Using Camcorders to Increase Awareness and Understanding of the Social Determinants of Health

Kelly Brittain PhD, RNBackgroundNUR 470: Community Health and Population Nursing is the students’ first comprehensive view of caring for individuals in the context of the community. Understanding the social determinants of health is particularly important to nursing students. Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. In the NUR 470 clinical sections, students work in small groups to complete a community assessment/analysis project. The purpose of the assignment is to demonstrate the ability to apply the nursing process within a specific community (geography or population) in order to assess its strengths, risk and health care needs using subjective and objective data.

The ProblemPart of collecting subjective data, students conduct a “windshield” survey. A windshield survey entails the students driving through the community and making notes of what they see. However, driving through a community does not lend itself to truly understanding the strengths and opportunities of the community. Students do not complete the project with an appreciation of the social determinants of health and how to incorporate the community assessment experience into their care of hospitalized patients.

The OpportunityEnhancement of the Community Health Assessment project will more fully develop the students’ views of the social determinants of health, increase how they value the relationship between the social determinants and health outcomes and further develop the students’ ability to provide culturally competent care.

Insights Students have a basic understanding of camcorder use which is sufficient for this type of project. Time was allotted for a tutorial on editing for those who have not edited pictures into a video. However, more time on editing may be necessary for some students.

MethodsSeven students, divided into two groups, worked together on the community assessment. The video and other data (Census, Center for Disease Control, Michigan Department of Community Health, etc.) was edited, narrated and formatted into a brief (10 minute) community assessment/analysis video the students presented to their fellow Senior Nursing students at the end of the Fall 2012 semester.

Tools & Measures•Pre-assignment & post-assignment survey: Administered via SurveyMonkey to assess the students’ understanding of the social determinants of health. Post survey asked the same question with the addition of questions related to the use of the camcorder, the experience and how the experience would effect their nursing practice.

•Samsung Digital Camcorders (n=9) were purchased at Best Buy.

•Shooting script: The “shooting script” of the social determinants of health guided the students’ data collection and created consistency of the subjective data collected.

Results: Social Determinants of Health

Next stepsWork with other faculty in NUR 470 to assess willingness to adopt this strategy as a component of the “Community Health Assessment” project as well as present and publish the results of this study.

How did the camcorder help you examine the social determinants of health in your assigned community? (selected comments)

“I think it helped me to be more interested in making the video and recording an accurate picture of our community--so, by trying harder and being more interested I was paying more attention to my surroundings and the resources of the community.”

“It helped to see what the community contained, the access to health care, and the access to transportation within the community. I am able to look up information on the Internet all day, but to get out in the community and actually observe it makes a big difference, a difference for the better.”

“The requirement of taking pics/videos forced us to explore various aspects of the community that may have been overlooked without completing the photo/video scavenger hunt (shooting script).”

The students (N=7; average age: 22) ability to list social determinants of health expanded from pre-assignment to post-assignment.

Results: Use of the camcorder100% of the students would recommend using cameras/camcorders as a way to increase student awareness of the social determinants of health in community/public health nursing.

Acknowledgements: This project was supported by the Lilly Teaching Fellowship Program (MSU Office of Faculty & Organizational Development) and the College of Nursing. Thank you to: my project mentor, Darcy Greene, Associate Professor, College of Communication Arts & Sciences; Dean Mundt. Dr. B. Smith and Dr. B. Given for their support and to Deb DeZure and my Lilly cohort for their support during our amazing year.

Results: Nursing practiceHow will you integrate your awareness of the social determinants of health into your nursing practice?(selected comments)“I will use what I have learned to be a resource for my patients as well as deliver non-judgmental, holistic care.”

“I think this semester has made me more aware of the health disparities that exist even within one community. I will think of this when I start working because it will remind me to be non judgmental and understand that people do not always have the same opportunity for health care or education.”

“I think I will definitely be more aware of health disparities in the community as well as strengths and weakness through my observations and interactions with others in the community.”

“In my nursing practice, I will be able to provide patients with resources that they can utilize in their community to improve their health and reach their health potential goals.

“I understand that it is important to understand the issue in a community in order to make appropriate referrals and implement interventions that are tailored to the individual/family.”

The photos above were taken by the students examples of a social determinant of health. Combined, the students took over 300 photos and a few hours worth of video.

Photos taken by the students

Post-Assignment Survey

Windshield approach Walking approach