergency food assistance and clothing distribution. This community center facilitates a nurturing environment that allows children to thrive, build self-esteem, and brings forth productive adults. The third strength is plentiful spiritually diverse facilities available in the community. Faith in a community inspires a sense of hope, peace of mind, and concept and purpose for life. Residents have the opportunity to connect with higher being, which, is accepted as a source of strength in the midst of the community’s disturbances.
The majority of the information is focused on STDs, sexual assault awareness, alcohol awareness, and crisis intervention. Health education programs and consultations are offered in sexual health, sexually transmitted infections, alcohol and drugs, healthy eating, stress management, and family planning. There seems to be a great deal of the adolescent population (age 16-21), who are screened that are promiscuous. The average age in which young women lose their virginity is age 10. Due to high incidence of promiscuity there are large proportions of the teens in this area with STD’s. See chart below:

Cases of STDs reported by state health departments: United States, 1997-2008 Source: Centers for Disease Control and Prevention (2009, November) 'Sexually Transmitted Disease Surveillance, 2008 '
Figure 5

The rates of three major sexually transmitted diseases in the United States continue to follow a nearly decade-long climb that has disproportionately affected minorities and women, according to a report from the Centers for Disease Control and Prevention. These trends in infection rates of Chlamydia, gonorrhea, and syphilis are not new, but the fact that they are continuing at such a dramatic level is really the major area of concern. According to data from the Virginia Department of Health, the numbers of STD case among African Americans compared to other ethnicities are disproportionate to the national data of STD’s among African Americans.
Areas of concern for STDs in Park Place community regarding STDS include HIV/AIDS, gonorrhea and syphilis. According to CDC Norfolk, VA is one of the Twelve U.S. cities in the nation to report high rates of both gonorrhea and syphilis. Norfolk Department of Public Health provides consultation and prevention for reportable disease. Free confidential testing and counseling (both before and after testing) for the AIDS virus (HIV). Referrals to other medical and community services agencies are provided for clients testing HIV positive.
Economics
The 2008 census stated that the Park Place community has the following data: community 38.9% of people were under 5-19 years of age, 26.6% were age 24-44, and 34.6% are between the ages of 45-85 years of age. Among all households there are 21.7 of married couples, 8.2% married couples with children, and 25.3%of single mothered households. Percentage of never married males 15 years old and over only 20.6% of males and 19.6% of females in this area have never been married. There are 2,359 Males and 2,585 Females. The average household size is 2.8. The Average Family size is 3.4 members. The median income is 20,549. Below are graphs that explain the mode of transportation, and the times in which people leave to work.

Figure 6

Figure 7

Education
Educational Attainment

Less than high school
High school or equiv.
Less than 1 year of college
1 or more years of college
Associate degree
Bachelor 's degree
Master 's degree
Less than High school Less than 1 or more Associate Bachelor’s Master’s Doctorate High school or equiv. 1yr of college yrs of college Park Place Norfolk average

Figure 8

If residents of Park Place need a break down of how things are handled in Norfolk. Below is a representation of the organization of elements within the City of Norfolk.

Figure 9

Communication
Members of the community have access to several forms of formal communication including newspapers, television, radio, and postal mail. The City of Norfolk delivers the areas major newspaper publication, The Virginia Pilot. The Virginia Pilot provides local news information about the Hampton Roads area, national, and world news. Community members have access to six commercial TV stations and one educational network. Radio is another means of formal communication that the community has access to. There are 41 FM radio stations and 23 AM radio stations. More specifically, there are seven Africa-American one Hispanic radio station. Radio stations consist of forums from popular talk to Christian talk radio. Most activities and any programs, take place in the local community center.
Likert Survey Methods
Methods of assessment included a windshield survey, a walk through, and a questionnaire/Interview. The group became familiar with life circumstances and common themes of participants by observations of the community’s structure and function (windshield survey), local health department, and interviewing people in the community. Data of residents’ perceptions of sexual activity and unprotected sex was performed through a Likert Scale questionnaire given randomly to fifty adolescents. The adolescences were approached in the local neighborhood park, local restaurants, the local community center, and the local basketball court. Participant assent was obtained during explanation and introduction of our topic. The teens were told that all information provided is completely anonymous.

Results

Figure 10 The majority of the adolescents believed that oral sex is less risky and that they are safe from any adverse consequences because intercourse didn’t actually happen. Also, a lot of them didn’t seem to have much knowledge regarding STDs when referring to the different types and different ways you can contract them. However, they did seem to possess the knowledge of using condoms and what they were used for. Almost all of them used the word STD and the term “burning” synonymously, which indicates the need for further teaching about other symptoms that may occur and the possibility of having no symptoms at all.
These findings are useful to nurses and other adults who are seeking to help adolescents make healthy choices about sexual behavior. There needs to be an STD education association program with the Norfolk Public School system, where adolescents can be reached and taught about safe sex or abstinence. By implementing mandatory teaching through school classes, we know that those who are enrolled in school have received the proper education about sex prevention and realistic actions they can take to turn away from such incidents. Since it would be difficult to physically reach every young resident in the community, by collaborating with local schools, we are able to connect with a greater number of adolescents.
These findings stress the importance of understanding the beliefs and attitudes underlying the extent of adolescents’ sexual experiences and that adolescents are engaging in a broad range of sexual behaviors. It is imperative that healthcare providers and educators in the community discuss not only health risks with adolescents, but also the social and emotional risks involved. To help adolescents make informed sexual decisions, parents, health care providers, and other educators must broaden their clinical and educational efforts to include screening, counseling, and education about sex, and social consequences and methods to prevent negative outcomes for all sexual activities (Cornell, Felsher, Kropp, & Tschann, 2005).
Conclusion
The community health assessment of Park Place Community concluded that this area needs assistance with sexual education and prevention. The community health nurse has a responsibility to educate, promote wellness through outreach programs, and the implement home health visits for at risk families. The first step in caring for a vulnerable community is to be an advocate or voice for the people who cannot care for themselves, or those who are not educated enough to realize the health risks associated in their neighborhoods. The next step is to get the community’s officials and local partnerships involved in cleaning up the neighborhoods of environmental pollutions such as poor water quality, noise, solid waste, and crime. Making the community a safer place to live will help efficiently achieve the goal of mental and physical wellness that will reinforce community cohesiveness and promote a healthy environment.

References
Weinstocks, H., Berman, S., & Cates, W. (2005). Sexually transmitted diseases among American youth: Incidence and prevalence estimates. Perspective Sex Reproduction Health, 36:6-

10.

Chesson, H.W., Blandford, J.M., Gift, T.L., Tao, G., & Irwin, K.L. (2006). The estimated direct cost of sexually transmitted diseases among American youth, 2000. Perspective Sex Reproductive Health, 36:11-19.
Centers for Disease Control and Prevention (CDC). (2007). Chlamydia screening among sexually active young female enrollees of health plans –United States. MMWR Morbidity Mortality Weekly Report, 53:983-5.
City-data.com. (2010). Park Place neighborhood in Norfolk, Virginia (VA), 23517, 23504, 23508, Detailed profile. Retrieved on April 8, 2010, from http://www.city-data.com/neighborhood/Park-Place-Norfolk-A.html#ixzz0mDEdnQxN.
Virginia Department of Health. (2010). HIV/AIDS, Sexually Transmitted Disease (STD), and

Tuberculosis Data and Statistics. Retrieved on April 10, 2010, from http://www.vdh.state.va.us/epidemiology/DiseasePrevention/DAta/#Annual.

Dodge, B., Reece, M., Herbenick, D. (2009). School-Based Condom Education and Its Relations With Diagnoses of and Testing for Sexually Transmitted Infections Among Men in the United States. Retrieved on April 7, 2010, from [e-mail]. Boekeloo, B.O., Griffin, M.A. University of Maryland, Department of Public and Community Health. (2007). Review of Clinical Trials Testing the Effectiveness of Clinician Intervention Approaches to Prevent Sexually Transmitted Diseases in Adolescent Outpatients. Retrieved on April 7, 2010, from [e-mail].
Ott, M.A., Ofner, S., Tu W., Katzand, B.P., & Fortenberry, J.D. (2007).Characteristics

Associated with Sex After Period s Of Abstinence Among Sexually Experienced Young.

Retrieved on April 7, 2010, from [e-mail].

Jha, S.M., Chaurasia, R., Jha, B. (2010). Knowledge about Condoms among Adolescents in Kathmandu Valley. Retrieved on April 7, 2010, from [e-mail].

, Milhausen, R.R., DiClementes, R. J., Lang, D. L., Spitalnicks, & McDermott-Sales, J. et. al. Frequency of sex after an intervention to decrease sexual risk-taking among African- American adolescent girls: results of a randomized controlled clinical trial. Retrieved On April 7, 2010, from [e-mail].

References: Weinstocks, H., Berman, S., & Cates, W. (2005). Sexually transmitted diseases among American youth: Incidence and prevalence estimates Chesson, H.W., Blandford, J.M., Gift, T.L., Tao, G., & Irwin, K.L. (2006). The estimated direct cost of sexually transmitted diseases among American youth, 2000 Centers for Disease Control and Prevention (CDC). (2007). Chlamydia screening among sexually active young female enrollees of health plans –United States. MMWR Morbidity Mortality Weekly Report, 53:983-5. City-data.com. (2010). Park Place neighborhood in Norfolk, Virginia (VA), 23517, 23504, 23508, Detailed profile Virginia Department of Health. (2010). HIV/AIDS, Sexually Transmitted Disease (STD), and Tuberculosis Data and Statistics Dodge, B., Reece, M., Herbenick, D. (2009). School-Based Condom Education and Its Relations With Diagnoses of and Testing for Sexually Transmitted Infections Among Men in the United States. Retrieved on April 7, 2010, from [e-mail]. Ott, M.A., Ofner, S., Tu W., Katzand, B.P., & Fortenberry, J.D. (2007).Characteristics Associated with Sex After Period s Of Abstinence Among Sexually Experienced Young Retrieved on April 7, 2010, from [e-mail]. Jha, S.M., Chaurasia, R., Jha, B. (2010). Knowledge about Condoms among Adolescents in Kathmandu Valley. Retrieved on April 7, 2010, from [e-mail].